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Self Regulatory Driving Behaviour Perceived Abilities And Comfort Level Of Older Drivers With Parkinsons Disease Compared To Age Matched Healthy Controls
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Book Synopsis Self-regulatory Driving Behaviour, Perceived Abilities and Comfort Level of Older Drivers with Parkinson's Disease Compared to Age-matched Healthy Controls by : Alexander Michael Crizzle
Download or read book Self-regulatory Driving Behaviour, Perceived Abilities and Comfort Level of Older Drivers with Parkinson's Disease Compared to Age-matched Healthy Controls written by Alexander Michael Crizzle and published by . This book was released on 2011 with total page 224 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction: Multiple studies have shown the symptoms of Parkinson's disease (PD) can impair driving performance. Studies have also found elevated crash rates in drivers with PD, however, none have controlled for exposure or amount of driving. Although a few studies have suggested that drivers with PD may self-regulate (e.g., by reducing exposure or avoiding challenging situations), findings were based on self-report data. Studies with healthy older drivers have shown that objective driving data is more accurate than self-estimates. Purposes: The primary objectives of this study were to examine whether drivers with PD restrict their driving (exposure and patterns) relative to an age-matched control group and explore possible reasons for such restrictions: trip purposes, perceptions of driving comfort and abilities, as well as depression, disease severity and symptoms associated with PD.
Book Synopsis Selection, Optimization, and Compensation in the Self-Regulatory Driving Behaviors of Older Adults by : Erin J. Lea
Download or read book Selection, Optimization, and Compensation in the Self-Regulatory Driving Behaviors of Older Adults written by Erin J. Lea and published by . This book was released on 2010 with total page 74 pages. Available in PDF, EPUB and Kindle. Book excerpt: To combat declines in functioning, older drivers engage in selection, optimization, and compensation (SOC). Often these behaviors are either ineffective at reducing accidents or associated with negative outcomes such as depressed mood. The Compensatory Driving Behavior Scale was created to clarify self-regulatory driving behaviors related to this process. The scale yielded a five-component solution assessing Comfort, Vision Comfort, Frequency, Avoidance, and Difficulty Adapting associated with driving in challenging situations. These components demonstrated relationships with age, health, changes in driving abilities, extraversion, emotional stability, and external locus of control. Older drivers reported additional self-regulatory behaviors, including increasing attention, defensive driving, and increasing adherence to the laws. Reasons for these adaptations varied from age to concern for others. A re-conceptualization of the SOC model, focused on independence through driving rather than mobility, follows.
Book Synopsis Tactical and Strategic Adaptation of Driving in Parkinson's Disease by : Karen Alice Scally
Download or read book Tactical and Strategic Adaptation of Driving in Parkinson's Disease written by Karen Alice Scally and published by . This book was released on 2015 with total page 454 pages. Available in PDF, EPUB and Kindle. Book excerpt: Individuals with Parkinson's disease (PD) have been reported to have impairments at both the operational and tactical levels of driving behaviour. Increasingly, studies have further shown associations between impaired driving performance and deficits in frontal-executive functioning in PD. Older driver research suggests that functional impairments, which compromise driving ability, may be compensated for by adaptations to tactical and strategic driving behaviour. However, effective adaptation of tactical and strategic driving behaviour is dependent on a range of frontal-executive functions that are commonly impaired in PD.The aim of this thesis therefore, was to investigate frontal-executive contributions to driving behaviour in PD. A series of three studies were undertaken to investigate: (1) the capacity for tactical adaptation of driving in PD, (2) the capacity for strategic adaptation of driving in PD, and (3) whether a novel dynamic test of frontal-executive functioning, The Subtle Cognitive Impairment Test (SCIT), which measures rapid visuoperceptual processing and decision-making, offers sensitivity as a potential screening tool of cognitive functions thought to be important for safe driving.The overall results from this thesis showed that the capacity for tactical adaptation of driving is significantly limited in individuals with PD and is associated with reduced frontal-executive functioning (i.e., Trail Making Test- Part B scores) but not with disease severity (i.e., duration of diagnosis, Unified Parkinson's Disease Rating Scale - Motor Scale Score). Tactical driving limitations were ameliorated by the timely provision of valid external cues. In terms of strategic adaptation, individuals with PD were found to self-regulate their driving to a significantly greater extent than healthy controls. Moreover, these self-regulatory practices appropriately targeted areas of self-perceived difficulty, the most prominent being avoidance of in-car distractions, a form of tactical self-regulation. Performance on the SCIT revealed a deficiency in the speed and accuracy of visuoperceptual processing and decision-making in PD, in the context of intact global cognitive functioning (as identified by MMSE). It remains to be determined whether this inefficient visuoperceptual processing is a limiting factor to the ability to adapt tactical driving behaviour in drivers with PD. The SCIT was shown to be sensitive to differences in cognition that fall within the range of normal variation on the MMSE. Future research should therefore investigate its utility as a screening tool for the early detection of mild cognitive impairment and emerging driving difficulties. In summary, these findings indicate that tactical driving ability is impaired in mild to moderate PD and is associated with deficits in frontal-executive functioning that may not be readily apparent to clinicians during examination. Importantly, findings also revealed that individuals with PD had insight into recent decline in their tactical driving ability and self-regulated their driving accordingly. Further research is required to determine whether strategic adaptations can effectively compensate for functional impairment at the operational and tactical levels in drivers with PD. The finding that timely external cues compensated for tactical driving limitations may have the greatest practical and clinical significance for extending safe independent driving in PD. It provides impetus for research into the potential rehabilitative utility of various Advanced Driver Assistance Systems for enabling safe driving in individuals with PD. Such research could lead to the availability of a larger and more varied array of car modifications capable of targeting specific driving difficulties. This could ultimately serve to broaden the application of conditional licensing and maximise participation in safe independent driving in individuals with PD.
Book Synopsis Self-awareness of Driving Performance in Older Adults by : Yu-ting Chen
Download or read book Self-awareness of Driving Performance in Older Adults written by Yu-ting Chen and published by . This book was released on 2019 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: "Having accurate self-awareness of driving ability may be one important factor to enable older drivers to adopt appropriate self-regulatory behaviors and maintain safe driving performance in their everyday living for as long as possible. Nevertheless, some methodological issues and knowledge gaps related to this topic exist. The overall objective of this thesis was to contribute evidence towards older drivers' self-awareness of their driving ability in a naturalistic driving environment. The first study compared and contrasted how the standard on-road driving evaluation (SODE) and the naturalistic driving observation (NDO) approaches influence older adults' driving performance using a reflective literature review. This study highlighted that, during the SODE, older drivers' performance may be negatively impacted by test anxiety and the unfamiliar environment, but changes in their driving capacity over time can be measured in this structured context. On the contrary, using the NDO approach, older drivers can adjust their driving behavior and environment based on their self-awareness of driving ability and self-regulatory modifications; by reducing the demands of their driving environment, their driving performance could be stable over time despite changes in their driving capacity (Manuscript #1). Based on the previous study, a validated NDO approach, the electronic Driving Observation Schedule (eDOS), was adopted to evaluate older drivers' performance in their everyday driving environment. Some improvements to its scoring system were required and 13 experts in driving rehabilitation were consulted using a two-round on-line survey. A weighted maneuver/environmental complexity score was created to represent the complexity of the driving maneuvers and environment in order to control the fact that the driving environment during each eDOS differs from each other. In addition, a weighted eDOS total score was generated to improve the scoring of older adults' driving performance by accounting for the different risk levels of each driving error type, the maneuver and environment complexity in which they occur (Chapter 4).The next study examined the accuracy of older drivers' self-awareness of driving ability and its associated demographic and clinical factors. The accuracy of self-awareness is defined by the correspondence between one's perceived and actual ability. Perceived driving ability was assessed using the Perceived Driving Ability [PDA] questionnaire, a valid and reliable tool and the weighted eDOS score was used to represent everyday driving performance. By comparing the two scores, 108 older drivers were classified into 3 groups based on the accuracy of estimation of their driving ability: under-estimation (19%); accurate (29%); over-estimation (53%). An ordinal regression model showed that older drivers who over-estimated their driving ability had better visuo-motor processing speed and fewer comorbid conditions (Manuscript #2). A longitudinal study was administered to further examine older drivers' self-awareness of their changes in driving ability over time (n=60). Results indicated that approximately one-third of the older drivers did not detect their declining driving ability over one year. Participants who had worse driving performance at the second session, regardless of their perceived changes in driving ability (Manuscript #3). The findings from this thesis indicate that many older drivers over-estimated their driving ability and did not perceive their declining driving performance over one year. Future studies are needed to examine the relationship between older drivers' accuracy of self-awareness and crash risk, as well as to create intervention programs for enhancing their accuracy of self-awareness of driving ability. " --
Book Synopsis Examination of Older Driver Perceptions and Actual Behaviour in Sole Household Drivers and Driving Couples by : Robin Ann Blanchard
Download or read book Examination of Older Driver Perceptions and Actual Behaviour in Sole Household Drivers and Driving Couples written by Robin Ann Blanchard and published by . This book was released on 2008 with total page 192 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction: Driver perceptions may be a more important determinant of behaviour than one's actual driving abilities. While there is evidence to support these associations, prior studies have relied on self-reports of driving behaviour. Purpose: The primary purposes of this study were to extend previous research by examining driver perceptions in relation to measures of actual driving behaviour and to compare the perceptions and behaviour of sole versus couple drivers. Methods: A convenience sample of 61 older drivers (aged 67 to 92, 59% women) were recruited as either sole drivers (only driver in the household, n=39) or couples (both currently driving and sharing a vehicle, n=22). Two in-vehicle devices (one with a GPS unit) were installed in participant vehicles for one week. Participants completed trip logs, out-of-home activity diaries, questions on usual driving habits and ratings of situational driving frequency and avoidance. Perceptions were assessed using the Driving Comfort Scales (DCS Day and Night) and Perceived Driving Abilities (PDA) Scales. Couples were also asked to rate their comfort level in their partner's driving using modified DCSs. Tools were administered at one of two home visits (during which vehicle devices were installed and removed) and an interview conducted at the end to ascertain whether the week's driving was typical. Results: Driving comfort scores were significantly related to multiple indicators of actual driving behaviour, including: radius from home (DCS-D, p
Book Synopsis Physician's Guide to Assessing and Counseling Older Drivers by : American Medical Association
Download or read book Physician's Guide to Assessing and Counseling Older Drivers written by American Medical Association and published by . This book was released on 2010 with total page 235 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Relationship of Driving Comfort to Perceived and Objective Driving Abilities and Future Driving Behaviour by : Lisa MacDonald
Download or read book Relationship of Driving Comfort to Perceived and Objective Driving Abilities and Future Driving Behaviour written by Lisa MacDonald and published by . This book was released on 2007 with total page 219 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction: Bandura's self-efficacy theory postulates that confidence is a stronger determinant of behaviour than one's actual skills or abilities. The Day and Night time Driving Comfort Scales (D-DCS and N-DCS) are new tools to measure perceived confidence in older drivers. Developed inductively with older drivers, the DCSs have good structural properties and preliminary psychometric support, including test-retest reliability. Purpose: This thesis builds on previous work by further examining the construct validity of the DCSs via (1) temporal associations (Study 1) and (2) cross-sectional relationships (Study 2). Study 1 prospectively examined the relationship between DCS scores and self-reported driving behaviour. Study 2, meanwhile, examined cross-sectional associations between DCS scores and selected sample characteristics, self-reported driving behaviour and driving problems, perceived abilities and seven objectively measured driving-related abilities (visual acuity, contrast sensitivity, disability glare, brake reaction time, lower body mobility, executive skills and visual attention). Methods: For Study 1, a convenience sample of 82 older drivers (aged 63 to 93) were assessed at baseline and follow-up (five to 17 months later). Study tools comprised the DCSs, multi-item ratings of driving frequency, avoidance and perceived abilities and a background questionnaire. Telephone interviews were conducted with a subgroup of 45 drivers to examine reasons for changes in driving comfort. For Study 2, cross-sectional relationships with the DCSs were examined using baseline data from 65 drivers (aged 63 to 93). A subgroup of 42 participants completed objective assessments of driving-related abilities assessed via ETDRS charts, Pelli-Robson charts, Brightness Acuity Tester, brake reaction time apparatus, the Rapid Paced Walk, the Trail Making Tests (Parts A and B) and the UFOV subtest 2. Results: Prospectively, lower baseline N-DCS scores (p
Book Synopsis The Effects of Medical Conditions on Driving Performance: a Literature Review and Synthesis by : National Highway Traffic Safety Administration
Download or read book The Effects of Medical Conditions on Driving Performance: a Literature Review and Synthesis written by National Highway Traffic Safety Administration and published by . This book was released on 2019-08-18 with total page 82 pages. Available in PDF, EPUB and Kindle. Book excerpt: One factor that distinguishes older drivers from their younger and middle-aged counterparts is a higher prevalence of medical conditions, and the medications used to treat them. Often, the medical conditions that are more prevalent among older people lead to impairments in visual, cognitive, or psychomotor functions needed to drive safely. Similarly, while some medications restore function and improve mobility for those who would otherwise be unable to drive, an array of potentially driver impairing (PDI) prescriptions and over-the-counter medications have been associated with a statistically significant increase in crash risk.The current understanding of how medical conditions can affect driving is based on the opinions of medical (including rehabilitation) professionals or traffic safety experts, or has been derived from simulation research. Other studies have compared the driving records of drivers whose licenses were restricted as a result of reported medical conditions to those of matched controls with the same conditions who had full driving privilege. However, there is a dearth of empirical data about the relationships between medical conditions common among older adults and either performance or safety outcomes of drivers under realistic driving situations. Further, few studies have explored how people with such conditions may limit their driving exposure.
Author :National Academies of Sciences, Engineering, and Medicine Publisher :National Academies Press ISBN 13 :0309448093 Total Pages :367 pages Book Rating :4.3/5 (94 download)
Book Synopsis Families Caring for an Aging America by : National Academies of Sciences, Engineering, and Medicine
Download or read book Families Caring for an Aging America written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2016-11-08 with total page 367 pages. Available in PDF, EPUB and Kindle. Book excerpt: Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.
Book Synopsis Occupational Therapy for People with Parkinson's Disease by : Ana Aragon
Download or read book Occupational Therapy for People with Parkinson's Disease written by Ana Aragon and published by . This book was released on 2010 with total page 76 pages. Available in PDF, EPUB and Kindle. Book excerpt: These practice guidelines draw upon the widest relevant knowledge and evidence available to describe and inform contemporary best practice occupational therapy for people with Parkinson's disease. They include practical examples of interventions to allow occupational therapists to apply new treatments to their practice.
Book Synopsis An Essay on the Shaking Palsy by : James Parkinson
Download or read book An Essay on the Shaking Palsy written by James Parkinson and published by . This book was released on 1817 with total page 86 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Effects of Parkinson's Disease on Heading Direction During Navigation and Coordination of Walking by : Cheng-Chieh Lin
Download or read book Effects of Parkinson's Disease on Heading Direction During Navigation and Coordination of Walking written by Cheng-Chieh Lin and published by . This book was released on 2012 with total page 168 pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract: Parkinson's disease (PD), traditionally regarded as a motor system disorder, has also been found to result in visuoperceptual disorders. Individuals with PD are aware of the changes in their visual perception by reporting problems in judging the distance between objects as well as perceiving speed of moving vehicles and pedestrians on the street. In addition, outcomes from studies on line bisection and size perception tasks suggest a unilateral compression of the left visual field in PD patients with predominant motor symptoms on the left body side. An asymmetry of optic flow between left and right visual fields can affect the heading direction during navigation. However, visuoperceptual disorders in PD may also result in a reliance on egocentric reference point in determining the heading direction, by taking the midline of the body as a reference. The objective of the first study was to investigate the effects of PD on the use of optic flow for heading direction and coordination of walking. A systematic manipulation of optic flow speed and the density of texture (dot density (DD)) between the left and right walls of the virtual hallway was achieved using virtual reality technology. Three dimensional kinematic data were collected by motion capture system. Compared to young controls (N=23) and age-matched normal controls (N=18), PD subjects (N=12) veered more to the left across conditions of optic flow speed (OS) and dot density manipulation. A significant linear effect of OS on lateral drift to the wall with lower OS was observed in healthy groups. A trend of veering toward the wall with lower DD suggested that visual texture guided navigation. It is hypothesized that the leftward veering bias in PD is related to the side of handedness and the asymmetry of the dopamine level between brain hemispheres.Parkinsonian gait is characterized by low walking speed, small stride length, shuffling gait, poverty of trunk movements, and reduced or absent arm swing. Compared to healthy controls, individuals with PD demonstrate reduced ability to change coordination pattern (reduced flexibility) which is accompanied by a reduced variability (increased stability) between transverse thoracic and pelvic rotation with change in walking speed. In addition, the degeneration of the dopaminergic system has also been related to a reduced flexibility of interlimb coordination in PD. The purpose of the second study was to investigate the impact of rigidity, as a neurological symptom, on the flexibility and stability of interlimb and trunk coordination during walking. Consistent with the outcomes reported in the literature, individuals with PD had smaller amplitude of arm and leg swings, thoracic, pelvic, and trunk rotations as well as smaller mean and variability of the relative phase between thoracic and pelvic rotation compared to healthy subjects. Remarkable is the finding that an increased variability in relative phase between the left and right arm swings was observed in PD which may be related to a reduced out-of-phase forcing of the arm movements at the shoulders as a result of axial rigidity. From these outcomes it can be hypothesized that improving the flexibility and stability of the gait patterns in individuals with PD can be achieved by facilitating the counter-rotation between transverse pelvic and thoracic rotations, for example, by subjects to move both arms and legs to the beat presented by a metronome (or music) during walking.
Book Synopsis Transforming the Workforce for Children Birth Through Age 8 by : National Research Council
Download or read book Transforming the Workforce for Children Birth Through Age 8 written by National Research Council and published by National Academies Press. This book was released on 2015-07-23 with total page 587 pages. Available in PDF, EPUB and Kindle. Book excerpt: Children are already learning at birth, and they develop and learn at a rapid pace in their early years. This provides a critical foundation for lifelong progress, and the adults who provide for the care and the education of young children bear a great responsibility for their health, development, and learning. Despite the fact that they share the same objective - to nurture young children and secure their future success - the various practitioners who contribute to the care and the education of children from birth through age 8 are not acknowledged as a workforce unified by the common knowledge and competencies needed to do their jobs well. Transforming the Workforce for Children Birth Through Age 8 explores the science of child development, particularly looking at implications for the professionals who work with children. This report examines the current capacities and practices of the workforce, the settings in which they work, the policies and infrastructure that set qualifications and provide professional learning, and the government agencies and other funders who support and oversee these systems. This book then makes recommendations to improve the quality of professional practice and the practice environment for care and education professionals. These detailed recommendations create a blueprint for action that builds on a unifying foundation of child development and early learning, shared knowledge and competencies for care and education professionals, and principles for effective professional learning. Young children thrive and learn best when they have secure, positive relationships with adults who are knowledgeable about how to support their development and learning and are responsive to their individual progress. Transforming the Workforce for Children Birth Through Age 8 offers guidance on system changes to improve the quality of professional practice, specific actions to improve professional learning systems and workforce development, and research to continue to build the knowledge base in ways that will directly advance and inform future actions. The recommendations of this book provide an opportunity to improve the quality of the care and the education that children receive, and ultimately improve outcomes for children.
Book Synopsis Self-awareness and Return to Driving After Traumatic Brain Injury by : James Roy Gooden
Download or read book Self-awareness and Return to Driving After Traumatic Brain Injury written by James Roy Gooden and published by . This book was released on 2015 with total page 400 pages. Available in PDF, EPUB and Kindle. Book excerpt: Traumatic Brain Injury (TBI) is a leading cause of disability in young adults and can severely impact everyday functioning. An important goal for many individuals with TBI is to make a return to driving. Post injury impairments may affect driving ability, resulting in a need for assessment and, in some cases, further rehabilitation. A common problem following TBI that has previously been implicated in fitness for return to driving is impaired self-awareness. Research exploring the role of awareness has been limited, however, and fraught with methodological limitations. The aim of this thesis was therefore to firstly develop a measure of awareness of on-road driving ability for use in return to driving assessments in brain injured populations; secondly, to use this measure to explore the characteristics and relationships of awareness of driving in individuals with TBI and healthy controls; and finally to explore the nature and extent of self-regulatory behaviour in individuals with TBI deemed fit to resume driving. Participants included 39 individuals with moderate to extremely severe TBI and 59 healthy age, gender and education matched controls. Participants completed neuropsychological tests, a standardised on-road driving assessment and the Brain Injury Driving Self-Awareness Measure (BIDSAM), and questionnaires on driving habits and behaviour at three time points, relating to premorbid driving, anticipated driving post injury and driving at three months post on-road assessment. The first study describes the development and validation of the BIDSAM, which is a new tool designed to assess awareness of on-road driving ability. The measure is completed by participants and clinicians and a discrepancy score is calculated to assess differences in ratings of driving ability between self and clinician opinions. The results of this study indicated that the BIDSAM self, clinician and awareness scales have very good levels of internal consistency. Criterion-related validity was established through significant correlations between clinician ratings and on-road driving performance. Furthermore, convergent validity was established through significant correlations between the BIDSAM awareness scales and an existing measure of self-awareness. The second study aimed to explore the differences in awareness of driving between individuals with TBI deemed fit and unfit to resume driving and healthy controls, in addition to examining the correlates of awareness and self-ratings of ability. The result of this investigation revealed that individuals who failed the on-road assessment significantly overestimated their driving abilities relative to controls and individuals with TBI who passed. Furthermore, poor awareness was associated with reduced cognitive functioning while poor self-ratings of driving ability were associated with symptoms of anxiety and depression. The third study explored the driving habits and self-regulatory practices of individuals with TBI who made a successful return to driving. Relative to controls, individuals with TBI expected greater reductions in their driving frequency and increases in their driving avoidance upon returning to driving. At three month follow up, individuals with TBI reported consistent reductions in their overall driving frequency but only circumscribed increases in avoidance. Changes in driving frequency and avoidance were associated with the female gender and anxiety. These findings suggest overall that awareness is a significant factor in fitness to drive and more severe cognitive impairments may be a risk factor for impaired awareness of driving. As such, clinicians may need to assess awareness of driving as part of return to driving assessments, in order to identify individuals who overestimate their abilities. These individuals may require additional support and rehabilitation prior to resuming driving. Interestingly, the factors associated with how individuals perceive their driving abilities and subsequently regulate their driving were almost entirely subjective in nature and this suggests that clinicians must consider the contribution of psychological factors such as anxiety when providing recommendations and feedback for driving. The fact that individuals with TBI acknowledged a need to change their driving habits and later reported having followed through with their intentions, suggests that these individuals may be open to recommendations by clinicians to enhance their self-regulatory behaviour and compensatory strategies in order to facilitate their safe return to driving post injury. Together, the findings of this thesis extend the literature on awareness and driving after brain injury and provide the first dedicated driving-related measure of awareness for use by clinicians in return to driving assessments.
Download or read book Theory at a Glance written by Karen Glanz and published by . This book was released on 1997 with total page 52 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis TIP 35: Enhancing Motivation for Change in Substance Use Disorder Treatment (Updated 2019) by : U.S. Department of Health and Human Services
Download or read book TIP 35: Enhancing Motivation for Change in Substance Use Disorder Treatment (Updated 2019) written by U.S. Department of Health and Human Services and published by Lulu.com. This book was released on 2019-11-19 with total page 208 pages. Available in PDF, EPUB and Kindle. Book excerpt: Motivation is key to substance use behavior change. Counselors can support clients' movement toward positive changes in their substance use by identifying and enhancing motivation that already exists. Motivational approaches are based on the principles of person-centered counseling. Counselors' use of empathy, not authority and power, is key to enhancing clients' motivation to change. Clients are experts in their own recovery from SUDs. Counselors should engage them in collaborative partnerships. Ambivalence about change is normal. Resistance to change is an expression of ambivalence about change, not a client trait or characteristic. Confrontational approaches increase client resistance and discord in the counseling relationship. Motivational approaches explore ambivalence in a nonjudgmental and compassionate way.
Book Synopsis Non-Motor Symptoms of Parkinson's Disease by : K. Ray Chaudhuri
Download or read book Non-Motor Symptoms of Parkinson's Disease written by K. Ray Chaudhuri and published by Oxford University Press, USA. This book was released on 2014 with total page 517 pages. Available in PDF, EPUB and Kindle. Book excerpt: Patients with Parkinson's disease (PD) are known to suffer from motor symptoms of the disease, but they also experience non-motor symptoms (NMS) that are often present before diagnosis or that inevitably emerge with disease progression. The motor symptoms of Parkinson's disease have been extensively researched, and effective clinical tools for their assessment and treatment have been developed and are readily available. In contrast, researchers have only recently begun to focus on the NMS of Parkinson's Disease, which are poorly recognized and inadequately treated by clinicians. The NMS of PD have a significant impact on patient quality of life and mortality and include neuropsychiatric, sleep-related, autonomic, gastrointestinal, and sensory symptoms. While some NMS can be improved with currently available treatments, others may be more refractory and will require research into novel (non-dopaminergic) drug therapies for the future. Edited by members of the UK Parkinson's Disease Non-Motor Group (PD-NMG) and with contributions from international experts, this new edition summarizes the current understanding of NMS symptoms in Parkinson's disease and points the way towards future research.
