Home-based training technology for persons with dementia: a qualitative study of barriers and facilitators for mobility-based training at home.

BACKGROUND: Physical training is increasingly used in rehabilitation for older people with dementia and several studies have documented positive results. Currently, welfare nations promote motion-based technology (MBT) at home to replace group training in various rehabilitation interventions. Research on the use of MBT by people with dementia is sparse. Therefore, this study explores how people with mild dementia and their relatives experience home-based MBT training in an intervention facilitated by a Danish municipality. METHODS: The study is part of a feasibility study and builds on participant observation and interviews with people with dementia (n = 4), their relatives (n = 4), and health care workers (n = 3) engaged in the project. RESULTS: Participants compared MBT training to group training and found that MBT was not a satisfactory replacement for group training. Some participants used and enjoyed MBT daily while others were challenged by the technology, the placement of the device, or motivation to independently complete the training program. CONCLUSION: MBT is possibly best considered as a supplement to group training, suitable for individuals able to use it in daily life.

Cross-sectorial collaboration in return to work interventions: perspectives from patients, mental health care professionals and case managers in the social insurance sector.

PURPOSE: Common mental disorders (CMD) are major causes of sick leave and have huge negative impacts on psychosocial well-being and to overall society. The return to work (RTW) process involves various welfare sectors, but often lack collaboration across these sectors and may cause uneven RTW processes. This study reports from an intervention aimed to increase collaboration between the mental health care system (MHCS) and the social insurance sector (SIS). The intervention consisted of two phases: (a) a development phase building on a participatory approach and (b) an implementation phase. Interprofessional meetings, evaluation workshops and joint consultations with workers from SIS and MHCS, and patients, comprised the key components of the intervention. The study explores how the collaborative process is experienced during the implementation phase with a focus on how collaboration maintains and challenges professional identities. METHODS: A qualitative design was employed consisting of individual interviews (n20), focus group discussions (4), and observations of interactions between Patients with CMDs, case managers from SIS, and professionals working in MHCS. RESULTS: Patients with CMDs felt supported and did not feel pushed to RTW prematurely. SIS and MHCS professionals reported that they were not sufficiently prepared and it was not clear who was responsible for which tasks. MHCS professionals experienced that their professional identities were in conflict with the aim of the intervention whereas SIS professionals found that the intervention improved their poor reputation. CONCLUSIONS: The results suggest that a higher level of participation in the intervention design and implementation process can improve a clear and transparent role distribution between professionals in MHCS and SIS.IMPLICATIONS FOR REHABILITATIONCollaboration across sectors is key to successful Return-to-work after sickness-related absence.Professional identities are challenged in collaborative interventions as different agendas are at play.Collaboration is most likely to be successful when engaging involved professions to decide goals and methods which are compatible with local work procedures.

European University Students' Experiences and Attitudes toward Campus Alcohol Policy: A Qualitative Study.

BACKGROUND: Many studies indicate that a substantial part of the student population drinks excessively, yet most European universities do not have an alcohol policy. In the absence of an alcohol guideline at universities and the easy access to alcohol sold at the student cafeteria, for instance, this has the potential to place students at risk of overconsumption, which has adverse health consequences. OBJECTIVES: Therefore, our study objectives were to explore and compare university students' experiences and attitudes toward alcohol policy on their campus using a qualitative approach. METHODS: 29 focus group discussions (FGDs) were conducted among students from universities in five European countries: Belgium (4 FGDs), Denmark (6 FGDs), France (5 FGDs), Hungary (6 FGDs), and the Slovak Republic (8 FGDs), with a total number of 189 participants. RESULTS: Across the five European countries, students recognized that alcohol was a big problem on their campuses yet they knew very little, if any, about the rules concerning alcohol on their campus. CONCLUSIONS: Students will not support an on campus alcohol restriction and a policy should therefore focus on prevention initiatives.

Use of information communication technology and stress, burnout, and mental health in older, middle-aged, and younger workers - results from a systematic review.

The aim of this systematic review is to summarise quantitative studies in occupational settings observing the association between Information communication technology (ICT) and stress, and burnout, considering age as an effect modifier. A systematic review using PRISMA guidelines was conducted through the following bibliographic databases: PubMed, Web of Science, Psycinfo, and the Cochrane Library. Inclusion criteria were occupational settings and content relevant to our research question. Risk of bias was assessed using the Newcastle-Ottawa scale. Two interventional, 4 cohorts, and 29 cross-sectional studies were found. ICT use in occupational settings was associated with stress seen in cross-sectional studies, but not in interventional studies. There was a concordant association with ICT and burnout in different study designs. Overall, there were no linear trends between age and technostress. We suggest that the observed associations were mostly present in the middle-aged working population and that these associations need to be supported in further studies.

Students' drinking behavior and perceptions towards introducing alcohol policies on university campus in Denmark: a focus group study.

BACKGROUND: High alcohol consumption among university students is a well-researched health concern in many countries. At universities in Denmark, policies of alcohol consumption are a new phenomenon if existing at all. However, little is known of how students perceive campus alcohol policies. The aim of this study is to explore students' perceptions of alcohol policies on campus in relation to attitudes and practices of alcohol consumption. METHODS: We conducted six focus group interviews with students from the University of Southern Denmark at two different campuses. The interviews discussed topics such as experiences and attitudes towards alcohol consumption among students, regulations, and norms of alcohol use on campus. The analysis followed a pre-determined codebook. RESULTS: Alcohol consumption is an integrated practice on campus. Most of the participants found it unnecessary to make major restrictions. Instead, regulations were socially controlled by students themselves and related to what was considered to be appropriate behavior. However students were open minded towards smaller limitations of alcohol availability. These included banning the sale of alcohol in vending machines and limiting consumption during the introduction week primarily due to avoiding social exclusion of students who do not drink. Some international students perceived the level of consumption as too high and distinguished between situations where they perceived drinking as unusual. CONCLUSION: The study showed that alcohol is a central part of students' lives. When developing and implementing alcohol policies on campus, seeking student input in the process and addressing alcohol policies in the larger community will likely improve the success of the policies.

Perceptions and Practices of Physical Activity Among Colombian Overweight/Obese Schoolchildren.

The purpose of this study was to explore the contexts that shape obese children's engagement in physical activity (PA) focusing on children's perceptions. The qualitative design consisted of non-participant observations, and unstructured and semi-structured focus group and individual interviews. Data were analyzed by use of conventional content analysis. Participants were overweight/obese children from a public school in Colombia. The findings show that the main context where PA took place was during physical education (PE) classes at school and in the children's neighborhoods. The participants perceived the PE classes to be too competitive and demotivating. PA taking place outside school was associated with fun, but occurred only on an infrequent basis and was challenged by living in insecure neighborhoods. Adapting a health promotion approach that emphasizes participation and social environments might motivate obese children to become physically active at school as well as during leisure time.

Betwixt and between: workplace perspectives on work reintegration in the eldercare sector in Denmark.

PURPOSE: Contemporary return-to-work (RTW) policies in Denmark and other welfare nations recommend employees on long-term sick leave, due to physical or mental health problems, to RTW gradually. Factors that influence the process of work reintegration (WR) is well documented, however, co-workers experiences of this process are a rather new research topic. Moreover, in the context of the present research, no studies have so far explored the workplace as an arena for social interaction. The aim of this study was to explore co-workers' experiences of the reintegration process and how these experiences are related to social positions at the workplace. METHODS: Ethnographic fieldwork was conducted at two nursing homes that were in a process WR after long-term sick leave. The data consist of field notes, policy documents, individual interviews, and focus group interviews. Data were organized by use of NVivo. A theoretical framework was adopted which enabled us to approach and interpret the reintegration process as one that changed the social position of the returning employee. RESULTS: The dataset demonstrates how the returnee is in a state of being betwixt and between the social positions of a co-worker and a non-co-worker. This is illustrated in three cases which show that this state prevents the returnee from taking on the role as a co-worker, excludes the returnee from the workplace, and creates uncertainty for all workplace actors. CONCLUSION: The study highlighted that WR creates a social position for the returnee that complicates the working routine and causes uncertainty in social interactions. Implications for Rehabilitation Work reintegration (WR) after long-term sick leave is commonly characterized by reduced working hours and modified working tasks. The WR process influences the whole work place including co-workers' everyday working life and complicates work situations where work tasks and roles are negotiated between the returning worker and co-workers. Future WR policies and guidelines could benefit from integrating co-workers' perspective to ensure that the returning worker is not socially excluded as well as ensuring that co-workers are not overburdened in the process.