scholarly journals Personalized Exergames Language: A Novel Approach to the Automatic Generation of Personalized Exergames for Stroke Patients

2020 ◽  
Vol 10 (20) ◽  
pp. 7378 ◽  
Author(s):  
David Vallejo ◽  
Cristian Gmez-Portes ◽  
Javier Albusac ◽  
Carlos Glez-Morcillo ◽  
José Jesús Castro-Schez

Physical rehabilitation of stroke patients is based on the daily execution of exercises with face-to-face supervision by therapists. This model cannot be sustained in the long term, due to the involved economic costs, the growing number of patients, and the aging population. Remote rehabilitation tools have emerged to address this unmet clinical need, but they face the double challenge of motivating patients and ensuring an effective remote rehabilitation. In this context, exergames allow patients to play while performing repetitive therapeutic tasks in a safe and ecological environment. This work proposes the design of Personalized Exergames Language (PEL), a language whose sentences can be processed via software in order to automatically generate exergames. The definition of exergames through PEL, guided by an effective methodology of the design and generation of personalized exergames, will include both game mechanics and the necessary metrics to monitor, guide, and adapt the rehabilitation of each patient. The integration of authoring tools are considered to visually guide the therapist when designing exergames. A study has been carried out with stroke patients and therapists from a hospital and two community centers, in order to evaluate several exergames, automatically generated using PEL, in terms of usability, understanding, and suitability.

2021 ◽  
Vol 30 (4) ◽  
pp. S28-S35
Author(s):  
Andrew Fishburn ◽  
Nicola Fishburn

Thyroid cancer is a complex disease requiring management by a large multidisciplinary team. The number of patients with a diagnosis of thyroid cancer is significantly increasing year-on-year, and traditional models of consultant-led follow up are no longer sustainable. Although nurse-led cancer follow-up clinics are becomining increasingly common, thyroid cancer nurse-led follow-up clinics are rare. An excellent understanding of the disease, treatment and management of risk of disease recurrence is essential for safe patient care, and is discussed in this article. The clinic discussed uses the skill set of head and neck nurse specialists, including psychological support, coping strategies for long-term side effects of treatment and non-medical prescribing. A patient survey of the service revealed high levels of patient satisfaction and a desire to continue face-to-face consultations rather than telephone clinics.


Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 632
Author(s):  
Byung-Joo Lee ◽  
Hyoshin Eo ◽  
Chang-Bae Lee ◽  
Donghwi Park

Introduction: The Videofluoroscopic Dysphagia Scale (VDS) is used to predict the long-term prognosis of dysphagia in patients with strokes. However, the inter-rater reliability of the VDS was low in a previous study. To overcome the mentioned limitations of the VDS, the modified version of the VDS (mVDS) was created and clinically applied to evaluate its usefulness in choosing the feeding method for stroke patients with dysphagia. Methods: The videofluoroscopic swallowing study (VFSS) data of 56 stroke patients with dysphagia were collected retrospectively. We investigated the presence of aspiration pneumonia and the selected feeding method. We also evaluated the correlations between the mVDS and the selected feeding method, and between the mVDS and the presence of aspiration pneumonia after stroke. Univariate logistic regression and receiver operating characteristic analyses were used in the data analysis. Results: The inter-rater reliability (Cronbach α value) of the total score of the mVDS was 0.886, which was consistent with very good inter-rater reliability. In all patients with dysphagia, the supratentorial stroke subgroup, and the infratentorial stroke subgroup, the mVDS scores were statistically correlated with the feeding method selected (p < 0.05) and the presence of aspiration pneumonia (p < 0.05). Conclusions: The mVDS can be a useful scale for quantifying the severity of dysphagia, and it can be a useful tool in the clinical setting and in studies for interpreting the VFSS findings in stroke patients with dysphagia. Further studies with a greater number of patients and various stroke etiologies are required for more generalized applications of the mVDS.


2021 ◽  
Author(s):  
Byung Joo Lee ◽  
Hyoshin Eo ◽  
Changbae Lee ◽  
Donghwi Park

Abstract Introduction: The Videofluoroscopic Dysphagia Scale (VDS) is used to predict the long-term prognosis of dysphagia in patients with stroke. However, the inter-rater reliability of the VDS was low in a previous study. To overcome the mentioned limitations of the VDS, the modified version of the VDS (mVDS) was created and clinically applied to evaluate its usefulness in choosing the feeding method for stroke patients with dysphagia.Methods: The videofluoroscopic swallowing study (VFSS) data of 56 stroke patients with dysphagia were collected retrospectively. We investigated the presence of aspiration pneumonia and the selected feeding method. We also evaluated the correlations between the mVDS and the selected feeding method, and between the mVDS and the presence of aspiration pneumonia after stroke. Univariate logistic regression and receiver operating characteristic analyses were used in the data analysis.Results: The inter-rater reliability (Cronbach α value) of the total score of the mVDS was 0.886, which was consistent with very good inter-rater reliability. In all patients, the supratentorial stroke subgroup, and the infratentorial stroke subgroup, the mVDS scores were statistically correlated with the feeding method selected (p<0.05) and the presence of aspiration pneumonia (p<0.05).Conclusions: The mVDS can be a useful scale for quantifying the severity of dysphagia, and it can be a useful tool in the clinical setting and in studies for interpreting the VFSS findings in stroke patients with dysphagia. Further studies with a greater number of patients and various stroke etiologies are required for more generalized application of the mVDS.


Author(s):  
Jenny E. Grigoropoulos ◽  
Heike Arnold ◽  
Christina J. Rocha

The intention of this chapter is to demonstrate the implementation of the innovative instructional i2Flex methodology in Elementary School, Middle School, and High School classes for young EFL, ESL, and Foreign Language learners. Within a conceptual framework consisting of the ACS educational philosophy, reference features of foreign language teaching and the terminological definition of i2Flex, the three authors will outline a detailed explanation of their methodological and educational procedures, translating the i2Flex into practice in their foreign language classes. In a common conclusion of the three study cases, the authors will critically evaluate their experiences in their classrooms and the learning outcomes. They will then give insights and recommendations on how to consolidate the mutual symbiosis between face-to-face and flexible guided student learning supported by technology, guided towards independent and inquiry based student learning, in order to create a long-term, meaningful, academic blended learning in accordance to the i2Flex methodology and practice.


Crisis ◽  
1999 ◽  
Vol 20 (3) ◽  
pp. 115-120 ◽  
Author(s):  
Stephen Curran ◽  
Michael Fitzgerald ◽  
Vincent T Greene

There are few long-term follow-up studies of parasuicides incorporating face-to-face interviews. To date no study has evaluated the prevalence of psychiatric morbidity at long-term follow-up of parasuicides using diagnostic rating scales, nor has any study examined parental bonding issues in this population. We attempted a prospective follow-up of 85 parasuicide cases an average of 8½ years later. Psychiatric morbidity, social functioning, and recollections of the parenting style of their parents were assessed using the Clinical Interview Schedule, the Social Maladjustment Scale, and the Parental Bonding Instrument, respectively. Thirty-nine persons in total were interviewed, 19 of whom were well and 20 of whom had psychiatric morbidity. Five had died during the follow-up period, 3 by suicide. Migration, refusals, and untraceability were common. Parasuicide was associated with parental overprotection during childhood. Long-term outcome is poor, especially among those who engaged in repeated parasuicides.


2018 ◽  
Vol 3 (3) ◽  

Introduction: Too many patients with moderate to severe psoriasis do not receive adequate treatment. This means a vast undersupply in the treatment of patients with psoriasis. Only biologics fulfill the whole range of the treatment of psoriasis – psoriasis does not affect only skin but the whole organism: It is a systemic disease! Between the biologics are evident differences concerning the effect. Discussion: Based on broad personal experience in the management of patients with moderate to severe psoriasis new data from clinical studies with ixekizumab are examined. This contains new data on long-term-efficacy of ixekizumab, effectiveness in special localizations (scalp psoriasis, nail psoriasis, palmoplantar psoriasis, genital psoriasis) as well as safely data and experience on patients switched to ixekizumab from other biologics. Personal clinical experience is based on >300 non-selected outpatients with moderate to severe psoriasis, >250 patients on biological therapies, > 50 patients with ixekizumab. Conclusions: Focusing on a relevant number of patients switched from secukinumab to ixekizumab due to first or secondary loss of efficacy significant differences between both IL-17A-inhibitors mainly in terms of efficacy and speed of therapeutic response are shown. Finally the correlation between PASI-90-/PASI-100 response and significant changes in DLQI are highlighted.


2014 ◽  
Vol 76 ◽  
pp. 15-23
Author(s):  
Barrie J. Wills

A warm welcome to our "World of Difference" to all delegates attending this conference - we hope your stay is enjoyable and that you will leave Central Otago with an enhanced appreciation of the diversity of land use and the resilient and growing economic potential that this region has to offer. Without regional wellbeing the national economy will struggle to grow, something Central Government finally seems to be realising, and the Central Otago District Council Long Term Plan 2012-2022 (LTP) signals the importance of establishing a productive economy for the local community which will aid in the economic growth of the district and seeks to create a thriving economy that will be attractive to business and residents alike. Two key principles that underpin the LTP are sustainability and affordability, with the definition of sustainability being "… development that meets the needs of the present without compromising the ability of future generations to meet their own needs."


GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 35-41
Author(s):  
T Yu Pestrikova ◽  
I V Yurasov ◽  
E A Yurasova

Medical, social and economic relevance of inflammatory diseases of the woman's reproductive organs requires a very careful attitude to the diagnosis and treatment of this pathology. The number of patients with genital infections and inflammatory diseases of the pelvic organs can takes the first place in structure of gynecological morbidity, and is 60.4-65.0%, and this fact is not unique to Russia, but all over the world. Incidence rate of inflammatory diseases of the pelvic organs in the first decade of the twenty-first century is increased at 1.4 times in patients who are from 18 to 24 years old and at 1.8 times in patients aged 25-29 years. At the same time, the cost of diagnosis and treatment has increased, reaching 50-60% of the total cost of providing gynecological care for population. The inflammatory diseases of pelvic organs are a collective concept. It includes of various nosological forms. There are numerous contradictions in the views on diagnostic approaches and treatment tactics, the nature of screening and control over the long-term results of treatment, the etiological and pathogenetic significance of various microorganisms found in the genital tract in patients with inflammatory diseases of the pelvic organs. Currently, there are many opinions among specialists about diagnostic approaches and treatment tactics, the type of screening and monitoring the long-term results of treatment, the etiological and pathogenetic role of various microorganisms which can be found in the genital tract in patients with inflammatory diseases. This review presents the results of a modern approach to the diagnosis, management and rehabilitation of patients with inflammatory diseases of the pelvic organs.


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