Rights based approaches to addressing food poverty and food insecurity in Ireland and UK

Food poverty is an important contributing factor to health inequalities in industrialized countries; it refers to the inability to acquire or eat an adequate quality or sufficient quantity of food in socially acceptable ways (or the uncertainty of being able to do so). Synonymous with household food insecurity, the issue needs to be located within a social justice framework. Recognising the clear interdependence between the right to food and the right to health, this paper explores how international human rights obligations could inform approaches to addressing food poverty and insecurity with specific reference to Ireland and the UK. Little attention has been paid to how countries should meet their obligations to respect, protect and fulfil the right to food in developed countries. The paper contributes by examining the social and policy circumstances which inhibit poor households from obtaining sufficient food to eat healthily, along with strategies and interventions from State and civil society actors in the two countries. In practice, problems and potential solutions have largely been directed towards the individual rather than at social determinants, particularly as research on environmental factors such as distance to shops has produced equivocal results. Other key structural aspects such as income sufficiency for food are broadly ignored by the State, and anti-poverty strategies are often implemented without monitoring for effects on food outcomes. Thus scant evidence exists for either Ireland or the UK meeting its rights to food obligations to date, in terms of roles and responsibilities in ensuring access to affordable, available and appropriate food for all

An exploration into factors which influence positive object play experience for children who are living with severe physical and intellectual disabilities

Background: Toy/object play is accepted as an integral and valued occupation for all children. Though play in general is a topic which commonly receives attention in research, object play, remains relatively unexplored especially for children with severe physical and intellectual disabilities, a population which is commonly described as experiencing ‘play deprivation’. Purpose: The purpose of this study is to explore factors which influence positive toy/object play experiences for children who are living with severe physical and intellectual disabilities. Method: This study took a qualitative methodology that is informed by the theoretical approaches of ethnography. This study utilises method triangulation; participant observations, semi-structured interviews and focus groups to obtain rich and in-depth findings. Participants: After ethical approval, 5 child participants, 6 parent(s)/guardian(s) and 6 teachers/SNAs were recruited. Findings: 4 major themes, ‘Play as an Occupation, Play as an Activity’; ‘An Empowered and Empowering Play Partner’; ‘The 'Just-Right' Play Object’ and ‘Considerations for Contextual participation’ as well as relevant subthemes were identified through thematic analysis. The interaction between the play form, play object and play context (including environment and social supports) is highlighted clearly within these analytical themes. Implications for practice: Although the findings are specific to this study sample, play facilitators may use them to further their understanding of the nature of object play for this population and inform future play interactions. By recognising the multiple facets of positive play influence, object play can be better understood and championed as a central to these children's occupational lives

Aggregating multiple body sensors for analysis in sports

Real time monitoring of the wellness of sportspersons, during their sporting activity and training, is important in order to maximise performance during the sporting event itself and during training, as well as being important for the health of the sportsperson overall. We have combined a suite of common, off-the-shelf sensors with specialist body sensing technology we are developing ourselves and constructed a software system for recording, analysing and presenting sensed data gathered from a single player during a sporting activity, a football match. We gather readings for heart rate, galvanic skin response, motion, heat flux, respiration, and location (GPS) using on-body sensors, while simultaneously tracking player activity using a combination of a playercam video and pitch-wide video recording. We have aggregated all this sensed data into a single overview of player performance and activity which can be reviewed, post-event. We are currently working on integrating other non-invasive methods for real-time on-body monitoring of sweat electrolytes and pH via a textile-based sweat sampling and analysis platform. Our work is heading in two directions; firstly from post-event data aggregation to real-time monitoring, and secondly, to convert raw sensor readings into performance indicators that are meaningful to practitioners in the field

A qualitative study of child participation in decision-making: Exploring rights-based approaches in pediatric occupational therapy

Background: According to Article 12 of the United Nations Convention on the Rights of the Child, therapists are duty-bound to include children in decisions that impact them. Although occupational therapists champion client-centred, collaborative practice, there remains a paucity of studies detailing children’s rights and experiences of decision-making in pediatric occupational therapy. Purpose: This qualitative study described the decision-making experiences of children, parents and therapists in occupational therapy. Methods: Semi-structured interviews were conducted with 17 participants (six children, five parents and six occupational therapists), and data analysed using thematic analysis. Findings: Three themes emerged: 1) Goal-setting experiences; 2) Adults: child-rights gatekeepers or defenders? and 3) Decision-making in context. Findings suggest that decision-making is mostly adult directed, and children’s voices are subsumed by adult-led services, priorities, and agendas. Implications: Children’s rights need to be embedded as an aspect of best practice in providing services that are child-centred in occupational therapy practices and education

Co-design and user validation of the MedFit App: a focus group analysis

This abstract details the development phase of the formative research process outlined by the Medical Research Council, used to develop a theoretically informed Android App, named MedFit, to enhance disease self-management and quality of life in adults with cardiovascular disease (CVD). The overall aim of the app is to increase physical activity minutes of adults with CVD. A key part of the development phase, which is the focus of this abstract, is the co-design and user validation of the MedFit app

Behavior Change Techniques in Physical Activity eHealth Interventions for People With Cardiovascular Disease: Systematic Review

Background: Cardiovascular disease (CVD) is the leading cause of premature death and disability in Europe, accounting for 4 million deaths per year and costing the European Union economy almost €196 billion annually. There is strong evidence to suggest that exercise-based secondary rehabilitation programs can decrease the mortality risk and improve health among patients with CVD. Theory-informed use of behavior change techniques (BCTs) is important in the design of cardiac rehabilitation programs aimed at changing cardiovascular risk factors. Electronic health (eHealth) is the use of information and communication technologies (ICTs) for health. This emerging area of health care has the ability to enhance self-management of chronic disease by making health care more accessible, affordable, and available to the public. However, evidence-based information on the use of BCTs in eHealth interventions is limited, and particularly so, for individuals living with CVD. Objective: The aim of this systematic review was to assess the application of BCTs in eHealth interventions designed to increase physical activity (PA) in CVD populations. Methods: A total of 7 electronic databases, including EBSCOhost (MEDLINE, PsycINFO, Academic Search Complete, SPORTDiscus with Full Text, and CINAHL Complete), Scopus, and Web of Science (Core Collection) were searched. Two authors independently reviewed references using the software package Covidence (Veritas Health Innovation). The reviewers met to resolve any discrepancies, with a third independent reviewer acting as an arbitrator when required. Following this, data were extracted from the papers that met the inclusion criteria. Bias assessment of the studies was carried out using the Cochrane Collaboration’s tool for assessing the risk of bias within Covidence; this was followed by a narrative synthesis. Results: Out of the 987 studies that were identified, 14 were included in the review. An additional 9 studies were added following a hand search of review paper references. The average number of BCTs used across the 23 studies was 7.2 (range 1-19). The top three most frequently used BCTs included information about health consequences (78%, 18/23), goal setting (behavior; 74%, 17/23), and joint third, self-monitoring of behavior and social support (practical) were included in 11 studies (48%, 11/23) each. Conclusions: This systematic review is the first to investigate the use of BCTs in PA eHealth interventions specifically designed for people with CVD. This research will have clear implications for health care policy and research by outlining the BCTs used in eHealth interventions for chronic illnesses, in particular CVD, thereby providing clear foundations for further research and developments in the area

Utilizing unsupervised learning to improve sward content prediction and herbage mass estimation

Sward species composition estimation is a tedious one. Herbage must be collected in the field, manually separated into components, dried and weighed to estimate species composition. Deep learning approaches using neural networks have been used in previous work to propose faster and more cost efficient alternatives to this process by estimating the biomass information from a picture of an area of pasture alone. Deep learning approaches have, however, struggled to generalize to distant geographical locations and necessitated further data collection to retrain and perform optimally in different climates. In this work, we enhance the deep learning solution by reducing the need for ground-truthed (GT) images when training the neural network. We demonstrate how unsupervised contrastive learning can be used in the sward composition prediction problem and compare with the state-of-the-art on the publicly available GrassClover dataset collected in Denmark as well as a more recent dataset from Ireland where we tackle herbage mass and height estimation.Comment: 3 pages. Accepted at the 29th EGF General Meeting 202

Outcomes of pulmonary rehabilitation for COPD in older patients: a comparative study

Pulmonary rehabilitation (PR) is established as an effective intervention in optimising function and quality of life in patients with chronic obstructive pulmonary disease (COPD). However, there are very limited data on the effectiveness of PR in older patients with COPD. We reviewed all patients attending an 8-week outpatient programme. Patients were divided into two groups; Group A (n = 202), below 70 years, and Group B (n = 122), above 70 years of age. Outcomes in both patient subgroups were compared using FEV1, Incremental Shuttle Walk Test (ISWT), Endurance Shuttle Walk Test (ESWT), Grip Strength, St. George's Respiratory Questionnaire (SGRQ), Hospital Anxiety and Depression Score (HADS), and COPD Assessment Test (CAT) score. Statistical analysis was conducted using Mann-Whitney non-parametric testing and chi-square testing for comparison of clinically relevant improvements between groups. There was no significant difference in PR outcomes between Group A and Group B using absolute values. Mean changes in ISWT for Groups A and B 39.7 m vs. 32.8 m (p = 0.63), respectively, SGRQ −2.5 vs. −2.8 (p = 0.95), HADS anxiety score −0.83 vs. −0.57 (p = 0.43) and HADS depression score −0.69 vs. −0.39 (p = 0.48), respectively. There was no difference in the proportion of patients who achieved the minimal clinically significant improvement in Group A versus Group B for parameters ISWT (38.6% vs 42.7%), SGRQ (27.8% vs 21.3%), and HADS total score (20.5% vs 28.1%). These data suggest that benefits of PR in COPD are not age dependent. Age should not be a barrier to enrolling patients with COPD in PR programmes

MedFit: The development of a mobile-application to enhance participant self-management of their cardiovascular disease

Background: Cardiovascular disease (CVD) is the leading cause of premature death and disability in Europe. Cardiac Rehabilitation (CR) can reduce the impact of CVD by lowering mortality and morbidity rates and promoting healthy active lifestyles. Yet adherence within CR is low. Research suggests that mHealth interventions are useful in supporting the self-management of chronic disease. The purpose of this research is to report on the development of an mHealth intervention. Methods: For the intervention development the Medical Research Council’s formative process consisting of 4 stages; i) development, ii) feasibility/piloting, iii) evaluation and iv) implementation will be used to develop a theoretically informed Android App to enhance disease self-management and quality of life in CVD. Like CR it will use exercise as its main modality, and provide advice on other health behaviours. Results: A systematic review of the use of behaviour change techniques (BCTs) in physical activity eHealth interventions for CVD patients has been conducted. Seven electronic databases yielded 987 articles, 97 of which met the inclusion criteria for full text review. A multidisciplinary team comprised of exercise scientists, health behaviour change and technology specialists are using this information to develop the intervention prototype. Stage one will be followed by qualitative research, where end-users will be asked to examine the intervention in order to determine its feasibility and acceptability, to ultimately improve its efficacy through a co-design process. Conclusion: Preliminary findings and systematic review protocol will be reported as per the PRISMA guidelines, ultimately aiding the development of the MedFit app

Evidence for implementing tiered approaches in elementary schools in school-based occupational therapy: a scoping review

Importance: Internationally, it is suggested that school-based occupational therapy (SBOT) has an important role in supporting inclusion in educational settings. In SBOT, multitiered service delivery models are identified as a way forward to maximize school inclusion. Therefore, identifying evidence for the implementation of tiered interventions in SBOT is vital. Objective: To identify and map evidence in the occupational therapy literature relating to SBOT interventions delivered in elementary schools for all children, for those at risk, and for those with identified diagnoses. Data Sources: Peer-reviewed literature published in 14 occupational therapy journals between 1990 and 2020, indexed in the EBSCOhost database. Study Selection and Data Collection: Included studies were those within the scope of SBOT that reported on school occupations and focused on elementary school–age children (excluding kindergarteners or preschoolers). Findings: Forty studies met the criteria. Individual-tier intervention studies (n = 22) primarily reported direct interventions with children at risk or with identified diagnoses (Tier 2 or Tier 3), focusing mostly on remedial approaches. None adopted a whole-school approach. Despite handwriting and self-regulation being dominant areas of concern, these studies were not explicitly related to inclusion outcomes. Evidence for implementing multitiered models primarily used indirect, collaborative consultation, embedded in the school context (n = 18). These studies identified positive school staff and child outcomes when collaboration was timely, consistent, and authentic. Conclusions and Relevance: More rigorous individual-tier intervention studies are required to inform the design and implementation of multitiered interventions in SBOT and to support participation and inclusion in schools. What This Article Adds: This scoping review provides evidence to support occupational therapists’ professional reasoning in developing evidence-based, contextual, educationally relevant multitiered models of intervention in SBOT