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Interventions to enhance cognitive and executive function performance are essential for the child's performance in current and future occupations. Occupational therapy practitioners are critical members of early intervention, education, and healthcare teams. Practitioners are distinctly qualified to address cognitive functioning within the context of occupational performance by providing evidence-based interventions to children and their families as well as training caregivers and teams to enhance cognitive and executive functioning (EF) performance. The purpose of this review was to update the previous systematic review on this topic. The focused question guiding the selection of research studies was: "What is the evidence for the effectiveness for interventions within the scope of occupational therapy practice to promote cognitive development and prevent further delay for children 0-5 and their families?" Due to the breadth of the review, the results were divided into two articles. This article (Part 1) focuses on cognitive interventions for children birth to 5 years with known conditions while Part 2, also in this issue, will address findings on interventions for children at risk due to environmental factors and promoting cognitive development for children birth to 5 years. [For Part 2, see EJ1333259.]

Aim: This article is the second part of a systematic review updates and broadens a previous systematic review (Frolek Clark & Schlabach, 2010) to examine the evidence for of interventions within the scope of occupational therapy practice to enhance cognitive and pre-academic development in young children with or without at-risk factors. This article is Part 2 of the review and will focus on interventions for children at-risk from environmental factors and interventions that promoting cognitive development in children ages birth to 5 years. Part 1 is published separately and focuses on children with specific diagnoses. Methods: A systematic search of studies published from 2010 to 2020 using MEDLINE, PsycINFO, CINAHL, ERIC, OTseeker, and Cochrane was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Twenty-seven studies met the inclusion criteria and were critically appraised: 19 Level I, 6 Level II, and 2 Level III evidence (Part 2). Two themes are discussed within this paper (Part 2): Children At-Risk of Cognitive Delays due to Environmental Factors, and Promoting Cognitive Development. Strong strength of evidence exists for cognitive and executive functioning training programs, literacy programs, and parent interactions focused on child's needs. Strong strength of evidence indicates explicit Tier II interventions assist preschool children in learning early literacy skills (e.g., print knowledge, letter names, letter sounds). Moderate strength of evidence supports using movement or play to enhance cognitive and executive functions in preschoolers. Conclusions: Occupational therapy practitioners working in home and preschool programs can use these evidence-based interventions to enhance cognitive development, executive functions, and pre-academic functions performance for young children with or without risk factors. Part 1 of the review also appears in this issue. [For Part 1, see EJ1333335.]

Background and Objectives Gay and lesbian older persons face a host of health inequalities related to their identity as they age. Challenges to health access and appropriate social support may be even more exacerbated for those living in rural environments; this may be due to the lack of supportive and affirming social connections. This project aimed to explore and describe the social networks and the relationship of these social networks to identity, health, and quality of life of gay and lesbian individuals in rural communities. Research Design and Methods Social network data on network type, size, and social capital were collected and supplemented by quantitative questionnaires relating to health, quality of life, marginalization, and identity. Results Participants (N  = 25) were recruited from three states. Thirteen participants self-identified as gay and 12 as lesbian. All but one identified as non-Hispanic White. The average age of all participants was 60.32 years. Findings indicate that rural gay and lesbian individuals develop networks with little consideration for network members' acceptance of their identity. Participants reported an average network size of 9.32 individuals. Gay men reported higher perceptual affinity (.69) than lesbian participants (.62). Lesbian networks showed significantly (p  = .0262) greater demographic similarity (.58) than aging gay men's networks (.55). Aging gay men (.89) reported statistically stronger (p  = .0078) network ties than aging lesbian females (.78). Among participants in this study, network size is not correlated with the health and quality of life of rural aging lesbian and gay individuals. Still, personal identity congruence does appear to relate to health and quality of life. Discussion and Implications The findings highlight the collective need to continue research into sexual minority aging and rural sexual minority aging, particularly employing novel methods. [ABSTRACT FROM AUTHOR]

This study explores the phenomenon of legacy as a component of the aging experience among women. Against a backdrop of prior focus on transmission of material possessions as the primary form of legacy, the concept is critically examined in developing an expanded, theoretically and empirically grounded perspective. In-depth interviews with 38 women, ranging in age from 31 to 94 and representing diverse marital, parental, and health statuses, reveal multiple dimensions of leaving a legacy in terms of content, creation, and transmission. Through the stories of the participants in this study, legacy emerges as a means of passing on the essence of one's self, in particular one's values and beliefs. Legacy is a method of leaving something behind after death and making meaning of the end of life. The desire to leave a legacy is manifest in many different ways dependent on the individual and their culture. While the idea of legacy is often couched in terms of material possessions, it appears that passing on values and beliefs is more important to older adults.

Background and Purpose: Individuals after stroke often have multiple chronic conditions, such as hypertension, diabetes, dyslipidemia, obesity, and tobacco use. These comorbidities not only are commonly found in individuals with stroke, but also negatively affect functional outcomes and increase risk for hospital readmission and overall mortality. It is important for physical therapists to address the whole person during treatment after stroke, including comorbidities, not just the problems resulting from the stroke itself. However, it is unclear how common it is for physical therapists to address multiple diagnoses at once using a wellness model. Therefore, the purpose of this scoping review was to examine current evidence regarding the role of physical therapy in addressing modifiable risk factors for individuals after stroke, to identify gaps in research associated with physical therapy management of related comorbid diagnoses during treatment for stroke. Methods: A scoping review methodology was utilized searching PubMed and CINAHL databases to identify interventional research studies specifically addressing multiple modifiable risk factors utilizing physical therapy for individuals after stroke. Results: The initial search yielded 5358 articles and 12 articles met full inclusion criteria. Only 2 studies included participants with significant mobility impairments, and none included individuals with communication impairments. Only 4 of the 12 studies provided education in their design. Eight studies did not include any patient-reported outcome measures. Only 3 studies included long-term follow-up assessments. Discussion: Secondary stroke risk factors can be positively addressed using physical therapy interventions; however, more research is needed regarding individuals with moderate to severe mobility or communication deficits. Opportunities for physical therapy research to address stroke risk factors in this complex population include expanding follow-up periods, improving educational interventions, and including caregivers in study design. Conclusions: This review highlights the need for better integration of clinical considerations into stroke rehabilitation research as a whole, along with the need for additional research regarding the role physical therapy can play in addressing multimorbidity in individuals with stroke. [ABSTRACT FROM AUTHOR]

Introduction: Successfully maintaining (managing) paid employment can be a challenge as people negotiate the cancer care pathway and survivorship. Little research explores the influence of age on this situation. The purpose of this project was to explore the role of age in managing employment for survivors from age 45 to 64 years. Method: A qualitative descriptive design was conducted to explore the intersection of age and managing employment for cancer survivors. In-depth semi-structured interviews were conducted with 19 United States cancer survivors (lung, breast, colorectal). Interviews were conducted in person or by phone. Verbatim transcripts were analyzed using thematic analysis. Codes were grouped by categories, incorporated into separate topical files, and then aggregated into broader emergent themes. Findings: Survivors are not just "returning" to work after treatment. They are often managing work both during and after treatment. Age may have benefits but can also provide barriers to positive survivorship and employment experiences. Fulfilling the role of employee and maintaining a worker identity was a strong driver for many participants. Again, this was potentially both a support and a barrier. It was discovered that health care providers provided little support to facilitate employment. Conclusion: Age is a factor that is poorly understood but influences both health and personal aspects of the experience of managing paid employment during and after cancer treatment. Occupational therapy practitioners should acknowledge this important role in addressing cancer survivorship. [ABSTRACT FROM AUTHOR]

The aging population is growing rapidly, raising rates of cognitive impairment, which makes strategies for protection against cognitive impairment increasingly important. There is little evidence indicating highly effective interventions preventing or slowing onset of cognitive impairment. Music playing influences brain and cognitive function, activating multiple brain areas and using cognitive and motor functions as well as multiple sensory systems, simultaneously. The purpose of this study was to review the current evidence related to playing a musical instrument being a potentially protective mechanism against cognitive decline among older adults. Using scoping review procedures, four databases were searched. Paired reviewers analyzed articles for content, design, and bias. Eleven studies met study criteria and were included in the review. All studies showed that music playing was correlated with positive outcomes on cognitive ability; more high-quality research is needed in this area to understand mechanisms behind potential cognitive protection of music. [ABSTRACT FROM AUTHOR]

Limited research exists examining video communication among cognitively intact nursing home residents to connect with family. This scoping review evaluated existing literature for video communication usage with nursing home residents, family, and nursing homes. A comprehensive search was completed using PubMed and EBSCOhost (including AgeLine, CINAHL, and PsycINFO) between 1972 and 2016 to locate English-language articles. The analysis identified five eligible studies (four involved an intervention, one assessed family views) meeting inclusion criteria. Findings included, seeing family members separated by distance, seeing other parts of their life, and visually monitoring resident's health. Participants described frustration with technology limitations, such as video or audio lag. Current literature does not show a comprehensive assessment of video communication usage for residents, family, and nursing homes. Future studies should address the complexity of the intersection of the person, nursing home, and families in terms of potential benefits and capability of video communication use with residents. [ABSTRACT FROM AUTHOR]