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The Individual with Disabilities Education Act (IDEA) mandates that a transition plan be in place for students with disabilities by the time they turn 16. This plan aims to facilitate the child’s movement from high school “to post-school activities, including postsecondary education, vocational education, integrated employment (including supported employment), and continuing and adult education, adult services, independent living, or community participation,” (20 U.S. C. 1401 (34)). Despite these mandates, studies have shown that youth with disabilities are having poor post-school outcomes when compared to their peers (Lindsay at el., 2019; Lipscomb et al., 2018; Rowe et al., 2021; Test, Mazzotti et al., 2009). Occupational therapy practitioners (OTP) are well situated to collaboratively work as part of the Individualized Education Plan (IEP) team with transition planning (Kardos & White, 2005). The OTP is distinctly qualified to assist the IEP team with developing goals, improving activities of daily living, assisting with staff and student training, and determining student occupational interests. Transition interventions are a widely variable and unregulated area of practice for school-based OTPs. Opportunity Café represents a solution to the problem of poor post-school outcomes for students with intellectual and developmental disabilities (IDD). This transition intervention applies evidenced based practices to guide education teams, students, and families through the transition planning process. It fulfills a need mandated by the IDEA for IEP teams to support the transition needs of students with IDD and provides an inclusive workplace to facilitate growth. Opportunity Café is a dynamic community-based replicable program that can impact student success. Program guidelines, methods for program dissemination, evaluation, and funding are discussed.

Recent studies have demonstrated that increases in dynamic strength after weight-training in healthy subjects were associated with reductions in heart rate (HR) and arterial blood pressure (ABP) during formal lifting of identical absolute loads (McCartney et al., 1989; Sale et al., 1990). This study investigated whether the effect could be transferred to strength-related activities of daily living in healthy older men. The effects of 10 weeks (30 sessions) of progressive dynamic weightlifting training on HR and ABP in 10 weight-trained (wttrain) subjects were compared with 5 control subjects. Before and after training intra-brachial artery pressure and HR were monitored continuously during: 10 repetitions of single-arm curl (SAC) and single-arm military press (SAMP) at 70 % of initial 1 repetition maximum (1 RM); 12 repetitions of single- (SLP) and double-leg press (DLP) exercise at 80% of initial 1 RM; 10 mins treadmill walking at 2.5 mph, carrying 20 and 30 pound loads between mins 4-6 and 8-10 respectively (T-10); 4 mins of treadmill walking at 3.0 mph up an incline of 8% (T-4); 12 flights of stairclimbing at 60 steps/min on a Stairmaster 6000 Ergometer (STR). In the wttrain group the 1 RM in SAC, SAMP, SLP and DLP increased overall by 61 (p < 0.007), 30 (p < 0.001), 27 (p<0.001) and 27 per cent (p < 0.001), respectively. After training the mean maximal systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and rate-pressure product (RPP; 10^3) values in all 4 weightlifting exercises were lower. The decreases were only significant however, for the DBP in the SAC (144.0 ± 14.9 to 110.0 ± 5.2 Torr; p < 0.001), SAMP (151.0 ± 5.9 to 144.0 ± 5.4 Torr; p < 0.007), the MAP for the DLP ( 154.0 ± 5.0 to 147.0 ±5.0 Torr; p < 0.021) and RPP for the SAC (22.7 ± 2.2 to 19.1 ± 1.4; p < 0.041). The same respective measurements in the control group were either unchanged or higher. After training, there were overall reductions in the SBP (p < 0.05, mins 8-10), DBP , MAP and RPP (P < 0.05, mins 1-4) responses during T-10 with consistently higher values found in the control group. Similar, but nonsignificant patterns emerged for T-4. In contrast, there was little or no reduction in any of the measured parameters during stairclimbing. It was concluded that improved strength in older subjects results in an attenuated HR and ABP response during weightlifting, and there is a modest transfer of this effect to certain activities of daily living which involve the trained muscles. / Thesis / Master of Science (MSc)

A historical study of women's costumes for selected periods as a reflection of the culture in Virginia was designed to gain some understanding of the costumes worn, to observe the role that clothing played in the lives of the settlers and of the influences that brought about changes in costume. Much information pertaining to this subject was found in books on history. The researcher conducted this study by visiting various museums, reviewing related books and studying historical portraits. The researcher found that most of the information that is recorded about clothing belonged to persons of some wealth and station of life. The costumes, fabrics, shoes, and other apparel still in existence are relics of past days. Thirty-eight illustrations on costumes have been included in this study. / Master of Science

Yes / A community-based occupational therapy intervention for people with mild to moderate dementia and their family carers (Community Occupational Therapy in Dementia (COTiD)) was found clinically and cost effective in the Netherlands but not in Germany. This highlights the need to adapt and implement complex interventions to specific national contexts. The current trial aims to evaluate the United Kingdom-adapted occupational therapy intervention for people with mild to moderate dementia and their family carers living in the community (COTiD-UK) compared with treatment as usual. Methods/Design This study is a multi-centre, parallel-group, pragmatic randomised trial with internal pilot. We aim to allocate 480 pairs, with each pair comprising a person with mild to moderate dementia and a family carer, who provides at least 4 hours of practical support per week, at random between COTiD-UK and treatment as usual. We shall assess participants at baseline, 12 and 26 weeks, and by telephone at 52 and 78 weeks (first 40 % of recruits only) after randomisation. The primary outcome measure is the Bristol Activities of Daily Living Scale (BADLS) at 26 weeks. Secondary outcome measures will include quality of life, mood, and resource use. To assess intervention delivery, and client experience, we shall collect qualitative data via audio recordings of COTiD-UK sessions and conduct semi-structured interviews with pairs and occupational therapists. Discussion COTiD-UK is an evidence-based person-centred intervention that reflects the current priority to enable people with dementia to remain in their own homes by improving their capabilities whilst reducing carer burden. If COTiD-UK is clinically and cost effective, this has major implications for the future delivery of dementia services across the UK. / This is independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP-PG-0610-10108). The VALID research team acknowledges the support of the National Institute of Health Research Clinical Research Network. This research is sponsored by North East London NHS Foundation Trust (NELFT).

Originalmente, o termo sarcopenia foi definido como a diminuição da massa muscular relacionada ao envelhecimento. Ao longo da última década, tornou-se um termo mais abrangente reunindo a redução da força muscular (dinapenia) à redução da massa muscular. Em 2010, o European Working Group on Sarcopenia in Older People (EWGSOP), no intuito de promover melhor a identificação e o tratamento de sarcopenia, sugere, em consenso, que a mesma seja reconhecida como uma síndrome geriátrica. Dessa forma, recomenda o diagnóstico baseado na redução da massa muscular, obrigatoriamente associada à redução da força muscular e do desempenho físico. Entretanto, poucos são os estudos que estimaram a prevalência de sarcopenia em idosos usando o consenso do EWGSOP e nenhum realizou essa estimativa na América Latina. Além disso, esse conceito não foi analisado como fator de risco para incidência de incapacidade e, em populações com mais de 60 anos, como fator de risco para óbito. Contudo, dada as divergências conceituais entre sarcopenia e dinapenia, nenhum estudo comparou os resultados desses dois conceitos para os desfechos supracitados. Essa tese apresenta três artigos: O primeiro analisou a prevalência e os fatores associados à sarcopenia em idosos residentes no Município de São Paulo. A prevalência de sarcopenia encontrada foi de 15,4 por cento (16,1 por cento em mulheres e 14,4 por cento em homens). Idade avançada, prejuízo cognitivo, baixa renda, fumo, desnutrição e risco de desnutrição (p<0,05) foram fatores associados à sarcopenia. O segundo artigo comparou a associação da sarcopenia e da dinapenia com a incidência de incapacidade em mobilidade ou atividades instrumentais de vida diária e com incapacidade em atividades básicas e instrumentais de vida diária, organizadas num modelo conceitual hierárquico. A sarcopenia foi associada à incapacidade em mobilidade ou atividades instrumentais de vida diária (razão de risco relativo = 2,38, IC 95 por cento 1,10 5,17) enquanto a dinapenia não foi associada à incapacidade. O terceiro artigo comparou a associação da sarcopenia e da dinapenia com mortalidade. Tanto a sarcopenia (hazzard ratio = 1,52, IC 95 por cento 1,06 2,19) quanto a dinapenia (hazzard ratio = 2,04, IC 95 por cento 1,24 3,37) foram fatores de risco independentes para óbito. Contudo, a sarcopenia pode ser usada como instrumento de screening em Saúde Pública para identificar idosos sob-risco de desenvolver tipos prematuros de incapacidade e em condições clínicas que possam aumentar o risco de óbito / Originally, the sarcopenia term was defined as a decrease in muscle mass related to aging. Over the last decade, it became a broader term gathering reduced muscular strength (dynapenia) and reduced muscle mass. In 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) in order to improve the identification and treatment of sarcopenia suggests, in consensus, that it be recognized as a geriatric syndrome. This way, recommends the diagnosis based on low muscle mass, necessarily associated with low muscle strength and low physical performance. However, few studies have estimated the prevalence of sarcopenia in elderly using the EWGSOP definition and none made this estimation in Latin America. Furthermore, this concept was not analyzed as a risk factor for incidence of disability and, in people over 60 years, as a risk factor for death. However, given the conceptual divergences between sarcopenia and dynapenia, none study has compared the results of these two concepts to the outcomes above. This thesis presents three papers. The first one examined the prevalence and associated factors of sarcopenia among community dwelling elderly in São Paulo. The prevalence of sarcopenia was 15.4 per cent (16.1 per cent in women and 14.4 per cent in men). Advanced age, cognitive impairment, low income, smoking, undernutrition and risk for undernutrition (p<0.05) were factors associated with sarcopenia. The second paper compared the association of sarcopenia and dynapenia with the incidence of disability in mobility or instrumental activities of daily living and with disability in activities of daily living and instrumental activities of daily living, organized in a hierarchical conceptual model. Sarcopenia was associated with mobility or instrumental activities of daily living disability (relative risk ratio = 2.38, 95 per cent CI 1.10 5.17) while dynapenia was not associated with disability. The third paper compared the association of sarcopenia and dynapenia with mortality. Both sarcopenia (hazzard ratio = 1.52, 95 per cent CI 1.06 2.19) as dynapenia (hazzard ratio = 2.04, 95 per cent CI 1.24 3.37) were independent risk factors for death. Nevertheless, sarcopenia can be used as a screening in Public Health in order to identify elderly at risk of developing premature types of disability and with medical conditions that may increase the risk of death

Diss. (sammanfattning) Umeå : Umeå universitet, 2010.

Originalmente, o termo sarcopenia foi definido como a diminuição da massa muscular relacionada ao envelhecimento. Ao longo da última década, tornou-se um termo mais abrangente reunindo a redução da força muscular (dinapenia) à redução da massa muscular. Em 2010, o European Working Group on Sarcopenia in Older People (EWGSOP), no intuito de promover melhor a identificação e o tratamento de sarcopenia, sugere, em consenso, que a mesma seja reconhecida como uma síndrome geriátrica. Dessa forma, recomenda o diagnóstico baseado na redução da massa muscular, obrigatoriamente associada à redução da força muscular e do desempenho físico. Entretanto, poucos são os estudos que estimaram a prevalência de sarcopenia em idosos usando o consenso do EWGSOP e nenhum realizou essa estimativa na América Latina. Além disso, esse conceito não foi analisado como fator de risco para incidência de incapacidade e, em populações com mais de 60 anos, como fator de risco para óbito. Contudo, dada as divergências conceituais entre sarcopenia e dinapenia, nenhum estudo comparou os resultados desses dois conceitos para os desfechos supracitados. Essa tese apresenta três artigos: O primeiro analisou a prevalência e os fatores associados à sarcopenia em idosos residentes no Município de São Paulo. A prevalência de sarcopenia encontrada foi de 15,4 por cento (16,1 por cento em mulheres e 14,4 por cento em homens). Idade avançada, prejuízo cognitivo, baixa renda, fumo, desnutrição e risco de desnutrição (p<0,05) foram fatores associados à sarcopenia. O segundo artigo comparou a associação da sarcopenia e da dinapenia com a incidência de incapacidade em mobilidade ou atividades instrumentais de vida diária e com incapacidade em atividades básicas e instrumentais de vida diária, organizadas num modelo conceitual hierárquico. A sarcopenia foi associada à incapacidade em mobilidade ou atividades instrumentais de vida diária (razão de risco relativo = 2,38, IC 95 por cento 1,10 5,17) enquanto a dinapenia não foi associada à incapacidade. O terceiro artigo comparou a associação da sarcopenia e da dinapenia com mortalidade. Tanto a sarcopenia (hazzard ratio = 1,52, IC 95 por cento 1,06 2,19) quanto a dinapenia (hazzard ratio = 2,04, IC 95 por cento 1,24 3,37) foram fatores de risco independentes para óbito. Contudo, a sarcopenia pode ser usada como instrumento de screening em Saúde Pública para identificar idosos sob-risco de desenvolver tipos prematuros de incapacidade e em condições clínicas que possam aumentar o risco de óbito / Originally, the sarcopenia term was defined as a decrease in muscle mass related to aging. Over the last decade, it became a broader term gathering reduced muscular strength (dynapenia) and reduced muscle mass. In 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) in order to improve the identification and treatment of sarcopenia suggests, in consensus, that it be recognized as a geriatric syndrome. This way, recommends the diagnosis based on low muscle mass, necessarily associated with low muscle strength and low physical performance. However, few studies have estimated the prevalence of sarcopenia in elderly using the EWGSOP definition and none made this estimation in Latin America. Furthermore, this concept was not analyzed as a risk factor for incidence of disability and, in people over 60 years, as a risk factor for death. However, given the conceptual divergences between sarcopenia and dynapenia, none study has compared the results of these two concepts to the outcomes above. This thesis presents three papers. The first one examined the prevalence and associated factors of sarcopenia among community dwelling elderly in São Paulo. The prevalence of sarcopenia was 15.4 per cent (16.1 per cent in women and 14.4 per cent in men). Advanced age, cognitive impairment, low income, smoking, undernutrition and risk for undernutrition (p<0.05) were factors associated with sarcopenia. The second paper compared the association of sarcopenia and dynapenia with the incidence of disability in mobility or instrumental activities of daily living and with disability in activities of daily living and instrumental activities of daily living, organized in a hierarchical conceptual model. Sarcopenia was associated with mobility or instrumental activities of daily living disability (relative risk ratio = 2.38, 95 per cent CI 1.10 5.17) while dynapenia was not associated with disability. The third paper compared the association of sarcopenia and dynapenia with mortality. Both sarcopenia (hazzard ratio = 1.52, 95 per cent CI 1.06 2.19) as dynapenia (hazzard ratio = 2.04, 95 per cent CI 1.24 3.37) were independent risk factors for death. Nevertheless, sarcopenia can be used as a screening in Public Health in order to identify elderly at risk of developing premature types of disability and with medical conditions that may increase the risk of death

Background: Shift work is performed in different times, often in evenings and during weekends. Shift worker’s physical health is affected in a negative way. Shift work contributes to reduced participation in everyday activities which in turn affects the quality of life and family life. Purpose: To describe the occupational performance and experience of participation in everyday activities among shift workers. Method: A questionnaire study was made at an industrial workplace where 30 shift workers participated. The questionnaire used was "Occupational Gap Questionnaire" (OGQ). The aim of the instrument is to study participation in everyday activities by measuring what people do and to what extent they want to do it. Shift workers were divided into each shift in order to study variations in occupational performance. Collected and processed data is presented using descriptive statistics. Results: Shift workers performed all activities included in the instrument, but on different levels. The types of activities that had most occupational gaps were in the category IADL. Conclusion: Shift workers in the study have good participation in their everyday activities despite shift work / Bakgrund: Skiftarbete är arbete som utförs på rullande schema, ofta under kväll och helger. Den fysiska hälsan påverkas negativt vid denna typ av arbete. Skiftarbete bidrar även till nedsatt delaktighet i vardagliga aktiviteter som därmed påverkar bland annat livskvalitet och familjeliv. Syfte: Att beskriva aktivitetsutförande och upplevelse av delaktighet i vardagliga aktiviteter bland skiftarbetare. Metod: En enkätstudie gjordes på en industriarbetsplats i Jönköping där 30 skiftarbetare deltog. Enkäten var konstruerad från det arbetsterapeutiska instrumentet ”GAP i vardagens aktiviteter” (GAP). Instrumentet avser att studera delaktighet i vardagliga aktiviteter genom att mäta vad en person gör samt i vilken grad personen vill utföra aktiviteten. Skiftarbetare delades in i respektive skift för att se variationer i aktivitetsutförande. Insamlad och bearbetad data presenterades via deskriptiv statistik. Resultat: Skiftarbetarna utförde alla aktiviteter som ingick i instrumentet men upplevde olika nivåer av delaktighet. Flest aktivitetsgap fanns inom aktivitetskategorin I-ADL. Slutsats: Skiftarbetarna i studien upplever god delaktighet i sina vardagliga aktiviteter trots skiftarbete.

La Réalité Virtuelle (RV) semble ouvrir des voies de recherche prometteuses, pour évaluer l’impact des troubles cognitifs chez des personnes cérébrolésées dans des situations de vie quotidienne simulées. Cette application réactualise des questions relatives à la validité écologique des évaluations neuropsychologiques et aux liens entre performance fonctionnelle et processus cognitifs. Objectif : La présente thèse se propose d’étudier la validité écologique d’environnements virtuels et les relations entre performance fonctionnelle et processus cognitifs à l’aide de deux tâches de vie quotidienne simulées sous RV, chez des patients cérébrolésés. Matériels et Méthodes Expérimentation 1 : 27 patients traumatisés crâniens ont été consécutivement inclus et répartis en 2 groupes. Le premier groupe de 13 sujets a appris un trajet dans un quartier proche de l’hôpital de Bordeaux. 14 sujets ont suivi la même procédure dans un quartier virtuel recréant le même environnement réel. Différents tests sur les représentations spatiales ont été ensuite effectués. Expérimentation 2 : 95 patients cérébrolésés après traumatisme crânien ou AVC ont réalisé une tâche de courses dans le supermarché virtuel VAP-S (Marié et al 2003, Klinger et al 2004). En outre, 50 de ces sujets ont passé une batterie neuropsychologique testant les grands processus cognitifs. Résultats Expérimentation 1 : Il n’y a pas de différence significative des caractéristiques générales ou pathologiques entre les deux groupes. Parmi les tests de représentation spatiale, seule une épreuve d’arrangement d’images montre des résultats supérieurs en environnement réel [U = 32.5; p = 0.01]. Expérimentation 2 : Il n’y a pas de différence significative entre les 50 sujets qui ont passé la batterie complète et les 45 autres sujets pour ce qui concerne les données démographiques, les scores neuropsychologiques, la thymie et l’insertion sociale. Une analyse en composantes principales (ACP) portant sur les résultats des 50 sujets testés avec la batterie neuropsychologique complète propose un modèle à 4 facteurs qui explique 69.4% de la variance. Dans ces facteurs, les capacités en mémoire épisodique, en mémoire prospective et en organisation perceptive montrent autant de liaisons avec les indicateurs VAPS que l’attention et les composantes exécutives (inhibition et mise à jour). L’un de ces facteurs (F3) est en outre relié à l’insertion sociale, ce qui est un argument en faveur de la validité écologique du VAP-S. Discussion. Dans la première expérimentation, bien que les représentations spatiales générées par un environnement réel et un environnement virtuel paraissent différentes, la RV donne des résultats comparables à l’environnement réel, et se montre ainsi une technique fiable et sans danger pour l’évaluation fonctionnelle de la performance topographique. La deuxième expérimentation suggère qu’une tâche de vie quotidienne simulée sous RV telle que faire des courses dans un supermarché virtuel mobilise l’ensemble des ressources cognitives dans des interactions probablement proches de la vie quotidienne réelle. Elle permet de dépasser les limites d’une neuropsychologie fractionnée du fonctionnement cognitif, dans de bonnes conditions de mesure écologique. Beaucoup de prudence s’impose néanmoins dans l’interprétation et la généralisation des résultats du fait d’importantes variations individuelles. Conclusion La présente thèse confirme la validité écologique d’évaluations d’activités de la vie quotidienne en environnement virtuel (validité écologique) et approche la complexité des relations entre la performance observée en vie quotidienne et les processus cognitifs qui les sous-tendent. / Virtual Reality (VR) seems to open promising ways to research, particularly regarding the impact of cognitive deseases among people with acquired brain injury (ABI) immersed in simulated daily life situations. The use of VR raises or brings up to date concerns about the ecological validity of neuropsychological tests and the links between functional performance and cognitive processes. Aim: This thesis aims to study the ecological validity of virtual environments and relationships between functional performance and cognitive processes using two simulated tasks of daily life among people with ABI. Apparatus and method: Experimentation 1 Study population: 27 patients with Traumatic Brain Injury had been consecutively included and divided into two groups.Method: the first group including 13 subjects learned a route in an urban district near from the hospital of Bordeaux. In the second group 14 subjects had to do the same procedure in a virtual district that replicated the real environment. All subjects had to complete spatial representation tests at the end of the delayed recall route. Experiment 2 Study population: 95 patients with ABI (essentially including people with TBI or Cerebral Vascular Desease) were included. Method: Subjects had to do errands in the virtual supermarket VAP-S (Marié et al 2003, Klinger et al 2004). Among the initial group 50 subjects had a neuropsychological battery.Results Experiment 1 No significant difference has been found between the two groups according to demographic data and TBI severity. There was no effect of the real or virtual environement on the recall of route and the number of error was the same wathever was the environmental condition [(1, 25) = 0.679; p = 0.4176)]. Among the spatial representation tests, only the scene arrangement test were higher in the real environment [U = 32.5; p = 0.01]. Expériment 2 No significant difference between the two groups has been found according to demographic data, neuropsychological tests, mood, and social integration. A Principal Componant Analysis (PCA) on the results of the 50 subjects who had completed the whole neuropsychological battery raised a four factor solution that accounts for 69.4% of the variance. Among these factors, episodic memory, prospective memory and perceptual organization showed as many relationships with VAP-S indicators as attention and executive componants (inhibition and updating). The factor 3 is linked to social integration. It is an argument in favor of the ecological validity of the VAP-S Discussion In the first experiment, despite the fact that spatial representations seemed different between the real and virtual environments, learning results were the same. RV is a reliable and safe to assess the topographical performance which is important in the daily life and notably in social and vocational rehabilitation. The second experiment suggested that VR simulated activity of daily living as shopping in a virtual supermarket bring together cognitive resources within interactions probably close than daily life. This result overcomes the limits of the splitting cognitive functioning in neuropsychology with a good ecological validity. However these results must be examined with caution due to large individual variation. Conclusion This thesis confirms the ecological validity of RV simulated activities of daily living close to the complexity of the relationships between the performance observed in the daily life and cognitive processes that are underlying it. It opens interesting perspectives to assessment and cognitive rehabilitation using RV of people with ABI and cognitive deseases with the purpose to improve autonomy in daily life.