The effects of increased therapy time on cognition and mood in frail patients with a stroke who rehabilitate on rehabilitation units of nursing homes in the Netherlands: a protocol of a comparative study

BACKGROUND: Recovery after stroke is dependent on how much time can be spent on rehabilitation. Recently, we found that therapy time for older stroke patients on a rehabilitation unit of a nursing home could be increased significantly from 8.6 to at least 13 hours a week. This increase was attained by the implementation of interventions, focused on strength, mobility and balance. Nurses carried out these exercises with the patients during their daily activities. The aim of the present study is to investigate if increased therapy time has a positive effect on cognition, mood (depression and anxiety), and ADL in stroke patients. METHODS: A comparative single blind controlled study will be applied. Patients suffering from a stroke and staying on one of the rehabilitation units of the nursing homes are eligible for participation. Participants belong to the intervention group if they stay in two nursing homes where four interventions of the Clinical Nursing Rehabilitation Stroke Guideline were implemented. Participants who stay in two nursing homes where therapy is given according to the Dutch stroke Guideline, are included in the control group. Clinical neuropsychologists will assess patients’ cognitive functioning, level of depression (mood) and anxiety. Nurses will assess a Barthel Index score on a weekly basis (ADL). These variables are measured at baseline, after 8 weeks and at the moment when participants are discharged from the nursing home. DISCUSSION: The present study evaluates the effect of increased therapy time on cognition, mood (level of depression and anxiety), and ADL in stroke patients. When positive effects will be found this study can guide policy makers and practitioners on how to implement more therapy time on rehabilitation wards of nursing homes. TRIAL REGISTRATION: TNR Our study has been documented in the Dutch Trial Registration, TC = 3871

Are all socialists anti-religious?: Anti-religiosity and the socialist left in 21 Western European countries (1990-2008)

The political situation in the Soviet Union during the twentieth century has led some to suggest that socialism is some kind of secular religion as opposed to ‘normal’ religion. In modern Europe, however, there have been vibrant Christian socialist movements. This article looks into the different attitudes of socialists towards religion and answers the question whether it is pressure of religious activity or pressure of religious identity that makes socialists resist religion. The results from a multilevel analysis of three waves of the European Values Study (1990–2008) in 21 Western European countries specifically point to an increase in anti-religiosity by socialists in countries marked by Catholic and Orthodox religious identities