'Normality in all the abnormality'-Older adults' experiences of holidays and celebrations from the COVID-19 pandemic.

INTRODUCTION: The importance of holidays, traditions, and family celebrations to human culture and occupational engagement has been neglected. The aim of this study was to explore how older adults experienced holidays and celebrations with social and physical distancing during the COVID-19 pandemic. METHODS: A secondary analysis was made on data from the At-Risk Study. Seventeen community-living adults (11 women and 6 men) aged 71-87 years, from Sweden participated. They were interviewed remotely four times during the first year of the pandemic. Data were analysed with qualitative content analysis. No consumer/community involvement occurred. FINDINGS: Three categories on how the participants hoped for, planned, decided, adapted, avoided, and experienced holidays and celebrations with social and physical distancing included expectations and preparations in unpredictable times; the constant need for re-evaluation; and almost everything turned out differently. CONCLUSIONS: The desire to celebrate despite pandemic restrictions shows the importance and meaning holidays hold for older adults. Celebrations can be disrupted for many reasons, not only as extreme as the ongoing pandemic. For wellbeing in later life health care, social care, and society need to understand the inherent components and acknowledge ways of supporting participation in occasional events such as holidays, traditions, and family celebrations.

Synthesizing implications of a collaborative project on socially sustainable housing policies for the aging population.

OBJECTIVE: Based on findings from four transdisciplinary original research studies on housing issues for the aging population, whereof three had a particular focus on marginalized groups, we report a co-produced synthesis of implications from a collaborative research project on socially sustainable housing policies. Researchers and non-academic partners in the ongoing Thematic Collaboration Initiative Social Rights and Housing for the Aging Population at Lund University collaborated in co-creative activities aiming at policy recommendations. RESULTS: Seven types of implications (i.e., themes) that represent macro and meso level approaches with potential to generate impact on social rights and housing for the aging population were identified. The content of legislation and regulations, financial institution strategies, and housing and neighbourhood development exemplify macro level implications. The three themes education and training, communicating with a diversity of stakeholders, and communicating with the public all relate to an overall need for integrated knowledge translation. The theme involving older adults as a resource delivered insight into underutilized capacities of the diverse target group. As the quest for integrated knowledge translation is growing stronger, this research note contributes to development of co-production approaches to synthesize implications of transdisciplinary collaboration, connecting research, practice and policy on societal challenges that ay population aging.

User involvement in ageing and health research: a survey of researchers' and older adults' perspectives.

BACKGROUND: User involvement in research has rapidly increased and is often a precondition to obtain research funding. Benefits such as effectiveness and increased relevance of research are described in the literature, but the evidence to support this is weak. Little is known about ageing and health researchers' experiences and perspectives towards user involvement in research, and their attitudes towards user involvement compared to the attitudes of the users involved are largely unknown. To examine researchers' experiences and perspectives of user involvement in research on ageing and health, and to compare their attitudes towards user involvement to the attitudes of older adults in the general population. METHODS: A panel study survey was used to elicit responses from researchers in ageing and health as well as from older adults (aged 60 years and older). The researcher sample (N = 64) completed the survey online, while the older adult sample (N = 881) could choose among three different options to complete the survey (online, paper format, telephone). A professional survey company collected the data. Descriptive statistics, exploratory comparisons and descriptive qualitative content analysis were used to analyse the data. RESULTS: More than half (58%) of the researchers had previous experience of involving different categories of users in a wide range of research activities. The most frequent motivation for involving users was to ensure that the research produced is relevant to the target population. A majority (86%) reported benefits, and more than half (59%) described challenges. Differences in attitudes were found between researchers and older adults in the general population. CONCLUSIONS: Ageing and health researchers involve users in their research to improve quality and ensure relevance, but there is no consensus among them whether users should be involved in publicly funded research. While several challenges were identified, training, institutional support and resources from funders could alleviate many of these. Findings reveal significant differences in attitudes between older adults in the general population and researchers. Further research with comparable larger samples is needed to confirm and understand the possible consequences such controversy might have and how to solve them. IRRID (International Registered Report Identifier): RR2-10.2196/17759.

Understanding Person-Environment Relationships as Criteria to Support the Operationalization of Universal Designing.

To reach a broader understanding of person-environment relationships as building blocks for universal design in research and practice, this paper combine and discuss three types of interaction between individuals and environments - instrumental, non-instrumental, and non-physical - and five constituent concepts, i.e. accessibility, usability, aesthetic experience, the experience of meaning and emotional experience. Theoretical frameworks/models for person-environment relationships are synthesized and combined based on a literature review and the author's previous experiences. The author proposes to classify accessibility and usability as instrumental person-environment interaction, aesthetic experience as non-instrumental interaction, and experience of meaning and emotional experience as non-physical interaction. At the same time, acknowledge the potential of the three types of interaction to embed cues and choices to accommodate the widest variety and number of people throughout their lifespans. This paper contributes to understanding person-environment relationships as criteria to support research strategies and the operationalization of universal designing.

Awareness of and attitudes towards public involvement in research on ageing and health among older people in Sweden.

BACKGROUND: While the importance of involving older people in research is increasingly acknowledged, quantitative studies exploring the perspectives of larger samples of older people who take an active role in research on ageing and health are scarce. The aim of this study was to investigate the awareness of and attitudes towards public involvement in research on ageing and health among older people in Sweden. MATERIALS AND METHODS: Data derived from a survey (N = 881) of people aged 60 years or older in Sweden. Demographics, self-rated health, and attitudes were analysed using descriptive statistics. Awareness of and previous active involvement in research were analysed using chi-square tests and Mann Whitney tests. Factors associated with willingness to be actively involved in research were determined by logistic regressions. RESULTS: Of the 26% who responded (N = 881), 39% (n = 343) were aware that they could be actively involved in research. Awareness and previous active involvement in research were significantly associated with a higher level of education. Public involvement was believed to enhance research communication and enable valuable contributions related to ageing. The proportion of respondents who were willing to be actively involved in research was significantly higher for respondents with previous experience and a higher level of education. CONCLUSIONS: Engaging older people in Sweden in research targeting active involvement in research presents a challenge. The study shows an over-representation of people with higher education, who tend to be more aware, have previous experience, and are more willing to be involved in research with public involvement. This implies a risk that groups with lower education are not represented, and that knowledge co-produced with mostly highly educated groups will lead to a biased picture. Further studies are needed to understand how an increased awareness of research and willingness to participate can be achieved. IRRID: RR2-10.2196/17759.

Changes in daily life and wellbeing in adults, 70 years and older, in the beginning of the COVID-19 pandemic.

BACKGROUND: In the beginning of the COVID-19 pandemic, Swedish authorities enforced specific recommendations on social distancing for adults 70 years and older (70+). Day-to-day life changed for 15% of the Swedish population. The aim of the study was to explore how adults 70+ experienced and managed changes in everyday life due to the COVID-19 pandemic and how those changes affected wellbeing at the beginning of the virus outbreak. METHODS: Eleven women and six men, (mean age 76 years), living in ordinary housing, participated in remote semi-structured interviews in April 2020. The interviews were analysed with qualitative content analysis. FINDINGS: The theme Suddenly at risk - '…but it could have been worse' included four categories My world closed down; Negotiations, adaptations and prioritizations to manage staying at home; Barriers and facilitators to sustain occupational participation; and Considerations of my own and other's health and wellbeing emerged from the data analysis. CONCLUSION: Everyday life changes had implications for health and well-being. The participants questioned previous conceptions of meaning in relation to habitual activities, likely leading to consistent occupational changes. However, these long-term effects remain to be explored, and considered to enable older adult's health during the pandemic and beyond.

Singlet Oxygen Quantum Yields in Environmental Waters.

Singlet oxygen (1O2) is a reactive oxygen species produced in sunlit waters via energy transfer from the triplet states of natural sensitizers. There has been an increasing interest in measuring apparent 1O2 quantum yields (ΦΔ) of aquatic and atmospheric organic matter samples, driven in part by the fact that this parameter can be used for environmental fate modeling of organic contaminants and to advance our understanding of dissolved organic matter photophysics. However, the lack of reproducibility across research groups and publications remains a challenge that significantly limits the usability of literature data. In the first part of this review, we critically evaluate the experimental techniques that have been used to determine ΦΔ values of natural organic matter, we identify and quantify sources of errors that potentially explain the large variability in the literature, and we provide general experimental recommendations for future studies. In the second part, we provide a qualitative overview of known ΦΔ trends as a function of organic matter type, isolation and extraction procedures, bulk water chemistry parameters, molecular and spectroscopic organic matter features, chemical treatments, wavelength, season, and location. This review is supplemented with a comprehensive database of ΦΔ values of environmental samples.

Understanding the Wicked Problem of Providing Accessible Housing for the Ageing Population in Sweden.

While accessible housing is known as important to promote healthy ageing, the societal issue of providing accessible housing for the ageing population bears the characteristics of a "wicked problem". The aim of this study was to gain a better understanding of crucial variables for decision-making about the provision of accessible housing for the ageing population in Sweden. Materials used for a deductive content analysis were elicited through a research circle involving three researchers and twelve non-academic representatives. Brown and colleagues' conceptual five-dimension framework to address wicked problems was used for the understanding of crucial variables in decision-making about housing provision. The findings show that such reasoning is dominated by the socioeconomic dimension. Findings in the biophysical dimension reveal well-known challenges pertaining to the definition and interpretation of the concept of accessibility and its operationalization. The dimensions are intertwined in a complex manner, which is essential for effective and efficient decision-making. The findings could make decision-makers aware of the diversity of individual thinking involved when addressing this wicked problem. Acting upon the crucial variables identified in this study could contribute to progressive decision-making and more efficient ways to develop and provide accessible housing to promote health ageing.

Awareness of and Attitudes Toward User Involvement in Research on Aging and Health: Protocol for a Quantitative Large-Scale Panel Study.

BACKGROUND: User involvement is a requirement of most research funders. There is a growing body of literature exploring the benefits and challenges of user involvement in research, but such studies are scarce in the field of aging and health. Moreover, the majority of such research is qualitative, which limits the generalizability of results. The UserAge panel study will be instrumental in expanding knowledge that will benefit the quality and impact of user involvement in future research. OBJECTIVE: The aim of this study is to determine the awareness and understanding of and attitudes toward user involvement in research among different categories of knowledge users and researchers over time. METHODS: A panel study will be implemented with 3 different categories of knowledge users (people aged 60 years and older, informal carers, and professionals in health care and architecture) and researchers in aging and health. A professional survey company will collect data from all samples in parallel. Potential participants will be asked to complete the survey via telephone or online, or participants can request a paper survey to be sent to them in the post. A draft set of questions on attitudes and behavioral patterns related to research utilization and user involvement in research was compiled based on existing literature and input from the research team. Using a participatory approach, we engaged a user forum, where 8 older people and 3 researchers jointly refined the survey for time/length to complete, terminology, readability, and context. Data collected via the internet or telephone will be automatically processed, and data collected on paper forms will be entered in machine-readable forms. The survey company will store all data and deliver the quality-controlled database to the university for further storage. Analyses of frequencies and measures of central tendency will be used for descriptive purposes. To compare groups, state-of-the art statistical analyses will be used. RESULTS: Data collection for the first study wave started in September 2019 and will be completed in spring 2020. Data will be ready for analysis following cleaning and quality control, which started during summer 2020 and will be completed autumn 2020. We anticipate the data collection for the second study wave to start in September 2021. CONCLUSIONS: This is the first quantitative large-scale panel study focusing on trends in attitudes toward, awareness of, and knowledge about user involvement in research on aging and health in Sweden. The results will generate new and important knowledge to advance the understanding of user needs and preferences as well as the relevance of user involvement in research on aging and health. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/17759.

Public entrance accessibility: Psychometric approach to the development of a new assessment instrument.

BACKGROUND: The accessibility of public facilities for all is an issue increasingly gaining focus in policy debates, especially regarding the ageing population. OBJECTIVE: This paper describes a psychometric approach to the development of a new instrument for assessing the accessibility of public entrances. METHODS: Items to include were selected by means of literature review and classified according to a typology of person-environment fit that uses the International Classification of Functioning, Disability and Health (ICF) as theoretical framework. Content validity was assessed by a scientific panel approach and construct validity by using simulation techniques and correlation analysis with a related construct. Reliability was evaluated by inter-rater agreement analysis, where 15 strategically selected public entrances were assessed by five rater pairs. RESULTS: Content validity was assessed as high (3.6 on a scale from 1 to 4) and correlation indicating convergent validity between instrument scores and a related construct was moderate (rs = 0.60, p < 0.001). Inter-rater reliability was acceptable to good (kappa 0.42, overall agreement 81%). After an iterative process including review of validity and reliability results, the resulting assessment instrument consisted of 56 items in 7 sections. CONCLUSIONS: This study demonstrated good content validity and acceptable to good inter-rater reliability. Though initial results were promising, user involvement and further testing of construct validity is needed. The goal of the new instrument is a feasible tool for planning, evaluation and accomplishment of policies intended to make public entrances accessible for all. The extent to which the instrument succeeds remains to be tested by practical use.

Towards a Decision Support System for Improved Accessibility in Multi-Family Housing: Co-Design of an Application for Environmental Barrier Inventory.

The demand for accessible housing is increasing. More people are expected to live longer and live more years with reduced functional capacity in ordinary multi-family housing. To address this, detailed knowledge of accessibility problems in the existing housing stock and systems that could contribute to efficient collaboration between housing industry and authorities concerned is needed. This paper introduces a project with the overarching aim to develop and evaluate a new decision support system (DSS) to inventory and support decision-making for improved accessibility in multi-family housing in Sweden. The specific aim is to describe the initial app development phase and to investigate the design-team interactions and their impact on the outcome. The app will constitute the core part of the new DSS. This phase involved co-design to fit the practice context at target and meet users' needs and expectations. The co-design process served to identify user requirements to guide the development. Housing Enabler (an internationally acknowledged instrument for assessment and analysis of accessibility problems) was the methodological starting point. The prototype app enables professional inventory of environmental barriers and registration of subsequent work for accessibility improvements. A fully functional prototype of an app including an example apartment database is ready for usability studies and further iterative refinements.

The "Free from Housing Accessibility Problems" App.

The present study concerns the development of a computerized tool targeting housing accessibility issues. A user-centered approach involving professionals from the housing sector and senior citizens from four European countries resulted in a fully functional prototype of a mobile application (app) including an apartment database. The app raises awareness on housing accessibility and has the potential to support decision making and strengthen all citizens regardless of functional capacity to be more active in their endeavors for a satisfying housing solution. Further refinements and additional features are needed to enhance the potential benefits; they include addressing potential challenges facing senior citizens, developing interactive features that allow users to provide input and adapting to different national contexts to make the app applicable for the European market.

Combining apps targeting professionals and senior citizens to improve housing accessibility and influence housing provision policies.

Two separate apps that address the increasingly important issue of accessible housing for senior citizens have been developed in different project settings. One of the apps was developed to facilitate the process for professional raters to assess housing accessibility in the context of individual housing adaptations. The other app was developed for senior citizens to raise their awareness of possible accessibility problems in their current dwelling and in other apartments within the available housing stock. Both apps were developed with a high degree of active user involvement in processes utilizing multiple state of the art methods. The results are two well accepted prototype apps perceived as user-friendly and appropriate for the intended user groups. By combining these two apps, our ambition is for the professional raters to benefit by gaining knowledge of their clients' perceived needs and desires, and for senior citizens to benefit by getting access to a database of professionally rated dwellings. The ultimate goal is the generation of sound knowledge reflecting the needs and desires of senior citizens and professional requirements regarding accessible housing as a means to inform and influence housing provision policies.

Population-based incidence of exudative age-related macular degeneration and ranibizumab treatment load.

BACKGROUND/AIMS: The use of intravitreal vascular endothelial growth factor antibodies for exudative age-related macular degeneration (AMD) has stressed ophthalmology services and drug budgets throughout the world. The authors study the population-based incidence of exudative AMD in Iceland and the use of intravitreal ranibizumab in a defined population. METHODS: This is a prospective study of 439 consecutive patients aged 60 years and older with exudative AMD starting intravitreal ranibizumab for exudative AMD in Iceland from March 2007 to December 2009. All patients initially received three consecutive ranibizumab injections, with regular follow-up visits and re-treatment as needed. RESULTS: In total, 517 eyes from 439 patients received treatment for exudative AMD (mean age 79 years). The annual incidence of exudative AMD in the population 60 years and older is 0.29%. The incidence increased with advancing age, double for patients 85 years and older compared with those 75-79 years. Approximately 2400 ranibizumab injections per 100,000 persons aged 60 years and older were given each year for exudative AMD. CONCLUSIONS: These data allow an estimation of the incidence of exudative AMD in a Caucasian population and the treatment load with ranibizumab, which may help plan anti-vascular endothelial growth factor treatment programmes and estimate costs.

Multivariate data analysis for enhanced interpretation of electrochemical impedance spectra of gramicidin-ion interactions in phospholipid monolayers.

This article describes a multifrequency electrochemical impedance study of phospholipid monolayers on a mercury drop electrode in solutions containing electrolytes and gramicidin derivatives: gramicidin A (gA), gramicidin-BOC (g-BOC), and desformylgramicidin (g-des). The impedance spectra have been studied individually (univariate approach) and also transformed using a multivariate data reduction method (multivariate approach). It was shown that the two approaches are complementary. Thus the formation of K+-conducting channels is observed in gA only, and these channels can be distinguished from an interaction of all gramicidin derivatives with Mg2+. An unknown peptide interaction in the monolayer was observed on a slow time scale.

GOLDsurfer: three dimensional display of linkage disequilibrium.

GOLDsurfer is a java-based analysis and graphics program for three-dimensional plotting of linkage disequilibrium (LD). Simultaneous presentation of LD measures, including recombination rate estimates and disease association statistics, helps to clarify LD patterns and facilitates interpretations based on multiple indices of local genetic data.