scholarly journals The Influence of Speech-Language-Hearing Therapy Duration on the Degree of Improvement in Poststroke Language Impairment

2017 ◽  
Vol 2017 ◽  
pp. 1-8
Author(s):  
Hitoshi Hayashi ◽  
Eisaku Okada ◽  
Yosuke Shibata ◽  
Mieko Nakamura ◽  
Toshiyuki Ojima
Keyword(s):  
Language Impairment ◽  
Propensity Scores ◽  
Rehabilitation Medicine ◽  
Functional Independence ◽  
Severe Dementia ◽  
Inverse Probability ◽  
Long Duration ◽  
Study Population ◽  
Hearing Therapy ◽  
Severity Of Dementia

Background. The relevance of speech-language-hearing therapy (ST) duration to language impairment remains unclear.Objective.To determine the effect of ST duration on improvement in language impairment as a stroke sequela and to compare the findings with those for occupational therapy (OT) and physical therapy (PT).Methods. Data regarding patients with stroke sequelae who were registered in the Japanese Association of Rehabilitation Medicine database were analyzed. Propensity scores for ST, OT, and PT duration were calculated using logistic regression, followed by inverse probability weighting in generalized estimating equations to examine the odds ratio for improvement in the Functional Independence Measures scores for comprehension, expression, and memory. Analyses stratified by age and dementia severity were also conducted.Results. Compared with short-duration ST, long-duration ST was significantly associated with improved scores for comprehension and expression in the overall study population and in some groups, with higher benefit especially for younger participants (<64 years) and those with more severe dementia. A significant but less pronounced effect was also observed for OT and PT.Conclusion. Long-duration ST is more effective than long-duration OT or PT for improving language impairment occurring as stroke sequela. However, these effects are limited by age and severity of dementia.

scholarly journals Impact of Social Isolation on People with Dementia and Their Family Caregivers

2021 ◽  
pp. 1-11
Author(s):  
Lílian Viana dos Santos Azevedo ◽  
Ismael Luis Calandri ◽  
Andrea Slachevsky ◽  
Héctor Gastón Graviotto ◽  
Maria Carolina Santos Vieira ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Social Isolation ◽  
Clinical Symptoms ◽  
Memory Function ◽  
South American ◽  
Severe Dementia ◽  
Dementia Caregivers ◽  
People With Dementia ◽  
Moderate Dementia ◽  
Severity Of Dementia

Background: People with dementia and their family caregivers may face a great burden through social isolation due to the COVID-19 pandemic, which can be manifested as various behavioral and clinical symptoms. Objective: To investigate the impacts of social isolation due to the COVID-19 pandemic on individuals with dementia and their family caregivers. Methods: Two semi-structured questionnaires were applied via telephone to family caregivers of people diagnosed with dementia in three cities in Argentina, Brazil, and Chile, in order to assess clinical and behavioral changes in people with dementia and in their caregivers. Results: In general, 321 interviews were conducted. A significant decline in memory function has been reported among 53.0%of people with dementia. In addition, 31.2%of individuals with dementia felt sadder and 37.4%had increased anxiety symptoms. These symptoms of anxiety were greater in individuals with mild to moderate dementia, while symptoms of agitation were greater in individuals with severe dementia. Moreover, compulsive-obsessive behavior, hallucinations, increased forgetfulness, altered appetite, and increased difficulty in activities of daily living were reported more frequently among individuals with moderate to severe dementia. Caregivers reported feeling more tired and overwhelmed during this period and these symptoms were also influenced by the severity of dementia. Conclusion: Social isolation during the COVID-19 pandemic triggered a series of negative behavioral repercussions, both for people with dementia and for their family caregivers in these three South American countries.

Group activity with Paro in nursing homes: systematic investigation of behaviors in participants

2016 ◽  
Vol 28 (8) ◽  
pp. 1345-1354 ◽  
Author(s):  
Nina Jøranson ◽  
Ingeborg Pedersen ◽  
Anne Marie Mork Rokstad ◽  
Geir Aamodt ◽  
Christine Olsen ◽  
...  
Keyword(s):  
Social Interactions ◽  
Systematic Investigation ◽  
Group Activity ◽  
Severe Dementia ◽  
Group Activities ◽  
Video Recordings ◽  
People With Dementia ◽  
Moderate Dementia ◽  
Total Session Time ◽  
Severity Of Dementia

ABSTRACTBackground:A variety of group activities is promoted for nursing home (NH) residents with dementia with the aim to reduce apathy and to increase engagement and social interaction. Investigating behaviors related to these outcomes could produce insights into how the activities work. The aim of this study was to systematically investigate behaviors seen in people with dementia during group activity with the seal robot Paro, differences in behaviors related to severity of dementia, and to explore changes in behaviors.Methods:Thirty participants from five NHs formed groups of five to six participants at each NH. Group sessions with Paro lasted for 30 minutes twice a week during 12 weeks of intervention. Video recordings were conducted in the second and tenth week. An ethogram, containing 18 accurately defined and described behaviors, mapped the participants’ behaviors. Duration of behaviors, such as “Observing Paro,” “Conversation with Paro on the lap,” “Smile/laughter toward other participants,” were converted to percentage of total session time and analyzed statistically.Results:“Observing Paro” was observed more often in participants with mild to moderate dementia (p = 0.019), while the variable “Observing other things” occurred more in the group of severe dementia (p = 0.042). “Smile/laughter toward other participants” showed an increase (p = 0.011), and “Conversations with Paro on the lap” showed a decrease (p = 0.014) during the intervention period.Conclusions:Participants with severe dementia seemed to have difficulty in maintaining attention toward Paro during the group session. In the group as a whole, Paro seemed to be a mediator for increased social interactions and created engagement.

scholarly journals Epidemiology of Intracranial Hemorrhage Associated with Oral Anticoagulants in Spain: Trends in Anticoagulation Complications Registry – The TAC 2 Study

2018 ◽  
Vol 7 (5) ◽  
pp. 284-295 ◽  
Author(s):  
Gustavo Zapata-Wainberg ◽  
Sonia Quintas ◽  
Álvaro Ximénez-Carrillo Rico ◽  
Jaime Masjuán Vallejo ◽  
Pere Cardona ◽  
...  
Keyword(s):  
Intracranial Hemorrhage ◽  
Clinical Characteristics ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Functional Independence ◽  
Antithrombotic Treatment ◽  
Study Population ◽  
Hemorrhage Volume ◽  
The Mean ◽  
Related Mortality

Objective: Patients receiving treatment with oral anticoagulants (OACs) are at risk of intracranial hemorrhage (ICH). In this study, we describe the epidemiological and clinical characteristics of patients receiving OACs who experience ICH and compare those receiving vitamin K antagonists (ICH-VKAs) with those receiving direct OACs (ICH-DOACs). Methods: We performed a national, multicenter, descriptive, observational, retrospective study of all adult patients receiving OACs who were admitted to the neurology department with ICH over a 1-year period. The study population was divided into 2 groups (ICH-VKAs and ICH-DOACs). Epidemiological, clinical, radiological, and therapy-related variables, as well as functional outcome, were compared at 3 months. A total of 366 cases were included (331 ICH-VKAs, 35 ICH- DOACs). Results: The crude annual incidence of OAC-induced ICH was 3.8 (95% CI, 2.78–3.41) per 100,000 inhabitants/year. The mean (± SD) age was greater for ICH-DOACs (81.5 ± 8.3 vs. 77.7 ± 8.3 years; p = 0.012). The median (IQR) volume of the hemorrhage was lower for ICH-DOACs (11 [30.8] vs. 25 [50.7] mL; p = 0.03). The functional independence rate at 3 months (modified Rankin Scale, mRS < 3) was similar in both groups, although stroke-related mortality was greater in ICH-VKAs (40 vs. 72.7%; p = 0.02). The most frequently indicated poststroke antithrombotic therapy was DOACs (38.7%). Conclusion: We found that the incidence of OAC-induced ICH was greater than in previous studies. Hemorrhage volume and mortality were lower in ICH-DOACs than in ICH-VKAs. After stroke, DOACs were the most frequently indicated antithrombotic treatment.

scholarly journals Common behavioral problems among patients with dementia attending in tertiary care hospitals in Dhaka city

2017 ◽  
Vol 28 (2) ◽  
pp. 50-52
Author(s):  
Sadya Tarannum ◽  
Bushra Sultana ◽  
Sultana Algin ◽  
Atiqul Haq Majumder
Keyword(s):  
Behavioral Problems ◽  
Tertiary Care ◽  
Behavioral Problem ◽  
Cross Sectional Study ◽  
Severe Dementia ◽  
Cross Sectional ◽  
Developed Country ◽  
Moderate Dementia ◽  
New Treatment ◽  
Severity Of Dementia

Elderly people are increasing day by day both in developing and developed country due to development of new treatment, increased awareness of people and improved health facilities. This present study was conducted with the aim to identify behavioral problems according to severity of dementia. This descriptive cross sectional study was conducted in the Department of Psychiatry and Department of Neuro-medicine of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh and in National Institute of Mental Health (NIMH), Sher-E-Bangla Nagar, Dhaka, Bangladesh from September 2013 to March 2015. A total 150 patients were selected purposefully; severity of dementia was graded according to Mini Mental State Examination (MMSE) and another questionnaire was applied to detect behavioral problems of patients. In this study mild dementia was found as the most frequent (38%), followed by severe dementia (35.3%) and moderate dementia (26.7%). The results indicated that behavioral problem was more common in severe dementia. Behavioral problem was more common in severe dementia than in mild and moderate dementia. Among behavioral problems sleep disturbance and sexual disturbance were statistically significant This study provides information about pattern of behavioral problems among patients with dementia. Liaison approach with other discipline may improve quality of life of these patients treatable.Bang J Psychiatry Dec 2014; 28(2): 50-52

scholarly journals Einbezug der Väter in die stationäre Mutter-Kind-Therapie: „Mit Papa geht es besser“

2021 ◽  
Author(s):  
Jakob Johann Müller ◽  
Svenja Taubner
Keyword(s):  
Propensity Scores ◽  
Parental Bonding ◽  
Symptom Checklist ◽  
Treatment As Usual ◽  
Inverse Probability ◽  
Post Hoc ◽  
Wissenschaftliche Studien

Zusammenfassung Hintergrund Obwohl Forschungsbefunde auf einen großen väterlichen Einfluss hinweisen, gibt es bislang kaum Interventionsprogramme und wissenschaftliche Studien, die den systematischen Einbezug von Vätern in die stationäre Mutter-Kind-Behandlung zum Gegenstand haben. Ziel der Arbeit Die Studie untersucht, wie sich der Einbezug von Vätern auf das Outcome stationärer Mutter-Kind-Behandlungen bei postpartalen psychischen Störungen auswirkt. In dieser Pilotstudie wird das Programm „Mit Papa geht es besser“ vorgestellt. Methodik Fünfzehn Partner/Kindsväter von behandelten Mutter-Kind-Dyaden durchliefen ein strukturiertes Begleitprogramm parallel zur Mutter-Kind-Behandlung („Mit Papa geht es besser“). Die Mütter in Behandlung wurden in einem Prä-post-Design zu ihrer Symptomatik (Symptom-Checklist 90, SCL-90), Mutter-Kind-Bindung (Parental Bonding Questionnaire, PBQ) und Partnerschaftszufriedenheit (Kurzversion des Partnerschaftsfragebogens, PFB-K) befragt. Diese Gruppe wurden mit einer historischen Kontrollgruppe von 30 behandelten Müttern verglichen, die die Behandlung wie bisher („treatment as usual“, TAU) durchliefen. Die Gruppen wurden post hoc mithilfe einer „Inverse-probability-of-treatment-weighting“(IPTW)-Schätzung von Propensity Scores (PS) balanciert. Ergebnisse Mütter in allen Versuchsbedingungen profitierten von der stationären Behandlung. Mütter in der Interventionsgruppe wiesen im Hinblick auf die Zielvariablen ein tendenziell verbessertes Outcome auf, insbesondere für die Veränderung der Partnerschaftszufriedenheit, die Unterschiede erreichten aber keine statistische Signifikanz. Schlussfolgerung Die Befunde weisen darauf hin, dass Mütter in stationärer Mutter-Kind-Behandlung vom Einbezug der Väter profitieren könnten. Die Intervention soll nun im Rahmen eines randomisierten kontrollierten Studiendesigns an einer größeren Stichprobe auf ihre Wirksamkeit überprüft werden.

scholarly journals 380. Environmental Contamination with SARS-CoV-2 in Nursing Homes

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S291-S292
Author(s):  
Lona Mody ◽  
Kristen Gibson ◽  
Liza Bautista ◽  
Karen Neeb ◽  
Ana Montoya ◽  
...  
Keyword(s):  
Environmental Contamination ◽  
Patient Characteristics ◽  
Functional Independence ◽  
Patient Room ◽  
Significant Disabilities ◽  
Environmental Surfaces ◽  
Common Area ◽  
Study Population ◽  
Clinical Records

Abstract Background The COVID-19 pandemic has disproportionately affected nursing home (NH) patients, accounting for 5% of all cases and 32% of all COVID-19 deaths nationwide. Little is known about the frequency and persistence of SARS-CoV-2 environmental contamination in NHs. We characterize SARS-CoV-2 contamination in the rooms of COVID-19 patients and common areas in and around COVID-19 units. Methods A prospective cohort study was conducted at four NHs in Michigan between October 2020 and January 2021. Clinical research personnel obtained swab specimens from high-touch room surfaces of COVID-19 infected patients, up to three times per patient. Weekly swab specimens from six high-touch surfaces in common areas were also obtained. Demographic and clinical data were collected from patient clinical records. Our primary outcome of interest was the probability of SARS-CoV-2 detection from specific environmental surfaces in COVID-19 patient rooms. Results One hundred four patients with COVID-19 were enrolled and followed for 241 visits. Patient characteristics included: 61.5% over the age of 80; 67.3% female; 89.4% non-Hispanic white; 50.1% short-stay. The study population had significant disabilities in activities of daily living (ADL; 81.7% dependent in four or more ADLs) and comorbidities including dementia (55.8%), diabetes (40.4%) and heart failure (32.7) (Table 1). Over the 3-month study period, 2087 swab specimens were collected (1896 COVID-19 patient room surfaces, 191 common area swabs). Figure 1 shows contamination rates at sites proximate and distant to the patient bed. SARS-CoV-2 positivity was 28.4% (538/1896 swabs) on patient room surfaces and 3.7% (7/191 swabs) on common area surfaces. Over the course of follow-up, 89.4% (93/104) of patients had SARS-CoV-2 contamination in their room at least once (Figure 2). Environmental contamination detected on enrollment correlated with contamination of the same site during follow-up. Functional independence increased the odds of proximate contamination. Table 1. Clinical and Demographic Characteristics of the Study Population Including Short- and Long-stay Patients Figure 1. Contamination of Environmental Surfaces Relative to Distance from Patient Bed Figure 2. SARS-CoV-2 on Swab Specimens Collected – Patient-level, Visit-level, and Swab-level Conclusion We conclude that environmental contamination of surfaces in the rooms of COVID-19 patients is nearly universal and persistent. Patients with greater independence are more likely than fully dependent patients to contaminate their immediate environment. Disclosures All Authors: No reported disclosures

Measurement in Rehabilitation — Lies, damned lies and statistics

1999 ◽  
Vol 5 (2) ◽  
pp. 62-68
Author(s):  
Hugh G. Dickson
Keyword(s):  
American Medical Association ◽  
Functional Independence Measure ◽  
Rehabilitation Medicine ◽  
Functional Independence ◽  
Data Set ◽  
Standard Data ◽  
Different Types ◽  
Functional Measure ◽  
Australian Standard ◽  
Mathematical Problems

Measurement in Rehabilitation Medicine commences with clear definitions of the terms used and clear ideas about the nature of the entity being measured. In this lecture, issues such as goal based measurement, the difficulties of comparison, weighting systems, different types of scales, and the mathematical problems they present are discussed. Scales discussed include the American Medical Association Guides to the Evaluation of Permanent Impairment, and the Functional Independence Measure (FIM). Caution is necessary when drawing conclusions from statistics generated from ordinal scales, especially when comparisons are being made. The Australasian Faculty of Rehabilitation Medicine supports the use of standard measures and has developed an Australian Standard Data Set for Rehabilitation Medicine. The functional measure used in this data set is the FIM.

scholarly journals Hypertension and Migraine in the Northern Manhattan Study

2016 ◽  
Vol 26 (3) ◽  
pp. 323 ◽  
Author(s):  
Hannah Gardener ◽  
Teshamae Monteith ◽  
Tatjana Rundek ◽  
Clinton B. Wright ◽  
Mitchell S.V. Elkind ◽  
...  
Keyword(s):  
Self Report ◽  
Uncontrolled Hypertension ◽  
Community Based ◽  
Cross Sectional ◽  
Predominantly Hispanic ◽  
Hispanic Community ◽  
Long Duration ◽  
Study Population ◽  
And Control

<p><strong>Objective: </strong>To investigate the association between migraine and hypertension in the Northern Manhattan Study (NOMAS), a multiethnic community-based sample. <strong></strong></p><p><strong>Design: </strong>Cross-sectional cohort study. </p><p><strong>Participants:</strong>1338 NOMAS participants (mean age 68.1±9.6 years, 37% male, 15% non-Hispanic White, 19% non-Hispanic Black, 67% Hispanic). </p><p><strong>Setting: </strong>Northern Manhattan community. <strong></strong></p><p><strong>Intervention: </strong>Participants were assessed for migraine symptoms using a self-report questionnaire based on criteria from the International Classification of Headache Disorders. Hypertension was defined as blood pressure ≥140/90 mm Hg, the patient’s self-reported hypertension, or use of anti-hypertensive medications. Duration (≤9 years vs &gt;9 years) and control (BP&lt;140/90) of hypertension were examined. We estimated the association between hypertension and migraine (overall and with/without aura) using logistic regression, adjusting for sociodemographic and vascular risk factors. </p><p><strong>Results: </strong>The majority of participants (80%) had no migraine, 6% had migraine with aura, and 15% had migraine without aura. Hypertension was present in 76% of the study population (7% had controlled hypertension ≤9 years duration, 5% controlled hypertension &gt;9 years duration, 41% uncontrolled hypertension ≤9 years duration, 23% uncontrolled hypertension &gt;9 years duration). Hypertension was associated with migraine (OR: 1.76, 95% CI: 1.21-2.54), both with and without aura. This association was particularly apparent for those with uncontrolled and long duration hypertension. </p><p><strong>Conclusion: </strong>Hypertension, particularly uncontrolled and of long duration, is associated with migraine, both with and without aura, in a predominantly Hispanic community-based cohort. <em>Ethn Dis. </em>2016;26(3):323-330; doi:10.18865/ed.26.3.323 </p>

Early Retrieval of Spanning Plates Used for Fixation of Complex Fractures of the Distal Radius

2021 ◽  
Author(s):  
Tyler W. Henry ◽  
Jacob E. Tulipan ◽  
Richard M. McEntee ◽  
Pedro K. Beredjiklian
Keyword(s):  
Short Duration ◽  
Distal Radius ◽  
Level Of Evidence ◽  
Plate Removal ◽  
Mean Values ◽  
Complex Fractures ◽  
Long Duration ◽  
Study Population ◽  
Quick Dash ◽  
Radiographic Alignment

Abstract Background Spanning plates are being increasingly used for the treatment of complex fractures of the distal radius. The traditional recommendation is to leave the hardware in place for at least 12 weeks. Questions/Purpose This study assesses the comparative outcomes of spanning plates removed at or before 10 weeks. We hypothesized that acceptable healing and functional outcomes can be achieved with earlier hardware removal to allow for earlier range of motion, rehabilitation, and return to function. Patients and Methods All patients treated for a comminuted, intra-articular distal radius fracture with a temporary spanning plate were identified. Outcomes of bridge plates removed before 10 weeks were compared with plates removed after 12 weeks. Twenty patients in the short duration cohort were compared with 40 patients in the long duration cohort. Results All fractures healed and there were 10 complications (4 short duration, 6 long duration) and 2 reoperations (1 short duration, 1 long duration) in the study population. There were no significant differences in final Quick-DASH scores (27.4 short duration, 20.9 long duration) or radiographic alignment. Mean values for wrist extension and ulnar deviation were significantly worse in the long duration cohort, although these differences are of unclear clinical significance. Conclusion It may be safe to remove spanning bridge plates earlier than what is traditionally recommended. Plate removal at or before 10 weeks did not detract from healing or radiographic alignment. Prospective investigations assessing the optimal duration of fixation for this technique are needed. Level of Evidence This is a Level IV study.

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