Search Results (185)

Health literacy improves informal caregivers’ knowledge and ability to provide care. The aim of this study is to analyze the impact of a group-based intervention on the health literacy of informal caregivers of children with special health needs (SHNs). The intervention focuses on movement, hydrotherapy, walking, and relaxation, with three evaluation stages. Participants included 34 informal caregivers of children with SHNs, recruited at a Physical Medicine and Rehabilitation Service. We collected sociodemographic data of the participants and measured their health literacy through the short-form version of the European Health Literacy Survey Questionnaire (HLS-EU-Q16). Around 70% of the participants were female, with a mean age of 41.06 ± 4.98 years, and nearly 85% were married or in a de facto union. About 26% were unemployed, and more than 65% had completed secondary education or higher. The mean scores of the HLS-EU-Q16 were statistically significantly higher throughout the intervention, with differences over the evaluation stages [F(2,56) = 75.55; p < 0.05]. A structured, dynamic, and group-based intervention plan showed improvements in the health literacy of the participants, with an increase in the percentage of participants with sufficient and excellent levels of health literacy at the end of the intervention. Full article

To enhance social interaction of residents living with dementia and their (in)formal carers in nursing homes, we examined the effects of a digital, person-centred, Photo-Activity (PA) versus a conversation activity (control). An explorative randomized controlled trial was conducted in 81 resident-informal carer (IC) dyads and 51 formal carers (FC) with three measurements (pre/post-test, 2-week follow-up). Intervention effects were tested using Mann–Whitney U’s, and ANCOVA’s with pre-test scores as covariates. Interaction effects were examined between dementia severity (DS; less/more) and condition (PA/control). A post-test effect was observed in social interaction (INTERACT-subscale: Mood [p = 0.037, ηp² = 0.07]), with PA residents showing better mood than controls. Residents with less DS showed more positive effects of PA than residents with more DS (interaction effects: INTERACT-subscales Mood [p = 0.017, ηp² = 0.092], Stimulation Level [p = 0.011, ηp² = 0.106], and Need for Prompting [p = 0.013, ηp² = 0.099]). Higher QUALIDEM Positive Affect scores were observed in the PA group, post-test (p = 0.025, ηp² = 0.082), and follow-up (p = 0.042, d = 0.39). PA FC showed less empathy (IRI; p = 0.006, ηp² = 0.185;) than controls, but reported getting to know the residents better (p = 0.035, r = 0.299). PA improved mood and positive affect of residents with dementia and led to FC knowing the residents better. Less empathy was observed in FC providing PA, requiring further investigation. Full article

Few studies have explored the views of children and young people (CYP) with selective mutism (SM), and even less is understood regarding their experiences in relation to the support that they receive within school. Across three case studies, direct interviews with CYP with SM attending mainstream secondary school were conducted non-verbally, aiming to explore their current experiences of school and support. Subsequent interviews were conducted with the CYP’s key stakeholders, including parents/carers, school staff, and professionals with ongoing involvement. These interviews aimed to build on information shared by the CYP. Analysis highlighted the importance of individual experiences and support, relationships with peers and trusted adults, collaboration, communication across the setting, and importantly, a secure understanding of SM across the school setting. Clear implications for school professionals emerged. Future research should continue to work toward the exploration and development of knowledge and understanding of SM and gather the experiences of a wider range of CYP and families. Full article

This review aimed to identify the available online interventions for family carers of people living with dementia and how effective they are when upskilling carers in how to support activities of daily living. Six databases were searched, and 10 articles with six online programmes were identified. Articles used an RCT design, a mixed approach, and a pre-post test design. Data were synthesised using a convergent integrated approach for mixed-methods reviews. Three overarching themes were identified, focusing on accessibility of the programme, the content and information provided, and the outcomes for the carer and the person with dementia. Online interventions with useful content for family carers of people with dementia are easy to access. However, this did not translate into carers’ outcomes, where mixed results were found. No positive findings were reported for people with dementia in terms of social participation, autonomy or self-management abilities. Development of future online interventions should consider integrating carers’ competence, skills and knowledge alongside daily activities to provide a comprehensive approach when training family carers. Full article

Background: The provision of education, health, and social care for children with special educational needs and disabilities (SEND) in England has long been criticised for its inequities and chronic underfunding. These systemic issues were further exacerbated by the onset of the COVID-19 pandemic and the accompanying restrictions, which disrupted essential services and resulted in widespread unmet needs and infringements on the rights of many children with SEND. This study aimed to use a three-phase consensus-building approach with 1353 participants across five stakeholder groups to collaboratively develop evidence-informed priorities for policy and practice. The priorities sought to help address the longstanding disparities and respond to the intensified challenges brought about by the pandemic. Methods: A total of 55 children with SEND (aged 5–16), 893 parents/carers, and 307 professionals working in SEND-related services participated in the first phase through online surveys. This was followed by semi-structured interviews with four children and young people, ten parents/carers, and 15 professionals, allowing for deeper exploration of lived experiences and priorities. The data were analysed, synthesised, and structured into five overarching areas of priority. These were subsequently discussed and refined in a series of activity-based group workshops involving 20 children with SEND, 11 parents/carers, and 38 professionals. Results and Conclusions: The consensus-building process led to the identification of key priorities for both pandemic response and longer-term recovery, highlighting the responsibilities of central Government and statutory services to consider and meet the needs of children with SEND. These priorities are framed within a children’s rights context and considered against the rights and duties set out in the United Nations Convention on the Rights of the Child (1989). Priorities include protecting and promoting children with SEND’s rights to (1) play, socialise, and be part of a community, (2) receive support for their social and emotional wellbeing and mental health, (3) feel safe, belong, and learn in school, (4) “access health and social care services and therapies”, and (5) receive support for their parents/carers and families. Together, they highlight the urgent need for structural reform to ensure that children with SEND receive the support they are entitled to—not only in times of crisis but as a matter of routine practice and policy. Full article

Background: The aging population is increasing, leading to a greater need for home care for older adults, often provided by informal caregivers (ICs). These caregivers face numerous challenges, requiring adequate training and support. Objectives: This study aimed to map the main interventions performed by the Rehabilitation Nursing Specialist in empowering ICs of older adults at home. Methods: A scoping review was conducted following the Joanna Briggs Institute methodology. The search included seven articles published between 2019 and 2024, in Portuguese, English, and Spanish, available in the PubMed e CINHAL Ultimate databases. The descriptors used were (Rehabilitation Nursing) AND (Informal Caregivers OR Caregivers) AND (Elderly OR Aged) AND (mentoring OR Training. Results: The RNS interventions focused on training caregivers in technical skills (e.g., positioning, transfers, hygiene care, feeding, medication administration), preventing caregiver burden, managing behavioral and psychological symptoms of dementia, promoting self-care, and emotional support. Educational programs and the use of technologies (telehealth) were identified as effective strategies. Conclusions: RNS interventions are crucial for enhancing the skills and well-being of ICs, improving the quality of care provided to older adults at home, and reducing caregiver burden. Person-centered care, continuous support, and recognizing the caregiver’s role are fundamental aspects of these interventions. Full article

In the news media, there are regular reports of family caregivers killing the people for whom they care, but scholarly research on this phenomenon is fragmented, and there has been little effort to predict or prevent future deaths. The aim of this study was to develop a typology of caregiver-perpetrated homicides that could provide a framework for more rigorous research and targeted responses in policy and practice. Ideal Type Analysis was applied to sixty-four homicides and homicide–suicides perpetrated by family caregivers in England and Wales between January 2015 and December 2019. The cases clustered into seven clear types: Ending Suffering; Genuine Burden of Care; Pre-existing Mental Illness; Neglect; Exploitation; Caregiver as Victim of Domestic Violence, Abuse or Coercive Control; and Caregiver as Perpetrator of Domestic Violence, Abuse, or Coercive Control. Each type was characterised by a distinct motive, context, or course of events leading to the homicide. This is the first typology of homicides and homicide–suicides perpetrated by caregivers. The Caregiver-Perpetrated Homicide Typology challenges previous claims that caregiver-perpetrated homicides are isolated events and provides a framework for the development of evidence-based prediction and prevention initiatives. Full article

Background: Dementia is a syndrome with a high global prevalence that includes a number of progressive diseases of the brain affecting various cognitive domains such as memory and thinking and the performance of daily activities. It manifests as symptoms which often include significant mood and behaviour changes that are highly varied. Changed moods and behaviours due to dementia may reflect distress and may be stressful for both the person living with dementia and their informal and formal carers. To provide dementia care support specific to mood and behaviour changes, the Behaviours in Dementia Toolkit website (BiDT) was developed using human-centred design principles. The BiDT houses a user-friendly, digital library of over 300 free, practical, and evidence-informed resources to help all care partners better understand and compassionately respond to behaviours in dementia so they can support people with dementia to live well. Objective: (1) To characterize the users that visited the BiDT; and (2) to understand the platform’s early impact on these users. Methods: A multi-method, descriptive study was conducted in the early post-website launch period. Outcomes and measures examined included the following: (1) reach: unique visitors, region, unique visits, return visits, bounce rate; (2) engagement: engaged users, engaged sessions, session duration, pages viewed, engagement rate per webpage, search terms, resources accessed; (3) knowledge change; (4) behaviour change; and (5) website impact: relevance, feasibility, intention to use, improving access and use of dementia guidance, recommend to others. Data was collected using Google Analytics and an electronic survey of website users. Results: From 4 February to 31 March 2024, there were 76,890 unique visitors to the BiDT from 109 countries. Of 76,890 unique visitors to the BiDT during this period, 16,626 were engaged users as defined by Google Analytics (22%) from 80 countries. The highest number of unique engaged users were from Canada (n = 8124) with an engagement rate of 38%. From 5 March 2024 to 31 March 2024, 100 electronic surveys were completed by website users and included in the analysis. Website users indicated that the BiDT validated or increased their dementia care knowledge, beliefs, and activities (82%) and they reported that the website validated their current care approaches or increased their ability to provide care (78%). Further, 77% of respondents indicated that they intend to continue using the BiDT and 81.6% said that they would recommend it to others to review and adopt. Conclusions: The BiDT is a promising tool for sharing practical and evidence-informed information resources to support people experiencing dementia-related mood and behaviour changes. Early evaluation of the website has demonstrated significant reach and engagement with users in Canada and internationally. Survey data also demonstrated high ratings of website relevance, feasibility, intention to use, knowledge change, practice support, and its contribution to dementia guidance. Full article

Cisheteronormativities inform and distort what LGBTQ+ young people’s bodies can be and do, and what choices about the body are possible, profoundly impacting mental health. This article presents findings from a UK study examining ‘what works’ in early intervention mental health support for LGBTQ+ youth to examine how these impacts can be addressed. Data were collected across 12 mental health support services via the following: interviews with LGBTQ+ youth aged 12–25, service staff/volunteers, and parents/carers (n = 93); document review; and non-participant observation. In analysis, ‘Body’ was identified as a key principle underpinning effective early intervention mental health support. This article presents three key areas: the ability to name and define the body; the body’s ability to ‘do’; and the ability to make informed decisions about one’s body, life, and future. This article highlights the urgent importance of upholding bodily autonomy for LGBTQ+ youth if efforts to address mental health inequalities are to have any chance at success. Full article

Background/Objectives: This study aims to explore how gender influences the role of informal caregivers aged 65 years, considering the increasing involvement of men in caregiving due to longer life expectancy and societal norms. Methods: A two-year cross-sectional study was conducted in the Valencian Community, Spain, involving informal caregivers of 65 years of age and older who provided home-based care for dependent individuals with chronic conditions. The participants were recruited through public health schools, carers’ associations, and clinical consultations. The caregivers completed a comprehensive semi-structured interview, which included items from the Zarit Brief Scale (seven items) to assess caregiver burden and questions about their caregiving responsibilities, training, and experience, as well as the self-perceived frequency of medication errors. Results: A sample of 80 caregivers over 65 years old was analyzed, including 23 men (28.8%) and 57 women (71.2%). Male caregivers were significantly less experienced (mean = 3.1 years, SD = 5.9) compared to female caregivers (mean = 10.1 years, SD = 13.0; p = 0.004). Men reported lower emotional and physical burdens than women (p-value = 0.003), as reflected in the Zarit scores. Caregiving performance, measured by self-reported errors, was comparable between genders. Conclusions: This study explores the growing role of older male caregivers, highlighting their lower experience and training compared to those of women but similar caregiving performance and lower burden. Additionally, trained caregivers demonstrated significantly lower odds of experiencing burden, underscoring the importance of training as a modifiable factor. The findings emphasize the need for gender-sensitive support and tailored training programs to address disparities, reduce caregiver burden, and enhance caregiving quality and equity. Full article

Background: Diabetes is common among nursing home residents, with approximately one in four affected, a figure expected to rise. Despite the complexity of care required, educational support for nursing home staff remains limited. This study will aim to co-design and evaluate a digital intervention to improve staff knowledge, confidence, and practices in diabetes care. Methods: The study will follow a logic model across three workstreams. Workstream 1 (WS1) will inform the model inputs through three phases: (1) a scoping review will be conducted to summarise existing diabetes education initiatives in nursing home settings; (2) approximately 20 semi-structured interviews will be carried out with nursing home staff to explore perceived barriers and supports in delivering diabetes care; and (3) a modified Delphi process involving 50–70 diverse stakeholders will be used to establish educational priorities. Workstream 2 (WS2) will involve co-designing a digital diabetes education intervention, informed by WS1 findings. Co-design participants will include nursing home staff, diabetes professionals, and people living with diabetes or their carers. Workstream 3 (WS3) will consist of a mixed-methods evaluation of the intervention. Pre- and post-intervention questionnaires will assess staff knowledge, confidence, and attitudes. The usability of the intervention will also be measured. Following implementation, focus groups with approximately 32 staff members will be conducted to explore user experiences and perceived impact on resident care. Discussion: This study will address an important gap in staff education and support, aiming to improve diabetes care within nursing home settings through a digitally delivered, co-designed intervention. Full article

Background/Objectives: Nutritional complications are highly prevalent in esophageal and gastric cancer survivors and can negatively impact their quality of life. Gaining insight into survivors’ experiences with nutrition care can inform the development of tailored nutrition care programs for this population. The present study investigated esophageal and gastric cancer survivors’ nutritional challenges and complications. It also explored survivors’ and their carers’ perceived unmet nutrition care needs. Methods: Esophageal and gastric cancer survivors and their caregivers were invited to participate in a semi-structured interview. Participants were asked about their nutritional challenges and experiences with existing dietetic services in meeting their nutrition care needs. Data were analyzed using Braun and Clarke’s six-stage approach to thematic analysis. Results: Twelve individual interviews were completed and analyzed, and three themes emerged: nutrition-related challenges and complications, experiences with dietetic services, and coping strategies. Persistent gastrointestinal symptoms were reported as the main nutritional challenges impacting survivors’ daily and social lives. While participants reported good access to dietetic services, they emphasized the need for additional support during early post-surgery stages and long-term survivorship. Key unmet needs included access to personalized dietary advice for symptom management and timely information on nutritional challenges and post-treatment complications. Conclusions: The present study underscores the need for increased dietitian support throughout the esophageal and gastric cancer journey to provide timely, personalized, and practical dietary information for survivors and their caregivers. These insights should be considered for developing tailored nutrition care programs for esophageal and gastric cancer survivors. Full article

Introduction: Advanced magnetic resonance imaging (MRI) techniques in neuroplasticity evaluations provide important information on stroke disease and the underlying mechanisms of neuronal recovery. It has been observed that gray matter density or volume in brain regions closely related to motor function can be a valuable indicator of the response to treatment. Objective: To compare structural MRI-evaluated gray matter volume changes in patients with post-stroke upper limb spasticity for >1 year between those undergoing surgery and those treated with botulinum toxin A (BoNT-A) and to relate these findings to upper limb function and quality of life outcomes. Materials and Methods: Design. A two-arm controlled and randomized clinical trial in patients with post-stroke upper limb spasticity. Participants. Thirty post-stroke patients with spastic upper limbs. Intervention. Participants were randomly assigned (1:1 allocation ratio) for surgery (experimental group) or treatment with BoNT-A (control group). Main outcome measures. The functional parameters were analyzed with Fugl-Meyer, Zancolli, Keenan, House, Ashworth, pain visual analogue, and hospital anxiety and depression scales. Quality of life was evaluated using SF-36 and Newcastle stroke-specific quality of life scales. The carer burden questionnaire was also applied. Clinical examinations and MRI scans were performed at baseline and at six months post-intervention. Correlations between brain volume/thickness and predictors of interest were examined across evaluations and groups. Results: Five patients were excluded due to the presence of intracranial implants. Eleven patients were excluded from analyses since they were late dropouts. Changes were observed in the experimental group but not in the control group. Between baseline and six months, gray matter volume was augmented at the hippocampus and gyrus rectus and cortical thickness was increased at the frontal pole, occipital gyrus, and insular cortex, indicating anatomical changes in key areas related to motor and behavioral adaptation These changes were significantly related to subjective pain, Ashworth spasticity scale, and Newcastle quality of life scores, and marginally related to the carer burden score. Conclusions: The structural analysis of gray matter by MRI revealed differences in patients with post-stroke sequelae undergoing different therapies. Gray matter volume and cortical thickness measurements showed significant improvements in the surgery group but not in the BoNT-A group. Volume was increased in areas associated with motor and sensory functions, suggesting a neuroprotective or regenerative effect of upper limb surgery. Full article

This study examines the role of linguistic regional variations in synthetic dataset generation and their impact on emotion detection performance. Emotion detection is essential for natural language processing (NLP) applications such as social media analysis, customer service, and mental health monitoring. To explore this, synthetic datasets were generated using a state-of-the-art language model, incorporating English variations from the United States, United Kingdom, and India, alongside a general baseline dataset. Two levels of prompt specificity were employed to assess the influence of regional linguistic nuances. Statistical analyses—including frequency distribution, term frequency-inverse document frequency (TF-IDF), type–token ratio (TTR), hapax legomena, pointwise mutual information (PMI) scores, and key-phrase extraction—revealed significant linguistic diversity and regional distinctions in the generated datasets. To evaluate their effectiveness, classification experiments were conducted with two models using bidirectional encoder representations from transformers (BERT) and its de-noising sequence to sequence variation (BART), beginning with zero-shot classification on the contextualized affect representations for emotion recognition (CARER) dataset, followed by fine-tuning with both baseline and region-specific datasets. Results demonstrated that region-specific datasets, particularly those generated with detailed prompts, significantly improved classification accuracy compared to the baseline. These findings underscore the importance of incorporating global linguistic variations in synthetic dataset generation, offering insights into how regional adaptations can enhance emotion detection models for diverse NLP applications. Full article

The eastern barn owl (Tyto javanica), a sub-group of Tyto alba, the most common species of owl in the world, is classified as “of least concern” under Queensland (Australia) legislation but appears to be affected by urban development. Between August 2010 and December 2021, 412 wild eastern barn owls were presented for treatment to the Currumbin Wildlife Hospital. A retrospective study of their medical records shows a strong association between the season and the number of admissions, with a combined total of 80% of admissions occurring in winter and spring (the breeding season for this species) in southeast Queensland. There was no significant association between age and admissions. The most common diagnosis was traumatic injuries, especially in winter and spring. Of all admissions, 46.61% died or were euthanized, 36.17% were transferred to wildlife carers, and 13.83% were discharged from the hospital. We postulate that the breeding season results in an increase in the owls’ activity, in turn resulting in greater risk exposure and increased admissions to veterinary clinics. These findings confirm that and thus provide information about the vulnerability of this species to anthropogenic activities and the implications for outcomes of injured owls. Full article