Welcome to the Neighborhood: Does Where you Live Affect the Use of Nutrition, Health, and Welfare Programs?

Despite the recent upsurge in neighborhood effects research, few studies have examined the impact of neighborhood characteristics on the use of nutrition, health, and welfare programs. To explore these issues, this study used data from Welfare, Children, and Families: A Three-City Study, a longitudinal dataset comprised of low-income neighborhoods in Boston, San Antonio, and Chicago (n=1,712). Using hierarchical linear models, the results indicated that both individual (education, employment, and marriage) and perceived neighborhood disorder factors were related to social service use

Patients' Experiences and Perspectives of Telehealth Coaching with a Dietitian to Improve Diet Quality in Chronic Kidney Disease: A Qualitative Interview Study

Background: Dietary behavior change interventions for the self-management of chronic kidney disease (CKD) have the potential to slow disease progression and reduce metabolic complications. Telehealth-delivered dietary interventions may assist in the self-management of CKD, although their acceptability by patients is unknown. Objective: This study aims to describe the acceptability and experiences of a telehealth coaching intervention that utilized telephone calls and tailored text messages to improve diet quality in patients with stage 3 to 4 CKD. Design: Semistructured interview study of adults with CKD. Participants/setting: Adults with stage 3 to 4 CKD (n=21) aged 28 to 78 (mean 62) years, who completed a 12-week telehealth-delivered dietary intervention in Queensland, Australia, were interviewed from March to July 2017. Data analysis: Interviews were transcribed verbatim and analyzed thematically. Results: Five themes were identified: valuing relationships (receiving tangible and perceptible support, building trust and rapport remotely, motivated by accountability, readily responding to a personalized approach, reassured by health professional expertise); appreciating convenience (integrating easily into lifestyle, talking comfortably in a familiar environment, minimizing travel and wait time burden); empowered with actionable knowledge (comprehending diet-disease mechanisms, practical problem solving for sustainable dietary behavior); increasing diet consciousness (learning from recurrent feedback, prompted by reiteration of messages); making sense of complexity (contextualizing and prioritizing comorbidities, gaining confidence to make dietary decisions, setting and achieving realistic goals). Conclusions: Among adults with stage 3 to 4 CKD, individualized telehealth coaching for improving diet quality was convenient for patients, and they felt supported and empowered to navigate recommendations and prioritize dietary behavior changes. Telehealth-delivered dietary interventions appear to be well accepted by patients as a way of providing regular, tailored contact with a health professional to support dietary management in CKD

Occupational Therapy Interventions to Optimize Functional Use of the Upper Extremity After Peripheral Nerve Injury: A Systematic Review

PURPOSE: Peripheral nerve injuries are a distinct group of injuries that are commonly caused by motor vehicle accidents, falls, industrial accidents, household accidents, and penetrating trauma (Kamble et al., 2019). A peripheral nerve injury can affect an individual’s daily occupations and routines due to unrelenting pain, loss of sensation, and/or burning sensations. Peripheral nerve injuries can result in motor loss and subsequent muscle imbalance which can create functional loss (Chae et al., 2020). The purpose of this systematic review was to provide occupational therapists with evidence supporting the use of interventions to increase the functional use of the upper extremity after peripheral nerve injury. DESIGN: We conducted a systematic review and included studies relevant to peripheral nerve injury, functional use of the upper extremity, and interventions within the scope of occupational therapy. All articles included were published within the last decade. METHOD: We reviewed 31 titles and abstracts from MEDLINE, CINAHL, Embase, and Scopus databases and retrieved 11 full-text articles. Six met inclusion criteria. To determine the strength of evidence, we used the U.S. Preventative Services Task Force levels of certainty and grade definitions. RESULTS: Three themes emerged: mirror therapy, sensory re-education, and the use of an orthosis. Three level I studies, and one level II study reported on the effectiveness of mirror therapy interventions. These studies provide moderate strength of evidence supporting the use of mirror therapy for improving upper limb function after peripheral nerve injury. One level II study reported on the effectiveness of sensory re-education interventions. Based on this study, sensory re-education is another supported intervention for improving functional outcomes of the upper limb after a peripheral nerve injury. However, this is based on low strength of evidence. One level IV study reported on the effectiveness of orthosis interventions. Using a volar wrist orthosis to enhance upper limb functional use is supported for treatment of Carpal Tunnel Syndrome but is found to be disadvised for ulnar nerve injuries, based on low strength of evidence provided by this study. More evidence is needed to determine the effectiveness of this intervention. CONCLUSION: Based on moderate level of evidence, mirror therapy is a recommended intervention for improving functional outcomes of the upper limb after a peripheral nerve injury. These findings suggest that occupational therapists should be well-educated and trained in mirror therapy procedures and protocols in order to provide best practice to increase functional use of the upper limb after peripheral nerve injury. Sensory re-education is another recommended intervention to improve functional outcomes of the upper limb after a peripheral nerve injury that can be considered on a case-by-case basis. Due to limited literature, future research in the area of peripheral neuropathy interventions within the scope of occupational therapy should focus on increasing sample size using high quality study designs and developing a more standardized mirror therapy protocol.https://digitalcommons.unmc.edu/cahp_ot_sysrev/1003/thumbnail.jp

Can People Experiencing Homelessness Acquire Financial Assets?

Through an innovative Individual Development Account (IDA) program run by the Community Empowerment Fund (CEF), individuals at risk for or experiencing homelessness receive financial education, access matched savings accounts, and have saved a total of $89,831.55. This is notable as low-income individuals often lack access to the means to build assets, which can moderate financial distress. In this mixed-method study we examine the program\u27s impact through administrative data, surveys, and qualitative interviews. Of the 17 interview participants, 15 opened an account, saving an average of$1,356.24 toward housing, emergency savings, cars, education, and computers. Few U.S. IDA programs have served those experiencing homelessness, although the results demonstrate they can save, which is remarkable considering the U.S. saving rate has been steadily declining to close to zero. Our findings suggest that this model is effective in working with the most disadvantaged populations to successfully acquire financial assets

Intergenerational preferences regarding punishment of criminal offenders

The purpose of this study is to examine intergenerational differences regarding corporal punishment of criminal offenders, particularly preferential differences that occur between members of the Baby Boom and Echo-Baby Boom generations. This research is of interest due to America \u27s changing culture. The children of Baby Roomers see fewer acts and practices as sinful and morally wrong than do their parents, and our research examines if similar changes occurred in the criminal justice system in response to how offenders should be punished. No studies currently exist which examine this issue, and this research will create awareness in the discipline of criminology. To investigate these preferences, we administered a survey instrument to members of both generations in the spring of 2003. Members of the Baby Boom generation completed the survey at Spring Commencement at the University of Northern Iowa while members of the Echo-Baby Boom generation filled out the survey in selected Liberal Arts Core classes at the university. The survey, designed to measure preferences toward corporal punishment, included several crime scenarios where the respondent picked either a corporal or non-corporal sanc;tion for the offender. Other questions focused on topics such as support fof the death penalty, surgical castration, and corporal punishment in general. Chi Squares were used to analyze the differences between the two ; generations and · initially failed to reveal statistically significant results. Logistic regression models were employed in order to further analyze generational differences as well as the impact of other variables such as race, education, and social class which may impact preferences. Although few statistically significant differences were identified, this lack of variation can partially be attributed to the homogenous nature of Iowa\u27s population. Even with limited significant findings, this research provides insight regarding preferential differences of corporal punishment and cultural change

Feasibility and acceptability of telehealth coaching to promote healthy eating in chronic kidney disease: A mixed-methods process evaluation

Objective To evaluate the feasibility and acceptability of a personalised telehealth intervention to support dietary self-management in adults with stage 3-4 chronic kidney disease (CKD). Design Mixed-methods process evaluation embedded in a randomised controlled trial. Participants People with stage 3-4 CKD (estimated glomerular filtration rate [eGFR]15-60 mL/min/1.73 m 2). Setting Participants were recruited from three hospitals in Australia and completed the intervention in ambulatory community settings. Intervention The intervention group received one telephone call per fortnight and 2-8 tailored text messages for 3 months, and then 4-12 tailored text messages for 3 months without telephone calls. The control group received usual care for 3 months then non-tailored education-only text messages for 3 months. Main outcome measures Feasibility (recruitment, non-participation and retention rates, intervention fidelity and participant adherence) and acceptability (questionnaire and semistructured interviews). Statistical analyses performed Descriptive statistics and qualitative content analysis. Results Overall, 80/230 (35%) eligible patients who were approached consented to participate (mean±SD age 61.5±12.6 years). Retention was 93% and 98% in the intervention and control groups, respectively, and 96% of all planned intervention calls were completed. All participants in the intervention arm identified the tailored text messages as useful in supporting dietary self-management. In the control group, 27 (69%) reported the non-tailored text messages were useful in supporting change. Intervention group participants reported that the telehealth programme delivery methods were practical and able to be integrated into their lifestyle. Participants viewed the intervention as an acceptable, personalised alternative to face-face clinic consultations, and were satisfied with the frequency of contact. Conclusions This telehealth-delivered dietary coaching programme is an acceptable intervention which appears feasible for supporting dietary self-management in stage 3-4 CKD. A larger-scale randomised controlled trial is needed to evaluate the efficacy of the coaching programme on clinical and patient-reported outcomes. Trial registration number ACTRN12616001212448; Results

Waiting for shelter: Perspectives on a homeless shelter’s procedures

Research on homeless shelter implementation is limited. Some shelters have lengthy waitlists, which raises important questions about implications of waitlists for individuals with immediate shelter needs. This study used qualitative methods to understand the experiences of shelter seekers who were on a shelter waitlist (N = 59), including individuals who entered the shelter from the waitlist, and those removed from the shelter waitlist for procedural reasons. The average waitlist time was nearly 3 weeks, and 22.0% stayed at least one night on the street or another public place while on the waitlist. Responses to open‐ended questions regarding barriers and effectiveness of the shelter referral procedures revealed 4 themes: procedural challenges, procedural benefits, benefits of the temporary stay, and communication challenges. Further research is needed to inform shelter implementation on a larger scale in accordance with current community‐wide efforts to coordinate shelter services.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138221/1/jcop21896_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138221/2/jcop21896.pd