10137 research outputs found
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Assistive technology: Occupational therapy assessment and services for people with dementia
Get PDFEleanor Curnow - ORCID: 0000-0001-9332-8248
https://orcid.org/0000-0001-9332-8248Fiona Maclean - ORCID: 0000-0003-0946-4891
https://orcid.org/0000-0003-0946-4891Introduction:
Research suggests that services are not effectively providing suitable assistive technology for people with dementia. There is a need to understand the challenges facing practitioners to identify where service changes should be focussed to improve this situation.
Method:
This study used an online survey to explore the experiences of 41 occupational therapists working with people with dementia, and/or assistive technology. Eight participants subsequently agreed to participate in online discussion groups. Group discussions were transcribed and checked. Data responses from group discussions and open questions in the survey were analysed thematically using the person-centred framework to identify domains supporting or obstructing effective assistive technology service delivery.
Results:
Forty-one occupational therapist participants described challenges to providing person-centred assistive technology services. These included restricted access to assistive technology interventions, limited knowledge regarding developments in the field, variable funding, unsupportive systems, limited relevant training and difficulties working across health and social care sectors.
Conclusion:
There is a need to revise the systems surrounding the provision of assistive technology for people with dementia. Occupational therapists need access to training relative to this field, and systems need to be adapted to support the provision of person-centred care by widening access to assistive technology.https://doi.org/10.1177/0308022624125228087pubpub
Autistic Traits and Psychosocial Predictors of Depressive Symptoms
Get PDFLorna Camus - ORCID: 0000-0002-9340-712X
https://orcid.org/0000-0002-9340-712XHigher rates of depression and of depressed mood are associated with autistic traits, and both are associated with social interaction factors, such as social self-efficacy, social motivation and loneliness. This study examined whether these social factors explain the association between autistic traits and depression. 658 participants (527 women) completed an online survey with measures of autistic traits (AQ), social self-efficacy (Social Self-Efficacy Scale), social motivation (Social Striving Assessment Scale), loneliness (UCLA Loneliness Scale) and depressive symptoms (Beck Depression Inventory-II). A mediation analysis found the relationship between autistic traits and depressive symptoms was fully mediated by the other three factors (β[indirect] = .005, z = 2.63, p .05), forming a pathway from autistic traits, to social self-efficacy, to social motivation, to loneliness and finally to depressive symptoms. These results suggest that targeting social self-efficacy may break this pathway and disrupt this relationship. Interventions targeting supporting positive social interaction should be considered.https://doi.org/10.1007/s10803-024-06361-y55pubpub
An African One Health network for antimicrobial resistance and neglected tropical diseases [Correspondence]
No full textPaul Kadetz - ORCID: 0000-0002-2824-1856
https://orcid.org/0000-0002-2824-1856Item is not available in this repository.https://doi.org/10.1038/s41591-023-02666-0aheadofprintaheadofprin
Assessing Proprioception in Children with Upper Motor Neuron Lesions: Feasibility, validity, and reliability of the Proprioception Measurement Tool (ProMeTo)
Get PDFPetra Marsico - ORCID: 0000-0002-2503-9142
https://orcid.org/0000-0002-2503-9142Marietta van der Linden - ORCID: 0000-0003-2256-6673
https://orcid.org/0000-0003-2256-6673Tom Mercer - ORCID: 0000-0002-5078-4769
https://orcid.org/0000-0002-5078-4769Hubertus J. Van Hedel - ORCID: 0000-0002-9577-5049
https://orcid.org/0000-0002-9577-5049VoR added 2024-08-09Introduction: To investigate the feasibility, discriminative and convergent validity, and reliability of a lower limb sensor-based proprioception measure in children with upper motor neuron (UMN) lesions.
Method: We assessed three proprioception modalities (joint movement, joint position, and dynamic position sense) of the lower limbs in 49 children with UMN lesions and 50 typically developing (TD) peers (5-19y). Forty-three children with UMN lesion had a congenital and six an acquired brain lesion and 82% are able to walk without a walking aid. We evaluated the feasibility, compared the test results between children with UMN lesions and TD peers, and calculated Spearman correlations (rs) between the modalities. We quantified relative reliability with Intra-Class Correlation Coefficients (ICC) and absolute reliability with Smallest Detectable Changes (SDC).
Results: Most children with UMN lesions (>88%) found the tests easy to perform. The children with UMN lesions had significantly (p<0.001) lower proprioceptive function than the TD children. The correlation between the three proprioceptive modalities was moderate to high (0.50 ≤ rs ≤ 0.79). The relative reliability for test-retest and the inter-rater reliability was moderate to high (ICCs=0.65-0.97), and SDC between 2° and 15°.
Discussion: The three tests are feasible, and discriminative and convergent validity and reliability were confirmed. Further studies should investigate the influence on motor function and performance in children with UMN lesions.https://doi.org/10.3389/fresc.2024.13737935pubpu
Blood pressure variability and frailty in end-stage kidney disease
Get PDFTom Mercer - ORCID: 0000-0002-5078-4769 https://orcid.org/0000-0002-5078-4769Marietta van der Linden - ORCID: 0000-0003-2256-6673 https://orcid.org/0000-0003-2256-6673Background
High blood pressure variability (BPV) is a predictor of cardiovascular events and all-cause mortality in people with end-stage kidney disease (ESKD) and a marker of aging in geriatric populations. Nevertheless, the relationship between BPV and geriatric syndromes, such as frailty, in people with ESKD is not well understood.
Objective
To examine the association between very short-term BPV and frailty in people with ESKD and receiving hemodialysis.
Design
Cross-sectional study.
Setting
Three dialysis units in the United Kingdom.
Participants
Sixty-nine people receiving hemodialysis (median age=62.0 years, interquartile range [IQR]=19.0; 52.2% male; median dialysis vintage=1.1 years, IQR=2.4).
Measurements
Systolic and diastolic BPV were recorded using continuous, non-invasive BP monitoring (Task Force Monitor). The very low, low, and high frequency components of BPV (VLF-BPV, LF-BPV, and HF-BPV), as well as the power spectral density (PSD-BPV) and low frequency/high frequency ratio of BPV (LF/HF-BPV) were analyzed. Frailty was evaluated using the Fried frailty phenotype.
Results
Twenty-six (37.7%) participants were classified as frail and 43 (62.3%) as non-frail. Frail participants had higher median systolic (2.1, IQR=5.2 mmHg2 vs. 1.1, IQR=1.6 mmHg2, p=0.002) and diastolic HF-BPV (0.9, IQR=2.3 mmHg2 vs. 0.5, IQR=1.0 mmHg2, p=0.048) compared to their non-frail counterparts. In addition, frail participants had higher median systolic VLF-BPV (3.2, IQR=12.5 mmHg2 vs. 2.0, IQR=2.4 mmHg2, p=0.012), LF-BPV (2.0, IQR=3.8 mmHg2 vs. 1.1, IQR=2.0 mmHg2, p=0.016), and PSD-BPV (6.6, IQR=27.6 mmHg2 vs. 4.5, IQR=5.9 mmHg2, p=0.005) compared to the non-frail participants. In age- and sex-adjusted logistic regression analyses, only systolic VLF-BPV (odds ratio [OR]=1.13, 95% confidence interval [CI]:1.01–1.26, p=0.035), HF-BPV (OR=1.26, 95%CI:1.01–1.57, p=0.044), and PSD-BPV (OR=1.06, 95%CI:1.01–1.12, p=0.029) were associated with increased odds of being frail.
Conclusion
Higher systolic BPV is associated with frailty in people receiving hemodialysis. Beat-to-beat assessments of BPV through continuous, non-invasive BP monitoring may be useful in evaluating frailty in ESKD populations.Funding: This work is supported by funding from a British Kidney Patient Association-British Renal Society joint grant; grant number: 16-003.13pubpu
Perceptions of feedback and engagement with feedback among undergraduates: an educational identities approach
Get PDFVoR added to record 09/09/2024.Engaging with feedback has been widely shown to support learning, but levels of engagement with feedback among individual students varies considerably. This study assessed educational identities to understand this variation, while also seeking to confirm the distinct but related role of perceptions of feedback. Data from 170 undergraduate students in the UK completed an online questionnaire to assess their perceptions of feedback, engagement with feedback, learner identity, consumer identity, and discipline identity, as well as provide age, gender, ethnicity, and level of study. As predicted, perceptions of feedback was significantly positively correlated with engagement with feedback, and learner identity and discipline identity were also significantly positively correlated with perceptions of feedback and engagement with feedback. Data were subsequently analysed to test various hypotheses about the interactions among these variables. Critically, we found support for the proposed mediating effect of perceptions of feedback on the relation between learner identity and engagement with feedback, however, consumer identity did not moderate this effect. These findings suggest that students who demonstrate the greatest engagement with feedback are those with a strong learner identity, thus, interventions to promote learner identity may increase students’ engagement with feedback and ultimately improve their outcomes.This research was supported with a small internal grant awarded to the first author from Staffordshire Centre of Learning and Pedagogic Practice.https://doi.org/10.1080/02602938.2024.239093350pubpub
Identifying vulnerabilities in essential health services: Analysing the effects of system shocks on childhood vaccination delivery in Lebanon
Get PDFShocks effects are under-theorised in the growing literature on health system resilience. Existing work has focused on the effects of single shocks on discrete elements within the health system, typically at national level. Using qualitative system dynamics, we explored how effects of multiple shocks interacted across system levels and combined with existing vulnerabilities to produce effects on essential health services delivery, through the prism of a case study on childhood vaccination in Lebanon. Lebanon has experienced a series of shocks in recent years, including large-scale refugee arrivals from neighbouring Syria, the COVID-19 pandemic and a political-economic crisis. We developed a causal loop diagram (CLD) to explore the effects of each shock individually, and in combination. The CLD was developed and validated using qualitative data from interviews with 38 stakeholders working in Lebanon's vaccination delivery system, in roles ranging from national level policy to facility-level service delivery, conducted between February 2020 and January 2022.
We found that each of the shocks had different effects on service demand- and supply-side dynamics. These effects cascaded from national through to local levels. Both Syrian refugee movement and the COVID-19 pandemic primarily exposed vulnerabilities in service demand, mainly through slowly emerging knock-on effects on vaccination uptake behaviour among host communities, and fear of contracting infection in crowded health facilities respectively. The economic crisis exposed wider system vulnerabilities, including demand for vaccination as household income collapsed, and supply-side effects such as reduced clinic time for vaccination, declining workforce retention, and reduced availability of viable vaccine doses, among others. Finally, important pathways of interaction between shocks were identified, particularly affecting the balance between demand for vaccination through publicly supported facilities and private clinics. Future research should incorporate dynamic approaches to identifying within-system vulnerabilities and their potential impacts under different scenarios, as a precursor to improved resilience measurement, system preparedness, and intervention targeting.This work was supported by a Wellcome Trust Clinical Research Fellowship awarded to the lead author (ref no 215654/Z/19/Z). The funder had no role in study design; in the collection, analysis and interpretation of data; in the writing of the article; or in the decision to submit it for publication.https://doi.org/10.1016/j.socscimed.2024.117260358pubpu
Digital HotSpot: virtual agencies in online performer training
Get PDFBianca Mastrominico - ORCID: 0000-0002-6827-7247
https://orcid.org/0000-0002-6827-7247In February 2020, while in lockdown, Edinburgh-based performance laboratory Organic Theatre embarked on a digital shift of their live performance processes halted by the Covid-19 pandemic through a series of explorative sessions experimenting with ensemble training on the Zoom platform. These digital encounters between remote performers from different backgrounds morphed into an open digital incubator researching how the technology itself could become an agential stimulus to continue training and practicing in a situation of confinement and isolation.
From there, Digital HotSpot was created and is still evolving as a performance research collective working remotely to explore the potential of online training and practice, as well as the soft boundaries between performance, space and spectatorship on digital. Embracing technology and hybrid interactions, Digital HotSpot sessions invite performers to react to the initial sense of disempowerment induced by physical distance, and virtually connect by experimenting with their digital performance presence in an online studio environment. While testing the possibilities of the online space to increase the agential elements of performer training, Digital Hotspot participants are enabled by the technology and hybrid working conditions to find unpredictable working strategies, establishing collective agency through their shared attempts to understand how to communicate somatic practice through screen technology.
This visual essay aims to analyse the extensive audio-visual Zoom documentation of Digital HotSpot sessions, following its developments through various stages of the pandemic and beyond, alongside the discussions and brainstorming by participants around their experience of self-determination through online training. While the initial stages of the pandemic-driven experimentation provided a fertile playground for emerging ideas of how to embrace the digital in our training practices, the focus of the sessions has now shifted towards building a professional toolkit for performers who wish to communicate and work together creatively through digital platforms.
© 2023 Digital HotSpot.https://doi.org/10.1080/19443927.2024.236658515pubpub
A good stick: An inquiry into creativity in Forest School
No full textItem is not available in this repository.Patrick Boxall - ORCID: 0009-0002-6428-4199
https://orcid.org/0009-0002-6428-4199Patrick Boxall analyses the problematic concepts of creativity and Forest School and provides insights into practice and pedagogy. He argues that person-centred philosophies within traditions of social constructivism and critical pedagogy underpin discussions of creativity and outdoor learning and that both contribute to discourses of social justice. ‘A Description of Creativity’ is given as a theoretical framework to explore concepts of creativity and explain their significance to social justice and outdoor learning. The framework is tested in the field through interviews with leaders of Forest School in Scotland. The analysis explores the leaders’ understanding of the concept of creativity, their description of creative pedagogy and their evaluation of the theoretical framework. The chapter concludes that creativity is a significant concern within Forest School, and that the framework is a useful tool to understand and enhance practice. It is argued that creative pedagogies within outdoor learning are important in forwarding social justice and can contribute to making learning meaningful within the contemporary educational political context. Questions are raised as to the extent that discourses of ‘eco-pedagogy’ and ‘eco-dynamics’ could further deepen understanding of broader conceptions of outdoor learning. © 2024 Taylor & Francis.https://doi.org/10.4324/9781003436928-5pubpu
The effect of Custom Foot Orthotic Materials on Running Economy, Comfort, Running Mechanics, and Performance
Get PDFCustom foot orthoses (CFOs) possess a unique surface geometry tailored to an individual’s foot, serving as an interface to redirect ground reaction forces. Their effect is defined by altering the orthotic shape in contact with the foot and choosing material characteristics to redirect or dampen these forces. In sports, CFOs have proven effective at mitigating injury risks and are part of a treatment plan for several lower limb and foot injuries. To date, empirical evidence for the impact of CFO materials on running and sprinting-related outcome measures is limited.
The overarching aim of this PhD thesis wasto investigate the effect of CFO materials on running mechanics (kinetics and kinematics), running economy (RE), sprint performance, footwear comfort, and fatigue perception in uninjured recreational runners. It comprises one systematic review and meta-analysis, and two double-blinded randomised controlled crossover studies, resulting in five peer-reviewed publications.
In the systematic review (article 1), with a meta-analysis of four studies (three weak and one moderate quality) revealed that oxygen consumption during submaximal running is reduced in the most comfortable footwear condition compared with the least comfortable footwear (MD: -2.06 mL.kg−1 .min−1 ; 95%CI: - 3.71, -0.42; P = 0.01). This finding underscored the importance of measuring footwear comfort along other variables such as running mechanics and RE.
Article two compared EVA and TPU CFOs on RE, running mechanics and comfort at two different running speeds. CFOs had no statistically significant effect on RE, irrespective of materials or running speed. Peak braking force reduced with EVA by ∼4% compared to CON (P = 0.027). Propulsive loading rate increased with TPU ∼18% compared to CON (P = 0.009). Footwear comfort remained consistent across all conditions. Although these results were associated with moderately low submaximal running speeds in a rested state, examining the effects of CFOs on similar outcome measures when runners are fatigued or engaged in higher intensity exercises like sprinting appeared justified.
Article three and four explored fatigue perception after repeated sprint exercises and constant velocity running, respectively. In Article three, both EVA and TPU increased sprint distance by respectively ∼0.6m (P = 0.004) and ∼0.4m (P = 0.018), without altering fatigue-induced mechanical changes. Article fourfound no significant differences in outcome measures between fatigued and fresh conditions, except for a reduction in loading rate (P = 0.046), increased minute ventilation (P = 0.020) and increased breathing frequency (P = 0.019).
Further research focused on a hybrid (HYB) CFO, combining EVA in the heel and TPU in the forefoot. Article five showed reduced peak frontal plane angles (ankle eversion: P < 0.001, 2 = 0.72) and angular velocities (ankle eversion: P < 0.001, 2 = 0.64; ankle inversion: P < 0.001, 2 = 0.60) between conditions. Statistical non-parametric mapping revealed that HYB resulted in the largest proportions of significant changes during stance, when compared to control.
In conclusion, the studies in this PhD thesis enhances the understanding of EVA, TPU and HYB CFOs in healthy recreational runners. For athletes, the findings could potentially expand the scope of foot orthoses use during sport activity, since it is not affecting RE. The small yet significant changes in running mechanics that were associated with material choice, could help guide clinicians in CFO prescription, whether using single materials or in combination
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