Breastfeeding experiences of Aboriginal and Torres Strait Islander mothers in an urban setting in Brisbane

This study examined urban Aboriginal and Torres Strait Islander mothers' breastfeeding experiences to inform support for mothers and their families.The research took a strengths approach, using qualitative methodology. Twenty semi-structured in-depth face-to-face interviews were conducted and analysed thematically.Indigenous mothers of infants 3 to 12 months were recruited through a Brisbane Indigenous health service.All mothers recounted considerable physical and emotional energy invested in breastfeeding. Although early introduction of formula made sense for some mothers under stressful circumstances, timely pro-breastfeeding support from family and health professionals facilitated continued breastfeeding. Professional and social/family contacts play key roles in steering infant feeding outcomes.Mothers' experiences strongly influence infant feeding strategies. Aboriginal and Torres Strait Islander community strengths are underutilised in supporting breastfeeding mothers. FUTURE IMPLICATIONS: Indigenous mothers, family and community strengths present points for engagement in future breastfeeding promotion and support initiatives

Characterization of patient care in non-alcoholic fatty liver disease in secondary care in Germany

Non-alcoholic fatty liver disease (NAFLD) has grown to currently be the leading cause of chronic liver disease globally. NAFLD has a prevalence of 25% worldwide and raises concern in the healthcare sector around the globe. Within this study the disease burden as well as standard of care throughout secondary care in Germany was evaluated. This study is part of the FLAG study. An observational real-world study was carried out in 507 patients with NAFLD (mean age 53 years, 53% male) at 13 centers (4 academic clinics, 9 office-based practices) throughout Germany. Non-invasive surrogate scores were used to estimate disease severity. Patient data was collected at baseline and 1 year follow up. The FIB-4 Index was used to classify patients into groups of significant fibrosis, indeterminate/moderate and advanced fibrosis with 58%, 31% and 11%, respectively. Patients with advanced fibrosis were older, had higher waist circumferences and showed higher serum levels of aspartate aminotransferase, gamma-glutamyl transferase and ferritin. Higher prevalence of comorbidities like arterial hypertension, type 2 diabetes, obesity, and the occurrence of cardiovascular events were seen with increasing fibrosis stages. 25% of the patients were given access to nutritional counselling. Only 5% of patients received drug-treatment with either vitamin E, silymarin or ursodeoxycholic acid. Physical exercise >2 times per week was reported in 18%, 18% and 6% of patients with no significant fibroses, moderate fibrosis, and advanced fibrosis, respectively. By using the FAST-score we identified 107 patients (17%) with progressive non-alcoholic steatohepatitis. After one year at follow-up 45% of patients presented with weight loss. Among 15% of these patients the weight loss was larger than 5% of their body weight. Serum levels of alanine aminotransferase were decreased by 16% in patients with weight loss. This study on NAFLD identified every 10th patient to have advanced fibrosis at baseline in a national secondary-care real-world setting. Standard of care included treatment of comorbidities and lifestyle recommendations. The data emphasize the pressing need for a systematic health agenda in NAFLD patients.Die nichtalkoholische Fettlebererkrankung (NAFLD) ist mit einer globalen Prävalenz von 25% die führende Ursache für chronische Lebererkrankungen weltweit und eine wachsende Herausforderung für das öffentliche Gesundheitswesen. Ziel dieser Arbeit ist die Untersuchung der Krankheitsschwere und Darstellung der ambulanten therapeutischen Herangehensweisen von Patient:innen mit NAFLD in Deutschland. Die vorliegende Arbeit ist Teil der FLAG-Studie. Wir führten eine prospektive klinische Beobachtungsstudie von NAFLD Patient:innen an 13 Standorten deutschlandweit, davon 4 Hochschulambulanzen und 9 Praxen, durch. Die Krankheitsschwere wurde mittels nicht-invasiver Surrogatparameter erfasst, die Datenerfassung erfolgte zur Baseline Visite und zum Follow-up nach 12 Monaten. Es wurden 507 Patient:innen eingeschlossen (mittleres Alter 53 Jahre, 47% Frauen). Anhand des FIB-4 Index erfolgte die Aufteilung je nach Fibrosestadium. 58% der Patient:innen hatte keine signifikante Fibrose, 31% eine moderate Fibrose (indeterminata) und 11% eine fortgeschrittene Fibrose. Patient:innen mit fortgeschrittener Fibrose waren älter, hatten höhere Taillenumfänge und höhere Serumspiegel von AST und GGT, sowie Serumferritin. Die Prävalenz von Komorbiditäten wie Adipositas, arterieller Hypertonie, kardiovaskulären Ereignissen und Diabetes Mellitus Typ 2 nahm mit zunehmender Fibrose zu. Zu den therapeutischen Herangehensweisen gehörte körperliche Betätigung > 2x/Woche, dies wurde von jeweils 18% der Patient:innen ohne signifikante und mit moderater Fibrose und 6% mit fortgeschrittener Fibrose umgesetzt. Eine medikamentöse Therapie mit entweder UDCA, Vitamin E oder Silymarin erhielten 5%. 25% der Patient:innen nahmen an einer Ernährungsberatung teil. Nach FibroScan-AST Score sind 17% dieser Patient:innengruppe (n=107) von einer fortschreitenden nichtalkoholischen Steatohepatitis betroffen. Zum 1-Jahres Follow-up (n=158) zeigte sich bei 45% eine Gewichtsabnahme, bei 15% sogar eine Abnahme von mehr als 5% des Körpergewichts. Patient:innen mit Gewichtsabnahme zeigten eine Reduktion der Serum ALT Werte um 16%

Improving Occupational Engagement: An Occupation-Based Virtual Program For Caregivers of Individuals with Dementia

Dementia is a progressive disorder that affects many people worldwide including informal caregivers of individuals with dementia (Harrison et al., 2019). Every year, more than 16 million Americans provide more than 17 billion hours of unpaid care for family and friends with Alzheimer’s disease or other related dementias (CDC, 2019). As a result, many informal caregivers experience higher levels of caregiver burden, depression, and anxiety (Amato et al., 2021; Raj et al., 2021; Walter & Pinquart, 2020). This causes an occupational imbalance in caregivers\u27 ability to meet their needs and those of their loved one. Leisure is within occupational therapy\u27s (OT\u27s) practice domain and utilized to facilitate occupational engagement (AOTA, 2020). The purpose of the program development type project was to implement an occupation-based program for informal caregivers of individuals with dementia that incorporates leisure to help improve occupational engagement (Chiu et al., 2020; DiLauro et al., 2017; Lee et al., 2020).https://soar.usa.edu/otdcapstones-spring2022/1017/thumbnail.jp

Exploration of Occupational Problems and Concerns in Individuals with Long-Covid (Post-Acute Sequelae of SARS-CoV-2)

Long-Covid is a complex illness causing disruption in the lives of millions of individuals suffering from its symptoms resulting from Covid-19 infection. With over 65 million confirmed cases of Covid-19 and 10% of individuals expected to experience Long-Covid, knowledge in this area is important to support occupational therapy practice. The purpose of this qualitative research project is to provide knowledge on the reported occupational performance problems and concerns being experienced by individuals with Long-Covid to help fill this gap in research and provide some guidance for OT evaluation and intervention.https://soar.usa.edu/otdcapstones-spring2022/1013/thumbnail.jp

Analysis of Role Changes for Women with Breast Cancer Related Lymphedema to Return to Work

Breast Cancer survivors diagnosed with secondary lymphedema have decreased quality of life and experience greater challenges when attempting to return to work compared to survivors who do not have secondary lymphedema. Limited research is available in understanding the impact breast cancer-related lymphedema has on survivors transitioning from traditional medical care to return to work. Occupational therapists specializing in Lymphedema therapy have the unique training skills and knowledge to address the challenges this population faces, as well as the tools needed to educate patients and their family members on how to manage returning to work, and make any adaptations to their work environment in order to achieve overall satisfaction and quality of life. A quantitative study was done to identify the impact BCRL has had on the role changes survivors with secondary lymphedema experience, as well as satisfaction with work. Results collected from the study were indicative of decreased overall satisfaction with return to work secondary to diagnosis, significant role changes with decreased independence and difficulties from employers, as well as little to no therapeutic services addressing return to work during this survivorship phase. Future recommendations include developing a program addressing return to work and successful techniques manage lymphedema symptoms of the affected limb within the work environment.https://soar.usa.edu/otdcapstones-spring2022/1042/thumbnail.jp

Occupation Based Program for African American Crossover Youth Aging Out of Foster Care

Unique challenges and differences surround the population of African American crossover youth and how they successfully transition into adulthood once aged out of foster care as compared to same-aged peers (Kim et al., 2019). The problem is that African American crossover youth aging out of the foster care system, are not receiving occupation-based transitional services focusing on IADLs required for adulthood independence resulting in increased prevalence of homelessness (Armstrong-Heimsoth et al., 2020; Flores et al., 2018; Kelly, 2020; Paul-Ward & Lambdin-Pattavina, 2016; Pérez et al., 2019). The purpose of this program development type project is to develop and implement an occupation-based transitional program for African American crossover youth aging out of the foster care system focused on IADLs required for adulthood independence, decreasing the prevalence of homelessness. An occupation-based program is essential in providing more programs for youth during those transitional ages to increase self-sufficiency into adulthood. The occupation-based program focusing on IADLs and health management, #Adulting, was successful based on the positive feedback from each activity.https://soar.usa.edu/otdcapstonesfall2021/1029/thumbnail.jp

Exploration of Occupational Therapy’s Role Within the LGBTQ+ Population

There are an estimated 11 million individuals who identify as LGBTQ+ in the United States (Rosendale et al., 2019). With this number steadily increasing, it is important that occupational therapists continue to become culturally competent and educated on different strategies to transform the way individuals who identify as LGBTQ+ are given and receive treatment. The problem is that there is a gap in the literature supporting occupational therapist cultural competence to integrate occupational roles of the LGBTQ+ population into their evaluation and intervention. Without culturally competent educational opportunities, the health care system is inadequately prepared to provide responsive health care (Singer, 2015). The purpose of this quantitative research type capstone project will be to analyze the evaluation and intervention strategies occupational therapists can use to better serve the LGBTQ+ population. This paper supports the beneficial role occupational therapy has in addressing the needs of the LGBTQ+ population. The author believes that occupational therapists have the expertise and competence to improve OT services in the LGBTQ+ population and play a big role in the quality of life of individuals who identify as LGBTQ+.https://soar.usa.edu/otdcapstonesfall2021/1033/thumbnail.jp

Qualitative Exploration of the Perception and Satisfaction of Occupational Engagement and Level of Awareness of Treatment options for Parous Women with Pelvic Floor Dysfunction.

This poster looks to provide an overview of the results of the capstone project looking to fill a gap in the literature regarding the impact that pelvic floor dysfunction has on the occupational engagement of parous women, and their knowledge of occupational therapy treatment options for pelvic floor dysfunction (Burkhart et al, 2021). Data collection occurred over 2 weeks and the inclusion criteria for this study consisted of parous (having beard children) women, ages 18 to 65, and having at least 1 symptom of pelvic floor dysfunction (i.e., urinary problem, bowel problem, or pelvic organ prolapse). The research questions were, what are common problem areas in occupational performance for parous women diagnosed with pelvic floor dysfunction? How do parous women diagnosed with pelvic floor dysfunction rate their satisfaction related to problem areas in occupational performance? Lastly, what awareness do parous women with pelvic floor dysfunction have of treatment options available to them? Although all areas presented to be problems areas for the participants of this study, the most common problem areas were functional mobility, active recreation, and self-care. The average satisfaction of each occupation was less than a 5.5 out of 10. 84.6% of participants state that they were not at all aware that occupational therapists treat pelvic floor concerns. At least 61.5% of participants rated themselves as not having any knowledge of treatment options concerning their pelvic floor symptoms based on the 1-10-point Likert scale interview.https://soar.usa.edu/otdcapstones-spring2022/1028/thumbnail.jp

Fostering Community Participation for Youth with Intellectual and Developmental Disabilities: An Occupation-Based Program for Caregivers

Caregiver expectations influence outcomes of youth with intellectual and developmental disabilities (IDD) as they seek more independence transitioning from adolescence to adulthood. The purpose of this program development capstone project is to promote realistic expectations of caregivers of youth by improving caregiver youth relationships and facilitating activities. Strategies of current and evidence-based programs that support caregivers of youth with IDD, such as Maximizing Adolescent Post-Secondary Success and TrASDition training. The American Occupational Therapy Association Vision 2025 aligns with the program as it aims to provide caregivers equal opportunity, access to care, and expands an individual’s capacity to advocate for caregivers. Program participants met inclusion criteria: youth 14 to 24 year’s old, caregivers and youth speak and understand English, and have an electronic device to access the virtual program. Flyers were handed out to identified pairs as candidates most receptive and those who would gain the most benefit from the 6-week program. Ensuring caregivers had unrealistic expectations rather than realistic expectations and lack of clinical experience working with caregivers and youth with IDD were challenges for the project. Site staff knowledge of current skills and preferences of caregivers and youth, local resources to direct caregivers to, and mentorship during development of program were supports for the project. The Model of Human Occupation takes a holistic approach on viewing meaningful activities and relationships of caregivers in their environment and was used in the program to look at how caregivers organize their thoughts, roles, and choose tasks to participate in.https://soar.usa.edu/otdcapstones-spring2022/1021/thumbnail.jp