Performance Assessment of Farm Machinery for Persimmon Fruit Cultivation in a Japanese Mountainous Area

Japanese agriculture is facing a decrease in agricultural workers. Mechanization, both to save time and reduce physical input, is essential to solving this issue. Recent worldwide progress in Internet-of-things technology has enabled the application of remote-controlled and unmanned machinery in agriculture. This study was conducted in the Gojo-Yoshino mountainous region in Nara, Japan, which is famous for its persimmon cultivation. The performance of newly introduced smart agricultural machinery was studied in the field by simulating cultivation work. The results showed that the remote-control weeder, speed sprayer, and remote-control mini crawler carrier saved 90%, 75%, and 5% of weeding, spraying, and harvesting times, respectively, when compared with conventional methods. Such time savings led to an 8% decrease in the total working time spent on persimmon cultivation. In addition, using the speed sprayer showed improvement in the fruit’s quality. Results of the power assist suits did not show a time-saving effect but showed a reduction of physical burden. These results suggest that the mechanization of persimmon cultivation is efficient and labor-saving, and satisfies the need for farmers. However, the high investment costs remain an issue in extending mechanization to the region.

Assistive Technology for Promoting the Independence and the Quality of Life in Persons With Alzheimer's Disease

Persons with Alzheimer's disease (AD) may present a loss of cognitive functioning, memory impairments, communication difficulties, obstacles to perform daily activities, disorientation, and challenging behaviours. Currently, there is no cure for AD. However, there are valid treatments to alleviate AD-related symptoms and to reduce the burden on carers; for example, the effectiveness of the use of assistive technology (AT) has been seen. The aim was to provide, in this chapter, an overview of the newest empirical evidences available on the use of AT-based programs to improve the independence and the quality of life of patients with Alzheimer's disease and their caregivers. A selective literature review was carried out considering Alzheimer's, assistive technologies, dementia, quality of life, and caregivers. Empirical data demonstrated the effectiveness and the suitability of the AT interventions allowing participants to improve their quality of life, as well as to mitigate the mental and physical burden of their caregivers.

The Mental Health of Caregivers and Their Patients With Dementia During the COVID-19 Pandemic: A Systematic Review

Background: Coronavirus Disease 2019 (COVID-19) is a worldwide public health concern. It continues to spread rapidly throughout the world causing multiple physical and psychological consequences in the population. Especially, people affected by severe psychiatric or neurological diseases are highly susceptible to serious health complications not only due to the direct effect of the infection but also to the indirect effect of COVID-19 following social distancing during lockdowns and its general social consequences. Indeed, lockdown and difficulties in using the care services produced psychological consequences in caregivers such as depression, anxiety, and worsening of the quality of life which in turn affected the ability to manage patients. Our aim was to systematically review the psychological consequences of the COVID-19 lockdown in caregivers of patients with cognitive impairment and dementia and the impact on the health of their patients.Methods: A systematic literature search was conducted by searching in MEDLINE/PubMed, Scopus, and Web of Science by two independent researchers following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. Data extraction and quality assessment were also performed. Papers were screened for eligibility by abstract and then those which met inclusion criteria were included in this review.Results: The initial search returned 410 records. After the abstract screening and the inclusion/exclusion criteria were applied, 315 were excluded because they were irrelevant, 30 because they were reviews, meta-analyses, letters to editors, editorials, guidelines, or case reports, and 10 because they were duplicates. Then, 38 out of 55 abstracts/full-text articles were excluded because they did not simultaneously assess mental health of patients and caregivers. In the end, 17 papers were deemed eligible and included in the present review.Conclusion: Based on current literature, the COVID-19 pandemic and the ensuing lockdown caused severe psychological consequences for caregivers of patients with dementia, worsening their mental health, and increasing the psychological and physical burden, independently from the severity of the disease of their relatives, which resulted also independently globally worsened.

The Effect of Workload on the Performance of Nurses in the Inpatient Installation of RSUP Dr. Tadjuddin Chalid Makassar

Performance is work performance or work results in quality and quantity achieved by an employee in carrying out his duties in accordance with the responsibilities given to him. This study aims to analyze the effect of workload on the performance of nurses in the Inpatient Installation of Dr. RSUP. Tajuddin Chalid Makassar. This type of research is a quantitative research using an observational study with a cross sectional study design. Sampling used total sampling so that the sample in this study were nurses at the Inpatient Installation of Dr. RSUP. Tajuddin Chalid Makassar, totaling 73 respondents. The results showed that there was an effect of time load on the performance of nurses, there was an effect of physical burden on the performance of nurses. there is an effect of psychological pressure on the performance of nurses in the Inpatient Installation of Dr. RSUP. Tajuddin Chalid Makassar. Therefore, it is hoped that the hospital management will increase the knowledge and skills of nurses so that they are able to compensate for the difficult work through providing training, the need to improve nursing management by making SOPs, especially the division of tasks and working hours of nurses so that they can be adjusted to the nurse's workload

Caregiver Challenges Seen From the Perspective of Certified Home Hospice Medical Directors

Background: Hospice medical directors (HMDs) play an important role as part of the interdisciplinary hospice team. Family caregivers (CGs) play a critical role in caring for patients receiving home hospice care. Understanding the challenges HMDs face when working with CGs is important when addressing potential gaps in care and providing quality end of life (EoL) care for the patient/CG dyad. Objectives: To understand issues HMDs encounter when working with and caring for CGs and to determine how they manage these issues in the home hospice setting. Design: Twelve semistructured phone interviews with certified HMDs were conducted. Data were analyzed using standard qualitative methods. Subjects: Participants included certified HMDs obtained from a public website. Results: Participants’ responses regarding the major issues HMDs faced when working with CGs were categorized into 6 themes: (1) assessing CG competency, (2) CG financial burden, (3) physical burden of caregiving, (4) managing CG expectations, (5) CGs denial of patient’s terminal condition, and (6) CGs unwilling or unable to engage with providers about their needs or the patient’s needs. Conclusions: HMDs confirmed the important role CGs play in providing care to home hospice patients. Challenges faced by HMDs vary from assessing CG competency in providing care to the patient, dealing with the physical and financial toll that CGs face, and addressing CGs’ expectations of hospice care. Future studies are needed to explore solutions to these issues to better support CGs in the home setting.

Caregiving Patterns and Their Association with Caregiving Burden and Gains

Family and friend caregivers play a critical role in helping older adults live long and healthy lives. Using the construct of "care types" we examine whether caregivers providing more intense care experience higher burden and lower gain compared to caregivers providing less intense care. Data are from the 2015 and 2017 rounds of the National Study of Caregiving (N=2,146), a study of the caregivers of older adults enrolled in the National Health and Aging Trends Study. In a previous analysis, we derived five care types at baseline (2015), that varied in the number and type of care activities, care duration, and regularity of care provided. Caregivers reported whether caregiving was financially, emotionally, and physically difficult for them. Participants were also asked whether caregiving made them more confident, taught them to deal with difficult situations, brought them closer to the recipient, and gave them satisfaction that the recipient was well cared for. We estimated the association between care types derived at baseline and caregiver burden and gains at follow-up using logistic regression. Compared to caregivers in the least intense care type, those in the more intense care types were significantly more likely to report financial and physical burden, as well as increased ability to deal with difficult situations and increased satisfaction that their loved one was well cared for. These associations remained significant after adjusting for confounders. Care types can be used to predict burdens and gains experienced by caregivers and to effectively target caregiver support services and interventions.

The Association Between Parents’ Physical Function and Adult Children’s Caregiving Burden

Using data from 544 older parents-adult children Chinese American dyads, this study aims to understand the association between older parents’ physical function and their adult children’s perceived caregiving burden. Parents’ physical function was assessed by the Katz Index of Activities of Daily Living (ADL) and the Lawton Instrumental ADL (IADL), with higher scores indicating more functional limitations. Adult children’s caregiving burden was assessed in five dimensions, including time dependence, developmental, physical, social, and emotion burden. Logistic regression was used to examine the association. More ADL limitations were associated with a higher likelihood of developmental burden (OR:1.14 (1.06-1.23)) and physical burden (OR:1.14 (1.06-1.23)) burden. More IADL limitations was associated with a higher likelihood of time dependence burden (OR:1.08 (1.03-1.12)), developmental burden (OR:1.06 (1.03-1.09)), and physical burden (OR:1.08 (1.04-1.12)). Parents’ physical function was not related to children’s social and emotional burdens. Practice and research implications will be discussed.

The relationship between family and residential settings: Aging in place vs long term care facility in South Korea

Objective This study aims to explore the factors influencing long-term-care beneficiaries’ decisions between home health care and institutional care in South Korea. This study further investigated the association between these two types of long-term care services and emotional, financial, and physical burden alleviation among the beneficiaries and their family members. Methods We analyzed data from 2019 Long-Term Care Survey. Out of 5,606 respondents, 4,079 long-term care beneficiaries and family members were included in this study. Logistic regression models were conducted to understand factors associated with types of long-term care services, and the association between types of long-term care services and burden alleviation. Results Having a spouse, having children, or a shorter geographic distance between the beneficiaries and their family members were factors associated with higher likelihood of receiving home health care rather than institutional care. Also, more sever mobility limitation, outpatient care, and fall experiences were associated with higher likelihood of receiving institutional care. Utilization of institutional care was significantly associated with higher alleviation of physical burden. No significant differences between home health care and institutional care were found on emotional and financial burden alleviation. Conclusions The findings suggest that family resources may be beneficial for older adults to pursue aging in place in later life. However, the physical toll of their family members may exist. Our findings provide evidence to inform public policy decisions on long-term care services for older adults and their family members.

Need for additional professional psychosocial and spiritual support in patients with advanced diseases in the course of specialist palliative care – a longitudinal observational study

Background We investigated the need for additional professional support and associated factors in patients (pts) at initiation and in the course of in- and outpatient specialist palliative care (I-SPC/O-SPC). Methods Pts entering an urban SPC network consecutively completed questionnaires on psychosocial/spiritual problems and support needs within 72 h (T0) as well as within the first 6 weeks (T1) of SPC. Hierarchical linear regression analysis was used to investigate the impact of sociodemographic / disease-related variables, psychological / physical burden, social support, and SPC setting on the extent of support needs. Results Four hundred twenty-five pts (70 years, 48% female, 91% cancer, 67% O-SPC) answered at T0, and 167 at T1. At T0, main problems related to transportation, usual activities, and dependency (83–89%). At T1, most prevalent problems also related to transportation and usual activities and additionally to light housework (82–86%). At T0, support needs were highest for transportation, light housework, and usual activities (35–41%). Cross-sectional comparisons of SPC settings revealed higher problem scores in O-SPC compared to I-SPC at T0 (p = .039), but not at T1. Support need scores were higher in O-SPC at T0 (p < .001), but lower at T1 (p = .039). Longitudinal analyses showed a decrease of support need scores over time, independent from the SPC setting. At T0, higher distress (p = .047), anxiety/depression (p < .001), physical symptom burden (p < .001) and I-SPC (p < .001) were associated with higher support need scores (at T1: only higher distress, p = .037). Conclusion Need for additional professional psychosocial/spiritual support was identified in up to 40% of pts. with higher need at the beginning of O-SPC than of I-SPC. During SPC, this need decreased in both settings, but got lower in O-SPC than in I-SPC over time. Support need scores were not only associated with psychological, but also physical burden.

A structured exercise to relieve musculoskeletal pain caused by face-down posture after retinal surgery: a randomized controlled trial

Face-down posture after vitrectomy physically burdens patients. Despite being of significant concern for patients, the intraoperative pain and discomfort has not been of great interest to retinal surgeons or researchers. This randomized controlled trial evaluated the effect of a 3-day novel structured exercise on reducing musculoskeletal pain from the face-down posture in 61 participants (31 in the exercise group) who underwent vitrectomy. Among the subjects, the median age was 62 years, 42 were female, 42 had macular holes, and 19 had retinal detachments. Participants in the exercise group received initial education on the exercise and performed three daily active exercise sessions. After the sessions, the exercise group had median numeric pain scores of 2, 1, and 1 at the back neck, shoulder, and lower back, respectively, while the control group had corresponding scores of 5, 3, and 4, respectively. The exercise group reported significantly lower pain scores (P = .003, .039, and .006 for the back neck, shoulder, and lower back, respectively). Application of the structured exercise would alleviate the patients’ position-induced postoperative physical burden, by reducing pain and discomfort.