Objectives-To evaluate a paging system designed to improve independence in people with memory problems and executive deficits. Methods-After a successful pilot study, a randomised control trial was conducted involving a crossover design with 143 people aged between 8 and 83 years. All had one or more of the following: memory, planning, attention, or organisation problems. Most had sustained a traumatic head injury or a stroke although a few had developmental learning diYculties or other conditions. The crossover design ensured that some people received a pager after a 2 week baseline whereas others were required to wait for 7 weeks after the baseline before receiving the pager. Participants were assessed at three time periods-namely, at baseline, 7 weeks, and at 14 weeks postbaseline. Results-More than 80% of those who completed the 16 week trial were significantly more successful in carrying out everyday activities (such as self care, self medication, and keeping appointments) when using the pager in comparison with the baseline period. For most of these, significant improvement was maintained when they were monitored 7 weeks after returning the pager. Conclusions-This particular paging system significantly reduces everyday failures of memory and planning in people with brain injury. (J Neurol Neurosurg Psychiatry 2001;70:477-482)
Neonatal screening for cystic fibrosis (CF) has been established in Leeds since 1975. The current method is measuring IRT and genotyping. Newborn screening for CF results in a small but significant number of false positives. This study explored the psychosocial reactions to such results in a group of parents (N=21) using semi-structured interviews. Responses were analysed using descriptive statistics and well-validated content analysis. Mothers described a range of emotions during the screening process including anxiety, distress and upset. Waiting for the repeat IRT test results was identified as the most emotionally difficult stage. Discussion focuses on good practice and implications for CF services.
Although memory problems following acquired brain damage are common, some people are able to compensate for these problems through external aids. It was recently demonstrated that a paging system could reduce the everyday memory and planning problems for people with non-progressive brain injury. The 143 patients who participated in the study comprised several diagnostic groups. This paper reports on the sub-group of people with TBI (n=63). This sub-group was part of the larger sample of 143 already published in the 2001 study. A randomized control cross-over design randomly allocated people to group A (pager first) or group B (waiting list first). Each participant chose their own tasks for which they needed reminders. During a 2 week baseline, successful task achievement was documented. Group A achieved 47.14% of tasks and group B 47.88%. People in group A then received a pager for 7 weeks. During the last 2 weeks of this 7 week period, task achievement was documented again. Group A now achieved 71.80% of tasks and group B (on the waiting list) achieved 49.05% (no different from baseline). Group A then returned their pagers and group B received pagers. During the last 2 weeks of this stage participants were monitored once more. At this point, people in group A had dropped back slightly but were still statistically significantly better than during the baseline (67.23%). Group B, meanwhile, were now achieving 73.62% of tasks. This was statistically significantly better than baseline and significantly better than group A, now in the post-pager phase. It is concluded that this paging system significantly reduces the everyday memory and planning problems of people with TBI.
Memory and executive problems following encephalitis are common yet there are few published papers on the successful rehabilitation of such patients. We recently demonstrated (Wilson, Emslie, Quirk, & Evans, 2001; Wilson, Emslie, Quirk, Evans, & Watson, 2005) that a paging system could reduce the everyday memory and planning problems for people with non-progressive brain injury. Among the 143 patients who participated in the 2001 study were four people who had survived encephalitis. Their results are reported here. During a 2-week baseline, the successful task achievement of our four clients ranged from 2-81%. They then received a pager for 7 weeks and task achievement was documented in weeks 6 and 7. All were significantly more successful with the pager than they had been at baseline with success rates ranging from 45-96%. Five weeks after returning their pagers they were monitored once more. One of the encephalitic patients failed to achieve any of his target tasks, returning to baseline level, the other three dropped back a little but were still significantly more successful than at baseline. It is concluded that the paging system can reduce everyday memory and planning problems of patients with encephalitis.
The authors report the case of George, a young man with very severe memory impairments after a head injury sustained in a road traffic accident several years earlier. George was one of 200 participants in a study evaluating NeuroPage®, an electronic memory aid. Like many other participants in the study, he responded well to NeuroPage® and was able to live independently with the new memory aid. Using an ABAB single-case experimental design, the authors show his response to the pager, describe his feelings about it, and consider reasons for its efficacy. It would appear that NeuroPage® is effective because it is easy for patients with brain injuries to use, the messages are relevant, the prompts appear at the time needed, and using a pager is prestigious.Much of the work in memory rehabilitation involves teaching people to compensate for their impairments by using aids such as diaries, tape recorders, organizers,
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