Why They Say They Leave

Mass Exodus ◽  
2019 ◽  
pp. 56-84
Author(s):  
Stephen Bullivant

The obvious way to discover why and how Catholics lapse or disaffiliate is simply to ask them. This chapter’s main aim, therefore, is to present and discuss the findings from the small number of qualitative studies that have done precisely that. These include Hoge et al.’s interviews with Catholic ‘dropouts’ in the late 1970s, and the more recent surveys of inactive or non-practising Catholics undertaken in two US dioceses (Trenton, NJ, and Springfield, IL), and one British diocese (Portsmouth). These studies probe the multivarious reasons why so many cradle Catholics have come, in later life, no longer to practise or—in many cases—even to identify as Catholics. They also shed rich new light on how ‘Catholic identity’ (and by extension, other religious identities) is understood in real life.

2020 ◽  
Vol 258 (10) ◽  
pp. 2077-2090 ◽  
Author(s):  
Christoph Ehlken ◽  
Focke Ziemssen ◽  
Nicole Eter ◽  
Ines Lanzl ◽  
Hakan Kaymak ◽  
...  

Abstract Purpose Intravitreal injection of VEGF inhibitors has become the standard of care for different macular diseases within the last years resulting in improved visual outcomes. Under real-life conditions, however, the necessity for frequent retreatments and reexaminations poses a burden for patients and treatment centers. Non-adherence and non-persistence to intravitreal treatment may lead to inferior clinical outcomes, and knowledge of contributing factors is crucial to improve adherence. This systematic review analyzes current literature for potential factors involved in non-adherence and non-persistence. Methods A systematic search was conducted in PubMed and Embase including three different aspects of intravitreal injection therapy: (1) diseases with intravitreal injections as treatment, (2) intravitreal injection, and (3) aspects of therapy adherence or therapy persistence. Data from identified quantitative studies were further extracted and grouped according to WHO criteria (condition, socio-economy, therapy, patient, and health system). The methodological quality of identified studies was graded. Identified qualitative studies (i.e., interviews) were descriptively analyzed and their findings narratively reported. Results Twenty-four publications were included. In 16 of those publications, a quantitative data analysis was conducted, analyzing factors associated with non-adherence. Worse visual acuity at baseline and unfavorable development of visual acuity, higher age, and greater distance to the treatment center were associated with non-adherence, while there was inconsistent evidence for an association of comorbidity. In qualitative studies, high follow-up/treatment burden, fear and anxiety, disappointed patient expectations, and lack of motivation to continue treatment were reported as reasons for non-persistence. Conclusions Knowledge of potential barriers in IVT treatment may improve adherence and potentially clinical results. Improvements can be achieved particularly in the healthcare complex (organizational improvements) and the “patient” complex by establishing realistic expectations. Recurrent education of the patient may be necessary.


2020 ◽  
Vol 32 (S1) ◽  
pp. 193-193
Author(s):  
J. Isaac ◽  
A. Gouveia ◽  
M. Suarez-Gomez ◽  
A. Rodrigues ◽  
R. Sousa ◽  
...  

Background: Loss of a spouse is a frequent occurrence in later life, with about 10% of the individuals finding themselves unable to cope and progressing to prolonged grief, risking further mental and physical problems.Objective: The development and implementation of an online grief program, such as LEAVES (optimizing the menta L hEalth and resilience of older Adults that haVe lost th Eir spou Se via blended, online therapy), intends to improve prevention and treatment of prolonged grief, so that elderly mourners can continue to lead an active, meaningful and dignified life.Methods: The LEAVES program, a project under AAL (Active and Assisted Living) 2019 Call for Sustainable Smart Solutions for Ageing Well, is in development by an international consortium and integrates academical, clinical and technical experts. The project will take place between February 2020 and January 2023 and involve real-life evaluation of 315 end-users. The Psychiatric Department at the Health Unit of Baixo Alentejo (ULSBA) will offer the service to its primary users, blending online services with telephone, video calls and face-to-face sessions. Widowed older adults >65 that express the need for help in mourning their spouse will be recruited in the community as well as via the geriatric psychiatry team and primary care.Results: With LEAVES program we aim for older adults to process the loss of a spouse in a blended online/presential environment, detecting olders at risk for complications, reveal negative trends in their emotional life, and act to counter such trends. The evaluation will focus on wellbeing and involve several measures to assess grief symptoms, loneliness, hopelessness, satisfaction and quality of life. Conclusions: ULSBA will use LEAVES to improve clinical practice on preventing and managing prolonged grief as well as, after testing and validating it in this project, to save economical costs and improve effectiveness, both to hospital and patients.


2011 ◽  
Vol 34 (12) ◽  
pp. 971-981 ◽  
Author(s):  
Samuel Robert Nyman ◽  
Bridget Dibb ◽  
Christina Rita Victor ◽  
Margot Ann Gosney

Author(s):  
Andrew Glazzard

In Memories and Adventures, Conan Doyle recounted how his Edinburgh lecturer, Joseph Bell, provided the real-life model for Sherlock Holmes’s methods of reasoning: ‘It is no wonder that after the study of such a character I used and amplified his methods when in later life I tried to build up a scientific detective who solved cases on his own merits and not through the folly of the criminal.’ But Bell was not the only source for Holmes. His literary model was Edgar Allan Poe’s ‘masterful’ Parisian detective, Le Chavalier C. Auguste Dupin, who first appeared in ‘The Murders in the Rue Morgue’ (1841), and reappeared in ‘The Mystery of Marie Rogêt’ (1842) and ‘The Purloined Letter’ (1844). Poe was one of the most powerful literary influences on Doyle’s writing.


2019 ◽  
Vol 69 (680) ◽  
pp. e171-e181 ◽  
Author(s):  
Rachael Frost ◽  
Angela Beattie ◽  
Cini Bhanu ◽  
Kate Walters ◽  
Yoav Ben-Shlomo

BackgroundDepressive symptoms are common in later life and increase both the risk of functional and cognitive decline and the use of healthcare services. Despite older people expressing preferences for talking therapies, they are less likely to be referred than younger adults, particularly when aged ≥80 years.AimTo explore how healthcare professionals (HCPs) manage older people in relation to depression and referrals to psychological therapies.Design and settingSystematic review and thematic synthesis of qualitative studies.MethodMEDLINE, Embase, PsycINFO, CINAHL, and the Social Sciences Citation Index (inception–March 2018) were searched for studies exploring HCPs’ views regarding management of late-life depression across all settings. Studies of older people’s views or depression management across all ages were excluded.ResultsIn total, 27 studies, were included; these predominantly focused on the views of GPs and primary and community care nurses. Many HCPs felt that late-life depression was mainly attributable to social isolation and functional decline, but treatments appropriate for this were limited. Clinicians perceived depression to have associated stigma for older adults, which required time to negotiate. Limited time in consultations and the complexity of needs in later life meant physical health was often prioritised over mental health, particularly in people with frailty. Good management of late-life depression appeared to depend more on the skills and interest of individual GPs and nurses than on any structured approach.ConclusionMental ill health needs to be a more-prominent concern in the care of older adults, with greater provision of psychological services tailored to later life. This may facilitate future identification and management of depression.


2012 ◽  
Vol 1 (3) ◽  
Author(s):  
David Sulz

Isop, Laurie. Illustrated by Gwen Millward. How do you Hug a Porcupine? New York: Simon & Schuster Books for Your Readers, 2011. Print. A charming and hopefully harmless little book.  The variety of animals is illustrated realistically enough to be recognizable on the page and probably even in real-life. The text is nicely lyrical with a rhythm and rhyme that makes you want to sing while reading. The message, however, is not all positive. On the good side, the portrayal of animals as worthy of human attention, respect, and appreciation (although not particularly original in children’s books) is always welcome.  Also nice is the mix of familiar animals (e.g. cow, horse, pig, giraffe) with some that don’t get much attention (e.g. hedgehog, yak, ostrich) so young readers might learn something new. On the negative side, however, is the encouragement to hug any-and-all animals. Knowledge of the difference between tame (domestic) animals and wild animals should be instilled from a young age and, even if not taught explicitly, children’s authors should at least not introduce ideas that must be unlearned in real life. Pandas, yaks, porcupines, kangaroos, and dolphins should NOT, as a general rule, ever be hugged and people should NOT be convinced that everything needs a hug. For one thing, animals are unpredictable and potentially dangerous to the hugger. For another, hugging or touching a wild animal can be dangerous for the hugged - hugging a porcupine would dislodge many quills and reduce its defenses against predators. Sometimes I wonder if the national park tourists who slather honey on their child’s arm to get a picture of the cute bear licking it or approach a fully-grown elk to touch its antler velvet were maybe too exposed to this sort of book. In short, the answer to “how do you hug a porcupine?” should be, “you don’t!” Stick to hugging your own kitty-cat or puppy-dog instead that you know will probably appreciate it and not attack you. Recommended with reservations: 2 out of 4 stars (charming and lyrical but potentially dangerous in later life). Reviewer: David Sulz David is a librarian at the University of Alberta working mostly with scholars in Economics, Religious Studies, and Social Work. His university studies included: Library Studies, History, Elementary Education, Japanese, and Economics. On the education front, he taught various grades and subjects for several years in schools as well as museums. His interest in Japan and things Japanese stands above his other diverse interests.    


10.2196/19344 ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. e19344
Author(s):  
Lex van Velsen ◽  
Miriam Cabrita ◽  
Harm op den Akker ◽  
Lena Brandl ◽  
Joana Isaac ◽  
...  

Background Loss of a spouse is a frequent occurrence in later life. While most older adults successfully process this loss and will return to a normal life, about 10% of the individuals are unable to cope, and progress to prolonged grief (PG). PG, in turn, can result in mental and physical problems including poor sleep, cardiovascular problems, depression, and suicidal tendencies. Objective LEAVES (optimizing the mentaL health and resiliencE of older Adults that haVe lost thEir spouSe via blended, online therapy) is an online bereavement program that will support the prevention and treatment of PG, so that elderly mourners can continue to lead an active, meaningful, and dignified life. LEAVES will cater to secondary end users (eg, family, informal caregivers) by reducing stress. Methods LEAVES will help older adults to process the loss of a spouse in an online environment, which consists of (1) an existing online grief self-help program LIVIA, (2) the Before You Leave program that allows for storing personal memories, (3) a virtual agent platform, and (4) an accessible front-end design. LEAVES can detect persons at risk for complications, reveal negative trends in their emotional life, and act to counter such trends. The service relies on online support whenever possible but is blended with telephone or face-to-face counseling when necessary. Results The project will take place between February 2020 and January 2023 and includes a real-life evaluation in which 315 end users will use the service across 3 countries (the Netherlands, Portugal, and Switzerland). The evaluation of LEAVES will focus on clinical effect, its business case, and technology acceptance. The results will pave the way for smooth integration into existing care paths and reimbursement schemes. Conclusions The LEAVES service aims to soften the mourning process, prevents depression or social isolation, strengthens widow(er)s resilience and well-being, and quickens one’s return to societal participation. International Registered Report Identifier (IRRID) DERR1-10.2196/19344


Author(s):  
Gisèle Pickering

The population of Europe is ageing, caused by fewer births and increased longevity. Increasingly the demand for pain assessment and treatment will change and the patients requesting help will present with more complex demands. In this chapter of European Pain Management we focus on the need for translational research, evidence-based randomized clinical trials, and non-pharmacological approaches in older persons, to assess the real-life risk/benefit ratio of recommendations in a context of multiple medication, co-morbidity, cognitive impairment, and frailty. It is essential to study the cognitive and emotional consequences of pain and analgesia in older persons, who are often prone to depression, and to improve their quality of life. Therapeutic education must be developed for older patients, who often have a fatalistic attitude toward pain, with age-related expectations and demands. Pain prevention remains the key to avoiding the consequences of pain, maintaining autonomy, and enabling healthy ageing.


2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Joanna Orr ◽  
Christine McGarrigle ◽  
Rose Anne Kenny ◽  
Linda Hogan

Abstract Background The previous decades have seen tangible changes in Ireland’s religious landscape. Religion has been investigated as an important factor in wellbeing for many populations, including those aged 65 and over. Women in this age group in particular have higher religiosity while also being more likely to face challenges such as widowhood and demanding caring roles. We explored the ways in which women relate their religious belief, practice and participation to their wellbeing in later life within the Irish context. Methods A qualitative research design was employed. In-depth, semi-structured interviews were conducted with women aged 65 and over (n=11), who self-identified as religious. Women were sampled from church congregations in the North Dublin area. Interviews were recorded and transcribed. Thematic analysis was carried out using NVivo. Women were invited to speak on their lifecourse religious trajectories, relationships, and health, using a flexible interview instrument. Both predetermined and emerging themes were explored. Results Participants were aged 67 to 89, and were Catholic-affiliated (n=10) and Church of Ireland-affiliated (n=1). The participants described a range of religious identities, and these coloured their strategies for facing the changing role of the church in Irish society. Church abuse scandals were discussed unprompted by the majority of participants. Apprehension regarding the future of the church was common, as was concern for the religious identities and practices of younger generations within their families. Nevertheless, the majority of participants outlined ways in which religious practice, in particular, was conducive to their wellbeing. Conclusion Religious feeling, identity and practice was not homogenous in the sample. Feelings of uncertainty around the future were common, and participants employed a range of strategies to cope with these. The study is limited in how generalisation can be made, but provides insight into some of the mechanisms that can link, both positively and negatively, health and religiosity.


2021 ◽  
Vol 23 (2) ◽  
Author(s):  
Mariam Hassoun

In this essay, I explore the relevance of Eve Tuck’s theorization of damage-centered research and Scheper-Hughes’ activist anthropology to my positionality in my research on displaced Iraqis’ navigational access to education. The work of Tuck (2009) and Scheper-Hughes (1995) shows us that our assumptions regarding our research participants influence the way we research, which in turn have real life impacts. As an Iraqi person, issues of representation through research and subsequent responses to social ills are rooted in family history and thus are deeply personal and urgent. The historical marginalization of Iraqi voices, both those of researchers and the researched, can be redressed by foregrounding qualitative studies in lived experiences which acknowledge Iraqis’ dignity and agency. I call for a decolonized methodology and ethics which surpasses traditional expectations of academic work and moves towards a proactive, human-centered ethos.


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