Orientador: Mônica Sanches Yassuda / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-22T00:34:44Z (GMT). No. of bitstreams: 1 Arroyo_NataliaCosta_M.pdf: 1902872 bytes, checksum: 5408a7c634beba4926a09b390cc2314a (MD5) Previous issue date: 2013 / Resumo: A funcionalidade é um novo paradigma de saúde entre os idosos. As atividades instrumentais de vida diária (AIVD) representam um importante indicador de saúde, visto que são as primeiras atividades a serem comprometidas na presença de comprometimento cognitivo e são essenciais para a manutenção do idoso no seu contexto social. Assim, este trabalho tem por objetivo identificar dentre as variáveis sociodemográficas, de saúde autorrelatadas e indicadores de fragilidade, quais fatores são independente e conjuntamente associados às dificuldades observadas na realização das AIVD. Trata-se de um estudo de caráter transversal, conduzido com 2282 idosos que participaram da pesquisa "Estudo da fragilidade em idosos brasileiros", desenvolvida pela Rede FIBRA - Fragilidade em idosos brasileiros, pólo UNICAMP. As AIVDs foram avaliadas pela Escala de Lawton e a síndrome da fragilidade foi identificada pelos critérios propostos por Fried et al. (2001). Verificou-se que cerca de 38% da amostra apresentou dependência para pelo menos uma AIVD. Análises de regressão multivariada indicaram que os fatores mais fortemente associados à dificuldade nestas atividades foram ser frágil ou pré frágil, ter 80 anos ou mais, ter renda familiar de 0 a 3 salários mínimos e apresentar sintomas depressivos. Conclui-se que a melhora das condições de saúde dos idosos brasileiros está intimamente relacionada à melhora das condições socioeconômicas, à diminuição das condições associadas à fragilidade e à melhora em saúde mental. O desenvolvimento de medidas preventivas à síndrome da fragilidade e de programas terapêuticos para a prevenção de sintomatologia depressiva faz parte da atenção integral à pessoa idosa / Abstract: Functionality is a new health paradigm among the elderly. Instrumental activities of daily living (IADL) are an important indicator of health, as they are the first activities to be impaired in the presence of cognitive impairment and they are essential for the maintenance of the elderly in their social context. Thus, this study aimed to identify among sociodemographic variables, self-reported health indicators and markers of frailty, which factors are independently and jointly associated with perceived difficulties in performing IADL. This was a cross sectional study, conducted with 2282 seniors who participated in the study "Study of frailty among elderly Brazilians," developed by the FIBRA network, at UNICAMP. IADLs were assessed by the Lawton scale and the frailty syndrome was identified by the criteria proposed by Fried et al. (2001). Multivariate regression analyzes indicated that about 38% of participants showed limitations in at least one IADL. The factors most strongly associated with difficulty in these activities were being frail or pre frail, being 80 years or older, having a family income of 0 to 3 minimum wages and depressive symptoms. We concluded that the improvement of the health conditions of older Brazilians is closely related to the improvement of socioeconomic conditions, the reduction of conditions associated with frailty and improvement in the mental health of seniors. The development of preventive measures for the frailty syndrome and therapeutic programs for the prevention of depressive symptoms should be part of the comprehensive care of the elderly / Mestrado / Gerontologia / Mestra em Gerontologia

The thesis deals with the issue of executive functions in patients with acquired brain injury and possibilies of executive deficit detection in real life circumstances. The thesis is divided into theoretical and empirical part.The theoretical part consists of three chapters. In the first chapterthe definition, localization and different disorders of executive functions are mentioned. The second chapter presents some neuropsychological methods suitable for executive functions assessment and their limits. In the final chapter the Multiple Errands Test method and its various modifications are introduced. The main purpose of the empirical part was to evaluate the ability of the Multiple Errands Test method - hospital version (MET - HV) to detect deficits in executive functions related to daily life functioning. The research group consisted of patients with acquired brain injury (N = 20) and neurologically healthy adults (N = 20) hospitalized in the Rehabilitation Center Kladruby. The results proved the ability of the method MET - HV to distinguish well between patients with acquired brain damage and healthy adults. The second hypothesis concerning the ability of the method to distinguish between patients with frontal and nonfrontal injury wasn't confirmed. Another purpose of the empirical part was to...

Bakgrund: Bensår är ett tillstånd som blir allt vanligare i Sverige, ökar i takt med hög ålder och definieras som sår som inte läkt inom sex veckor. Att leva med en kronisk hudsjukdom innebär att anpassningar i det dagliga livet måste ske. Syfte: Syftet med föreliggande studie var att beskriva hur personer med bensår upplever sin vardag samt att beskriva vilka undersökningsgrupper som ingick i de inkluderade artiklarna. Metod: En beskrivande litteraturstudie som inkluderade tio stycken vetenskapliga artiklar som söktes fram i databaserna Cinahl och PubMed. Huvudresultat: Bensår påverkade personernas liv fysiskt, psykiskt och socialt. Stora faktorer som bidrog till begränsningar i det dagliga livet var förekomsten av smärta, depression samt rädsla för att utöva fysisk aktivitet. Kontakten med vården var en stor del av vardagen, där personerna upplevde att vården tog upp mycket tid och personerna upplevde även att sjuksköterskorna hade för lite kunskap avseende deras sjukdom och lidande. I artiklarna som utgör resultatet var det mellan 5-1824 deltagare, de flesta deltagarna var kvinnor, åldersspannet var mellan 18 - 104 år, det var främst venösa bensår som förekom och deltagarna hade haft sina bensår mellan 6 veckor - 43 år. Slutsatser: Att leva med ett bensår skapade begränsningar i det dagliga livet och smärta, depression samt rädsla för att utöva fysiskt aktivitet förekom. Det är viktigt som sjuksköterska att uppmärksamma denna patientgrupp för att ge ett professionellt bemötande och en god omvårdnad. / Background: A Leg ulcer is a condition that is becoming more common in Sweden with higher age. Leg ulcers are defined as wounds that are not healed within six weeks. Living with a chronic skin disease means that adaptions in daily life must happen. Aim: The purpose of this study was to describe how people with leg ulcers experience their daily life and to describe which study groups are applied in the included articles. Method: A descriptive literature study that includes ten scientific articles which were searched in the databases Cinahl and PubMed. Main result: Leg ulcer affected people's lives physically, psychologically and socially. Major factors that contributed to daily life limitations where the presence of pain, depression and fear of performing physical activity. The contact with healthcare was a major part of everyday life, were the persons perceived that care took up a lot of time and the persons also found that the nurses had little knowledge about their illness and suffering. In the articles that represented the result there were between 5-1824 participants, most of the participants were women, the age range was between 18-104 years, it was mainly venous leg ulcers that occurred and the participants have had leg ulcer between 6 weeks - 43 years. Conclusion: Living with a leg ulcer created limitation in daily life as a result of pain, depression and fear of performing physical activity. As a nurse it is very important to pay attention to this patient group to provide professional treatment and good care.

Background: Subjective Memory Concerns (SMC) in seniors can be one of the earliest indicators of future dementia. There is a lack of research into the nature of these concerns and functional impairments. Methods: This retrospective secondary analysis gathered data from 67 healthy seniors aged 65+ using neuropsychological tests, memory concern questionnaires and daily functioning scales. Informants corroborated memory concerns and daily functioning. Participants comprised two groups: SMC if worried about their memory and Not Concerned about Memory if not. Results: People with SMC report more difficulty with word finding, remembering appointments, learning to use new equipment, and remembering details of social and personal events. Informants perceive word finding difficulties and minor problems with vocational abilities and bowel/bladder control in SMC participants. Conclusions: The SMC group primarily reports social difficulties. Further research is required to create a comprehensive list of cognitive concerns, which will ultimately improve care of the SMC population. Contexte: Les préoccupations subjectives de mémoire (PSM) chez les aînés peuvent être indicatives d’une démence future, bien qu’il existe un manque d’information sur les préoccupations et l’effet fonctionnel. Méthodes: Une analyse rétrospective secondaire de questionnaires de mémoire, de tests neuropsychologiques, et d’échelles fonctionnelles a été entreprise auprès de 67 personnes, en bonne santé, âgées de 65 ans et plus. Les aidants naturels ont pu appuyer les préoccupations cognitives et le niveau de fonctionnement chez deux groupes de participants: ceux avec préoccupations ou non. Résultats: Les participants PSM relèvent des difficultés de manque du mot, de rappel (rendez-vous, événements sociaux), et d’utilisation de nouveaux équipements. Les aidants naturels ont aussi trouvé de légères difficultés au travail et au niveau du contrôle intestinal et urinaire. Conclusions: Les PSM identifient principalement des lacunes au niveau social. Les recherches devront viser l’identification d’une liste exhaustive des préoccupations afin de pouvoir octroyer de meilleurs soins.

Orientador: Mônica Sanches Yassuda / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-27T17:29:07Z (GMT). No. of bitstreams: 1 Sposito_Giovana_D.pdf: 2581166 bytes, checksum: 5b2db24cb3b900af8525ab613c018eca (MD5) Previous issue date: 2015 / Resumo: Este estudo teve como objetivo investigar as associações entre o engajamento em atividades avançadas de vida diária (AAVD) e o desempenho cognitivo em idosos da comunidade. Os dados foram extraídos do estudo de base populacional, intitulado Fragilidade em Idosos Brasileiros (FIBRA-Unicamp). A amostra foi composta por 2.549 idosos sem comprometimento cognitivo sugestivo de demência, sendo 65,71% mulheres, com idade média de 72,32 anos (±5,55) e escolaridade de 4,37 anos (±3,99). Foram coletadas informações sobre características sociodemográficas (gênero, idade, escolaridade e renda familiar) e condições de saúde (número de doenças relatadas e sintomas depressivos). As AAVD autorrelatadas foram agrupadas em físicas, sociais e intelectuais. O desempenho cognitivo foi avaliado pelo Mini Exame do Estado Mental (MEEM), considerando a pontuação global e os domínios de orientação, memória, atenção e cálculo, linguagem e praxia construtiva. Os escores médios do MEEM foram significativamente maiores entre os homens, os indivíduos mais jovens e aqueles que tinham maior escolaridade, maior renda, menos doenças relatadas e não apresentavam sintomas depressivos. As análises de regressão linear multivariada e análise de regressão hierárquica realizada em blocos (variáveis sociodemográficas, condições de saúde e AAVD físicas, sociais e intelectuais) mostraram que o engajamento em AAVD intelectuais foram associados positivamente com o escore total do MEEM (p=<0,01, R2=0,014 e p=<0,01, R2=0,013 respectivamente). Em relação aos domínios cognitivos, embora modesta, a análise de regressão multivariada mostrou associação entre as AAVDs intelectuais e os domínios de orientação, atenção/ cálculo, linguagem e praxia construtiva (p=0,017, R2=0,005; p=<0,042, R2=0,008; p=<0,001, R2=0,021 e p=<0,001, R2=0,021 respectivamente). As AAVD sociais se associaram aos domínios de memória (p=0,024, R2=0,002) e linguagem (p=0,023, R2=0.004). Não houve associação entre o engajamento em AAVD físicas e o desempenho cognitivo. Anos de escolaridade e maior renda familiar foram as variáveis que se associaram de forma mais robusta ao escore total do MEEM e seus domínios (com exceção apenas entre renda familiar e memória). Os resultados sugerem que o engajamento em AAVD sociais e intelectuais podem ter um papel protetor no envelhecimento cognitivo e que o engajamento em AAVD pode representar uma estratégia viável para a promoção da saúde mental entre os idosos / Abstract: This study aimed to investigate the relationship between the engagement in advanced activities of daily living (AADL) and cognitive performance in community-dwelling seniors. The data presented is drawn from the population-based study Frailty Profile of Elderly Brazilians (FIBRA-Unicamp). The sample comprised 2.549 older adults without cognitive impairment suggestive of dementia, and 65.71% females, mean age of 72.32 years (±5.55) and education of 4.37 years (±3.99). Information on sociodemographic characteristics were collected (gender, age, education and family income) and health conditions (number of diseases and depressive symptoms). The self-reported AADL were grouped into physical, social and intellectual. Cognitive performance was assessed using the Mini Mental State Examination (MMSE), considering the global score and guidance fields, memory, attention and calculation, language and constructive praxis. The mean scores of MMEE were significantly higher among men, younger individuals and those who had more education, higher income, less related diseases and had no depressive symptoms. The analysis of multivariate linear regression and hierarchical regression analysis performed in blocks (sociodemographic variables, health and physical, social and intellectual AADL) have shown that engaging in intellectual AADL were positively associated with total MMSE score (p=<0.01, R2=0.014 and p=<0.01, R2=0.013 respectively). Regarding cognitive domains, though modest, multivariate regression analysis showed an association between the intellectual AADL and guidance fields, attention / calculation, language and constructive praxis (p=0.017, R2=0.005; p=<0.042, R2=0.008; p=<0.001, R2=0.021 e p=<0.001, R2=0.021 respectively). Social AADL joined the domains of memory (p=0.024, R2=0.002) e language (p=0,023, R2=0.004). There was no association between engaging in vigorous physical AADL and cognitive performance. Years of education and family income were the variables associated more robustly to the total MMSE score and your domains (except only between family income and memory). The results suggest that engagement in social and intellectual AADL may have a protective role in cognitive aging and engaging in AADL may represent a viable strategy for promoting mental health among the elderly / Doutorado / Gerontologia / Doutora em Gerontologia

Bakgrund: Robotteknik kan komma att ha en betydande roll i att stötta äldre i framtiden genom att ge såväl kognitivt som fysiskt stöd. Flertalet äldre är sköra och i ständigt behov av hjälp med dagliga aktiviteter. Det bör arbetas för att äldre självständigt ska kunna leva och bo under trygga förhållanden. Syfte: Syftet med studien var att belysa äldres uppfattningar av vårdrobotar som kan hjälpa till med aktiviteter i det dagliga livet. Metod: En litteraturstudie genomfördes med inspiration av en innehållsanalys där 11 artiklar med kvantitativ, kvalitativ och mixad metod användes. Resultat: Resultatet presenterades i fem olika kategorier: äldres önskemål av en vårdrobot, att acceptera en vårdrobot, att välja mellan människa och vårdrobot, betydande aspekter vid användandet av en vårdrobot och att få möjligheten att bli mer självständig. Konklusion: Resultatet visade delade uppfattningar av vårdrobotar som skiljde sig beroende på vad som skulle utföras och vilken typ av vårdrobot aktiviteten utfördes med. Det ses av vikt att sjuksköterskor vid möjlig implementering av vårdrobotar låter äldre själva bestämma om önskan att bli vårdad av en människa eller en robot. Ytterligare forskning kring äldres individuella upplevelser krävs. / Background: Technology of robotics can have a significant role in supporting older persons in the future by providing both cognitive and physical support. The majority of elderly are fragile and in constant need of support in daily activities. Efforts should be made to enable the elderly to independently live, stay and be safe. Aim: The aim of the study was to illustrate older persons perceptions of care robotics to assist activities of daily living. Method: A litterature review was conducted including 11 articles where quantitative, qualitative and mixed method was used. Result: The result was presented in five different categories: elderly’s wishes for a care robot, to accept a care robot, to choose between a human and a care robot, significant aspects of using a care robot and to have the opportunity to be more independent. Conclusion: The results showed that older peoples perceptions differed significantly depending on the specific task performed by the care robotic. When implementing care robotics the nursing staff allows the elderly to decide wether to be taken care of by a human or a robot. Further research is needed in order to reveal the individual experiences of the older people.

Background: Functional Assessment (FA) in older adults is an important measure of their health status. FA using Activities of Daily Living (ADL) is a strong predictor of health outcomes, especially as we age. With the development of increasingly-connected health, we have a new opportunity for more robust and improved FA. Objective: The objective of this thesis is to collate and discuss published evidence on FA predictors and how the FA predictors can be collected using the paradigm of Connected Health (CH) architectures through an industrial case study in CHAPTER 5: INDUSTRIAL CASE STUDY. Methods: The method is to do two Systematic Literature Reviews (SLRs). The two SLRs were undertaken with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) and Parsifal, an online tool for SLR. This thesis catalogs various FA and state-of-the-art Software Engineering Architectural Tactics and Styles (SEATS) used within Connected Health (CH) that focus on ADL. The results of the cataloged information were used in the industrial case study where some of the FA predictors were automated. Articles obtained from the data source during the SLRs were filtered based on the titles, abstracts, full-text provision, English language literature, including age, which must be sixty-five years and above. Another reviewer was also included in this study, while all the defined inclusion and exclusion criteria detailed in this thesis were applied. Information about FA via ADL were extracted from the articles with further extraction on the SEATS used for computer-supported FA during the industrial case study. Data Source: During the SLRs processes, database searched included PubMed, EBSCOhost, Engineering Village, IEEE Xplore Digital Library, and ScienceDirect. The conducted search contains both controlled terms called Medical Subject Headings(MeSH) such as activities of daily living and search strings such as functional assessment, older adults, geriatrics, seniors, elderly care, and aging. Results: From four hundred and ninety-five initial abstracts and titles, nineteen full-text journal articles were included in the final review for the SLR on FA predictors. Six full-text journal articles were obtained from the SLR on CH architectures after reading its 449 titles and abstracts. In the SLR on FA predictors, predictor metrics for FA via ADL were extracted from each of the articles. Gait speed, sleep quality, and movement activities were assessed as ADL predictor metrics for FA in older adults. Other FA predictors published involved self-reported metric scale measurement using Barthel-20 scale and performance-based scale through Timed-UP and Go test. This thesis reviewed each metric for sleep quality and movement activities. In the SLR on CH architectures, quick response of ADL and resource efficiency such as sensors were some of the major tactics related to performance in Software Engineering (SE) quality in CH, while confidentiality and integrity of FA measures related to security in SE quality in CH was another major concern. Conclusion: Having conducted the two SLRs, a wide range of measures were used for FA in older adults, including consideration on the SEATS used for computer-supported FA. Overall, these FA measures and SEATS provide inexpensive and easy-to-implement FA. The diversity of the FA measures and SEATS contributes towards the development of computer-supported FA. However, future work is needed to consider the result of this study as an open-source computer-supported FA tool, and such tool should also be evaluated and verified through direct examination with older adults. / Graduate

The aim of this master's thesis is to describe the possibilities of interprofessional cooperation of an occupational therapist and a behavioral analyst in selected personal activities of daily living in children with autism spectrum disorder (ASD). With the help of activity analysis the view of both experts was demonstrated resulting in the description of their therapeutic intervention. The theoretical part describes the basic characteristics of ASD including selected personal activities of daily living with which children with ASD may have difficulties. The following chapters are about the basic principles of occupational therapy including the description of activity analysis, which is one of the important evaluation methods in occupational therapy. Furthermore the history and the basic characteristics of applied behavioral analysis (ABA) is described focusing on activity analysis used in the ABA program. The next chapter describes the common areas of both professions including shared elements and therapeutic approaches. The last chapter is devoted to the description of the interprofessional cooperation of an occupational therapy and a behavioral analyst. The practical part consists of 3 descriptive case studies in which an occupational therapist and a behavioral analyst performed a task analysis...

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.