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Environmental Restrictors to Occupational Participation in Old Age: Exploring Differences across Gender in Puerto Rico.

ABSTRACT: Many older adults face challenges that prevent them from accomplishing common daily activities such as moving around, home maintenance, and leisure activities. There is still a need to examine and understand how environmental factors impact daily participation across gender. This study sought to make a qualitative comparison of gender differences regarding environmental barriers to participation in daily occupations from the perspectives of older adults who live alone in Puerto Rico. Twenty-six Hispanic older adults, 70 years or older participated in this study. We used a descriptive qualitative research design in which researchers administered an in-depth interview to each participant. The results elucidated that women were more likely than men to experience restricted participation due to lack of accessibility of the built environment and transportation systems. The findings could help with the development of tailored, occupation-based, preventive interventions that address gender specific environmental barriers and promote greater participation among both women and men. Further research is required to explore whether these environmental barriers to occupational participation remain consistent across living situations, socioeconomic status and ethnicity.

SUBMITTER: Orellano-Colon EM

PROVIDER: S-EPMC4586676 | biostudies-literature | 2015 Sep

REPOSITORIES: biostudies-literature

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Environmental Restrictors to Occupational Participation in Old Age: Exploring Differences across Gender in Puerto Rico.

Orellano-Colón Elsa M EM Mountain Gail A GA Rosario Marlene M Colón Zahira M ZM Acevedo Sujeil S Tirado Janiliz J

International journal of environmental research and public health 20150910 9

Many older adults face challenges that prevent them from accomplishing common daily activities such as moving around, home maintenance, and leisure activities. There is still a need to examine and understand how environmental factors impact daily participation across gender. This study sought to make a qualitative comparison of gender differences regarding environmental barriers to participation in daily occupations from the perspectives of older adults who live alone in Puerto Rico. Twenty-six ...[more]

PMID: 26378554

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Project description:Human well-being is often an overarching goal in environmental decision-making, yet assessments are often limited to economic, health, or ecological endpoints that are more tangible to measure. Composite indices provide a comprehensive approach to measuring well-being in terms of multi-dimensional components, such as living standards, health, education, safety, and culture. For example, the Human Well-Being Index (HWBI) framework, initially developed for the U.S. fifty states, was recently applied to quantify human well-being for Puerto Rico. However, the paucity of data at spatial scales finer than state or county levels, particularly for social metrics, poses a major limitation to quantifying well-being at neighborhood-scales relevant to decision-making. Here we demonstrate a spatial interpolation method to fill in missing fine-scale data where coarser-scale data is available. Downscaling from municipio (i.e., county-equivalent) to census-tract revealed a greater range of variability in well-being scores across Puerto Rico, in particular, a larger proportion of low well-being scores. Furthermore, while some components of wellbeing (e.g., Education, Health, Leisure Time, Safety and Security, Social Cohesion) showed consistent improvement over time from 2000-2017 across Puerto Rico, others (e.g., Connection to Nature, Cultural Fulfillment, Living Standards) were variable among census tracts, increasing for some but declining for others. We use a case study in the San Juan Bay estuary watershed to illustrate how approaches to quantify baseline levels of well-being can be used to explore potential impacts of management actions on communities, including to identify environmental justice inequalities among neighborhoods. Spatial clustering analysis was used to identify statistically significant cold or hot spots in well-being. This study demonstrates how indicators of well-being, coupled with interpolation methods to overcome limitations of data availability, can help to monitor long-term changes over time and to better communicate the potential value of ecosystem restoration or resource management.

Project description:BackgroundDengue is a potentially fatal acute febrile illness (AFI) caused by four mosquito-transmitted dengue viruses (DENV-1-4) that are endemic in Puerto Rico. In January 2010, the number of suspected dengue cases reported to the passive dengue surveillance system exceeded the epidemic threshold and an epidemic was declared soon after.Methodology/principal findingsTo characterize the epidemic, surveillance and laboratory diagnostic data were compiled. A suspected case was a dengue-like AFI in a person reported by a health care provider with or without a specimen submitted for diagnostic testing. Laboratory-positive cases had: (i) DENV nucleic acid detected by reverse transcriptase-polymerase chain reaction (RT-PCR) in an acute serum specimen; (ii) anti-DENV IgM antibody detected by ELISA in any serum specimen; or (iii) DENV antigen or nucleic acid detected in an autopsy-tissue specimen. In 2010, a total of 26,766 suspected dengue cases (7.2 per 1,000 residents) were identified, of which 46.6% were laboratory-positive. Of 7,426 RT-PCR-positive specimens, DENV-1 (69.0%) and DENV-4 (23.6%) were detected more frequently than DENV-2 (7.3%) and DENV-3 (<0.1%). Nearly half (47.1%) of all laboratory-positive cases were adults, 49.7% had dengue with warning signs, 11.1% had severe dengue, and 40 died. Approximately 21% of cases were primary DENV infections, and 1-4 year olds were the only age group for which primary infection was more common than secondary. Individuals infected with DENV-1 were 4.2 (95% confidence interval [CI]: 1.7-9.8) and 4.0 (95% CI: 2.4-6.5) times more likely to have primary infection than those infected with DENV-2 or -4, respectively.Conclusions/significanceThis epidemic was long in duration and yielded the highest incidence of reported dengue cases and deaths since surveillance began in Puerto Rico in the late 1960's. This epidemic re-emphasizes the need for more effective primary prevention interventions to reduce the morbidity and mortality of dengue.

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Environmental Restrictors to Occupational Participation in Old Age: Exploring Differences across Gender in Puerto Rico.

Publications

Environmental Restrictors to Occupational Participation in Old Age: Exploring Differences across Gender in Puerto Rico.

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