The development of a cognitive screening protocol for Aboriginal and/or Torres Strait Islander peoples: the Guddi Way screen.

Background Many Aboriginal and/or Torres Strait Islander peoples are exposed to risk factors for cognitive impairment. However, culturally appropriate methods for identifying potential cognitive impairment are lacking. This paper reports on the development of a screen and interview protocol designed to flag possible cognitive impairments and psychosocial disability in Aboriginal and/or Torres Strait Islander adults over the age of 16years. Methods The Guddi Way screen includes items relating to cognition and mental functions across multiple cognitive domains. The screen is straightforward, brief, and able to be administered by non-clinicians with training. Results Early results suggest the Guddi Way screen is reliable and culturally acceptable, and correctly flags cognitive dysfunction among Aboriginal and/or Torres Strait Islander adults. Conclusions The screen shows promise as a culturally appropriate and culturally developed method to identify the possibility of cognitive impairments and psychosocial disability in Aboriginal and/or Torres Strait Islander adults. A flag on the Guddi Way screen indicates the need for referral to an experienced neuropsychologist or neuropsychiatrist for further assessment and can also assist in guiding support services.

Use of fresnel prism glasses to treat stroke patients with hemispatial neglect.

OBJECTIVE: To explore the functional effects of prism adaptation training on patients with hemispatial neglect after stroke. DESIGN: Observational study. SETTING: Inpatient rehabilitation unit in rural Australia. PARTICIPANTS: Four subjects with hemispatial neglect, recruited from consecutive admissions of patients less than 60 days poststroke. INTERVENTION: Prism adaptation treatment, consisting of five 10-minute training sessions over 12 to 17 days. MAIN OUTCOME MEASURES: The FIM instrument, Catherine Bergego Scale (CBS), subjective straight ahead pointing, Albert's line cancellation, letter cancellation, and line bisection. Ambulatory patients also performed the Timed Up & Go test. RESULTS: Immediate effects of prism adaptation training included improvements in both subjective straight ahead pointing and in the Albert's line cancellation task. Letter cancellation, line bisection, FIM, and CBS scores improved in all subjects. Improvements in a functional task were also observed immediately following prism adaptation treatment. Obstacle avoidance while walking improved after prism adaptation training in 2 ambulatory subjects. CONCLUSIONS: Prism adaptation training shows promise as a new treatment to supplement current strategies for the clinical management of hemispatial neglect after stroke. This study is limited by small sample size and absence of a control group. Further research will be needed to demonstrate efficacy for this inexpensive and relatively safe device.