Goal setting with older people in acute care before and after discharge: Occupational therapists' perspectives

Background: The World Health Organisation identified that there is an increased risk to elderly of readmission to hospital following an acute hospital admission due to decreased function and deconditioning during hospitalisation. As such, researchers have reviewed the discharge process of older adults to identify areas for potential improvement. The aim of this study was to explore the experiences of occupational therapists during goal setting in acute aged care in Australia and to determine whether implementing training and a structured goal setting procedure such as the HOME protocol is feasible and beneficial. Method: This study used a phenomenological study design and semi-structured interviews. Four therapists who participated in the HOME trial were recruited from New South Wales and Victoria. Interviews were conducted by telephone and focused on the therapist experiences of goal setting before, during and after the HOME study. Interviews were recorded and transcribed verbatim. Thematic analysis of the interview data was conducted and involved coding, data reduction, categorisation and determining themes and relationships. Results: Results suggested three themes related to goal setting in acute aged care: (a) developing client-centred goals, (b) the therapist experience and training and (c) the ideal goal setting practice. However, therapists perceived that the reality of practice puts a number of pressures on them when setting goals in order to manage the return home for older persons – as such, some elements of best practice in goal setting must be forfeited. Conclusions: Goal setting in acute aged care in Australia is complex and therapists face many of the same challenges as those in other western countries. Furthermore, therapists found structured goal setting frameworks to be beneficial, however, felt that they are not feasible in the current context of practice

Goal setting with older people in acute care before and after discharge: Occupational therapists' perspectives

Background: The World Health Organisation identified that there is an increased risk to elderly of readmission to hospital following an acute hospital admission due to decreased function and deconditioning during hospitalisation. As such, researchers have reviewed the discharge process of older adults to identify areas for potential improvement. The aim of this study was to explore the experiences of occupational therapists during goal setting in acute aged care in Australia and to determine whether implementing training and a structured goal setting procedure such as the HOME protocol is feasible and beneficial. Method: This study used a phenomenological study design and semi-structured interviews. Four therapists who participated in the HOME trial were recruited from New South Wales and Victoria. Interviews were conducted by telephone and focused on the therapist experiences of goal setting before, during and after the HOME study. Interviews were recorded and transcribed verbatim. Thematic analysis of the interview data was conducted and involved coding, data reduction, categorisation and determining themes and relationships. Results: Results suggested three themes related to goal setting in acute aged care: (a) developing client-centred goals, (b) the therapist experience and training and (c) the ideal goal setting practice. However, therapists perceived that the reality of practice puts a number of pressures on them when setting goals in order to manage the return home for older persons – as such, some elements of best practice in goal setting must be forfeited. Conclusions: Goal setting in acute aged care in Australia is complex and therapists face many of the same challenges as those in other western countries. Furthermore, therapists found structured goal setting frameworks to be beneficial, however, felt that they are not feasible in the current context of practice

Aging in Place in Late Life: Theory, Methodology, and Intervention

This special issue focuses on aging in place in late life. Aging in place is about being able to continue living in one’s own home or neighborhood and to adapt to changing needs and conditions. It is of high concern due to the increasing number of old and very old people in all societies and challenges researchers, practitioners, and policy makers in many societal and scientific areas and disciplines. We invited authors to contribute original research papers as well as conceptually driven review papers that would stimulate the continuing efforts to understand the different aspects of aging in place in late life. The papers that were submitted came from very diverse disciplines, such as sociology, psychology, occupational therapy, nursing, architecture, public planning, and social work. Given the number and diversity of papers submitted, we can conclude that aging in place is an important concern throughout the world and that different kinds of measures are taken to come up with local, national, and international solutions that enhance aging in place. [...

Activity Planner

Dissertação de mestrado em Ecologia, apresentada ao Departamento de Ciências da Vida da Faculdade de Ciências e Tecnologia da Universidade de Coimbra.O Jardim Botânico da Universidade de Coimbra (JBUC) é composto essecialmente por espécies de plantas exóticas. A maioria destas espécies não são invasoras, mas algumas possuem comportamento invasor, causando problemas para a conservação do Jardim, sendo importante gerir de forma sustentável as áreas afectadas por estas espécies. Para tal, é necessário, em primeiro lugar, analisar a dimensão da invasão e identificar as suas possíveis causas. Para este efeito, este trabalho focou-se no mapeamento das três espécies invasoras mais problemáticas (Ailanthus altissima, Oxalis pes-caprae e Tradescantia fluminensis) e ainda de uma quarta espécie, Acanthus mollis, que embora não listada como invasora na legislação Portuguesa, apresenta na mata do JBUC um potencial invasor preocupante. Foi também objectivo deste trabalho elaborar um reconhecimento mais detalhado (através de mapeamento das regiões invadidas com respectivo número de espécimes) de A. altissima, a espécie mais “agressiva” de todas as presentes no JBUC. Através de análises de campo e usando Sistemas de Informação Geográfica foi possível mapear as áreas invadidas, determinar o número de indivíduos em cada local, a cobertura vegetal destas espécies, a acessibilidade a cada área e conhecer o historial das acções de controlo de A. altissima realizados anteriormente no Jardim, tentando contribuir, assim, com informação relevante para um plano de gestão eficaz e fundamentado das plantas invasoras na mata do JBUC. A espécie A. altissima encontra-se em elevado número na mata do Jardim e tentativas de controlar esta espécie apenas por corte simples mostraram ser ineficazes. No entanto, metodologias que incorporaram a injecção de herbicida mostraram ser mais eficazes no controlo desta espécie. Oxalis pes-caprae e T. fluminensis são espécies existentes na mata também com uma distribuição batstante extensa. Acanthus mollis encontra-se também espalhada por toda a mata. Contudo, não deve ser uma prioridade para controlo, pois restringe de alguma forma a invasão do subcoberto por outras invasoras mais agressivas. O mapeamento das áreas invadidas realizado neste trabalho conjuntamente com um estudo com base científica do controlo das espécies de plantas que existem na mata do JBUC, ajudará certamente na elaboração de um plano de gestão eficaz a longo prazo deste importante Jardim Botânico.The Botanical Garden of the University of Coimbra (BGUC) is composed mainly by exotic species. Most of these species are not invasive, but some have an invasive behavior, causing problems for the conservation of the Garden, beeing important to sustainably manage the areas affected by this type of species. For this it is necessary to identify and analyze the extent of the invasion and to identify possible causes. To this porpuse, this work focused on mapping the three most problematic invasive species (Ailanthus altissima, Oxalis pes-caprae, and Tradescantia fluminensis) and a fourth species, Acanthus mollis, though not listed as invasive in the Portuguese legislation, presents a concerning invasive potential in the woods of the BGUC. It was also an objective of this study to elaborate a more detailed acknowledgment (through mapping of invaded areas and respective number of specimens) of A. altissima, the more "aggressive" species of all. Through analysis of field work and using Geographic Informations Systems, it was possible to map the invaded areas, to determine the number of individuals for each site, vegetation cover of these species, the accessibility to each area, and previous types of control applied to A. altissima in the Garden, attempting this way, to contribute with relevant information to an effective management plan of the invasive plant species in the BGUC. The species A. altissima is found in large number in the woods of the Garden and attempts to control this species only by simple cut of the trees proved to be ineffective. However, methods that incorporated the injection of herbicide have demonstrated to be most effective in controlling this species. Oxalis pes-caprae and T. fluminensis are also species quite dispersed in the woods. A. mollis has been spread throughout the woods. However, it should not be considered a priority for control because somehow limits invasion at ground level by other invasive species. The mapping of the invaded areas together with a scientific-based study about the control of plant species that inhabit the woods of the BGUC will certainly help in developing a and long-term and effective management plan of this important Botanical Garden

Interventions to delay functional decline in people with dementia: a systematic review of systematic reviews.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/Objective To summarise existing systematic reviews that assess the effects of non-pharmacological, pharmacological and alternative therapies on activities of daily living (ADL) function in people with dementia. Design Overview of systematic reviews. Methods A systematic search in the Cochrane Database of Systematic Reviews, DARE, Medline, EMBASE and PsycInfo in April 2015. Systematic reviews of randomised controlled trials conducted in people with Alzheimer's disease or dementia measuring the impact on ADL function were included. Methodological quality of the systematic reviews was independently assessed by two authors using the AMSTAR tool. The quality of evidence of the primary studies for each intervention was assessed using GRADE. Results A total of 23 systematic reviews were included in the overview. The quality of the reviews varied; however most (65%) scored 8/11 or more on the AMSTAR tool, indicating high quality. Interventions that were reported to be effective in minimising decline in ADL function were: exercise (6 studies, 289 participants, standardised mean difference (SMD) 0.68, 95% CI 0.08 to 1.27; GRADE: low), dyadic interventions (8 studies, 988 participants, SMD 0.37, 95% CI 0.05 to 0.69; GRADE: low) acetylcholinesterase inhibitors and memantine (12 studies, 4661 participants, donepezil 10 mg SMD 0.18, 95% CI 0.03 to 0.32; GRADE: moderate), selegiline (7 studies, 810 participants, SMD 0.27, 95% CI 0.13 to 0.41; GRADE: low), huperzine A (2 studies, 70 participants, SMD 1.48, 95% CI 0.95 to 2.02; GRADE: very low) and Ginkgo biloba (7 studies, 2530 participants, SMD 0.36, 95% CI 0.28 to 0.44; GRADE: very low). Conclusions Healthcare professionals should ensure that people with dementia are encouraged to exercise and that primary carers are trained and supported to provide safe and effective care for the person with dementia. Acetylcholinesterase inhibitors or memantine should be trialled unless contraindicated. Trial registration number CRD42015020179