Background. Rehabilitation of the severely affected paretic arm after stroke represents a major challenge, especially in the presence of sensory impairment. Objective. To evaluate the effect of a therapy that includes use of a mirror to simulate the affected upper extremity with the unaffected upper extremity early after stroke. Methods. Thirty-six patients with severe hemiparesis because of a first-ever ischemic stroke in the territory of the middle cerebral artery were enrolled, no more than 8 weeks after the stroke. They completed a protocol of 6 weeks of additional therapy (30 minutes a day, 5 days a week), with random assignment to either mirror therapy (MT) or an equivalent control therapy (CT). The main outcome measures were the Fugl-Meyer subscores for the upper extremity, evaluated by independent raters through videotape. Patients also underwent functional and neuropsychological testing. Results. In the subgroup of 25 patients with distal plegia at the beginning of the therapy, MT patients regained more distal function than CT patients. Furthermore, across all patients, MT improved recovery of surface sensibility. Neither of these effects depended on the side of the lesioned hemisphere. MT stimulated recovery from hemineglect. Conclusions. MT early after stroke is a promising method to improve sensory and attentional deficits and to support motor recovery in a distal plegic limb.

No abstract

ObjectiveThe tracking of one’s own physical activity with mobile devices is a way of monitoring and motivating oneself to remain healthy. Older adults’ general use of mobile devices for physical activity tracking has not yet been examined systematically. The study aimed to describe the use of physical activity trackers, smartwatches and smartphones, or tablets for tracking physical activity and to examine the reasons for the use of these technologies.MethodsParticipants aged ≥50 years (N = 1013) living in Switzerland were interviewed in a telephone survey. To address the research questions, we calculated descriptive frequency distributions, tested for differences between groups, and performed logistic regression analyses.ResultsDescriptive and multivariate analyses showed that (a) 20.5% of participants used mobile devices for physical activity tracking; (b) men, younger individuals, those with a strong interest in new technology, and those who frequently exercised had a higher likelihood of using mobile devices for physical activity tracking; and (c) participants more often agreed with reasons for use relating to tracking physical activity and motivating oneself to remain healthy than they did with reasons relating to social factors.ConclusionsThe study presented representative data about the actual use of mobile tracking technology in persons over 50 years of age. Today, mainly active and younger elderly (mostly men) with a high interest in technology are using tracking technologies. Results indicate a need for further studies on motivational and usability aspects regarding the use of mobile health tracking devices by older adults.

Background The purpose of our study was to identify predictors of a high risk of involuntary psychiatric in-patient treatment. Methods We carried out a detailed analysis of the 1773 mental health records of all the persons treated as in-patients under the PsychKG NRW (Mental Health Act for the state of North Rhine-Westphalia, Germany) in a metropolitan region of Germany (the City of Cologne) in 2011. 3991 mental health records of voluntary in-patients from the same hospitals served as a control group. We extracted medical, sociodemographic and socioeconomic data from these records. Apart from descriptive statistics, we used a prediction model employing chi-squared automatic interaction detection (CHAID). Results Among involuntary patients, organic mental disorders (ICD10: F0) and schizophrenia and other psychotic disorders (ICD10: F2) were overrepresented. Patients treated as in-patients against their will were on average older, they were more often retired and had a migratory background. The Exhaustive CHAID analysis confirmed the main diagnosis to be the strongest predictor of involuntary in-patient psychiatric treatment. Other predictors were the absence of outpatient treatment prior to admission, admission outside of regular service hours and migratory background. The highest risk of involuntary treatment was associated with patients with organic mental disorders (ICD 10: F0) who were married or widowed and patients with non-organic psychotic disorders (ICD10: F2) or mental retardation (ICD10: F7) in combination with a migratory background. Also, referrals from general hospitals were frequently encountered. Conclusions We identified modifiable risk factors for involuntary psychiatric in-patient treatment. This implies that preventive measures may be feasible and should be implemented to reduce the rate of involuntary psychiatric in-patient treatment. This may include efforts to establish crisis resolution teams to improve out-patient treatment, train general hospital staff in deescalation techniques, and develop special programs for patients with a migratory background.

Background and Objectives A good person–environment-fit has positive effects on well-being in old age. As digital technologies are an integral part of older adults’ environments, we predicted that the use of information and communication technologies (ICT) is associated with subjective well-being among the oldest-old. Specifically, we compared different user groups of ICT devices (nonusers, users of nonweb-connected ICT, users of web-connected ICT) and analyzed the relations among ICT use and three domains of subjective well-being (loneliness, anomie, autonomy). Research Design and Methods We performed a quantitative data analysis using data from the first representative state-wide survey study in North-Rhine Westphalia, Germany on quality of life and well-being of the oldest-old (n = 1,698; age range: 80–103; 9% long-term care). Multiple regression analyses were applied. Results The findings revealed that 25.9% of all individuals aged 80 years and older reported using web-connected ICT, in contrast to 38.5% who do not use ICT at all. Individuals who used web-connected ICT reported lower levels of loneliness and anomie, and higher levels of autonomy. These differences remain significant when controlling for indicators of social inclusion and individual characteristics. Discussion and Implications This study investigated an underexplored group in terms of ICT use, shedding light on the relationship between ICT use and subjective well-being. The oldest-old generally use ICT in their everyday life but an age-related digital divide still exists. To avoid negative consequences of nonuse digital infrastructures and technology training for older adults need to be established.