Usability of a Low-Cost Head Tracking Computer Access Method following Stroke.

Assistive technology devices for computer access can facilitate social reintegration and promote independence for people who have had a stroke. This work describes the exploration of the usefulness and acceptability of a new computer access device called the Nouse™ (Nose-as-mouse). The device uses standard webcam and video recognition algorithms to map the movement of the user's nose to a computer cursor, thereby allowing hands-free computer operation. Ten participants receiving in- or outpatient stroke rehabilitation completed a series of standardized and everyday computer tasks using the Nouse™ and then completed a device usability questionnaire. Task completion rates were high (90%) for computer activities only in the absence of time constraints. Most of the participants were satisfied with ease of use (70%) and liked using the Nouse™ (60%), indicating they could resume most of their usual computer activities apart from word-processing using the device. The findings suggest that hands-free computer access devices like the Nouse™ may be an option for people who experience upper motor impairment caused by stroke and are highly motivated to resume personal computing. More research is necessary to further evaluate the effectiveness of this technology, especially in relation to other computer access assistive technology devices.

A pilot randomized controlled trial of community-based occupational therapy in late stroke rehabilitation.

Chronic participation deficits are common following stroke. We hypothesized that a brief period of occupation-focused, client-centered occupational therapy would lead to improved participation in valued activities for individuals who had experienced strokes 6 or more months previously. Sixteen individuals were randomized to the intervention or no-treatment control group. All participants identified up to five activities in which they wished to improve. Following intervention, both groups rated their performance of these activities similarly. However, those who received the intervention rated their satisfaction with these activities significantly higher than did the participants who did not receive the occupational therapy intervention. There were no differences between postintervention measures of well-being or overall participation. Further evaluation of such a program of late stroke rehabilitation is recommended.

Quantitative analysis of multiple sclerosis patients' preferences for drug treatment: a best-worst scaling study.

BACKGROUND: With recent developments in drug therapy for multiple sclerosis (MS), new treatment options have become available presenting patients with complex treatment decisions. OBJECTIVES: The objective of this study was to elicit patients' preferences for different attributes of MS drug therapy. METHODS: A representative sample of patients with MS across Canada (n=189) participated in a best-worst scaling study to quantify preferences for different attributes of MS drug therapy, including delaying progression, improving symptoms, preventing relapse, minor side effects, rare but serious adverse events (SAEs), and route of administration. Conditional logit models were fitted to estimate the relative importance of each attribute in influencing patients' preferences. RESULTS: A latent-class analysis revealed heterogeneity of preferences across respondents, with preferences differing across five classes. The most important attributes of drug therapy were the avoidance of SAEs for three classes and the improvement of symptoms for two other classes. Only a smaller group of patients demonstrated a specific preference for avoiding SAEs, and route of administration. CONCLUSION: This study shows that preferences for drug therapy among patients with MS are different, some of which can be explained by experiences with their disease and treatment. These findings can help to inform the focus of interactions that healthcare practitioners have with patients with MS, as well as further drug development.

Incidental lingual thyroid informs surgery.

This case study presents an incidental noting of a lingual thyroid on thyroid scintigraphy that had implications in later breast surgery. This information changed patient management and mitigated risk during intubation for breast cancer surgery.