A simple test of learning ability and the amputation site can help to predict the patient's ability to learn to use a prosthesis following amputation and is recommended as part of the assessment process.
The aim of this study was to evaluate the role of the rehabilitation assistant: a junior multidisciplinary grade combining key elements from nursing, occupational therapy, physiotherapy and speech and language therapy. The authors analysed daily activities, sophistication of clinical thinking and functioning of the role using timesheets, the think-aloud technique and semi-structured interviews. Rehabilitation assistants were found to facilitate rehabilitation and extend therapists' roles. Mobility, washing and dressing and activities of daily living were found to constitute most of a rehabilitation assistant's average day, with nursing skills and speech and language therapy appearing only in specific teams. All of the rehabilitation assistants displayed the ability to be able to think about the reasons behind the tasks they carried out, as opposed to merely following instruction from senior staff. The organization of the role of the rehabilitation assistant differed according to the team focus, structure and process within which the team operated. However, the specific role and boundaries of rehabilitation assistants' responsibilities need to be clearly defined for the role to function optimally.
Twenty-five CAT-scan-confirmed stroke patients and 25 matched controls were studied. All the stroke patients were stable 2-3 months after unilateral hemispheric stroke. Those with ear disease, other central neurological disorder, severe dysphasia and acute or chronic confusion were excluded. There were no significant differences between the groups for average pure tone hearing threshold (APTT) or ability to discriminate pre-recorded speech presented to one ear at 35 decibels (dB) above APTT. The stroke subjects had significantly impaired performance on dichotic competing sentence testing (DCST). Seventeen stroke patients but only one control subject failed DCST. Failure rate was similar for left and right stroke and for temporal and non-temporal lobe involvement. Two-thirds of patients failing DCST did so in the ear opposite the side of the cortical lesion. We conclude that (i) DCST is useful in detecting central auditory dysfunction in stroke patients; and (ii) stroke can affect central auditory perception in older patients.
A comparative study of two different methods of counselling for informal carers of elderly people with dementia was carried out in their own homes over an 18-week period. Carers were randomly allocated to short-term emotional support, information-provision or no-treatment control groups. Carers were assessed for mood, stress (Beck Depression Inventory and General Health Questionnaire), degree of burden and knowledge of problems of dementia. Carers receiving emotional support experienced the greatest reduction in stress, whereas those receiving information only showed an increase in knowledge, but no reduction in stress.
Forty-seven subjects (19 elderly dements, 18 elderly depressives, 10 elderly physically ill) were given a continuous false recognition technique (FRT) in a test battery including a measure of short-term memory and the Kendrick Synonym Learning Test. Results were analysed according to signal detection theory and interpreted in terms of an encoding breakdown. Depressives were found to be characterized by conservative error-free performance whereas the demented made more errors, partly because of their more liberal criterion and partly because of their greater loss of encoding characteristics. From these results, an optimal cut-off score was chosen for differential diagnosis using the FRT. This was shown to hold more promise than the SLT in discriminating between dementia and depression.
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