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Evaluates the Post-Hospital Support Program for frail elderly patients at Johns Hopkins Hospital in Baltimore (Maryland) who were returning home to the care of a non-paid caregiver for at least a year. Results showed reduction in caregiver stress and in number of days spent in hospital after initial release. (JS)

Objective: The objective of this study is to compare treatment trajectories in anorexia nervosa (AN) and atypical AN. Method: Adolescents and adults with AN (n = 319) or atypical AN (n = 67) in a partial hospitalization program (PHP) completed diagnostic interviews and self‐report questionnaires measuring eating disorder (ED), depression, and anxiety symptoms throughout treatment. Results: Premorbid weight loss did not differ between diagnoses. Individuals with atypical AN had more comorbid diagnoses, but groups did not differ on specific diagnoses. ED psychopathology and comorbid symptoms of depression/anxiety did not differ at admission between groups nor did rate of change in ED psychopathology and comorbid symptoms of depression/anxiety from admission to 1‐month. From admission to discharge, individuals with atypical AN had a faster reduction in ED psychopathology and comorbid symptoms of depression and anxiety (ps < 0.05; rs = 0.01–0.32); however, there were no group differences in ED psychopathology or depression symptoms at discharge (ps>.50; ds =.01–.30). Individuals with atypical AN had lower anxiety at discharge compared to individuals with AN (p = 0.05; d =.4). Length of stay did not differ between groups (p = 0.11; d =.21). Discussion: Groups had similar ED treatment trajectories, suggesting more similarities than differences. PHP may also be effective for AAN. Public Significance: This study supports previous research that individuals with AN and atypical AN have more similarities than differences. Results from this study indicate that individuals with AN and atypical AN have similar treatment outcomes for both ED psychopathology and depressive symptoms; however, individuals with atypical AN have lower anxiety symptoms at discharge compared to individuals with AN. AN and atypical AN also have more symptom similarity at admission and throughout treatment, which challenges their current designation as distinct disorders. [ABSTRACT FROM AUTHOR]

Importance: The importance of developing age-friendly environments is globally recognized. However, few clinical trials have comprehensively evaluated physical and social components of environments and examined the effects of offering support. Objective: To clarify the effectiveness of occupational therapy–based comprehensive environmental support for community-dwelling older adults. Design: A single-blind parallel-groups randomized controlled trial with blinded participants. Setting: Eight community-based settings under the long-term-care insurance system in regional towns and cities throughout Japan. Participants: Sixty older adults age ≥65 yr who were new users of adult day care or adult day health care and allocated by stratified block randomization on the basis of age. Intervention: Comprehensive environmental support was provided to participants for 3 mo according to results on the Comprehensive Environmental Questionnaire for older adults (CEQ) to make improvements in environmental factors participants wanted to change to create a more satisfying life. Outcomes and Measures: The primary outcome measure was the Japanese Medical Outcomes Study 36-Item Short-Form Health Survey (SF–36) score at 3 mo postrandomization. Additionally, scores on the Short-Form Six-Dimension utility index were calculated. Results: The experimental group showed significant improvements in the SF–36's Role/Social Component Summary (p =.005) and Role–Physical (p =.02), Role–Emotional (p =.01), and Mental Health (p =.05) domains, with moderate effect sizes. The number needed to treat was 3.46, showing statistical significance. Conclusions and Relevance: Occupational therapy–based comprehensive environmental support based on CEQ scores was effective, resulting in moderate improvements in health-related quality of life among community-dwelling older adults. Plain-Language Summary: Older adults experience a decline in physical and mental functions along with changes in social relationships. These problems make it challenging for older adults to perform valuable occupations, thus reducing their quality of life. This study demonstrated that occupational therapy based on the Comprehensive Environmental Questionnaire for older adults can improve health-related quality of life among community-dwelling older adults. Our findings pave the way for the development of an effective compensatory intervention model in occupational therapy practice. Occupational therapy based on the Comprehensive Environmental Questionnaire for older adults can improve health-related quality of life among community-dwelling older adults. [ABSTRACT FROM AUTHOR]

Objective: Little is known about how individuals with atypical anorexia nervosa (AN) respond to eating disorder (ED) treatment in a partial hospitalization program (PHP), nor how certain factors such as trauma, childhood abuse, psychiatric comorbidity, and suicidal thoughts and behaviors might contribute to poor treatment outcomes. Thus, the current study (1) compares prevalence of these factors between individuals with AN and atypical AN upon admission to an ED PHP, (2) compares PHP treatment response between groups, and (3) investigates whether experiencing these factors impacts treatment outcomes. Method: We conducted a retrospective chart review of young adults admitted to a PHP with AN (n = 95) and atypical AN (n = 59). Histories of psychiatric comorbidities and adverse childhood experiences were obtained from initial psychiatric evaluations. ED symptoms were assessed at intake and discharge with the Eating Disorder Examination‐Questionnaire (EDE‐Q). Results: No significant differences were found at intake in ED symptom severity or prevalence of lifetime trauma, childhood abuse, number of psychiatric diagnoses, or suicidal thoughts and behavior. Symptomatology at discharge also did not differ between groups. Emotional abuse was significantly related to discharge shape and weight overvaluation. No other intake characteristics were significantly related to discharge symptomatology. Discussion: To our knowledge, this is the first study to compare the prevalence of comorbidities for both AN and atypical AN, as well as differential treatment outcomes for these individuals in a PHP. Results add to growing literature suggesting that, other than weight, AN and atypical AN have few properties that reliably distinguish them from one another. Public Significance: This study adds to a growing body of literature that raises questions about whether anorexia nervosa (AN) and atypical AN are truly different diagnoses. Our findings suggest these two groups present to treatment in a partial hospitalization program (PHP) with similar ED symptoms, as well as prevalence of lifetime trauma, childhood abuse, suicidal thoughts and behavior, and number of psychiatric comorbidities, and demonstrate similar treatment trajectories in PHP. [ABSTRACT FROM AUTHOR]

Despite recent research showing that early childhood education and daycare settings (ECEC) have an important role in promoting toddlers' physical activity (PA), crucial information gaps remain regarding toddlers' PA and sedentary behavior (SB) in these outdoor settings. We aimed in this study to: (a) analyze PA patterns and SB during unstructured outdoor play time in preschool and daycare environments using accelerometry and systematic observation; (b) provide concurrent accelerometry and observational data to help validate the Observational System for Recording Physical Activity in Children-Preschool Version (OSRAC-P); and (c) examine individual, social and environmental correlates of PA and SB during toddlers' unstructured outdoor play time. We found that: (a) toddlers displayed high amounts of PA with no sex, BMI, and/or age differences in PA and SB levels,; (b) environmental variables (e.g., fixed equipment and playground density) were not associated with PA levels or SB intensity; (c) the OSRAC-P was a reliable and valid means of observing and analyzing toddlers' PA patterns during unstructured outdoor play time; and (e) different social patterns between boys and girls did not impact PA levels or patterns. Combining different measurement methods permitted an improved understanding of unstructured outdoor play in preschool and daycare settings. [ABSTRACT FROM AUTHOR]

Introduction: Psychiatric day-care services play a central role in community-based care in Japan. Recovery and related psychosocial factors are critical in promoting community participation of people with mental illness. This study aimed to reveal the relationships among activity information, personal recovery, and related psychosocial factors in day-care users. Method: Forty day-care participants answered self-report questionnaires. The following assessments were applied: Recovery Assessment Scale, Occupational Questionnaire, Perceived Devaluation Discrimination Scale, and 26-item version of World Health Organization Quality of Life (QOL). The correlations among the factors were analyzed. Results: Data for 35 people were analyzed. Total recovery score was strongly correlated with total WHOQOL-26 score (r = 0.76, p < 0.001). Total QOL score was positively related with the value of activities (r = 0.46, p < 0.05). Social QOL and total stigma score had a significant negative relationship (r = −0.44, p < 0.05). Conclusion: Participation in activities was suggested to improve QOL. Although there was a strong relationship between recovery and QOL, it was unclear to what extent participation in activities was related to recovery. We should consider approaches regarding other factors to fully accomplish community integration and personal recovery. [ABSTRACT FROM AUTHOR]

To identify facilitators, barriers, and formulate recommendations for the implementation of exergames for people with dementia (PWD) in day-care centers (DCCs). Within a randomized controlled trial into the effectiveness of exergaming, 73 PWD with their informal caregivers (IC) from 11 DCCs in the Netherlands and two exergame providers participated in a process evaluation. This was a mixed-methods study using focus groups, semi-structured interviews, the Measurement Instrument for Determinants of Innovations, forms for DCC staff, and a short satisfaction questionnaire. We used descriptive statistics for the quantitative outcomes, and thematic analysis for qualitative data. The Medical Research Council guidance for process evaluation was used to identify facilitators and barriers to the implementation, mechanisms of impact, and context. Implementation-related facilitators and barriers were the availability of budget, staff, equipment, instructions, location, and supervision. Mechanisms of impact-related facilitators were experienced positive effects on physical functioning and mobility, cognitive, emotional, and social functioning, and quality of life. Barriers were mainly linked to the need to customize the intervention for each participant. Contextual facilitators were support and enthusiasm from others; barriers were costs and planning. Recommendations by DCC staff involved technical support, instructions, responsibility, location, supervision, planning, and exergaming as a group or individually. Users, IC, and staff positively valued exergaming. We found various facilitators and barriers leading to recommendations for successful implementation. We recommend further research into tailoring exergaming to specific users and contexts, and into usability and cost-effectiveness. This may contribute to further dissemination and implementation of exergaming for PWD. [ABSTRACT FROM AUTHOR]

Advance care planning (ACP) is a crucial process in clinical practice, enabling individuals to articulate their care preferences and goals, with significant implications for future healthcare. However, ACP practice of health and social care professionals (HSCPs) concerning patients, or their family members are rarely explored. The objective of the study was to adapt and validate a four-item scale assessing ACP practices of HSCPs toward patients or their family members. The ACP Practice Scale was evaluated through a cross-sectional online survey administered to HSCPs in Macao, assessing its factor structure, validity, and reliability. Based on a sample of 186 valid responses, the ACP Practice Scale demonstrated satisfactory levels of validity and reliability among HSPCs in Macao. The four-item scale explained 65.87% of the variance in ACP practice and exhibited strong internal consistency, with Cronbach's alpha and McDonald's omega coefficients of 0.82. Furthermore, item factor loadings ranged from 0.71 to 0.90. The ACP Practice Scale provides reliable and valid measurements of ACP practice among HSCPs. This instrument can help to enhance our understanding of ACP practices in clinical settings and support the advancement of advance care planning. [ABSTRACT FROM AUTHOR]

Introduction: Capecitabine is a molecule of choice in the therapeutic arsenal of anticancer drugs used in Morocco for the treatment of breast cancer and colorectal cancer. Its frequent use imposes a follow-up and a post-prescription monitoring of the treatment modalities as well as the adverse events that may occur following its administration. Objective: The objective of this study is to evaluate the level of knowledge of patients in the day hospital of an oncology facility about their treatment with capecitabine. Materials and methods: This is a prospective study conducted over a period of 2 months (January–February 2022) at the day hospital in the National Institute of Oncology in Rabat, and it was conducted using a questionnaire in order to evaluate patients' knowledge about their treatment with capecitabine. Results: This study involved 95 patients, 76% claimed to have ever received pharmaceutical advice on capecitabine treatment. The main indications were colorectal and breast cancer. Ninety seven percent knew the indication for capecitabine and the action of the molecule on the relevant tumor. Eighty three percent receiving capecitabine therapy reported the occurrence of side effects and hand-foot syndrome was the most reported in 31.2% of the total listed side effects. Discussion: Capecitabine is an oral treatment of choice for colorectal and breast cancer in Morocco. Therapeutic education happens to be an effective tool in order to guarantee the best effectiveness and manage the possible side effects that can occur during the treatment. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effects of an outreach dental care program (ODCP) on the oral health status and oral health‐related quality of life (OHRQoL) of older adults who used residential or day care services in Hong Kong. Methods: Older adults who had received dental treatments provided in the ODCP were recruited. Clinical examinations were performed by one calibrated examiner (SXY) at baseline and 1‐year follow‐up in the residential homes or day care centres. Face‐to‐face interviews were conducted using the transition scale of the Oral Health Impacts on Daily Living (OHIDL) questionnaire to investigate the perceived change in OHRQoL at baseline, 2‐month and 1‐year follow‐ups. The Wilcoxon matched‐pair signed‐rank test or McNemar/McNemar‐Bowker test was used to explore the change in oral health status after dental treatments. Factors associated with the perceived change in OHRQoL were explored with binary logistic regression. Results: Four hundred and thirteen older adults (mean age = 83.8 years) participated in the study at baseline, and 377 (91.3%) and 359 (86.9%) were successfully followed 2 months and 1 year after receiving the outreach dental service, respectively. At the 1‐year follow‐up, the number of decayed teeth and functional tooth units, and the prevalence of poor denture hygiene decreased while there was more dental plaque deposition and a higher proportion of participants with gingival bleeding upon probing. More than 50% of the participants perceived no change or an improvement in OHRQoL in all domains at both follow‐ups. Older adults who perceived their oral health status as 'healthy or fair' and those who suffered from toothache at baseline had a higher chance to perceive having a better or at least the same OHRQoL at the 2‐month and 1‐year follow‐ups, respectively. Conclusions: The ODCP in Hong Kong can solve some of the dental problems of older adults using long‐term care services and keep most of them from deterioration in OHRQoL, especially those suffering from toothache. [ABSTRACT FROM AUTHOR]

Short breaks help maintain caring relationships, enabling people to remain living in their own homes and contributing significant economic benefit to public services. However, relatively little is known about the added social value generated by community-based short breaks. To address this evidence gap, we explored the feasibility of using a social return on investment (SROI) evaluation to explore a day support service in North Wales for people living with dementia and their unpaid carers. Following good practice for evaluating complex interventions, we developed a logic model based on the literature and interviews to understand the mechanisms and outcomes of the day support service. Using questionnaires, we quantified outcomes for the current service cohort, which included people living with dementia, unpaid carers, and paid companions. Seven people living with dementia, three unpaid carers, and four companions completed questionnaires. By following the SROI analysis approach, three key learning points were identified. The first was around ways to capture outcomes from all stakeholder subgroups expected to experience material change. The second concerned the importance of collecting longitudinal data. This included the need to consider how to adapt the SROI method to work with small populations. The third concerned how to value "maintenance" of wellbeing as well as improved wellbeing. [ABSTRACT FROM AUTHOR]

This study evaluated the effectiveness of a multiple-intervention program (MIP) on the life satisfaction, social support, and depressive tendencies of older adults. A cross-sectional, pretest-posttest design involving a questionnaire survey was adopted. Thirty-seven older adults were recruited from 2 daycare centers for an 8-week MIP comprising 60-min sessions conducted once a week. The questionnaire comprised the Short Portable Mental Status Questionnaire, Geriatric Depression Short Form-15 (GDS-SF15), Life Satisfaction Scale (LSS), and Inventory of Social Support Scale (ISSB). The participants' average GDS-SF15 score decreased considerably (by 35.3%), their average ISSB score increased from 61.9% to 80.9%, and their average LSS score increased from 48% to 64%. The outcomes for depressive tendencies, social support, and life satisfaction were measured before and after the intervention, and the participants successfully engaged in the MIP throughout its duration and exhibited improvement. The MIP can serve as a basis for planning group activities for older adults. The MIP benefits older adults at daycare centers. Incorporating multiple activities into daily care can help increase the diversity, uniqueness, and innovativeness of a daycare center. [ABSTRACT FROM AUTHOR]

Intellectual disability (ID) is assumed to be a dynamic phenomenon influenced by personal and environmental factors. During the 18 months of the coronavirus disease (COVID-19) pandemic, most day centers remained open for adults with ID who lived with their families (most of them with severe/profound [S/P] ID) but were closed to those who lived in group homes (with moderate and mild ID). Owing to the fewer participants in day centers, adults with S/P ID received more hours of therapy than before the pandemic. Using a functional screening tool, functional and environmental changes were mapped and discussed in team meetings. As expected, the pandemic caused environmental and personnel changes that affected all groups. The moderate (n = 29) and mild (n = 31) groups deteriorated over the 18 months of the study, especially the senior ones. However, the functional state of the S/P group (n = 16) improved. These results support the understanding that ID is truly dynamic throughout the lifespan. Functional improvements for S/P ID can occur during adulthood with intense and individually adapted interventions. [ABSTRACT FROM AUTHOR]

(1) Background: Currently, Taiwan has adopted a "person-centered" approach to Advance Care, including Hospice Palliative Care and Advance Decisions, both of which are intended to enhance the right of individuals to choose their own end-of-life care; however, it is extremely challenging and difficult to implement the principle of autonomy for psychiatric patients. (2) Methodology: The aim in this study is to investigate the factors affecting the intention of day ward patients to sign up for hospice and palliative care by using the questionnaire content of the "Survey on Knowledge, Attitude Toward, Experience, and Behavior Intention to Sign Up for Hospice and Palliative Care". A cross-sectional design compliant with STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) was employed. An independent sample t-test, Pearson's correlation analysis, and stepwise regression analysis were used to determine the factors influencing the intention of psychiatric patients to sign up for advanced care planning. (3) Results: The relationships between knowledge of and attitude toward advanced care planning, knowledge of and behavior intention to sign up for advanced care planning, and attitude toward and behavior intention to sign up for advanced care planning were all positive (p-value < 0.001). The final three most relevant indicators were attitude toward hospice and palliative care, hospitalization of family members during the previous five years, and death of a close friend within the previous five years. (4) Conclusions: The results of the study show that the hospice and palliative care attitude and past experience of psychiatric patients affect the intention to sign up, reminding us that psychiatric patients are at an increased risk of decision-making disability as their illness progresses and that, in addition to initiating the discussion of Advance Care Planning as soon as possible, it may be an opportune time for medical professionals to actively promote Advance Care Planning among their patients. [ABSTRACT FROM AUTHOR]

Despite the availability of improvisational theater training in different settings, studies that assess its effectiveness as a means for enhancing cognitive training for older adults are scarce. This study examines the influence of short theater improvisation exercises on the cognitive flexibility of cognitively-healthy older adults, and their influence on the four core components of improvisation (i.e., spontaneity, flow, creativity, playfulness). The study also examines the correlation between an improvement in these four key agents and an improvement in cognitive flexibility among older adults. This quantitative empirical study was conducted in retirement homes and daycare centers in Israel. A total of 45 participants took part in this study, all in good physical health and with age-appropriate cognitive abilities. The participants were divided into five research groups; each group met twice a week for a one-hour improvisation session over a six-week period. The data was collected through five questionnaires that were completed at four points of time (before, during, and after the workshop). The findings did not indicate a significant effect of the improvisation exercises on the participants' cognitive flexibility, yet they did show improvement in three components of improvisation: spontaneity, flow, playfulness. As such, the findings of this study indicate that despite a normal decline in basic cognitive functioning among older adults, the beneficial effect of improvisation on cognitive flexibility might still occur through spontaneity, playfulness, and flow. In conclusion, short theater improvisation exercises could contribute to various indicators of healthy aging in various settings. [ABSTRACT FROM AUTHOR]

Background: In recent years, a new recovery model has gained ground in which recovery is understood as a process of change where individuals are able to improve their health and wellbeing, lead self-sufficient lives and strive to achieve their maximum potential (personal recovery). Despite the existence of data regarding the effectiveness of mental health day hospitals (MHDHs) in reducing relapses in terms of hospital admissions and emergencies, no studies have to date assessed how this change affected the new personal recovery model. Objectives: To verify the effectiveness of MHDHs in improving personal recovery processes among people with mental disorders (MDs). Methods: A prospective cohort study. A group of patients receiving follow-up at MHDHs was compared with another group of patients receiving follow-up in other therapeutic units over a period of three months. Results: Patient recovery at the MHDHs, assessed using the Individual Recovery Outcomes Counter (I.ROC), was found to be significantly better than that of patients attended in other units. Conclusions: MHDHs can contribute to the recovery of people with MDs. This is particularly important at a time when some patients may have experienced impediments to their recovery processes due to the pandemic. [ABSTRACT FROM AUTHOR]

Objective: To assess the sustained effects of a buddy-style intervention aiming to improve physical activity. Design: A parallel-group, open-label, randomized controlled trial. Setting: Three adult day-care centers. Participants: Sixty-five community-dwelling older adults with disabilities. Intervention: All participants received a 12-week home-based exercise program. An intervention group (n = 33) received a 5–10 min buddy-style intervention once a week at an adult day-care center for older adults. Main measures: The primary outcome was the average daily time spent performing "walking outside home" and "muscle strength exercises" at 24 weeks follow-up post-intervention. Results: Of the 65 participants, one participant in each group dropped out before the program began, 4 and 5 in the intervention and control groups by the 12-week assessment, and 4 and 3 by the 24-week assessment, respectively. Analysis of covariance of the 47 participants who were able to be assessed after 24 weeks revealed that outdoor walking time (min/day) was significantly longer in the intervention group (n = 24) than in the control group (n = 23) at 24 weeks (intervention group, 73.5 [66.1]; control group, 42.7 [45.5]; P = 0.030, f = 0.38). There was no significant difference in the duration of muscle strength exercises (min/day) between the two groups at 24 weeks (intervention group, 8.2 [9.7]; control group, 6.5 [9.3]; P = 0.593, f = 0.08). Conclusions: The buddy-style intervention increased the duration of outdoor walking, with a sustained effect up to 12 weeks after the end of the intervention. [ABSTRACT FROM AUTHOR]

Aim: SARC‐F, a sarcopenia screening tool, has limited use but may be beneficial for detecting sarcopenia in frail older people. This study aimed to clarify the validity of the SARC‐F questionnaire in older people. Methods: In this validation study, 74 (36 men; age, 81.9 ± 6.7 years, 38 women; age, 83 ± 6.2 years) community‐dwelling older people who attended a daycare facility participated in our study. Participants completed the SARC‐F and SARC‐calf circumference (SARC‐CalF) questionnaires, and their body composition, walk speed and grip strength were measured. Sarcopenia was determined using the Asian Working Group for Sarcopenia criteria, and the participants were divided into non‐sarcopenia and sarcopenia groups. SARC‐F and SARC‐CalF scores were evaluated using receiver operating characteristic curve analysis for sarcopenia considering the area under the curve. Internal consistency was evaluated using Cronbach's alpha. Results: The prevalence of sarcopenia, defined by physical characteristics, was 60.0% in men and 48.1% in women. The area under the curve of the SARC‐F for sarcopenia was 0.703 (95% confidence interval [CI]: 0.585–0.821, P = 0.001). Cronbach's alpha was 0.81, and the internal consistency was high. SARC‐F had lower sensitivity (0.47; 95% CI: 0.31–0.64) but higher specificity (0.78; 95% CI: 0.60–0.89) than the sensitivity and specificity of SARC‐CalF, respectively, and the sensitivity of SARC‐F was higher than that reported in previous studies. Conclusion: The SARC‐F questionnaire is more sensitive in assessing sarcopenia in low‐functioning populations and can be used as a screening tool for sarcopenia in long‐term daycare facilities for older people rather than in community‐based healthcare activities. Geriatr Gerontol Int 2022; 22: 889–893. [ABSTRACT FROM AUTHOR]

Compassion has been suggested as a relevant variable for understanding dementia caregivers' psychological distress. The objectives were to analyse the psychometric properties of the Caregiving Compassion Scale (CCS) and to explore the association between caregivers' compassion and their emotional health. Two hundred and thirty‐six dementia caregivers were evaluated for compassion, depressive symptoms, guilt, ambivalence, care‐recipient's functional and cognitive status, frequency of behavioural problems and desire to institutionalise the care‐recipient. Exploratory factor analyses, correlations and regression analyses were done. Two factors were obtained. The factor labelled "Distress from witnessing the care recipient suffering" was associated with higher stress linked to witness depressive problems in the care‐recipient and with caregivers' ambivalence and guilt levels. The factor labelled "Motivation/disposition for helping" was associated with less desire for institutionalisation, and it showed a negative association with ambivalence and guilt feelings. The CCS seems to be a valid and reliable scale for assessing compassion in dementia caregivers. [ABSTRACT FROM AUTHOR]

The growing number of people living with dementia will result in increased costs of dementia worldwide. The e‐Health intervention 'Exergaming' may improve health and quality of life of people with dementia, but the cost‐effectiveness is unknown. We assessed the cost‐effectiveness of exergaming compared to regular activities from a societal perspective in day‐care centres (DCC) for people with dementia and their informal caregivers (IC) alongside a cluster randomised controlled trial. We included 112 dyads (person with dementia and IC) from 20 psychogeriatric DCCs (11 exergaming, 9 control) across the Netherlands. Exergaming consisted of interactive cycling at least twice a week for 6 months. Measurements were conducted at baseline (T0), after 3 (T1) and 6 (T2) months. Primary outcomes were minutes of physical activity, mobility of the participants with dementia (Short Physical Performances Battery, SPPB), and Quality‐Adjusted Life‐Years (QALYs) of participants with dementia and ICs. ICs filled out cost diaries to measure healthcare and informal care utilisation during the study. There were no statistically significant differences in outcomes or costs between the groups at the level of participants with dementia, the ICs or the dyad. With regard to QALYs and SPPB, the probability that exergaming is cost‐effective compared to control was low for all possible willingness‐to‐pay (WTP) thresholds. However, for physical activity at WTP thresholds of 0, 50 and 250 Euros per additional minute of physical activity, the probability of cost‐effectiveness is 0.46, 0.84 and 0.87, respectively. Exergaming in DCC was not cost‐effective compared to usual activities. However, considering the small sample size and the large number of missing observations, findings should be interpreted with caution. Future studies with larger samples are recommended to obtain definitive answers on the cost‐effectiveness of exergaming. This trial was registered in the Netherlands Trial Register (NTR5537/NL5420). [ABSTRACT FROM AUTHOR]

In addition to palliative care delivery at home or in hospital, palliative day care centres occupy an in‐between position in palliative care. In palliative day care centres, multidisciplinary teams provide holistic care and support for people with (chronic) life‐limiting conditions, or clients, in a homely surrounding, allowing them to remain living at home while attending a specialist palliative care service. This study aims to evaluate palliative day care centres from a user perspective. We conducted a full‐population cross‐sectional survey of clients (N = 86) and their family caregivers (N = 63) in all five palliative day care centres in Flanders, Belgium from January until December 2019. We used validated instruments supplemented with self‐developed items to measure participants' reasons for use, support provided, unmet support needs and added value to other (palliative) care services across palliative care domains, i.e., physical, psychological, social and spiritual care. Response rate was 77% for clients and 81% for family caregivers. The most often indicated reasons for use were that the client needs social contacts (clients: 73%, caregivers: 65%), to enable the client to live at home as long as possible (resp. 58%, 55%) and to reduce the family caregiver's mental burden (resp. 42%, 65%). Three out of four family caregivers felt better able to combine daily activities with caring for the client (77%) and felt better able to perform their family care‐giving tasks (77%) because the client attends the palliative day care centre. Thirty‐six per cent of clients had received support for social needs exclusively in the palliative day care centre and not from any professionals outside palliative day care. Palliative day care centres seem to be of added value for those care domains to which often less attention is paid in other settings, particularly social and emotional support, both for clients and family caregivers. [ABSTRACT FROM AUTHOR]

The objectives of the study were (a) to compare self‐reported Quality of Life (QoL) in a 24‐month follow‐up of people with dementia attending day care designed for people with dementia (day‐care group, DC) with people with dementia who did not attend day care (control group, CG) and (b) to explore factors associated with QoL. A quasi‐experimental design with a 24‐month follow‐up period was used. The DC group included 181 participants recruited from 53 day‐care services. The CG included 76 participants recruited from 19 municipalities with no available day care designed for people with dementia. The sample covered the four health regions of Norway and inclusion period lasted from December 2013 to July 2015. The Quality of Life in Alzheimer's Disease (QoL‐AD) scale was used as the outcome measure. The differences in QoL between groups and the associations between participant characteristics and QoL, such as depressive symptoms and functional dependency, were examined using a linear mixed model. In the multiple model, the overall trend in QoL did not differ significantly between the DC and CG. However, the DC group exhibited significantly higher self‐reported QoL than the CG at all time points (p < 0.001 at T0, p = 0.018 at T12, and p = 0.006 at T24). Participants with shallow or no awareness who attended day care had significantly higher scores on QoL‐AD than persons with full awareness (p = 0.017). More depressive symptoms (p < 0.001) and higher functional dependency (p < 0.001) were associated with lower self‐reported QoL. The study revealed higher scores of self‐reported QoL among people attending day care compared with those who did not attend, showing that day care might have positive impact on the lives of people with dementia. [ABSTRACT FROM AUTHOR]

Copyright of Alcoholism & Drug Addiction / Alkoholizm i Narkomania is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Every country in the world is facing serious demographic aging, since the average life expectancy is consistently increasing. Agencies involved in the implementation of caregiving through long-term care institutions can develop more convenient approaches using information and communication technology to enhance overall efficiency. Communication technology has enabled the strengthening of physiological instruments, improving the efficiency and quality of services, while integrating management systems for optimum efficiency. This work conducted empirical studies, collecting responses to questionnaires from residents and caregivers in five institutions located in the south of Taiwan. The PZB model, proposed by Parasuraman, Zeithaml, and Berry, was used to construct the questionnaire to analyze the service quality following the incorporation of information and communication technology. The results of the empirical study show that 34% and 63% of the relatives of the residents agreed and strongly agreed that the system was practical and convenient, respectively. As for the caregivers, 77% of them agreed or strongly agreed that the system was mobile, practical, and convenient, and they agreed that the system could significantly increase working efficiency, reduce waiting time, and improve administration for chronic diseases among care-home residents. [ABSTRACT FROM AUTHOR]

Copyright of Portuguese Journal of Mental Health Nursing / Revista Portuguesa de Enfermagem de Saúde Mental is the property of Portuguese Society of Mental Health Nursing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Physical activity is a predictor of the health outcomes of the older adults, and many approaches have been introduced for its implementation. The present study aimed to investigate the effect of group physical games on life quality (QOL) of older adults at an adult day care center. Methods: This quasi-experimental study was conducted using pre-test and post-test. Using convenience sampling, a total of 50 senior citizens above 60 years of age from two adult daycare centers of Babol and Amol in 2017 was placed in an intervention (25) and a control (25) group, respectively. The intervention group received physical games program twice a week for 6 weeks. The SF12 questionnaire was used to assess the QOL. The statistical analysis of the variables was carried out using t-tests, Wilcoxon, and Mann-Whitney tests at a significant level (P < 0.05) with SPSS software. Results: The QOL scores of the participants in the intervention group, compared to the control group have significantly improved (p < 0.001). The calculated difference for the quality of life of the intervention group was (d = 4.40 ± 2.36) being (d = 1.68 ± 1.74) and (d = 2.72 ± 1.51) in the physical and mental aspects, respectively. Conclusion: Physical exercise program (especially stationary physical game) can improve the quality of life of the older adults both physically and mentally. Therefore, such activities can be used to improve the quality of life of the older adults. [ABSTRACT FROM AUTHOR]

Objective: Chemotherapy-induced alopecia (CIA) is one of the most common and distressing side effects of chemotherapy treatment. This study aims to assess the illness perceptions of female patients dealing with CIA, and their associations with demographic and clinical characteristics, coping strategies, and quality of life. The secondary aim was to compare the illness perceptions of patients with CIA with other samples, to help elucidate the specific perceptions of patients with CIA. Method: Forty female patients at risk of severe hair loss due to chemotherapy treatment were included at the oncological daycare unit of a teaching hospital in the Netherlands. Patients were asked to complete the Brief-Illness Perception Questionnaire (B-IPQ) and the Hair Quality of Life (Hair-QoL) questionnaire. Results: Illness perceptions indicated that although patients understood their hair loss, they lacked being able to make sense of managing it, negatively impacting patients' lives. Psychological quality of life was significantly correlated with the B-IPQ domains: consequences, degree of concern, and emotional response. Social quality of life was significantly correlated with psychological quality of life. Patients with CIA felt significantly less able to manage their hair loss, compared to patients with breast cancer and psoriatic arthritis. Conclusion: As patients' beliefs of being able to manage their hair loss are important for adopting and maintaining adequate coping behaviors, additional effort of health care providers in fostering patients' sense of control is indicated, focusing on patients' strengths during and after chemotherapy treatment. In the context of developing interventions for patients with CIA, consequences, concern, and emotional response are the major dimensions that should be taken in account to help patients deal with hair loss. [ABSTRACT FROM AUTHOR]

Background: We sought to assess diet quality among people with intellectual disabilities or borderline intellectual functioning, living in residential facilities or receiving day care. Methods: We measured diet quality using the Dutch Healthy Diet Food Frequency Questionnaire (DHD) and compared this between participants with (n = 151) and controls without intellectual disabilities (n = 169). Potential correlates of diet quality were explored. Results: We found lower mean diet quality among people with intellectual disabilities (M = 80.9) compared to controls (M = 111.2; mean adjusted difference −28.4; 95% CI [−32.3, −24.5]; p <.001). Participants with borderline intellectual functioning and mild intellectual disabilities had lower diet quality and higher body mass index than individuals with severe to profound intellectual disabilities. Being female was a predictor of better diet quality. Conclusions: Overall, we found that diet quality was low in the sample of people with intellectual disabilities or borderline intellectual functioning. [ABSTRACT FROM AUTHOR]

Objective: To evaluate patients' experiences of shortened hospitalization in relation to bone grafting of unilateral alveolar clefts with mandibular symphyseal bone grafts. Design: Prospective cohort questionnaire study. Setting: Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Denmark. Patients: Thirty-nine (male n = 26, female n = 13) patients with unilateral residual clefts after primary reconstruction, mean age 10.4 years. Interventions: All patients underwent a standardized procedure with closure of the alveolar defect using mandibular symphyseal bone grafts. Patients were discharged within a day after surgery. Within 24 hours after discharge from surgery, patients and their parents filled in a 14-item psychometric questionnaire assessing the quality of their recovery. For all questions, a visual analogue scale (VAS) (0-10) was used. Main Outcome Measure: Patients' experience of shortened hospitalization in relation to secondary bone grafting of alveolar defects. Factors influencing the overall experience were measured using a VAS scale. Results: A significant correlation between "Information from the hospital" and feeling worried and anxious was found (P =.04). Additionally, the ability to sleep correlated with pain (P =.003) and with nausea (P =.001). Conclusions: Although this study included a limited number of patients, the findings suggest that treatment of alveolar residual cleft with bone grafting from the mandibular symphyseal region in a day care surgery setting is characterized by very high patient satisfaction. [ABSTRACT FROM AUTHOR]

Introduction: The use of pain neuroscience education in older adults has seldom been reported. While this age group shows high rates of chronic pain prevalence, its characteristics may also challenge an intervention of this nature. This case series aimed to describe a group intervention of pain neuroscience education and dance in institutionalized older adults with chronic pain. Case Series: Seven older adults institutionalized in a day care center/nursing home with chronic pain entered the study and received a group intervention of six sessions of pain neuroscience education and dance. Participants were assessed at baseline and at the end of the intervention regarding knowledge of pain neurophysiology, pain intensity, depressive symptoms, catastrophizing, fear of movement and lower limb performance. Outcomes: There was a mean (±SD) decrease of −1.0 ± 2.3 for pain intensity and of −6.1 ± 9.7 for pain catastrophizing and a mean increase in the score of the pain neurophysiology questionnaire of 4.0 ± 3.1. Mean change values were smaller than the minimal detectable difference, but a few individual participants changed above the minimal detectable difference (four participants for pain intensity and 2 for pain catastrophizing and knowledge of pain neurophysiology). Conclusion: Results suggest pain neuroscience education is a feasible intervention and when combined with dance may have a positive impact on pain intensity. [ABSTRACT FROM AUTHOR]

Objective: To assess outcomes in adult patients with eating disorders administered enhanced cognitive behavioral therapy (CBT‐E) in a day‐hospital setting. Method: Forty‐three consecutive patients with eating disorders (86% females; mean age 28.8 [SD = 11.8]) were admitted to a 13‐week day‐hospital CBT‐E program. Twenty‐five (58.1%) patients were underweight (i.e., body mass index [BMI] <18.5 kg/m2; BMI 15.4 [SD = 2.2]) and 18 not (mean BMI 23.1 [SD = 6.3]) at baseline. All patients responded poorly to prior outpatient treatment. Body mass index and Eating Disorder Examination Questionnaire (EDE‐Q), Brief Symptom Inventory (BSI), and Clinical Impairment Assessment (CIA) scores were recorded at baseline, end of treatment, and 20‐week follow‐up. Results: In 37 patients (86.0%) who completed the treatment, there were substantial improvements in eating‐disorder features, general psychopathology, clinical impairment, and body weight (only in underweight patients), which were well maintained at follow‐up. Discussion: Day‐hospital CBT‐E is a promising treatment for adults with eating disorders. [ABSTRACT FROM AUTHOR]

Therapeutic day rehabilitation (TDR) is a non-residential intensive structured program designed for individuals recovering from substance misuse. A weekly afternoon of therapeutic gardening was a new incentive initiated in a TDR program at one Australian community health service, designed to give participants the opportunity to spend time outdoors connecting with nature and each other. The aim of this study was to explore perceptions of participants enrolled in this program by employing a convergent parallel mixed-method design using qualitative individual, semi-structured interviews (n = 14) and longitudinal quantitative quality of life (QOL) data at three different intervals (n = 17). The analysis of the quantitative data showed that there was a statistically significant increase in the participants' QOL scores in three of four domains (physical health, psychological, social relationships) when comparing baseline and post completion of the TDR. These observed changes were maintained at the 4-week follow up. The key findings from the semi-structured interviews include positive effects for participants on social connectivity, structure and achievement, understanding of recovery and relaxation from contact with nature. This study shows that a combination of TDR and therapeutic gardening can improve participants' physical health, psychological health and social relationships. Incorporating therapeutic gardening within therapeutic day rehabilitation is an appropriate program design for individuals recovering from substance abuse. This research has demonstrated positive outcomes with this combination, improving participants' physical health, psychological health, and social relationships. In addition, it has helped participants to build social connections, a better understanding of recovery and a sense of achievement on completion of the program. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) pandemic is thought to have greatly impacted families of individuals with autism spectrum disorder (ASD) due to lockdown, given lack of access to healthcare, therapy, and day-care centers. This survey was conducted to understand the magnitude of the impact of lockdown, and its effect on the health and behavior of individuals with ASD and their families. Materials and Methods: We conducted an anonymous online survey, disseminated to families registered with our hospital and collaborating centers. The survey questionnaire collected information on sociodemographic details, details of the patient's and parents' behavior and health during the COVID-19 lockdown, and treatment details of the patient. Results: A total of 153 families completed the survey. Of the 153, nearly half of the individuals with ASD had an inadequate understanding of lockdown, 54% had increased screen-time, while a third reported new-onset behavioral changes. About 40% received online therapies, of which 85% reported benefits. Of the 132 who answered the parent's section, 55% reported decreased interest and/or pleasure in doing daily activities and 43% felt depressed and/or hopeless. About 80% of families reported short-term positive changes such as improved speech, language skills, and participation in household chores. Conclusion: The COVID-19 pandemic has disrupted routines, triggered behavioral issues in individuals with ASD, and impacted the coping skills of both individuals and families, along with the mental health and well-being of the family. Valuable suggestions to improve therapy services and clinical care using technology have been uncovered and need to be explored. [ABSTRACT FROM AUTHOR]

The efficacy of family-based treatment (FBT) in outpatient settings has led to efforts to incorporate FBT principles into higher levels of care. The present study examined predictors of improvement in an FBT-based partial hospitalization program/intensive outpatient program (PHP/IOP) as measured by the Eating Disorder Examination–Questionnaire. Participants were 113 patients with anorexia nervosa (AN) or eating disorder not otherwise specified (EDNOS) consecutively participating in an FBT-based PHP/IOP. Multilevel modeling was used to investigate predictors for adolescents and young adults separately. Predictors considered included illness duration, previous hospitalization, hospitalization immediately prior to treatment, previous outpatient therapy, hospitalization during treatment, diagnosis, gaining 4 pounds in 4 weeks, and family status as time-invariant variables. Time-varying variables considered included depression symptoms and mothers'/fathers' ratings of parental self-efficacy and expressed emotion. For adolescents, depression by time and diagnosis by time interactions were statistically significant. At all levels of depression, adolescent patients with AN demonstrated greater reductions in eating disorder symptoms compared to patients with EDNOS. For young adults, depression and gaining 4 pounds in 4 weeks were significant predictors. The relationships for young adults were curvilinear such that, while lower eating disorder symptoms were found during treatment, these gains were not maintained at follow up. [ABSTRACT FROM AUTHOR]

Using Guangdong Province as the focus for this research, this article explores the role and functions of social work services in the elderly care system, and then analyses the relationship between social work services and family care services in urban China. The research found that social workers are confronted with challenges when providing culturally sensitive services, indicating a need for them to further develop their capacity to interpret service items and service provision procedures for older adults and family members. IMPLICATIONS In China, social workers should focus on the impact of filial piety on older adults who are clients of community service programs. At the initial stage of service provision, social workers may need to exert considerable effort to interpret service items and service provision procedures for older adults and family members. In Australia and other countries, where social workers often work with elderly Chinese immigrants and their families, familiarity with the concept of filial piety may be important. [ABSTRACT FROM AUTHOR]

Objectives To determine the impact of difficult-to-treat rheumatoid arthritis (D2T RA) on (costs related to) healthcare utilization, other resource use and work productivity. Methods Data regarding healthcare utilization, other resource use and work productivity of 52 D2T (according to the EULAR definition) and 100 non-D2T RA patients were collected via a questionnaire and an electronic patient record review during a study visit. Annual costs were calculated and compared between groups. Multivariable linear regression analysis was performed to assess whether having D2T RA was associated with higher costs. Results Mean (95% CI) annual total costs were €37 605 (€27 689 – €50 378) for D2T and €19 217 (€15 647 – €22 945) for non-D2T RA patients (P <0.001). D2T RA patients visited their rheumatologist more frequently, were more often admitted to day-care facilities, underwent more laboratory tests and used more drugs (specifically targeted synthetic DMARDs), compared with non-D2T RA patients (P <0.01). In D2T RA patients, the main contributors to total costs were informal help of family and friends (28%), drugs (26%) and loss of work productivity (16%). After adjustment for physical functioning (HAQ), having D2T RA was no longer statistically significantly associated with higher total costs. HAQ was the only independent determinant of higher costs in multivariable analysis. Conclusions The economic burden of D2T RA is significantly higher than that of non-D2T RA, indicated by higher healthcare utilization and higher annual total costs. Functional disability is a key determinant of higher costs in RA. [ABSTRACT FROM AUTHOR]

Background: Day care services support older people living with long-term conditions (LTC's). Aims: The aims of the study were to determine outcomes in terms of loneliness and health-related quality of life for older people with LTCs attending day care services in the United Kingdom. Methods: Newly referred older people with LTCs to day care services in North West of England and Wales were invited to participate. The EQ-5D-3L and De Jong Loneliness questionnaires were completed at recruitment, 6 and 12 weeks. Results: Ninty-four older people (64% female), age range 65–99 years; mean number of LTCs 4.3 (range: 2–9) were recruited. About 52% lived alone and 36% lived in one of the 20% most deprived local authorities in England and Wales. Outcomes over 12 weeks were comparable for paid, blended, and for volunteer-led services. Conclusion: Following the Covid-19 pandemic, it is increasingly urgent to support older people with LTCs who may have lost physical and cognitive function during lockdown and to support their recovery. Our study suggests that volunteers can provide services and complement the care provided by paid staff, freeing up resources and enabling increasing numbers of older people to be supported. [ABSTRACT FROM AUTHOR]

Minnesota has the largest population of Somali refugees with the majority depending on public insurance for dental care. The social determinants of health (SDOH) framework is helpful to identify factors that may be related to oral health, and subsequently plan for public health initiatives. The purpose of this study was to measure the correlation between Somali refugee mother–child caries experience, and to identify associations between SDOH factors and child caries. The study was conducted in day care facilities where oral screenings and surveys identified SDOH factors at the individual, provider, community and environmental levels. A positive correlation was found between mother–child caries experience. Factors associated with child caries (p ≤ 0.05) were found at all SDOH levels except the provider level though only individual level factors for mothers and children yielded the expected results. SDOH affecting child caries were limited to individual demographic, behavioral and attitudinal factors. [ABSTRACT FROM AUTHOR]

The authors present an economic evaluation performed alongside a randomized controlled trial of mentalization-based treatment in a day hospital setting (MBT-DH) versus specialist treatment as usual (S-TAU) for borderline personality disorder (BPD) with a 36-month follow-up period. Ninety-five patients from two Dutch treatment institutes were randomly assigned. Societal costs were compared with the proportion of BPD remissions and quality-adjusted life years (QALYs) measured using the five-dimensional EuroQol instrument. The incremental societal costs for one additional QALY could not be calculated. The costs for one additional BPD remission with MBT-DH are approximately €29,000. There was a 58% likelihood that MBT-DH leads to more remitted patients at additional costs compared with S-TAU, and a 35% likelihood that MBT-DH leads to more remissions at lower costs. MBT-DH is not cost-effective compared with S-TAU with QALYs as the outcome, and slightly more cost-effective than S-TAU at 36 months with BPD symptoms as the outcome. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the clinical effectiveness of metacognitive training (MCT) as a transdiagnostic program, on a diverse population with mental disorders in routine Japanese day‐care settings. Methods: This study employed a prospective, multicenter, single‐group pre‐post design. Participants diagnosed with various mental disorders received 10 MCT group sessions. We set transdiagnostic outcomes to assess quality of life, global functioning, cognitive insight, and depressive symptoms. At the end of the MCT, we also evaluated participants' satisfaction with treatment. Assessments were conducted at baseline (Pre), Week 5 (Mid), Week 10 (Post), and Week 14 (follow‐up: FU). Results: Thirty‐four participants enrolled in the study and received MCT (schizophrenia = 22, non‐schizophrenia = 12). Intent‐to‐treat analyses revealed significant improvements in quality of life/global functioning during the intervention period, and further improvements were observed during the follow‐up (all p <.05). The Pre–FU treatment effect sizes for quality of life and global functioning were small (Hedge's g = 0.44 and 0.47, respectively). Significant improvements were also found in depressive symptoms during both the intervention and follow‐up periods (all p <.05), but not in cognitive insight. Overall, participants were highly satisfied with the MCT content and format. Scores on almost all outcomes (except for depression) at each assessment point were not significantly different between the schizophrenic and non‐schizophrenic sub‐groups. Conclusions: Despite several limitations, mainly due to small sample size and having no control conditions, our results suggest that MCT for a diverse population with mental disorders is a potentially effective approach in improving quality of life/global functioning and other clinical outcomes in routine day‐care settings. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study is to describe the influences of lower limb edema on the daily lives of elderly individuals in elderly day care to describe the necessity of care for lower limb edema. Methods: Semi‐structured interviews based on a quality of life questionnaire for limb lymphedema were conducted. Two types of text mining analysis methods were used: a frequent word analysis and a content analysis. The edema severity was graded on a scale of 0 to 3, and the sum of the numerical values of the grades for each person was defined as the pitting score. Results: The seven participants had a mean age of 83.4 ± 4.6 years (mean ± SD). The pitting scores ranged from 1 to 25 in the participants. The words "think" (389 times), "walk" (136 times), and "put on" (135 times) were extracted frequently. The content analysis focused on the words "walk" and "put on." The participants complained of difficulty walking, pain, and numbness when walking, weakness of their lower limbs, difficulty putting on shoes, restrictions on shoe types, and difficulty finding shoes. Conclusions: These results demonstrate that elderly individuals experienced troubles during their daily lives caused by lower limb edema, which highlights the necessity of symptom management. Active interventions for edema by nurses are necessary to improve quality of life in elderly individuals. [ABSTRACT FROM AUTHOR]

People with dementia should be able to live in the community, and day care services are recommended as a means for people to live in their own homes for as long as possible. In this study we wanted to compare the quality of care at one type of small‐scale day care situated at community farms to regular day care provided in connection with residential care facilities for elderly people. A total of 42 participants from 10 farm‐based day care offers and 46 participants from seven regular day care offers were included. A qualitative observational design using the validated Maastricht Electronic Daily Life Observation tool was used. The data were collected between March and June 2018. Ecological momentary assessments of the activities taking place, level of engagement, physical effort, location, social interaction and mood were conducted while the participants attended their day care offer. The results showed that familiar daily activities were common at farm‐based day care, and a linear mixed model analysis showed that farm‐based day care attendees used more physical effort, spent more time outdoors, had more social interaction and experienced more positive mood compared to regular day care attendees. These findings contribute with valuable information about care provided at different types of day care services, and indicate that farm‐based day care has more activities with the potential to meet the social and activity needs of people with dementia compared to regular day care. There are two main implication of this study. First, regular day care services should focus on including more familiar daily activities found to be important for attendees' sense of identity and feelings of contributing. Second, regular day care services should utilise the potential of available outdoor areas as time spent outdoors has been found to facilitate physical activity, relaxation, health and well‐being. [ABSTRACT FROM AUTHOR]

This study presents the design of an integrated, proactive palliative care pathway covering the full care cycle and evaluates its effects using 3 types of outcomes: (1) physician-reported outcomes, (2) outcomes reported by family, and (3) (utilization of) health care outcomes. A clustered, partially controlled before-after study with a multidisciplinary integrated palliative care pathway as its main intervention. after assessment in hospital departments of oncology, and geriatrics, and in 13 primary care facilities, terminally ill patients were proactively included into the pathway. Patients' relatives and patients' general practitioners (GPs) participated in a before/after survey and in interviews and focus groups. A multidisciplinary, integrated palliative care pathway encompassing (among others) early identification of the palliative phase, multidisciplinary consultation and coordination, and continuous monitoring of outcomes. Measures included GP questionnaire: perceived quality of palliative care; questionnaires by family members: FAMCARE, QOD-LTC, EDIZ; and 3 types of health care outcomes: (1) utilization of primary care: consultations, intensive care, communication, palliative home visits, consultations and home visits during weekends and out-of-office-hours, ambulance, admission to hospital; (2) utilization of hospital care: outpatient ward consultations, day care, emergency room visits, inpatient care, (radio) diagnostics, surgical procedures, other therapeutic activities, intensive care unit activities; (3) pharmaceutical care utilization. GPs reported that palliative patients die more often at their preferred place of death, and that they now act more proactively toward palliative patients. Relatives of included, deceased patients reported clinically relevant improved quality of dying, and more timely palliative care. Patients in the pathway received more (intensive) primary care, less unexpected care during out-of-office hours, and more often received hospital care in the form of day care. An integrated palliative care pathway improves a variety of clinical outcomes important to patients, their families, physicians, and the health care system. The integration of palliative care into multidisciplinary, proactive palliative care pathways, is therefore a desirable future development. [ABSTRACT FROM AUTHOR]

An exploratory study was implemented to characterize the sedentary behavior of people older than 75, attending day care, and study its association with quality-of-life. Sedentary behavior was measured with accelerometer and its patterns characterized with an Activity Diary. Quality-of-life was measured with the WHOQOL. Fifty-four people (84.5 ± 5.4) reported on 378 days. More than 75% of awake time was sedentary, mostly watching TV (53.3%) in the afternoon (48.4%) alone (57.4%). No significant associations with quality-of-life were found. To break sedentary periods, clinical interventions need to focus on this context and day period, inspired in existing routine activities. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the practices of preventing infectious diseases by daycare center teachers. The focus was on the mediating effects of self-efficacy in the relationship between communication skills and practices of preventing infectious diseases. Methods: This study used a descriptive correlational design. The participants were 164 daycare center teachers. Hierarchical regression was used to test the mediating effect of self-efficacy in the relationship between communication skills and practices of preventing infectious diseases. Data were analyzed using the independent t-test, one-way analysis of variance, Pearson correlation coefficients, and hierarchical regression. The mediation effect was analyzed using an SPSS Macro program, PROCESS. Results: Significant relationships were found between communication skills and practices of preventing infectious diseases (β=.19, p<.001), self-efficacy and practices of preventing infectious diseases (β=.59, p<.001), and communication skills and self-efficacy (β=.27, p<.001). Self-efficacy had a significant mediating effect (β=.17, 95% confidence interval=0.07-0.29) on practices of preventing infectious diseases. Conclusion: In order to improve practices of preventing infectious diseases among daycare teachers, it is necessary to develop and apply interventions and methods that can increase effective communication skills and self-efficacy. [ABSTRACT FROM AUTHOR]

Fall injuries are the leading cause of injury death in older adults, yet despite this, health-care providers do not routinely incorporate fall prevention into practice. A fall prevention training program was developed for non-clinical caregivers serving community-dwelling older adults using the CDC's STEADI tool. The project outcomes revealed statistically significant increases in items related to knowledge and confidence in fall risk and assessment. Findings could guide the development of fall prevention training programs targeted at non-clinical caregivers to community-dwelling older adults. [ABSTRACT FROM AUTHOR]

Aim: The aim was to gain an understanding of what the United Kingdom (UK) Punjabi Sikh community understands and thinks about advance care planning (ACP). This is in response to evidence showing a lack of service usage by Black, Asian, and Minority Ethnic groups. Methods: Surveys containing questions about the impressions of terms, advance decisions for care, do-not-attempt-resuscitation, and lasting power of attorney were taken to targeted community groups; these included community day centers, sporting groups, temples, and social media circles. Surveys were available in both Punjabi and English languages. Results: A total of 311 surveys were received in total. There was a 50/50 gender split and a mixed group of ages; 75% were born in the UK and 15% were born in Punjab, India. Only a third had some understanding of what ACP meant. Nearly 50% of the participants did express wishes toward the end of their life, however only a third of the respondents knew how to access services. Cardiopulmonary resuscitation was felt to be mandatory by 36%. Sixty percent thought that their decision would be legally binding in relatives who do not have capacity. Conclusion: This study showed that wishes for religious rites were common, however many do not know how to make them known. If they do know about services, then people are highly likely to engage with the ACP process. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis adult day programs (MSADPs) are nonmedical service programs that provide care and support to people with multiple sclerosis (MS) experiencing levels of impairment that interfere with employment and activities of daily living. The purpose of this study was to identify how program participants think MSADPs benefit them. Methods: We conducted in-depth interviews with 95 people with MS who were MSADP participants. Interviews occurred as part of site visits to ten programs across the country. We supplemented participant interviews with interviews of program staff and ethnographic observation of activities at each site over 1 to 3 days. Results: Participants reported several benefits from participating in an MSADP. Almost universally, participants explained that receiving and giving social support were the most important benefits. Other positive outcomes described included increased emotional well-being, better understanding and acceptance of MS, practical know-how for accomplishing ordinary tasks, and increased mobility and improved motor functioning. Conclusions: Participants believe that MSADPs have a profound influence on their psychosocial health, much of which they attribute to membership in a socially cohesive community. Clinicians and policy makers should consider recommending these programs for people with MS who have unmet psychosocial needs and experience functional impairments. [ABSTRACT FROM AUTHOR]