WEBVTT

1
00:00:00.001 --> 00:00:12.799
Okay. Hello. Everyone. Welcome to our session today on community influences, on lifestyle and health. My name is Sophie Lewis, and I'll be chairing the session for today.

2
00:00:12.870 --> 00:00:22.180
And first like to acknowledge the traditional owners of the lands on which we're meeting today and the lands of the war. Andrew, people of the Cullen nation.

3
00:00:22.290 --> 00:00:41.420
I'd like to acknowledge the the past and present elders, and how they've been contributing to to caring for country and community for many malalia. And I'd also like to thank all first nations delegates who are here with us today and contributing to knowledge in this discipline.

4
00:00:41.660 --> 00:00:57.479
so we have 5 speakers today. We've got a a few in the room here, and we've got a couple of speakers online as well. So what we're thinking is that we'll each speaker will present, and then we'll save our questions and comments for the end of the session.

5
00:00:57.600 --> 00:01:09.259
and I'll give you a a 5 min and a one-minute warning as well. when you're presenting. I'd also like to welcome our session organizers who are joining us online today. 250.

6
00:01:11.240 --> 00:01:13.740
And Angela, you there

7
00:01:15.040 --> 00:01:16.199
Ángel Zapata: I have.

8
00:01:16.450 --> 00:01:26.950
Ángel Zapata: Hello, everyone. Thank you for. Thank you for all people attending morning, afternoon, or evening, spending on the way on you. You are in the world.

9
00:01:26.970 --> 00:01:29.430
Ángel Zapata: for example, in Spain we are in.

10
00:01:29.560 --> 00:01:39.630
Ángel Zapata: It's 2 Am. So I hope that the long end of the of the system will not be UN crazy by the or sleeping, or or my lack of. I sleep sorry for that.

11
00:01:39.950 --> 00:01:56.549
Ángel Zapata: and it first of all, I I would like to thanks a for your attendance to your session between Community rich and and

12
00:01:56.680 --> 00:02:01.550
Ángel Zapata: and I. I do like also to to to.

13
00:02:02.140 --> 00:02:07.870
Ángel Zapata: We thank you for for a from the University of Sydney.

14
00:02:08.050 --> 00:02:11.360
Ángel Zapata: He is presenting the this in

15
00:02:11.390 --> 00:02:29.519
Ángel Zapata: and for us. We this is all. So we we can, To say that they, as you know, help. And this population is solution depends on complex integration between the characteristics of individuals and the place where they spend the most of their life.

16
00:02:29.960 --> 00:02:40.399
Ángel Zapata: One of the five-year-olds to supernatural, and you would have to call Dimension. That's already being investigate. They symbolic cool to that division of place as being places forward.

17
00:02:40.560 --> 00:02:45.680
Ángel Zapata: So, therefore, this system is to open a space for the presentation of papers

18
00:02:45.740 --> 00:02:57.600
Ángel Zapata: on the influences of community and the revolution of lifestyles of hand, with the special interest in the same symbolic cool to a dimension of local communities, and they compile different studies.

19
00:02:57.790 --> 00:03:07.130
Ángel Zapata: So we we are sure to have a very interesting, you know, a on the word being done on the influence of communities on health related to this time.

20
00:03:07.220 --> 00:03:18.649
Ángel Zapata: I think the for a presented a might be introduced in in person by by Sophie, because I think he's in the

21
00:03:18.700 --> 00:03:20.000
Ángel Zapata: thank you very much.

22
00:03:20.880 --> 00:03:26.929
Thank you. So I'd like to introduce Dr. Rivera Navarro, who's going to be presenting first

23
00:03:34.970 --> 00:03:36.090
hold on.

24
00:03:38.200 --> 00:03:40.809
okay, okay.

25
00:03:51.190 --> 00:03:55.050
good morning. Thank you for coming.

26
00:03:55.180 --> 00:04:16.070
and this presentation is called for the environmental inequalities, the terminals and food consumption. In Spain they all 4, or in from Paolo Lavida University, in Spain, in, Salamanca and

27
00:04:16.950 --> 00:04:37.950
and in Spain. The prevalence of a disease related to a healthy eating habits has increased at the same time that the traditional Mediterranean diet is being replaced by other data patents, characteristics by a greater consumption of processed products

28
00:04:37.950 --> 00:04:48.489
due in the last part to a change in attitudes toward towards food. In addition it in thehali, or follows a clear societal grant.

29
00:04:48.500 --> 00:05:00.439
From a general point of view, John people a living in a urban environments have a poorer quality diet than adults or other people

30
00:05:01.740 --> 00:05:27.040
in other instance, are more disposed than other groups to advertising and marketing strategies for food and food establishments that lead to the consumption of unhealthy folks products. The vulnerability increase in the lower social strata. Social inequalities in food are also present in the school environment.

31
00:05:27.150 --> 00:05:34.670
In ever since. Gender difference in diet are more noticeable than in other age groups.

32
00:05:34.930 --> 00:05:44.630
We consider that the deficiencies and needs of adolescents in relations to healthy and habits are that it is in a

33
00:05:44.650 --> 00:05:59.329
can javel weigh in the highest school on secondary center to reduce and minimize this deficiencies. Activities in a school such as healthy breakfasts are carried out.

34
00:06:00.690 --> 00:06:12.779
related to a theoretical framework. We use grass muscines, a model theory. In this conceptual framework

35
00:06:12.989 --> 00:06:23.619
we point out the cultural and physical environments, cultural embarrassment refer to country ethnicity and so economic and status.

36
00:06:23.760 --> 00:06:32.739
a physical environment. They refer to community level school environments and perceived physical embedded

37
00:06:33.340 --> 00:07:00.510
in the social environments, which is a fact, or that is so simulating the cultural in physical. A, we point out the influence of the mass media on food is included also are included the unknowns, the lighted to food, internal, internal. Aside by the study as students. The reference group, In it's influenced the economical status of the family is not

38
00:07:00.510 --> 00:07:17.880
and rules. Finally, at a more micro level, we include personnel or individual factors, including behavior such as screen use physical activity in other dimensions, such as habits or refinance, 150

39
00:07:17.950 --> 00:07:23.300
knowledge about healthy or unhealthy things and

40
00:07:23.400 --> 00:07:31.559
barriers. in addition to the model of the determinants of dire by Rasmus, since Ital in a one.

41
00:07:31.600 --> 00:07:52.040
In our theoretical framework we have used also the angular framework. The annual framework is bicycles also in the and the ecological model of from Brainer. In this model the environment is key. Thus 2 types of environments can be distinguished.

42
00:07:52.060 --> 00:08:06.320
a one associated with side micro in macro environments, and another associated with the shape of the environments, physical, economic, political, and social culture

43
00:08:07.330 --> 00:08:18.600
delighted to adjectives. The primary objective is to study the factors that determine the inequality in food consumption. In other instance, in Spain.

44
00:08:18.760 --> 00:08:34.220
and the secondary of all the objectives are to study the fit of your one in Beamat, in the layout of all instance, and to analysis, the Russian seat between physical activity in diet. In other lessons.

45
00:08:34.850 --> 00:08:40.429
the 2 methods the project was a

46
00:08:40.450 --> 00:08:46.260
funded by the Spanish Ministry of Science in Northern Ireland, in 2,000

47
00:08:46.350 --> 00:08:54.129
21 in his being Conduitis in Madrid, in Bilbao, through 2,024.

48
00:08:54.330 --> 00:09:02.349
We choose these 2 cities because they imply 2 different dynamics

49
00:09:02.470 --> 00:09:21.129
go to represent a large European city and build well a medium series sites city. These cities were known by the A research group, and the members of the project had conduced qualitative researches related to health inequality.

50
00:09:21.150 --> 00:09:36.890
Madrid's A municipality with a population of just over 3 million inhabitants is organicized into 21 districts. In 1,031 neighborhoods.

51
00:09:36.910 --> 00:09:48.600
Bilbao has a 35,000 people, and organicized into 8 districts in 40 neighborhoods.

52
00:09:48.770 --> 00:09:58.999
says 6 secondary schools. From its only were selected 2 and 2 neighborhoods with a low socioeconomic level to a neighborhood.

53
00:09:59.070 --> 00:10:05.349
we say, maybe on such economic level and to a neighborhood with a high socioeconomic level.

54
00:10:05.400 --> 00:10:17.740
the qualitative case study a methods use hearing follow the interpretative cost of the it's parallel to seek out multiplayer pestive.

55
00:10:18.140 --> 00:10:25.710
A delighted 2 simple metals. the champagne number, which was followed several steps.

56
00:10:25.890 --> 00:10:45.500
a classification of the neighborhoods in malari. In Bilbao, according to a socioeconomic status we use indicator related to unemployment temporary and part-time employment, educational level foreign bone dressing in single heated Families.

57
00:10:45.780 --> 00:10:48.720
a horse-called income.

58
00:10:48.940 --> 00:10:54.719
This data data and we are available

59
00:10:55.180 --> 00:11:02.100
on the west side of the local government of Mali in Bilbao, the last 3 indicators

60
00:11:02.250 --> 00:11:08.110
or marijuana juice blues, David. It's a personal in cone. And David it's family income.

61
00:11:08.140 --> 00:11:14.859
The data Bilbao were processing from local governments of of Bilba

62
00:11:15.180 --> 00:11:16.720
and

63
00:11:16.990 --> 00:11:40.219
for building day. In this we are standardized. It's indicator using Seta, a scores of 10 in a score for Aids neighborhood nets. We're stratified. They never in to the first start till included neighborhoods with a high socioeconomic status.

64
00:11:40.220 --> 00:11:54.689
The second turtle includes neighborhood with a million socioeconomic status in the third, until includes neighborhood, with low socio-economic status. This type of a standardizing has been used in other publications.

65
00:11:54.800 --> 00:12:09.960
first we pressed it 30 neighborhoods according to their socioeconomic, because status in Mali. and it's a imbalance among the 30 neighborhood we select the cemetery

66
00:12:10.070 --> 00:12:25.300
5. We are finally selective for the quality that if a study, one for low socioeconomic status 2. For

67
00:12:25.300 --> 00:12:41.649
we are finally selected for this case. Study to for low socio-economical status to 4 million s. As economically we start to saying one for high socioeconomic status we first selected at least one.

68
00:12:41.730 --> 00:12:51.459
A 2 secondary school is as schools for a such economic. I started to be

69
00:12:53.180 --> 00:12:54.160
is.

70
00:12:54.890 --> 00:13:00.579
and a total of a first. First, we conduct it

71
00:13:00.690 --> 00:13:18.880
to have a semi-structor interviews with the school principals. They were considered. It came 4 months between April and October 2,022, we integrate them to have a comprehensive bicycle of the school.

72
00:13:18.950 --> 00:13:30.250
The neighborhood and dynamics related to the terribly harvest among adolescents fay work started in April 2,022 and finish. Presently we have

73
00:13:30.330 --> 00:13:53.639
conducted 36 senior structures, interviews in 24 focus group, the focus group companies between 5 in 8 participants. There are taking place in the chosen schools the interviews outlasting between 30 and 45 min in focus group between 60 and 19 min

74
00:13:53.700 --> 00:14:15.690
the interviews in Focus group has coordinated by by members of the research projects the institution as as follows, thank you. A total of 12 semester interviews have been carried out to secondary schools. Students between 15 in 18 G assaults and Maria in in Milwaukee

75
00:14:16.590 --> 00:14:40.969
12 semi stress towards interview have been carried out to parents half, and it's CD, 12, Interviews have been carried out to gain 4 months. And she's focus group have become the with this students in 12 focus group with features in this, with with panel half in it, is city in this presentation. Finally, we will only analyze the results

76
00:14:40.970 --> 00:14:51.600
from the 2,017 interviews in Cis-fokov with adolescence, we will use constructive. It's groundy theory to analysis the data

77
00:14:52.910 --> 00:15:19.560
and related to results in what analysis we distinct 4 types of another list. Since diet factors, individuals, social community, and microsystems related to individual fast, we find out gender factors, gender stereotypes, influenced, fought choice female adolescence, whereas societies with a biddles in strange inmates.

78
00:15:19.560 --> 00:15:40.119
sas female adults, and usual, who are more concerned about bully width and healthy eating in mail out of instance, per se. Heating as an a masculine behavior means we are more involved in physical activities. Fish is physical activity related to

79
00:15:40.220 --> 00:16:08.810
a individual motivations. maintaining good societal relation seat in achieving such as we are. Motivational factor for her seating and light of time, like of time, was also a barrier to her savings which limited parents ability to prepare healthy food, and was associated with purchasing processed food like of time, was also associated with skipping

80
00:16:09.160 --> 00:16:20.320
a related to social. factors a. We point out pilot and influence balancing tables, paygivers. Where are one of the biggest's influence on other lessons?

81
00:16:20.360 --> 00:16:27.449
eating behavior? There are 2 types of influence, positive influence, and negative influence.

82
00:16:27.530 --> 00:16:49.350
A. We pronounce it also influenced of pay groups in addition to the family, or the another social group emerit as being influenced influential adults and pay groups. Assad's place, mates and friends, pig groups were considered at barrel because they put pressure on developing and healthy food heights.

83
00:16:50.150 --> 00:17:03.760
A, we point out the commonly factors, Included a school for environments, a school project, a significant role in nutrition, education and school activities might promote the naval

84
00:17:03.770 --> 00:17:16.080
physical activity, monologue, and but the school countries normally promote unhealthy foods. Neighborhood environments are healthy food. As to why are festivals to our lessons in your socioeconomic

85
00:17:16.240 --> 00:17:22.320
areas, especially around a schools in lots of economical neighborhoods. A.

86
00:17:22.880 --> 00:17:43.119
In the last, lastly, A, we point out micro system, factors included mass media mass media quoting fully at the perception of the ideal body appearance screen time. The screen time was associated with what's naturally outcomes in lower physical activity levels Internet and Internet use the Internet.

87
00:17:43.210 --> 00:17:47.240
a increasingly influenced other less than 18. We have

88
00:17:47.660 --> 00:18:13.879
discretion. One. Several qualitative studies have been carried out to a study. Okay, the relationship between now less than population and but now half provide a systematically signed to select the network in a school for type of levels of factor. What identify individual social community and micro system factors. Gender was phone and to be individual factored. And in fluid, other lessons, eating a habits.

89
00:18:14.060 --> 00:18:31.740
discretion to. In social factors the influences of parent. What? Usually positive because they act as role models control other less than for choice employees routing with family meals, however, policy influence could be a barrier.

90
00:18:31.740 --> 00:18:48.590
If forms a parental indulgence we are giving in. They made food, choose diet by our less than taste. Moreover, socioeconomic inequalities are very present. Make a low socioeconomic,

91
00:18:48.640 --> 00:18:53.970
Eating? And finally conclusions.

92
00:18:54.060 --> 00:19:07.019
The methods in the sign of this qualitative study comes here as a reference and guide to the services who decide to address Notician. In other instance, considering economic inequality.

93
00:19:07.210 --> 00:19:22.699
food policies in secondary schools or or high school, that we are studied, emphasized, healthy, and traditions. However, the daily full-related practice in each of the families, in the greater or lesser they are 2

94
00:19:22.960 --> 00:19:38.620
of physical activity means that the desired results are not all chive, Especially in areas of low socioeconomic, a statute? I will have like it to read what, but I have no time.

95
00:19:39.380 --> 00:19:41.090
Thank you for your attention.

96
00:19:46.730 --> 00:19:52.580
Thank you so much for that really interesting presentation. As you mentioned, we're going to hold the questions to the end of the session.

97
00:19:52.800 --> 00:20:04.120
 so our next presenter is presenting online. So Dr. Renard Ronders, do you want to share your screen?

98
00:20:06.590 --> 00:20:08.199
Camila Ronderos Bernal: Yes, thank you.

99
00:20:11.910 --> 00:20:14.560
and I will let you know, when you 5 min left.

100
00:20:15.840 --> 00:20:16.780
Camila Ronderos Bernal: Okay.

101
00:20:20.670 --> 00:20:23.360
can you go firmly when you are seeing my screen?

102
00:20:24.080 --> 00:20:35.580
Camila Ronderos Bernal: Okay, cool. Thank you. Well, Hi, everyone. Camilla Ronaldo, I'm from Columbia, and I'm presenting a project we have

103
00:20:35.710 --> 00:20:49.340
Camila Ronderos Bernal: in Wahida, which is at the northeast of of our country. It's a desert area. It's a very isolated area and so we developed a health project based on community participation.

104
00:20:49.390 --> 00:20:55.820
Camila Ronderos Bernal: And you know, based on what they really have and empowering the local leaders.

105
00:20:55.910 --> 00:20:57.540
Camila Ronderos Bernal: And

106
00:20:58.690 --> 00:21:01.380
so this is what we're going to present. So how we started

107
00:21:01.530 --> 00:21:05.199
Camila Ronderos Bernal:  and it's okay.

108
00:21:05.670 --> 00:21:14.160
Camila Ronderos Bernal: So we we started working around the project that could work for rural, isolated areas, especially in countries like ours.

109
00:21:14.230 --> 00:21:31.330
Camila Ronderos Bernal: that the rural, isolated areas are really rural, isolated. And so we needed to understand that there was a limitation of resources, and it was very precarious, and we needed to make sure that we had something that could work with what they had. The usual analysis of those areas that it's done

110
00:21:31.330 --> 00:21:44.529
Camila Ronderos Bernal: mit Ctl, and it's in terms of what they do have, what they don't have. But we wanted to understand what they do they did have, and how could they work with what they had? And so we started working on identifying their own health assets or resources? 250,

111
00:21:44.650 --> 00:21:57.030
Camila Ronderos Bernal: working with local leaders that could help others take care of themselves. understanding early alerts around health care and empowering the community so that they understood that they could change the reality.

112
00:21:58.280 --> 00:22:22.509
Camila Ronderos Bernal: So our methodology is an innovation process where we focus on the theoretical theory of self-dogenesis which focuses on the positive aspect of health and understanding that health is not just the absence of disease, but it's actually the concept of having well-being and being able to grow your well-being with the issue, with the things that you do have around you.

113
00:22:22.850 --> 00:22:32.339
Camila Ronderos Bernal: And so we based on that, you starting thing, the resources that the community have, and you strengthen that community itself so that they can achieve better outcomes.

114
00:22:33.310 --> 00:22:50.040
Camila Ronderos Bernal: And we wanted, therefore, to achieve those that better health and well-being by improving the local leadership around health issues and working with the other institutions that were on the ground, improving the coordination of the institutions. We found often that in rural settings

115
00:22:50.130 --> 00:22:59.479
Camila Ronderos Bernal: because of the isolation it was pinpoint interventions, instead of connecting the different interventions, instead of putting all of the pieces of the puzzle together.

116
00:22:59.500 --> 00:23:03.250
and we wanted to support that process of connecting the pieces of the possible.

117
00:23:09.670 --> 00:23:30.910
Camila Ronderos Bernal: So this is the communities that we work with. This is the different surveys that we do every year. So we have the 2020, 2021 and 2022. It was a real struggle, because we started in 2022 in 2,020, the process of training the communities. And of course, that's when Covid hit, and in Columbia Covid closed down the country.

118
00:23:31.240 --> 00:23:43.109
Camila Ronderos Bernal: and so there was no flying, no leaving your house, nothing. And we were just starting to work with a community that is totally isolated. They don't necessarily have access to Internet 24, 7, like most of. But then

119
00:23:43.300 --> 00:24:04.479
Camila Ronderos Bernal: you don't necessarily have cell phone signal there. And so getting our our connection and training of the teams that we wanted to work with the local leaders was quite a struggle. We work with 2 main communities, and and Jordi Hadoo One of them has 107 people, on the other hand, has 262 when we started.

120
00:24:04.510 --> 00:24:12.160
This is the border with Venezuela in the northern tip of Columbia. And so you can see there that we had a.

121
00:24:12.180 --> 00:24:19.730
Camila Ronderos Bernal: we could identify that 84%, for example, were Colombian, and then a 16% with Venezuela when we started.

122
00:24:19.850 --> 00:24:29.350
Camila Ronderos Bernal: and it's cool and Yamala. And then in Jordi had the the ratio was different. How many were female? How many were male. And we've done this every year since we started.

123
00:24:29.910 --> 00:24:46.599
Camila Ronderos Bernal: This is the name of the training that we started doing so. Aquipa. Yuba panel is the name in the indigenous language of this community, because the community we work with is a Yu community, which is an indigenous traditional community in the northern part of Columbia.

124
00:24:46.670 --> 00:25:02.570
Camila Ronderos Bernal: And so we, everything we've done has been adapted to the reality and the conceptions that they have of health and well-being. And so the name of the training process that we had with them was also done, based on their reality and their consequence.

125
00:25:08.630 --> 00:25:23.330
Camila Ronderos Bernal: Sorry my computer is acting up today. There we go. So our mother, our healthy rural communities model is based on in a first and exploratory face, where we understand what the territory is like, and we work with the communities to understand who they are.

126
00:25:23.360 --> 00:25:31.609
Camila Ronderos Bernal: Then we train and map the health assets or resources that they have in the community, and that we will vary depending on the community where we are.

127
00:25:31.780 --> 00:25:39.390
Camila Ronderos Bernal: Then we activate those health assets. So we connect the community to those free resources, because sometimes people are not even aware that they have them here.

128
00:25:39.410 --> 00:25:47.450
Camila Ronderos Bernal: And in this community. That was one of the things we found because of their indigenous background. They had used medicinal plants many, many years.

129
00:25:47.480 --> 00:26:04.499
Camila Ronderos Bernal: and but the younger population or the younger generation did not want to have to do with it. So maybe they didn't have Internet. But they were still stuck to a phone. And so we started working with them so that we could connect them again to those backgrounds and to those ancestral knowledge that their communities had.

130
00:26:04.530 --> 00:26:26.099
Camila Ronderos Bernal: And we started doing that. And then after that, we want to make sure that their community as a whole takes over the model because we don't want them to depend on us. We want us to be able to. I work for an Ngo that does this with different areas of the country. And we wanted to make sure that it meant eventually, when we did have to pull out of the community those results, and that training could stay there.

131
00:26:26.160 --> 00:26:37.020
Camila Ronderos Bernal: And so right now, we're in that sustainability phase, and we should be pulling out in the next couple of months, but we now know that this will remained because we managed to make enough

132
00:26:37.770 --> 00:26:54.049
Camila Ronderos Bernal: agreements with the community, but the leaders have done enough agreements with the other institutions on the ground, so that this will remain well. We have achieved with the work that we have done, starting in 2,020, and, as I said, we started in a very difficult moment with a covid

133
00:26:54.180 --> 00:27:04.929
Camila Ronderos Bernal: is that in terms of respiratory diseases, which was one of the major issues we had in those areas. Both communities were reduced by 23%.

134
00:27:05.160 --> 00:27:28.210
Camila Ronderos Bernal: In terms of diarrhea diseases, which was the thing that killed the most children. And this is an area of the country that is normally on the news, not for the right ways. It's usually in the news, because a lot of children die because they have diarrheaal diseases, and they the nearest hospital for some people can be up to 8 h away walking because there are no roads in Syria of the country.

135
00:27:28.360 --> 00:27:57.259
Camila Ronderos Bernal: and so to get to the nearest hospital, you sometimes have to walk. Wait 8 h if you don't know when it's time to start walking, because your child is at risk, then that child might not make it. And so with this intervention, we actually manage to get the community to understand how to deal when a diarrhea starts, because that can happen to anyone, even in an urban setting, but that the difference is that the Earthland setting you would have access to information that you wouldn't have in the rural settings.

136
00:27:57.360 --> 00:28:06.060
Camila Ronderos Bernal: and when you have no signal and nothing Close to you. And so what we started doing is with those earlier lerge training that we did with the

137
00:28:06.410 --> 00:28:20.840
Camila Ronderos Bernal: health managers that we call the well-being managers. They would be able to understand and sort of talk you through, and then have that early knowledge of knowing when to start walking towards the closest hospital, or when to alert the hospital

138
00:28:21.350 --> 00:28:38.489
Camila Ronderos Bernal: so that could bring someone that could support you, and so that allowed us to reduce dioral diseases by 23. But also when we talk to the hospital. We now know that our communities are not coming into the hospital because they're not getting sick, and when they do come to the hospital. They're coming at the right time.

139
00:28:38.940 --> 00:28:52.449
Camila Ronderos Bernal: 66% of both communities are starting to understand the community leaders. Well, the well-being leaders that we trained as something that is very important for them, because they are allowing them to take better. Take care of themselves.

140
00:28:52.540 --> 00:29:11.649
Camila Ronderos Bernal: 92% of those families. Now, for example, use a different kind of stove that allows them to cook better because one of the reasons why we identify they had so many respiratory diseases is because they cooked in fire. It would fire, and they would cook within the house. So they were, you know.

141
00:29:11.740 --> 00:29:38.820
Camila Ronderos Bernal: having all of that smoke go directly into the lungs, and it was in a closed space. So we worked with them around how to do that better, and then in terms of washing kitchen utensils, and how to use water wisely. Why, sir, this is a desert, remember. So this allowed us also to work with them in terms of how to use water wise here, and then they would. This off, of course, impacted also the diarrhea.

142
00:29:40.110 --> 00:29:53.190
Camila Ronderos Bernal: and so we started talking with them about assets in health. But then they also asked us to start talking about mental health and gender equality, which for us was a little bit of a surprise, because this is a very

143
00:29:53.540 --> 00:30:06.240
Camila Ronderos Bernal: macho society in many ways, and we were surprised that they wanted to talk about this, and they also felt that around mental health they had issues that they want to talk about. So we sat down with them and understood what they would want to

144
00:30:06.640 --> 00:30:10.840
Camila Ronderos Bernal: talk about, so that we could support them in that process.

145
00:30:14.040 --> 00:30:38.169
Camila Ronderos Bernal: And so we started talking, as I said, about mental health. But we didn't do it just around, you know, depression or things like that. But it was about acknowledging your own feelings and being able to talk about. You know what's going on? What are the the issues in your life that you're facing. And so by 2022, more than 50% of the population knew how to recognize their emotions and how to start talking about.

146
00:30:39.250 --> 00:30:59.199
Camila Ronderos Bernal: One of the most relevant things we did is that we we rescued some of the knowledge of the hats that we knew community knowledge, and we created about the megroom with their original plants, so that the communities could identify it and could start using them, but also planting some of them in their own communities

147
00:30:59.200 --> 00:31:10.639
Camila Ronderos Bernal: mit Ctl. And and so by 2,022, we have increased the population that is aware of the plants that they have and how they can use them to better take care of themselves. 3.

148
00:31:10.930 --> 00:31:25.510
The well-being leaders that we trained are doing work around their own community and taking care of their community, and then And so all of them now have, you know, been acknowledged by the community as key players. There.

149
00:31:25.590 --> 00:31:46.180
Camila Ronderos Bernal: hospital is very far away, as I mentioned. So this becomes sort of that primary care, doctor, that's there, even though they're not doctors. But they can take care of them, and they can support them in understanding those early adults, but also in general terms, how to do preventive medicine, which for us was the basis of everything that we wanted to there

150
00:31:47.050 --> 00:31:59.439
Camila Ronderos Bernal: and then also, we started talking because they asked us to around gender equality. And so by 2,022, more than 50% of the men were performing different tasks.

151
00:31:59.440 --> 00:32:17.910
Camila Ronderos Bernal: and when you go and visit them you see how that has truly changed, and how the men are getting involved, and I'm sorry with all of the men in the auditorium. But in this community this is a very different type of community. And so we were very happy to see that men were starting to get involved in the processes, and women that have 10 children.

152
00:32:18.110 --> 00:32:34.170
Camila Ronderos Bernal: that are dealing with them by themselves, and men used to be usually in their hammock. Just drinking chilin, to which is a traditional drink from the when you community. And this started a conversation about equality that has truly transparent that conversation.

153
00:32:34.240 --> 00:32:48.350
Camila Ronderos Bernal: and so overall this. The process of involving the well-being leaders has not only improved health and well-being outcomes. He has created a closer knit community that understands reporting importance of supporting themselves.

154
00:32:48.670 --> 00:33:05.150
Camila Ronderos Bernal: It has also impacted mental wellbeing, which, being so isolated as they are currently, and having so many Sdoh tacking them. This has been a great issue for them, and they do feel healthier and with better. Well, being, currently.

155
00:33:05.180 --> 00:33:18.200
Camila Ronderos Bernal: we have started implementing this project in at 2 other communities in the same area. And we're also implementing into other areas of the country where we hope to have similar resources.

156
00:33:18.540 --> 00:33:19.960
Camila Ronderos Bernal: Thank you very much.

157
00:33:25.590 --> 00:33:32.209
Thank you so much, Camilla, and I think everyone can appreciate the struggles of starting projects in the middle of covert.

158
00:33:32.550 --> 00:33:39.460
So now I'd like to invite Dr. Fujitami up to the stage to present

159
00:34:10.390 --> 00:34:11.270
Lisa.

160
00:34:12.750 --> 00:34:32.050
Good morning. My name is Dalaki Huttani in this. In in this case, study. I intend to invest with the talent activities of people affect By World War 2 and a lot of their land to the Us. Military based cardinal in Okinawa, Japan.

161
00:34:32.720 --> 00:34:34.240
What they study.

162
00:34:35.560 --> 00:34:36.260
isn't it?

163
00:34:39.340 --> 00:34:40.380
100?

164
00:34:46.800 --> 00:34:47.510
Okay?

165
00:34:48.770 --> 00:34:57.360
On this study field work was conducted to examine how the identified activities help maintain individuals. Vitality.

166
00:34:58.560 --> 00:35:27.480
What do you take a look at this, this outline fast? Are you to briefly a describe of canal history, and also presents a background of this study. Then I will characterize the current activities of the world if we lost a long land to us. Days following this initial presentation we will have a little discussion referring to that, these analysis of a definition of community, I will concur.

167
00:35:29.170 --> 00:35:37.359
Okinawa consists of the southern Western islands of Japan, near Taiwan, China, and the Korea.

168
00:35:39.310 --> 00:35:47.249
In the battle of Okinaw, in 1,945, about 200,000 people died, including American soldiers.

169
00:35:47.540 --> 00:35:52.740
The United States went on to occupy Okinawa until 1972.

170
00:35:53.570 --> 00:36:04.400
Even after this date many you, as a military, has remained on the island form an essential base for us. Population in the Far East.

171
00:36:05.010 --> 00:36:06.330
and

172
00:36:06.740 --> 00:36:13.449
the Kadenaya base is located in the part of the main island of Okinawa.

173
00:36:14.270 --> 00:36:23.069
This place was originally farming areas. but the Japanese army occupied it during a World War 2.

174
00:36:23.810 --> 00:36:29.900
Since 1,945, it has been used by the United States as an air field.

175
00:36:31.420 --> 00:36:32.960
After the war

176
00:36:35.250 --> 00:36:46.189
those who lived in the area of the year field were scattered around the base. and the formed organization on the former village

177
00:36:47.280 --> 00:36:51.480
in Okinawa such organizations are called to Yuki.

178
00:36:51.750 --> 00:36:55.049
We more than 100 study organizations

179
00:36:55.240 --> 00:37:00.360
due to the basis can be confirmed. You can. Now, now.

180
00:37:01.880 --> 00:37:05.350
during my field work, I forecast

181
00:37:05.470 --> 00:37:08.750
starting organizations. In particular.

182
00:37:09.200 --> 00:37:16.149
they already originated in the those in in that those they go like this to

183
00:37:16.560 --> 00:37:22.300
southeast of Kalamaria Base. The saddish the party is of this area.

184
00:37:23.000 --> 00:37:38.620
The membership of the organizations range from about 100 to 300 individuals. Even today. 80 years later, they still gathered and deepened their friendship similar time each year.

185
00:37:39.140 --> 00:37:43.300
But the activities are carried out by these groups.

186
00:37:45.910 --> 00:37:56.340
Several annual events include the New Year the ceremony are meeting to show respect for the aged and the picnic, etc.

187
00:37:57.510 --> 00:38:14.060
At these meetings they confirmed their memories. such as those of their former settlement, war, and the postal war period. These groups hopes to pass on their memory to the Atlantic and the Grand or Chilo. The

188
00:38:14.370 --> 00:38:17.430
by exchanging memories. In this way

189
00:38:17.560 --> 00:38:21.830
the relationship forms the former community are maintained.

190
00:38:22.490 --> 00:38:29.930
I discovered several notable activities as well. I would like to describe the following 3 in particular.

191
00:38:30.490 --> 00:38:35.149
First, they have created the books about their former communities.

192
00:38:36.010 --> 00:38:45.219
This contains history, maps, and sketches of village, as well as their rules of association, and the list of their members.

193
00:38:45.560 --> 00:38:50.669
5 of the organizations that I absorbed produce the books.

194
00:38:51.710 --> 00:39:00.660
These, of course, are not made to be solved, but to be distributed to among the bands and fix their memories.

195
00:39:01.670 --> 00:39:02.630
Second.

196
00:39:03.320 --> 00:39:15.770
some have built the Diolana. 2 organizations had a three-dimensional models made over their former settlement. They outsourced the creation of this.

197
00:39:16.070 --> 00:39:20.820
but their content had been developed by exchanging ideas

198
00:39:21.020 --> 00:39:26.469
and hearing from the more elderly members who had to live in their abilities.

199
00:39:27.570 --> 00:39:28.840
Sad

200
00:39:28.860 --> 00:39:37.300
they found the legislative ceremony in Okinawa. Each older village had its own right for ancestor. Was it

201
00:39:37.530 --> 00:39:44.799
the association of they are shooting we as a Pahoma literature? Once a year

202
00:39:46.000 --> 00:39:56.010
some organizations have moved to their students outside the Canada air base, and the rights are still held around them.

203
00:39:58.070 --> 00:40:02.380
I want to discuss the case of a classic Korea in more detail.

204
00:40:03.399 --> 00:40:12.699
The over the village of Kolassiki was so submerged in 59, due to the construction of a dam by the U. S. Military

205
00:40:13.000 --> 00:40:18.229
in 1,995. It was a return to the Okinawa Prefecture.

206
00:40:18.240 --> 00:40:31.370
In a corner of this land Glasgow Yukai set up a simple place of wasp and held a rich ritual event once a year landed

207
00:40:32.340 --> 00:40:34.910
the offering. But of that.

208
00:40:36.450 --> 00:40:41.249
as we have seen, such activities require as a social interaction

209
00:40:41.620 --> 00:40:52.900
the actor recall the Seattle memories of the plates, especially for elderly members. Now I would like to discuss these results.

210
00:40:54.689 --> 00:41:07.899
The odor. Italy pointed out, many researchers-defined community using the 3 events of a geographical area, common tides and social interactions

211
00:41:09.189 --> 00:41:14.889
using this game, how can we understand the activities of associations.

212
00:41:16.060 --> 00:41:22.409
Their activities are based on the shared memories of the of the former communities

213
00:41:22.649 --> 00:41:27.679
by example creating historic books, stabilize their identities.

214
00:41:28.580 --> 00:41:32.749
The creation of the Dalai Lama materialides. The memories

215
00:41:33.689 --> 00:41:44.869
in addition, the persistence of literal events confirmed their group's roots as they immediately came, wrote, they construct social good connections

216
00:41:45.680 --> 00:41:59.589
in both activities active social interactions occur. The joint work together maintains and storage. So storage in the ties well is a set area not necessarily

217
00:42:02.070 --> 00:42:10.510
for organizations that can afford it, have their own assembly falls and continue their activities based there.

218
00:42:11.350 --> 00:42:14.960
In this, in these cases the meeting place

219
00:42:15.000 --> 00:42:24.259
functions as a replacement for the lost area. On the other hand, 9 organizations cannot have as somebody falls.

220
00:42:24.720 --> 00:42:30.149
so they rent a space for events and whole activities.

221
00:42:30.690 --> 00:42:36.240
Of course this is not sufficiently functioning. Where? What ought there to be

222
00:42:37.150 --> 00:42:57.909
now? The organizations jointly request a Japanese Government to provide them with a shared a meeting hall. I heard of their dream. If it comes through, they plan to display pictures, books, dialer, and the consumer with those times in the for conducting the activities there.

223
00:42:58.220 --> 00:43:05.579
as we have seen, they are deprived of their land after the war, and cannot use it.

224
00:43:05.620 --> 00:43:18.030
Even now they wish to perform their community activities. The dream is obviously of Sh. Already approved, they will have a substitute for their own

225
00:43:18.170 --> 00:43:23.369
area. I considered that this is not something to be criticized.

226
00:43:26.050 --> 00:43:30.070
Near 80 years have passed since the world's end.

227
00:43:30.120 --> 00:43:45.839
and people who are younger adults are over 100 years old, even their children and generation is aiding, and the memories worry about and the member to worry about the decline of the associations.

228
00:43:46.130 --> 00:43:56.310
However, this example shows how eager people are to maintain their former community's tide through the social interactions.

229
00:43:56.830 --> 00:44:06.679
In addition, this case study also proves, even if the idea is lost, people's social interactions are community ties

230
00:44:06.930 --> 00:44:12.899
based on their memories of the place. we'd support a member's lives.

231
00:44:13.540 --> 00:44:21.689
At the same time, this study clarifies the damage done to the communities due to war and the presence of basis.

232
00:44:22.470 --> 00:44:31.059
The challenge is that this reserves should be compared with other cases, and in Okinawa, Japan, if possible, as a cantor.

233
00:44:31.230 --> 00:44:32.769
Thank you very much.

234
00:44:42.890 --> 00:44:45.610
Thank you very much that was really interesting.

235
00:44:48.220 --> 00:44:51.400
So now I'd like to welcome Dr. Dohan

236
00:44:51.890 --> 00:44:53.390
to prison.

237
00:45:03.280 --> 00:45:12.140
Good morning. My name is Dan Dohan. I'll be presenting on behalf of my colleagues, Alma, Melissa, Stefan, and Corey, who are not here. But back in San Francisco

238
00:45:15.920 --> 00:45:16.710
I'll give

239
00:45:18.510 --> 00:45:30.900
So here's a roadmap and some housekeeping items that I'll be focusing on today. I'll be talking about a project we call Discern Mc. I'll describe that in just a little bit. Give you a bit of theoretical framing for the project.

240
00:45:30.930 --> 00:45:34.500
Spend some time on the findings, and then a few takeaways.

241
00:45:34.550 --> 00:45:41.409
This is supported by the Us. National Institutes of Health, and they're not responsible for anything I'm saying.

242
00:45:41.500 --> 00:45:43.520
but we appreciate their support.

243
00:45:45.420 --> 00:45:55.650
So desert Mc is a project that is short for diverse cultures, ethnography and decision making and dementia implications for medical culture.

244
00:45:55.730 --> 00:46:06.140
This project focuses on experiences of cognitive decline in aging, in diverse communities and cognitive decline raises a lot of sort of very interesting

245
00:46:07.220 --> 00:46:08.520
socio.

246
00:46:10.460 --> 00:46:19.629
medical questions, About like confiding and consulting with family friends, doctors, or specialists, about one's experiences and condition.

247
00:46:19.670 --> 00:46:31.899
dealing with issues of loss of independence, especially around things like driving and finances, and also the necessities of getting more care at home or moving to assisted living, as one's condition declines.

248
00:46:32.260 --> 00:46:43.489
This project really focuses on how culture shapes these decision making processes and tries to problematize the notion of a decision making process itself in many ways.

249
00:46:43.530 --> 00:46:52.099
And we look at aspects specific to cognitive decline, but also at the sort of broader experience of aging. And how this plays out over time.

250
00:46:54.140 --> 00:47:23.879
We're doing a comparative ethnographic study. In 4 communities there are little red dots there on the big map of the United States. They are a little hard to see, but 2 of the areas where we're doing work is in California and the western part of the United States, there are about 5 or 6 communities that we're spending time with in the San Francisco Bay area, which is a large metropolitan area, and then also additional communities in a rural area not far from San Francisco that's called the Central Valley of California. That's the 2 dots on the

251
00:47:24.260 --> 00:47:25.600
left side of the map.

252
00:47:25.690 --> 00:47:48.029
On the right side is a dot representing a rural community in the State of Maine, which is about as far away from California as one can get in the Continental United States. And all of these communities, we're doing traditional, comparative of community-based field work, observing and taking notes, conducting in-depth interviews. And we're doing this over an extended period of time.

253
00:47:48.030 --> 00:48:00.250
like some of the other projects that we've heard about today. We were very much impacted by Covid. This project began in August 2,020, and we really were not able to get into the field. In Maine

254
00:48:00.320 --> 00:48:15.840
folks were a little less nervous about Covid, so I began field work there in about October of 2020, but some of my colleagues in the Bay area were delayed even more so. These are very much preliminary results that we're discussing today and sharing with you in some some of the ideas that are emerging.

255
00:48:18.270 --> 00:48:30.300
So the framework that we're bringing this are the sort of cultural sociology, and in applied health research. I would have to say, cultural sociology is not really the way folks are thinking about decision making processes.

256
00:48:30.350 --> 00:48:35.549
researchers use identity or place in the Us. Especially as a proxy for culture

257
00:48:35.620 --> 00:49:03.209
and a lot of the models that are used to describe the processes around decision making are taken from the behavioral sciences, more psychological orientations, and one of my favorite mentors describes their utility as like a compass on Mars. That is, when you're on Mars. There's no magnetic field, and your compass doesn't do you much good at all. And similarly, the behavioral models sometimes are not particularly helpful when trying to understand the complex decisions that occur in areas such as aging and cognitive decline.

258
00:49:03.210 --> 00:49:17.180
This mentor, Ben, a passic, actually used it to look at cancer screening decisions. But I think the same issues apply that when you have a deeply embedded, meaningful process, a psychological model isn't necessarily the most helpful.

259
00:49:17.300 --> 00:49:32.109
So we're trying to explore the utility of a more sociological model. We're looking at 3 different layers that shape decision, making processes and activities in the different communities and trying to understand similarities and differences across these communities.

260
00:49:32.210 --> 00:49:41.639
First, we are looking at structural position, and this really has to do with the capital resources that are available in these different communities, the rural communities and the urban communities

261
00:49:41.640 --> 00:50:07.549
are somewhat different in that respect. I'll just say that one of the things that we're not doing yet, but hope to begin doing in the next few months is actually to spend more time. The communities with lots of capital resources. Most of the folks that we're working with now are working class or low income. And I think that is definitely a constraint. I've done some preliminary research and higher-income, better resource communities. So I think the model is still applicable. But certainly the the dynamics look quite different.

262
00:50:08.090 --> 00:50:27.670
We're looking at institutional context, which we think of as mostly related to community resources. Some of these developed indigenously within communities through the social processes my colleague was just describing, and some of these more related to governmental or social welfare programs, and how these play out in individual circumstances of different communities.

263
00:50:27.790 --> 00:50:49.519
And then the cultural practices, the publicly meaningful ways of doing things that exist in different communities, and I trained with Anne Swidler, who talks about the role of culture and action. So I tend to very much focus on the public meetings that are shared among people and the people, the way that folks use those resources strategically as they make decisions and live their lives.

264
00:50:51.380 --> 00:50:57.280
So I'm going to dive into some examples here, and I'm not sure I have time for all of them.

265
00:50:57.430 --> 00:50:59.070
We'll get as far as we can.

266
00:50:59.200 --> 00:51:04.839
 what I'm going to do is read. This is an excerpt from an interview.

267
00:51:04.920 --> 00:51:10.740
and as I'm reading you'll see some sort of pieces pop up that you see on the screen.

268
00:51:10.780 --> 00:51:13.759
and as I said, we'll see how far I get with this

269
00:51:16.330 --> 00:51:19.629
timing myself, so I know how many, how fast I have to read.

270
00:51:19.800 --> 00:51:27.150
so this is an example of caring. This is from the main field site. From the interview I conducted with a a woman.

271
00:51:28.160 --> 00:51:37.619
I'd loaned my middle daughter a substantial amount of money she'd gotten into credit card problems. In June of 20, 2,006, I loaned her about $30,000 to pay off her debt.

272
00:51:37.910 --> 00:51:45.979
and she was paying it back to me without interest. So she didn't have that huge interest accumulating the way it does on credit cards, making it a whole you can never get out of.

273
00:51:46.270 --> 00:52:01.350
And I was so afraid of this five-year look back with the Department of Health and Human Services that they would look at that and make me repay that somehow, as nursing home care before he could go on their benefits. Now just take a step back here. This is a woman who's caring for her husband with severe dementia.

274
00:52:01.360 --> 00:52:11.389
The Department of Health and Human Services is the agency which administers the benefits for getting assistance for an individual like that.

275
00:52:12.870 --> 00:52:26.220
I think they would just look back at me giving her $30,000. And yeah, that they would say, you've got to get that. You've got to pay that amount for his nuisance care before we kick in. That is, she would have to pay the $30,000 back before the State would provide assistance.

276
00:52:26.330 --> 00:52:28.229
That's how that 5 year look back.

277
00:52:28.340 --> 00:52:41.360
and I'm not sure now, in retrospect, whether that was a valid thought, and maybe should have investigated at the time. If you read my diaries and see what I went through. And why would anyone do that for $30,000. And again, the context here is, her husband had

278
00:52:41.490 --> 00:52:49.029
incredible incontinence, and she kept him at home for about a year and a half or 2 years, despite these incredible difficulties caring for him.

279
00:52:50.150 --> 00:53:15.309
I don't know but it was my whole life saving. So it was huge to me. So I felt that I needed to get through at least June of 2,011 for that 5 year, and I thought, I'm going to go right to the end of 2,011, so that they never see. I never have to present anything from 2,006, i. E. When she gave the daughter the money. I just start with (200) 789-1011. That's 5 years. So I waited until the end of 2,011 to approach Medicaid

280
00:53:15.750 --> 00:53:17.480
on September 20, first

281
00:53:17.830 --> 00:53:36.539
of May 2,011. That doesn't scoring. I went to see an elder lawyer to tell me what I needed to do to get a Medicaid. And then I asked, and that was because you felt you are now through the five-year window. She says, yeah, that it is going to be soon, and that I could reveal my financial statements to Department of Health and Human Services. Come January first, of 2,012,

282
00:53:36.580 --> 00:53:47.250
and they say, but I do have one question. So if I'm understanding you correctly, this was 2,011. It sounds like that. $30,000 would have been actually okay from the perspective of main care. Am I not understanding that?

283
00:53:47.370 --> 00:53:50.269
And she says, I've never determined that I don't know.

284
00:53:50.360 --> 00:53:54.390
I said, Okay, that's a mystery. She says, Yeah, sometimes I think

285
00:53:54.440 --> 00:54:07.639
maybe when I reread this her diary and see how I suffered for 3 years, I sometimes think you know I should have at least asked is going to be a problem. But I didn't know anybody didn't want anybody to know it existed. So I wasn't asking anybody.

286
00:54:07.880 --> 00:54:29.890
So the back story to this is that it turns out the look back window was only 2 years, not 5 years, but she was so afraid to even ask someone about that question that she spent an extra number of years caring for her husband while he had this incredibly difficult incontinence problem. just because of not wanting to ask the question about what was the real regulations.

287
00:54:29.910 --> 00:54:34.360
So there are a couple of things here that I've highlighted, you know, in some of these.

288
00:54:34.370 --> 00:54:52.460
in some of these boxes, first on the structural side, just the the $30,000 is a lot of money. and and to think about the difficulty that she and her family were in their structural position, and the the difficulties that are raised that that created for them the necessity of dealing with those debts

289
00:54:53.090 --> 00:55:21.450
on the institutional side. This five-year window is an aspect of the institutional setup. It's it's kind of the rules of the game. That's the way it's played in the United States and in the Us. The way these institutions work is, they purposely make things complicated and difficult, and that's something that she experienced. One of the things that means is that The local knowledge that arises around how these institutions work may be accurate may not be accurate. And I think that's one of the things we're seeing here. This is someone who is very much

290
00:55:21.930 --> 00:55:36.530
articulate on top of things. She's actually an incredible community resource, helping others navigate these complex processes. But in her own case it led to incredible suffering for many years, just because the rules themselves purposely obscure how how to get help.

291
00:55:41.740 --> 00:55:54.040
I'm going to see if I can get through one other example. This is also about. This is from one of the San Francisco. Web! field sites! And and this is about getting Government assistance. I'm going to read this a little quickly.

292
00:55:54.280 --> 00:56:02.910
This interview is done by my colleague, Alma. It's a little bit less. The informative is a little less clear than mine, so I'll go along. We'll see how far we get

293
00:56:03.600 --> 00:56:30.440
it says, Oh, I never been on Medicaid. Medicaid is the public assistance health care program for low-income folks in the Us. But, in fine, for years, you know, when my husband passed a friend of mine, she said, go on now, it's only one check. So I went, and I got up here, and oh, my God, I'm scared of those people, I mean. So I went to enterprises very. My God, take me day and nice, very nice people. The lady said, no, because the minimum is like 3 60 minimum month. Otherwise I would share the cost. 7, 20. Are you kidding me.

294
00:56:30.690 --> 00:56:34.790
anyway? I said. But I work all my life. She says that don't make no difference.

295
00:56:35.040 --> 00:56:55.140
So what I had my heart problem. I was in the hospital for 2 weeks because I did internal bleeding in my heart problem. So the doctor was very nice because they charge you 1 25 for emergency room now, and she put in. When a woman came and registered me, she said, you have no Medicaid. I said no. Why, I said, I don't know. She called a social work from the hospital and told her to help me.

296
00:56:55.140 --> 00:57:16.300
So she filled out the papers and everything, and a brochure come to my house, and I said, oh, my God! Let me read that! So I told the lady. I'm not sure I even have a Medicare. My Medicare cards I have on retire, but, Medicaid. I never have it, but some people say I have it so, she said. I will come and talk to you, so she's come to my apartment, and we talk and we check. You have Medicaid, I said. Oh, boy, I went nuts.

297
00:57:17.140 --> 00:57:18.669
but in the meantime

298
00:57:18.720 --> 00:57:25.209
he this is her husband, before he passed, was applying for Section 8, which is housing assistance because he was disabled.

299
00:57:25.720 --> 00:57:48.839
They give us immediately the voucher. Yeah, that was the help I get from the government first time in my life. Now, when he died here I am in the other building, I said. How my earth am I going to live with $900, paying the rent, even including the government, help you with these 2 checks. As for a friend called, and I said, What am I supposed to do, he said. Why don't you go? You go to the house and start to talk to the people and tell her that your husband passed, and I said, but I'm ashamed

300
00:57:49.050 --> 00:58:07.690
as ashamed of stealing and killing and selling it. You better go. You pay taxes. You don't have to be ashamed. That lady was very nice, she said. Don't worry, Mrs. Wade. Everything is going to be fine. You, his wife. You have the right to get death signed by him. And then I said to me, Oh, well, yeah, it's the only help I've gotten from the government, honey. And now this one.

301
00:58:08.050 --> 00:58:20.559
So again, these sort of very complex Rules and systems, a family that does not have By any means, extra resources. To afford the health care and the housing that they need.

302
00:58:20.560 --> 00:58:39.109
And the way this all plays out, I think you can still see the structural position of people and needing care. The way that the Medicaid and housing rules make it so complicated to find care. And then the way this results in different kinds of understandings about how those programs work which may or may not be entirely accurate, and even when they are entirely accurate.

303
00:58:39.110 --> 00:58:59.609
the rules themselves change over time. So it's very difficult to keep up. Keep up. I'll just also point out that this is an individual who did not have any cognitive issues. So Almah says in later in this interview, do we have any menu problems or anything like that? She says. No, almost said, I know you said you didn't, and Alma has been spending time with her in the community center. So who knows her will?

304
00:58:59.640 --> 00:59:05.370
She says. Good thing, I said. I prayed. Lord, I said, look you give me so much. I'm asking for one more little thing.

305
00:59:05.460 --> 00:59:07.029
Don't make me lose my mind.

306
00:59:08.420 --> 00:59:11.129
I'm going to have to skip over the third example.

307
00:59:11.470 --> 00:59:39.939
But I'll just give a couple takeaways and analytical thoughts. first of all, that the folks that we're working with are completely aware of the fact that their structural and political arrangements place them in jeopardy, and that they're very vulnerable as they age. They appreciate that their local institutions can provide protection and resources for them, but they're also a little bit worried about by asking for help? Are they going to put those local arrangements at risk? And are they actually going to hurt their communities by asking for help from government agencies.

308
00:59:40.220 --> 00:59:50.389
hiding shame and independence, assume meaningfulness as cultural practices. Within these circumstances. These make sense to everybody. Folks know where these things are coming from

309
00:59:50.880 --> 00:59:58.000
looking ahead, we're going to be thinking about how older adults strategically navigate the decisions related to health and cognitive decline.

310
00:59:58.010 --> 01:00:01.010
Oftentimes this doesn't happen with full success.

311
01:00:01.240 --> 01:00:12.730
We recognize that the knowledge that they have is extensive and it's actionable. Yet it's often imperfect. and that wrong steps are rightly seen as carrying very serious, potential negative consequences.

312
01:00:13.450 --> 01:00:30.850
It's unhelpful to cast these kinds of orientations as cultural misbeliefs or carryovers from some sort of other place or time, and where they're no longer relevant and recognize that cognitive decline includes an additional cultural charge and other types of changes over time.

313
01:00:30.930 --> 01:00:33.809
Thank you very much for your time, and

314
01:00:33.850 --> 01:00:34.950
it's great to be here.

315
01:00:42.250 --> 01:00:50.750
Thank you very much for the presentation. And we actually transition now to another San Francisco attendee, Dr. Leslie Dubbin.

316
01:00:51.020 --> 01:00:52.570
who is presenting online.

317
01:00:58.120 --> 01:00:59.660
Leslie Dubbin: Oh.

318
01:01:03.740 --> 01:01:05.950
Leslie Dubbin: Can you guys see my screen?

319
01:01:08.380 --> 01:01:09.560
No, not yet.

320
01:01:09.760 --> 01:01:10.680
Leslie Dubbin: Okay.

321
01:01:11.960 --> 01:01:13.370
Leslie Dubbin: 1 s.

322
01:01:17.170 --> 01:01:19.320
Leslie Dubbin: Where did you go? Here we are.

323
01:01:32.970 --> 01:01:34.080
Leslie Dubbin: you see. Now.

324
01:01:34.310 --> 01:01:47.759
Leslie Dubbin: Yup, okay. Great. Well, good morning, everyone in greetings from San Francisco. I'm Leslie Devin from the University of California, San Francisco. And today we're going to explore the spatial and place dimensions of loneliness.

325
01:01:48.290 --> 01:02:04.910
Leslie Dubbin: In this presentation we share some preliminary results and preliminary theorizing. As we take a sociological approach to generate new knowledge about the experience and meanings of loneliness for people with chronic illness, and the social factors implicated in the rise of loneliness and contemporary Australia.

326
01:02:06.370 --> 01:02:16.569
Leslie Dubbin: Our objectives are one to understand the myriad ways that spatial and material factors create, sustain and mitigate loneliness and disconnectedness for people living with chronic illness.

327
01:02:16.770 --> 01:02:23.129
Leslie Dubbin: to explore the nature of informal social interactions and the intersection of one sense of place.

328
01:02:23.150 --> 01:02:31.840
Leslie Dubbin: and to investigate the complexities of the relationship between one sense of place, feelings of loneliness and the social built and natural environments.

329
01:02:33.120 --> 01:02:41.079
Leslie Dubbin: Our data collection involved in depth interviews with 40 participants, walking interviews and the use of photo elicitation.

330
01:02:42.200 --> 01:03:05.940
Leslie Dubbin: Our analysis is guided by the concepts underpinning the work of Pierre Bourdieu. In particular, his concept of habitats, as you may recall, habitals, is our individual embody non natural set of in of of acquired characteristics, dispositions, and styles which are the products of our social conditions. The way we walk, the way we talk gesture and comport ourselves in the social situations.

331
01:03:05.970 --> 01:03:12.509
Leslie Dubbin: It is through habitats that we feel in or out of place with our social, physical, and geographical world

332
01:03:12.700 --> 01:03:36.579
Leslie Dubbin: as a product of our own biograph, biographical history, habitat is not static. It evolves over time through new experiences, when our social and physical conditions of existence change dramatically, our dispositions may lose coherence, and our sense of place becomes tenuous. This dynamic has application for the study of chronic illness as it intersects with loneliness and the lived environment.

333
01:03:37.240 --> 01:03:55.500
Leslie Dubbin: We also drop from the work of Oldenburg and Brassette, as they elaborate on the notion of the third place, the third place comprises those non-work non home environments that are by nature particularly social coffee houses, pubs, parks, cafes, bakeries, or one's favorite luncheon spot.

334
01:03:55.720 --> 01:04:09.139
Leslie Dubbin: The important point here is not their function as a business space, but rather the ways in which these spaces become transformed into place through the imbued value an individual attaches to a particular location.

335
01:04:09.410 --> 01:04:14.809
Leslie Dubbin: Hence these places provide individuals with the place of personal meaning and well being

336
01:04:14.950 --> 01:04:27.170
Leslie Dubbin: conceptualizing. The third place allows us to broaden our frame of reference as we explore the implications of the built social and natural environments to those living with chronic illness and vulnerable to loneliness.

337
01:04:27.940 --> 01:04:31.339
Leslie Dubbin: Now I'll start sharing with you some of our preliminary findings

338
01:04:31.520 --> 01:04:53.040
Leslie Dubbin: for many of our participants. Chronic illness ultimately impact their economic capital to the point that they had to rely on government assistance for housing. Lisa is 70 years old, and lives on a fixed pension. She suffers from severe back injuries. Following a car accident, she and her husband have been priced out of their previous community, and now find themselves living in a low income neighborhood

339
01:04:53.190 --> 01:05:17.670
Leslie Dubbin: thrust into a wholly new physical environment, like social housing, where the rules of the game are unknown creates an embodied sense of unease leading to self isolation and loneliness. For example, Lisa states, I just don't trust the neighborhood. I have a next door, neighbor. I don't know them. I keep to myself. I'm very aware who comes to the door who we speak to. We're very fussy. We have to be otherwise. We're not going to be safe. You feel very unsafe

340
01:05:19.710 --> 01:05:34.450
Leslie Dubbin: when we consider the notion of habitat. We must also consider that habitat has a spatial component as well as a social one. The place where one feels at home or belonging to is the intersection or habitus and habitat are congruent.

341
01:05:34.490 --> 01:05:50.620
Leslie Dubbin: One's habitat may change quickly and radically, but habitus must evolve over time. This creates a best congruence, or what board you called habitus Cleve, a a sense of being out of place. Lisa expounds on this notion in the following exemplar

342
01:05:50.620 --> 01:06:09.250
Leslie Dubbin: in this area there's a whole lot of public housing, and they pour out onto the street, knocking on your door, trying to sell you drugs. Half the energy is just trying to survive them. That's the synthesis of being lonely when you're in communities like this. There is more loneliness here because you have to isolate people, geography, demographics. It's all very significant.

343
01:06:11.540 --> 01:06:38.969
Leslie Dubbin: Once physical disability is also part of the calculus as our next participant. Vernon negotiates her own habitatist habitat mismatch. Vernon is 17 years old, selfish suffers from multiple sclerosis, and lives alone in social housing burn. A sense of loneliness and isolation is in that will be linked to our bodily self and the place she inhabits. She hides aspects of the bodily self, so it's not to appear vulnerable and weak as she navigates her position on the social field.

344
01:06:38.970 --> 01:06:54.780
Leslie Dubbin: It is here board to use concepts, bring the contracts construct of loneliness out of the spike of social dimensions. I've got to keep my head down. I don't discuss my condition or anything with them. My neighbors. There's this thing of the week praying on the week, and it's not nice

345
01:06:54.870 --> 01:07:13.289
Leslie Dubbin: while the first place is where we live. It is still a social field that needs to be navigated. Our habitat and habitats intersect to create a sense of place when there is a mismatch between habitat and habitat, a sense of unease, or being out of place, predominates, creating exacerbating feelings of loneliness.

346
01:07:15.560 --> 01:07:35.709
Leslie Dubbin: The notion of the second place was originally conceived as places with purpose, like workplace or schools, the place where we make a living, execute our career goals and develop our professional sounds. In our study we found that many participants wouldn't work who wouldn't work because of their chronic illness, developed a place attachment to their hospital doctors, office or community clinic.

347
01:07:35.750 --> 01:07:54.929
Leslie Dubbin: Given that the interactions between participant and these venues were purposeful and structured. We expanded the definition of the second place to include them in this context, for example, Elizabeth is 30 years old and suffers from debilitating vowel issues. As a result, she's frequently hospitalized and needs to follow up with her apartment. Care, doctor.

348
01:07:55.350 --> 01:08:15.159
Leslie Dubbin: it is the hospital that fills a void for her in terms of the social interaction and safety, and mitigates any sense she has of loneliness. In this example we see the hospital as the second place provides Elizabeth a sense of well being and safety where she doesn't need to hide her disabilities, and where she can have meaningful purposeful interactions with the staff

349
01:08:17.790 --> 01:08:30.439
Leslie Dubbin: in its original construct. The third place, are those of pure sociability, public spaces, where individuals have opportunities for some expression outside of their purposeful roles. In the first and second places

350
01:08:30.450 --> 01:08:46.670
Leslie Dubbin: we found that the third place was centrally important to mitigating participants, loneliness and elevating their sense of self and well-being. We learned from our participants that third places were not random individuals in view value to these places over time, and they become connected to it

351
01:08:46.670 --> 01:09:01.740
Leslie Dubbin: over time. They themselves become recognized by others as a normal part of the scene, as belonging to the scene. Despite not being known at all, loneliness becomes invisible, and then it dates, if only temporarily. And here's what Verna says.

352
01:09:01.740 --> 01:09:13.660
Leslie Dubbin: I have lots of encounters with people for which I'm incredibly grateful. There's a community in that. I'm always sort of floating around the neighborhood while they wouldn't search me out. It's a small town thing which I think we also crave in a way.

353
01:09:16.650 --> 01:09:39.169
Leslie Dubbin: We also identified what we call the Blue Places uninhabited outdoors that leave indelible connections on one sense of well being what our third places for some are actually first places for others. Take, for example, Greg, he's 27 disabled from a back entry. He's also homeless and lives in his van at the beach. The beach is a safe place where he spent much of his use surfing.

354
01:09:39.170 --> 01:10:06.159
Leslie Dubbin: It's the place he knows best and feels most at home. Yet he recognizes that while the beauty of the beach is part and parcel to a sense of well being. It's the social interactions with others that provide his life with vibrancy and diminish a sense of loneliness, no matter how short or superficial those interactions are. And here's what he said. I'm accepted at the beat. I would talk to a lot of people. But the cohesive factor was the surf. We'd talk about the swell, the tide, the winds, the break.

355
01:10:06.160 --> 01:10:13.719
Leslie Dubbin: So there was community. But at the same time they all got to go home. I never got invited. I don't know how real that was.

356
01:10:15.940 --> 01:10:35.170
Leslie Dubbin: Our preliminary data and analysis demonstrate that the inhabitant environment is central to the experience of loneliness in those living with chronic illness. These data also suggest that participants who are housing and secure or living in unsafe communities and developments. A sense of loneliness was born out of a sense of fear and disconnectedness.

357
01:10:35.260 --> 01:10:45.709
Leslie Dubbin: Many participants living in these environments thought of their illness as a sign of weakness, something that needed to be hidden in order to maintain a more advantageous position on the field.

358
01:10:45.890 --> 01:11:08.429
Leslie Dubbin: We are also learning that informal relationships and encounters within the third place significantly seem to bridge loneliness and isolation being seen, and rock, not recognize being seen and recognized, not necessarily known, may build social confidence and self esteem. Yet more needs to be learned about how and if these encounters evolve into more root nice connections.

359
01:11:08.670 --> 01:11:36.160
Leslie Dubbin: we also underscore how much so. we. We also underscore how much incorporating the natural green environment or blue places as part of one's repertoire of sensory intake drastically reduces one sense of loneliness with connectedness, and finally analyzing the construct of loneliness through the lens of board use, concept of habitats, and the notion of the third place expands our understanding of loneliness beyond the realm of the psychosocial.

360
01:11:37.040 --> 01:11:38.300
Leslie Dubbin: Thank you so much.

361
01:11:45.110 --> 01:11:46.860
Thank you so much.

362
01:11:47.020 --> 01:11:56.420
Leslie. so I might actually invite all our speakers to come up the front here, and we'll start

363
01:11:56.830 --> 01:12:02.660
discussion and comments. So I might invite people online and in the room to ask questions.

364
01:12:15.770 --> 01:12:18.850
Are there any questions for any of our speakers.

365
01:12:18.900 --> 01:12:23.410
There's a microphone there that just so everyone online can hear us.

366
01:12:41.340 --> 01:12:42.740
Leslie Dubbin: So, Sophie.

367
01:12:43.420 --> 01:13:04.069
Leslie Dubbin: I have a question. for Camilla. I was just wondering. given the isolation of the of the people that they worked with. Can she talk a little bit more about how she gained entree into into these into these communities.

368
01:13:07.590 --> 01:13:14.269
Camila Ronderos Bernal: Sure. so we are part of for our foundation. That is a part of the Health care organization

369
01:13:14.300 --> 01:13:38.540
Camila Ronderos Bernal: that some point, I would say about 6 years ago, started doing health brigades there. And so we started going every year because we were bringing healthy gates because of the lack of specialized health care. We have a first-level hospital that has well primary care that a general doctor and

370
01:13:38.540 --> 01:13:52.750
Camila Ronderos Bernal: so people doing their Residency. And so we started going as a as the facility, the health care that did brigades. And so we started gaining their trust and So 4 years ago

371
01:13:52.760 --> 01:14:02.700
Camila Ronderos Bernal: when I came into the foundation, we decided to do something different. And that's when we did the switch. But in a way, they had seen us for the last 3 years

372
01:14:02.710 --> 01:14:06.850
Camila Ronderos Bernal: before we started doing this project, doing something differently.

373
01:14:07.440 --> 01:14:08.950
Leslie Dubbin: Oh, great, thank you.

374
01:14:09.400 --> 01:14:11.810
We have a couple of questions in the rooms

375
01:14:12.050 --> 01:14:13.719
might invite them up. Yeah.

376
01:14:17.280 --> 01:14:20.390
I wanted to connect

377
01:14:20.720 --> 01:14:26.779
Maybe Camilla and and Jesus presentation on on food environments.

378
01:14:26.910 --> 01:14:35.949
I can imagine that the context is very different between Madrid Bilbao and the, you know frontier of Venezuela and Colombia.

379
01:14:35.990 --> 01:14:39.790
But nevertheless, I think that if you can think a little bit about

380
01:14:40.050 --> 01:14:44.549
the food environment and how that might

381
01:14:45.090 --> 01:14:48.689
play a role in understandings of well-being.

382
01:14:48.730 --> 01:15:08.139
not only the nutritional side of it and dietary outcomes, but the larger sense of of well-being. I'm I'm sure that in Camilla's case there's a big question about traditional cuisine which is related to the knowledge of the elders, which, of course, relates to health. What is good to eat? What is edible

383
01:15:08.150 --> 01:15:14.490
in the case of Bilbao and Madrid? It's probably the

384
01:15:14.680 --> 01:15:17.460
more related to, you know the the

385
01:15:17.770 --> 01:15:36.820
the outcomes of diet on perceptions of body, but nevertheless, perhaps the active eating itself, the food environment itself has already some influence on well-being. We can talk about this by looking a little bit deeper than what is actually consumed, but how it is consumed, and in what environment.

386
01:15:37.090 --> 01:15:37.930
Thank you.

387
01:15:42.260 --> 01:15:46.720
But in in okay. in the in

388
01:15:47.240 --> 01:15:48.820
is is this, in

389
01:15:49.720 --> 01:15:50.490
see?

390
01:15:51.070 --> 01:15:57.030
In the case of a marine, me wow is more important of perception.

391
01:15:57.060 --> 01:16:00.210
more the food in embarrassment.

392
01:16:00.300 --> 01:16:09.800
But the food environments is important in the case, especially in the socioeconomic

393
01:16:10.000 --> 01:16:12.350
low socioeconomic status.

394
01:16:12.520 --> 01:16:18.330
But the percession and the influence of

395
01:16:18.390 --> 01:16:26.379
the parental parental influence as microsystem factors.

396
01:16:27.000 --> 01:16:32.069
such as a mass media or Internet

397
01:16:32.220 --> 01:16:35.589
done 40 environments.

398
01:16:35.640 --> 01:16:43.989
For instance, the how the procession is internalized

399
01:16:44.440 --> 01:16:50.040
in it's a very social strata

400
01:16:50.240 --> 01:16:52.200
is more important

401
01:16:52.230 --> 01:16:55.830
than than in 40 environments.

402
01:16:56.020 --> 01:16:57.430
In the case of

403
01:16:57.750 --> 01:17:03.340
Maurice is a large city with vowice site. Medium City

404
01:17:03.460 --> 01:17:07.689
is more important in in

405
01:17:07.720 --> 01:17:11.870
community factors, the the

406
01:17:12.110 --> 01:17:16.530
the influence of per group or the

407
01:17:16.570 --> 01:17:19.760
friends? No. A.

408
01:17:19.790 --> 01:17:23.380
But I think in another place.

409
01:17:23.440 --> 01:17:26.760
such as a United States

410
01:17:26.910 --> 01:17:30.510
or a native American countries

411
01:17:30.550 --> 01:17:32.090
we are. The

412
01:17:32.270 --> 01:17:35.769
social inequalities is a beer

413
01:17:35.970 --> 01:17:39.680
than in Europe, especially in Spain.

414
01:17:39.800 --> 01:17:41.540
the food environments.

415
01:17:41.700 --> 01:17:45.740
It's more important, for instance, if you. If you want

416
01:17:45.780 --> 01:17:47.480
to buy fruit

417
01:17:47.520 --> 01:18:16.000
in any neighborhoods in in New York or in Washington, in Los Angeles, it's more difficult than, for instance, in in any neighborhood in may even be well, it's possible to to to buy flute in in any place, in in any neighborhoods, For this, for this reason it's more important, the the the

418
01:18:16.110 --> 01:18:19.849
in low, such economic status neighborhoods.

419
01:18:19.890 --> 01:18:43.079
many children's spends many hours alone without violence. They don't eat a normally with a parents in in these. These I women is important for for understanding why they they eat unhealthy and healthy food.

420
01:18:48.280 --> 01:18:50.019
let's change.

421
01:18:55.600 --> 01:19:04.900
Hi, everyone. Thank you very much for the presentation. I think everything was very, very fantastic. I have a question for Daniel.

422
01:19:04.910 --> 01:19:10.259
because I'm very much interested in ethnography research. I do quite a lot of cultural

423
01:19:10.380 --> 01:19:22.389
understanding well run around the diabetes, self-management behaviors among African community in the Uk. My question is because you you specifically mentioned that there was no cognitive decline

424
01:19:22.450 --> 01:19:48.830
among your participants, and I'm wondering when you're able to identify the reason why was there. Other factors like family family supports, friends, support where the measures they've put in place in terms of self-managing. You know the health on their home, because I think there was so much focus on institutional factors that were in plays, and that how that hasn't contributed Major to the culture or change. But I'm wondering, was there any other thing

425
01:19:49.090 --> 01:20:03.629
that you identify with? Was there anything that emerged that you? Probably maybe you haven't taken record of it. But families support where there are things that are put in place to self manage themselves that there was not just, you know, any evidence to say there was a decline

426
01:20:03.760 --> 01:20:04.750
yet.

427
01:20:07.440 --> 01:20:09.729
Yeah, thanks for the question.

428
01:20:09.760 --> 01:20:22.619
and I guess I should expand a little bit on how we're doing the work. Which is that we're we're speaking to a lot of different people, some caregivers. So the the extended example I gave was from a caregiver who was

429
01:20:22.640 --> 01:20:26.720
we met actually a caregiver support group where she is a part of

430
01:20:26.730 --> 01:20:36.759
the community. She's not actively caring for anyone because her husband has passed, but many of the others in the group are actively caring for spouses, parents.

431
01:20:36.770 --> 01:20:42.470
siblings who are experiencing cognitive decline, and then in some of the other.

432
01:20:42.670 --> 01:20:54.610
I'll just, I'll state with that one example, because a lot of our methods are similar more broadly within that community center. We're also talking to older adults, some of whom are experiencing cognitive decline. And some of them are not.

433
01:20:54.710 --> 01:21:07.330
So we're not really focused on who's experiencing it. But more, how do people respond? And what do they do when that occurs from the perspective of the individual themselves?

434
01:21:07.330 --> 01:21:27.610
And actually, the third example of someone who has been experiencing cognitive decline. I didn't have time to go into it, but he describes the situation and the tension he's experienced as he's required more assistance because of his decline, and he's had to move in with his son. His son has certain rules that he does not really enjoy following, but he feels that he has to follow them.

435
01:21:27.640 --> 01:21:30.379
And I think one of the interesting things about

436
01:21:30.610 --> 01:21:36.359
cognitive decline is that it affects people, affects lots of communities.

437
01:21:36.460 --> 01:21:51.669
and unpredictably for Alzheimer's. There's very little understanding of why this arises in some places and not in others. But then there are other kinds of cognitive decline that definitely have very strong social determinants of health factors either related to lifestyle or

438
01:21:51.850 --> 01:22:07.499
a traumatic injury or things of that nature. So we're keeping an eye on those issues. But our primary goal is not to describe who's experiencing this and who is not, but rather how people from different circumstances respond. As this occurs, I think

439
01:22:08.520 --> 01:22:12.979
you know, the issues in the area where you're working are very. I think

440
01:22:13.020 --> 01:22:40.399
I don't env for you, because in some ways. They're even more complex because the interactions between diabetes and the social environment is so complicated. One of the nice things about coding of the client in my previous work on cancer is there for many people? These are really biological accidents. It's very difficult to know why they occur for them. And then, in certain cases they're associated with with with with particular behavior. So that that's I don't know if that helps address your question. But it's

441
01:22:40.990 --> 01:22:44.020
It's it is, it is a difference in the different conditions that we're looking.

442
01:22:52.060 --> 01:23:09.779
Well. First of all, I'd just like to thank all our presenters for some really really interesting presentations. Thank you very much. My question is for Tadaki about your study. Could you tell us a little bit more about how you collected your data?

443
01:23:09.890 --> 01:23:16.079
For example, did you visit these organizations? Did you observe

444
01:23:16.230 --> 01:23:22.949
their meetings, or did you interview them? I just like to hear a little bit more about that data collection. Please

445
01:23:27.800 --> 01:23:29.590
sent over your question.

446
01:23:29.960 --> 01:23:30.950
or

447
01:23:31.150 --> 01:23:40.459
today I cut due to the time I in interview research from

448
01:23:41.170 --> 01:23:49.210
2,015 to 2,020,

449
01:23:49.550 --> 01:24:08.620
I I go. I went to Okinawa in March, and in September, about 10 times each research and I do a field work for 7 days

450
01:24:08.630 --> 01:24:17.249
and many data I have, but

451
01:24:17.450 --> 01:24:30.819
I am interested in the case of study. Of course we have another case.

452
01:24:31.210 --> 01:24:46.340
But I today I have made a presentation. This case show the point. I want to say.

453
01:24:49.270 --> 01:24:52.240
okay. think, think.

454
01:24:55.320 --> 01:25:00.250
Thank you very much to the presenter for this interesting presentation.

455
01:25:00.270 --> 01:25:06.089
I have a specific question for the first speaker.

456
01:25:06.180 --> 01:25:17.179
do you take into account family characteristics in the full conscience and in the children in secondary school? So

457
01:25:17.420 --> 01:25:22.450
you present a many aspects according to

458
01:25:22.700 --> 01:25:31.010
 socioeconomic strata, and also it depends on the of the cities. But

459
01:25:31.250 --> 01:25:41.539
it seems to me very important in the Spanish culture, where the family culture in

460
01:25:41.580 --> 01:25:51.510
and cooking food, or in the good, how to take into account this aspect in your analysis in your study.

461
01:25:52.050 --> 01:25:57.230
for instance, yeah, sure.

462
01:26:01.900 --> 01:26:03.410
sorry.

463
01:26:04.140 --> 01:26:11.949
and in the low and medium socioeconomical status.

464
01:26:11.980 --> 01:26:18.530
a percent of the sample where immigrants, families.

465
01:26:18.660 --> 01:26:25.950
and in this case, in seminary interviews and focus group

466
01:26:25.960 --> 01:26:28.870
we are in

467
01:26:30.030 --> 01:26:38.020
did or with it questions about the different cultures and in food consumption.

468
01:26:38.230 --> 01:26:52.730
But in the rest of of the interviews and the focus group only, we consider the economic situation of economic.

469
01:26:52.940 --> 01:27:02.420
the status, the situation of employment, anything more

470
01:27:02.900 --> 01:27:04.390
in the.

471
01:27:04.540 --> 01:27:20.030
in the, in the interviews in the focus group. adults and parents and and teachers comments Different different aspects, you know, as such as the time

472
01:27:20.100 --> 01:27:22.150
A of the

473
01:27:22.270 --> 01:27:24.380
of the.

474
01:27:24.700 --> 01:27:25.700
And

475
01:27:25.940 --> 01:27:28.859
if I spend spending

476
01:27:29.570 --> 01:27:34.170
between adolescents and and and

477
01:27:34.570 --> 01:27:35.690
the

478
01:27:35.730 --> 01:27:42.350
the customs of buying foods.

479
01:27:42.550 --> 01:27:44.880
the Douglas.

480
01:27:45.150 --> 01:27:47.649
the different phone

481
01:27:47.670 --> 01:27:53.009
and the weekends and the level of Aids

482
01:27:53.170 --> 01:27:56.770
a but

483
01:27:56.980 --> 01:28:04.740
culture different in culture aspects between the Spanish

484
01:28:04.960 --> 01:28:09.199
citizen of Spanish Ibrah

485
01:28:09.420 --> 01:28:12.300
are not a many different.

486
01:28:12.480 --> 01:28:16.790
but a in immigrants

487
01:28:17.040 --> 01:28:18.980
and other instance

488
01:28:19.300 --> 01:28:22.700
are more different, but

489
01:28:23.250 --> 01:28:27.220
this difference are

490
01:28:27.280 --> 01:28:32.620
less when live with

491
01:28:32.630 --> 01:28:36.139
with native other lessons.

492
01:28:36.210 --> 01:28:39.129
A is is more

493
01:28:39.490 --> 01:28:45.680
more problem mark and different generations

494
01:28:46.460 --> 01:28:51.800
done a difference between between families.

495
01:28:55.260 --> 01:29:02.530
Ángel Zapata:  I in okay.

496
01:29:05.750 --> 01:29:06.990
Ángel Zapata: Hello, Sophie.

497
01:29:07.140 --> 01:29:25.119
Ángel Zapata: Yes, would you like to know? I have a cover of question, if possible. If we have a some time a first, I would like to to thanks a all person days, For the very interesting presentation. My first question is a for

498
01:29:25.280 --> 01:29:35.959
Ángel Zapata: a it is relate to a recent study that they conducted a I. You have first, and the pandemic, then this product, or is study using, they are on the frequency

499
01:29:36.510 --> 01:29:43.099
Ángel Zapata: with the with which is school to implement healthy 18. Prevention and promotion interventions.

500
01:29:43.250 --> 01:29:56.509
Ángel Zapata: science. Such innovation can have a contemporary efforts in the latest. In the the previous, a little tool we can see contradictory effects of the school intervention on wave

501
01:29:56.610 --> 01:30:08.360
Ángel Zapata: and on healthy food. Also they can help you to improve 18. But if not properly target, they can't contribute to wait a stigma decision, especially when they.

502
01:30:08.470 --> 01:30:15.489
Ángel Zapata: our way to center intervention, are the intervention center. Only on the weight of people

503
01:30:15.590 --> 01:30:25.399
Ángel Zapata: have you been able to explore anything in relation to this contrary result in the of the actions developed by a force in your study.

504
01:30:27.050 --> 01:30:31.500
and thank you for the question. It's very interesting.

505
01:30:31.560 --> 01:30:36.509
and in the school a high school.

506
01:30:36.560 --> 01:30:38.400
and but

507
01:30:38.530 --> 01:30:44.480
especially in the in the primary school. They try to

508
01:30:44.720 --> 01:30:56.540
to. We implement intervention plants, especially with healthy breakfast, or in the blade.

509
01:30:56.750 --> 01:30:58.280
A

510
01:30:58.390 --> 01:31:01.709
puts fruit in the in the halls.

511
01:31:01.860 --> 01:31:04.529
But the the results is.

512
01:31:04.910 --> 01:31:10.299
I'm not very, very good, but the the adolescence and the

513
01:31:10.340 --> 01:31:12.700
John, John. People

514
01:31:13.020 --> 01:31:24.090
don't don't eat the the fruit. even they they play with the food, but don't eat. No.

515
01:31:24.360 --> 01:31:27.920
and they've

516
01:31:28.180 --> 01:31:32.059
this is a contortion. But

517
01:31:32.390 --> 01:31:35.509
the adolescents know the

518
01:31:35.810 --> 01:31:39.299
the nutrition rules.

519
01:31:40.220 --> 01:31:47.970
know the properties of different different footpaths. Then

520
01:31:48.210 --> 01:31:53.500
day in in your free time, or in in the weekend.

521
01:31:53.560 --> 01:31:56.420
they they date a

522
01:31:56.610 --> 01:32:03.950
unhealthy and healthy food. No, it's not necessary, or it's not enough.

523
01:32:04.210 --> 01:32:14.999
The knowledge or the objective knowledge about about food or

524
01:32:15.460 --> 01:32:20.809
presence, fruit or healthy or healthy food.

525
01:32:20.870 --> 01:32:23.460
and I seem to say

526
01:32:23.580 --> 01:32:25.590
in in some case.

527
01:32:25.730 --> 01:32:29.630
and in the schools they prefer to work

528
01:32:29.920 --> 01:32:31.950
with the, with the parents.

529
01:32:32.150 --> 01:32:36.100
with the parents doing or promote

530
01:32:36.110 --> 01:32:40.840
a meal with the whole family.

531
01:32:40.910 --> 01:32:45.579
the the World family in the promote.

532
01:32:45.740 --> 01:32:47.030
They.

533
01:32:47.040 --> 01:32:53.759
the adolescents, cook in your house. This type of practice

534
01:32:53.810 --> 01:33:07.050
is more useful to promote healthy food than to speak about the properties of healthy hoods.

535
01:33:08.430 --> 01:33:11.830
Ángel Zapata: Thank you. Thank you very much for your answer it.

536
01:33:12.120 --> 01:33:17.310
Ángel Zapata: if possible. The second question is for Camila a

537
01:33:17.590 --> 01:33:23.530
Ángel Zapata: a camila, a she has presented a very positive results

538
01:33:23.560 --> 01:33:26.780
Ángel Zapata: of the

539
01:33:27.370 --> 01:33:47.649
Ángel Zapata: on my question is, If a the evaluation of this impact A has considered the possibility of including cultural groups or control communities where the project has not been implemented. A. I don't know if it is a if you do consider this a kind of a methodological, a

540
01:33:47.900 --> 01:33:51.330
Ángel Zapata: in contrast, in your studies. I don't know.

541
01:33:53.780 --> 01:34:06.120
Camila Ronderos Bernal: We have a community nearby where we didn't work with. And so we did a survey. A similar health health survey than that when we did in our communities.

542
01:34:06.190 --> 01:34:27.879
Camila Ronderos Bernal: and the outcomes at the get go. So the baseline Were similar in terms of, you know, the prevalence of the issues or the not knowledge of medicinal plants and stuff like that. And then, as we kept going, we we we started working with that community that we had done sort of the baseline at the beginning.

543
01:34:27.900 --> 01:34:45.600
Camila Ronderos Bernal: and they were still at the same place. Than the so the community that we use that we hadn't intervened, that we did a survey at the beginning as well. When we had moved forward with ours they asked us to work with them as well, and so we did a new baseline to see if something had changed

544
01:34:45.610 --> 01:34:50.100
and the numbers stayed similar for that. But other community that we hadn't worked with

545
01:34:50.160 --> 01:34:57.410
Camila Ronderos Bernal: And so so we we managed to do a sort of comparison there with both communities, one that we had

546
01:34:57.720 --> 01:35:01.040
Camila Ronderos Bernal: touch or intervene. And what that we have it.

547
01:35:01.420 --> 01:35:02.980
Ángel Zapata: Okay, thank you very much.

548
01:35:03.680 --> 01:35:08.749
So we have a couple of questions in the room, and then we'll get to the question on in the chat.

549
01:35:10.160 --> 01:35:39.389
So thank you for the presentation of for all the presentations. It's very interesting, and I have a couple of questions for Leezi and for his. So, firstly, I think your topic is quite relevant in the in of the house of chronic population. And Is there any community-based help for the pronic people like? Some talk among all

550
01:35:39.470 --> 01:35:49.760
Like community-based talks among the chronic people so that they can know each other, and they can feel lies lonely.

551
01:35:49.910 --> 01:36:18.810
And the second question to his. The the conclusion. I think that this, that the continue of the school sometimes provides unhealthy foods, and in a comparative perspective of a Chinese or other Asian countries as a school contains normally have to make the applying for for for the school director, and sometimes in most cases they have to provide the most healthy foods.

552
01:36:18.810 --> 01:36:29.319
So I am really curious about this this part. Why, in the schools, as you interviewed the school, can provide some unhealthy food.

553
01:36:35.120 --> 01:36:36.710
You want to go first. Lily.

554
01:36:37.180 --> 01:37:03.790
Leslie Dubbin: yeah, sure, thanks. Thanks for the question. I think, really, what our our data is. is pointing to? a, especially the participants thus far. are these kind of non structured areas where they find themselves most comfortable? certainly a lot of them do access certain social services. but really our interest was kind of out

555
01:37:03.790 --> 01:37:19.600
Leslie Dubbin: outside of those those areas to to find out what other, what other venues are there for folks, particularly those who are struggling with with chronic illness and And who are vulnerable or experiencing loneliness.

556
01:37:19.600 --> 01:37:43.419
Leslie Dubbin: And so You know, this. This came up really, inductively, through through our data. And so, you know, it's still preliminary. But you know, as we open up that black box. We're certainly finding an awful lot of what people do in their in their own lives without the benefit of structured places to go and meet other people.

557
01:37:46.560 --> 01:38:01.189
I I I have very, very, with your your question. Can can you repeat, please? Your question? Yeah. in the conclusion parts? for the school continued. They said,

558
01:38:01.220 --> 01:38:05.730
In school contains. Sometimes they provide unhealthy food

559
01:38:06.210 --> 01:38:22.719
for the students. but from the Asian perspective. Like in the school context. the continued to provide so or like they have to make applying for their weekly lunch or dinner.

560
01:38:22.750 --> 01:38:27.860
and they have to provide for the most healthy food.

561
01:38:28.240 --> 01:38:30.559
Yeah. So, okay, okay, okay.

562
01:38:30.780 --> 01:38:38.720
no, no, no. The the the plants we concede in in 2

563
01:38:38.910 --> 01:38:44.459
to speak with the families.

564
01:38:44.610 --> 01:39:00.999
to change the daily practice to try the families and buy a foods together to supermarket a cook

565
01:39:01.060 --> 01:39:05.880
sometimes together with with with adolescents.

566
01:39:05.940 --> 01:39:08.970
And speak

567
01:39:09.020 --> 01:39:26.170
about the health of food. For instance, in the pandemic, when many people are close in our houses, or some at least

568
01:39:26.240 --> 01:39:29.639
a to value

569
01:39:29.680 --> 01:39:33.410
the foot of a different way.

570
01:39:33.510 --> 01:39:41.659
because they cook in your house. They never cook before.

571
01:39:41.740 --> 01:39:45.440
In this period

572
01:39:45.790 --> 01:39:49.499
2 or 3 months, depending on the country

573
01:39:49.560 --> 01:40:01.260
they they' to to value, or food a of different way. And I I refer this this

574
01:40:01.310 --> 01:40:06.070
type of of of of

575
01:40:06.180 --> 01:40:10.980
of plan. No, no.

576
01:40:11.190 --> 01:40:11.880
a

577
01:40:12.090 --> 01:40:19.930
to give presence healthy, healthy, healthy foods

578
01:40:25.630 --> 01:40:42.669
question for Leslie. If that's okay and somebody who's used Borges work in my own studies. And I've also done some work around green and blue spaces. I just wondered if you could talk a little bit more about bringing those 2 things together. It's something I haven't done, and I'm really interested in it.

579
01:40:44.470 --> 01:40:46.830
Leslie Dubbin: Yeah,

580
01:40:47.240 --> 01:41:07.760
Leslie Dubbin: but you know I I I always I I always think that you know board you is. And his concepts really are a kind of a a grounding influence in in, in my work. So I tend to think about him, and through an awful lot, in in the ways I think about place and and various spaces.

581
01:41:07.760 --> 01:41:35.180
Leslie Dubbin: I I think you know, just thinking off the top of my head, particularly blue spaces, is the intersection of whether or not, they are empty spaces, or and the the ways in which it becomes a social field, with the introduction of of folks in particular, strangers, and how strangers start to occupy that field, those blue spaces and start to interact with one another. And and I think the the the

582
01:41:35.350 --> 01:41:43.110
Leslie Dubbin: the exemplar I had of of of Greg, who was the surfer, you know. Here is this, this wide open space that

583
01:41:43.110 --> 01:42:07.659
Leslie Dubbin: multiple people get to enjoy for particularly the same reason they all have. They all have something in common. They're all at at an even playing field at that point, because they all enjoy the same things. So they have this commonality about them that they're easily, they can easily negotiate around each other. And so I I think, board you. really helps to identify those dynamics. How is it that strangers

584
01:42:07.660 --> 01:42:29.830
Leslie Dubbin: can come from different places and up in one place, and then start having these interactions that are not necessarily, you know, lifelong friendships, but they they serve a social purpose and and and can alleviate Some of this kind of need for for social interaction. So I'm not not sure if that totally

585
01:42:30.420 --> 01:42:46.919
Leslie Dubbin: answered your question, but but I do think his concepts of habit is field and the in and capital. Certainly. I tend to use all 3 of them together in order to kind of paint this picture of the dynamics that are happening? in in a variety of places.

586
01:42:49.640 --> 01:42:53.599
Samuel's got a question on did you want to ask a question.

587
01:42:54.840 --> 01:42:58.650
I,  yeah.

588
01:42:59.040 --> 01:43:02.319
Emma, do you want to ask your question first

589
01:43:05.640 --> 01:43:07.779
can write it out. What? So?

590
01:43:09.130 --> 01:43:10.830
There was a question.

591
01:43:12.120 --> 01:43:12.900
Oh.

592
01:43:13.200 --> 01:43:14.340
the Dan!

593
01:43:14.380 --> 01:43:17.380
I from Remando! Sorry.

594
01:43:20.500 --> 01:43:24.390
Remando asks about how did you perform the ethnography if you could?

595
01:43:28.950 --> 01:43:32.080
Yeah, thanks for the question. I I I just but

596
01:43:32.150 --> 01:43:40.840
I just have to say I'm I'm very intrigued by this question that you just asked Leslie, and your response in sort of the notion of loneliness, and how that relates to

597
01:43:41.010 --> 01:43:46.740
companionship in public spaces. So something maybe we'll we'll talk about it in San Francisco at some point.

598
01:43:46.870 --> 01:43:52.549
 so we we have a team. We're doing team ethnography. We have

599
01:43:52.580 --> 01:43:59.179
 4 different folks who are doing the ethnography, including myself.

600
01:43:59.230 --> 01:44:02.989
It really is a community-based participant observation.

601
01:44:03.020 --> 01:44:13.419
So we have been spending time in different community settings, senior centers and community centers in really developing organic relationships with the folks who we meet there.

602
01:44:13.470 --> 01:44:20.340
And then, as we identify folks either who who appear to be experiencing cognitive

603
01:44:20.380 --> 01:44:28.450
decline, or or issues or caregivers. We then have been asking them for interviews, but mostly the ethnography has been very open-ended

604
01:44:28.560 --> 01:44:49.549
sort of a classic sort of solo ethnographer, participant observation very unstructured, which I will say the the research assistance on the project find very challenging. I think we all find it challenging. It's something I enjoy doing a lot in my own career, and I I guess I would just say that I see the project as also very much

605
01:44:49.650 --> 01:44:54.890
around developing the skills and orientations of the research assistance who agree with the work.

606
01:44:55.010 --> 01:45:03.780
So I think they're learning a lot about these communities by just having unstructured time there to spend time there and and finding ways to develop relationships.

607
01:45:03.890 --> 01:45:14.049
And it has taken a long time for us to actually develop the kinds of data that that will inform our analyses. I would just say, there's one other aspect of this project which is

608
01:45:14.200 --> 01:45:37.519
we're taking the field notes and interview transcripts and using machine learning processes to begin to analyze the data. So one of the things we're hoping to do is use a very open-ended way of gathering data, and then a more structured way of analyzing the data, to try to help us appreciate the ways in which various themes arise across different field sites.

609
01:45:37.590 --> 01:45:41.299
and, as I mentioned briefly in the talk, it really is

610
01:45:41.310 --> 01:45:47.459
taking hand notes and writing up observations, and then conducting interviews that are very open-ended.

611
01:45:47.490 --> 01:45:52.699
I'm asking people depending on their own circumstances whether they're an individual experiencing, cognitive.

612
01:45:52.810 --> 01:45:58.099
caregiver to describe their experiences and how they navigate from basic decisions.

613
01:45:59.220 --> 01:46:04.930
So one of the nice things about this project is unlike most of the National Institutes of health projects, we actually.

614
01:46:04.960 --> 01:46:14.420
we have a good deal of freedom to figure it out as we go along. We don't have specific aims defined in advance

615
01:46:21.450 --> 01:46:31.289
to to soar questions for one for Daniel and another forlessly. Dublin

616
01:46:31.560 --> 01:46:38.269
using Medicaid is systematic and systematized, systematicized in

617
01:46:38.320 --> 01:46:41.289
in your sample, in your study

618
01:46:44.660 --> 01:46:51.359
dementia. No, no, no, no, they're using Medicaid, the proland medicate.

619
01:46:53.070 --> 01:46:54.370
Make it me.

620
01:46:55.000 --> 01:46:58.209
Yeah, yeah, yeah. Yeah. Sorry.

621
01:46:58.800 --> 01:47:03.420
Using. Medicaid is a systematic side or no.

622
01:47:04.500 --> 01:47:10.150
Do you understand? No, I'm stigmatized.

623
01:47:10.410 --> 01:47:18.019
 it's a complicated question.

624
01:47:21.020 --> 01:47:22.579
I would say no

625
01:47:22.760 --> 01:47:37.339
in this particular context, where people are using Medicaid. So Medicaid is how the only way that people can get care for for assisted living, for for people who need lots of home care or care in an institution.

626
01:47:37.490 --> 01:47:48.979
and although people tend to avoid it, I think one of the things that we've not seen is that it's not necessarily stigmatized itself. but it's but people are wary of it.

627
01:47:48.990 --> 01:47:59.559
So, as in the example I described, people are worried that it'll expose their whole life to observation, in that there will be financial consequences for asking for assistance.

628
01:47:59.690 --> 01:48:01.840
And then there's some issues about

629
01:48:01.910 --> 01:48:03.420
whether

630
01:48:04.040 --> 01:48:06.990
keeping keeping someone at home when you're caring for them.

631
01:48:07.250 --> 01:48:13.739
And because these decisions are made by caregivers, not by the individuals themselves, who have cognitive decline.

632
01:48:13.890 --> 01:48:17.819
There's a lot of complicated issues that arise on keeping people at home.

633
01:48:17.980 --> 01:48:25.690
But I would say, so far we have not seen a reluctance to use Medicaid because of stigma as one of those issues.

634
01:48:26.110 --> 01:48:37.559
There are other issues about keeping people at home and caring for them. And then, as I said, as the example I gave. There's the concern that asking for help would then create other problems.

635
01:48:38.100 --> 01:48:42.570
But we haven't seen a lot of stigma around Medicaid

636
01:48:42.760 --> 01:48:43.709
per se.

637
01:48:44.100 --> 01:49:04.509
which I think is interesting and is a little bit different, I think. Sometimes it looks that way from the outside. But as you hear more of the detailed stories. it doesn't seem as that as much. People feel like they've let down their loved ones when they have to send them to assisted living that has come up quite frequently. But again, that's different than the issue of Medicaid.

638
01:49:04.740 --> 01:49:07.430
A stigma per se. Let me see.

639
01:49:07.530 --> 01:49:12.490
Thank you. Sorry. So, thank you. No, no, thank you. A

640
01:49:12.790 --> 01:49:13.490
it.

641
01:49:14.059 --> 01:49:23.620
I have not understood well the concept of blue space. Can you explain by that

642
01:49:24.150 --> 01:49:26.129
the concept of blue and space?

643
01:49:26.889 --> 01:49:28.270
No.

644
01:49:28.750 --> 01:49:30.990
I don't understand. Hello! This.

645
01:49:32.420 --> 01:49:46.530
Leslie Dubbin: There you go. Thank you. The blue, the blue space is, it comes from the literature. but we kind of tweaked it it a bit. just using kind of blue sky

646
01:49:46.750 --> 01:50:15.480
Leslie Dubbin: areas that are uninhabited. as just a way to kind of visualize an open area that anyone could access because it's public, but there are no it. There's nothing built on it. So immediately it comes to mind, you know, beaches, meadows, parks, national parks. These kinds of places that that really have emotional

647
01:50:15.480 --> 01:50:30.870
Leslie Dubbin: connections to people and are very, very powerful. So it's really just that it was really just a coding tag that I kind of placed on it. And I probably have read it in the literature somewhere. I just can't can't quite find it.

648
01:50:31.020 --> 01:50:41.310
Leslie Dubbin: So really, it was just a coding tag for me. to underscore that these open spaces are extremely important. And in but in this context.

649
01:50:41.860 --> 01:50:42.770
thank you.

650
01:50:43.000 --> 01:50:56.110
I am going to have to bring this session to a close, as we're right on time now. But, please join me in thanking our speakers for being here today and for presenting such stimulating work. So thank you all.

651
01:51:05.950 --> 01:51:06.759
Excuse me.

652
01:51:07.469 --> 01:51:11.779
 see him. It's confusing with Medicaid.

653
01:51:13.290 --> 01:51:19.269
Ángel Zapata: Thank you very much for your participation, and thank you again. So for for your

654
01:51:19.440 --> 01:51:22.520
Ángel Zapata: for your

655
01:51:23.830 --> 01:51:25.549
Ángel Zapata: thank you.

656
01:51:27.540 --> 01:51:28.480
Ángel Zapata: everybody

657
01:51:28.959 --> 01:51:29.000
Cristina: right here.