Individuals who are facing death today are doing so in an environment that is significantly different than it was in the past. Medical technology is increasingly able to keep people alive even with multiple complex chronic conditions. While these advances in medicine are beneficial to many, it can also unnecessarily prolong inevitable deaths.Concerns over the ability to have a death that is in alignment with personal values has increased the interest in the use of formal end-of-life planning including writing an advance instructional directive and assigning a durable power of attorney for health care. Although research has indicated that the use of these formal planning strategies is beneficial, not everyone completes them. Using a current nationally representative sample, the three specific aims of this study were to examine whether there are racial and ethnic differences in formal end-of-life planning done by older African American, Hispanic, and White adults; to examine socioeconomic factors including education and income in formal end-of-life planning as well as assess the contribution of these factors in explaining racial and ethnic differences in formal end-of-life planning; and to examine the role of religiosity in formal end-of-life planning and to assess its influence on racial and ethnic differences in explaining formal end-of-life planning.Logistic regression was run on data from the Health and Retirement Study Both Blacks and Hispanics were less likely to complete a written advance directive, assign a proxy, or complete both forms of formal planning than were Whites.Group differences remained after controlling for region of death and cause of death.Both Blacks and Hispanics were less likely to complete any form of formal planning than Whites. Group differences remained after additionally controlling for gender, age, marital status, whether the decedent had children, income, education, religious preference, importance of religion, and frequency of attending religious services.Higher levels of income and education both increased the odds that formal advance planning would take place. Religious preference was not significant, but decedents who had stated that religion was very important were less likely to plan while those that attended services frequently were more likely to plan.

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The potential for urban open spaces to convey therapeutic benefits is increasingly substantiated. More work is needed to specifically consider how low impact designs to manage stormwater such as ecoroofs perform in this context. Here, we report on a pilot study addressing: (1) factors determining whether a hospital has an ecoroof, and (2) how ecoroofs might convey therapeutic benefits. We utilized a mixed methods approach which encompassed phone interviews of hospital ecoroof managers as well as analysis of national hospital databases. We also conducted a local case study which compared cortisol samples and stress indicators from patients, staff, and caregivers visiting an ecoroof to those waiting indoors at the Oregon Health and Sciences University in Portland OR. Behavioral observations took place at this same location. In 2017, we identified 105 hospitals with ecoroofs in the contiguous United States. Our analysis of a national hospital database found two factors that significantly increased the likelihood of a hospital having an ecoroof: Medicaid discharges per year; and non-profit status. Interviews with practitioners nationally revealed a wide range of motivations but that therapy was a consideration for a majority, but notably not all, of the hospitals surveyed. They similarly noted variation in roof design, maintenance, and programming around horticultural therapy; we highlight some best practices here. Our physiological case study was limited in sample size. Preliminary findings showed that salivary cortisol levels varied by ecoroof visitor type, ranging on average from 0.09 μg/ml for caregivers to 0.30 μg/ml for patients. We did not observe any significant changes in visitor cortisol. This could be explained by low replication or the short treatment duration. Alternatively, these pilot data may indicate a gap in horticultural therapy theory vs. practice. Behavioral observations demonstrated a wide array of different uses of the ecoroof space such as cell phone use and passing by. Though preliminary, our findings suggest that therapeutic effects may vary by user type and activity and depend on roof design and goals. This study offers both information on the therapeutic potential of hospital ecoroofs as well as lessons learned regarding different approaches to researching this somewhat new topic.

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Why do some master's level students feel confident in completing their programs and some do not? Why do some feel connected to their department and some do not? Why do some feel legitimate as graduate students and some do not? This research proposes that there may be differences in how master's students understand the graduate student role based on whether they went directly from high-school through their bachelor's to their master's, or if they took time off between their bachelor's and master's program. This thesis used in-depth interviews with twelve second-year master's students at Portland State University to explore these questions: six with students who had a linear trajectory through higher education and six with students who had a break after completing their bachelor's and before returning for their master's (broken trajectory students).Students from both groups began their programs with questions about their ability to perform at a master's level. Broken trajectory students were more likely to have thought through their chances of success and entered their programs 'knowing' that they would successfully co~plete the programs even when they questioned their academic abilities. Students from both groups overall felt a progressive increase in feelings of connection to their departments. The linear trajectory students entered their programs with some established feelings of connection with other graduate students.The broken trajectory students did not have these established connections, but desired connection with other serious students. Overall, students from both groups experienced increased feelings of legitimacy as graduate students, but the criteria by which they judged their legitimacy differed between groups. Linear trajectory students used academic ability as a primary measure of legitimacy, where broken trajectory students used having a clear understanding of why they were in graduate school as the standard to determine whether they "belonged in college." The two groups also differed in the source of their student role standard: broken trajectory students used professors as their role reference group, whereas the linear trajectory students used peers and undergraduate students. This thesis closes with a discussion of the implications of this research for theory, programs, and current models of persistence. 'DO I REALLY BELONG HERE?/