A Profile of Canadians Over the Age of 65 Years Living with Coexisting Vision and Mobility Impairments: A Sequential Mixed Method Analysis

The purpose of this dissertation was (i) to investigate the prevalence of older Canadian adults living with coexisting vision and mobility impairments, and (ii) to describe how disability associated with both impairments relate to health status, activities of daily living, physical activity participation, assistive technology use, and health care services. These goals were achieved by using mixed methodology approach. The first manuscript was based on secondary analyses of the 2006/2007 National Population Health Survey (NPHS). The results of the secondary analysis of the NPHS revealed that approximately 3% of the Canadian population over the age of 65 was living with coexisting vision and mobility impairments. Also, older adults with both conditions required more assistance with activities of daily living and they reported the lowest levels of physical activity participation compared to those living with one or no impairment. The second part of the core component was based on secondary analyses of the 2006 Participation and Activity Limitations Survey (PALS). The PALS was specifically designed for individuals who reported they were living with a disability. As a result, a greater proportion of respondents indicated the presence of both target conditions – approximately 15% of older Canadians who reported having a disability were living with coexisting vision and mobility impairments. The analysis of the PALS data revealed that older adults with both impairments required more assistance with activities of daily living and they reported a higher use of assistive technology; however, there was a higher level of unmet needs for vision related assistive technology. The final manuscript consisted of in-depth interviews conducted to add the personal perspective of older adults with both impairments, and to expand and clarify the quantitative findings. The analyses of the transcripts revealed four main themes among participants: (i) the meaning behind vision, mobility, and coexisting impairments; (ii) adaptation of desired activities; (iii) external support for engaging in activity; and (iv) internal support for engaging in activity. The results of this dissertation contribute knowledge about living with coexisting vision and mobility impairments and offer a starting point to guide rehabilitation services for clients with multiple impairments

Current Developments in Services for People with Intellectual Disabilities

[Taken from Executive Summary] This literature review is the culmination of the Saskatchewan Community Living Division jurisdictional study which began in the autumn of 2003. Following a brief survey of developments in providing services to people with intellectual disabilities (hitherto the People) for creating the questionnaire for this study, information was gleaned from the provinces and territories on their services. The CLD Jurisdictional Project was completed in the spring of 2005. Subsequently, a thorough search and examination of pertinent resources for serving this People and for policy development was conducted. From over 800 documents about 350 were selected for this literature review. The material is recorded in the following chapters: Public Consultation and Policy Development; Social Philosophy: the philosophical influence on contemporary social issues; Definition of disabilities; Needs assessment systems; Human Rights; Advocacy; Community services & Deinstitutionalization; Issues and Influences; Citizenship; Inclusion; Self-determination; Person-centered planning; Supports; Respite; Individualized funding; Canadian governmental initiatives; Provincial Services

Women, Health and Aging: Building a Statewide Movement

Provides an overview of current policy and program environments that affect the state's most vulnerable elder population, and considers some effective strategies to address the growing needs of older persons in California

Axial Spondyloarthritis: Patient-Reported Impact in Europe

This open access book provides an overview of the International Map of Axial Spondyloarthritis (IMAS) project -focusing on Europe-, a wide-ranging, multi-disciplinary collaboration between academic groups, Health Care Professionals (HCPs), patient organizations and Novartis. IMAS was conceived to improve knowledge of Axial Spondyloarthritis (axSpA) and raise awareness of its heavy burden globally. By asking more than 2,000 patients across Europe about the impact of axSpA on multiple aspects of their life, the full extent of this disease was investigated from a direct patient perspective. This allowed a unique understanding of how living with axSpA affects the daily lives and well-being of patients, and how this varies between European countries. Axial Spondyloarthritis: Patient-Reported Impact in Europe highlights opportunities for progressing quality patient care to be applied to health services globally. HCPs, policy makers and patients will find this book to be an indispensable resource for improving the understanding of this chronic condition, including patients’ clinical outcomes, the protection of those at risk of psychological distress, and the economic burden on patients and society

Custom-Made Helmet Fabrication for Occupational Therapists Treating Patients with Traumatic Brain Injury

Soldiers within the Veteran\u27s Administration who have sustained a traumatic brain injury (TBI) were the focus of this project. Reports showed a growing number of soldiers have returned from Iraq with head injuries, including cranial and brain defects (Defense and Veterans Brain Injury Center, 2007). Symptoms individuals with TBI commonly exhibit include dizziness, balance problems, sleep problems, excessive fatigue, headaches, and difficulties with cognitive processes. Other symptoms associated with a TBI are blurred vision, ringing in the ears, and bad tastes in the mouth (National Institute of Neurological Disorders and Stroke, 2007). The purpose of this project was to develop a cranial helmet that would be custom-fit to the individual who has sustained a TBI to protect his or her cranium during the healing process to prevent a secondary TBl or additional complications. A literature review was conducted using PubMed, CINAHL, and electronic organizational resources to identify existing occupational therapy resources pertaining to the fabrication process of custom-made helmets. Information was also obtained from textbooks, seminars, and library searches. Limited resources existed for the use of custom-made helmets in the area of adult TBI. Instead, we used research literature regarding the fabrication of helmets for children with cranial defects to guide the development of our project. The helmet was designed incorporating the client\u27s values and interests. A mold of the individuals head was created with plaster around which we formed materials in Custom-made Helmet for Patients with Traumatic Brain Injury subsequent steps. The helmet was comprised of insulated foam used for protection and comfort. Thermoplastic splinting material was then formed on top of the foam to create the shell of the helmet. The helmet had four quadrants for air circulation to allow cool air along the head. A chin strap was added to support the helmet in place. An accompanying manual was also designed to guide the fabrication of the helmet. For the purpose of the scholarly project, time and financial aspects, this fabricated prototype is the first step in the development of the helmet. The final product will need extensive testing from competent engineers to ensure the safety of the clients using the helmet

Self-Efficacy, Health Promotion, And Rehabilitation In Acquired Brain Injury

Health self-efficacy is important to health behaviors and self-management of chronic conditions. It has been associated with positive health and rehabilitation outcomes generally but has been understudied in acquired brain injury (ABI). Given the high rates of disability and long-term impairments associated with ABI, health self-efficacy and health behaviors are promising factors to evaluate in the assessment and management of ABI. This study examined the relationships among health self-efficacy, health behaviors, and functional independence in ABI rehabilitation, and the extent to which cognitive impairment and trait affectivity affected these relationships. This study also examined the unique role of rehabilitation self-efficacy as measured by the newly developed Rehabilitation Self-Efficacy Scale. Overall, this study found that health beliefs and trait affectivity provided important information about functional status after brain injury, their relative contributions to outcome prediction varied as a function of severity of cognitive impairment, and rehabilitation self-efficacy provided novel considerations for understanding these relationships. These findings highlight areas for potential interventions focused on health and rehabilitation beliefs to augment outcomes of brain injury rehabilitation