Looking Forward and Looking Back: Older Adults' Views of the Impacts of Stopping Driving.

This project aimed to identify the impact of driving cessation from the perspectives of older drivers and former drivers. Participants included 17 adults aged 65-88 years residing in a city in Northwestern Ontario, Canada. Using a semi-structured interview guide (with questions regarding mobility, personal impact, impact on others, engagement with life, and finances), two focus groups were held with nine current drivers, and one-on-one interviews were held with six former drivers and two current drivers.

Narcotherapy in the treatment of post-traumatic stress disorders: a report of two cases.

The history of narcotherapy is outlined and reasons are given for its current obsolescence. A modified procedure and two cases in which it has been employed successfully are described. The rationale of narcotherapy and its application to the treatment of post-traumatic stress disorders are discussed and elucidated.

Using the Resident Assessment Instrument-Mental Health (RAI-MH) to determine levels of care for individuals with serious mental illness.

This paper outlines the development of an algorithm to determine appropriate levels of care (LOC) for individuals with a serious mental illness (SMI). The algorithm, drew on several domains of the Resident Assessment Instrument-Mental Health (RAI-MH) to support a statistical model that would explain a maximum of variance with the gold standard, a consensus-based global rating of required LOC. The RAI-MH model explained 67.

A comparison of client and mental health worker assessment of needs and unmet needs.

This study was set up to examine agreement on needs identified by mental health clients and their primary mental health workers. Mental health workers assessed a convenience sample of clients who completed an interview about the services they receive. Data were collected from 78 client and staff dyads regarding 11 need domains.

Renal impairment and medication use among psychogeriatric inpatients.

Objectives: To determine the prevalence of renal impairment and the dosage appropriateness of several medications for which dosing guidelines in the advent of renal impairment are available.

Method: The authors assessed the renal function and medication use of 37 psychogeriatric patients (mean age of 75 years) living in a psychiatric hospital. Renal function was determined by serum creatinine (SCr) levels and creatinine clearance (CCr) data using the Cockcroft and Gault equation.

Pilot evaluation of a mindfulness-based intervention to improve quality of life among individuals who sustained traumatic brain injuries.

Primary Objective: To examine the potential efficacy of a mindfulness-based stress reduction approach to improve quality of life in individuals who have suffered traumatic brain injuries.

Research Design: Pre-post design with drop-outs as controls.

Methods And Procedures: We recruited individuals with mild to moderate brain injuries, at least 1 year post-injury.

Current evaluation and future needs of a mental health data linkage system in a remote region: a Canadian experience.

Linking client data across care sectors and agencies is becoming essential to ensure continuity of care, evaluation, and planning of mental health services delivery. The Data Linkage System (DLS), a record-linked, client-based, mental health database in northwestern Ontario, was established in response to this need. It is a voluntary system currently used by 30 of 40 mental health programs.

The independent contribution of driver, crash, and vehicle characteristics to driver fatalities.

Several driver, crash, and vehicle characteristics may affect the fatality risk of drivers involved in crashes. To determine the independent contribution of these variables to drivers' fatality risk, we used data from single-vehicle crashes with fixed objects contained in the US Fatal Accident Reporting System. A multivariate logistic regression revealed that the odds ratio (OR) of a fatal injury increased with age, reaching 4.

Traffic-related fatalities among older drivers and passengers: past and future trends.

Purpose Of The Study: This study was initiated to forecast the number of older drivers and passengers who may be fatally injured in traffic crashes in future years.

Design And Methods: The study was based on data from the U.S.

The Zarit Burden Interview: a new short version and screening version.

Purpose: The purpose of the study was to develop a short and a screening version of the Zarit Burden Interview (ZBI) that would be suitable across diagnostic groups of cognitively impaired older adults, and that could be used for cross-sectional, longitudinal, and intervention studies.

Design And Methods: We used data from 413 caregivers of cognitively impaired older adults referred to a memory clinic. We collected information on caregiver burden with the 22-item ZBI, and information about dependence in activities of daily living (ADLs) and the frequency of problem behaviors among care recipients.

Burden in caregivers of cognitively impaired older adults living in the community: methodological issues and determinants.

Considerable burden is reported by informal caregivers of older individuals with cognitive impairment. Significant progress in the understanding of determinants of this burden has been achieved. However, further progress could be attained if we considered important methodological issues that may have limited our understanding of caregiver burden.

Comparative analysis of Native admissions and registrations to northwestern Ontario treatment facilities: hospital and community sectors.

Objective: To study Native and non-Native admissions to acute psychiatric care in the northwestern region of Ontario in 1992.

Method: To replicate a 1986 to 1987 study comparing Native to non-Native admissions to acute psychiatric care in the northwestern region of Ontario in 1992 and examine Native registrations to community mental health agencies in the first 6 months of 1993.

Results: The comparative analysis of hospital admissions revealed that: Natives are still being admitted at 33% more than the rate expected on the basis of population; depression appears to be underdiagnosed for Natives; they continue to be admitted mainly for reasons other than major psychiatric conditions; substance abuse and forensic history are commonly involved; they stay in hospital for twice as long as their non-Native control; they more often come from rural settings; and they are less likely to be followed by the outpatient service and more likely to be followed by the criminal justice system.

Record linkage in a regional mental health planning study: accuracy of unique identifiers, reliability of sociodemographics, and estimating identification error.

Assembling information about individuals over time allows health managers and researchers to describe the progression of diseases, the care history of individuals and the sequences of care episodes that potentially result in improving individuals' health status. However, current mental health statistics generally focus on sets of events rather than groups of individuals making it impossible to distinguish between two different persons being admitted and the same person being admitted twice. Accurate figures on treatment prevalence cannot be generated and multiservice users across time or across agencies will inflate the statistics used to plan needed services.

Cross-validating factors associated with discharges against medical advice.

Between six percent and 35% of psychiatric patients discharge themselves from hospital against medical advice (AMA). The discharges may prevent patients from deriving the full benefit of hospitalization and may result in rapid rehospitalization. We examined sociodemographic and clinical characteristics of 195 irregular discharges from a 237 bed psychiatric hospital over a five year period and found that AMA discharges increased over the study period to a peak of 25% in 1986.

Implications of the model of human occupation for intervention with native canadians.

The following paper provides a theoretical framework for occuaptional therapy with Native Canadians. Traditional models of care have not been entirely satisfactory with this population, as they have failed to come to terms with cultural issues and to recognize cultural stereotyping. NAtive culture is first explored, both from a traditional and a transitional standpoint, with a focus on issues which are of particular interest to occupational therapy, such as role performance, role learning, work patterns, and interpersonal patterns.