Carolina Bottari - Academia.edu (original) (raw)
Papers by Carolina Bottari
Canadian Journal of Occupational Therapy
Journal of Alzheimer's Disease, 2016
Dysfunctions in complex activities of daily living (ADLs) are a normal part of the aging process.... more Dysfunctions in complex activities of daily living (ADLs) are a normal part of the aging process. However, differentiating functional decline associated with healthy aging from the subtle decline experienced by individuals with mild cognitive impairment and early dementia constitutes a challenge. Finding an appropriate tool that can capture these subtle but important functional changes represents a priority. The aims of this study were to evaluate the feasibility of using the Instrumental Activities of Daily Living Profile (IADL Profile) with elderly participants and to describe their level of difficulty encountered in each task. The tool was administered to a group of 40 elderly participants living in the community. The IADL Profile was found to be feasible to use in older individuals; the tool also showed sensitivity to the difficulties experienced by this population in everyday functioning. The IADL Profile is a promising ecological tool to evaluate independence in aging and may help to identify individuals with MCI. This tool may also contribute to the development of tailored interventions to enhance everyday functioning in the older population.
Neuropsychological Rehabilitation, 2015
The objective of the study was to explore the neurophysiological correlates of altered functional... more The objective of the study was to explore the neurophysiological correlates of altered functional independence using functional magnetic resonance imaging (fMRI) and event-related potentials (ERP) after a mild traumatic brain injury (mTBI). The participants consisted of three individuals with symptomatic mTBI (3.9 ± 3.6 months post-mTBI) and 12 healthy controls. The main measures used were the Instrumental Activities of Daily Living (IADL) Profile observation-based assessment; a visual externally ordered working memory task combined to event-related potentials (ERP) and fMRI recordings; neuropsychological tests; post-concussion symptoms questionnaires; and the Activities of Daily Living (ADL) Profile interview. Compared to normal controls, all three patients had difficulty with a real-world complex budgeting activity due to deficits in planning, ineffective strategy use and/or a prolonged time to detect and correct errors. Reduced activations in the right mid-dorsolateral prefrontal cortex on fMRI as well as abnormal frontal or parietal components of the ERP occurred alongside these deficits. Results of this exploratory study suggest that reduced independence in complex everyday activities in symptomatic mTBI may be at least partly explained by a decrease in brain activation in the prefrontal cortex, abnormal ERP, or slower reaction times on working memory tasks. The study presents an initial attempt at combining research in neuroscience with ecological real-world evaluation research to further our understanding of the difficulties in complex everyday activities experienced by individuals with mTBI.
American Journal of Occupational Therapy, 2016
This pilot study explored the experiences of brain injury survivors after a change in financial m... more This pilot study explored the experiences of brain injury survivors after a change in financial management (FM) independence. Using a qualitative descriptive design, 6 participants with acquired brain injury were recruited from a community brain injury organization and participated in semistructured interviews. Data were analyzed using thematic analysis. Three themes emerged from the interviews: (1) trajectory of FM change, involving family members as key change agents; (2) current FM situation, involving FM strategies such as automatic deposits and restricted budgets; and (3) the struggle for control, in which survivors desired control while also accepting supports for FM. This study identifies some of the challenges brain injury survivors face in managing their finances and the adjustment associated with a loss of FM independence. Occupational therapists should be aware of clients' experiences when supporting them through a change in independence.
Http Dx Doi Org 10 1080 09602011 2013 835739, Sep 16, 2013
Impairments in executive function, self-regulation and attribution individually have been implica... more Impairments in executive function, self-regulation and attribution individually have been implicated in impairment in goal-directed behaviour, resulting in reduced participation in daily activities by individuals with brain injury. There is minimal literature that explicitly addresses the relationships among these constructs, how these may be affected by brain injury and the implications for rehabilitation. The objectives of this study were to determine what is known about the relationship between executive function, self-regulation and attribution, and to understand how these inter-relationships affect goal-directed behaviour in adults with acquired brain injury. A scoping review of the cognitive neuroscience, neuropsychology, rehabilitation, educational and social psychology literature from 1985 to 2011 was performed. The identified literature provided definitions of the constructs and insight into the relationships between them according to their neural underpinnings and theoretical models. These data also provided for the development of a new model illustrating the hypothesised relationships between constructs. This review and the model developed, suggest that attribution may play an important role in executive function and self-regulation. Rehabilitation interventions that address formulation of appropriate attributions should be considered in conjunction with those targeting self-regulation and executive function for individuals with brain injury.
Archives of Physical Medicine and Rehabilitation, 2015
British Journal of Occupational Therapy, 2015
ABSTRACT
The Open Journal of Occupational Therapy, 2015
Canadian journal of occupational therapy. Revue canadienne d'ergothérapie, 2011
Although the assessment of the activities of daily living (ADL) through task analysis is central ... more Although the assessment of the activities of daily living (ADL) through task analysis is central to the role of the occupational therapists working with children with traumatic brain injury (TBI), no review has revealed any study aimed at analyzing the instruments used to this effect, in regard to their potential to highlight the deficits associated with the executive functions (e.g., formulate a goal, planning). To determine if any ADL assessment tools validated for children 10 to 15 years with a TBI consider executive functions. Four tools, i.e., "Assessment of Motor and Process Skills' the "Children's Kitchen Task Assessment', the "Chocolate Cake Task" and the "ADL Profile' were analyzed according to the following criteria: 1) complexity of the tasks, 2) non-structured assessment method, and 3) psychometric properties appropriate for the target population. These tools are only partially consistent with the desired criteria. Further researc...
Australian Occupational Therapy Journal, 2014
Patients frequently report sleep disruptions or insomnia during their hospital stay, particularly... more Patients frequently report sleep disruptions or insomnia during their hospital stay, particularly after a traumatic brain injury (TBI). The consequences of these sleep disturbances on everyday activities are not well documented and are therefore not considered in the evaluation of independence in activities of daily living (ADLs). The goal of this narrative review is to explore the consequences of poor sleep quality on cognition and ADLs in the acute and subacute stages of a moderate and severe TBI, when patients are in acute care or inpatient rehabilitation. We will present an overview of normal sleep and its role in cognitive functioning, and then present the findings of studies that have investigated sleep characteristics in hospital settings and the consequences of sleep disturbances on ADLs. During hospitalisation, TBI patients present severe sleep disturbances such as insomnia and sleep fragmentation, which are probably influenced by both the medical condition and the hospital or rehabilitation environment. Sleep disruption is associated with several cognitive deficits, including attention, memory and executive function impairments. Poor quality and/or insufficient quantity of sleep in acute TBI probably affect general functioning and ADLs calling for these cognitive functions. The cognitive impairments present following TBI are probably exacerbated by poor sleep quality and sleep deprivation during hospitalisation, which in turn impact ADLs among this population. Health-care personnel should further consider sleep disturbances among people with TBI and a sleep protocol should be established.
ALTER - European Journal of Disability Research / Revue Européenne de Recherche sur le Handicap, 2014
ABSTRACT People who have suffered a traumatic brain injury (TBI) often experience a decreased abi... more ABSTRACT People who have suffered a traumatic brain injury (TBI) often experience a decreased ability to carry out complex daily activities such as shopping, and these difficulties are likely amplified when confronted with a shopping environment that is not adapted to their cognitive difficulties. Goal The purpose of this study was to identify the environmental factors present within a grocery store that influence, positively or negatively, the independence of persons who have suffered a TBI within the activity of shopping for groceries. This is an exploratory study in the form of a qualitative analysis of the performance of 10 participants with moderate or severe TBI who completed the “shopping for groceries” task of the IADL profile. The main facilitators observed at the grocery store were the organization of food and the presence of signs. The main obstacles were the distractions, the wide variety of food and recent changes in food placement. Frequenting a supermarket appears to cause an increase in the use of environmental facilitators. This study highlights the various environmental factors that help or hinder grocery shopping for individuals with cognitive deficits. Particular attention should be paid to environmental obstacles in a grocery store when working with these individuals.
The Physician and Sportsmedicine, 2010
Neurosurgical Focus, 2012
Neuropsychological Rehabilitation, 2013
Impairments in executive function, self-regulation and attribution individually have been implica... more Impairments in executive function, self-regulation and attribution individually have been implicated in impairment in goal-directed behaviour, resulting in reduced participation in daily activities by individuals with brain injury. There is minimal literature that explicitly addresses the relationships among these constructs, how these may be affected by brain injury and the implications for rehabilitation. The objectives of this study were to determine what is known about the relationship between executive function, self-regulation and attribution, and to understand how these inter-relationships affect goal-directed behaviour in adults with acquired brain injury. A scoping review of the cognitive neuroscience, neuropsychology, rehabilitation, educational and social psychology literature from 1985 to 2011 was performed. The identified literature provided definitions of the constructs and insight into the relationships between them according to their neural underpinnings and theoretical models. These data also provided for the development of a new model illustrating the hypothesised relationships between constructs. This review and the model developed, suggest that attribution may play an important role in executive function and self-regulation. Rehabilitation interventions that address formulation of appropriate attributions should be considered in conjunction with those targeting self-regulation and executive function for individuals with brain injury.
Journal of the International Neuropsychological Society, 2013
In theory, semantic memory may trigger and support the execution of everyday activities. This stu... more In theory, semantic memory may trigger and support the execution of everyday activities. This study explored this question by comparing three patients with semantic dementia to 40 normal controls performing different everyday activities. Participants were tested in their home using the Instrumental Activities of Daily Living Profile, an ecological measure of everyday functioning. Participants were informed that they had unknowingly invited two guests for lunch and should prepare accordingly. With these instructions, they dress to go outdoors, go to the grocery store, shop for food, prepare a hot meal, have the meal with the guests, and clean up after the meal. Performance was analyzed on the basis of four operations related to problem solving: formulate a goal, plan, execute, and verify attainment of the goal. Results indicate that compared to normal controls, two patients had significant difficulties and needed assistance with all operations of problem-solving, particularly while preparing a meal and cleaning up after the meal. One patient showed no difficulties despite severe semantic deficits. These results suggest that semantic deficits alone cannot explain the difficulties observed, but may contribute to some aspects of everyday actions such as those involved in everyday problem-solving.
Journal of Neurotrauma, 2011
Journal of Head Trauma Rehabilitation, 2014
The objective of this study was to examine the reasoning used by clinicians when deciding whether... more The objective of this study was to examine the reasoning used by clinicians when deciding whether errors observed during the performance of everyday activities were made by clients with acquired brain injury (ABI) or by healthy controls. Ninety clinicians observed 27 short video clips of subjects (ABI, healthy controls), carrying out the Baycrest Multiple Errands Test. On the basis of their observations, they classified subjects into either an ABI or healthy control group and specified their reasons. Their reasoning was analyzed using qualitative content analysis. The majority of the coded material explaining the reasoning behind correct attributions of performance errors to people with ABI related to 3 general themes: (1) inefficient executive functioning, (2) task-related difficulty, and (3) prediction of impact on independence in everyday activities. Clinicians were most successful at identifying neurological subjects when subjects either omitted tasks or took an excessive amount of time to complete the test. Correctly interpreting performance errors in real-world tests relies on clinicians' observational and clinical reasoning skills combined with their theoretical knowledge of constructs underlying the evaluation. Some clinical signs bear more weight than others when clinicians interpret performance errors to determine whether the behavior is pathological.
Canadian Journal of Occupational Therapy
Journal of Alzheimer's Disease, 2016
Dysfunctions in complex activities of daily living (ADLs) are a normal part of the aging process.... more Dysfunctions in complex activities of daily living (ADLs) are a normal part of the aging process. However, differentiating functional decline associated with healthy aging from the subtle decline experienced by individuals with mild cognitive impairment and early dementia constitutes a challenge. Finding an appropriate tool that can capture these subtle but important functional changes represents a priority. The aims of this study were to evaluate the feasibility of using the Instrumental Activities of Daily Living Profile (IADL Profile) with elderly participants and to describe their level of difficulty encountered in each task. The tool was administered to a group of 40 elderly participants living in the community. The IADL Profile was found to be feasible to use in older individuals; the tool also showed sensitivity to the difficulties experienced by this population in everyday functioning. The IADL Profile is a promising ecological tool to evaluate independence in aging and may help to identify individuals with MCI. This tool may also contribute to the development of tailored interventions to enhance everyday functioning in the older population.
Neuropsychological Rehabilitation, 2015
The objective of the study was to explore the neurophysiological correlates of altered functional... more The objective of the study was to explore the neurophysiological correlates of altered functional independence using functional magnetic resonance imaging (fMRI) and event-related potentials (ERP) after a mild traumatic brain injury (mTBI). The participants consisted of three individuals with symptomatic mTBI (3.9 ± 3.6 months post-mTBI) and 12 healthy controls. The main measures used were the Instrumental Activities of Daily Living (IADL) Profile observation-based assessment; a visual externally ordered working memory task combined to event-related potentials (ERP) and fMRI recordings; neuropsychological tests; post-concussion symptoms questionnaires; and the Activities of Daily Living (ADL) Profile interview. Compared to normal controls, all three patients had difficulty with a real-world complex budgeting activity due to deficits in planning, ineffective strategy use and/or a prolonged time to detect and correct errors. Reduced activations in the right mid-dorsolateral prefrontal cortex on fMRI as well as abnormal frontal or parietal components of the ERP occurred alongside these deficits. Results of this exploratory study suggest that reduced independence in complex everyday activities in symptomatic mTBI may be at least partly explained by a decrease in brain activation in the prefrontal cortex, abnormal ERP, or slower reaction times on working memory tasks. The study presents an initial attempt at combining research in neuroscience with ecological real-world evaluation research to further our understanding of the difficulties in complex everyday activities experienced by individuals with mTBI.
American Journal of Occupational Therapy, 2016
This pilot study explored the experiences of brain injury survivors after a change in financial m... more This pilot study explored the experiences of brain injury survivors after a change in financial management (FM) independence. Using a qualitative descriptive design, 6 participants with acquired brain injury were recruited from a community brain injury organization and participated in semistructured interviews. Data were analyzed using thematic analysis. Three themes emerged from the interviews: (1) trajectory of FM change, involving family members as key change agents; (2) current FM situation, involving FM strategies such as automatic deposits and restricted budgets; and (3) the struggle for control, in which survivors desired control while also accepting supports for FM. This study identifies some of the challenges brain injury survivors face in managing their finances and the adjustment associated with a loss of FM independence. Occupational therapists should be aware of clients' experiences when supporting them through a change in independence.
Http Dx Doi Org 10 1080 09602011 2013 835739, Sep 16, 2013
Impairments in executive function, self-regulation and attribution individually have been implica... more Impairments in executive function, self-regulation and attribution individually have been implicated in impairment in goal-directed behaviour, resulting in reduced participation in daily activities by individuals with brain injury. There is minimal literature that explicitly addresses the relationships among these constructs, how these may be affected by brain injury and the implications for rehabilitation. The objectives of this study were to determine what is known about the relationship between executive function, self-regulation and attribution, and to understand how these inter-relationships affect goal-directed behaviour in adults with acquired brain injury. A scoping review of the cognitive neuroscience, neuropsychology, rehabilitation, educational and social psychology literature from 1985 to 2011 was performed. The identified literature provided definitions of the constructs and insight into the relationships between them according to their neural underpinnings and theoretical models. These data also provided for the development of a new model illustrating the hypothesised relationships between constructs. This review and the model developed, suggest that attribution may play an important role in executive function and self-regulation. Rehabilitation interventions that address formulation of appropriate attributions should be considered in conjunction with those targeting self-regulation and executive function for individuals with brain injury.
Archives of Physical Medicine and Rehabilitation, 2015
British Journal of Occupational Therapy, 2015
ABSTRACT
The Open Journal of Occupational Therapy, 2015
Canadian journal of occupational therapy. Revue canadienne d'ergothérapie, 2011
Although the assessment of the activities of daily living (ADL) through task analysis is central ... more Although the assessment of the activities of daily living (ADL) through task analysis is central to the role of the occupational therapists working with children with traumatic brain injury (TBI), no review has revealed any study aimed at analyzing the instruments used to this effect, in regard to their potential to highlight the deficits associated with the executive functions (e.g., formulate a goal, planning). To determine if any ADL assessment tools validated for children 10 to 15 years with a TBI consider executive functions. Four tools, i.e., "Assessment of Motor and Process Skills' the "Children's Kitchen Task Assessment', the "Chocolate Cake Task" and the "ADL Profile' were analyzed according to the following criteria: 1) complexity of the tasks, 2) non-structured assessment method, and 3) psychometric properties appropriate for the target population. These tools are only partially consistent with the desired criteria. Further researc...
Australian Occupational Therapy Journal, 2014
Patients frequently report sleep disruptions or insomnia during their hospital stay, particularly... more Patients frequently report sleep disruptions or insomnia during their hospital stay, particularly after a traumatic brain injury (TBI). The consequences of these sleep disturbances on everyday activities are not well documented and are therefore not considered in the evaluation of independence in activities of daily living (ADLs). The goal of this narrative review is to explore the consequences of poor sleep quality on cognition and ADLs in the acute and subacute stages of a moderate and severe TBI, when patients are in acute care or inpatient rehabilitation. We will present an overview of normal sleep and its role in cognitive functioning, and then present the findings of studies that have investigated sleep characteristics in hospital settings and the consequences of sleep disturbances on ADLs. During hospitalisation, TBI patients present severe sleep disturbances such as insomnia and sleep fragmentation, which are probably influenced by both the medical condition and the hospital or rehabilitation environment. Sleep disruption is associated with several cognitive deficits, including attention, memory and executive function impairments. Poor quality and/or insufficient quantity of sleep in acute TBI probably affect general functioning and ADLs calling for these cognitive functions. The cognitive impairments present following TBI are probably exacerbated by poor sleep quality and sleep deprivation during hospitalisation, which in turn impact ADLs among this population. Health-care personnel should further consider sleep disturbances among people with TBI and a sleep protocol should be established.
ALTER - European Journal of Disability Research / Revue Européenne de Recherche sur le Handicap, 2014
ABSTRACT People who have suffered a traumatic brain injury (TBI) often experience a decreased abi... more ABSTRACT People who have suffered a traumatic brain injury (TBI) often experience a decreased ability to carry out complex daily activities such as shopping, and these difficulties are likely amplified when confronted with a shopping environment that is not adapted to their cognitive difficulties. Goal The purpose of this study was to identify the environmental factors present within a grocery store that influence, positively or negatively, the independence of persons who have suffered a TBI within the activity of shopping for groceries. This is an exploratory study in the form of a qualitative analysis of the performance of 10 participants with moderate or severe TBI who completed the “shopping for groceries” task of the IADL profile. The main facilitators observed at the grocery store were the organization of food and the presence of signs. The main obstacles were the distractions, the wide variety of food and recent changes in food placement. Frequenting a supermarket appears to cause an increase in the use of environmental facilitators. This study highlights the various environmental factors that help or hinder grocery shopping for individuals with cognitive deficits. Particular attention should be paid to environmental obstacles in a grocery store when working with these individuals.
The Physician and Sportsmedicine, 2010
Neurosurgical Focus, 2012
Neuropsychological Rehabilitation, 2013
Impairments in executive function, self-regulation and attribution individually have been implica... more Impairments in executive function, self-regulation and attribution individually have been implicated in impairment in goal-directed behaviour, resulting in reduced participation in daily activities by individuals with brain injury. There is minimal literature that explicitly addresses the relationships among these constructs, how these may be affected by brain injury and the implications for rehabilitation. The objectives of this study were to determine what is known about the relationship between executive function, self-regulation and attribution, and to understand how these inter-relationships affect goal-directed behaviour in adults with acquired brain injury. A scoping review of the cognitive neuroscience, neuropsychology, rehabilitation, educational and social psychology literature from 1985 to 2011 was performed. The identified literature provided definitions of the constructs and insight into the relationships between them according to their neural underpinnings and theoretical models. These data also provided for the development of a new model illustrating the hypothesised relationships between constructs. This review and the model developed, suggest that attribution may play an important role in executive function and self-regulation. Rehabilitation interventions that address formulation of appropriate attributions should be considered in conjunction with those targeting self-regulation and executive function for individuals with brain injury.
Journal of the International Neuropsychological Society, 2013
In theory, semantic memory may trigger and support the execution of everyday activities. This stu... more In theory, semantic memory may trigger and support the execution of everyday activities. This study explored this question by comparing three patients with semantic dementia to 40 normal controls performing different everyday activities. Participants were tested in their home using the Instrumental Activities of Daily Living Profile, an ecological measure of everyday functioning. Participants were informed that they had unknowingly invited two guests for lunch and should prepare accordingly. With these instructions, they dress to go outdoors, go to the grocery store, shop for food, prepare a hot meal, have the meal with the guests, and clean up after the meal. Performance was analyzed on the basis of four operations related to problem solving: formulate a goal, plan, execute, and verify attainment of the goal. Results indicate that compared to normal controls, two patients had significant difficulties and needed assistance with all operations of problem-solving, particularly while preparing a meal and cleaning up after the meal. One patient showed no difficulties despite severe semantic deficits. These results suggest that semantic deficits alone cannot explain the difficulties observed, but may contribute to some aspects of everyday actions such as those involved in everyday problem-solving.
Journal of Neurotrauma, 2011
Journal of Head Trauma Rehabilitation, 2014
The objective of this study was to examine the reasoning used by clinicians when deciding whether... more The objective of this study was to examine the reasoning used by clinicians when deciding whether errors observed during the performance of everyday activities were made by clients with acquired brain injury (ABI) or by healthy controls. Ninety clinicians observed 27 short video clips of subjects (ABI, healthy controls), carrying out the Baycrest Multiple Errands Test. On the basis of their observations, they classified subjects into either an ABI or healthy control group and specified their reasons. Their reasoning was analyzed using qualitative content analysis. The majority of the coded material explaining the reasoning behind correct attributions of performance errors to people with ABI related to 3 general themes: (1) inefficient executive functioning, (2) task-related difficulty, and (3) prediction of impact on independence in everyday activities. Clinicians were most successful at identifying neurological subjects when subjects either omitted tasks or took an excessive amount of time to complete the test. Correctly interpreting performance errors in real-world tests relies on clinicians' observational and clinical reasoning skills combined with their theoretical knowledge of constructs underlying the evaluation. Some clinical signs bear more weight than others when clinicians interpret performance errors to determine whether the behavior is pathological.