Difference in quality of life,fatigue and societal participation between living and deceased donor kidney transplant recipients

Purpose of this study was to assess whether living (LD) and deceased donor (DD) kidney transplant recipients differ in health‐related quality of life (HRQoL), fatigue and societal participation, depending on time since transplantation and after adjustment for clinical and demographic variables. A questionnaire study was performed among 309 LD and 226 DD recipients (response rate 74% and 61%) transplanted between 1997 and 2009. After adjustment for age, sex, and education, LD recipients transplanted less than or equal to five yr ago experienced better HRQoL than DD recipients on the domains' role limitations due to physical problems, general health perception, and on the physical component summary score (all p < 0.05) and a better societal participation (all subscales, p < 0.05). No differences were found in the mental health domains. The LD recipients also had better renal clearance than DD recipients (62.1 vs. 55.9 mL/min, p = 0.01). After additional adjustment for renal clearance, the differences in HRQoL and societal participation between LD and DD recipients remained. No differences were found in recipients transplanted more than five yr ago. We conclude that LD recipients on average have better HRQoL and societal participation than DD recipients, in the first years after transplantation.     

Littéracie et déficience intellectuelle : une nouvelle exigence dans le paradigme de la participation sociale ?

The development of literacy skills is hindered by intellectual disability. High rates of analphabetism in this population are a growing concern in the context of the paradigm of social participation. A literature review of mainly anglo-saxon research shows that current knowledge about specific characteristics of children with intellectual disabilities allows developing methods of teaching literacy more effectively. The interest and the feasibility of transposing these promising results into French speaking countries is first examined on the basis of research studying the link between literacy and intellectual disability. The discussion is further completed with some results reported in a dissertation carried out in a French-speaking canton of Switzerland. Special education teachers and parents of children with Down Syndromes were asked about the importance of literacy in the school curriculum of these children.     

Communication style before and after aphasia: A study among Finnish population

Background: Communication difficulties in aphasia have a big effect on communicative activity and social participation. Contacts with other people than family become more infrequent because of problems in communicating. Rehabilitation should make a real difference in being able to communicate and in the life of people with aphasia.

Aims: The aim of this study was to explore the impact of aphasia on the communication style of people with aphasia in the Finnish population. The term “communication style” is used to describe how active the person is in communication situations and in participating in social interaction. In addition, a clinical evaluation of the communication style was made 6 months after an intervention concentrating on training total communication and guiding the partner to facilitate the use of different communication methods and support the interaction.

Methods & Procedures: The data were collected during natural rehabilitation courses for people with aphasia and their communication partners. The participants were 38 communication partners of people with aphasia. The courses were carried out in two parts (8 + 4 days) with a 3-month interval. A questionnaire concerning the communication style of people with aphasia was constructed using parts of Green’s questionnaire (1984) and its unpublished Finnish modification. The communication partners estimated the communication style of people with aphasia. At first, they estimated how the communication style was before the onset of aphasia and how it was 2 weeks before the intervention. Six months after the intervention, they estimated the communication style again.

Outcomes & Results: Aphasia has a drastic impact on the communicative activity and social participation of people with aphasia in Finland. Activity in conversations decreases and contacts with people other than family members and relatives become much more infrequent. The social interaction occurs mostly at home. The conversation topics focus on health, home matters and TV programmes when other topics such as work, hobbies, leisure time and plans for the future are discussed much less often.

Conclusion: Aphasia has a drastic impact on communication style, activity in communication and participation in social interaction, also according to this study conducted in Finland. There seems to be a decrease in communication between the people with aphasia and people other than their significant others and outside the home. To be able to have an impact on social participation, interventions also including people other than family members are needed.     

术前决策辅助对关节置换患者决策参与的影响

目的探讨术前决策辅助对关节置换患者决策参与的影响。方法将120例关节置换患者以简单随机化法分组,奇数分配到对照组,偶数分配到观察组,每组各60例,对照组按常规实施护理,观察组在常规护理基础上实施术前决策辅助干预,比较两组患者决策参与意愿和实际决策参与有无差异。结果两组决策参与意愿类型比较,差异无统计学意义(P0.05);观察组实际决策参与程度显著高于对照组(P0.01)。结论术前决策辅助能提高关节置换患者在实际临床活动中的决策参与程度。     

Perceived influence of intrinsic/extrinsic factors on participation in life activities after spinal cord injury

Background

Various types of limitations on community participation are experienced by people with spinal cord injury (SCI).

To spray or not to spray? Understanding participation in an indoor residual spray campaign in Arequipa,Peru

Current low participation rates in vector control programmes in Arequipa, Peru complicate the control of Chagas disease. Using focus groups (n?=?17 participants) and semi-structured interviews (n?=?71) conducted in March and May 2013, respectively, we examined barriers to and motivators of household participation in an indoor residual spray (IRS) campaign that had taken place one year prior in Arequipa. The most common reported barriers to participation were inconvenient spray times due to work obligations, not considering the campaign to be necessary, concerns about secondary health impacts (e.g. allergic reactions to insecticides), and difficulties preparing the home for spraying (e.g. moving heavy furniture). There was also a low perception of risk for contracting Chagas disease that might affect participation. The main motivator to participate was to ensure personal health and well-being. Future IRS campaigns should incorporate more flexible hours, including weekends; provide appropriate educational messages to counter concerns about secondary health effects; incorporate peer educators to increase perceived risk to Chagas in community; obtain support from community members and leaders to build community trust and support for the campaign; and assist individuals in preparing their homes. Enhancing community trust in both the need for the campaign and its operations is key.     

Representation in the Care Planning Process for Nursing Home Residents With Dementia

Objectives

Federally mandated assessments of nursing home (NH) residents drive individualized care planning. Residents with cognitive impairment may not be able to meaningfully communicate their care needs and preferences during this process—a gap that may be partially addressed by involving surrogates. We describe the prevalence of family participation in the care planning process for long-stay NH residents with varying degrees of cognitive impairment.

Turning the gaze: challenges of involving biomedical researchers in community engagement with research in Patan,Nepal

Abstract

Global health funding bodies are increasingly promoting and offering specific funding support for public and community engagement activities, in addition to research and programme funding. In the context of this growing commitment to engagement work, we need to find ways to better support contextually appropriate and meaningful exchanges between researchers and community members. I argue that, rather than focusing solely on how to involve communities in engagement with global health research, we should also pay attention to the quality and depth of the involvement of researchers themselves. This is an often overlooked dimension of community engagement in both practice and the literature. In this paper, I present three contextual factors, which created logistical and attitudinal obstacles for researchers’ involvement in meaningful engagement in a global health research unit in Nepal. These comprised implicit and explicit messages from funders, institutional and disciplinary hierarchies and educational experiences. Lessons were drawn from an exploration of the successes and failures of two participatory arts projects connected to the research unit in 2015 and 2016. Both projects intended to foster mutual understanding between researchers and members of their research population. As an engagement practitioner and ethnographic researcher, I documented the processes.     

Empowering senior citizens for healthy nutrition in Germany: A pilot study

Main goal of this study was to analyse how empowerment processes and bottom‐up activities aimed at healthier food choices and food environment could be initiated among a group of senior citizens (between 60 and 75 years old). The intervention was set up as a pilot study in a rural community (15,000 inhabitants) in the federal state of Bavaria, South Eastern Germany. A process evaluation documented how group formation and empowerment processes developed during the course of the intervention. Extensive field notes were taken in 27 meetings, interviews (n = 13) and focus groups (n = 4) were conducted with participants and key persons at different points of the intervention. Data were analysed using content analysis. The intervention succeeded in motivating senior citizens to participate in regular meetings over 11 months. During the intervention, the group members’ awareness of factors influencing their eating behaviour increased. Furthermore, they developed ideas to improve the community's food environment and accomplished duties needed to implement these ideas. However, initiating empowerment processes, especially in terms of fostering leadership and transferring responsibility, took longer than expected and could be realised only partially. The findings support a further use and evaluation of the empowerment approach for addressing nutritional aspects among senior citizens.