Trough previous research we have knowledge about the connection between balance in daily life and the experience of health. The psychological or stressrelated ill health increases despite more people receiving care and treatment. It is therefore a central issue to shed further light on whether we provide the right care based on the perspective of the individuals. The purpose of the study was to describe experiences from adult individuals on sick leave due to psychological or stress related ill health regarding maintaining balance in everyday activities. Data were generated through individual narrative interviews with individuals with psychological or stress related illness, from primary care and analysed using a narrative analysis. The analysis of the data resulted in four themes called strategies for maintaining balance, barriers to balancing strategies to maintaining balance, roles and habits that affects the ability to maintain balance, new experiences that affects the ability to maintain balance. Results show that there is a complexity to maintain balance in daily living and there are many components that effects the ability and conditions to maintain a balance in daily life that promotes health. The results could give a deeper understanding about the need for care through the individuals experience and highlight occupational therapy and the occupational therapist role. This regarding working with the ability to delimit in activity as a step towards developing care and treatment for individuals with psychological or stress related illness. And raise the perspective on the importance of creating sustainability perspective and from socioeconomic gain

This work presents comprehensive analytics of trajectories of functional loss and recovery using sequence analysis and clustering techniques. The study focuses on a large dataset consisting of assessments of activities of daily living conducted among nursing home residents. The first main part of this research involves converting the assessments into sequences of disability combinations and utilizing graphical tools and various indicators to gain valuable insights into the trajectories of functional disabilities over time. In the second part of the research, a novel clustering approach is introduced that combines Markov models with distance-based techniques. This hybrid methodology results in 13 distinct clusters of trajectories. The clusters are thoroughly examined, and representative sets are carefully selected based on various criteria. This selection process ensures that the chosen sets accurately represent the characteristics of each cluster. The findings of this study have significant implications for healthcare systems, including developing predictive models which can be utilized to forecast the trajectory of individual patients based on their cluster membership. This enables healthcare providers to anticipate disease progression, tailor treatments, and dynamically adjust care plans, resulting in improved patient outcomes and the overall quality of care. Moreover, the information derived from the analytics can aid in optimizing healthcare systems by facilitating resource allocation and cost optimization. The insights gained can also guide policymakers and families in planning appropriate care for patients. This research advances healthcare decision-making and ensures appropriate support. / Thesis / Master of Science (MSc) / The ability to independently perform activities of daily living (ADLs) is a crucial indicator of an individual's health status, and the loss of this ability can have a profound impact on their overall quality of life. Our research focuses on analyzing the trajectories of patients as they experience functional decline and recovery. While various techniques have been utilized to explore ADL trajectories, this study stands out by employing clustering and sequence analysis approaches to examine different groups of trajectories. To overcome the computational challenges involved, we propose a combined clustering approach. This hybrid approach consists of two phases: applying a Markov model prior to distance-based algorithms. The findings derived from our research hold significant applications in optimizing healthcare systems, improving health outcomes, facilitating the development of targeted and effective interventions that support patients in preserving their independence, and enhancing the quality of care.

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)