Counselling for people with sight loss in the UK: The need for provision and the need for evidence

This is an open access article - Copyright @ 2010 BMJ Publishing Group.The Department of Ophthalmology at UCSF is supported by a core grant from the National Eye Institute, EY02162, That Man May See and the South Asia Research Fund. In addition, this work was supported in part by a grant from the Doris Duke Charitable Foundation to UCSF to fund Clinical Research Fellow Allison Loh

Psychosocial impact of visual impairment in working age adults

This is an open access article - Copyright @ 2010 BMJ Publishing GroupAim: To review the evidence for the presence of lower levels of psychosocial well-being in working-age adults with visual impairment and for interventions to improve such levels of psychosocial well-being. Methods: Systematic review of quantitative studies published in English from 2001 to July 2008 that measured depression/mental health, anxiety, quality of life, social functioning or social support. Results: Included were 29 studies that measured one or more outcomes (N=52). Working-age adults with visual impairment were significantly more likely to report lower levels of mental health (mean difference=14.51/100), social functioning (MD=11.55/100) and quality of life. Studies regarding the prevalence of depressive symptoms produced inconsistent results but had methodological limitations. Conclusions: Future research is required into the prevalence of loneliness, anxiety and depression in adults with visual impairment, and to evaluate the effectiveness of interventions for improving psychosocial well-being such as counselling, peer support and employment programmes.Funding was obtained from the Thomas Pocklington Trust, 5 Castle Row, Horticultural Place, Chiswick, London W4 4JQ

Feasibility and Accuracy of Different Methods for Collecting Data on Falls Among Older People With Dementia.

This study compared different methods for collecting data on falls among people with dementia to identify which is most feasible and accurate. Eighty-three dyads, comprised of a community-dwelling person with dementia and their informal carer, participated in the TAi ChI for people with demenTia (TACIT) trial. Falls were collected prospectively over 6 months using monthly calendars, weekly and monthly telephone interviews, and 3-monthly telephone interviews with the carer. Unique falls identified across the reporting methods were combined, and this total was compared against each reporting method in isolation and combinations. A higher frequency of falls indicated greater accuracy. Falls data collection was most feasible with weekly telephone interviews (84%), and most accurate with the combination of weekly telephone interviews with monthly calendars (96%). For the greatest completeness and accuracy of falls data with community-dwelling people with dementia, researchers should use both weekly telephone interviews and monthly calendars

Doping-induced carrier profiles in organic semiconductors determined from capacitive extraction-current transients

A method to determine the doping induced charge carrier profiles in lightly and moderately doped organic semiconductor thin films is presented. The theory of the method of Charge Extraction by a Linearly Increasing Voltage technique in the doping-induced capacitive regime (doping-CELIV) is extended to the case with non-uniform doping profiles and the analytical description is verified with drift-diffusion simulations. The method is demonstrated experimentally on evaporated organic small- molecule thin films with a controlled doping profile, and solution-processed thin films where the non- uniform doping profile is unintentional, probably induced during the deposition process, and a priori unknown. Furthermore, the method offers a possibility of directly probing charge-density distributions at interfaces between highly doped and lightly doped or undoped layers

Gender perspectives on views and preferences of older people on exercise to prevent falls: a systematic mixed studies review

Background: To offer fall prevention exercise programs that attract older people of both sexes there is a need to understand both womens and mens views and preferences regarding these programs. This paper aims to systematically review the literature to explore any underlying gender perspectives or gender interpretations on older peoples views or preferences regarding uptake and adherence to exercise to prevent falls. Methods: A review of the literature was carried out using a convergent qualitative design based on systematic searches of seven electronic databases (PubMed, CINAHL, Amed, PsycINFO, Scopus, PEDro, and OTseeker). Two investigators identified eligible studies. Each included article was read by at least two authors independently to extract data into tables. Views and preferences reported were coded and summarized in themes of facilitators and barriers using a thematic analysis approach. Results: Nine hundred and nine unique studies were identified. Twenty five studies met the criteria for inclusion. Only five of these contained a gender analysis of mens and womens views on fall prevention exercises. The results suggests that both women and men see women as more receptive to and in more need of fall prevention messages. The synthesis from all 25 studies identified six themes illustrating facilitators and six themes describing barriers for older people either starting or adhering to fall prevention exercise. The facilitators were: support from professionals or family; social interaction; perceived benefits; a supportive exercise context; feelings of commitment; and having fun. Barriers were: practical issues; concerns about exercise; unawareness; reduced health status; lack of support; and lack of interest. Considerably more women than men were included in the studies. Conclusion: Although there is plenty of information on the facilitators and barriers to falls prevention exercise in older people, there is a distinct lack of studies investigating differences or similarities in older womens and mens views regarding fall prevention exercise. In order to ensure that fall prevention exercise is appealing to both sexes and that the inclusion of both men and women are encouraged, more research is needed to find out whether gender differences exists and whether practitioners need to offer a range of opportunities and support strategies to attract both women and men to falls prevention exercise.Funding Agencies|Swedish Research Council [2015-03481]; Strategic Research Programme in Care Sciences, Umea University; Karolinska Institute, Sweden; Umea University</p

Characteristics of outdoor falls among older people: A qualitative study

Background Falls are a major threat to older people’s health and wellbeing. Approximately half of falls occur in outdoor environments but little is known about the circumstances in which they occur. We conducted a qualitative study to explore older people’s experiences of outdoor falls to develop understanding of how they may be prevented. Methods We conducted nine focus groups across the UK (England, Wales, and Scotland). Our sample was from urban and rural settings and different environmental landscapes. Participants were aged 65+ and had at least one outdoor fall in the past year. We analysed the data using framework and content analyses. Results Forty-four adults aged 65 – 92 took part and reported their experience of 88 outdoor falls. Outdoor falls occurred in a variety of contexts, though reports suggested the following scenarios may have been more frequent: when crossing a road, in a familiar area, when bystanders were around, and with an unreported or unknown attribution. Most frequently, falls resulted in either minor or moderate injury, feeling embarrassed at the time of the fall, and anxiety about falling again. Ten falls resulted in fracture, but no strong pattern emerged in regard to the contexts of these falls. Anxiety about falling again appeared more prevalent among those that fell in urban settings and who made more visits into their neighbourhood in a typical week. Conclusions This exploratory study has highlighted several aspects of the outdoor environment that may represent risk factors for outdoor falls and associated fear of falling. Health professionals are recommended to consider outdoor environments as well as the home setting when working to prevent falls and increase mobility among older people

We are all one together : peer educators\u27 views about falls prevention education for community-dwelling older adults - a qualitative study

Background: Falls are common in older people. Despite strong evidence for effective falls prevention strategies, there appears to be limited translation of these strategies from research to clinical practice. Use of peers in delivering falls prevention education messages has been proposed to improve uptake of falls prevention strategies and facilitate translation to practice. Volunteer peer educators often deliver educational presentations on falls prevention to community-dwelling older adults. However, research evaluating the effectiveness of peer-led education approaches in falls prevention has been limited and no known study has evaluated such a program from the perspective of peer educators involved in delivering the message. The purpose of this study was to explore peer educators’ perspective about their role in delivering peer-led falls prevention education for community-dwelling older adults. Methods: A two-stage qualitative inductive constant comparative design was used.In stage one (core component) focus group interviews involving a total of eleven participants were conducted. During stage two (supplementary component) semi-structured interviews with two participants were conducted. Data were analysed thematically by two researchers independently. Key themes were identified and findings were displayed in a conceptual framework. Results: Peer educators were motivated to deliver educational presentations and importantly, to reach an optimal peer connection with their audience. Key themes identified included both personal and organisational factors that impact on educators’ capacity to facilitate their peers’ engagement with the message. Personal factors that facilitated message delivery and engagement included peer-to-peer connection and perceived credibility, while barriers included a reluctance to accept the message that they were at risk of falling by some members in the audience. Organisational factors, including ongoing training for peer educators and formative feedback following presentations, were perceived as essential because they affect successful message delivery. Conclusions: Peer educators have the potential to effectively deliver falls prevention education to older adults and influence acceptance of the message as they possess the peer-to-peer connection that facilitates optimal engagement. There is a need to consider incorporating learnings from this research into a formal large scale evaluation of the effectiveness of the peer education approach in reducing falls in older adults

Snow White Is Missing: An Interactive Locative Story for Dementia Patients

With the increasing prevalence of powerful mobile technology, interactive entertainment is also becoming increasingly mobile. This can also be said for a range of applications including those pertaining to mental and physical health which are also looking to take advantage of the increase in mobile technology to create digital interventions and other treatment based software for mobile devices that can benefit from the mobile deliver form. In this paper we propose a new form of serious game in this vein: therapeutic locative interactive fiction. These are interactive story experiences, read while on the move, that respond to the readers environment and location context, and have therapeutic value. The locative nature of these stories enables therapeutic activities connected with out door spaces, and allows for content to enrich users, the readers of locational context. We present a demonstration of this concept through our own therapeutic locative interactive narrative: Snow White is Missing, and detail both its design from an interactive narrative and therapeutic activity perspectives

Facilitators and barriers to participation in mental well-being programs by older Australians with vision impairment: community and stakeholder perspectives

Older adults with vision impairment experience high rates of mental health problems, but very few access psychological support. We investigated community and stakeholder perspectives of the barriers and facilitators to participation in mental well-being programs for older adults with vision impairment. Adults aged ≥ 50 years with vision impairment (community) were recruited from the client database, and low vision rehabilitation (LVR) professionals (stakeholders) from staff of a LVR provider. Participants completed one-on-one semi-structured interviews, which were designed and analyzed using behavior change theory. Twenty-nine participants were interviewed; 16 community members and 13 stakeholders. Both groups cited mental health problems as a major concern, with many stakeholders reporting the grief and distress associated with vision loss experienced by their clients as having a negative impact on their mental and physical health. Major barriers to participation in mental well-being programs included a lack of awareness and difficulties accessing such programs, with stakeholders adding that their clients' lack of insight into their own mental health problems may reduce motivation to participate. Facilitators to participation in programs included the appeal of social interaction and inspirational speakers. An appropriate intervention could overcome these barriers, or enhance participation through education, persuasion, incentivisation, modeling, environmental restructuring, training, and enablement. While barriers were discussed more than facilitators to participation, there was general support for mental well-being programs. This study provides guidance from stakeholders for the development of mental well-being programs to address mental health problems in the growing number of older adults with vision impairment