Hispanic Older Adult's Perceptions of Personal, Contextual and Technology-Related Barriers for Using Assistive Technology Devices.

Assistive technologies (AT) are tools that enhance the independence, safety, and quality of life of older people with functional limitations. While AT may extend independence in ageing, there are racial and ethnic disparities in late-life AT use, with lower rates reported among Hispanic older populations. The aim of this study was to identify barriers experienced by Hispanic community-living older adults for using AT. Sixty Hispanic older adults (70 years and older) with functional limitations participated in this study. A descriptive qualitative research design was used guided by the principles of the Human Activity Assistive Technology Model to gain in-depth understanding of participants' perspectives regarding barriers to using AT devices. Individual in-depth semi-structure interviews were conducted, using the Assistive Technology Devices Cards (ATDC) assessment as a prompt to facilitate participants' qualitative responses. Data analysis included descriptive statistics and rigorous thematic content analysis. Lack of AT awareness and information, cost of AT, limited coverage of AT by heath care plans, and perceived complexity of AT were the predominant barriers experienced by the participants. A multi-level approach is required for a better understanding of the barriers for using AT devices. The personal, contextual, and activity-based barriers found in this study can be used to develop culturally sensitive AT interventions to reduce existent disparities in independent living disabilities among older Hispanics.

A systematic review of the rehabilitation of moderate to severe acquired brain injuries.

OBJECTIVE: To conduct a systematic review of the rehabilitation literature of moderate to severe acquired brain injuries (ABI) from traumatic and non-traumatic causes. METHODS: A review of the literature was conducted for studies looking at interventions in ABI rehabilitation. The methodological quality of each study was determined using the Downs and Black scale for randomized controlled trials (RCTs) and non-RCTs as well as the Physiotherapy Evidence Database (PEDro) scale for RCTs only. RESULTS: Almost 14 000 references were screened from which 1312 abstracts were selected. A total of 303 articles were chosen for careful review of which 275 were found to be interventional studies but only 76 of these interventional studies were RCTs. From this, 5 levels of evidence were determined with 177 conclusions drawn; however of the 177 conclusions only 7 were supported by two or more RCTs and 41 were supported by one RCT. CONCLUSION: Only 28% of the interventional studies were RCTs. Over half of the 275 interventional studies were single group interventions, pointing to the need for studies of improved methodological quality into ABI rehabilitation.