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The ethical and practical importance of actively involving older people in the research process is increasingly articulated in the gerontology literature. This article contributes to the literature by outlining a community-based participatory research project that centered on the design and administration of a questionnaire exploring older people's use and perceptions of community services. The authors discuss both older adults' and the researchers' views of the participatory process. The key lessons and challenges that emerged from the research are analyzed using the nine principles of community-based participatory research outlined by Israel et al. The authors question whether older people in all instances seek extensive involvement in all aspects of participatory projects and raise a number of questions that require further analysis before a robust and viable understanding of participatory research that safeguards against the tokenistic involvement of older people can be developed. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the views of older home care recipients on the care that they receive and the preferences of the home help staff to work more flexible times, in order to provide a more person-centred service for the older person. A mixed-methods design was used, incorporating both qualitative and quantitative research methods. The qualitative phase involved five focus groups (total participants: n=23), to gain information on the recipients’ views on the home help received and how the service may become more person-centred. The quantitative phase involved sending postal questionnaires to Health Service Executive (HSE) home help employees (n=202) and to home help employees from a voluntary home help agency in Dublin South West (n=147). The findings from the qualitative phase of the research highlighted that the recipients were mainly satisfied with the service received but would like more communication with home help managers, and to be consulted regarding their care to allow for a more person-centred service. Companionship was also identified as a need for the older person. Data from the quantitative analysis indicated that home help employees, particularly in the HSE, are willing to work outside current contracted hours; for example, 8 p.m. to midnight midweek, or on Sunday evenings. Therefore, the future possibility of recruiting HSE home help staff to work more flexible hours needs to be considered to allow for a more person-centred home help service.

Abstract Background This article provides new insights into the impact of social engagement on CVD risk factors in older adults. We hypothesized that objective (social participation, social ties and marital status) and subjective (emotional support) aspects of social engagement are independently associated with objective measures of cardiovascular risk. Methods Data from the English Longitudinal Study on Ageing (ELSA) were analyzed. The effects of social participation, social ties, marital status, and emotional support on hypertension, obesity, high sensitivity C-reactive protein, and fibrinogen were estimated by logistic regression controlling for age, sex, education, physical function, depression, cardiovascular disease, other chronic diseases, physical activity, and smoking. Results Social participation is a consistent predictor of low risk for four risk factors, even after controlling for a wide range of covariates. Being married is associated with lower risk for hypertension. Social ties and emotional support are not significantly associated with any of the cardiovascular risk factors. Conclusion Our analysis suggests that participation in social activities has a stronger association with CV risk factors than marital status, social ties or emotional support. Different forms of social engagement may therefore have different implications for the biological risk factors involved.

Background: Populations are ageing, making the quality of old age a crucial issue. Some adversity in old age, such as loss of loved one or loss of physical function, is often experienced, as is the need for recovery from such adversity. Resilience in later life has become an important topic and has accumulated much empirical research. However, the research has mainly centred on individual factors, such as personality, rather than social factors, such as family relationships or community engagement. There is no systematic review of the social dimensions of resilience in old age, a focus that should be especially important for policy and practice seeking to create supporting environments., Methods: Our review comprises quantitative and qualitative empirical original English language studies, published 2013-2023, using predefined search phrases including 'resilience' and various terms for old age and social dimensions. Titles and abstracts are screened by the first two authors using registered exclusion criteria. Final inclusion, based on full-text reading, is decided using registered inclusion criteria, and verified by co-authors. Qualitative articles are read by authors specialized in qualitative research and quantitative articles by authors specialized in quantitative research. Due to large expected heterogeneity, meta-analysis is not conducted, but weighted effect sizes or funnel plots may be prepared if parallel quantitative studies are encountered. Qualitative studies are synthesized using meta-aggregation. The risk of bias is evaluated with applicable Joanna Briggs Institute checklists for each study design. A narrative synthesis brings together the qualitative and quantitative studies., Conclusion: Methodological strengths and weaknesses of the included studies are reported to assess the quality of the research. Summary of the most significant social dimensions of resilience in old age is prepared, emphasizing interactions between contexts, stressors, mechanisms and outcomes; and research gaps are identified., Systematic Review Registration: Protocol is registered in PROSPERO (CRD42023412532)., (© 2024 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Social isolation and loneliness in long-term care settings are a growing concern. Drawing on concepts of social citizenship, we developed a peer mentoring program in which resident mentors and volunteers formed a team, met weekly for training, and paired up to visit isolated residents. In this article, we explore the experiences of the resident mentors. As part of a larger mixed-methods study conducted in 10 sites in Canada, we interviewed mentors ( n = 48) and analysed data using inductive thematic analysis. We identified three inter-related themes: Helping others, helping ourselves described the personal benefits experienced through adopting a helping role; Building a bigger social world encapsulated new connections with those visited, and; Facing challenges, learning together described how mentors dealt with challenges as a team. Our findings suggest that a structured approach to mentoring benefits residents and helps them feel confident taking on a role supporting their isolated peers.

Objectives: Low back pain is highly prevalent in rowing and can be associated with significant disability and premature retirement. A previous qualitative study in rowers revealed a culture of concealment of pain and injury due to fear of judgement by coaches or teammates. The aim of this study was to explore rowers' perspectives in relation to diagnosis, contributory factors, and management of low back pain., Design: Qualitative secondary analysis., Methods: We conducted a secondary analysis of interview data previously collected from 25 rowers (12 in Australia and 13 in Ireland). A reflexive thematic analysis approach was used., Results: We identified three themes: 1) Rowers attribute low back pain to structural/physical factors. Most rowers referred to structural pathologies or physical impairments when asked about their diagnosis. Some participants were reassured if imaging results helped to explain their pain, but others were frustrated if findings on imaging did not correlate with their symptoms. 2) Rowing is viewed as a risky sport for low back pain. Risk factors proposed by the rowers were primarily physical and included ergometer training, individual technique, and repetitive loading. 3) Rowers focus on physical strategies for the management and prevention of low back pain. In particular, rowers considered stretching and core-strengthening exercise to be important components of treatment., Conclusions: Rowers' understanding of low back pain was predominantly biomedical and focused on physical impairments. Further education of rowers, coaches and healthcare professionals in relation to the contribution of psychosocial factors may be helpful for rowers experiencing low back pain., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Optimistic expectations of technology can be identified in policy documents, academic centres and businesses that aim to create and promote a variety of technologies so that older people can age at home. This article draws on recent data from Ireland and Finland, two countries at different stages of technological development, to examine the role of technology in the home care for older adults. Research participants (service providers and care recipients) agreed that technology could play an important role by improving communications, enabling social contact, and connecting the 'lone worker' and 'isolated patient' to other stakeholders in home care services. However, participants also had serious concerns around technology. Care was conceptualised as relational and participants expressed apprehension about technology replacing face-to-face contact. Service providers expressed trepidation about the digital divide and technology driving further inequalities in the future. It is important that attempts to develop technology for older adults consider the concerns identified in this study, in order for home care technology to be successfully implemented, widely adopted and meaningfully used., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objectives: Loneliness and depression are of increasing concern in long-term care homes made more urgent by viral outbreak isolation protocols. An innovative program called Java Mentorship was developed that engaged community volunteers and resident volunteers (mentors) as a team. The team met weekly, received education, and provided visits and guidance in pairs to socially disengaged residents (mentees). The purpose of this study was to assess the feasibility of conducting a larger study. Method: We conducted a mixed-methods pre-post study to evaluate the program. We collected feasibility data associated with the program implementation, including assessment of the sample and ability to recruit; procedures for data collection; retention, program adherence and acceptability; and residents' responses including loneliness, depression, purpose in life, social identity and sense of belonging outcomes. We enrolled community mentors ( n  = 65), resident mentors ( n  = 48) staff facilitators ( n  = 24) and mentees ( n  = 74) in 10 Canadian sites. Results: Most feasibility objectives were met, and adherence and acceptability were high. Some resource challenges and low retention rates among resident mentors were noted. We found a 29% reduction in depression scores ( p  = .048; d  = .30) and 15% reduction in loneliness scores ( p  = .014; d  = .23). Purpose in life, social identity and sense of belonging were unchanged. Interviews among participants indicated high acceptability and positive perceptions of the program. Conclusion: The study findings reveal a potential role for mentorship as a viable approach to reducing loneliness and depression in long-term care settings and lay the groundwork for future research.

Loneliness, depression, and social isolation are common among people living in long-term care homes, despite the activities provided. We examined the impact of a new peer mentoring program called Java Mentorship on mentees' loneliness, depression, and social engagement, and described their perceptions of the visits. We conducted a mixed-methods approach in 10 homes in Ontario, Canada, and enrolled residents as mentees ( n = 74). We used quantitative surveys and qualitative interviews to understand their experience. After 6 months, mentees ( n = 43) showed a 30% reduction in depression ( p = .02, d = .76), a 12% reduction in loneliness ( p = .02, d = .76), and a 60% increase in the number of monthly programs attended ( p = .01, d = .37), with small-to-medium effect sizes. The analysis of mentee's interviews revealed positive perceptions. This program offers an innovative, nonpharmacological alternative to the treatment of loneliness and depression.

This article challenges the dominance of age homophily in the literature on friendship. Using findings from a recent study on intergenerational friendship, we put forward a new conceptualization of a homophily of doing-and-being in friendships between adults who are of different generations. This research took a qualitative approach using constructivist grounded theory methodology. Homophily of doing-and-being has three components: being "friends in action" (pursuing interests and leisure activities, or simply spending time together), being "not only old" (sharing identities beyond age), and sharing attitudes and approaches to friendship and life. Additionally, "differences" were an important element of interest between the intergenerational friends. Our discovery of the centrality of doing-and-being, and the relative insignificance of age homophily, constitute a novel way of looking at friendship, and a new way of conceptualizing how and why (older) adults make and maintain friendships.

Objectives: Low back pain (LBP) is common in rowers and leads to considerable disability and even retirement. The athlete voice can help clinicians to better understand sport-related pain disorders. We aimed to capture the lived experience of LBP in rowers., Methods: Cross-sectional qualitative study using a grounded theory approach. Adult competitive rowers with a rowing-related LBP history were recruited in Australia and Ireland. Data were collected through interviews that explored: context around the time of onset of their LBP and their subsequent journey, experiences of management/treatment, perspectives around present beliefs, fears, barriers and expectations for the future., Results: The 25 rowers (12 women/13 men) who participated were aged 18-50 years; they had a mean 12.1 years of rowing experience. They discussed a culture of concealment of pain from coaches and teammates, and fear of being judged as 'weak' because of the limitations caused by LBP. They reported fear and isolation as a result of their pain. They felt that the culture within rowing supported this. They reported inconsistent messages regarding management from medical staff. Some rowers reported being in a system where openness was encouraged-they regarded this a leading to better outcomes and influencing their LBP experience., Conclusions: Rowers' lived experience of LBP was influenced by a pervasive culture of secrecy around symptoms. Rowers and support staff should be educated regarding the benefits of early disclosure and rowers should be supported to do so without judgement., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Theoretical sampling is a key procedure for theory building in the grounded theory method. Confusion about how to employ theoretical sampling in grounded theory can exist among researchers who use or who want to use the grounded theory method. We illustrate how we employed theoretical sampling in diverse grounded theory studies and answer key questions about theoretical sampling in grounded theory. We show how theoretical sampling functions in grounded theory and how it differs from sampling for data generation alone. We demonstrate how induction, retroduction, and abduction operate in grounded theory and how memoing drives theoretical sampling in the pursuit of theory. We explicate how theoretical sampling can contextualize data to build concepts and theory. Finally, we show how theoretical sampling in grounded theory operates in secondary analysis to derive theory that goes beyond the original purpose of data collection.

In this article, we examine the social construction of the home care worker from the perspective of various professionals in the elder care sector in Ireland. The research, using the Grounded Theory method, involved focus groups with 31 participants comprising health and social work professionals as well as care agency managers and policy planners. The social construction of the elder care worker is characterised by ambivalence. We connect the concept of ambivalence at the micro level of human relationships to structural factors that are driving the ambivalence. Ambivalence towards home care workers is shaped by structural factors including the precariousness of care work, the commodification of time, and the stipulated personalisation of services. The irreconcilable contrasts between portrayals of care workers as both 'good' and 'bad' are indicative of deep contradictions in the expectations that contemporary care systems direct at paid caregivers. Ambivalence arises from the commodified and dispensable status of care workers, and fundamental transformations in their training, working conditions and pay are required to move away from this ambivalence and towards care workers' equal status with professionals in the care sector.

Background: Intergenerational friendship is a friendship which occurs between differing generations of older and younger adults. Intergenerational friendship as a research topic has received little attention from sociologists of ageing, despite the cultural turn. This study set out to explore and understand intergenerational friendships from the perspective of the older friend., Method: This research took a qualitative approach using Constructivist Grounded Theory methodology. Twenty-three people aged 65 and over were interviewed in Ireland to attain rich narrative accounts and observational memos were generated., Findings: Intergenerational friendship formed part of the process that shaped the older friends' approach to ageing in their everyday lives (micro level), being influenced by stereotyping and commonly held understandings of ageing and older people in contemporary society (macro level). Engaging with intergenerational friends was congruent with the meaning these participants attached to 'being old' or 'being young' and how adults 'should' be in older and in younger age., Discussion: For the older adults in this study, ageing is about performance - how they perform as older adults in their pursuits or interests - and not about chronological age. Intergenerational friendship is an integral part of this strategy for doing ageing in a meaningful yet mundane (everyday, taken for granted), way., (Copyright © 2019 Elsevier Inc. All rights reserved.)

The authors wish to make the following modification to this paper [...].

Few studies have examined how the allocation and consequences of grandchild care vary across different socioeconomic groups. We analyze qualitative data alongside data from The Irish Longitudinal Study on Ageing (TILDA), in a convergent mixed-methods approach. Regression models examined characteristics associated with grandchild care, and the relationship between grandchild care and depressive symptoms and well-being. Qualitative data shed light on processes and choices that explain patterns of grandchild care provision. Tertiary-educated grandparents provided less intensive grandchild care compared with primary educated. Qualitative data indicated that this pattern stems from early boundary-drawing among higher educated grandparents while lower socioeconomic groups were constrained and less able to say no. Intensive grandchild care was associated with more depressive symptoms and lower well-being and was moderated by participation in social activities and level of education attainment. The effect of grandchild care on well-being of grandparents depends on whether it is provided by choice or obligation., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

In the era of global ageing, amid political concerns about increasing care needs and long-term sustainability of current care regimes, most high-income economies are seeking to minimise the use of institutional care and to expand formal home care for their older populations. In long-term care reforms, concerns about public funding, formal providers and the paid care workforce are foremost. However, an integral yet hidden part of all these reforms is the stealthily growing role of family carers. This article aims to identify and spell out how developments in formal home care bring about different modes of increasing, encouraging and necessitating family care inputs, across welfare states. Using secondary sources, three different modes were identified, and the article outlines the logic of each mechanism, drawing on illustrative examples of policy dynamics in both European and Asian countries. Family care inputs have increased through policy changes that are not explicitly or primarily about family care, but rather about expansion or changes in formal care. In some cases, this is explicit, in other cases something that happens 'through the back door'. Nonetheless, in all cases there are implications for the family caregivers' time, health and employment options. Future studies are needed to examine longitudinal trends from a comparative perspective to confirm our findings and elucidate how government commitments to formal home care provision and financing interact with the changing nature and volume of family caregiving.

Active ageing and successful ageing are ubiquitous concepts in contemporary societies. In the European Union, active ageing is monitored and promoted chiefly by the Active Ageing Index, a policy tool in use since 2012. We acknowledge that the AAI may contribute to sensitizing people, including policymakers, to the multidimensionality and complexity of the process of "ageing well". However, we note that despite being widely used and promoted, the Active Ageing Index remains under-scrutinized. In this article, we undertake a comprehensive critical analysis of the Active Ageing Index. This critical analysis is supported by the Theory of Model Ageing, the Capability Approach and, to a lesser extent, by relevant literature on composite indices. We conclude that the Active Ageing Index was developed with the paradoxical aim of deriving "the solution" from "the problem". It is an under-theorized and narrowly conceptualized index that contributes to the process of Model Ageing, as its conceptual foundation, and its domains and indicators, convey a certain model of active ageing. This model is expert-based and ingrained with a priori assumptions about the potential of older people, the domains of life and activities they value and how strongly they value them. Finally, the Active Ageing Index measures current achievements, not capabilities (i.e. the opportunity set of achievable "doings" and "beings"), resulting in a valuable but incomplete tool for policymaking purposes. We hope that this critical analysis will initiate a debate on the Active Ageing Index that, in our view, is overdue., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: Caregiver burden affects the physical, psychological and emotional well-being of the caregiver. The purpose of this analysis was to describe an informal caregiver cohort (n = 81), their subjective assessment of burden and difficulties experienced as a result of providing care to people with Amyotrophic Lateral Sclerosis (ALS)., Methods: Using mixed methods of data collection and analysis, we undertook a comprehensive assessment of burden and difficulties associated with informal caregiving in ALS. As part of a semi-structured interview a series of standardised measures were used to assess quality of life, psychological distress and subjective burden, and in an open-ended question caregivers were asked to identify difficult aspects of their caregiving experience., Results: The quantitative data show that psychological distress, hours of care provided and lower quality of life, were significant predictors of caregiver burden. From the qualitative data, the caregiving difficulties were thematised around managing the practicalities of the ALS condition, the emotional and psychosocial impact; limitation and restriction, and impact on relationships., Conclusions: The collection and analysis of quantitative and qualitative data better explores the complexity of caregiver burden in ALS. Understanding the components of burden and the difficulties experienced as a result of caring for someone with ALS allows for better supporting the caregiver, and assessing the impact of burden on the care recipient.

Ticks carry several human pathogenic microbes including Borreliae and Flavivirus causing tick-born encephalitis. Ticks can also carry DNA of Chlamydia-like organisms (CLOs). The purpose of this study was to investigate the occurrence of CLOs in ticks and skin biopsies taken from individuals with suspected tick bite. DNA from CLOs was detected by pan-Chlamydiales-PCR in 40% of adult ticks from southwestern Finland. The estimated minimal infection rate for nymphs and larvae (studied in pools) was 6% and 2%, respectively. For the first time, we show CLO DNA also in human skin as 68% of all skin biopsies studied contained CLO DNA as determined through pan-Chlamydiales-PCR. Sequence analyses based on the 16S rRNA gene fragment indicated that the sequences detected in ticks were heterogeneous, representing various CLO families; whereas the majority of the sequences from human skin remained "unclassified Chlamydiales" and might represent a new family-level lineage. CLO sequences detected in four skin biopsies were most closely related to "uncultured Chlamydial bacterium clones from Ixodes ricinus ticks" and two of them were very similar to CLO sequences from Finnish ticks. These results suggest that CLO DNA is present in human skin; ticks carry CLOs and could potentially transmit CLOs to humans., Competing Interests: The authors declare no conflict of interest.

Research has shown that family caregivers of ALS patients encounter carer burden. Studies that have investigated the impact of caring on family in ALS have reported predominantly from the family caregiver perspective. We undertook in-depth qualitative interviews with a diverse group of ALS patients (n = 34) sampled from the Irish ALS population-based register and explored their experiences of receiving care from family members and from formal service providers. Interviews were audio recorded and transcribed and data were coded to identify psychosocial processes. Findings showed that patients perceived their care as a burden on family and had concerns about the adverse effects that caring had on family caregivers. However, participants also resisted being a burden on family and they provided emotional support to their family. Participants felt a strong sense of obligation towards family and their concern about family members shaped their expressed preferences for care. We identified that the caring process between ALS patients and their family is often bi-directional, leading in some cases to the patient experiencing carer burden. In conclusion, greater attention in ALS research and practice to patients' supportive roles in family is required to counterbalance the already strong focus on family caregiver burden.

Background: The aim of this study is to examine the long-term association between childhood sexual abuse (CSA) and mental and physical health, especially with conditions related to hypothalamic-pituitary-adrenal axis dysfunction such as mood disorders, cardiovascular disorders, gastrointestinal disorders, pain disorders, and measures of frailty and functional mobility. In addition, we examined the impact of CSA on self-reported health and healthcare utilization., Methods: Data from the Irish Longitudinal Study on Ageing were employed (N = 8,178). The effects of CSA on mental health, physical health, and healthcare utilization in old age population were estimated by ordinal least square, logistic regression, and Poisson regression, controlling for demographic factors, childhood adversities, and behavioral health., Results: Six percent of respondents reported CSA with little variation by gender. A significant association was found between CSA and mental health. Those who reported CSA were more likely to have depression, anxiety, worry, loneliness, and low quality of life. Poor self-reported health, lung disease, arthritis, peptic ulcer, chronic pain as well as high levels of total cholesterol and low-density lipoprotein were associated with CSA. Further, those who reported CSA were more likely to report doctor and hospital visits than those without a history of CSA., Conclusions: Findings from the present study show that CSA has significant long-term mental and physical consequences, whereby early life events are linked to later life health outcomes.

Loneliness and depression are serious mental health concerns across the spectrum of residential care, from nursing homes to assisted and retirement living. Psychosocial care provided to residents to address these concerns is typically based on a long-standing tradition of 'light' social events, such as games, trips, and social gatherings, planned and implemented by staff. Although these activities provide enjoyment for some, loneliness and depression persist and the lack of resident input perpetuates the stereotype of residents as passive recipients of care. Residents continue to report lack of meaning in their lives, limited opportunities for contribution and frustration with paternalistic communication with staff. Those living with dementia face additional discrimination resulting in a range of unmet needs including lack of autonomy and belonging-both of which are linked with interpersonal violence. Research suggests, however, that programs fostering engagement and peer support provide opportunities for residents to be socially productive and to develop a valued social identity. The purpose of this paper is to offer a re-conceptualization of current practices. We argue that residents represent a largely untapped resource in our attempts to advance the quality of psychosocial care. We propose overturning practices that focus on entertainment and distraction by introducing a new approach that centers on resident contributions and peer support. We offer a model-Resident Engagement and Peer Support (REAP)-for designing interventions that advance residents' social identity, enhance reciprocal relationships and increase social productivity. This model has the potential to revolutionize current psychosocial practice by moving from resident care to resident engagement., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Objective: Grounded theory (GT) is an established qualitative research method, but few papers have encapsulated the benefits, limits, and basic tenets of doing GT research on user and provider experiences of health care services. GT can be used to guide the entire study method, or it can be applied at the data analysis stage only., Methods: We summarize key components of GT and common GT procedures used by qualitative researchers in health care research. We draw on our experience of conducting a GT study on amyotrophic lateral sclerosis patients' experiences of health care services., Findings: We discuss why some approaches in GT research may work better than others, particularly when the focus of study is hard-to-reach population groups. We highlight the flexibility of procedures in GT to build theory about how people engage with health care services., Conclusion: GT enables researchers to capture and understand health care experiences. GT methods are particularly valuable when the topic of interest has not previously been studied. GT can be applied to bring structure and rigor to the analysis of qualitative data., (© Health Research and Educational Trust.)

In the 1920s, Karl Mannheim developed the concept of generation in a treatise entitled 'The Problem of Generations' (1952/1928). His conceptualisation pertained to what Pilcher (1994) calls 'social generations', that is, cohort members who have similar attitudes, worldview and beliefs grounded in their shared context and experiences accumulated over time. It is often argued that social generation has been hollowed out as a sociological concept, yet it continues to feature prominently in policy debates, media, academic literature and everyday talk. This article develops a grounded conceptual framework of how the notion of 'generation' is employed by 'ordinary people'. We induct the meaning of 'generation' from how people use the term and the meaning they attribute to it. We contribute to the current scholarship engaging with Mannheim to explore how people's portrayals of their 'performance' of generation can help to develop further the concept of social generation. We draw on qualitative primary data collected in the Changing Generations project, a Grounded Theory study of intergenerational relations in Ireland. Far from outdated or redundant, generation emerges as a still-relevant concept that reflects perceptions of how material resources, period effects and the welfare state context shape lives in contemporary societies. Generation is a conceptual device used to 'perform' several tasks: to apportion blame, to express pity, concern and solidarity, to highlight unfairness and inequity, and to depict differential degrees of agency. Because the concept performs such a wide range of important communicative and symbolic functions, sociologists should approach generations (as discursive formations) as a concept and practice that calls for deeper understanding, not least because powerful political actors have been quicker than sociologists to recognise the potential of the concept to generate new societal cleavages., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Purpose of the Study: This article examines the impact of early- and later-life circumstances on loneliness among people aged 65+ in Ireland., Design and Methods: Data are from the first wave of the Irish Longitudinal Study on Ageing, a nationally representative sample of community-dwelling adults aged 50+. The participants (N = 2,645) aged 65+ were included in the analysis. Because of the large number of never married persons in the older Irish population, we first used a multinomial logistic model to examine which childhood circumstances are associated with current marital status. We then estimated multiple regression models for loneliness, in stages conforming to the life course, to examine the extent to which early events are mediated by later events., Results: Poor childhood socioeconomic status (for men and women) and parental substance abuse (for men) have direct effects on loneliness at older ages., Implications: The results indicate the significance of the childhood environment for understanding loneliness in later life. Future research should examine possible pathways not currently measured that may be responsible for the association of early environment and later-life loneliness and explore the links between childhood and other measures of well-being in old age. The relationship of childhood socioeconomic deprivation and parental substance abuse with adult well-being should be an important consideration in social policy planning., (© The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: People with motor neurone disease access healthcare services from disease onset to end-of-life care, but there has been paucity of research on how people with motor neurone disease understand and use healthcare services., Aim: To identify key psycho-social processes that underpin how people with motor neurone disease engage with healthcare services., Design: Grounded theory approach comprising in-depth qualitative interviews was used in this study. Data were collected and analysed using open, axial and selective coding procedures., Setting/participants: A total of 34 people with motor neurone disease were recruited from the Irish motor neurone disease population-based register., Results: We identified that control, reassurance, resignation and trust are key variables that shape how people with motor neurone disease engage with healthcare services. Participants exerted control in care to cope with loss. Most participants were resigned to death and sought reassurances from healthcare professionals about end-of-life care. Participants questioned the benefit of life-sustaining interventions in motor neurone disease and few of them associated life-sustaining interventions with palliative care. Participants trusted healthcare professionals who reassured them about their care and who were attuned to how they were coming to terms with loss., Conclusion: This study identified new and important aspects of control, trust and reassurance which shed light on how people with motor neurone disease engage with healthcare professionals and approach end-of-life care. People with motor neurone disease exert control in care and meaningful relationships with healthcare professionals are important to them. Some people with motor neurone disease prefer to die without life-sustaining interventions.

People with amyotrophic lateral sclerosis (ALS) engage with a broad range of health care services from symptom onset to end-of-life care. We undertook a grounded theory study to identify processes that underpin how and why people with ALS engage with health care services. Using theoretical sampling procedures, we sampled 34 people from the Irish ALS population-based register during September 2011 to August 2012. We conducted in-depth interviews with participants about their experiences of health care services. Our study yielded new insights into how people with ALS engage with services and adapt to loss. People with ALS live with insurmountable loss and never regain what they have already lost. Loss for people with ALS is multidimensional and includes loss of control. The experience of loss of control prompts people with ALS to search for control over health care services but exerting control in health care services can also include rendering control to service providers. People with ALS negotiate loss by exerting control over and rendering control to health care services. Our findings are important for future research that is attuned to how people with terminal illness exert control in health care services and make decisions about care in the context of mounting loss., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Researchers have explored perceptions of health care services among people with amyotrophic lateral sclerosis (ALS), but little is known about how and why people with ALS engage with services. We undertook a grounded theory study to identify key psychosocial processes that underpin how and why people with ALS engage with health care services. We conducted in-depth interviews with 34 participants sampled from the Irish ALS population-based register. We found that age and life stage shaped participants' decision making about care. Participants in later life were more accepting of ALS and of death than young and middle-aged participants. Family was the primary context to how participants engaged with services, and their decisions about care were shaped by parenthood at different life stages. Health care professionals need to be attuned to the impact of life-course trajectories and family relations on the decisions people with ALS make about their care.

The relationship between class and intergenerational solidarities in the public and private spheres calls for further conceptual and theoretical development. This article discusses the findings from the first wave of a qualitative longitudinal study entitled Changing Generations , conducted in Ireland in 2011-2012, comprising 100 in-depth interviews with men and women across the age and socioeconomic spectrums. Constructivist grounded theory analysis of the data gives rise to the following postulates: (1) intergenerational solidarity at the family level is strongly contoured by socioeconomic status (SES); (2) intergenerational solidarity evolves as family generations observe each others' practices and adjust their expectations accordingly; (3) intergenerational solidarity within families is also shaped by the public sphere (the welfare state) that generates varying expectations and levels of solidarity regarding State supports for different age groups, again largely dependent on SES; (4) the liberal welfare state context, especially at a time of economic crisis, enhances the significance of intergenerational solidarity within families. We conclude by calling for research that is attuned to age/generation, gender and class, and how these operate across the family and societal levels.

Objective: This article contributes to the literature on depression and the life course by examining the impact of both early and later life circumstances on depressive symptoms among men and women aged 65 and over in Ireland., Method: Data are from the first wave of The Irish Longitudinal Study on Ageing, a nationally representative sample of 8504 community-dwelling adults aged 50 years and older. About 3507 respondents aged 65 years and over were included in the analysis. Multinomial logistic regression was used to examine the childhood and early adult life circumstances associated with marital status. A series of nested models were estimated to evaluate which childhood and adulthood circumstances are associated with depressive symptoms. Models were estimated separately for men and women., Results: Ill health in childhood and in later life has a strong and direct effect on depression in later life for both men and women. Other early stressors are mediated by later circumstances. Marital status is a significant independent predictor of depression in later life. Later life circumstances mediate between some marital statuses and depressive symptoms. When later life circumstances are included, widowhood and, for men, divorce, are directly associated with depression, but singlehood is not. Income in later life is strongly associated with depressive symptoms for women., Conclusion: Both early and later life circumstances affect late-life depressive symptoms. Our findings indicate that previous studies which did not consider both may have underestimated or overestimated the effect of marital status, education, current health and education on depressive symptoms.

People with amyotrophic lateral sclerosis (ALS) frequently express dissatisfaction with services. Patient satisfaction with services in ALS care is not always measured and service user perspectives are not usually included when evaluating the outcomes of care. There is a lack of consensus on what constitutes satisfaction for patients in ALS care. To date, health care professionals' conceptualization of outcomes in ALS care has excluded measures of patient satisfaction with services. Exploring the context of the ALS service user experience of care will identify a conceptual framework that will include the domains of satisfaction with care for patients with ALS. An instrument that draws on the ALS patient perspective of services, developed on the basis of qualitative investigation, should be used to measure satisfaction with services.