Group Of Older People Research Articles

Does the 15-item Geriatric Depression Scale function differently in old people with different levels of cognitive functioning?

BackgroundThe 15-item version of the Geriatric Depression Scale (GDS-15) is widely employed to screen depression among elderly but little is known about the scale functioning in cognitively impaired individuals when compared to normal ones. The aim of the current study is to investigate Differential Item Functioning (DIF) across groups of older people that differ in terms of cognitive functioning applying Item Response Theory (IRT)-based analyses. MethodsData from an Italian multi-centric clinical-based study on cognitive impairment and dementia in old people were employed (N = 1903; Age: M = 77.33, SD = 7.05, 62% women). All the participants underwent a comprehensive evaluation (including clinical examination, laboratory screening, neuroimaging, and cognitive and behavioral assessments) and they were assigned to three different groups on the basis of their cognitive functioning (normal, mild cognitive impairment, cognitive impairment) ResultsTwo items showed uniform DIF but their differential functioning does not propagate to the GDS-15 total scores in such a way that a differential interpretation is needed LimitationsWhereas an advantage of the study is the large sample size, the relatively small size of the mild cognitive impairment group might reduce the stability of the present results ConclusionsSince a screening tool for elderly is intended to apply to everyone in the target population, the current findings support the clinical utility of the GDS-15 as screening tool for depression.

Active, Empowered And Young At Heart

Introduction: In 2003, the SRC started with participatory community work (PCW) and empowerment of older people[1] in Bulgaria alongside a home care program. The participatory methods with older people were new to the SRC and its partners. The SRC and partners followed the principles of the Madrid International Plan of Action on Aging (UNECE, 2002). Through the introduction of participatory approaches, the SRC aimed to change the agenda of local Red Cross Partners from doing things FOR older people to do things WITH and BY older people. Older people, based on the past cultural/political context belong to the vulnerable layers of the society, with low pensions, low recognition and high exclusion from information and entitlements. Objectives: In March 2016 the Swiss Red Cross reviewed the approaches and measured the impact of participatory work in three “Active Ageing/Advocacy Projects” with Elderly implemented in Bosnia-Herzegowina, Bulgaria and Belarus in relation to empowerment, improvement of wellbeing and reduced vulnerability. The review was conducted using questionnaires, individual interviews and focus group discussions with elderly people engaged in community groups, project staff and authorities. In total 454 persons participated in focus group discussion and 565 questionnaires were analysed.The five levels of analysis addressed the general context and its most relevant enablers and hindrances for active ageing; approaches used in the whole PCW process, Initiative Groups’ (IG) activities/results and finally the impact of PCW in terms of reducing the vulnerability and empowerment at individual, community and social level. Results: The review revealed the greatest change at the individual level. In all three countries, partners have succeeded in establishing groups of older people who are committed and making a difference in their communities. There is a perceived increase in their social capital, self-reliance and decrease in social vulnerability. Success factors mentioned were: trainings, peer-exchange and doing good for other people. Initiative groups advocated for specific concerns affecting their everyday life. Triggers for moving into advocacy[2] were: experience of working together for a common cause; a good reputation in communities; partnerships with local institutions; good knowledge of local needs and training (introduction to tools, methods and rights-based documents). Empowered community groups effectively influence local decision making bringing changes into their communities: establishment of advisory bodies in LPA, introduction of new services or reduction of prices of some services, improved accessibility and affordability of infrastructure. Conclusion: Older people benefitted through their involvement in Initiative groups or as volunteers of local Red Crosses. Interviews showed, that groups are mainly bringing together older, already active people. Future activities should focus on involvement of self-isolated, passive people While advocacy work was done by 30% of all groups successfully, more support by partners is required to connect state strategies with the realities of older people in communities. The review has also demonstrated how participatory approaches transform the organisational culture of the implementing partner over time i.e. moving away from a pure charity approach. The review could not identify the most effective tools that lead to participation because the result depends on how we use participatory methodologies - not in the fact that we use them. At the same time, it concluded the crucial role of three components: 1) developing capacity of vulnerable people for analysing their circumstances of living, their potentials and their problems in order to actively decide on changes (through learning by doing); 2) creating spaces for practicing new skills (through support to local initiatives); 3) promoting the value of participation. [1] 65+, but as well younger people were involved, often young pensioneers (invalids). [2] Rights-based approaches

Priorities and recommendations in oral health care for older people

The oral health of older people in the Netherlands, especially those who are vulnerable and dependent on care, is insufficient. Older people and other stakeholders participated in a so-called Priority Setting Partnership study to identify hindrances that have been experienced in oral health care and to distil from their experience items for the agenda for further research. For this reason, discussions were held in 5 focus groups with respectively 1 group of older people, caregivers, external parties and health care professionals. In a fifth focus group, a so-called 'consensus group', the definitive list of prioritised items on the agenda was formulated. The most important priorities concern policy and organisation of oral health care, awareness, cooperation among various health care professionals, the financing and organisation of oral health care for older people living at home and education concerning oral health care for all health care professionals. Awareness about the importance of good oral health for older people among health care professionals is the first step towards better oral health care for older people in the Netherlands.

Functioning Without Cartilage: Older People With Radiographic Knee Osteoarthritis Who Self-Report No Functional Limitations Do Score Lower on a Performance Battery.

The majority of the older population shows signs of radiographic knee osteoarthritis. However, many remain without functional complaints for a long period. This study aims to find early functional changes associated with stages of radiographic knee osteoarthritis. A group of older people without self-reported complaints was divided in two groups: knee osteoarthritis (K&L = 2-4, N = 29) and control (K&L = 0-1, N = 31). Muscle function was assessed with voluntary and electrically-stimulated isometric knee contractions, including a fatigue test. Physical functioning was assessed with a 6-min walk test (6MWT), a stair climb test (SCT), and a short performance battery. There were no differences in muscle function parameters, 6MWT, and SCT between groups. A clinically relevant lower score on the performance battery was found in participants with knee osteoarthritis. In conclusion, even when older people indicate to have no functional limitations, a decline in functional outcome can be measured with a physical performance battery.

An analysis of the ability to take a rapid step forward, concerns about falling and balance in a group of older people with osteoporosis – a cross sectional study

Purpose: To describe the ability to take a rapid step forward, and to investigate the relationship between a rapid step forward, concerns about falling (CAF) and balance performance.Materials and methods: A cross-sectional study including 96 elderly people, aged 66–87, with osteoporosis and fear of falling. The ability to take a rapid step forward (step execution) under single- (ST) and dual-task (DT) conditions was measured, as were CAF (Falls Efficacy Scale International (FES-I)) and balance performance (MFE).Results: A step executed during DT takes significantly longer than during ST (p < .001). Significant differences for step execution during both ST (p = .007) and DT (p = .005) were observed when comparing participants with low CAF (FES-I < 22) and high CAF (FES-I > 23). There was a moderate correlation between balance performance and step execution (rs = 0.54) for ST and a low correlation (rs = 0.39) for DT. Little, if any correlation was found between CAF (FES-I) and step execution (rs = 0.13–0.19).Conclusion: It takes significantly longer for elderly with osteoporosis and fear of falling to execute a rapid step forward during DT than during ST. Moreover, it takes significantly longer to execute a step forward during both ST and DT for elderly people with high CAF compared to those with low CAF.

Investigating mental health in patients with osteoarthritis and its relationship with some clinical and demographic factors.

ObjectiveThe reduction in the level of mental health, particularly depression is associated with outcome of treatment in patients with osteoarthritis (OA). There is no broader research into mental health or mental health care for OA patients. The purpose of the present study was to determine mental health and its relationship with some clinical and demographic factors among patients with OA.Material and methods94 patients with osteoarthritis were included in presented study. Patients were referred to hospital during the year of 2016, 30 male patients (31.9%) and 64 female (68.1%), female/male ratio was about 2 : 1. All patients were evaluated in the term of mental health through demographic questionnaire and SCL-90R questionnaire and the obtained data were analyzed using version 22 of SPSS Software.ResultsThe results showed that 58.5% of patients with osteoarthritis had mental health disorders. Among all studied patients mental health disorders were found in 55 patients (58.5%), including both isolated and complex disorders such as: psychological discomfort in the form of somatic symptoms disorder (n = 45), obsessive compulsive disorders (n = 43), interpersonal sensitivity (n = 44), depression (n = 47), anxiety (n = 41), aggression (n = 52), phobia (n = 42), paranoid psychosis (n = 32), psychosis (n = 3). In addition, the prevalence of mental health problems in patients with OA was significantly higher at the age range of 18 to 20 years old (p = 0.002). Also revealed that the greater risk of mental health disorders is in the first months of diagnosis of OA compare to the patients with longer disease duration more than six months (p = 0.01) and patients taking corticosteroids were significantly higher risk of mental health disorders development (p = 0.00).ConclusionIn presented study although the prevalence of OA is higher in group of older people, but psychiatric disorders is more common in OA patients with age range below 20 years. In addition, patients in the early months of OA are at greater risk of psychiatric disorders which the disorders were observed higher in patients taking corticosteroids.

Health and well-being promotion strategies for 'hard to reach' older people in England: a mapping exercise.

Older people from deprived areas, the oldest old and those from ethnic minorities engage less in health promotion interventions and related research, potentially generating inequities. Aim To explore and map the extent to which such 'hard to reach' groups of older people, are the focus of local health and well-being strategies in England. Document analysis of current health and well-being promotion strategies in a purposive sample of 10 localities in England with high proportions of some or all of the three hard to reach groups. Documents were analysed using an interpretive approach. Findings A total of 254 documents were retrieved and reviewed. Much of the content of the documents was descriptive and reported the implications for resources/services of population ageing rather than actual initiatives. All localities had an Older People's Strategy. Strategies to counter deprivation included redistribution of winter fuel payments, income maximisation, debt reduction and social inclusion initiatives, a focus on older owner occupiers and recruitment of village 'agents' to counter rural deprivation. The needs of the oldest old were served by integrated services for older people, a community alarm service with total coverage of the 85+ population, and dietary advice. The needs of black and minority ethnic (BME) older people were discussed in all localities and responses included community work with BME groups, attention to housing needs and monitoring of service use by BME older people. Three other themes that emerged were: use of telecare technologies; a challenge to the idea of 'hard to reach' groups; and outreach services to those at most risk. Document analysis revealed a range of policy statements that may indicate tailoring of policy and practice to local conditions, the salience of national priorities, some innovative local responses to policy challenges and even dissenting views that seek to redefine the policy problem.

Effects of a 20-week high-intensity strength and sprint training program on tibial bone structure and strength in middle-aged and older male sprint athletes: a randomized controlled trial.

High-load, high-speed and impact-type exercise may be an efficient way of improving bone strength even in old age. We evaluated the effects of combined strength and sprint training on indices of bone health in competitive masters athletes, who serve as a group of older people who are likely to be able to participate in vigorous exercise of this kind. Seventy-two men (age 40-85) were randomized into an experimental (EX, n=40) and a control (CTRL, n=32) group. EX participated in a 20-week program combining heavy and explosive strength exercises with sprint training. CTRL maintained their usual, run-based sprint training schedules. Bone structural, strength and densitometric parameters were assessed by peripheral QCT at the distal tibia and tibial midshaft. The intervention had no effects on distal tibia bone traits. At the mid-tibia, the mean difference in the change in cortical thickness (ThCO) in EX compared to CTRL was 2.0% (p=0.007). The changes in structure and strength were more pronounced in the most compliant athletes (training adherence >75%). Compared to CTRL, total and cortical cross-sectional area, ThCO, and the area and density-weighted moments of inertia for the direction of the smallest flexural rigidity (I minA , I minD ) increased in EX by 1.6-3.2% (p=0.023-0.006). Polar mass distribution analysis revealed increased BMC at the anteromedial site, whereas vBMD decreased (p=0.035-0.043). Intensive strength and sprint training improves mid-tibia structure and strength in middle-aged and older male sprint athletes, suggesting that in the presence of high-intensity loading exercise, the adaptability of the bone structure is maintained during aging.

Experienced fear of crime and its implications for everyday mobilities in later life: an ethnographic case study of an urban Swedish neighbourhood

This study aims to provide an understanding of the everyday life of older people in a Swedish urban neighbourhood, with a special focus on the experienced fear of crime and how fear may affect mobilities in later life. The paper draws upon in-depth data from an ethnographic case study conducted between December 2011 and April 2013, which followed a group of older people in the neighbourhood of Seved in the city of Malmö, Sweden. The average income in the neighbourhood is one of the lowest in the city, where unemployment is high. Seved is often negatively portrayed in the media, and the residents generally feel more insecure than those in the rest of Malmö. The senior group followed, is part of a municipal project aimed at strengthening networks and enhancing feelings of social participation for older people. Through a variety of activities, the municipality seeks to achieve social sustainability through everyday life mobility and social participation. Findings highlight that news media plays a substantial role in forming perceptions of the neighbourhood. Mental maps and imagined geographies do negatively impact the everyday mobility of persons both inside and outside the area. Some older residents display both avoidance and protective behaviour, which implies that their everyday life mobility is restricted because of their fear of crime. However, social participation and knowing people in the neighbourhood seems to have a salutary effect on their fear of crime and a commendatory effect on their everyday life mobility. The results also raises questions about stereotyping (the Other) and ageism.

Older active users of ICTs make sense of their engagement

Research on older people’s ICT usage tends to focus on either the ways in which they go about learning to use these technologies or the impact that ICTs have on their lives. This research seems, in other words, to take for granted that older people are ‘digital immigrants’ as the digital divide debate proposed. Research that specifically looks at the ways in which older ICT users make sense of their engagement with these technologies is still limited. This article explores therefore – through focus group interviews – how a group of older people who are active ICT users make sense of their ‘digital nativeness’. The analysis shows that the interviewees are well aware that their ICT proficiency differentiated them from their peers, which is why they make sense of their ICT usage by making reference to the issues that make them ‘exceptional’ older people. These include the fact that they have used computers for many years and therefore made ICT usage an everyday habit early on; the fact that most older people do not have the skills that they themselves have, which is why they feel the need to share them with others; and the fact that their lifelong experience means they can use these technologies in judicious ways. By bringing attention to how older active ICT users make sense of their engagement, this article contributes to the notion of the digital spectrum and the debate on the inequalities that ICT proficiency brings about.

Reproducibilidad de los tiempos de ejecución de la prueba de Timed Up and Go, medidos con acelerómetros de smartphones en personas mayores residentes en la comunidad

IntroductionInertial Measurement Units (IMU) incorporated in smartphones can provide records that match registers obtained by laboratory instruments. This means that the use of smartphones would be feasible for recording three-dimensional kinematics parameters like velocity and acceleration, enabling more robust analyses, such as the Timed Up and Go (TUG) test, that assess the risk of falls older people (OP) living in the community. MethodThe study included 35 female OP, users of the Family Health Centres (CESFAM) Juan Pablo II and Corvallis from Antofagasta city, Chile. They were evaluated with the TUG, with linear and angular acceleration and velocity being recorded simultaneously using a smartphone equipped with a three-dimensional IMU. Using a computer macro application, the start and end time of each sub-stage of the test was determined by two independent observers. Reproducibility of the times of each sub-stage of TUG was assessed using the Intraclass Correlation Coefficient (ICC). ResultsThe ICC gave values of 0.78 to 0.99, with an acceptable confidence interval, (0.45-1.00), thus providing a reproducible and reliable recording. ConclusionsThe reproducibility of the times of the sub-stages of TUG, recorded with inertial measurement units from a smartphone enables it to be used in clinical practices with OP groups, in order to improve the evaluation and prevention of the risk of falls.

Methodology for senior-proof guidelines: A practice example from the Netherlands.

Evidence-based guidelines constitute a foundation for medical decision making. It is often unclear whether recommendations in general guidelines also apply to older people. This study aimed to develop a methodology to increase the focus on older people in the development of guidelines. The methodology distinguishes 4 groups of older people: (1) relatively healthy older people; (2) older people with 1 additional specific (interfering) comorbid condition; (3) older people with multimorbidity; and (4) vulnerable older people. The level of focus on older people required may be determined by the prevalence of the disease or condition, level of suffering, social relevance, and the expectation that a guideline may improve the quality of care. A specialist in geriatric medicine may be involved in the guideline process via participation, provision of feedback on drafts, or involvement in the analysis of problem areas. Regarding the patient perspective, it is advised to involve organisations for older people or informal carers in the inventory of problem areas, and additionally to perform literature research of patient values on the subject. If the guideline focuses on older people, then the relative importance of the various outcome measures for this target group needs to be explicitly stated. Search strategies for all the 4 groups are suggested. For clinical studies that focus on the treatment of diseases that frequently occur in older people, a check should be made regarding whether these studies produce the required evidence. This can be achieved by verifying if there is sufficient representation of older people in the studies and determining if there is a separate reporting of results applying to this age group.

Serotype-specific effectiveness of 23-valent pneumococcal polysaccharide vaccine against pneumococcal pneumonia in adults aged 65 years or older: a multicentre, prospective, test-negative design study

The serotype-specific effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal pneumonia has not been established in people aged 65 years or older. We assessed the effectiveness of PPV23 in this population. For this multicentre, prospective study, we enrolled all individuals aged 65 years or older with community-onset pneumonia who visited four study hospitals in Japan between Sept 28, 2011, and Aug 23, 2014. Streptococcus pneumoniae was isolated from sputum and blood samples, and serotyped by the capsular Quellung method. Sputum samples were further tested by PCR assay to identify pneumococcal DNA, and positive samples were examined for 50 serotypes by a nanofluidic real-time PCR assay. Urine samples were tested by a urinary antigen test. Serotype-specific vaccine effectiveness was estimated using the test-negative design. 2621 eligible patients visited the study hospitals, of whom 585 did not have sputum samples available and were excluded from our analysis. 419 (21%) of 2036 patients were positive for pneumococcal infection (232 by sputum culture, 317 by sputum PCR, 197 by urinary antigen test, and 14 by blood culture). 522 (26%) patients were judged to be vaccinated in the analyses. Effectiveness of PPV23 was 27·4% (95% CI 3·2 to 45·6) against all pneumococcal pneumonia, 33·5% (5·6 to 53·1) against PPV23 serotypes, and 2·0% (-78·9 to 46·3) against non-PPV23 serotypes. Although no significant differences between subgroups were seen, higher protection was noted in people younger than 75 years, women, and individuals with lobar pneumonia or health-care-associated pneumonia. PPV23 showed low to moderate effectiveness against vaccine serotype pneumococcal pneumonia in people aged 65 years or older. To improve the current pneumococcal vaccination programme, the variability of PPV23 effectiveness in different groups of older people must be further investigated. Pfizer and Nagasaki University.

Sleep Problems of Older People in Bangladesh

Sleep is a vital physiological process with important restorative functions. The proportion of older people is increasing, and many of them experience sleep problems which increase the risk of accidents, falls, and chronic fatigue. The dual purposes of this study, which was conducted in two southern districts of Bangladesh, were to evaluate older people’s sleep problems and to investigate the relationship between this problem and socio-demographic characteristics. Data were collected from 280 older people via the Athens Insomnia Scale (AIS-5). Descriptive statistics were used to analyze demographic and sleep problem data. One way classification of analysis of variance (ANOVA) was used to compare different groups of older people with different socio-demographic characteristics. Almost all (87.9%) of the participants reported having severe sleep problems. Being widowed, being illiterate, living in a nuclear family, and having a low income were found to be significant factors associated with older people’s sleep problems. The identification of further factors that affect older people’s sleep problems is recommended to inform improved assessment of sleep problems and the development of prevention and treatment programs.

INTERVENSI ILMI-SPARE DALAM MENURUNKAN STATUS DEPRESI PADA KELOMPOK LANSIA

One of nursing community intervention to decrease depression level of elderly is ILMI SpaRe. The aim of this report is to show description application of ILMI SpaRe intervention for erlderly with depression in community nursing care. Result shows decreasing level of depression in older people for knowledge by 10,08%, attitude by 8,05 % and 60,8% for skill in spiritual care intervention and progressive muscle relaxation. By result of intervention application of ILMI SpaRe is concluded that spiritual care intervention combined with progressive muscle relaxation can reduce depression in older people group. This research is recommended for decision maker elderly program in community to increase community empowerment, activation self help group for elderly with health problem, especially depression and involving the seniors in community activities as form for appreciations, so older people can live health and healthy

The normalization of sport for older people?

ABSTRACTOpportunities for older adults in Western countries, particularly women, to participate in physically demanding, competitive sports have increased since the 1960s. Now, coinciding with the neoliberal shift in social policy, older adults live at a time when physical activity is highly encouraged through ‘healthy or active ageing’ discourses in media, policy policies and the sport/exercise sciences. This study sought to understand how 63 Masters athletes (aged 60 and over) explain their participation in sport and, in particular, the extent to which they use neoliberal language of personal moral responsibility and economic efficiency to explain their own participation and the non-participation of older adults in sport. While degrees of moral talk were evident in the older athlete responses, in almost all cases, non-participation in sport was seen as irrational and in need of explanation. Overall, our findings suggest that older people’s participation in sport has been, or at least is in the process of being, normalized among participants in Masters sport. We discuss how this changing idea about sport and ageing might reshape social policy, as well as social relationships, between older people and the state and between different groups of older people.

A serious game developed for physical rehabilitation of frail elderly

Introduction Serious games (SG) have been used to increase the level of physical activity, balance training and muscle strength in older people with frailty syndrome (FS). The aim of this study was to evaluate the effects of an exercise program with a SG developed for the rehabilitation of older people. Materials and methods In this quasi-experimental study, 24 institutionalized older people with average (SD) age of 80.9 (5.6) years old (16 women) were distributed into two groups (experimental and control). The SG exercise program was conducted twice a week for three months (20 sessions of 15 to 25 minutes). The participants were evaluated in terms of mobility with the Timed Up and Go Test (TUG), balance with the Functional Reach Test (FRT), and strength with dynamometer measurements of handgrip, upper and lower limbs. Results Only the experimental group showed significant changes in post-test measurements regarding functional mobility (TUG: d = −1.3, p = 10 −4 ), balance (FRT: d = 1.2, p = 0.003), and upper and lower limb strengths ( d = [0.2–0.6], p = [0.04–0.01]). Discussion–conclusion The results are in line with previous studies suggesting that the SG could integrate the therapeutic repertoire to increase the level of physical activity. Moreover, physical stimulation of older people with SG is a viable and interesting strategy to involve them in the rehabilitation process. The exercise program with the SG resulted in significant improvements in terms of balance, mobility and strength of large muscle groups of older people with FS. This SG has a potential for home or institutional use, since it is relatively safe, allows the training of important functions in older people and could help the stimulation and the monitoring of patients in treatment by the health team.

Using photovoice methods to explore older people's perceptions of respect and social inclusion in cities: Opportunities, challenges and solutions

Urbanisation and population ageing have contributed to recognise cities as important settings for healthy ageing. This paper considers opportunities, challenges and solutions of using photovoice methods for exploring how individuals perceive their cities and the contribution this makes to their health. It focuses on one aspect of older people's experiences – respect and social inclusion, in the context of a community-based participatory research. Drawing on selected findings (participants' photographs, associated quotes and researchers' field notes), we provide an assessment of the suitability of photovoice methodology for the intended purpose. Four groups of older people (n=26; aged 60 years or more) from four contrasting geographical areas in Liverpool, UK, were recruited purposively. Participants photographed perceived positive and negative aspects of respect and social inclusion in the city, reflecting on the meanings of the photographs in individual (n=23) and group interviews (n=9). Thematic and content analysis was conducted using NVivo 10 software.The work reported here provides insights into how participants engage with the photovoice process; factors preventing taking photos of interest; and how photographs complement interviews and focus groups. The findings demonstrate that photovoice both facilitated the dissemination of personalised relevant knowledge, and encouraged critical dialogue between participants, and city stakeholders. Reported difficulties included photography of negative and social concepts, and anxiety when taking photographs due to (i) expectations of what is a ‘proper’ photograph, and (ii) the need to obtain consent from subjects. With preparation, training, and discussion of participants’ ideas not expressed through photographs, photovoice was well-suited to this topic, providing insights complementing other research methods. Through analysing the application of photovoice for exploring perceptions of respect and social inclusion in cities, our paper has identified potential issues and provides important recommendations for researchers on how photovoice methodology can be strengthened in exploring conditions for better health in the urban environment.

Ageing with a Captive Society in London: Audrey, Ron and Smokey at the Zoo

ABSTRACTThis essay considers the spatio-temporal capacity of a set of relationships as they are identified by a group of older people who are regular visitors to London Zoo. It explores the intersections between the time of retirement and the scales and directionality of time commonly invoked by zoological forms of knowledge about species and biodiversity. This includes a look at how both positive and negative theories of futures, including the future of the zoo itself, become a prism through which individuals examine their relationships to time towards the end of life. In addition, the essay focuses on those visitors who seek, in a hopeful manner, to reorient themselves in the city through engagements with individual captive animals.

Lessons from a comparative study of user involvement

Grounded in the context of the significant differences in service user involvement in social work education and research between the UK and Israel, a joint project between Anglia Ruskin University in the UK and Tel-Hai College in Israel was developed. Its aim was to develop a comparative research methodology to evaluate the outcomes of service user involvement in social work education. A main tenet of our research methodology consisted of partnering with a group of older people who used health and social care services as co-researchers from each country. This co-researching methodology together with the evaluation tools worked effectively in the two respective countries. The key findings highlight that while students in both countries valued the involvement of service users in their training, this occurred more so in Israel, where this is a very new development. Students in both countries developed rich concept maps illustrating the complexity of such an involvement. Yet, while the responses of both groups to vignettes describing user involvement scenarios reflected the positive impact of such an involvement, the UK students focused on the negative impact of potential risk more so than the Israeli students.