Older Adults’ Perspective: Exploring the Experience of Owning a Guide Dog

Guide dogs have been shown to be an effective assistive device that can help older adults with low vision navigate their community and improve overall well-being. Despite vast research conducted on pet therapy and dog companionship, limited research exists on the facilitators and barriers of owning a dog guide among older adults with low vision. The purpose of this qualitative phenomenological study is to explore the facilitators and barriers of owning a guide dog as experienced by older adults with low vision participating in Guide Dogs for the Blind (GDB) organization. Data were gathered among seven participants using semi-structured phone interviews and themes were extracted. Five themes emerged using constant comparison methods: changes in habits and routines, being a dog guide owner, increase in community integration, human-dog guide bonding, and guide dog enhances autonomy. Participants’ increased confidence from using their guide dog contributed to further engagement in unfamiliar environments, thus improving self-esteem, freedom, and autonomy. Themes revealed that using a guide dog for the first time required adjustments in daily habits and routines to fit the guide dog’s lifestyle. Moreover, participants felt calmer and safer with the guide dogs resulting in a reciprocal bond with their guide dogs. Study results provide health practitioners, such as occupational therapists (OTs), insight to how guide dogs may affect the daily living patterns and quality of life of older adults with low vision. Additionally, study results provide insight for GDB and OTs into improving support and training processes

Older Adults’ Experience in Owning a Guide Dog

Low vision is an age-related condition that affects many older adults, and may create challenges in everyday activities in older adults. Guide dogs have been shown to be an effective assistive device that can help older adults within their community. Despite vast research on dog companionship, there is limited research on the facilitators and barriers of owning a guide dog among older adults with low vision. The purpose of this qualitative phenomenological study is to explore the facilitators and barriers of owning a guide dog as experienced by older adults with low vision participating in Guide Dogs for the Blind (GDB) organization. Seven first time guide dog owners, ages 55 and older, were interviewed using semi-structured questions. Through constant comparison methods, five major themes emerged: changes in habits and routines, being a dog guide owner, increase in community integration, human-dog guide bonding, and dog guide enhances autonomy. Study results provide implications for occupational therapists (OT) of how guide dogs affect the daily living patterns of older adults. Additionally, study results provide insight for GDB and OTs into improving support and training processes.https://scholar.dominican.edu/ug-student-posters/1063/thumbnail.jp

Having a family doctor is associated with some better patient-reported outcomes of primary care consultations

<b>Background</b> Hong Kong (HK) has pluralistic primary care that is provided by a variety of doctors. The aim of our study was to assess patient-reported outcomes of primary care consultations in HK and whether having a family doctor (FD) made any difference.<p></p> <b>Methods</b> We interviewed by telephone 3148 subjects from 5174 contacted households (response rate 60.8%) randomly selected from the general population of HK about the experience of their last primary care consultations in September 2007 and April 2008. We compared the patient-reported outcomes (PRO) and patient-centered process of care in those with a FD, those with other types of regular primary care doctors (ORD) and those without any regular primary care doctor (NRD). PRO included patient enablement, global improvement in health, overall satisfaction, and likelihood of recommending their doctors to family and friends. Patient-centered process of care indicators was explanations about the illness, and address of patient’s concerns.<p></p> <b>Results</b> One thousand one hundred fifty, 746, and 1157 reported to have FD, ORD, and NRD, respectively. Over 80% of those with FD consulted their usual primary care doctors in the last consultation compared with 27% of those with NRD. Compared with subjects having ORD or NRD, subjects with FD reported being more enabled after the consultation and were more likely to recommend their doctors to family and friends. Subjects with FD and ORD were more likely than those having NRD to report a global improvement in health and satisfaction. FD group was more likely than the other two groups to report receiving an explanation on the diagnosis, nature, and expected course of the illness, and having their concerns addressed. Patient enablement was associated with explanation of diagnosis, nature, and expected course of illness, and address of patient’s concerns.<p></p> <b>Conclusion</b> People with a regular FD were more likely to feel being enabled and to experience patient-centered care in consultations

First-Time Experience in Owning a Dog Guide by Older Adults with Vision Loss

Introduction: Dog guides were found to be effective in helping adults with vision loss navigate in the community and improve overall well-being. In spite of the vast amount of literature on pet therapy and dog companionship, limited study exists on older adult with vision loss experience of owning a dog guide. The purpose of this study is to explore the facilitators and barriers of first time owning and using a dog guide as experienced by older adults with vision loss. Methods: Data were gathered among seven participants using open-ended semi-structured telephone interviews. Participants were asked to describe their experiences related to owning a dog guide. Data analysis was carried out using phenomenological analysis and themes were extracted from verbatim transcriptions. Results: Through constant comparison methods, five themes emerged: increased responsibilities for new guide dog owners, changes in habits and routines, quick human-dog guide bonding, increase in community integration, and enhancement of autonomy through dog guide ownership. Discussion: The study results suggest that obtaining a dog guide increased the older adults with vision loss everyday engagement in outside of home activities. The increased confidence in community mobility may have led participants to engage in activities in unfamiliar environments, thus improving their autonomy, self-esteem, and physical abilities. These changes resulted in increased feelings of independence and freedom for the older adults with vision loss. Participants also revealed positive changes in their daily habits. Due to the increased physical ability and motivation needed to complete activities, making adjustments to owning a dog guide became easier. Furthermore, a human-dog guide bond was prevalent among all seven participants. Implications for Practitioners: Themes extracted provide health practitioners and dog guide organizations insight into how owning dog guides may empower older adults with vision loss

Cross-Coupling Biarylation of Nitroaryl Chlorides Through High Speed Ball Milling

Solvent-free reaction using a high-speed ball milling technique has been applied to the classical Ullmann coupling reaction. Cross-coupling biarylation of several nitroaryl chlorides was achieved in good yields when performed in custom-made copper vials through continuous shaking without additional copper or solvent. Cross-coupling products were obtained almost pure and NMR-ready. These reactions were cleaner than solution phase coupling which require longer reaction time in high boiling solvents, and added catalysts as well as lengthy extraction and purification steps. Gram quantities of cross biaryl compounds have been synthesized with larger copper vials, a proof that this method can be used to reduce industrial waste and for sustainability

Critically Appraised Paper for “Adaptive vs. non-adaptive cognitive training by means of a personalized App: A randomized trial in people with multiple sclerosis.”

Multiple sclerosis (MS) is a condition that causes cognitive and physical fatigue, which can slow cognitive processing speed (CPS). Slow CPS affects occupational engagement. Evidence suggests that physical activity can be used as an intervention to address and manage slowed CPS in MS. This Level I randomized controlled trial (RCT) examined the impact of a physical-activity behavioral intervention on CPS and walking performance among people with mild to moderate MS. Seventy-six participants with mild to moderate MS participated in the study for 6 months. The participants were split into two groups, the intervention group and the wait-list control group. In the intervention group, participants were provided a social–cognitive theory (SCT) program for increasing physical activity through a website and one-on-one video behavioral-coaching sessions. The main intention of this SCT program was to increase ambulatory physical activity by teaching the behavioral strategies of self-monitoring, goal setting, and goal attainment

Activation mechanism of the calcium-activated chloride channel TMEM16A revealed by cryo-EM

The calcium-activated chloride channel TMEM16A is a ligand-gated anion channel that opens in response to an increase in intracellular Ca2+ concentration(1-3). The protein is broadly expressed(4) and contributes to diverse physiological processes, including transepithelial chloride transport and the control of electrical signalling in smooth muscles and certain neurons(5-7). As a member of the TMEM16 (or anoctamin) family of membrane proteins, TMEM16A is closely related to paralogues that function as scramblases, which facilitate the bidirectional movement of lipids across membranes(8-11). The unusual functional diversity of the TMEM16 family and the relationship between two seemingly incompatible transport mechanisms has been the focus of recent investigations. Previous breakthroughs were obtained from the X-ray structure of the lipid scramblase of the fungus Nectria haematococca (nhTMEM16)(12,13), and from the cryo-electron microscopy structure of mouse TMEM16A at 6.6 A (ref. 14). Although the latter structure disclosed the architectural differences that distinguish ion channels from lipid scramblases, its low resolution did not permit a detailed molecular description of the protein or provide any insight into its activation by Ca2+. Here we describe the structures of mouse TMEM16A at high resolution in the presence and absence of Ca2+. These structures reveal the differences between ligand-bound and ligand-free states of a calcium-activated chloride channel, and when combined with functional experiments suggest a mechanism for gating. During activation, the binding of Ca2+ to a site located within the transmembrane domain, in the vicinity of the pore, alters the electrostatic properties of the ion conduction path and triggers a conformational rearrangement of an a-helix that comes into physical contact with the bound ligand, and thereby directly couples ligand binding and pore opening. Our study describes a process that is unique among channel proteins, but one that is presumably general for both functional branches of the TMEM16 family

A qualitative study of the views of patients with long-term conditions on family doctors in Hong Kong

<b>Background</b> Primary care based management of long-term conditions (LTCs) is high on the international healthcare agenda, including the Asia-Pacific region. Hong Kong has a 'mixed economy' healthcare system with both public and private sectors with a range of types of primary care doctors. Recent Hong Kong Government policy aims to enhance the management of LTCs in primary care possibly based on a 'family doctor' model. Patients' views on this are not well documented and the aim of the present study was to explore the views of patients with LTCs on family doctors in Hong Kong.<p></p> <b>Methods</b> The views of patients (with a variety of LTCs) on family doctors in Hong Kong were explored. Two groups of participants were interviewed; a) those who considered themselves as having a family doctor, b) those who considered themselves as not having a family doctor (either with a regular primary care doctor but not a family doctor or with no regular primary care doctor). In-depth individual semi-structured interviews were carried out with 28 participants (10 with a family doctor, 10 with a regular doctor, and 8 with no regular doctor) and analysed using the constant comparative method.<p></p> <b>Results</b> Participants who did not have a family doctor were familiar with the concept but regarded it as a 'luxury item' for the rich within the private healthcare system. Those with a regular family doctor (all private) regarded having one as important to their and their family's health. Participants in both groups felt that as well as the more usual family medicine specialist or general practitioner, traditional Chinese medicine practitioners also had the potential to be family doctors. However most participants attended the public healthcare system for management of their LTCs whether they had a family doctor or not. Cost, perceived need, quality, trust, and choice were all barriers to the use of family doctors for the management of their LTCs.<p></p> <b>Conclusions</b> Important barriers to the adoption of a 'family doctor' model of management of LTCs exist in Hong Kong. Effective policy implementation seems unlikely unless these complex barriers are addressed