Evaluation of a Sleep Knowledge Translation Strategy for Occupational Therapists Working with Persons who have Dementia

Introduction: Sleep deficiency is a significant, largely overlooked issue for persons with dementia (PWD), and is associated with physical and mental health problems, increased caregiver burden, and increased likelihood of institutionalization. Despite the high prevalence of sleep deficiency in PWD, most health care professionals lack knowledge of the relationship between sleep problems and dementia. This project aimed to determine the feasibility of an archived online presentation, a knowledge translation (KT) strategy to increase therapists’ understanding of the impact of blue-spectrum light on sleep in PWD. Method: Therapists who participated in a previous sleep and dementia survey were recruited via email. Participants completed a pre-knowledge test, accessed an online presentation regarding the relationship between sleep and light, and completed a post-test. Results: On average there was a 22% improvement in knowledge scores and participants were positive about the KT strategy being accessible, applicable, and evidence based. Conclusion: For a sample of therapists self-identified as specializing in geriatric rehabilitation, online audio-visual resources appear to be a feasible KT strategy to disseminate information and increase occupational therapists’ knowledge regarding the evidence-based relationship between blue-spectrum light and sleep in PWD. Further study is required to determine if this increased knowledge translates to practice settings

Review of best practice in cardiac rehabilitation for women

Purpose: Cardiovascular disease is defined as damage to, or narrowing of, arteries due to atherosclerosis and is the leading cause of mortality and morbidity among women worldwide. Cardiovascular disease is recognized to be both a leading cause of mortality and an undertreated condition for women. The goals of this review manuscript are to present the current background literature specific to cardiac rehabilitation programs for women and serve as a knowledge translation strategy to help raise therapists’ awareness of the need for cardiac rehabilitation programs specifically designed for female patients. Methods: A review of best practice literature in cardiac rehabilitation for women. Results: With current increasing trends in risk factors, including stress, obesity, poor diet, smoking, and a sedentary lifestyle, the future burden could be overwhelming from the perspective of individuals’ health and health authorities’ resources. Conclusions: Emerging research clearly demonstrates the need for cardiac rehabilitation programs tailored for women and highlighting the unique features of program delivery that can reduce the risk of under-referral and treatment program dropout

The experience of meaningful rehabilitation as perceived by people with chronic pain: A phenomenological study

BACKGROUND: People with chronic pain may seek rehabilitation to reduce pain and restore productivity and valued roles. Theoretically, a biopsychosocial approach makes rehabilitation more meaningful, however, the limited research on meaningful rehabilitation predominantly describes the perspective of therapists and researchers. The client\u27s perspective of meaningfulness in rehabilitation is lacking. OBJECTIVE: To investigate the experience of meaningfulness in rehabilitation from the perspective of people with chronic pain. METHODS: Qualitative, semi-structured interviews were conducted with Australian adults who had chronic pain and recent experience of occupational therapy or physiotherapy. Sampling continued until thematic saturation occurred. Transcripts were coded and analyzed using theory-driven and data-driven thematic analysis. RESULTS: Ten participants (four males; six females) were interviewed. Pain histories ranged from nine months to 20+ years, with conditions such as fibromyalgia or trauma. Three themes from a prior concept analysis were upheld, and a further three data-driven themes emerged. Results indicate that people with chronic pain seek a genuine connection ; from a therapist who is credible ; and can become a guiding partner , and they find rehabilitation meaningful when it holds personal value ; is self-defined ; and relevant to their sense of self-identity . CONCLUSIONS: The genuine connection and guiding partnership with a credible therapist, that is sought by people with chronic pain, may be at odds with aspects of contemporary rehabilitation. Client-defined meaningfulness is an important construct to engage clients in treatment and improve work and other occupational outcomes for people with chronic pain

Patient-defined meaningfulness within chronic pain rehabilitation: A concept analysis

Background: As the problem of chronic pain grows worldwide, rehabilitation is critical to improved patient well-being. There is thus a need for rehabilitation-focused research. It appears that outcomes are improved when patients perceive the rehabilitation process to be meaningful. However, there is no empirical evidence determining how this would be achieved. An important first step is to identify and describe the concept of meaningfulness as it is used in the chronic pain rehabilitation literature. Objective: This paper reports the findings of a structured concept analysis to define meaningfulness from the patient perspective in chronic pain rehabilitation. Methodology: In consultation with a medical librarian, a search strategy was developed and articles retrieved. The Walker and Avant concept analysis method was used to analyze the data, identify the defining attributes of meaningfulness, develop contrary, borderline, and model cases, and identify its antecedents and consequences. Results: The search revealed extensive use of the terms ‘meaningfulness’ and ‘meaningful’ within the chronic pain rehabilitation literature from the healthcare provider and system perspective. However, only ten articles met the inclusion criteria, and used the terms meaningful or meaningfulness from the patients’ perspective. Given the paucity of relevant studies, it was not possible to retrieve a clear definition of meaningfulness specific to the context of chronic pain rehabilitation, nor to identify specific outcome measures used to confirm whether rehabilitation is meaningful for people with chronic pain. Conclusions: There is a worrisome gap in the chronic pain rehabilitation literature regarding the application of the concept of ‘meaningfulness’ as perceived by the patient. This study lays the foundation to further the conceptual clarity required for rigorous research to determine potential benefits of personally meaningful chronic pain rehabilitation. Further work is required to define and operationalize the concept, develop valid assessment tools, and build the evidence base regarding relationships between patient-defined meaningfulness and positive outcomes in rehabilitation

Cross-sectional survey of sleep practices of Australian university students

Background and Aim: Sleep insufficiency is often associated with the life of a university student, yet it is well known that inadequate sleep can have a negative impact on physical and mental health and be detrimental to cognitive skills for learning. The aim of this study was to replicate a Canadian study to survey university student sleep practices, the way in which students address any sleep issues, and the students’ preferred method to receive targeted sleep information. Methods: An anonymous on-line survey was promoted to all enrolled students at one Australian University in August 2017. Results: In total, 601 students responded to the survey. One third indicated that they had insufficient sleep (less than 6.5 hrs). Almost two thirds reported a perception of not getting sufficient sleep. There was a significant association between the reported number of sleep hours, and the perception of high-quality sleep. Strategies to get to sleep included the use of social media which is counter to best practice in sleep hygiene. Conclusion: The study supports the need for education about sleep health coupled with stress management to better the demands of student life

Job Club: A program to assist occupational therapy students\u27 transition to practice

Transition to practice can be identified as the change from the role of student to the role of practitioner. This period of transition is a time of intense professional and personal development. Typically, it can take anywhere between six months to two years before an entry-level therapist feels competent in the workplace. A number of factors affect the transition process, including role uncertainty, inadequate supervision, and an overall lack of confidence in clinical skills. This paper discusses a case example of a Job Club, provided by a Western Australian Occupational Therapy university program. The concept was initially set up to support students through the process of seeking and gaining employment. Over time, the club developed a broader scope based on the needs of attendees. This example illustrates the needs of students for greater support in this important transition, and lays the groundwork for formal research in future

Sleep and Military Members: Emerging Issues and Nonpharmacological Intervention

Background. Many individuals who work in the military experience sleep deficiency which presents a significant problem given the nature of their work. The cause of their sleep problems is likely multifactorial, stemming from the interplay between their personal health, habits and lifestyle juxtaposed with the stress of their military work such as emotional and physical trauma experienced in service. Objective. To present an overview of sleep deficiency in military members (MMs) and review of nonpharmacological treatment options. Discussion. Although there are a number of promising nonpharmacological treatment options available for people working in the military who experience problems sleeping, testing interventions within the context of the military are still in the early stages. Further research utilizing rigorous design and standardized, context appropriate outcome measures is needed to help treat this burgeoning problem

Assessment of Barotrauma Resulting from Rapid Decompression of Depth Acclimated Juvenile Chinook Salmon Bearing Radio Telemetry Transmitters

A multifactor study was conducted by Battelle for the US Army Corps of Engineers to assess the significance of the presence of a radio telemetry transmitter on the effects of rapid decompression from simulated hydro turbine passage on depth acclimated juvenile run-of-the-river Chinook salmon. Study factors were: (1) juvenile chinook salmon age;, subyearling or yearling, (2) radio transmitter present or absent, (3) three transmitter implantation factors: gastric, surgical, and no transmitter, and (4) four acclimation depth factors: 1, 10, 20, and 40 foot submergence equivalent absolute pressure, for a total of 48 unique treatments. Exposed fish were examined for changes in behavior, presence or absence of barotrauma injuries, and immediate or delayed mortality. Logistic models were used to test hypotheses that addressed study objectives. The presence of a radio transmitter was found to significantly increase the risk of barotrauma injury and mortality at exposure to rapid decompression. Gastric implantation was found to present a higher risk than surgical implantation. Fish were exposed within 48 hours of transmitter implantation so surgical incisions were not completely healed. The difference in results obtained for gastric and surgical implantation methods may be the result of study design and the results may have been different if tested fish had completely healed surgical wounds. However, the test did simulate the typical surgical-release time frame for in-river telemetry studies of fish survival so the results are probably representative for fish passing through a turbine shortly following release into the river. The finding of a significant difference in response to rapid decompression between fish bearing radio transmitters and those not implies a bias may exist in estimates of turbine passage survival obtained using radio telemetry. However, the rapid decompression (simulated turbine passage) conditions used for the study represented near worst case exposure for fish passing through turbines. At this time, insufficient data exist about the distribution of river-run fish entering turbines, and particularly, the distribution of fish passing through turbine runners, to extrapolate study findings to the population of fish passing through FCRPS turbines. This study is the first study examining rapid decompression study to include acclimation depth as an experimental factor for physostomous fish. We found that fish acclimated to deeper depth were significantly more vulnerable to barotrauma injury and death. Insufficient information about the distribution of fish entering turbines and their depth acclimation currently exists to extrapolate these findings to the population of fish passing through turbines. However, the risk of barotrauma for turbine-passed fish could be particularly high for subyearling Chinook salmon that migrate downstream at deeper depths late in the early summer portion of the outmigration. Barotrauma injuries led to immediate mortality delayed mortality and potential mortality due to increased susceptibility to predation resulting from loss of equilibrium or swim bladder rupture

Children\u27s Sleep during COVID-19: How Sleep Influences Surviving and Thriving in Families

Objective The COVID-19 pandemic has the potential to disrupt the lives of families and may have implications for children with existing sleep problems. As such, we aimed to: (1) characterize sleep changes during the COVID-19 pandemic in children who had previously been identified as having sleep problems, (2) identify factors contributing to sleep changes due to COVID-19 safety measures, and (3) understand parents and children s needs to support sleep during the pandemic. Methods Eighty-five Canadian parents with children aged 4 14 years participated in this explanatory sequential, mixed-methods study using an online survey of children s and parents sleep, with a subset of 16 parents, selected based on changes in their children s sleep, participating in semi-structured interviews. Families had previously participated in the Better Nights, Better Days (BNBD) randomized controlled trial. Results While some parents perceived their child s sleep quality improved during the COVID-19 pandemic (14.1%, n 12), many parents perceived their child s sleep had worsened (40.0%, n 34). Parents attributed children s worsened sleep to increased screen time, anxiety, and decreased exercise. Findings from semi-structured interviews highlighted the effect of disrupted routines on sleep and stress, and that stress reciprocally influenced children s and parents sleep. Conclusions The sleep of many Canadian children was affected by the first wave of the COVID-19 pandemic, with the disruption of routines influencing children s sleep. eHealth interventions, such as BNBD with modifications that address the COVID-19 context, could help families address these challenges