The churches and persistent pockets of poverty in the U.S.A. A report on the problem of poverty issued by the Division of Christian Life and Work and the Division of Home Missions, the National Council of the Churches of Christ in the U.S.A. and based on a consultation held in January, 1962.

Mode of access: Internet.

In-home Assessment of Turning and Transitions using Inertial Sensors in Older Adults with Dementia and Older Caregivers

Thesis (Master's)--University of Washington, 2016-06

Evidence-based practice and rehabilitation: occupational therapy in Australia and New Zealand experiences

Evidence-based practice has become the dominant paradigm in the delivery of rehabilitation programme. However, occupational therapists in Australia and New Zealand have been slow in making the transition to become evidence-based practitioners. Collaboration between the university/ tertiary institute and clinical setting is one way that clinicians can be assisted with incorporating research into their practice. Two case examples are presented outlining how collaborative practice can result in improved out.. comes for all concerned.

Paediatric palliative home care with Internet-based video-phones: lessons learnt

We have designed and tested an Internet-based video-phone suitable for use in the homes of families in need of paediatric palliative care services. The equipment uses an ordinary telephone line and includes a PC, Web camera and modem housed in a custom-made box. In initial field testing, six clinical consultations were conducted in a one-month trial of the videophone with a family in receipt of palliative care services who were living in the outer suburbs of Brisbane. Problems with variability in call quality-namely audio and video freezing, and audio break-up-prompted further laboratory testing. We completed a programme of over 250 test calls. Fixing modem connection parameters to use the V.34 modulation protocol at a set bandwidth of 24 kbit/s improved connection stability and the reliability of the video-phone. In subsequent field testing 47 of 50 calls (94%) connected without problems. The freezes that did occur were brief (with greatly reduced packet loss) and had little effect on the ability to communicate, unlike the problems arising in the home testing. The low-bandwidth Internet-based video-phone we have developed provides a feasible means of doing telemedicine in the home.

Exploring Alternative Terrain in the Rehabilitation and Treatment of Offenders: Findings from a Prison-based Music Project

The arts in prison settings have provided an alternative or complimentary component to rehabilitation. Despite increased interest, studies capturing the voice of offenders participating in projects and the long-term impact are limited. Data from semistructured interviews with 18 men who had taken part in a music-based project while incarcerated, including one group of five participants who were tracked for 18 months with supplemented data from correctional staff and official documentation, is presented. Participants of the art-based projects comment on changes they believe to have derived from participating in the project, particularly relating to emotions, self-esteem, self-confidence, communication and social skills. An exoffender sample of participants reported that participation in art projects provide experiences that promote beneficial skills that have been useful for post prison life.

New tools for cognitive and motor rehabilitation: development and clinical validation

Nervous system disorders are associated with cognitive and motor deficits, and are responsible for the highest disability rates and global burden of disease. Their recovery paths are vulnerable and dependent on the effective combination of plastic brain tissue properties, with complex, lengthy and expensive neurorehabilitation programs. This work explores two lines of research, envisioning sustainable solutions to improve treatment of cognitive and motor deficits. Both projects were developed in parallel and shared a new sensible approach, where low-cost technologies were integrated with common clinical operative procedures. The aim was to achieve more intensive treatments under specialized monitoring, improve clinical decision-making and increase access to healthcare. The first project (articles I – III) concerned the development and evaluation of a web-based cognitive training platform (COGWEB), suitable for intensive use, either at home or at institutions, and across a wide spectrum of ages and diseases that impair cognitive functioning. It was tested for usability in a memory clinic setting and implemented in a collaborative network, comprising 41 centers and 60 professionals. An adherence and intensity study revealed a compliance of 82.8% at six months and an average of six hours/week of continued online cognitive training activities. The second project (articles IV – VI) was designed to create and validate an intelligent rehabilitation device to administer proprioceptive stimuli on the hemiparetic side of stroke patients while performing ambulatory movement characterization (SWORD). Targeted vibratory stimulation was found to be well tolerated and an automatic motor characterization system retrieved results comparable to the first items of the Wolf Motor Function Test. The global system was tested in a randomized placebo controlled trial to assess its impact on a common motor rehabilitation task in a relevant clinical environment (early post-stroke). The number of correct movements on a hand-to-mouth task was increased by an average of 7.2/minute while the probability to perform an error decreased from 1:3 to 1:9. Neurorehabilitation and neuroplasticity are shifting to more neuroscience driven approaches. Simultaneously, their final utility for patients and society is largely dependent on the development of more effective technologies that facilitate the dissemination of knowledge produced during the process. The results attained through this work represent a step forward in that direction. Their impact on the quality of rehabilitation services and public health is discussed according to clinical, technological and organizational perspectives. Such a process of thinking and oriented speculation has led to the debate of subsequent hypotheses, already being explored in novel research paths.

Outcomes of a general hospital-based Home Parenteral Nutrition (HPN) program: report of our experience from a 26-year period

Background: Home parenteral nutrition (HPN) was introduced in Spain in the late 1980s. Our hospital was a pioneering medical centre in this field. Aim: Analyze outcomes of our HPN program. Methods: Retrospective study of patients receiving HPN between 1986-2012. Study variables are expressed as frequency, mean ± SD (range), median [interquartile range]. Parametrics, non-parametrics test and survival analysis (p < 0.05) were applied. Results: 91 patients (55 females and 36 males, mean age: 50.6 ± 5 yrs.) who received HPN for an accrual period of 55,470 days (median: 211 days [range: 63-573]) were included. The most prevalent underlying condition was cancer (49.5%), with the commonest HPN indication being short bowel syndrome (41.1%). The most frequently used catheter type was the tunneled catheter (70.7%). The complication rate was 3.58/1,000 HPN days (2.68, infection; 0.07, occlusion; 0.07 thrombosis; and 0.59, metabolic complications). Complications were consistently associated with both the underlying condition and HPN length. Infections were most frequent within the first 1,000 days of HPN. Liver disease incidence was related to HPN duration. HPN could be discontinued in 42.3% of patients. Ten-year survival rate was 42%, and varied across the underlying conditions. Conclusions: In the present series, the commonest reason for HPN was cancer. Our complication rate is in keeping with that reported in the literature. The overall survival rate was 42%, and varied across the underlying conditions.

Home and group-based implementation of the "Growing Up Happily in the Family" program in at-risk psychosocial contexts

"Growing Up Happily in the Family" is a program to prevent child maltreatment targeted at parents of children aged 0-5 years old in at-risk psychosocial contexts. The program is delivered via either a group-based or a home-visit format. The objective of this study was to evaluate the impact of various implementation components in the home and group versions on changes in parental attitudes about child development and education. At-risk and non at-risk parents participated in the group-based (196 participants in 26 groups) and home-visit (95 participants) versions of the program delivered through local social services. We analyzed program adherence, adaptations, participant responsiveness, quality of delivery, and implementation barriers as predictors of changes in parental attitudes. The results showed that greater program adherence, better quality of delivery and participant responsiveness, and positive climate predicted changes in parental attitudes in both formats. Therefore, it is important to take into account the quality of the implementation process when testing the effectiveness of early group-based and home-visit interventions in at-risk families.

Using an evidence-based online module to improve parents’ ability to manage their child with Developmental Coordination Disorder

Background : Developmental coordination disorder (DCD) is a prevalent neurodevelopmental disorder. Best practices include raising parents’ awareness and building capacity but few interventions incorporating these best practices are documented. Objective : To examine whether an evidence-based online module can increase the perceived knowledge and skills of parents of children with DCD, and lead to behavioural changes when managing their child’s health condition. Methods : A mixed-methods, before-after-follow-up design guided by the theory of planned behaviour was employed. Data about the knowledge, skills and behaviours of parents of children with DCD were collected using questionnaires prior to completing the module, immediately after, and three months later. One-way repeated measures ANOVAs and thematic analyses were performed on data as appropriate. Results : Fifty-eight participants completed all questionnaires. There was a significant effect of time on self-reported knowledge [F(2.00,114.00)=16.37, p=0.00] and skills [F(1.81,103.03)=51.37, p=0.00] with higher post- and follow-up scores than pre-intervention scores. Thirty-seven (65%) participants reported an intention to change behaviour postintervention; 29 (50%) participants had tried recommended strategies at follow-up. Three themes emerged to describe parents’ behavioural change: sharing information, trialing strategies and changing attitudes. Factors influencing parents’ ability to implement these behavioural changes included clear recommendations, time, and ‘right’ attitude. Perceived outcomes associated with the parental behavioural changes involved improvement in well-being for the children at school, at home, and for the family as a whole. Conclusions : The online module increased parents’ self-reported knowledge and skills in DCD management. Future research should explore its impacts on children’s outcomes long-term.

Using an evidence-based online module to improve parents’ ability to manage their child with Developmental Coordination Disorder

Background : Developmental coordination disorder (DCD) is a prevalent neurodevelopmental disorder. Best practices include raising parents’ awareness and building capacity but few interventions incorporating these best practices are documented. Objective : To examine whether an evidence-based online module can increase the perceived knowledge and skills of parents of children with DCD, and lead to behavioral changes when managing their child’s health condition. Methods : A mixed-methods, before-after design guided by the theory of planned behavior was employed. Data about the knowledge, skills and behaviors of parents of children with DCD were collected using questionnaires prior to completing the module, immediately after, and three months later. Paired T-tests, sensitivity analyses and thematic analyses were performed on data as appropriate. Results: One hundred-sixteen, 81 and 58 participants respectively completed the three questionnaires. For knowledge and skills, post- and follow-up scores were significantly higher than baseline scores (p<0.01). Fifty-two (64%) participants reported an intention to change behavior post-intervention and 29 (50%) participants had tried recommended strategies at follow-up. Three themes emerged to describe parents’ behavioral change: sharing information, trialing strategies and changing attitudes. Factors influencing parents’ ability to implement these behavioral changes included clear recommendations, time, and ‘right’ attitude. Perceived outcomes associated with the parental behavioral changes involved improvement in well-being for the children at school, at home, and for the family as a whole. Conclusions : The online module increased parents’ self-reported knowledge and skills in DCD management. Future research should explore its impacts on children’s long-term outcomes.

mHealth-based Methods for Neuromotor Assessment and Rehabilitation

Recent years observed massive growth in wearable technology, everything can be smart: phones, watches, glasses, shirts, etc. These technologies are prevalent in various fields: from wellness/sports/fitness to the healthcare domain. The spread of this phenomenon led the World-Health-Organization to define the term 'mHealth' as "medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants, and other wireless devices". Furthermore, mHealth solutions are suitable to perform real-time wearable Biofeedback (BF) systems: sensors in the body area network connected to a processing unit (smartphone) and a feedback device (loudspeaker) to measure human functions and return them to the user as (bio)feedback signal. During the COVID-19 pandemic, this transformation of the healthcare system has been dramatically accelerated by new clinical demands, including the need to prevent hospital surges and to assure continuity of clinical care services, allowing pervasive healthcare. Never as of today, we can say that the integration of mHealth technologies will be the basis of this new era of clinical practice. In this scenario, this PhD thesis's primary goal is to investigate new and innovative mHealth solutions for the Assessment and Rehabilitation of different neuromotor functions and diseases. For the clinical assessment, there is the need to overcome the limitations of subjective clinical scales. Creating new pervasive and self-administrable mHealth solutions, this thesis investigates the possibility of employing innovative systems for objective clinical evaluation. For rehabilitation, we explored the clinical feasibility and effectiveness of mHealth systems. In particular, we developed innovative mHealth solutions with BF capability to allow tailored rehabilitation. The main goal that a mHealth-system should have is improving the person's quality of life, increasing or maintaining his autonomy and independence. To this end, inclusive design principles might be crucial, next to the technical and technological ones, to improve mHealth-systems usability.

[diet Quality And Associated Factors Among The Elderly: A Population-based Study In Campinas, São Paulo State, Brazil].

The aim of this study was to assess the quality of diet among the elderly and associations with socio-demographic variables, health-related behaviors, and diseases. A population-based cross-sectional study was conducted in a representative sample of 1,509 elderly participants in a health survey in Campinas, São Paulo State, Brazil. Food quality was assessed using the Revised Diet Quality Index (DQI-R). Mean index scores were estimated and a multiple regression model was employed for the adjusted analyses. The highest diet quality scores were associated with age 80 years or older, Evangelical religion, diabetes mellitus, and physical activity, while the lowest scores were associated with home environments shared with three or more people, smoking, and consumption of soft drinks and alcoholic beverages. The findings emphasize a general need for diet quality improvements in the elderly, specifically in subgroups with unhealthy behaviors, who should be targeted with comprehensive strategies.