Cognitive Functional Evaluation (CFE) Process for Individuals with Suspected Cognitive Disabilities

The purpose of this paper is to conceptualize the evaluation process for individuals with suspected cognitive disabilities. The Cognitive Functional Evaluation (CFE) process yields a comprehensive profile of the clients' cognitive strengths and weaknesses in occupational performance. The components of the CFE are outlined in six stages as a decision tree with examples of standardized instruments from which to choose the assessments for each client evaluated: (1) interview and background information; (2) cognitive screening and baseline status tests; (3) general measures of cognition and executive functions in occupation; (4) cognitive tests for specific domains; (5) measures of specific cognitive domains in occupations; and (6) environmental assessment. The first three stages are required to ascertain basic cognitive abilities underlying occupational performance. Tests for each stage can be chosen from the ones listed according to the client characteristics and the theory utilized, there is no need to use all of them. Once this data is available a further decision is made whether a more in-depth assessment is needed (stages (4) and (5)). The environmental component is evaluated in all instances with at least one of the assessments. The CFE process for individuals with suspected cognitive disabilities is recommended to be used by occupational therapists as a common ground for evaluation, documentation, and communicating information.     

Parenting Perceptions and Social Supports of Mothers with Cognitive Disabilities

The current study identified a range of parenting perceptions and experiences of mothers with intellectual difficulties, and examined the relationship between identified vulnerabilities and mothers' perceived social supports. Common parenting perceptions were positive feelings about parenting and mothers' abilities to nurture their children. Mothers also perceived more support than interference from their social networks and viewed their relatives as both supportive and interfering. They also expressed satisfaction with the therapeutic services they received. Mothers varied in terms of their perceptions of themselves as parents and their experiences of caregiving as related to their personal histories. Many mothers experienced financial difficulties and social isolation.     

Effects of Matcha Green Tea Powder on Cognitive Functions of Community-Dwelling Elderly Individuals

Matcha Green Tea Powder contains a variety of active ingredients beneficial to health, such as tea catechins, lutein and vitamin K. It is also known that these ingredients confer benefits upon cognitive functions of elderly people. Therefore, we aimed to investigate the relationship between a daily supplementation of Matcha and the change in cognitive functions of community-dwelling elderly people. A randomized, double-blind, placebo-controlled 12-week trial was performed. Sixty-one participants were recruited and randomly assigned to receive test drink containing 3 g powder from fresh Matcha or placebo powder per day. Changes in cognitive function were assessed utilizing a psychometric test battery. Daily food intake was assessed by a Brief-type Self-administered Diet History Questionnaire (BDHQ). In the gender-specific analysis, a significant cognitive enhancement was observed in the Montreal Cognitive Assessment (MoCA) score in the active group of women. In dietary analysis, we found a significant inverse correlation between consumption of vitamin K in daily diet, excluding test drinks, and change in MoCA. The present study suggests that daily supplementation of Matcha Green Tea Powder has protective effects against cognitive decline in community-dwelling elderly women.     

Consumption of Oleic Acid on the Preservation of Cognitive Functions in Japanese Elderly Individuals

We recruited 154 community-dwelling elderly individuals and conducted a cohort study to find out the nutrient intake that is suitable for maintaining cognitive function in Japanese elders. Cognitive function was evaluated by the two functional tests, the Montreal Cognitive Assessment (MoCA) and Wechsler Memory Scale-Delayed Recall (WMS-DR), and daily nutrient intake was estimated from a Brief-type Self-administered Diet History Questionnaire (BDHQ). By a multiple regression analysis, among the four major nutrients (protein, fat, carbohydrate and ash), we detected a significant correlation between the score of cognitive functions assessed by both MoCA and WMS-DR and daily consumption of fat (p = 0.0317 and p = 0.0111, respectively). Among categories of fatty acid, we found a significant correlation between the score of both MoCA and WMS-DR and consumption of monounsaturated fatty acid (MUFA) (p = 0.0157 and p = 0.0136, respectively). Finally, among MUFAs, we observed a significant correlation between the score of both MoCA and WMS-DR and consumption of oleic acid (p = 0.0405 and p = 0.0165, respectively). From these observations, we can propose that daily consumption of fat, especially in oleic acid, has a beneficial effect against cognitive decline in community-dwelling Japanese elderly individuals.     

Drivers of Hiring Discrimination for Individuals with Disabilities

INTRODUCTION: Hiring discrimination in the workplace is defined as failure or refusal by an employer to engage a qualified applicant as an employee due to the existence or consequence of disability. The specific intent of this study is to determine what differentiates an allegation (perception of discrimination) from an actual discriminatory event (Merit Resolution). METHODS: Researchers used a data-mining approach, the Chi-square Automatic Interaction Detector (CHAID), to examine 19,527 resolved allegations of hiring discrimination in order to differentiate between Merit Resolution and Non-Merit Resolution outcomes. RESULTS: CHAID analysis confirmed that hiring discrimination is a complex matter with a variety of influences. Primary among these is the age of the Charging Party, with younger applicants (16-34) prevailing in their allegations 34% of the time. Within this subgroup, the sequence of predictor variables involves the Charging Party's impairment, followed by the Employer's industry classification. Behavioral disabilities, even among the young, result in generally lower Merit Resolution rates in hiring discrimination. CONCLUSIONS: Providers of training and technical assistance regarding hiring and disability may be able to adjust their services accordingly on the basis of findings such as these.     

The Use of Dexterity Tests in Hand Rehabilitation

A battery of American standardized tests for assessing dexterity was used in 15 patients undergoing rehabilitation after hand injuries and in 15 healthy controls. Our purpose was to identify tests that would discriminate healthy from non-healthy individuals with respect to functional motor skills in the hand. Out of the test battery including 4 tests and 10 subtests, the Crawford small parts dexterity test, the Purdue pegboard test, the Minnesota manual dexterity test and Valpar no. 4, two tests, the Crawford pin test and the Purdue right and left test, found to make a clear distinction between subjects with impaired hand function and those in the healthy group. The Purdue right/left/bilateral test, the Minnesota picking and turning tests, the Crawford screw test, the Purdue bilateral test and Valpar no. 4 also appeared useful, but had less capacity to discriminate between the two groups compared with the two tests already mentioned. We conclude that the tests presented in this study deserve a place in our current arsenal of instruments for evaluating dexterity, but a larger material is needed in order to make a more precise evaluation of these tests.     

Factors Related to Returning to Work Following a Work-Oriented Occupational Therapy Program for Individuals with Physical Disabilities

The purpose of this study was to determine factors related to return to work following the completion of a Work-Oriented Occupational Therapy Program (WOOTP). This program is conducted at the Department of Occupational Therapy, National Taiwan University Hospital, Taipei, Taiwan, Republic of China. One hundred and twelve subjects were discharged from WOOTP between November 1, 1995 and May 31, 1997. Forty-five (40.2%) subjects returned to work. Univariate analysis showed that gender, marital status, area of injury, subject's physical capacity level, and change in physical demand level after WOOTP, ADL, and job waiting related to return-to-work status following the completion of WOOTP. Factors related to return to work were compared bivariately using forward stepwise logistic regression procedures. Results indicated that ADL, gender, and marital status contributed significantly to the logistic regression model. Those most likely to return to work were female, married, and/or that they had higher Barthel ADL index scores. It was concluded that further research was needed to determine the applicability of these results to broader groups of subjects, and to refine and expand the predictive model to include other relevant factors.     

Experiences and Perceptions of Sexuality and HIV/AIDS among Young People with Physical Disabilities in a South African Township: a Case Study

This study explored the experiences and perceptions of sexuality and HIV/AIDS among 15–24 year-old young people with physical disabilities in a South African Township characterised by high unemployment rates and lack of social services. Ten young people and ten parents participated in multiple individual interviews as well as in focus group discussions. The analysis of audio taped and transcribed responses identified common experiences and perceptions among participants. The results indicate that disabled young people have limited factual knowledge about sexuality and HIV/AIDS. The decisions and choices they make about sexual behaviour are not informed by what they know; rather, they are part of the whole life situation in Nyanga. Their need to be loved and accepted, need for job security and family life, were more important than practicing ‘safe sex’. Therefore, there is need for HIV/AIDS programme developers to take into account the experiences and perceptions of the target population.In this paper the phrases ‘young people with physical disabilities’ and disabled young people’ are used interchangeably.     

Vocational Evaluation: The Use of Work Samples

A more scientific, objective and professional approach is needed by occupational therapists if they wish to ensure a role in vocational evaluation. The use of work samples in evaluating vocational potential and as a basis for recommending individualised treatment programming is one possible approach. In this article, the author explores the process involved in vocational evaluation and suggests various benefits from following such a procedure.     

The Development of an Assessment of Interpersonal Violence for Individuals with Intellectual and Developmental Disabilities

Individuals with intellectual and developmental disabilities experience rates of interpersonal violence much higher than those in the general population. Not only do they face physical, sexual, emotional, and financial abuse, they also face additional forms of interpersonal violence specific to their disability and care. While rates of interpersonal violence experienced by people with disabilities exist in the literature, measurement of these rates has been widely divergent across the field of disabilities. Currently, there are no-known evidence-based measures of interpersonal violence for individuals with intellectual and developmental disabilities. This article describes the development of an assessment tool, the Interpersonal Violence Interview (IVI), to measure the number of incidents of interpersonal violence against people with intellectual and developmental disabilities. A Delphi technique was used in the development of the tool in order to reach consensus regarding the content of the assessment. The results show the IVI is a promising first step towards the development of an evidence-based measure of interpersonal violence for individuals with intellectual and developmental disabilities.     

女性抑郁症认知功能及临床特点

目的研究女性抑郁症患者认知功能的特点及认知功能与疗效间的关系。方法纳入符合入选及排除标准的女性抑郁症患者143例,于基线时及抗抑郁剂治疗6周后进行汉密尔顿抑郁量表-17项评分及认知功能测验,包括汉诺塔、连线测验、韦氏智力测验（成人）、语言流畅性、威斯康星卡片测验。结果抑郁症患者存在认知功能损害,经6周抗抑郁治疗后,疗效好组认知功能大多数指标恢复正常,连线测试各项指标均有显著性差异（t值分别为14．779、12．113、12．113、15．333、2．747、2．036,均P〈0．01）。WCST各项指标、语言流畅总数明显改善（t值分别为-5．690、15．351、21．547、2．142、-18．251,均P〈0．05）,TOH计划时间、执行时间、总分有显著改善（t值分别为4．256,2．048,均P〈0．05）,疗效差组大多数指标仍低于正常。结论女性抑郁症与正常女性在认知功能方面存在差异,经过抗抑郁治疗后认知功能得到部分改善,且疗效好组改善较疗效差组改善更明显,两组认知功能各项指标与病程均无相关性,与年龄呈负相关。     

计算机认知矫正治疗对康复期双相情感障碍患者认知功能的影响

目的 探讨计算机认知矫正治疗(CCRT)对康复期双相情感障碍患者认知功能的影响.方法 选取2018年1月至2019年12月我院收治的100例康复期双相情感障碍患者,根据治疗方法 不同分为对照组(48例,常规药物治疗)和观察组(52例,CCRT+常规药物治疗).比较两组患者治疗前及治疗2个月后的认知功能.结果 治疗2个月...     

Ascorbic Acid and the Brain: Rationale for the Use against Cognitive Decline

This review is focused upon the role of ascorbic acid (AA, vitamin C) in the promotion of healthy brain aging. Particular attention is attributed to the biochemistry and neuronal metabolism interface, transport across tissues, animal models that are useful for this area of research, and the human studies that implicate AA in the continuum between normal cognitive aging and age-related cognitive decline up to Alzheimer’s disease. Vascular risk factors and comorbidity relationships with cognitive decline and AA are discussed to facilitate strategies for advancing AA research in the area of brain health and neurodegeneration.     

不同麻醉和镇痛方法对老年患者非心脏手术术后早期认知功能的影响

目的：探究不同麻醉和镇痛方法对老年患者非心脏手术术后早期认知功能的影响,为临床提供参考。方法：选取2012年6月-2013年12月来本院接受非心脏手术治疗的240例老年患者,按照随机数字表法将其分为全身麻醉静脉镇痛组和腰硬联合麻醉硬膜外镇痛组各120例,观察两组患者术后36 h内的疼痛程度、神经精神功能以及术前、术后7 d认知功能障碍的发生率。结果：两组术中的ECG、BP、HR、SpO2均在正常范围,无显著差异;术后36 h内,每隔12 h进行1次的VAS评分结果显示,全身麻醉静脉镇痛组的镇痛效果均明显优于腰硬联合麻醉硬膜外镇痛组（P〈0.05）;通过两组手术期MMSE评分比较,腰硬联合麻醉硬膜外镇痛组术后12、24、36 h的MMSE评分均明显高于全身麻醉静脉镇痛组（P〈0.05）;两组术前发生认知功能障碍的患者数量均为0,而腰硬联合麻醉硬膜外镇痛组术后7 d认知功能障碍的发生率明显低于全身麻醉静脉镇痛组（P〈0.05）。结论：老年人术后认知障碍的发病机理尚不明确,还需更深入的研究不同麻药、不同麻醉方法和镇痛方法对老年人术后精神和神经方面的影响,以指导临床合理用药,减少术后不良反应的发生率。     

The Development of a Regional Association to Address the Sexuality Needs of Individuals with Disabilities

This article describes the development of a regional Association to address the needs for sexuality related staff training, and consumer and family education. The Association completed several initial steps including generating a philosophy statement and a statement of basic rights; conducting a needs identification and offering training for professionals and families. Further steps followed from the concerns of providers regarding the availability of appropriate educational resources. The Association collected information about available resources and developed and piloted a tool to evaluate these curricula. This article will also discuss the Associations's recommendations for future expansion of networking activities.     

The development of satisfaction with service-related choices for disabled young people with degenerative conditions: evidence from parents' accounts

Satisfaction with service-related choices has not received much research attention, especially beyond medical/health-related decisions. This paper reports findings from an analysis of parents' accounts of making service-related choices with, or on behalf of, a disabled son or daughter with a degenerative condition. It focuses particularly on factors and processes, which contribute to parents' satisfaction. This is particularly interesting given that sub-optimal outcomes or negative consequences are often experienced following a service-related choice being implemented. The data reported here were collected as part of a larger, longitudinal study (the Choice and Change project) of service users' experiences of choice-making, including the outcomes and consequences of those choices. Parents of disabled young people with degenerative conditions formed part of this sample. The accounts of 14 of these parents, collected over three interviews during a two and a half-year period, all of whom expressed satisfaction with the medium- to long-term outcomes of a service-related choice, were selected for specific analyses to understand what underlies satisfaction with service-related choices. Clarity of the desired outcome for the young person supported effective decision-making and led parents to feel confident that the best possible choice was being made. Evidence of desired outcomes being attained were used by parents to 'trade off' the negative consequences of a choice. These included the considerable demands placed on parents' personal, financial and practical resources to operationalise a choice, and the emotional impact incurred by significant changes such as the loss of the carer role. The passage of time was important in allowing evidence of positive outcomes to emerge, psychological or emotional adjustments to be made, and for parents to develop trust in new service providers. The findings suggest that practitioners can have an important role in both practical and emotional support for parents' choice-making for, or with, their disabled son/daughter.     

Finger Tapping Test for Assessing the Risk of Mild Cognitive Impairment

AimA testing method for early diagnosis of Mild cognitive dementia (MCI) that can be easily applied in clinical practice was investigated in this study. We examined whether MCI risk can be determined through finger movements.MethodsBetween 2013 and 2020, 1097 individuals were screened. After applying propensity-score matching to adjust for variability between the groups, 173 individuals each in the mild cognitive impairment and control groups were selected. Thereafter, differences between groups in mean values of parameters extracted from finger tap movements were determined using unpaired t-test and effect size. Furthermore, area under the curve, sensitivity, and specificity were calculated from the receiver operating characteristic curve for parameters with significant difference.ResultsA significant difference was observed, especially in the number of taps in the MCI group compared with that in the control group (p < .001; 95% CI, −12.7 to −8.8; r = 0.51). A cut-off value of 30 taps was applied (sensitivity, 0.77; specificity, 0.67; AUC, 0.79). Significant differences were also observed in rhythm-related parameters.ConclusionsThese parameters might be useful for capturing MCI risk. Finger taps are easily measured and may be suitable for screening large populations. This tool might be used as a supplemental method to increase the sensitivity of traditional cognitive tests.     

国内外强化食品对人群重点微量营养素的贡献率

  目的  探索在中国饮食模式和户外活动方式下,维生素D与人群认知功能的关系。  方法  2017年6 — 9月在辽宁省4个城市抽取1 115名 ≥ 60岁老年人,通过简易智力状态检查量表（MMSE）进行认知功能筛查,同时收集过去富含维生素D食物摄入习惯和户外活动行为等信息。使用聚类分析分别将人群富含维生素D食物摄入习惯和户外活动行为分为低、中、高3组,分析其与人群认知功能的关系。  结果  低维生素D组人群MMSE评分[（25.7 ± 3.3）分]低于中、高维生素D组[分别为（26.1 ± 3.3和26.4 ± 2.9）分]（F = 4.42,P < 0.05）,低户外活动组人群MMSE评分[（25.4 ± 3.2）分]低于中、高户外活动组[分别为（26.5 ± 3.2和26.4 ± 3.0）分]（F = 17.08,P < 0.01）。控制年龄、教育程度等认知功能的其他影响因素后,富含维生素D食物摄入、户外活动的单独效应仍然存在,高维生素D食物摄入是认知功能的保护因素（OR = 0.62,95 % CI = 0.46～0.83）,高户外活动也是认知功能的保护因素（OR = 0.69,95 % CI = 0.49～0.98）。  结论  多摄入富含维生素D食物和增加有效日光暴露的户外活动有利于预防老年人认知功能受损。