Three Perspectives on Older Adults' Daily Performance, Health, and Technology Use During COVID-19: Focus Group Study.

Background: During COVID-19 lockdowns, older adults' engagement in daily activities was severely affected, causing negative physical and mental health implications. Technology flourished as a means of performing daily activities in this complex situation; however, older adults often struggled to effectively use these opportunities. Despite the important role of older adults' social environments-including their families and health professionals-in influencing their technology use, research into their unique perspectives is lacking. Objective: This study aimed to explore the daily activity performance, health, and technology use experiences of healthy independent Israeli adults (aged ≥65 years) during COVID-19 from a 3-dimensional perspective: older adults, older adults' family members, and health professionals. Methods: Nine online focus groups, averaging 6-7 participants per group, were conducted with older adults, family members, and health professionals (N=59). Data were analyzed using thematic analysis and constant comparative methods. Results: The intertwining of daily activity performance and health emerged as a central theme, with differences between the groups. Older adults prioritized their self-fulfilling routines based on motivation and choice, especially in social-familial activities. In contrast, family members and health professionals focused on serious physical and mental health COVID-19-related consequences. A consensus among all three groups revealed the meaningful role of technology use during this period in bridging functional limitations. Participants delved into technology's transformative power, focusing on the need for technology to get engaged in daily activities. Conclusions: This study illustrates the profound interplay between daily activity performances, physical and mental health, and technology use, using a 3-dimensional approach. Its focus on technology's uses and benefits sheds light on what older adults need to increase their technology use. Interventions for improving digital activity performance can be tailored to meet older adults' needs and preferences by focusing on motivational and preference-related activities.

"You Need to Set a Daily Schedule": Understanding Successful Aging via Three-Sided Viewpoints.

This study aimed to identify the constructs related to successful aging in the context of engagement in social and productive activities. A qualitative design was used to explore three viewpoints on the aging period with 9 focus groups (3 each for adults 65 years or older, older adults' family members, and health professionals) and 18 interviews with older adults (older adults Mage = 71.7 years, Standard Deviation = 4.62). The transcripts were analyzed using constructivist grounded theory principles. Three categories were identified for successful aging: (a) engagement with life, including social participation, fixed/flexible schedule, time, and meaningful occupation; (b) self-management abilities, including producing daily schedules, independence, and initiation/striving toward goals; and (c) diversity among older adults, including their views on retirement, being active or not, and their dreams/values/goals. Considering the diverse nature of older adults, recognizing the importance of life engagement and self-management abilities emphasizes the necessity for an occupation-based, self-tailored approach to enable successful aging.

Cross-Cultural Participation in Food-Related Activities and Quality of Life among Children with Celiac Disease.

Children with celiac disease may face challenges in managing a gluten-free diet during their daily interactions and activities. The objective of this study was to compare how children with celiac disease manage their gluten-free diet and participate in food-related activities in Italy and Israel and to assess their quality of life. The previously validated Children's Activities Report (CD-Chart) and the Disease-specific Health-Related Quality of Life Questionnaire for Children with Celiac Disease (CDDUX) were administered in Italy to children aged 8-16 diagnosed with CD (n = 39). The results were compared to data that had been previously gathered from Israeli children with CD (n = 106). The CD-Chart demonstrated satisfactory internal reliability within each cultural group (Italy: α = 0.82; Israel: α = 0.76). Mann-Whitney U-tests indicated significant differences between the two groups. The Italian children exhibited a significantly higher preference for participating in the activities compared to the Israelis (U = 3283.50, p < 0.001). Nonetheless, the Italian children displayed a notable decrease in their level of involvement in the preparation required before engaging in different activities (U = 760.50, p < 0.001). Moreover, they exhibited significantly lower self-determination in this preparatory process compared to the Israeli children (U = 726.00, p < 0.001). Significant group differences were found between the CDDUX children's self-reports and parents' proxy reports in the Israeli group but not in the Italian group. The CD-Chart revealed both shared and distinct participation characteristics in daily food-related activities across different cultural contexts. By incorporating the CD-Chart and the CDDUX, healthcare professionals can emphasize crucial aspects of day-to-day health management and guide them in establishing suitable intervention objectives to enhance effective health self-management.

Exploring Intergroup Peer Exclusion: Validation of the Latency Social-Psychological Developmental Questionnaire (LSPD).

Intergroup peer exclusion has been studied mainly from a pathological aspect. Currently, methods of diagnosis and treatment focus on this pathological point of view. Qualitative research has revealed that social intergroup peer exclusion has a role in the developmental task of the latency stage. The study's main aim was to develop and validate a quick and easy quantitative questionnaire for use in a school setting that reflects the social developmental variables exposed in previous qualitative research. The 32-item Latency Social-Psychological Developmental questionnaire (LSPD) and the Loneliness and Social Dissatisfaction Questionnaire were administered to 20 Grade 4 and Grade 5 classes at four co-ed public elementary schools (N = 373 participants). Factor analysis revealed six developmental factors, and correlations were found between these factors and loneliness. The LSPD is a tool for assessing latency stage development among children who experienced exclusion as well as the developmental status of the entire class. The LSPD can assist in identifying specific development areas to focus on in treatment and intervention.

Mind Sports: Exploring Motivation and Use of Cognitive Strategies in Bridge.

The game of Bridge is one of the world's most widely played mind-sport games. A growing number of people consider it a meaningful leisure activity and are motivated to play. The aim of this study was to describe a sample of Bridge players in Israel in terms of demographics, player records, motivations, and cognitive strategies used to play Bridge and examine the associations between these variables. A sample of 488 Bridge players' completed an online demographic questionnaire, the Bridge Motivational Factors Checklist, and the Bridge Cognitive Strategies Questionnaire. Most players in the study were men with a mean age of 68.7 years and a Bridge player level between Vice Master and Senior Master. Most players play bridge because "bridge is a fun game". Strategy use that occurred in-game (versus pre- or postgame) obtained the highest mean score. Because Bridge is a strategy game that can be played from childhood to older adulthood, it is important to continue research to further understand the nature and different aspects of the cognitive strategy used among Bridge players and in other mind sports.

Early identification of subjective cognitive functional decline among patients with Parkinson's disease: a longitudinal pilot study.

Practical methods for early identification of Parkinson's disease (PD) mild cognitive impairment (PD-MCI) through changes in real-life daily functioning are scarce. The aim of the study was to examine whether the cognitive functional (CF) feature, comprising of seven self-reported Movement Disorder Society's (MDS) Unified Parkinson's Disease Rating Scale (UPDRS) items, predicts PD patients' cognitive functional status after a year. We conducted a 1-year follow-up of 34 PD patients (50-78 year; 70.6% men) suspected of MCI using the following measures: the MDS-UPDRS, UPDRS-CF feature, Beck Depression Inventory (BDI), Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), Parkinson's Disease Cognitive Functional Rating Scale (PD-CFRS), and Daily Living Questionnaire (DLQ). The first and second UPDRS-CF feature scores, and additional measures at the 1-year follow-up significantly correlated. Hierarchical regression revealed that the initial MoCA, TMT, and BDI scores predicted the second UPDRS-CF, and the first UPDRS-CF predicted 31% of the second PD-CFRS score variance. Depression moderated the relationship between the first UPDRS-CF score and the DLQ Part A. These results suggest practical, self-reported, daily functional markers for identifying gradual decline in PD patients. They consider the patients' heterogeneity, underlying cognitive pathology, and implications on daily functioning, health, and well-being.

Promoting Effective Self-Management of the Gluten-Free Diet: Children's and Adolescents' Self-Generated Do's and Don'ts.

Celiac disease (CD) is a chronic health condition treated by managing a lifelong, strict, and demanding gluten-free diet. Managing the diet entails effective use of self-management skills. This study aimed to explore self-generated procedures children and adolescents with CD in Israel perform when participating in food-related activities considering their self-management skills and health requirements. Participants included children and adolescents with CD, aged 8 to 18 years, that had been diagnosed more than 6 months prior to the study. Parents completed a demographic questionnaire and reported their child's constancy in adherence to the diet. Children and adolescents were asked to share the things they do themselves to prepare for participating in the various activities. Responses were qualitatively analyzed, and common themes were identified and categorized using directed analysis. Participants were 126 children and adolescents (Mage = 12.33 yr, SD = 2.85), 67.5% of whom had been diagnosed more than 3 yr prior to the study. Based on parents' reports, almost all (97.6%) participants "always adhered" to the diet. A total of 10 categories were defined from the qualitative responses describing 125 do and don't actions used by the children and adolescents to self-manage their diet. The do and don't actions encompass cognitive planning far beyond the mere act of avoiding gluten. These actions can serve as an initial database of suggested strategies to support acquiring independent self-management. Understanding the cognitive complexity of routinely carrying out the diet while actively participating in everyday activities can assist health professionals in building support and intervention programs, promoting effective self-management, and facilitating optimal adherence to the diet.

Technology use characteristics among older adults during the COVID-19 pandemic: A cross-cultural survey.

Personal computers, tablets, and smartphones may support older adults' engagement when people are required to stay home and opportunities to engage in meaningful activities are reduced during the COVID-19 period. This study aims to screen older adults' technology-use characteristics across social, leisure, and education domains during the COVID-19 pandemic from a crosscultural viewpoint. The sample included 576 participants aged 60 and older from France (n = 62), Spain (n = 110), and Israel (n = 404). Participants completed the technology-use survey, which consists of questions about their facilities, technology usability, need for adaptations to support technology use, and changes in technology use since COVID-19. Significant differences were found between countries in facilities, χ2 (2) = 25.16, p < .001, and usability, χ2 (2) = 64.14, p < .001, across the three domains. Furthermore, 34% of technological usability was predicted by country and facilities, F (4, 568) = 72.39, p < .001. Participants noted a willingness to use technology if it was adapted for social (61%-73%), leisure (51%-71%), or educational (67%-76%) activities and that they devoted substantially more time to technology across domains (>58%) due to COVID-19. These findings highlight culture and facilities as factors that play an imperative role in supporting and enhancing the usability of technology among older adults.

Capturing Subjective Mild Cognitive Decline in Parkinson's Disease.

This study aimed to capture subjective daily functional cognitive decline among patients with Parkinson's disease. Participants (40-79 y; 78 with Parkinson's disease and 41 healthy matched controls) completed the Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Parkinson's Disease Cognitive Functional Rating Scale (CFRS), Daily Living Questionnaire (DLQ), and Time Organisation and Participation Scale (TOPS) questionnaires. Patients with Parkinson's disease were divided into groups with or without suspected mild cognitive decline according to their scores on the Cognitive Functional (CF) feature, which is based on certain items of the MDS-UPDRS. Significant between-group differences were found in the DLQ and TOPS scores. Significant correlations were found among the questionnaire results, with specific DLQ and TOPS items accounting for 35% of the variance in the CF feature, which correlated with daily cognitive functional states. This study's results are relevant for detecting subtle deficits in Parkinson's disease patients suspected of mild cognitive decline, which can affect health and quality of life and relates to risk for later dementia.

Relationships between executive functions and sensory patterns among adults with specific learning disabilities as reflected in their daily functioning.

Adults with specific learning disabilities (e.g., dyslexia, dysgraphia, and dyscalculia) reveal limitations in daily functioning in various life domains. Following previous evidence of deficient executive functions and unique sensory patterns in this population, this study examined how relationships between these two domains are expressed in daily functioning. Participants included 55 adults with specific learning disabilities and 55 controls matched by age, gender, socioeconomic status, and education. Participants completed a sociodemographic questionnaire, the Behavioral Rating Inventory of Executive Functions-adult version, and the Adolescent/Adult Sensory Profile. Results indicated significant relationships between executive functions (per the Behavioral Rating Inventory of Executive Functions-adult version) and sensory patterns (per the Adolescent/Adult Sensory Profile) as reflected in daily functioning. The low sensory registration pattern predicted 12% to 16% of the variance in the behavioral regulation index, metacognitive index, and general executive composite scores and was a significant predictor of specific executive function abilities. Results indicated that the difficulties of adults with specific learning disabilities in using executive function abilities efficiently might be tied to a high sensory threshold and passive self-regulation strategies. A deeper understanding of this population's sensory-executive mechanisms may improve evaluation and intervention processes. This understanding can consequently increase executive abilities for improved daily functioning and life satisfaction.

Patients' Self-Report and Handwriting Performance Features as Indicators for Suspected Mild Cognitive Impairment in Parkinson's Disease.

Early identification of mild cognitive impairment (MCI) in Parkinson's disease (PD) patients can lessen emotional and physical complications. In this study, a cognitive functional (CF) feature using cognitive and daily living items of the Unified Parkinson's Disease Rating Scale served to define PD patients as suspected or not for MCI. The study aimed to compare objective handwriting performance measures with the perceived general functional abilities (PGF) of both groups, analyze correlations between handwriting performance measures and PGF for each group, and find out whether participants' general functional abilities, depression levels, and digitized handwriting measures predicted this CF feature. Seventy-eight participants diagnosed with PD by a neurologist (25 suspected for MCI based on the CF feature) completed the PGF as part of the Daily Living Questionnaire and wrote on a digitizer-affixed paper in the Computerized Penmanship Handwriting Evaluation Test. Results indicated significant group differences in PGF scores and handwriting stroke width, and significant medium correlations between PGF score, pen-stroke width, and the CF feature. Regression analyses indicated that PGF scores and mean stroke width accounted for 28% of the CF feature variance above age. Nuances of perceived daily functional abilities validated by objective measures may contribute to the early identification of suspected PD-MCI.

Structural validation and dyadic child-parent measurement invariance of the celiac disease quality of life questionnaire.

OBJECTIVE: The celiac disease quality of life questionnaire (CDDUX) is used widely in numerous languages worldwide. However, it's structural and construct validity and child-parent invariance had not been thoroughly examined. The objective of this study was to examine the psychometric properties of the 12-item CDDUX and the extent to which it meets the acceptable requirements of reliability and structural and convergent validity, as well as its child-parent invariance. METHODS: In this cross-sectional study, 126 dyads of children aged 8-18 years and their parents completed the Hebrew version self-report and parent-proxy report CDDUX. Recently developed methods to examine psychometric properties and to measure invariance of dyadic samples were used while properly accounting for nonindependence in measurement patterns. RESULTS: A three-factor structure, each with sufficient internal consistency, is confirmed for both children and parents. Removing a single indicator of the diet subscale resulted in full configural (χ2(181) = 202.277, P > 0.05, RMSEA = 0.026) and metric (χ2(189) = 209.543, P > 0.05, RMSEA = 0.043) invariance of the measure between children and parents. However, this occurred only in partial-scalar (χ2(198) = 229.813, P > 0.05, RMSEA = 0.031) and uniqueness invariance, which is nevertheless sufficient for meaningful comparison between the groups. CONCLUSION: Overall, with minor modifications, the Hebrew version of the CDDUX was found to be a valid measure of children's celiac-related quality of life when measured across children's self-reports and parent-proxy reports. The CDDUX provides meaningful measurement and allows child-parent comparison.

Work-Related Self-Efficacy and Illness Identity in Adults with Autism.

Finding and retaining employment significantly challenges individuals with autism spectrum disorder (ASD). The employment rates of individuals with ASD are described as extremely low, barred by various environmental, occupational, and personal factors. Illness identity is how a person's health condition integrates with their identity and daily life and relates to self-esteem, employment, and quality of life. Adults with ASD may experience challenges developing positive identities within social and work environments, but illness identity has not been studied among this population. This study examines the autism identity of adults with ASD and the relationships to their self-reported work-related self-efficacy and quality of life. Seventeen participants aged 19-47 years diagnosed with ASD completed the Illness Identity Questionnaire, Work-Related Self-Efficacy Scale and World Health Organization Quality of Life Assessment. Participants reported significantly higher autism acceptance feelings. Negative feelings about living with autism were significantly correlated to lower work-related self-efficacy. Higher levels of enrichment feelings were significantly associated with a higher quality of life. These findings highlight the effect of illness identity on the work-related self-efficacy and quality of life among individuals with ASD. Allied health professionals and educators can assist these individuals in raising their awareness of how they perceive their autism, and in promoting its positive perception.

DailyCog: A Real-World Functional Cognitive Mobile Application for Evaluating Mild Cognitive Impairment (MCI) in Parkinson's Disease.

Parkinson's disease (PD) is the second most common progressive neurodegenerative disorder affecting patient functioning and quality of life. Aside from the motor symptoms of PD, cognitive impairment may occur at early stages of PD and has a substantial impact on patient emotional and physical health. Detecting these early signs through actual daily functioning while the patient is still functionally independent is challenging. We developed DailyCog-a smartphone application for the detection of mild cognitive impairment. DailyCog includes an environment that simulates daily tasks, such as making a drink and shopping, as well as a self-report questionnaire related to daily events performed at home requiring executive functions and visual-spatial abilities, and psychomotor speed. We present the detailed design of DailyCog and discuss various considerations that influenced the design. We tested DailyCog on patients with mild cognitive impairment in PD. Our case study demonstrates how the markers we used coincide with the cognitive levels of the users. We present the outcome of our usability study that found that most users were able to use our app with ease, and provide details on how various features were used, along with some of the difficulties that were identified.

Mobile Application for Promoting Gluten-Free Diet Self-Management in Adolescents with Celiac Disease: Proof-of-Concept Study.

Celiac disease (CD) is a chronic disease treated by maintaining and managing a lifelong restrictive gluten-free diet. The purpose of this study was to develop a mobile application, Plan My C-Day, to promote self-management skills among youth with CD during adolescence-a time when decreased adherence often occurs-and examine its usability among adolescents with CD. Plan My C-Day contains three simulations of activities involving eating out and actions to take when preparing for these events. It was developed and pilot tested by 13 adolescents with CD. Application use and user perception data were collected and analyzed. Participants chose 160 actions within the simulations. For over 75% of participants, the time to complete the simulation decreased from the first to the third (last) simulation by an average of 50%. The average reported usability perception was 3.71 on a scale of 1 to 5, with system ease of use and ease of learning obtaining the highest scores. This study demonstrated that the Plan My C-Day mobile application's self-management content, features, and functions operated well and that the simulations were easy to understand and complete. Further development will include the option to add self-created activities and adaptation to different languages and cultures.

Examining core self-management skills among adolescents with celiac disease.

A strict gluten-free diet is the only treatment for celiac disease, and it is especially challenging among adolescents. Participation in food-related activities and self-managing the chronic health condition involve use of cognitive skills. This cross-sectional study examined how executive functions might be associated with participation in food-related activities. Adolescents aged 12-18 years (N = 65; Mage = 14.67) with celiac were interviewed about participation, and their parents completed an executive function questionnaire. Poorer participation significantly correlated with poorer executive abilities. Identifying executive function profiles may contribute to understanding and advancing resourceful daily functioning and participation in daily food-related activities.

Illness Identity in Adolescents With Celiac Disease.

OBJECTIVES: The aim was to examine the reliability and validity of the Illness Identity Questionnaire (IIQ) among adolescents with celiac disease (CD), to describe their illness identity characteristics, and to examine relationships between illness identity and self-reported participation in food-related activities and quality of life. METHODS: Adolescents with CD (n = 91) were recruited for this cross-sectional study via social media interest groups. Participants completed online questionnaires: the IIQ, the CD Children's Activities Chart (CD-Chart), and the Pediatric Quality of Life Inventory (PedsQL). RESULTS: Internal reliability was established for IIQ items (α = 0.87) and for its 4 components (α = 0.75--0.90). The positive components (acceptance, enrichment) significantly differed from the negative components (rejection, engulfment), t(90) = 11.45, P < 0.001, d = 1.98. Feelings were more positive (M = 3.48, SD = 0.67) than negative (M = 2.06, SD = 0.76). The total IIQ was positively associated with the CD-Chart amount of activities (r = 0.30, P < 0.01) and enjoyment (r = 0.34, P < 0.001) and with the PedsQL social scale (r = 0.53, P < 0.001). CONCLUSIONS: The IIQ established acceptable reliability and validity. In all, the adolescents with CD exhibited an illness identity profile that was more positive and adaptive than negative. The IIQ can contribute to understanding the developmental status of illness identity during the critical transition process from adolescence to adulthood.

The Montreal Cognitive Assessment: Is It Suitable for Identifying Mild Cognitive Impairment in Parkinson's Disease?

BACKGROUND: Administering an abbreviated global cognitive test, such as the Montreal Cognitive Assessment (MoCA), is necessary for the recommended first-level diagnostic criteria for mild cognitive impairment (MCI) in Parkinson's disease (PD). Level II requires administering cognitive functioning neuropsychological tests. The MoCA's suitability for identifying PD-MCI is questionable and, despite the importance of cognitive deficits reflected through daily functioning in identifying PD-MCI, knowledge about it is scarce. OBJECTIVES: To explore neuropsychological test scores of patients with PD who were categorized based on their MoCA scores and to analyze correlations between this categorization and patients' self-reports about daily functional-related cognitive abilities. METHODS: A total of 78 patients aged 42 to 78 years participated: 46 with low MoCA scores (22-25) and 32 with high MoCA scores (26-30). Medical assessments and level II neuropsychological assessment tools were administered along with standardized self-report questionnaires about daily functioning that reflects patients' cognitive abilities. RESULTS: A high percentage of the low MoCA group obtained neuropsychological test scores within the normal range; a notable number in the high MoCA group were identified with MCI-level scores on various neuropsychological tests. Suspected PD-MCI according to the level I criteria did not correspond well with the level II criteria. Positive correlations were found among the 3 self-report questionnaires. CONCLUSIONS: These results support the ongoing discussion of the complexity of capturing PD-MCI. Considering the neuropsychological tests results, assessments that reflect cognitive encounters in real life daily confrontations are warranted among people diagnosed with PD who are at risk for cognitive decline.

The Child Evaluation Checklist (CHECK): A Screening Questionnaire for Detecting Daily Functional "Red Flags" of Underrecognized Neurodevelopmental Disorders among Preschool Children.

BACKGROUND: Early identification of invisible comorbid neurodevelopmental disorders, such as specific learning disorders, attention deficit hyperactive disorders, and developmental coordination disorders, is crucial to improving children's daily functional deficits related to executive functions. However, a practical questionnaire to address parents' concerns is lacking. AIMS: To develop a reliable and valid assessment tool that can identify young children at risk for invisible underrecognized neurodevelopmental disorders. This article describes the development and standardization of the Child Evaluation Checklist (CHECK). METHODS AND PROCEDURES: Participants were 186 children aged 3 to 6 years: 91 with suspected invisible neurodevelopmental disorders, and 95 controls with typical development. Parents completed a demographic questionnaire, the CHECK, and the Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P). OUTCOMES AND RESULTS: The CHECK's construct validity indicated high internal consistency for each part (Part A: α = .94; Part B: α = .90) and moderate-to-high consistency for each of Part A's four factors. Significant correlations, as well as significant group differences, were found between the CHECK factors and BRIEF-P scores. CONCLUSIONS AND IMPLICATIONS: Use of the CHECK allows for timely identification of suspicious ("red flags") invisible neurodevelopmental disorders. It may support parents' sufficient awareness and knowledge to refer their children for comprehensive evaluation and intervention.

Conceptualisation and use of executive functions in paediatrics: A scoping review of occupational therapy literature.

BACKGROUND/AIM: Knowledge and understanding of deficits in executive functions has expanded in recent years and its relevance to occupational therapy has been established. The purpose of this review was to identify, analyse, synthesise and describe the updated occupational therapy scientific literature that addresses the subject of executive functions, specifically focusing on children and adolescents. METHOD: Scoping review methodology was implemented to map the occupational therapy literature on executive functions in children and adolescents over the past decade. Articles were retrieved from five electronic databases. RESULTS: Fifty publications met the inclusion criteria. The research included a wide age range, different diagnoses, use of diverse executive functions definitions and assortment of assessments and interventions. CONCLUSION: A unique definition of executive functions among children and adolescents was proposed. This definition can assist both clinicians and researchers in the field. Continued research to establish the profession in a key position is recommended to understand the underlying mechanisms of daily performance.