The number of annual implantable cardioverter defibrillator (ICD) implants has substantially increased over the last 5 years and is expected to grow rapidly. Implantable cardioverter defibrillators have a proven mortality benefit by terminating the life-threatening arrhythmias, even near end of life. In patients with moderate/severe symptomatic heart failure, enough clinical literature representing mortality benefits has been published, but limited numbers of studies have reviewed the dwindling risk-benefit profile near end of life, studying quality of life (QoL)/psychosocial impact. Criteria outlining either continued use or deactivation policy/procedures near end of life have not been clearly defined and/or largely implemented, which in turn requires more focused research using multifactorial approach to determine improved patient-centered outcomes.

Activities of daily living (ADL) are fundamental to participation in daily life. Even if participation is necessary for person’s well-being and development, individuals with disabilities often are not participating in basic life domains. Children with autism spectrum disorder (ASD) can have an impact on many basic functional areas such as daily living skills. The daily living skills (DLS) contain the ability of children to participate in activities such as personal hygiene, dressing, household chores and money management that are important prerequisites for self-sufficiency and autonomy. The aim of this systematic literature review was to investigate the existence and the outcomes of intervention programs which can enhance daily living skills for children with autism spectrum disorder. A search for peer-reviewed articles evaluating such intervention programs and published between 2010 and 2020 was performed. The search in several databases resulted in eight articles. The findings were grouped based on the kind and the target activity of each intervention program. Most of the identified studies have reported effective outcomes using various intervention programs for the improvement of DLS such as picture prompting, video prompting, video-game training, self-monitoring, behavioural training and therapeutic horseback riding aiming in activities such as hygiene, clothing, cooking and money management.  The International Classification of Functioning, Disability and Health, version for Children and Youth (ICF-CY) and the Occupational Therapy practice framework were used as a base for the discussion after the analysis. Despite the number of studies found, not enough research has been done to describe and evaluate interventions enhancing the performance in ADL. The findings of this review may serve as a resource for future researchers, who are working with children in need of special support.

Policies at assisted living facilities should be designed to develop high quality social relationships among older persons that could increase the contentment of the residents. Despite the broad consensus on this mission, the role of social support in the perceived contentment of assisted living facility residents has not been adequately explored. Using social network theory as the framework for this study, the purpose of this quantitative study was to determine whether (a) perceived level of social support was related to perceived level of contentment with life among assisted living facility residents, (b) the length of time spent in the facility was related to perceived levels of contentment, and (c) perceived social support moderated the relationship between the length of time in the facility and perceived levels of contentment with life. The sample included 100 residents from 2 assisted living facilities in North Carolina. The Multidimensional Scale of Perceived Social Support and the Generalized Contentment Scale were used in this study. Linear regression analyses were employed to answer the research questions. Participants with higher levels of perceived social support tended to have higher levels of perceived contentment with life, and the length of time residents had spent in the facility was not related to their perceived contentment with life. In addition, levels of social support did not moderate the relationship between the length of time respondents had been in the facility and contentment; age, gender, ethnicity, and marital status were not related to perceived contentment with life. This study leads to positive social change by providing long-term care providers with information on social support systems and how staff can create conditions for them to enjoy better social relationships and experience greater support, thereby facilitating their contentment with life.

© [2015] American Physical Therapy Association. / 京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第19641号 / 人健博第33号 / 新制||人健||3(附属図書館) / 32677 / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 市橋 則明, 教授 山田 重人, 教授 妻木 範行 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

Bakgrund: Höftfraktur hos äldre är en vanlig anledning till inläggning på ortopediska avdelningar. Att som äldre patient vårdas på sjukhus är associerat med negativa hälsoeffekter då det påverkar förmågan att utföra aktiviteter i dagliga livet (ADL), ADL är grundläggande för att en patient ska kunna klara sig hemma utan stöd från vården. Under vårdtiden behöver denna förmåga bedömas i syfte att skapa rätt omvårdnadsåtgärder för att bibehålla patientens ADL, samt sträva efter att dessa aktiviteter utförs självständigt. Syfte: Identifiera vilka åtgärder som kan främja äldre patienter till bibehållen ADL efter genomgången höftoperation. Metod: En allmän litteraturstudie användes för att besvara syftet. Resultat: Resultatet presenteras i fyra teman: “Tidig mobilisering”, “Personcentrerad rehabilitering”, “Stöd för att optimera näringsintaget” samt “Användandet av mätinstrument”. För att beskriva ADL användes flera mätskalor som gav information om patientens utgångspunkt och effekten av rehabilitering. Patienter som mobiliserades tidigt efter operationen hade en minskad risk för komplikationer och därmed hade patienten större möjlighet att återhämta sin personliga ADL-förmåga. Välutbildad vårdpersonal gav personcentrerad och tydlig information, vilket gjorde att rehabiliteringsplanen följdes. Ytterligare information om patientens näringsintag behövde införskaffas för att kunna optimera rehabiliteringen, då patienterna led av otillräcklig näringstillförsel. Konklusion: För att hjälpa patienten till bibehållen ADL under vårdtiden behövs kontinuerlig personcentrerad information från vårdpersonalen, när personal är välutbildad finns det bättre möjlighet för patientinvolvering. Detta kan uppmuntra till att omvårdnadsåtgärderna utförs och följs av patienten. Näringsintaget behöver identifieras och observeras för att patienten ska få i sig tillräckligt med näring och få ut det mesta av rehabiliteringen. / Background: Hip fracture among elderly is a common reason for patient admission to orthopedic wards. Being treated in a hospital as an elderly patient is associated with adverse health effects, as it affects their ability to perform activities of daily living (ADL). ADL is fundamental for patients to manage at home without support from caregivers. During hospitalization this ability needs to be assessed in order to create the right nursing measures to maintain the patients ADL, as well as strive for these activities to be performed independently. Aim: Identify which measures can promote elderly patients to maintain ADL after undergoing hip surgery. Method: A general literature study was used to answer the purpose. Results: The results are comprised of four themes: "Early mobilization", "Person-centered rehabilitation", "Support for optimizing nutrient intake” and “The usage of measuring instruments”. To examine ADL, several measurement scales were used that provided information about the patient's starting point and the effect of rehabilitation. Patients who were mobilized early after surgery had a reduced risk of complications and thus the patient had a greater opportunity to regain their personal ADL ability. Well-trained staff provided person-centered care and clear information, which meant that the rehabilitation plan is followed. Additional information about the patient's nutritional intake needed to be obtained in order to optimize rehabilitation, as the patients suffered from insufficient nutritional supply. Conclusion: To help the patient to maintain ADL during the care period, continuous person-centered information from the care staff is needed, when the staff is well trained, there is a better opportunity for patient involvement. This can encourage the nursing measures to be performed and followed by the patient. Nutritional intake needs to be identified and observed in order for the patient to get enough nutrition and get the most out of the rehabilitation.

No description available.

Att handla dagligvaror i ett digitaliserat samhälle ur äldre personers perspektiv Inledning och bakgrund: Samhället blir allt mer digitaliserat och människor lever allt längre. Görandet, processen och utförandet av att göra inköp av dagligvaror med digital teknik kan bli begränsat när kunskaper och färdigheter utmanas i aktiviteten hos äldre personer. Syfte: Att beskriva aktiviteten inköp av dagligvaror både digitalt och i verkliga livet ur äldre personers perspektiv. Metod: En Scoping review genomfördes i databaserna Scopus, Cinahl, ProQuest Central samt Google Scholar och Bielefeld Academic Search Engine (BASE) för grålitteratur. Manuella sökningar och fritextsökning gjordes också. Totalt inkluderades 18 artiklar som granskades och sammanställdes genom numerisk och tematisk analys.  Resultat: Resultatet beskriver en översikt utifrån de tre huvudteman med tillhörande underteman; Hinder vid utförande av att handla dagligvaror, Äldre personers upplevelse av att handla dagligvaror med stöd av digital teknik samt Stödjande strategier vid inköp med digital teknik. Slutsats: Denna studies övergripande bild minskar kunskapsluckan om hur arbetsterapeuter kan arbeta strategiskt och möta de krav och behov som ställs hos äldre personer i utförandet av aktiviteten inköp av dagligvaror med digital teknik. Vidare kan den bidra till ökad inkludering av digital teknik i samhället hos äldre personer. / Grocery shopping in a digitalized society from the perspective of older persons Introduction: Society is becoming increasingly digitalized, and people are living longer. The doing, process and performance of grocery shopping with digital technology can be limited when knowledge and skills are challenged in the activity of older people.  Aim: To describe the activity of grocery shopping both digitally and in real life from the perspective of older people. Method: A Scoping review was conducted in the databases Scopus, Cinahl, ProQuest Central, and Google Scholar, Bielefeld Academic Search Engine (BASE) for gray literature. Manual searches and free text searches were also performed. A total of 18 articles were included, which were reviewed and summarized through numerical and thematic analysis. Results: The results describe an overview based on the three main themes with associated sub-themes; Barriers in performing grocery shopping, Older people`s experience of shopping for grocery with the support of digital technology and Supportive strategies when shopping with digital technology.  Conclusions: This study´s overall picture reduces the knowledge gap on how occupational therapists can work strategically and meet the requirements and needs of older people in the performance of being able to conduct the activity of buying groceries with digital technology. Contribute to increasing the digital inclusion of older people in society.

The author examined current literature supporting the use of innovative, music-based interventions to support young children with autism spectrum disorder and other developmental disabilities engage in the things that they want, need, and desire to do. The author introduced Song-based Interventions for Navigating Gains in Occupational Therapy (SING-OT), as an innovative, music-based educational intervention program designed to support the engagement, participation, and performance needs of young children with disabilities. SING-OT uses an evidenced-supported, client-centered, and interests and strengths-driven approach. This proposed multi-phase program focuses on improving knowledge on the literature connecting evidence to song-based interventions and providing access to uniquely composed, occupation-inspired songs, that support children’s performance and participation needs. Additionally, conducting an initial feasibility study that assesses the effectiveness of task completion in a common personal hygiene and grooming task within the preschool setting was recommended. Future developments extend to improving caregiver health and wellness outcomes through training opportunities. The author provided a comprehensive program evaluation plan that highlights key stakeholders, a proposal for a single-subject study design, and implications of the program. The SING-OT program can be utilized as (1) an additional intervention tool for practicing occupational therapy practitioners and other professionals, (2) an avenue for interprofessional collaboration, and (3) a vehicle for improving the occupational performance outcomes among young children with disabilities.

Research has demonstrated that everyday functional abilities are compromised in mild cognitive impairment (MCI), a transitional stage between normal cognitive aging and dementia, as well as in healthy aging. These functional changes have been shown to be strong predictors of future decline, highlighting their importance. However, early changes in everyday functioning remain poorly characterized, largely due to a scarcity of sensitive measures capable of detecting subtle disruption. Recent research suggests that eye-tracking methodology may be effective in addressing this gap. Fifty-two participants (27 younger adults and 25 non-demented older adults) completed a novel eye-tracking task involving passive viewing of a naturalistic scene and verbalization of a task goal (e.g., make coffee, pack a lunch). Participants also completed a performance-based measure of everyday action that required them to enact the same tasks (e.g., coffee, lunch) that were included in the eye-tracking paradigm, self-report measures of functional ability, and neuropsychological measures. Mixed ANOVAs were conducted to examine group (young, old) and condition (passive viewing, verbalization)/task (simple, complex) effects on eye-tracking and everyday action performance. Independent samples t-tests/Mann-Whitney U tests were conducted to examine group differences in eye-tracking and everyday action performance. Correlation analyses across all measures were conducted to evaluate the potential mechanisms of eye-tracking and everyday action results. Results showed no significant group differences in the primary eye-tracking variables, but both groups made a lower proportion of fixations to distractor (i.e., non-target) objects during task verbalization compared to passive scene viewing. Older adults made more inefficient actions during performance-based everyday task completion, particularly when task demands were high. Eye tracking and everyday action variables were related to different measures of self-reported functional ability. Finally, eye-tracking variables were primarily related to neuropsychological measures of executive functions/working memory, whereas everyday action performance was most strongly related to measures of verbal learning and memory. These findings suggest that age-related functional changes at the level of eye movements may occur after changes in behavioral performance of everyday tasks. Importantly, performance-based assessment of everyday action appears sensitive to age-related decline. Additionally, naturalistic eye movements and everyday task performance may reflect distinct components of self-reported functioning and may be driven by distinct cognitive processes. Future research with refined naturalistic eye-tracking tasks and samples with a wider range of impairment is necessary to further explore these findings and improve characterization and detection of risk for dementia. / Psychology

This study examined the role of health care access and health care resources in the association between subjective aging and activities of daily living among older adults. We examined subjective aging in the context of subjective cognitive decline (SCD) relationships in three studies: (1) a scoping review of healthcare access (HCA) and resources (HCR) on dementia and COVID-19 among African American older adults; (2) subjective cognitive decline in basic activities of daily living (bADL) across age cohorts, older adults and (3) subjective cognitive decline in instrumental activities of daily living (IADL) across older adults' moderation by HCA and mediation by HCR. For the scoping review, we utilized the population, concept, and context inclusion and exclusion criteria for study admissibility for articles published on dementia and COVID-19 studies in English language journals that published from January 2019 to December 2022. The two empirical studies utilized the 2021 round 11 of the National Health and Aging Trends dataset of older adults aged 70 to above 90 funded by the National Institute for Aging. We employed multiple regression and the bias-corrected percentile Bootstrap with 5000 samples using standard path-analytic approaches for the moderated-mediation approach for the two empirical studies. Findings from the scoping review indicated racial and age disparities affected older African American adults with dementia and COVID-19, associated with lower HCA and marginal HCR. Results of mediation–moderation analysis showed SCD, lower HCR, and HCA predict a decline in bADL to be higher among the older-old age (80-89) compared to the middle-old age (70-79) or oldest-old (90 years +) cohorts. We observed similar effects for IADL. The findings from the two empirical studies suggest a "doughnut" effect by which the older-old age cohort of 80-89 may be coping less well with their bADL, as well as IADL, while the oldest-old may have adapted to functional loss in their everyday living and/or comprises adults who may have passed a mortality selection despite a more significant burden of comorbidity.