Monitoring Home-Based Activity of Stroke Patients: A Digital Solution for Visuo-Spatial Neglect Evaluation

The possibility to prescribe home-based rehabilitation activity after stroke strongly increases the amount of exercises to perform, thus helping the maintenance of relearned skills, the completion of the rehabilitation program, the practice of physical and mental concentration. Even more important is the monitoring of the patient activity at home, as it is provided by the Remote Monitoring Validation Engineering System (ReMoVES) platform [1]. The present work refers to the implementation and integration in ReMoVES platform of a digital and web-based version of Albert\u2019s [2] and Line Bisection [3] tests devoted to visuo-spatial neglect evaluation and its remote monitoring. A statistical analysis devoted to validating test-retest reliability is proposed. Concurrent correlation between digital and traditional administration of the tests is presented, in order to evaluate the validity of the remote monitoring of the home-administration through ReMoVES platform

Efficiency and productivity change in Ukrainian health care

Hospitals, Efficiency, Order-m , Malmquist, Index, D24, I18,

Geriatric rehabilitation of stroke patients in nursing homes: a study protocol.

Contains fulltext : 88482.pdf (publisher's version ) (Open Access)BACKGROUND: Geriatric patients are typically underrepresented in studies on the functional outcome of rehabilitation after stroke. Moreover, most geriatric stroke patients do probably not participate in intensive rehabilitation programs as offered by rehabilitation centers. As a result, very few studies have described the successfulness of geriatric stroke rehabilitation in nursing home patients, although it appears that the majority of these patients are being discharged back to the community, rather than being transferred to residential care. Nevertheless, factors associated with the successfulness of stroke rehabilitation in nursing homes or skilled nursing facilities are largely unknown. The primary goal of this study is, therefore, to assess the factors that uniquely contribute to the successfulness of rehabilitation in geriatric stroke patients that undergo rehabilitation in nursing homes. A secondary goal is to investigate whether these factors are similar to those associated with the outcome of stroke rehabilitation in the literature. METHODS/DESIGN: This study is part of the Geriatric Rehabilitation in AMPutation and Stroke (GRAMPS) study in the Netherlands. It is a longitudinal, observational, multicenter study in 15 nursing homes in the Southern part of the Netherlands that aims to include at least 200 patients. All participating nursing homes are selected based on the existence of a specialized rehabilitation unit and the provision of dedicated multidisciplinary care. Patient characteristics, disease characteristics, functional status, cognition, behavior, and caregiver information, are collected within two weeks after admission to the nursing home. The first follow-up is at discharge from the nursing home or one year after inclusion, and focuses on functional status and behavior. Successful rehabilitation is defined as discharge from the nursing home to an independent living situation within one year after admission. The second follow-up is three months after discharge in patients who rehabilitated successfully, and assesses functional status, behavior, and quality of life. All instruments used in this study have shown to be valid and reliable in rehabilitation research or are recommended by the Netherlands Heart Foundation guidelines for stroke rehabilitation.Data will be analyzed using SPSS 16.0. Besides descriptive analyses, both univariate and multivariate analyses will be performed with the purpose of identifying associated factors as well as their unique contribution to determining successful rehabilitation. DISCUSSION: This study will provide more information about geriatric stroke rehabilitation in Dutch nursing homes. To our knowledge, this is the first large study that focuses on the determinants of success of geriatric stroke rehabilitation in nursing home patients

Screening tests are not enough to detect hemineglect Testes de triagem não são suficientes para diagnosticar heminegligência

OBJECTIVE: To verify the sensitivity of the conventional subtests of the Behavioral Inattention Test (BIT) in the diagnosis of hemineglect after stroke. METHOD: One hundred and two patients with cerebral infarct or hemorrhage were prospectively evaluated. In 22, hemineglect was diagnosed using standard BIT criteria. The frequency of hemineglect using 6 commonly used screening subtests of this battery was assessed. RESULTS: Hemineglect would not be recognized in 10 patients if they were only screened using the line crossing test; this would be the case in 2 patients with the letter cancellation test; and in 4 patient with the line bisection test. Three patients would not be diagnosed even if both line crossing and line bisection tests were used. CONCLUSION: Hemineglect may not be recognized with single screening tests commonly used. The use of a standard battery is recommended to improve diagnostic sensitivity in individuals with various subtypes of hemineglect.<br>OBJETIVO: Verificar a sensibilidade dos subtestes convencionais da Behavioral Inattention Test (BIT) no diagnóstico da heminegligência após o acidente vascular cerebral (AVC). MÉTODO: Foram avaliados prospectivamente 102 pacientes com AVC. Em 22 casos heminegligência foi diagnosticada através do BIT. A freqüência de diagnóstico correto utilizando os 6 subtestes específicos desta bateria foi analisada. RESULTADOS: 10 pacientes não seriam diagnosticados como heminegligentes se fossem avaliados apenas com o " line crossing" , 2 se o teste de triagem escolhido fosse o " letter cancellation" , e 4 se utilizássemos apenas o " line bisection" . Além disso, 3 pacientes não teriam recebido o diagnóstico correto mesmo utilizando dois testes usuais de triagem - " line crossing" e " line bisection" . CONCLUSÃO: O uso de testes isolados de triagem pode falhar em diagnosticar heminegligência após o AVC. O uso de uma bateria formal de avaliação é necessário para identificar indivíduos com diferentes tipos de heminegligência

Scent communication by female Columbian ground squirrels, Urocitellus columbianus

Scent-marking is a frequent behaviour of highly social ground squirrels and might play an important role in their social dynamics. Female Columbian ground squirrels exhibit considerable scent-marking during the reproductive period. We examined how gestating and lactating females responded to jugal gland scent-marks of same-sexed and opposite-sexed conspecifics with attention to genetic relatedness and the geographical location of the territory of individuals. We tested the dear-enemy, threat-level and kin-discrimination hypotheses to explain patterns of scent-marking. Females sniffed the scent of non-neighbouring males significantly longer than other types of scent categories and tended to over mark the scent of females more than the scent of males. Furthermore, females sniffed significantly longer at scents during gestation than during lactation. We concluded that scent-marking mainly functioned in the defence of female territories and for protection of pups against infanticidal females (threat-level hypothesis). Our results were also in accordance with the kin-discrimination hypothesis, because greater attention was paid to the marks of non-kin females. Kin females might not pose an infanticidal threat, perhaps explaining greater tolerance among related reproductive females. We concluded that scent-marking may be a relatively low-cost means of territorial defence, as well as a means of communication of aspects of individual identity