As the average age of life expectancy continues to rise, so too has the number of elderly individuals seeking long-term care. Performing daily tasks becomes a struggle while those affected by Alzheimer's disease and dementia risk their safety by living alone. Aged individuals lacking the means or faculties to live independently often seek assisted living and memory care facilities as the most viable options for the growing elderly population. Typical facilities are compact and sterile where residents are under watchful supervision to perform basic daily activities. As a result, aged individuals spend every day inside the facility with a structured, monotonous routine. A repetitive lifestyle within the same surroundings and with little autonomy can lead to feelings of isolation, depression, and disengagement from the same facility designed to care for the elderly population. My thesis aims to create an assisted living and memory care village, rather than a facility, that calls upon the comforts of home in a neighborhood setting. Within the village, residents are free to engage, explore, and take part in activities as self-sufficient human beings. Located in Frederick, Maryland, my objective is to design a small-town community that enables both on and off-site engagement. I analyzed architectural design methods that mitigate the struggles of daily activities while maintaining privacy and independence, and also researched a largely overlooked aspect of assisted living facilities: site development. This enabled me to curate a space where residents are free to explore and take part in various activities throughout the site. A monotonous routine leads to a stagnant mind. My thesis aims to create a space where exploration and independence are not only permitted but encouraged. Rather than aging in place, the goal is to live in place while the mind and body are in motion, making new memories and discoveries every day. / Master of Architecture / My aunt faced the challenge of her elderly mother experiencing white coat hypertension: an increase in blood pressure due to anxiety and stress during doctor visits. But it made a remarkable difference after she switched to a specialized geriatric office that emphasized a welcoming, homelike design. The warm ambiance, comforting decor, and personalized care reduced her anxiety, alleviating her white coat hypertension and resulting in regular blood pressure readings. This experience inspired me to emphasize the importance of geriatric-friendly design in assisted living and memory care facilities. In response to this issue, my thesis proposes the creation of an assisted living and memory care village instead of a traditional facility. The village aims to provide a homelike setting where residents can experience a sense of comfort and freedom. I have analyzed architectural design methods that address the struggles of daily activities while maintaining privacy and independence. Additionally, I have explored the often overlooked aspect of site development in assisted living facilities to curate the space thoughtfully where residents are encouraged to explore and engage in various activities throughout the village and evoke feelings of home, community, and comfort.

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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.