Therapy Sessions Research Articles

Self-reported problems and functional difficulties in anxious pregnant women in Pakistan: The use of a patient-generated mental health outcome measure.

Anxiety during pregnancy affects women worldwide and is highly prevalent in Pakistan. The Psychological Outcome Profiles (PSYCHLOPS) questionnaire is an instrument used in therapy to assess patient-generated problems and the consequent functional difficulties. Using the PSYCHLOPS, we aimed to describe the type of problems and the consequent functional difficulties faced by anxious pregnant women in Pakistan. Secondarily, we sought to explore if a cognitive behavioral therapy (CBT)-based intervention brought about changes in the severity score for certain problems or functional difficulties. Anxious pregnant women were recruited from the Obstetrics/Gynecology Department of a tertiary hospital in Rawalpindi, Pakistan. Of 600 pregnant women randomized to receive a psychosocial intervention for prenatal anxiety delivered by non-specialist providers, 450 received ≥1 intervention session and were administered the PSYCHLOPS. Eight types of problems were identified; worries about the unborn baby's health and development (23%), concerns about family members (13%), and financial constraints (12%) were the most frequently reported primary problems. Severity scores between baseline and the last available therapy session indicated the largest decrease for relationship problems (mean = 2.4) and for concerns about family members (mean = 2.2). For functional difficulties, 45% of the participants reported difficulties in performing household chores, but the intervention showed the greatest decrease in severity scores for mental or emotional functional difficulties. Focus on certain types of patient-generated problems, e.g., relationship problems, could anchor therapy delivery in order to have the greatest impact. Tailored CBT-based intervention sessions have the potential to address important but neglected problems and functional difficulties in anxious pregnant women.

New Hyperacusis Therapy Combines Psychoeducation, Sound Exposure, and Counseling.

The aim of this study was to investigate the short- and long-term effects of a new cognitive sound exposure therapy (CSET) in patients with hyperacusis. A new therapy was developed to reduce hyperacusis using sound exposure combined with breathing and relaxation strategies from both acceptance and commitment therapy and cognitive behavioral therapy. Patients who were referred to the Speech and Hearing Centers located in Hengelo and Zwolle in the Netherlands and aged ≥ 18 years with hyperacusis as main complaint and no or mild hearing loss were included in this study. Patients were seen for CSET between June 2020 and August 2022. The sessions took place biweekly. Sessions ended when exposure reached a level with a maximum of 70-80 dB SPL. Short-term effects between the start and the end of therapy were based on tolerable level of sound exposure (dB SPL), subjective-level hinderance of hyperacusis, and sensitivity to sound using the Hyperacusis Questionnaire (HQ). The long-term effect was based on HQ 6 months after the end of therapy. Linear mixed-effects and regression models were applied to study outcomes over time. In total, 30 patients, 15 men and 15 women, aged between 24 and 76 years were included in this study. The mean number of sessions during therapy was 6 and ranged between 4 and 8. Results showed an increase of exposure level (mean change was +23.7 dB with an SD of 7.9, p < .001), a decrease in sensitivity to daily sounds (mean [SD] change was -1.6 [2.1], p < .001), and a decrease in HQ (mean [SD] change was -9.8 [4.9], p < .001), between the start and the end of therapy. There was no significant change in HQ after the end of therapy and 6 months later; mean (SD) change was 0.2 (4.3), p = .81. The evaluation of CSET indicated a decrease in short- and long-term sensitivity to sound in patients with hyperacusis. Additionally, CSET has shown a positive impact, not only for the sounds used in the therapy sessions but also in transferring benefits to everyday sounds. The results of combining psychoeducation, sound exposure, and counseling are promising and warrant further evaluation.

Effect of Cognitive-Behavioral Therapy-Based Anger Management Training on Anger and Aggression Levels of Individuals Convicted of Violent Crimes.

To determine the effect of cognitive-behavioral therapy (CBT)-based anger management training on anger and aggression levels of individuals convicted of violent crimes. This study was a randomized controlled trial conducted in a prison. Seventy-two individuals who met inclusion criteria were included in the study sample. The experimental group received 10 sessions of CBT-based anger management therapy over a 5-week period. After CBT-based anger management training, mean total score and mean subdimension scores of the Trait Anger and Anger Expression Style Scale of the experimental group decreased significantly compared to the control group. Similarly, Buss-Perry Aggression Questionnaire total mean score and mean sub-dimension scores of the experimental group significantly decreased compared to the control group. Results demonstrate that CBT-based anger management training effectively reduces anger and aggression levels among individuals convicted of violent crimes. In this regard, it is recommended that forensic psychiatric-mental health nurses, physicians, and psychologists working in correctional institutions apply CBT-based anger management training. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Feasibility and preliminary efficacy of behavioral activation for treatment of depression in autistic adolescents.

Depression is common among autistic youth and has a significant negative impact on quality of life and day-to-day functioning. Despite great need for efficacious treatments, there are currently limited research-supported interventions for depression symptoms in autistic young people. This study tested a novel, behavior-based approach or psychotherapy for treatment of depression symptoms in autistic adolescents without intellectual disability (i.e. Behavioral Activation for Autistic Adolescents, BA-A) with 15 youth (11-16 years old). BA-A is an individually delivered 12-session therapy that was developed for and to meet the needs of autistic youth with depression. Results found that autistic youth and their caregivers were able to participate in BA-A therapy sessions, and clinicians were able to deliver BA-A in accordance with the treatment manual. Notably, results demonstrated that autistic youth depression symptoms significantly improved after participating in BA-A. Furthermore, anxiety symptoms and social skills significantly improved following BA-A.

Grief and Sexual Intimacy: Exploring Therapists’ Views of Bereaved Clients

The interaction between sexual intimacy and grief remains unexplored despite its potential to offer valuable insights into how individuals, couples, and society perspectives shape bereaved individuals’ sexual intimacy. Through semi-structured interviews with ten clinical psychologists and psychotherapists specialized in grief therapy, this study explores the impact of grief on sexual intimacy, the challenges faced by bereaved individuals, and the role of sexual intimacy in the grieving process. The study also investigates therapists’ approaches to addressing sexual intimacy within grief therapy sessions. Findings reveal that grief often disrupts sexual intimacy, affecting individuals’ ability to engage emotionally and physically with their partners. Factors such as secondary loss, emotional availability, traumatic experiences, and the nature of the loss contribute to difficulties in resuming sexual intimacy. Nevertheless, the helpful role of sexual intimacy in grief was also highlighted. Therapists note the significance of communication, mutual empathy, and understanding in overcoming these challenges, advocating for therapy to address these issues comprehensively. Moreover, therapist-related, client-related, and shared factors hindering the exploration of sexual intimacy in grief therapy were identified. Strategies for managing these challenges include normalizing discussions around sexual intimacy and death, integrating systemic approaches into therapy, and providing training in sexuality or sexual therapy for grief therapists. Overall, this study underscores the importance of recognizing and addressing the interplay between sexual intimacy and grief to support bereaved individuals effectively. Insights from therapists shed light on potential avenues for enhancing clinical interventions and fostering awareness of the complex dynamics surrounding bereavement and sexuality.

Assessment of the Effectiveness and Safety of Wheelchair Use Training for Patients with Hemiparesis

INTRODUCTION. The rationale of the research is defined by the large number of patients with hemiparesis, unable to restore an upright posture and in need of training to use a wheelchair. AIM. To present the methodology of wheelchair training of patients with hemiparesis. MATERIALS AND METHODS. We observed 30 patients with severe hemiparesis during wheelchair training. Examination included assessment of clinical, neurological, and mental status (MMSE — Mini-Mental State Examination), testing of limb muscle strength according to Lovett’s scale modified by L.D. Potekhin, level of sitting function compensation assessment, wheelchair skills (Wheelchair Skills Test). Each patient attended 10 wheelchair training sessions and related physical therapy (PT) sessions, with PT classes preceding the wheelchair training sessions and practicing the wheelchair-using movements required in the wheelchair training sessions. Patients controlled the wheelchair using only healthy limbs. RESULTS. At the moment of admission, 14 patients were not able to use wheelchair independently; 16 patients were able to use wheelchair to varying degrees. As a result of the sessions, the muscle strength of healthy limbs increased; statistically significant improvement in sitting and wheelchair skills was noted. None of the patients who scored 10 for MMSE test improved their wheelchair skills. CONCLUSION. Persons with severe hemiparesis learn to use the wheelchair with the help of healthy limbs. Physical therapy sessions precede wheelchair training and form the movements necessary for learning to use the wheelchair.

Sociodemographic Characteristics and Clinical Profile of Inpatients in the Psychiatry Unit of a Tertiary Care Hospital in Assam: A Retrospective Study

Objectives Recent years have seen a significant evolution in the understanding pertaining to mental health issues. The analysis of the intricate interplay between an individual’s sociodemographic factors, genetic makeup, the environment, and clinical profile (diagnosis and treatment) of patients will help us understand the prevalence and types of mental health disorders prevalent in Assam, which is a culturally, ethnically and socially diverse state. The pattern of utilization of electroconvulsive therapy has also been analyzed. The aims and objectives of the study is to analyze the sociodemographic characteristics and clinical profile of patients admitted in Psychiatry ward, Assam Medical College and Hospital. Material and Methods An analysis on the case records of all individuals admitted to the hospital’s Psychiatry ward between August 1, 2022 and July 31, 2023 was done. Data on socio-demographic details such as age, gender, domicile and clinical profile (diagnosis, mode of discharge, duration of stay and treatment) was compiled using semi-structured format designed by authors. Information regarding patients undergoing electroconvulsive therapy was also gathered from the records. Statistical analysis: The data were subjected to analysis utilizing the Statistical Package for Social Sciences (IBM SPSS Statistics for Windows, version 25.0). Results A total of 680 patients got admitted of which higher proportion constituted of male (77.58%) and majority individuals were aged between 30 and 39 years (29.65%). The predominant diagnosis among the inpatients was substance use disorders (39.09%). Out of all the psychotropic drugs, olanzapine (17.94%) was mostly prescribed on discharged followed by risperidone (10.15%). Escitalopram (3.97%) was the mostly prescribed antidepressant on discharge. Patients diagnosed as substance use disorders were mostly discharged on lorazepam (5%), baclofen (14.26%) and received an average number of 1.8 sessions of Motivational Enhancement Therapy (MET). Whereas, schizophrenia and related disorders was the most common diagnosis among inpatients receiving ECT (51.52%). Conclusion Our study helped to understand the socio-demographic attributes and clinical profile of the inpatients to foster better management approaches.

Influence of Music Therapy on the Improvement of Perceived Well-Being Indices in Women with Breast Cancer Undergoing Hormonal Treatment

ABSTRACT Background Although there are a growing number of studies investigating the benefits of music therapy interventions with patients diagnosed with cancer, few studies have taken an approach that specifically examines indices of perceived well-being in women with breast cancer. Overcoming these challenges can be an important step in the recovery process. Purpose The purpose of our study was to know the positive influence of responsive music therapy through gong sounds, emitted live, on different areas of well-being of women with breast cancer. Methods Four individual sessions of responsive music therapy with live gong sounds were conducted in which three women (M = 54; SD = 5.57) participated both in the music therapy program and in the completion of the Functional Assessment of Cancer Therapy – Breast (FACT-B) and a semi-structured interview with ad hoc designed questions about perception of qualitative aspects. Results The results showed that the music therapy sessions significantly improved, p = .043 < 0.05, various domains of perceived well-being in women with breast cancer. Discussion This article highlights several key benefits associated with music therapy and various indices of well-being in women with breast cancer, identifies the limitations of the study, and discusses the findings. It is considered necessary to replicate this practice in future studies that include a larger sample and age range over longer follow-up periods. Translation for Health Education Practice The text highlights the importance of considering music therapy as a complementary intervention in comprehensive cancer care programs, which may be relevant to health educators when considering intervention and support approaches for cancer patients. Health education interventions targeting the enhancement of cancer patients’ well-being should incorporate music therapy techniques.

Solution Focused Trifecta: A Guide to Being Solution Focused. Workbook for School Counsellors by Joe George

Joe George’s workbook on the Solution Focused model is easy-to-read, thoughtful and concise. Geared towards school counsellors and conversations that might be shorter than a standard therapy session, it supports an informal SF model well attuned to school environments, making it equally easily to co-construct both quick hallway conversations with students or contacts with colleagues and families.

Group Size: An Active Ingredient of School-Based Language Therapy.

This study explored the relation between therapy group size and language outcomes for children receiving school-based language therapy through an implementation science lens. Data for the current study were gathered as part of the Speech-Language Therapy Experiences in Public Schools study. Participants included 273 English-speaking kindergarten through second-grade children with language impairment receiving business-as-usual therapy on the caseloads of 75 speech-language pathologists. Data were collected over an academic year, including weekly therapy logs, speech-language pathology questionnaires, and pre- and post-language measures. Descriptive analysis revealed that children primarily experienced small-group therapy sessions (two to four children); however, there was considerable variability in group size. Hierarchical general linear modeling indicated that caseload size did not explain group size variability. However, the number of student cancellations was positively associated with receipt of large-group sessions. Notably, a significant negative association was found between receipt of large-group sessions (i.e., five to 10 children) and language outcomes. Children who received more than the average number of sessions in large groups (i.e., more than 5% of total sessions) experienced 0.18 SD less language gain over the academic year compared to the mean (0.54 SD). No other group size configurations (i.e., individual, small group, and extra large) yielded significant associations with language outcomes. The findings suggest that young children receiving language-based therapy in large groups make substantially fewer language gains over an academic year. These results have considerable implications for educational policy and clinical practice, which are discussed through an implementation science frame.

Mobilization with Femoral Catheters in the Burn ICU: A retrospective review following change in practice guidelines.

Femoral catheters are a known barrier for Burn ICU mobility progression due to the anatomical location and potential risk of complications. The purpose of this study was to examine outcomes and complication rates following implementation of femoral catheter mobilization guidelines, as well as determine safety and feasibility of mobilization with femoral catheters in place within the burn population. Retrospective review was completed on 17 patients prior to and following implementation of new femoral catheter mobility guidelines, 34 patients total. Burn therapy notes were reviewed for burn admissions with at least one femoral catheter in place, including arterial, central, and dialysis catheters. Demographic data, admission statistics, line placement timelines, and active mobility achieved during therapy sessions were recorded for both the non-mobilization (NMG) and mobilization groups (MG). The 34 patients reviewed had 99 total lines placed (30 NMG, 69 MG). Change in mobility protocols for the MG resulted in more therapy sessions (n=516 vs 281) and a significant increase in active mobility sessions (n=83 vs 5, p < 0.001), including 146 total mobility activities such as transitions to chairs, tilt table, sitting edge of bed (EOB), standing, active chair transfers, ambulation, and cycle ergometry. No catheter associated adverse events occurred during active mobility sessions and no complications were associated with participation in mobility. This study supports that the presence of femoral catheters alone should not limit the progression of mobility interventions. Using clinical judgement and specialty training, burn therapists can safely mobilize burn ICU patients with femoral catheters in place.

Conceptual Model of Effective Parenting Strategies for Mother with Children Who Experience Developmental Disorders

Aim Prior studies on Japanese parents raising children with developmental disorders have predominantly emphasized negative psychological aspects like parenting conflicts and challenges. Purpose of this study was to construct a conceptual model to aid mothers in parenting children with developmental disorders by identifying effective parenting strategies. Methods In this qualitative study, participants were mothers who engaged in a home program through individual outpatient occupational therapy. Therapy sessions occurred biweekly, totaling 12 sessions, each lasting 40 min. Data collection involved semi-structured interviews, and the data were analyzed through the Modified Grounded Theory Approach. Results Analysis of mothers’ narratives revealed heightened physical burden, psychological distress, severe stress, and social isolation. Our findings highlight those mothers who engaged in the home program navigated the intricate parenting landscape through problem-solving, including managing negative emotions, their demanding schedules, and societal norms. Conclusion This study offers insights into the perceptions, experiences, and behaviors of families in supporting the development of parenting strategies within the family. Occupational therapy should prioritize evaluating a mother’s parenting context and her interactions with her environment. Furthermore, it is crucial to provide support for her to independently formulate suitable parenting strategies that resonate with the specific circumstances of her family.

Recognizing Sign Language using Machine Learning and Deep Learning Models

Individuals with hearing impairments communicate mostly through sign language. Our goal was to create an American Sign Language recognition dataset and utilize it in a neural network-based machine learning model that can interpret hand gestures and positions into natural language. In our study, we incorporated the SVM, CNN and Resnet-18 models to enhance predictability when interpreting ASL signs through this new dataset, which includes provisions such as lighting and distance limitations. Our research also features comparison results between all the other models implemented under invariant conditions versus those using our proposed CNN model. As demonstrated by its high levels of precision at 95.10% despite changes encountered during testing procedures like varying data sets or scene configurations where losses are minimal (0.545), there exists great potential for future applications in image recognition systems requiring deep learning techniques. Furthermore, these advancements may lead to significant improvements within various fields related explicitly to speech-language therapy sessions designed specifically around helping people overcome challenges associated with deafness while building bridges towards improved social integration opportunities.

Forest Therapy Research in Europe: A Scoping Review of the Scientific Literature

This scoping review aims to outline key discoveries, gaps in knowledge, and potential future directions in the field of forest therapy research in Europe. Clinical studies investigating the effects of forest therapy sessions in Europe were systematically screened through PubMed, Embase, Cochrane Library, the Directory of Open Access Journals (DOAJ), and Google Scholar (search date: January 2024). This review encompasses 26 selected studies, collectively engaging 2775 participants across various European countries, including Italy, Poland, Spain, Germany, Finland, Hungary, Sweden, Iceland, and Switzerland. These studies predominantly measured psychological outcomes such as mood states, affect, attention levels, subjective wellbeing, and quality of life. Additionally, physiological assessments were conducted, covering vital signs, salivary cortisol, body composition, and blood count. Notably, most of the investigation sites were covered by evergreen forests. Forest therapy practices in Europe demonstrated significant benefits in psychological aspects, including relaxation, mood enhancement, and improved wellbeing, accompanied by physiological improvements, particularly in asthma patients. While a fair-to-good methodological quality was identified in randomized controlled trials, the acknowledged weaknesses point towards a need for more rigorous and standardized research approaches. In conclusion, this comprehensive scoping review provides valuable insights into the current landscape of forest therapy research in Europe, highlighting its potential to positively impact both physical and mental wellbeing. The findings underscore the need for further research addressing methodological limitations and exploring gaps in understanding, thereby contributing to the continued advancement of forest therapy as a holistic wellbeing intervention within the European context.

The potential value of brief waitlist interventions in enhancing treatment retention and outcomes: a randomised controlled trial

ABSTRACT People with eating disorders are often placed on lengthy waitlists for treatment. This is problematic, as increased time spent on waitlists has been shown to predict dropout. We examined whether providing brief interventions to people on a waitlist improved retention or outcomes in treatment. Participants (N = 85) were referred to a university training clinic for 10-session cognitive behavioural therapy for non-underweight patients with eating disorders (CBT-T). While waitlisted for CBT-T, participants were randomised to one of two waitlist interventions or a control condition. In one waitlist intervention (CRT-Brief), participants received a cognitive remediation therapy session at the start of the waitlist period. In the other waitlist intervention (brief contact), participants were sent a short supportive email and psychoeducation halfway through the waitlist period. The control condition was waitlist as usual. There was no evidence to suggest that the waitlist interventions improved symptoms during the waitlist period or CBT-T. However, participants who received a waitlist intervention were three times more likely to complete treatment. The present study suggests that providing even brief contact while people are waitlisted for eating disorder treatment significantly improves retention. However, replication in a more adequately powered study is required.

Algorithm-based modular psychotherapy vs. cognitive-behavioral therapy for patients with depression, psychiatric comorbidities and early trauma: a proof-of-concept randomized controlled trial.

Effect sizes of psychotherapies currently stagnate at a low-to-moderate level. Personalizing psychotherapy by algorithm-based modular procedures promisesimproved outcomes, greater flexibility, and a better fit between research and practice. However, evidence for the feasibility and efficacy of modular-based psychotherapy, using a personalized treatment algorithm, is lacking. This proof-of-concept randomized controlled trial was conducted in 70 adult outpatients with a primary DSM-5 diagnosis of major depressive disorder, a score higher than 18 on the 24-item Hamilton Rating Scale for Depression (HRSD-24), at least one comorbid psychiatric diagnosis according to the Structured Clinical Interview for DSM-5 (SCID-5), a history of at least "moderate to severe" childhood maltreatment on at least one domain of the Childhood Trauma Questionnaire (CTQ), and exceeding the cut-off value on at least one of three measures of early trauma-related transdiagnostic mechanisms: the Rejection Sensitivity Questionnaire (RSQ), the Interpersonal Reactivity Index (IRI), and the Difficulties in Emotion Regulation Scale-16 (DERS-16). Patients were randomized to 20 sessions of either standard cognitive-behavioral therapy alone (CBT) or CBT plus transdiagnostic modules according to a mechanism-based treatment algorithm (MoBa), over 16 weeks. We aimed to assess the feasibility of MoBa, and to compare MoBa vs. CBT with respect to participants' and therapists' overall satisfaction and ratings of therapeutic alliance (using the Working Alliance Inventory - Short Revised, WAI-SR), efficacy, impact on early trauma-related transdiagnostic mechanisms, and safety. The primary outcome for efficacy was the HRSD-24 score at post-treatment. Secondary outcomes included, among others, the rate of response (defined as a reduction of the HRSD-24 score by at least 50% from baseline and a score <16 at post-treatment), the rate of remission (defined as a HRSD-24 score ≤8 at post-treatment), and improvements in early trauma-related mechanisms of social threat response, hyperarousal, and social processes/empathy. We found no difficulties in the selection of the transdiagnostic modules in the individual patients, applying the above-mentioned cut-offs, and in the implementation of MoBa. Both participants and therapists reported higher overall satisfaction and had higher WAI-SR ratings with MoBa than CBT. Both approaches led to major reductions of depressive symptoms at post-treatment, with a non-significant superiority of MoBa over CBT. Patients randomized to MoBa were nearly three times as likely to experience remission at the end of therapy (29.4% vs. 11.4%; odds ratio, OR = 3.2, 95% CI: 0.9-11.6). Among mechanism-based outcomes, MoBa patients showed a significantly higher post-treatment effect on social processes/empathy (p<0.05) compared to CBT patients, who presented an exacerbation on this domain at post-treatment. Substantially less adverse events were reported for MoBa compared to CBT. These results suggest the feasibility and acceptability of an algorithm-based modular psychotherapy complementing CBT in depressed patients with psychiatric comorbidities and early trauma. While initial evidence of efficacy was observed, potential clinical advantages and interindividual heterogeneity in treatment outcomes will have to be investigated in fully powered confirmation trials.

Providing Cognitive Remediation Therapy to People with Schizophrenia: Results of a Survey in Psychiatric Clinics in Germany

Schizophrenia is accompanied by significant cognitive impairments, which often persist to a relevant extent after remission of clinical symptoms and has a negative impact on psychosocial functioning. These impairments are often experienced as very stressful by those affected. Under the umbrella term of Cognitive Remediation Therapy (CRT), evidence-based therapy options are available that improve both the respective cognitive target functions and the psychosocial functioning. According to expert recommendations, at least 20 sessions should be carried out, accompanied by qualified therapeutic staff. The current edition of the S3 treatment guideline schizophrenia of the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology recommends CRT with the highest level of recommendation. It is unclear to what extent CRT has become part of routine inpatient care. Between July 2021 and May 2022, 395 psychiatric university hospitals and non-university psychiatric specialist hospitals in Germany were invited to fill in a 14-item questionnaire. A total of 103 institutions took part in the survey; 56.3% of these hospitals used at least one evidence-based CRT programme. Among the CRT programmes used, Cogpack, Rehacom and the Integriertes Psychologisches Therapieprogramm (IPT) were named most frequently. In 87.5% of the participating facilities, fewer than half of the people with schizophrenia received CRT. With regard to the clinics which used evidence-based CRT, 64.3% carried out fewer than 11 therapy sessions, 28.6% between 11 and 20 sessions and 7.2% more than 20 sessions. It is thus clear that CRT is not yet offered in all of the participating psychiatric hospitals in Germany, not yet for all people with schizophrenia, and not yet with sufficient intensity, with clinics indicating the need for more technical and personnel resources and more extensive development of competencies for CRT application.The low response rate of 26.1% and possible selection effects for participation in the study are addressed and are to be seen as limitations.

Fostering the discussion of planetary health in occupational therapy and physiotherapy.

Occupational therapists and physiotherapists aim to promote health, prevent various diseases and help people in their rehabilitation processes. So far, there is a paucity of understanding of the big picture of how the new paradigm of planetary health (PH) is connected to the education and practice of these professionals. This research aimed to address this gap by investigating and deploying a bibliometric analysis to elucidate the pivotal role of occupational therapists and physiotherapists in addressing PH challenges. The ultimate goal is to construct a comprehensive framework crosschecking the bibliometric analysis and the collection of 10 case studies selected by experts to outline how best practices in occupational therapy and physiotherapy, related to the three pillars of sustainability and the UN's Sustainable Development Goals (SDGs), can contribute to increasing PH. The bibliometric analysis revealed four major research strands: 1) enhancing patient care and quality of life; 2) integrating sustainability in health care and rehabilitation; 3) professional development and clinical competence; and 4) evidence-based practice and quality improvement. Moreover, further temporal analysis revealed how the topic evolved, from advancing evidence-based practice and clinical effectiveness, exploring the strengthening of health care and person-centred practices, to connecting the topic to aspects also predicted by the SDGs, such as integrating environmental and climate concerns in therapy and addressing psychological and self-care impacts on health. The case studies confirmed this trend, and a framework of PH in occupational therapy and physiotherapy through the lens of the SDGs was developed to support future research and practitioners in advancing this research field. Occupational therapists and physiotherapists are essential players in public health and can integrate sustainability at every level of practice, from using resources during therapy sessions to advocating for more sustainable lifestyles.

Designing a Dementia Caregiver-Centered Recommendation and Context-Aware AI Media Analytical Application: A Comprehensive System Requirements Analysis

During technology-assisted reminiscence therapy sessions, caregivers need to quickly assess and select suitable multimedia content to elicit positive memories and emotions in the participating person or persons living with dementia. Especially when relying on online content, caregivers encounter difficulties in identifying dementia-friendly media items due to the large number of search results and the uncertainty about dementia-related selection criteria (e.g., visual and thematic composition). This study seeks to develop an AI-based recommendation and media analysis application for reminiscence therapy by presenting participatory co-design results and outlines caregiver-driven application requirements. Collaborating with n = 14 caregivers from three care facilities, we defined user needs based on our initial definition of the minimum viable components that emerged from previous studies and from the research undertaken as part of this study, including profiling, media search, media storage, media rating, AI-based media analysis, and a recommendation system. Our main findings result in system requirements that correspond to the practical implementation of dementia friendly, digital media-based reminiscence sessions in daily practice. These findings also aid future research and the design of similar applications, benefiting researchers and developers.

Treatment of orthostatic hypotension during acute inpatient rehabilitation after spinal cord injury: usual care versus anti-hypotensive therapy.

To compare pharmacological treatment of hypotension and orthostatic hypotension (OH) initiated based upon a blood pressure (BP) threshold, regardless of symptoms (TXT), to usual care pharmacological treatment of symptomatic hypotension (UC), during acute inpatient rehabilitation (AIR) following spinal cord injury (SCI). Block randomization, based on the neurological level of injury as: cervical lesions (C1-C8); high thoracic lesions (T1-T5) and low thoracic lesions (T6-T12), was used to determine responses to the primary question "was the therapy session affected by low BP or concern for low BP development?". Study participants and therapists were unaware of group assignment. A total of 66 participants enrolled; 25 (38%) in the TXT group, 29 (44%) in the UC group, and 12 (18%) withdrew. Responses to the primary question were recorded for 32 participants, 15 in the TXT and 17 in the UC group. There was an average of 81±51 therapy sessions/participant in the TXT and 60±27 sessions/participant in the UC group. Of those therapy sessions, low BP or concerns for low BP affected an average of 9±8 sessions/participant in the TXT group and 10±12 sessions/participant in the UC group. Neither the total number of therapy sessions (p=0.16) nor group assignment (p=0.83) significantly predicted the number of sessions affected by low BP. These data are not conclusive but indicate that the treatment of asymptomatic hypotension and OH does not increase time spent in therapy compared to usual care treatment of symptomatic hypotension and OH in newly injured patients with SCI.