Lived Environment Research Articles

Including local knowledge in coastal policy innovation: comparing three Dutch case studies

ABSTRACT In the context of a growing emphasis on research and application of citizen engagement methods in environmental planning and management (e.g. Reed 2008; Von Korff et al. 2010), we compare three collaborative activities aimed at finding innovative coastal policy solutions in the Netherlands. In these activities, participants across the citizen, science and policy divide were involved in designing nature-based interventions for specific areas in the Netherlands. The activities are compared in terms of the theoretical promise stakeholder engagement holds for influencing participants’ understanding of the respective bio-geophysical systems, the actor networks and for effecting knowledge sharing. We find local knowledge offers the potential for crafting coastal policy solutions to fit the specific bio-geophysical and societal context. The empirical analysis revealed the deep competence of local people, who generally understand their lived environment in a systemic way, and the knowledge that can be harvested to broaden and enrich the design space for coastal solutions – in addition to a willingness on the part of the stakeholders to collaborate in developing local solutions for sustainable futures. Although measures to reduce power differences and enable local knowledge inclusion served to broaden the design space for innovative solutions in our case studies, they also constrained the scientific and technical quality of the contributions from professional experts such as bio-geophysical scientists, engineers, spatial planners and policy analysts. As such, future work addressing the dilemma of integrating high quality professional inputs into coastal policy solutions founded on local expertise is advocated.

The politics of green infrastructure: A discrete choice experiment with Flemish local decision-makers

Being confronted with increasing and expanding urbanisation and the loss of natural green spaces, our living environment is threatened more and more by the effects of global climate change. Green infrastructure is often thought of as the solution to increase climate resilience and reinforce the quality of the lived environment simultaneously. While the benefits, or ecosystem services, that are generated through green infrastructure have been studied intensively, forces that influence green infrastructure decision-making have been far less subjected to thorough research. In this study a discrete choice experiment was conducted with local decision makers in Flemish municipalities to reveal crucial factors in the decision process applied to green infrastructure projects. Flanders is one of the most densely built regions in Europe, stressing the urgency to understand local spatial decision factors to guarantee green space. 568 decision makers active in the local administration of 235 Flemish municipalities participated in the experiment, set in a hypothetical neighbourhood park. Every choice alternative exists of five attributes: investment cost, maintenance cost, deferred investment, recreational value, and climate impact. We find that barriers hampering Flemish munipalities' GI implementation, differ over size of the municipality: smallers municipalities are more affected by knowledge gaps, while larger municipalities are experiencing prioritization issues. Results from hierarchical Bayes choice models indicate that municipal decisions on green infrastructure are highly – almost solely - cost-driven, rarely consider the full range of benefits, and centre around short-term and immediate arguments. Moreover, interaction models reveal that a municipalities' financial result is a key determinant of its willingness to invest in public greening and consider long term benefits, suggesting that GI is a luxury good. The results expose some of the heuristics in GI decision making and can be used to inform higher authorities on ways to overcome barriers towards informed decision-making and to facilitate GI investment.

Tox and Detox

Tox and Detox

Singing the Faith: Soundings of Lyrical Theology in the Methodist Tradition

Paul Wesley Chilcote is highly equipped for writing a book on this theme. His career as a Professor of Historical Theology and Wesleyan Studies has furnished his passion for and knowledge of this area of work. Chilcote is currently Interim Director of Global Wesleyan Theology at Wesley House theological college in Cambridge, UK, and the global reach of his current work has been present throughout his working life. This global reach is a welcome presence in the text under review.This book adds a significant contribution to the field of Wesleyan hymnody, providing valuable insight into key hymn and song writers in the Methodist tradition since the inception of Methodism in the eighteenth century. The work is substantially a historical presentation of fifty-two significant lyricists within this Methodist world, yet Chilcote also offers his readers an identification of key theological themes and a ‘signature text’ for each of these hymnologists. These signature texts are gathered in the sizeable appendix to the work. Furthermore, Chilcote lays out a taxonomy of five streams of Methodist lyrical theology: classic hymns, gospel and holiness songs, black gospel music, social gospel hymns, and global song, which shape the progression of the text (15).The book starts by establishing the purpose and methodology, with a discussion of lyrical theology and Methodist tradition. Thereafter the book is arranged broadly chronologically and follows this pattern for chapters 2 to 8. In chapters 9 and 10 the text changes direction and moves beyond Britain and America to examine a broader context, the ‘worldwide chorus of voices’ (131). Chapters 1 and 2 begin on familiar territory with an examination of Charles Wesley’s texts and John Wesley’s translations. The text soon expands into lesser-known terrain, examining successors within the tradition in the nineteenth, twentieth, and twenty-first centuries. The global contexts explored in the final chapters consider hymnologists in Europe, Africa, Asia, Latin America, and the Caribbean. Chilcote’s work, introducing the reader to these hymnologists, is informative and enlightening, as is his identification of the theological themes of different time periods and places. This contextualization of lyrical theology offers tantalizing glimpses into the response of faith to the lived environment and prompted for me further questions of how the interplay of political, social, and geographical contexts contributes to the sung theology of their time and place.In the introduction Chilcote identifies just four of the Methodist lyricists presented in this volume as ‘lyrical theologians’: Charles Wesley, Fanny Crosby, Charles A. Tindley, and Fred Pratt Green, though all the authors, he says, ‘engage in what I have described as lyrical theology’ (13). While Chilcote’s rationale for allocating the accolade ‘lyrical theologian’ is explained, drawing partly on S T Kimbrough’s work (large enough corpus to make a judgement; continued use of their hymns; discernible theological trajectories, 13–14), the allocation of the term seemed to be somewhat restricted. I agree with Chilcote that all the lyricists who appear in the volume engage in lyrical theology—so are not all lyrical theologians, given that their work shapes the faith and theology of the singers? It would have been interesting to see an engagement with the question of whether these hymnologists can be classed as poets or not: perhaps there is a distinction to be made there.Finally, one of Chilcote’s initial questions asks, ‘How has this sung theology changed over the years?’(vii). It was sobering, therefore, to read the first stage of Asian lyricist I-to Loh’s five-stage paradigm for the contextualization of church music, which is ‘Imitation of Western gospel hymn style’ (154). This seeming legacy from a colonial past needs to be renounced to allow songs to break free from this stricture. The hymns referenced in the book indicate that in style and structure things have changed very little. One exception is Patrick Matsikenyiri’s ‘Jesu tawa pano’, which Chilcote quotes as an example of the indigenization of Christian song. It is to be hoped that the next generation of lyrical theologians in the Methodist tradition can embrace new styles and structures for this sung theology and plant their work firmly in their current context and time.This volume is a stimulating and informative work that will particularly appeal to readers interested in Methodist historical and contemporary lyrical theologians who carry on the crucial role of enabling people to sing their faith, and thereby learn their theology.

“It’s All in Your Head”

In this contribution, we examine three stories of beneficent deception in medicine: the placebo machine invites children with treatment-resistant disorders to enter a high-tech machine and let their brains heal themselves; dementia villages extend validation therapy to the lived environment of geriatric care, supporting the illusion of living in the past through architecture; provocative testing relies on tricking patients suspected of fakery into experiencing seizures so that they can receive an expedited diagnosis. Enlisting the concept of misdirection from the realm of magic and theoretical contributions related to ‘stories’ and ‘storying practices’ from Feminist Science and Technologies Studies, we ask of each: Who is being deceived? Which ‘characters’ are given voice when these stories are told? How is deception justified? Following this, we question the onto-epistemological assumptions of reality and causation underlying each story and offer concluding thoughts on how ‘magic’ could be embraced within medicine and research.

A thematic analysis of patients’ and their informal caregivers’ gendered experiences in traumatic brain injury

Purpose Research shows that patients’ perceptions of themselves and others, in addition to their understanding of the concept of gender, changes after traumatic brain injury (TBI). Little is known about gendered experiences in TBI and care delivery. This study aims to explore perceptions of gender through life experiences and interactions between adult patients with TBI and their informal caregivers. Materials and Methods Seven patients with mild and moderate-severe TBI and eight informal caregivers were interviewed. Transcripts were coded and analysed according to Braun and Clarke’s thematic analysis. The Consolidated Criteria for Reporting Qualitative Research guidelines were followed in reporting results. Results The participants described a transformation of their understanding and experiences of gender following the TBI event. Three themes were identified: (1) Gender designations of "man" and "woman";( 2) Post-injury performativity of gender; and (3) Gender in giving and receiving care. Conclusions The findings emphasize the importance of raising awareness among researchers and practitioners on gender as a transformative process for patients with TBI and informal caregivers after the injury. The diversity of patient-caregiver experiences and critical needs based on gender call for intervention approaches that mitigate gender disparities in giving and receiving care. Implications for Rehabilitation Historically, rehabilitation of persons with traumatic brain injury has targeted physical and cognitive impairments, with little attention to their gendered demands in the lived environment. Gender prevails in the lived experiences of persons with traumatic brain injury, and their informal caregivers, and in giving and receiving quality care. A major challenge for clinicians is identifying harmful gendered roles, norms, and relations and the affective/behavioral problems they produce to alleviate enduring distress and reduce disability. Rehabilitation interventions focusing on flexible and adaptive responses to gendered demands in the lived environment of persons with traumatic brain injury are timely.

Élucider le trouble de la situation. L’enquête et son écologie selon John Dewey

ContextThe new climate regime, or the Anthropocene age, raises the question of the intelligibility and the experimentation, on an individual and collective scale, of the uncertainty that has become intrinsic to the lived environment. ObjectivesThe author borrows from the theory of inquiry developed in the work of John Dewey a description of the troubled situation in which Being is placed, for lack of a connection with what surrounds it. This article considers the aesthetic experience as a paragon of all experience, in order to describe the existential matrix of the investigation. MethodThe article proposes a reading of the major texts that John Dewey dedicates to the inquiry. The epistemology developed by pragmatic philosophy favors inquiry over result, and assertability (“what works”) over truth; lacunar states and disagreements are not removed from inquiry; beliefs are not discredited under the accusation of subjectivism; and the notion of “community” presides over the quest for certainty and guarantee. In this framing, scientific activity is considered to produce knowledge, but it also fundamentally produces uncertainty and questioning, and knowledge is not so much a result as the process of an approach. ResultsWith uncertainty about the environment gaining a general and absolute status, it is by the means of intensification of the experience of a co-existence of beings that a pragmatic investigation can advance within a pessimistic surrounding, against a generalized capture and alienation of life. ConclusionWhile summarizing the theory of inquiry developed in John Dewey's work, this article emphasizes the particular role of aesthetic experience in elucidating the disturbances of the ecological situation.

Dai in the “Land of Tropical Miasma”: Encounters of Early Chinese Anthropology in Yunnan

In early- to mid-twentieth century China, the tropical landscapes and indigenous peoples of southern Yunnan entered public consciousness in two different modes of representation: as a desolate and unfamiliar frontier fraught with the peril of diseases and in desperate need of environmental and social engineering; or, as a haven of fertile land with an ideal of harmonious society. In the process of making new senses of this tropical border region, anthropology played a major role as Chinese anthropologists working in this newly institutionalized discipline turned the Dai, traditionally regarded by Han people as a marginal group living within a dangerous land of zhangqi (tropical miasma), into an ethnographic subject. From Ling Chunsheng’s vision of environmental modification and medical advancement as a twofold project to engineer a new landscape and a new people, to Tian Rukang’s cultural critique that imagined the way of life of Dai people as an antidote for modernity, this article examines early Chinese anthropological discourses on the Dai people and their lived environment. I investigate how technological and epistemological changes fundamentally reshaped the meaning of tropical landscapes in China, a multi-ethnic country of a vast and diverse territory struggling to rejuvenate within a new global order, and I ponder the symbolic and material consequences of this recent history.

Understanding Barriers and Facilitators to Compliance with UK Social Distancing Guidelines During the COVID-19 Pandemic: A Qualitative Interview Study

AbstractWhen followed, there is evidence that social distancing measures play a major role in reducing the transmission of viruses such as COVID-19. However, not all individuals follow the guidance. We explored barriers and facilitators to compliance with UK social distancing guidelines during the COVID-19 pandemic through semi-structured interviews with 116 adults. Data were analysed using reflexive thematic analysis and themes mapped to the Capability, Opportunity and Motivation Model of Behaviour (COM-B). Barriers to compliance included inconsistent rules, caring responsibilities, fatigue, unintended consequences of control measures, and the need for emotional support. Facilitators were informational support and social responsibility. Six themes were both a barrier and a facilitator: lived environment, beliefs about consequences of non-compliance, influence of others, practical support, and trust in government. Reflective motivation, psychological capability, and social opportunity were important drivers for compliance. Measures that enable social support alongside strategies to maintain motivation to comply, provide clear guidance and optimise social cohesion should be promoted.

Perception, concern, competency: children's understanding of physical and non-physical aspects of urban environment in Iran

ABSTRACT This study explores how Iranian children perceive urban settings, what concerns they have in these environments, and examines their competency to accurately read or understand their lived urban environment. To achieve this, primary school students were invited to participate in a mixed-methods qualitative study. The findings present children's perceptions of physical and non-physical aspects of urban settings, each of these consisting of sub-themes relevant to the concerns and competency of participants. Findings include children's understanding of deficiencies in access to urban spaces, meeting children's needs, their experiences of city flows, their perceptions of socio-cultural features of their society, their need to be present in urban spaces, and the sense of belonging and feeling valued in their community. The findings also highlight that some priorities of children are consistent with UNICEF child-friendly city characteristics, but others exceed UNICEF guidelines. The results convey a message to urban decision-makers to provide more space in the urban development process for young citizens since children show competence in comprehending urban spaces.

The Emergence of Planetary Pediatrics.

Pediatrics has witnessed an evolution from primary care, family-centered care, community pediatrics, social pediatrics and global pediatrics, which has shifted our attention beyond the clinic setting to an appreciation of children in their lived environment. We are witnessing the emergence of planetary pediatrics that further broadens the focus of children’s health to include the continued importance of clinical care, but also the impacts of climate change, environmental degradation, child migration, unrelenting war and conflict, social injustice, pandemics and violence against children. If we do not acknowledge the present and ever-increasing adverse planetary changes of what children are experiencing now and in the future, we will have failed to adequately protect them from impending catastrophes. The hope of pediatrics for the future is to improve the health and well-being of all children. This hope remains as relevant today as it was for our predecessors and serves as a beacon for the voyage through the remainder of the twenty-first century.

‘Working in a comfort formerly unknown’: medical holism and the radical ambitions behind interwar Bermondsey’s foot clinic

In 1930, the Bermondsey Public Health Department made the rather unusual decision to establish the first municipal foot clinic in Britain. This pioneering and popular clinic was founded at a...

At Home in the World: Wandering Earth, Environmentalism, and Reimagined Homelands

Abstract Based on a 2000 novella by Cixin Liu with the same title, Frant Gwo’s 2019 film Wandering Earth has been celebrated as China’s first big-budget science fiction film. As a Chinese film with a global theme that simultaneously targets both a domestic and an international audience, accordingly, the work invites a reflection on the relationship between the local and the global—on how we understand the concept of home, and what it might mean to be home in the world. This essay, accordingly, examines three intersecting ways in which Wandering Earth (both the film and the original novella) explores the relationship between home and the world, including the status of the Earth as an ecological system, the planet’s status as a lived environment, as well as a set of contemporary geopolitical discourses about China’s shifting position within the contemporary world order, and particularly its relationship to the Global South.

Unwatchable: Alfredo Jaar, Lament of the Images (2002), and the Ends of Representation

Alfredo Jaar’s Lament of the Images (2002), commissioned for and first exhibited at Documenta11, draws upon the Chilean-born artist’s longstanding interests at the crossroads of photography, the cinematic, and the architectural in search of a spectatorial ethics in the face of contemporary image flows. Jaar’s installation inquires into the possibilities for what Abigail Solomon-Godeau has termed an “ethics of representation” capable of resisting a critical enervation born of an excessive visuality. More specifically, it does so at a historical conjuncture where there is apparently no end to the surfeit of images constituting the mediascape that is our lived environment, yet in which authority over images and their technologies of production is increasingly concentrated within the hands of private corporations and government entities. My claim is that Lament of the Images in particular, and in a broader sense Jaar’s artistic practice since the mid-1990s, anticipates and negotiates what media theorists Nicholas Baer, Maggie Hennefeld, Laura Horak, and Gunnar Iversen have recently identified as a contemporary crisis of “unwatchable” imagery.

Usability, Usefulness, and Acceptance of a Novel, Portable Rehabilitation System (mRehab) Using Smartphone and 3D Printing Technology: Mixed Methods Study

BackgroundSmart technology use in rehabilitation is growing and can be used remotely to assist clients in self-monitoring their performance. With written home exercise programs being the commonly prescribed form of rehabilitation after discharge, mobile health technology coupled with task-oriented programs can enhance self-management of upper extremity training. In the current study, a rehabilitation system, namely mRehab, was designed that included a smartphone app and 3D-printed household items such as mug, bowl, key, and doorknob embedded with a smartphone. The app interface allowed the user to select rehabilitation activities and receive feedback on the number of activity repetitions completed, time to complete each activity, and quality of movement.ObjectiveThis study aimed to assess the usability, perceived usefulness, and acceptance of the mRehab system by individuals with stroke and identify the challenges experienced by them when using the system remotely in a home-based setting.MethodsA mixed-methods approach was used with 11 individuals with chronic stroke. Following training, individuals with stroke used the mRehab system for 6 weeks at home. Each participant completed surveys and engaged in a semistructured interview. Participants’ qualitative reports regarding the usability of mRehab were integrated with their survey reports and quantitative performance data.ResultsOf the 11 participants, 10 rated the mRehab system between the 67.5th and 97.5th percentile on the System Usability Scale, indicating their satisfaction with the usability of the system. Participants also provided high ratings of perceived usefulness (mean 5.8, SD 0.9) and perceived ease of use (mean 5.3, SD 1.5) on a 7-point scale based on the Technology Acceptance Model. Common themes reported by participants showed a positive response to mRehab with some suggestions for improvements. Participants reported an interest in activities they perceived to be adequately challenging. Some participants indicated a need for customizing the feedback to be more interpretable. Overall, most participants indicated that they would like to continue using the mRehab system at home.ConclusionsAssessing usability in the lived environment over a prolonged duration of time is essential to identify the match between the system and users’ needs and preferences. While mRehab was well accepted, further customization is desired for a better fit with the end users.Trial RegistrationClinicalTrials.gov NCT04363944; https://clinicaltrials.gov/ct2/show/NCT04363944

A recipe for thriving in nursing homes: A meta-ethnography.

To explore contributors for thriving in nursing homes by evaluating, analysing and synthesizing peer-reviewed qualitative literature on the topic. Thriving is a positive life-world concept that has been explored by several qualitative studies; however, descriptions of thriving and contributors to thriving have not been compared or contrasted among different studies and contexts, nor have they been reviewed and synthesized. Qualitative meta-ethnography. Four electronic databases were searched in October 2019, with sources published between 2000 and 2019 included. Sources of peer-reviewed literature that employed qualitative methods to explore thriving in nursing homes were evaluated. In total, 1,017 sources were screened at title-level, 95 advanced to abstract-level review and 11 were assessed at full-text level. Each source was evaluated by two researchers independently in relation to methodological quality and relevance to the study aim. Themes pertaining to thriving in nursing homes were extracted, interpreted and synthesized. In total, seven sources of peer-reviewed literature were included. Two main themes illustrating the contributors to thriving were identified: ingredients for thriving (subthemes: personal contributors and social contributors) and environment for thriving (subthemes: spacial contributors and societal contributors). Contributors to thriving in nursing homes include personal attributes, relationships with others, the lived environment and societal structures. Thriving for older people could thereby be defined as a holistic concept denoting lived experiences of situated contentment. Future studies should explore different temporal facets of thriving in the nursing home setting. This meta-synthesis proposes a 'recipe' for thriving as comprising the right ingredients and the right environment, determined by the preferred 'taste' of the individual person. The proposed definition and contributors illuminate thriving as a positive life-world concept that is based on one's lived experiences and context.

Urban and rural environments differentially shape multisensory perception in ageing

ABSTRACT Recent studies suggest that the lived environment can affect cognition across the lifespan. We examined, in a large cohort of older adults (n = 3447), whether susceptibility to a multisensory illusion, the Sound-Induced Flash Illusion (SIFI), was influenced by the reported urbanity of current and childhood (at age 14 years) residence. If urban environments help to shape healthy perceptual function, we predicted reduced SIFI susceptibility in urban dwellers. Participants reporting urban, compared with rural, childhood residence were less susceptible to SIFI at longer Stimulus-Onset Asynchronies (SOAs). Those currently residing in urban environments were more susceptible to SIFI at longer SOAs, particularly if they scored low on general cognitive function. These findings held even when controlling for a several covariates, such as age, sex, education, social participation and cognitive ability. Exposure to urban environments in childhood may influence individual differences in perception and offer a multisensory perceptual benefit in older age.

Social Literacy: Nurses’ Contribution Toward the Co-Production of Self-Management

We share findings from a larger ethnographic study of two urban complex care management programs in the Western United States. The data presented stem from in-depth interviews conducted with 17 complex care management RNs and participant observations of home visits. We advance the concept of social literacy as a nursing attribute that comprises an RN’s recognition and responses to the varied types of hinderances to self-management with which patients must contend in their lived environment. It is through social literacy that complex care management RNs reconceptualize and understand health literacy to be a product born out of the social circumstances in which patients live and the stratified nature of the health care systems that provide them care. Social literacy provides a broader framework for health literacy—one that is situated within the patient’s social context through which complex care management RNs must navigate for self-management goals to be achieved.

Socialist Heritage: The Politics of Past and Place in Romania by Emanuela Grama

Reviewed by: Socialist Heritage: The Politics of Past and Place in Romania by Emanuela Grama Maria Bucur Emanuela Grama. Socialist Heritage: The Politics of Past and Place in Romania. Bloomington: Indiana University Press, 2019. 268 pp. “Heritage” entrepreneurship has been an important site for constructing legitimacy and accumulating power in the modern world. Though presumably revolutionary in ideology and goals, state socialist regimes have also used this memorialistic framework to articulate the cultural legitimacy of their ascent to power. How that heritage discourse has fared in the post-socialist world is at the heart of the analysis Emanuela Grama offers in Socialist Heritage: The Politics of Past and Place in Romania. By focusing on a neighborhood in Bucharest that has been dubbed “the Old City,” Grama takes us through a journey of how the heritage discourse was first constructed and operationalized through archaeological, historiographic, and urban planning activities under state socialism, and then repurposed as well as contested after 1989, with results that show profound fissures in the ability to deploy “heritage” as a successful legitimating tool. Though the author focuses on a relatively small site of heritage building and negotiation, the case study is meant to represent a larger trend in Romania. The overall argument of the book can be divided into two parts. To begin with, Grama shows how after 1948 Romanian architects, archaeologists, and members of the Politburo turned the Old City neighborhood in Bucharest into an object of personal attention on the part of these various players. Uncovering and restoring medieval ruins became a way to gain visibility and resources from the political leadership. These heritage entrepreneurs eventually helped grow the Marxist-nationalist brand of historical narrative about the past that culminated under Nicolae Ceaușescu. Historians joined the chorus by unearthing or simply adhering to a historical materialist [End Page 563] discourse imposed by the Marxist ideological straight jacket dictated by the Politburo, for the sole purpose of aligning historical narratives—together with archives, archaeological sites, and thus any representation of the past through institutional means—with the ideology of the Romanian Communist Party. Within that universe of constrained access to power, entrepreneurial professionals constructed discourses and practices that advanced a dialectic inscribed in the urban landscape, for the purpose of bolstering the claims of the political leadership to have played the revolutionary role of liberating the nation from the shackles of capitalist oppression. That argument was made most powerfully over two decades ago by Katherine Verdery, who appears quite frequently in the footnotes. I see the current contribution as a distinct articulation of the theoretical insights made in National Ideology under Socialism (Verdery 1995), confirming the workings of hierarchies of institutional and discursive power detailed in that analysis of knowledge making under state socialism. It is in tying that analysis of power relations among the communist elites to the lived environment—in short, as material and not just intellectual consequences of those struggles—that this book deepens our understanding of state socialism. And by starting Socialist Heritage with the reactions of someone who lives in that area today, Grama makes clear that revealing the consequences of these contests for the citizens of this lived environment is ultimately the stake of her work. The book excels especially when she brings in the concept of heritage as a means for governance and shaping the everyday experience of the bucureșteni (Bucharesters). The first three chapters are dedicated to exploring how various knowledge makers became heritage entrepreneurs and helped turn streets and buildings in the Old City into so many signposts of the political order that dominated Wallachia’s medieval period. The focus here is on the political negotiations among intellectual and professional elites of the early state socialist period. Archaeological speculation became historiographic certainty about evidence of specific forms of feudalism that would enable the telling of a longer story about class struggle and the dialectics of power in the premodern period, enabling the Romanian Communist Party to generate a genealogy of oppression and struggle that fit neatly with the Marxist dictates of the Politburo as articulated both in Bucharest and in Moscow. But, ironically, the specific inflections of the archaeological and historio-graphic speculations...

Implications of Exceeding the Age and Interventions to Extend Life Purpose: Perspectives From Asian Centenarians

Centenarians have often been regarded as living paradigms of exceptional longevity yet little is known from their perspective about the purpose, meaning and quality of living longer lives. In Singapore, the number of centenarians has multiplied 30-fold from 50 in 1990 to about 1500 in 2020. Although centenarians are respected as ‘national treasures’ – having witnessed Singapore’s transformation from British colony to global city state, their needs remain invisible in both the healthcare and social sectors. The tendency to romanticize exceptional longevity neglects a deeper understanding of (i) its consequence on the oldest old (85+ years) who may be impacted by severe functional and sensory deficits and (ii) their experience of social isolation in the family and communities. This paper discusses findings based on interviews with 15 Singapore centenarians (100 to 111 years old) and their family carers. Diverse experiences of longevity are shaped by these factors: health status; personal disposition; strength of family and social networks; exposure to adversity and coping resources; spiritual beliefs; role loss; and changes in the lived environment. Appropriate health and psychosocial interventions could have been delivered earlier in the life trajectory to enable better quality of life and continued social engagement. Learning from the challenges (eg. social withdrawal; extensive functional and sensory losses) of existing centenarians contributes to a more precise understanding of how best to harness the productive capacities of our oldest old.