Bright light appears to have a modest but measurable effect on sleep in this population, and ambient light may be preferable to stationary devices such as light boxes.
Routine activity situations on an Alzheimer's disease (AD) special care unit were examined with respect to residents' social and physical environmental interactions, time use, and apparent affect. Using a computer-assisted observational tool, observers recorded prevailing activity situations and corresponding behaviors and affects of seven residents every 10 minutes, from 8:00 AM to 8:00 PM, across four days. Although meals/snacks and some activity groups were positively associated with use of physical objects and engagement in activities, residents were predominantly environmentally disengaged, inactive, or without positive affects during the most prevalent activity situations of background media, downtime, and television. Findings suggest that routine activity situations may act as potent environmental influences on the quality of life (QOL) of people with AD and mediate the effectiveness of other environmental interventions undertaken on their behalf.
Objective To evaluate the effect of ambient bright light therapy on agitation among institutionalized persons with dementia. Methods High intensity, low glare ambient lighting was installed in activity and dining areas of a state psychiatric hospital unit in North Carolina and a dementia-specific residential care facility in Oregon. The study employed a cluster-unit crossover design involving four ambient lighting conditions: AM bright light, PM bright light, All Day bright light, and Standard light. Sixty-six older persons with dementia participated. Outcome measures included direct observation by research personnel and completion by staff caregivers of the 14-item, short form of the Cohen-Mansfield Agitation Inventory (CMAI). Results Analyses of observational data revealed that for participants with mild/moderate dementia, agitation was higher under AM light (p=0.003), PM light (p<0.001), and All Day light (p=0.001) than Standard light. There also was a trend toward severely demented participants being more agitated during AM light than Standard light (p=0.053). Analysis of CMAI data identified differing responses by site: the North Carolina site significantly increased agitation under AM light (p=0.002) and PM light (p=0.013) compared with All Day light while in Oregon, agitation was higher for All Day light compared to AM light (p=0.030). In no comparison was agitation significantly lower under any therapeutic condition, in comparison to Standard lighting. Conclusions Ambient bright light is not effective in reducing agitation in dementia and may exacerbate this behavioral symptom.
The history of occupational therapy may be understood as a continual transaction between two cultural discourses: pragmatism and structuralism. Pragmatism is a way of thinking that presupposes humans are agentic by nature and knowledge is tentative and created within particular contexts. Structuralism is a way of thinking that assumes humans are composites of recurring general frameworks and that knowledge is objective and can be generalized to multiple contexts. Early in the field's history, both pragmatist and structuralist assumptions about the human and knowledge produced different readings, or interpretations, of what constituted the appropriate tools, methods, and outcomes for occupational therapy. Consequently, occupational therapy adopted an interesting mix of pragmatist language regarding the human and structuralist approaches to knowledge, resulting in professional identity problems still experienced today. However, recent developments offer an opportunity for occupational therapists to correct old identity problems through critically evaluating incompatible assumptions and carefully reading the prevailing cultural ethos.
The primary purpose of this study was to investigate whether or not a group of zoo chimpanzees responded to environmental enrichment differently given higher weekend crowds in contrast to lower weekday crowds. Findings showed that foraging, feeding, and object‐using were more likely with new enrichment; conversely, grooming, playing, watch‐idle, and aberrant behaviors were more likely with 1 day‐old enrichment. Across both new and 1 day‐old enrichment, however, high crowds corresponded with diminished frequencies of foraging, object‐using, grooming, and play. The study's second purpose was to examine how zoo visitors responded to chimpanzees under varying conditions of environmental enrichment. Analysis of zoo visitors' verbatim responses suggested that the public's behavior was influenced by desires to interact with the chimpanzees, the state of the chimpanzees' habitat, the relative complexity of the chimpanzees' activities, and human sociocultural norms. Thus a variety of contextual factors were found to influence the behavior of chimpanzees and humans alike. Future research is encouraged that investigates the ways in which multiple elements within the full captive socioecology of chimpanzees fluidly interact to influence the effectiveness of environmental enrichment as well as zoo visitors' responses to, and lasting impressions of, zoo chimpanzees. Zoo Biol 17:211–230, 1998. © 1998 Wiley‐Liss, Inc.
The objective of this instrumental case study was to explore interrelationships among routine activity situations on 2 Alzheimer's special care units (SCUs) and 2 resident quality-of-life (QoL) indicators: daily time use and emotional well-being. Fourteen residents participated. We collected data across four 12-hr days using computer-assisted direct observations and computed associations of activity situations with QoL indicators and mean durations of QoL indicators in activity situations and daily by facility. We compared mean durations of QoL indicators across facilities and analyzed time-use profiles of 2 residents. We found that participants' capacities for activity engagement and emotional vitality were infrequently expressed at both SCUs. Diminished QoL was attributable to participants' dementia-related impairments coupled with insufficient attention to their occupational needs, initiatives, and capacities. Findings call for occupational therapists' involvement as educators, mentors, and consultants to enhance the effectiveness of routine activity situations in promoting QoL through everyday occupations.
Objectives Teacher retention is a key issue facing schools, with stress, student behavior, current competitive policies, and practices resulting in many leaving within the first 5 years of qualification. Consequently, recent in-school research initiatives have focused on resilience training, although the quality of such conducted studies is debated. Drawn from compassion-focused therapy (CFT), this study set out to explore a six-module compassionate mind training (CMT) program with school staff to improve well-being. Methods As part of their continued professional development, over 70 teachers and support staff took part in the CMT, with a mixed-measures AAB quantitative and qualitative design employed. This enabled us to explore both implementation effectiveness and outcome effectiveness in terms of parameters of well-being. Results The initiative was well received with the majority of staff reporting positively on their experiences of the curriculum and practices. Additionally, exercise practice was associated with significant increases in self-compassion (p < 0.01) and significant decreases in self-criticism (p < 0.05). Thematic analyses further revealed benefits of CMT for dealing with emotional difficulties. Conclusions As a feasibility study, our results demonstrate many benefits of CMT in educational settings. CMT may hold promise as a way of helping those in education counteract the current competition-based nature of education, especially that which contributes to negative changes in well-being. Given this, future research should employ a control group design, a larger sample size, and a range of well-being measures at follow-up, to fully evaluate the utility of CMT in educational settings.
Institutional facilities face challenges providing experiences to residents with dementia that promote participation in meaningful activities. Guided by the Lived Environment Life Quality Model, this study investigated associations between 9 different activity situations-one an equine-assisted activities program (EAAP)-and positive, negative, and neutral behavioral indicators of quality of life (QoL) in 6 residents with dementia who expressed an interest in horses. Direct observational data were collected for 4 hours twice weekly over 8 weeks. Using χ tests, differences across activity situations were tested. More positive patterns of time use (conversation; χ = 44.3, P < .001) and emotional well-being (pleasure; χ = 21.8, P = .001) were found in EAAP compared to other activity situations. Further, EAAP was the only activity situation associated with all positive QoL indicators. These findings add to our understanding the importance of providing meaningful activities that promote use of abilities and provide environmental support, for enhancing QoL, especially for institutionalized people with dementia.
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