Expert’s View on Central Components of the Actional Model of Older People’s Coping with Health-Related Declines: A Pilot Study with Professional Caregivers

peer reviewedAbri & Boll (2022) proposed the “Actional Model of Older People´s Coping with Health-Related Declines” to explain the use of various action alternatives of older persons for dealing with diseases, functional declines, activity limitations, and participation restrictions. It draws on a broad knowledge base: an action-theoretical model of intentional self-development, models of the use of assistive technologies (ATs) and medical services, qualitative studies on reasons for using or not-using ATs, and quantitative studies on older people’s health-related goals. The present study aims to gather evidence to further refine this model by additionally relying on expert knowledge from professional caregivers serving older people. Six experienced geriatric nurses working in mobile care services or residential care facilities were interviewed about key components of the above model in relation to 17 older people aged 70 to 95 with stroke, arthrosis, or mild dementia. The results revealed additional goals of reducing or preventing health-related discrepancies beyond those already included in the model (e.g., moving without pain, doing things alone, driving a car again, social return). Moreover, new motivating or demotivating goals for using certain action possibilities were found (e.g., to be at home, to be alone, to rest, to motivate other older people). Finally, some new factors were identified from the biological-functional (e.g., illness, fatigue), technological (e.g., pain inducing ATs, maladaptive devices), and social contexts (e.g., lack of staff time) that are likely to promote or hinder the use of certain action possibilities. Implications for refining the model and future research are discussed

A qualitative meta-synthesis of reasons for the use or non-use of assistive technologies in the aging population

Models of the use of assistive technologies (ATs) have only moderate value for predicting older people´s use of ATs. To find further predictors we performed a systematic literature review and – applying an action-theoretical approach – a meta-synthesis of seven qualitative studies about older people´s reasons for use or non-use of ATs. We found 25 reasons referring to user´s beliefs and desires (e.g., about demand, act of using ATs, its consequences) of which 18 were not contained in existing AT use models. Some reasons generalized across ATs (e.g., perceived unreliability), whereas others (e.g., privacy concerns, desire to avoid burden to others) appeared specific to tele-alarm or smart home technology. We discuss findings with respect to improving AT use models and developmental counseling

Gains and losses of caring for an older relative and the indication for geropsychological intervention

Caring for a close person involves and impacts several aspects and domains of personal life. A scenario that is often sketched here indicates that caring is physically exhausting, demanding time, leaving no time for leisure, and excluding the carer from further social activities. In this view, caring is strain as it is clearly described by the concept of caregiver burden, and a risk for the psychological and/or physical health of family carers. But caring may also have another side of positive gratification and of fulfilment. To care for another person may represent a meaningful work for both the cared for and the caring person that may also go along with recognition and positive feedback from others. This is the starting point of the present study that addressed a sample of 151 informal carers (n = 111 female) with a mean age of 58 years (SD=14 years) with self-report questionnaire. The measure offered in a first part positive (n=35) and negative aspects (n=23) of caring for a close person and subjects had to rate how much they agree that these aspects are present in their own care giving relationship. Moreover, life satisfaction as well as positive and negative affect were assessed in a second part. Multivariate analyses by factor as well as cluster analyses showed different profiles of gains and losses that were systematically linked to indicators of subjective well-being. Findings will be discussed with respect to their implications for psychosocial intervention in the field of informal care

Self-care Assistive Technologies: A systematic review of studies on efficiency and factors influencing their use

A gradual decline in functional and mental capacity, as well as a growing risk of care dependency constitute major concerns of life in old age. These are expected to become more urgent in the future, because the old-age dependency ratio in the EU is projected to nearly double until 2060 due to demographic change. On the other side, there is a strong desire to maintain the autonomy of older people as long as possible. In reaction to this, there have been strong health and social policy recommendations across Europe to develop and promote the use of assistive technologies (ATs). Whereas systematic reviews already exist for several kinds of ATs, reviews about self-care ATs are still missing. Based on a systematic literature search in PsycINFO, MEDLINE, and Google Scholar databases 203 papers were identified of which 13 were included according to our selection criteria. The methodological quality of all the reviewed studies is evaluated. We reviewed findings on objective and subjective indicators of independent living as efficiency criteria as well as evidence about facilitating and inhibiting factors in the use of these technologies. Self-care ATs turned out to be efficient, with respect to care hours, independence level, and self-reported satisfaction. The actual use of these ATs was influenced by diverse personal, contextual, and device aspects. Lack of randomized control trial studies and the need for a further research about ATs in the diverse subdomains of self-care activities is revealed. Based on the findings of the current study, we generate recommendations for future research

RaQuN: a generic and scalable n-way model matching algorithm

Model matching algorithms are used to identify common elements in input models, which is a fundamental precondition for many software engineering tasks, such as merging software variants or views. If there are multiple input models, an n-way matching algorithm that simultaneously processes all models typically produces better results than the sequential application of two-way matching algorithms. However, existing algorithms for n-way matching do not scale well, as the computational effort grows fast in the number of models and their size. We propose a scalable n-way model matching algorithm, which uses multi-dimensional search trees for efficiently finding suitable match candidates through range queries. We implemented our generic algorithm named RaQuN (Range Queries on input models) in Java and empirically evaluate the matching quality and runtime performance on several datasets of different origins and model types. Compared to the state of the art, our experimental results show a performance improvement by an order of magnitude, while delivering matching results of better quality.Peer Reviewe

Photophysics of indole upon x-ray absorption

A photofragmentation study of gas-phase indole (C$_8$H$_7$N) upon single-photon ionization at a photon energy of 420 eV is presented. Indole was primarily inner-shell ionized at its nitrogen and carbon $1s$ orbitals. Electrons and ions were measured in coincidence by means of velocity map imaging. The angular relationship between ionic fragments is discussed along with the possibility to use the angle-resolved coincidence detection to perform experiments on molecules that are strongly oriented in their recoil-frame. The coincident measurement of electrons and ions revealed fragmentation-pathway-dependent electron spectra, linking the structural fragmentation dynamics to different electronic excitations. Evidence for photoelectron-impact self-ionization was observed.Comment: 11 pages, 6 figure

Neural response development during distributional learning.

We investigated online electrophysiological components of distributional learning, specifically of tones by listeners of a non-tonal language. German listeners were presented with a bimodal distribution of syllables with lexical tones from a synthesized continuum based on Cantonese level tones. Tones were presented in sets of four standards (within-category tokens) followed by a deviant (across-category token). Mismatch negativity (MMN) was measured. Earlier behavioral data showed that exposure to this bimodal distribution improved both categorical perception and perceptual acuity for level tones [1]. In the present study we present analyses of the electrophysiological response recorded during this exposure, i.e., the development of the MMN response during distributional learning. This development over time is analyzed using Generalized Additive Mixed Models and results showed that the MMN amplitude increased for both within- and across-category tokens, reflecting higher perceptual acuity accompanying category formation. This is evidence that learners zooming in on phonological categories undergo neural changes associated with more accurate phonetic perception.This research was also supported by a Research Networking grant (ESF) NetwordS No. 6609 to NB and a Leiden University AMT Individual Researcher Grant to JSN

High-repetition-rate and high-photon-flux 70 eV high-harmonic source for coincidence ion imaging of gas-phase molecules

Unraveling and controlling chemical dynamics requires techniques to image structural changes of molecules with femtosecond temporal and picometer spatial resolution. Ultrashort-pulse x-ray free-electron lasers have significantly advanced the field by enabling advanced pump-probe schemes. There is an increasing interest in using table-top photon sources enabled by high-harmonic generation of ultrashort-pulse lasers for such studies. We present a novel high-harmonic source driven by a 100 kHz fiber laser system, which delivers 10$^{11}$ photons/s in a single 1.3 eV bandwidth harmonic at 68.6 eV. The combination of record-high photon flux and high repetition rate paves the way for time-resolved studies of the dissociation dynamics of inner-shell ionized molecules in a coincidence detection scheme. First coincidence measurements on CH$_3$I are shown and it is outlined how the anticipated advancement of fiber laser technology and improved sample delivery will, in the next step, allow pump-probe studies of ultrafast molecular dynamics with table-top XUV-photon sources. These table-top sources can provide significantly higher repetition rates than the currently operating free-electron lasers and they offer very high temporal resolution due to the intrinsically small timing jitter between pump and probe pulses