Extrinsic Barriers Research Articles

Implications of Constraints on the Language of Emerging Aided Communicators and Intervention Decisions: A Tutorial

This tutorial offers speech-language pathologists (SLPs) an opportunity to consider the theoretical constructs of language acquisition theory and the multifactorial determinants that can impinge on the language acquisition process for children with complex communication needs. The system of constraints observed through the lens of optimality theory is discussed alongside intrinsic and extrinsic barriers associated with children who acquire their first language simultaneous to their introduction to aided augmentative and alternative communication (AAC) systems. This examination calls into question whether the language competence of emerging aided communicators may be masked by their ability to produce language that accurately represents their understanding of their native language. Specific to this question is whether vocabularies available to emerging aided communicators, opportunities to access aided language models, and intervention decisions made by SLPs may be implicated in the language acquisition and development process. Suggestions for clinical practice are offered as a means of mitigating adverse outcomes related to extrinsic constraints.

Unveiling Barriers and Challenges of AI Technology Integration in Education: Assessing Teachers’ Perceptions, Readiness and Anticipated Resistance

This study seeks to fill a gap in the literature concerning the extrinsic barriers that affect the integration of artificial intelligence (AI) technologies, such as ChatGPT, within the educational sphere. While previous studies have predominantly focused on intrinsic factors like teachers’ attitudes and beliefs, as well as the general benefits and drawbacks of AI in education, there has been limited investigation into how external obstacles, such as large class sizes, insufficient resources, slow internet connections, and outdated technology, affect this integration. The importance of this study lies in its assessment of whether these extrinsic barriers contribute to teachers' resistance to embracing AI technology. This study employs a quantitative method to explore this issue, using a questionnaire administered to thirteen (n=13) EFL instructors from the Department of English at Ibn Khaldoun University of Tiaret, Algeria. The results derived from this study reveal that while participants recognised AI's potential to improve student learning and expressed confidence in its integration, they also identified extrinsic barriers such as technical complexity, inadequate training, limited resources, and large class sizes as critical factors contributing to their resistance to incorporating AI tools into their teaching practices. This research emphasises the necessity of addressing these external barriers to better align technological innovations with teachers' needs and readiness, thereby enhancing the effective integration of AI in education.

RHNO1: at the crossroads of DNA replication stress, DNA repair, and cancer.

The DNA replication stress (DRS) response is a crucial homeostatic mechanism for maintaining genome integrity in the face of intrinsic and extrinsic barriers to DNA replication. Importantly, DRS is often significantly increased in tumor cells, making tumors dependent on the cellular DRS response for growth and survival. Rad9-Hus1-Rad1 Interacting Nuclear Orphan 1 (RHNO1), a protein involved in the DRS response, has recently emerged as a potential therapeutic target in cancer. RHNO1 interacts with the 9-1-1 checkpoint clamp and TopBP1 to activate the ATR/Chk1 signaling pathway, the crucial mediator of the DRS response. Moreover, RHNO1 was also recently identified as a key facilitator of theta-mediated end joining (TMEJ), a DNA repair mechanism implicated in cancer progression and chemoresistance. In this literature review, we provide an overview of our current understanding of RHNO1, including its structure, function in the DRS response, and role in DNA repair, and discuss its potential as a cancer therapeutic target. Therapeutic targeting of RHNO1 holds promise for tumors with elevated DRS as well as tumors with DNA repair deficiencies, including homologous recombination DNA repair deficient (HRD) tumors. Further investigation into RHNO1 function in cancer, and development of approaches to target RHNO1, are expected to yield novel strategies for cancer treatment.

Development of the Scale of Parental Playful Attitude During the Co-Occupation of Play

Abstract Importance: There is a need for tools to measure adults’ playfulness in reference to parent–child joint play. Objective: To (1) develop items for the Scale of Parental Playful Attitude (PaPA), (2) evaluate evidence for validity based on content, and (3) evaluate evidence for validity based on the response process. Design: A mixed-methods design with three phases: (1) development of the first draft of the PaPA (based on the literature, focus groups, and semistructured interviews), (2) review by experts and revision of the first draft, and (3) cognitive interviews with parents. Setting: Various (e.g., schools, a university). Participants: Phase 1 had 32 participants: 13 parents of children ages 2.5–6 yr without major diagnosed conditions; 8 parents of autistic children age 4–7 yr; and 11 preschoolers age 3–5 yr. Phase 2 involved 10 experts. Phase 3 had 5 participants: 3 mothers and 2 fathers of children ages 2.5–6 yr; 1 child was autistic. Outcomes and Measures: Interview protocols and experts’ review form. Results: Phase 1 involved the initial item development. Extrinsic motivation and barriers to play emerged as important areas to include. Experts’ review enhanced representation of the construct of playfulness. Content validity index values ranged from .78 to 1.00. Cognitive interviews provided insights into parents’ comprehension of PaPA items. Conclusions and Relevance: Validity related to test content and the response process was supported. Additional sources of validity testing are necessary. Plain-Language Summary: Adult playfulness is critical for both the child and the parent, especially for developing a deeper connection. The Scale of Parental Playful Attitude (PaPA) assesses parents’ self-perceptions of their playfulness when playing with their child. The study authors developed the PaPA (in both English and Spanish) to address a lack of tools for assessing how parents perceive their own playfulness relative to their child’s playfulness. Understanding how parents perceive their own playful attitudes can create opportunities for occupational therapists to guide parents to approach play with an attitude that is as attuned as possible to their child’s playfulness. Future validity studies are needed to support the clinical use of the PaPA.

UK midwives delivering physical activity advice; what are the challenges and possible solutions?

Despite physical activity (PA) providing specific health benefits during pregnancy and the postpartum period, many women report decreased PA during this time. Provision of PA advice has been found to be lacking amongst midwives due to a range of barriers. This study aimed to evaluate United Kingdom's midwives' current role and knowledge regarding the provision of PA advice to pregnant and postpartum women and identify the barriers and potential solutions. Ten UK midwives (mean work experience ± SD: 15.5 years ± 10.2) participated in semi-structured interviews between May and July 2023. Data were analysed using a deductive thematic approach following Braun and Clarke's six steps. Demographic data were collected by Microsoft Forms then summarised using Microsoft Excel. Six themes with 25 subthemes were identified as barriers and solutions in delivering PA advice. The role of midwives in providing PA advice during pregnancy; the role of midwives in providing PA advice postpartum; intrinsic barriers that limit PA advice provision (confidence, safety concerns, knowledge, and midwife's personal body habitus); extrinsic barriers that limit PA advice provision (lack of time, education, PA not a priority in care); solutions to allow midwives to promote PA (including formal PA education, and dissemination of resources); and optimising delivery of PA advice (personalized approach, interprofessional collaboration, and linking to mental health benefits). Midwives consider themselves ideally placed to provide PA advice to pregnant women, with many aware of the benefits PA provides. Despite this, there is a lack of PA advice provision and knowledge of PA guidelines. Postpartum PA advice appeared to be considered outside the remit of midwives, due to limited contact. Further research is needed to determine the current level of PA advice provision for pregnant and postpartum women and explore the role of other healthcare professionals involved in maternity care.

Predictors of psychiatric treatment-seeking attitudes in older adults

Objectives Understanding the factors that contribute to treatment-seeking attitudes among older adults—a growing population with frequent mental health concerns—is vital. Although past research has identified some demographic and belief-based predictors of mental health treatment attitudes among this population, previous studies are limited by only evaluating these variables in isolation and not distinguishing between different types of treatment (e.g. medication and psychotherapy). Methods In a pre-registered online survey of 606 older adults (age 60 years and older), we evaluated stigmatizing attitudes, etiological beliefs about depression, psychological symptoms, and health literacy as well as attitudes about psychotherapy and medication separately. Results Pre-registered linear regression analyses showed that greater stigmatizing attitudes uniquely predicted more negative attitudes for both therapy and medication treatment seeking over and above gender, education, income, extrinsic barriers, health literacy, depression, and anxiety. Additionally, loneliness was a significant predictor of less favorable medication attitudes. Exploratory analysis revealed that attributing depression to a chemical imbalance predicted positive attitudes about medication, but not psychotherapy. Conclusion These findings indicate that older adults’ treatment-seeking behaviors are separately influenced by stigma, etiological beliefs, and loneliness.

Factors that impact mental health help-seeking in Australian adolescents: a life-course and socioecological perspective.

Help-seeking provides opportunities for early prevention and intervention of mental health problems. However, little is known about factors that impact help-seeking from a life-course and socioecological perspective. This study aimed to examine factors that impact adolescents' formal and informal help-seeking in three population groups: the whole population, adolescents with depressive symptoms and adolescents with anxiety symptoms. We drew on data from the Longitudinal Study of Australian Children birth cohort. Participants were followed from birth to 14-15 years. Based on previous literature and life-course and socioecological models, we measured a range of factors at individual and family, interpersonal and community levels at three time points (0-1 year, 4-5 years and 12-13 years). Outcomes at 14-15 years were help-seeking behaviours divided into three categories (formal help from health professionals, close informal help from friends and family members and broad informal help from other sources). Generalised linear models with logit-binomial links were used. There were varying and common patterns of influencing factors across the three population groups and sources of help-seeking. In the whole population, five common factors (female, previous depressive or anxiety symptoms, discrimination and bully victimisation) were associated with all three sources of help-seeking. Among adolescents with depressive or anxiety symptoms, four common barriers to help-seeking were male adolescents, speaking a language other than English, having poor relationships with peers and less social support. Both intrinsic and extrinsic barriers exist for adolescents' mental health help-seeking. There are priority groups of adolescents with mental health problems who are unlikely to seek support and warrant attention. There is a need for multisector collaborations to address barriers to mental health care and promote help-seeking among adolescents.

The spatial ecology of Mojave rattlesnakes (Crotalus scutulatus), prairie rattlesnakes (Crotalus viridis), and their hybrids in southwestern New Mexico

Abstract Hybridization between species provides unique opportunities to understand evolutionary processes that are linked to reproductive isolation and, ultimately, speciation. However, the extrinsic factors that limit hybridization are poorly understood for most animal systems. Although the spatial ecology of individuals in natural habitats is fundamental to shaping reproductive success and survival, analyses of the spatial ecology of hybrids and their parental groups are rarely reported. Here, we used radiotelemetry to monitor wild rattlesnakes across an interspecific hybrid zone (Crotalus scutulatus and Crotalus viridis) and measured movement parameters and space use (utilization distributions) of individuals to evaluate the hypothesis that hybridization resulted in transgressive or atypical movement patterns. Unexpectedly, of the spatial metrics we investigated, we found that hybrids were very similar to parental individuals. Nonetheless, hybrids did show increased patchiness of core utilization distributions, but this result is likely to be driven by increased habitat patchiness in the hybrid zone. Overall, we did not find evidence for overt extrinsic barriers to hybridization associated with spatial ecology; thus, we suggest that the close evolutionary history between the two parental species and their ecological and behavioural similarities are likely to increase the probability of hybridization events in this unique region of New Mexico.

Intrinsic and extrinsic actions of human neural progenitors with SUFU inhibition promote tissue repair and functional recovery from severe spinal cord injury

Neural progenitor cells (NPCs) derived from human pluripotent stem cells(hPSCs) provide major cell sources for repairing damaged neural circuitry and enabling axonal regeneration after spinal cord injury (SCI). However, the injury niche and inadequate intrinsic factors in the adult spinal cord restrict the therapeutic potential of transplanted NPCs. The Sonic Hedgehog protein (Shh) has crucial roles in neurodevelopment by promoting the formation of motorneurons and oligodendrocytes as well as its recently described neuroprotective features in response to the injury, indicating its essential role in neural homeostasis and tissue repair. In this study, we demonstrate that elevated SHH signaling in hNPCs by inhibiting its negative regulator, SUFU, enhanced cell survival and promoted robust neuronal differentiation with extensive axonal outgrowth, counteracting the harmful effects of the injured niche. Importantly, SUFU inhibition in NPCs exert non-cell autonomous effects on promoting survival and neurogenesis of endogenous cells and modulating the microenvironment by reducing suppressive barriers around lesion sites. The combined beneficial effects of SUFU inhibition in hNPCs resulted in the effective reconstruction of neuronal connectivity with the host and corticospinal regeneration, significantly improving neurobehavioral recovery in recipient animals. These results demonstrate that SUFU inhibition confers hNPCs with potent therapeutic potential to overcome extrinsic and intrinsic barriers in transplantation treatments for SCI.

Goal setting among older adults starting mobile health cardiac rehabilitation in the RESILIENT trial.

There is growing recognition that healthcare should align with individuals' health priorities; however, these priorities remain undefined, especially among older adults. The Rehabilitation Using Mobile Health for Older Adults with Ischemic Heart Disease in the Home Setting (RESILIENT) trial, designed to test the efficacy of mobile health cardiac rehabilitation (mHealth-CR) in an older cohort, also measures the attainment of participant-defined health outcome goals as a prespecified secondary endpoint. This study aimed to characterize the health priorities of older adults with ischemic heart disease (IHD) using goal attainment scaling-a technique for measuring individualized goal achievement-in a sample of 100 RESILIENT participants. The ongoing RESILIENT trial randomizes patients aged ≥65 years with IHD (defined as hospitalization for acute coronary syndrome and/or coronary revascularization), to receive mHealth-CR or usual care. For the current study, we qualitatively coded baseline goal attainment scales from randomly selected batches of 20 participants to identify participants' cardiac rehabilitation outcome goals and their perceptions of barriers and action plans for goal attainment. We used a deductive framework (i.e., 4 value categories from Patient Priorities Care) and inductive approaches to code and analyze interviews until thematic saturation. This sample of 100 older adults set diverse health outcome goals. Most (54.6%) prioritized physical activity, fewer (17.1%) identified symptom management, fewer still (13.7%) prioritized health metrics, mostly comprised of weight loss goals (10.3%), and the fewest (<4%) were related to clinical metrics such as reducing cholesterol or preventing hospital readmission. Participants anticipated extrinsic (access to places to exercise, time) and intrinsic (non-cardiac pain, motivation) barriers. Action plans detailed strategies for exercise, motivation, accountability, and overcoming time constraints. Using goal attainment scaling, we elicited specific and measurable goals among older adults with IHD beginning cardiac rehabilitation. Priorities were predominantly functional, diverging from clinical metrics emphasized by clinicians and healthcare systems.

Cooking behavior among mothers of children aged 2-5 years old in Kendari, Southeast Sulawesi, Indonesia.

Cooking at home was associated with parental feeding practices. This study aimed to explore the interplay of components in cooking behavior of mothers with young children aged 2-5 years old in Kendari city of Southeast Sulawesi, Indonesia. This qualitative study involved 33 mothers from Kendari city, which was represented by each two sub-districts in coastal and mainland areas that were randomlyselected. Six focus group discussions (FGDs) were carried out using 20-item guide questions. The guide questions were developed following the Model of Goal-Directed Behavior (MGDB) theory approach exploring the components of cooking behavior i.e., skill, intention, desire, confidence, and attitude in cooking. Data analysis was performed in the field to assist decision on data saturation, followed by data analysis at desk through multilevel coding from the verbatim transcripts using NVivo R1 software. The data was analyzed thematically using pre-determined themes according to the MGDB theory. Emerging topics on enabling factors and constraints were captured to enhance our understanding of the complexity of cooking behavior. The mothers' mean age was about 30 years old with a comparable representation of younger and older mothers. Most mothers were housewives and accomplished secondary school level. The mothers' intention was shown as they frequently cooked at home and allocated time for cooking. The enabling factors included their knowledge about food and nutrition, food source availability, their confidence in cooking meals and following recipes, and their motivation to keep their children healthy representing some intrinsic factors. The main constraint was the lack of skill to make snacks. The other extrinsic barriers were dependence on mobile food sellers and the availability of food kiosks that facilitated children's snack preferences. The study obtained some insights that mothers had favorable cooking intention and desire, were supported with a confidence in some basic cooking skills. However, the existing constraints that encouraged the development of unfavorable children's snacking habit were beyond the mothers' control. A cookbook specifically for snack recipes that utilizes local ingredients may assist mother in preparing more healthier options for the children.

Enhancing pedagogy for teaching visual arts in the South African Foundation Phase classroom: A collaborative endeavor

In this article, we report on the pedagogy of a cohort of South African Foundation Phase teachers in the praxis of visual arts. We used participatory action learning and action research (PALAR) as paradigm and methodology and data was generated collaboratively through arts-based strategies such as photovoice, visual journaling, and reflexive group conversations. We analysed the data using an inductive analysis approach. The data indicated a set of extrinsic and intrinsic barriers experienced by the participants in the praxis and pedagogy of visual arts in a South African context. We provide recommendations for Foundation Phase teachers, school management teams, and governmental Departments of Education. This study contributes to the field of arts education by highlighting the plight of generalist teachers having to teach visual arts without sufficient training or support. We create opportunities for arts educators to contribute to the experiences of these teachers.

The benefits, barriers and facilitators of mentoring programs for first-year doctors: A systematic review.

The transition from medical student to first-year doctor is notoriously difficult, yielding a high rate of transition failure, burn-out and mental health deterioration. Doctors in this cohort experience unique challenges during this time, which manifest through performance gaps, issues of professional identity, new occupational pressures, and cultural expectations. Mentoring programs are commonly utilised in the medical profession to foster personal and professional development and improve psychosocial well-being and career satisfaction. However, there exist no systematic reviews examining the use of mentorship specifically for the first-year doctor cohort, given the unique transition challenges faced by this vulnerable group. Due to their transition difficulties, evaluate the research on mentorship specifically for first-year doctors, and identify the emerging themes that can inform the benefits to this group, the barriers that impede program implementation and the facilitators that contribute to successful mentorship programs for this cohort. The PEO (population, exposure outcome) framework was adopted to develop the research inquiry, after which, a systematic review was conducted, adhering to PRISMA guidelines. The search strategy was conducted with assistance from an experienced university librarian. Screening and selection were completed independently against inclusion/exclusion criteria, by two reviewers. The methodological quality of included studies was assessed using Joanna Briggs critical appraisal instruments. Data sources used included Web of Science Medline, Ebsco Cinahl Plus, Scopus, Web of Science Core Collection and Ovid Journals. Search parameters were restricted to English language and peer-reviewed; date range was unobstructed up to 26 August 2022. A total of 4137 articles were retrieved, with 13 considered to have met full inclusion criteria. An integrative review synthesis identified three major themes; benefits of mentoring for first-year doctors, intrinsic and extrinsic barriers to mentoring programs and facilitating factors that improve successful program implementation. First-year doctors report untenable and highly strenuous working conditions, that result in poor mental health and high attrition rates. Formalised, near-peer, tier mosaic mentoring programs provide significant psychosocial and career benefits to this cohort specifically, bridge the training gap from medical student to first-year doctor and ameliorate patterns of intergenerational bullying, hierarchy and emotional inhibition. However, mentorship is inextricably interrelated to societal-cultural considerations of identity. Mentorship alone cannot overcome endemic cultural challenges within medicine without broader systemic change; however, programs are a valuable option towards positive support for first-year doctors.

An Exploration of the Lived Experiences and Psychological States of Migrants and Refugees

UNHCR reports that about 82.4 million individuals were forcibly displaced as they attempted to avoid persecution, conflict, or human rights violations in their home countries. In addition to traumatic experiences, refugees encounter stressors such as low income, reduced social support, and language barriers. This qualitative study aimed to explore the impact of pre-migration trauma and political detainment on mental health outcomes and living conditions. A total of eight interviewees participated in video conferencing interviews. A non-probability convenience sampling using the snowballing technique was utilized to identify participants. Data were analyzed using an inductive approach for thematic analysis. The software Dedoose was used to come up with codes and the research team refined the codes into distinct themes. Four themes emerged from data analysis: extrinsic barriers, symptoms of psychological distress, coping and help-seeking behaviors, and interpersonal relationships. Results of the study show the intensity and difficulty of experiences faced by participants and the toll it takes on their mental state and family life. The results highlight a lack of resources available to refugees in the United States and a suggestion to further the research efforts for this understudied population.

“It just felt like another thing to do”: Examining teacher barriers and motivators to utilizing trauma‐informed resources during COVID‐19

AbstractGiven that over two‐thirds of children in the United States are exposed to at least one traumatic event by age 16, it is imperative that schools support these students with trauma‐informed practices and resources. The current study investigated factors that affected teacher use of trauma‐informed resources within two school districts in California during the COVID‐19 pandemic. The specific research questions included assessing how intrinsic barriers, extrinsic barriers, administrator support, and school climate affect the use of trauma‐informed resources, as well as what barriers to and motivators of implementation teachers report. Eighty‐five teachers participated. A logistic regression model indicated that teacher‐administrator relationships (B = 0.77, p = .016) and intrinsic barriers (B = −0.84, p = .002), were predictive of resource use. Open‐ended responses revealed barriers to teacher resource use that included lack of time and district problems. Teachers reported being motivated to use resources based on their concern for the well‐being of students and themselves. Results indicate a myriad of extrinsic and intrinsic barriers making it difficult for teachers to use resources despite their motivation to support themselves and their students, and have implications for rethinking the way that teachers are expected to operate within the school system.

Flu Shots Unveiled: A Global Systematic Review of Healthcare Providers' Uptake of, Perceptions, and Attitudes toward Influenza Vaccination.

Influenza, with its potential for widespread transmission and significant health repercussions for individuals and populations, demands the immediate implementation of effective preventive measures. Vaccination stands as a long-standing evidence-based strategic approach to bolster immunity, especially for healthcare providers at heightened risk due to repeated exposure. Nevertheless, studies indicate a variance in adherence to recommended vaccination protocols and a notable prevalence of hesitancy and negative attitudes toward influenza vaccination among this critical group globally. Recognizing the multifaceted nature of attitudes is essential for the development of targeted interventions and strategies tailored to address the specific concerns and motivations of healthcare providers. To this end, this study synthesized the evidence gathered from an exhaustive systematic review of studies on healthcare providers' uptake of and perceptions and attitudes toward influenza vaccination. A systematic literature search was conducted across the databases PubMed, CINAHL, PsycINFO, Scopus, Web of Science, and EMBASE. The review adhered to PRISMA guidelines, using Covidence for screening. The process involved 4970 references, with 2684 screened after duplicate removals and 1891 excluded, leaving 793 full texts evaluated, resulting in a final 368 selected references for analysis. Due to the considerable heterogeneity observed among the studies, a narrative synthesis method was employed. Five themes emerged from the systematic review's analysis, offering a multifaceted perspective on healthcare providers' attitudes toward influenza vaccination: (1) fostering positive views: factors promoting attitudes toward influenza vaccines; (2) navigating hesitancy: barriers and challenges to attitudes on influenza vaccines; (3) empowering change: interventions and their impact on healthcare providers' attitudes; (4) pandemic overlap: intersecting attitudes toward influenza and COVID-19 vaccines; and (5) twin challenges: the impact of mandatory policy on attitudes and influenza vaccination. Healthcare providers' attitudes toward influenza vaccination are complex and influenced by intrinsic and extrinsic motivations, barriers, demographics, organizational factors, interventions, pandemic contexts, and policy considerations. Effective strategies for promoting influenza vaccination should be multifaceted, adaptable, and tailored to address these interconnected aspects, ultimately contributing to improved vaccination rates and public health outcomes.

UK Nurses Delivering Physical Activity Advice: What Are the Challenges and Possible Solutions? A Qualitative Study

There are a multitude of health benefits gained from regular physical activity (PA). Currently, PA advice implementation from NHS nurses is inadequate despite their ever-increasing role in lifestyle and preventive medicine. By assessing their knowledge of current PA guidance, this study proposed to investigate the issues with regular PA advice being given and expand upon nurses’ proposed barriers and solutions. A qualitative approach using semi structured interviews was undertaken between March and August 2023 involving 13 NHS nurses. Thematic analysis was undertaken using Braun and Clarke’s six step approach. Four themes and fifteen subthemes emerged as barriers and solutions in delivering PA advice. Intrinsic barriers included a lack of nurse knowledge on the topic and PA being seen as an afterthought. Extrinsic barriers included time pressures and a lack of staff engagement. Solutions involved increasing staff awareness of guidelines through teaching, policy, encouraging staff to be active and optimising PA advice delivery through a piecemeal approach and utilising online and visual resources. This study displayed an insight into nurses’ thoughts on their consultations with patients regarding PA, and proposed several barriers and solutions. Further work is needed to improve nurses’ PA knowledge and to assess the proposed strategies to improve its delivery.

Exploring Perceived Barriers to Physical Activity among Older Adults Living in Low-Population Density Regions: Gender Differences and Associations with Activity Dimensions.

Older people in low-population density regions tend to have fewer resources to engage in regular physical activity (PA) compared to their counterparts in urban areas. Moreover, PA assumes different dimensions, and the amount of PA related to each dimension may differ between women and men, predisposing them to different PA practices. Therefore, this cross-sectional study aims to describe the prevalence of barriers to PA, gender differences, and their associations with different PA dimensions. A total of 259 older adults (153 women and 106 men; age, 75.17 ± 8.05 years old) living in the community in the region of Guarda (Portugal) were interviewed face to face to record their sociodemographic characteristics, general health status (comorbidity index and self-reported health), PA behaviour, and barriers to PA. Women were more likely to report "low" income and living alone (p ≤ 0.05), while men reported a higher negative health status than women (p < 0.05). Two intrinsic ("Fear of injury" (40.1%) and "Need for rest" (26.3%)) and two extrinsic barriers ("Lack of nearby facilities" (30.5%) and "I don't have transport" (25.6%)) were the most prevalent. For women, age, self-reported health, comorbidity index, and intrinsic and extrinsic barriers were similarly associated with the different PA dimensions. However, only self-reported health and extrinsic barriers were the variables associated with the different PA dimensions in men. Therefore, strategies to promote active ageing in low-population density regions should be focused on reducing intrinsic and extrinsic barriers based on gender and the PA dimension to be achieved.

Knowledge, familiarity, and impact of the COVID-19 pandemic on barriers to seeking mental health services among older people: a cross-sectional study.

The COVID-19 pandemic caused drastic changes in older people's daily activities with a negative impact on their mental health, yet older people are less likely to seek mental health services. This study aims to explore the relationship between knowledge of and familiarity with mental health services, along with the impact of the COVID-19 pandemic, and barriers to seeking mental health services among older people. A descriptive cross-sectional study was conducted with a convenience sample of 352 older people, recruited among community-dwelling adults who attended randomly selected postal offices and pension outlets. Three tools were used: a structured interview schedule for sociodemographic and clinical characteristics of older people, the revised version of the Knowledge and Familiarity of Mental Health Services Scale (KFFMHS-R), and the Barriers to Mental Health Services Scale Revised (BMHSS-R). All participants reported experiencing mental health distress during the COVID-19 pandemic. Intrinsic barriers had a higher mean score than extrinsic barriers, and 27.4% of the variance of overall barriers to seeking mental health could be explained through regression analysis by familiarity, knowledge of mental health services, and age. Overall barriers explained 24.4% of the variance of older people's perceived distress as an impact of the COVID-19 pandemic (F = 22.160, P < 0.001). Knowledge of mental health services was the most significant predictor of barriers to seeking mental health services during the COVID-19 pandemic. Higher barriers predicted higher distress as an impact of the COVID-19 pandemic. The results of the study suggest the need for a multidisciplinary mental health team for older people.

The Lived Experience of Persons with Spinal Cord Injuries Engaging in Remote Work: A South African Perspective.

In South Africa, traumatic SCI cases are disproportionately high in comparison to other countries. Low retention and maintenance of work for persons with SCIs are further exasperated by structural barriers and societal stigma. Persons with SCIs have the ability to contribute to the labour market, and doing so could lead to the improvement of their quality of life and socioeconomic status. Addressing engagement in work as a meaningful occupation for persons with SCIs is essential to mitigate occupational risk factor and uphold occupational justice. Currently, there is a paucity of literature on remote work practices for persons with SCIs. This study seeks to add to this body of knowledge to increase occupational therapists' awareness of the possibility of remote work to facilitate the inclusion of persons with SCIs in the open labour market. This phenomenological study explored the facilitators and barriers of engaging in remote work in the open labour market for paid employment, as experienced by persons with SCI within the Gauteng metropole, South Africa. Data was collected via semistructured interviews from four participants and analysed thematically. Four themes were generated from the data: (1) intrinsic facilitators of remote work, (2) extrinsic facilitators of remote work, (3) intrinsic barriers to remote work, and (4) extrinsic barriers to remote work. Remote work can be utilised to include persons with SCIs in their chosen occupation of work and is a holistic and client-centred approach. Remote work should not be seen as the sole method of inclusion but can also be used in conjunction with traditional office work to accommodate persons with SCIs in the workplace.