OBJECTIVES: This study performed meta-analysis on the literatures that surveyed cognitive test to forecast unsafe driving by older drivers and identified objective and consistent cognitive test for predicting unsafe driving of older drivers. SELECTIO

Introduction: Virtual reality (VR)-based training for functions such as cognition, upper extremities, balancing, and activities of daily living (ADL) has been used on stroke patients, and its efficacy has been reported. However, no comparison has been made between the efficacy of VR-based training for daily activities that exactly reproduces ADL and functional training. Therefore, this study sought to analyze the difference in independency enhancement of VR-based training for daily activities compared to cognitive and motor functional training. Patient concerns and diagnosis: This study was conducted on 4 patients who have been diagnosed with stroke and are currently receiving rehabilitation therapy in G hospital located in the city of Gwangju, using A-B-A’-B’ design from single-subject experimental designs. Interventions: Intervention was performed in 2 ways: application of VR-based training for daily activities after the application of cognitive and motor function training; and application of cognitive and motor function training after the application of VR-based training for daily activities. The Assessment of Motor and Process Skills, Computer Cognitive Screening Assessment System, Box and Block Test, and Grip and Pinch Strength Test were used to measure the changes in the performance of daily activities, cognitive function, and upper extremities function. Outcomes: The results confirmed that the performance of daily activities, cognitive function, and upper extremities function was improved after the application of VR-based intervention. In addition, the efficacy of independency enhancement was maximized by the early approach of training for daily activities at the time of VR-based intervention in stroke patients. Conclusions: VR-based intervention of training for daily activities and functional training can be considered to benefit the improvement of the performance of daily activities, cognitive function, and upper extremities function in stroke patients. In addition, although functional training was also effective in enhancing independency and functional improvement in stroke patients, an early approach to training for ADL based on tasks with objectives was deemed to be more effective.

Purpose: Although there are over 40,000 licensed radiological technologists (RTs) in Korea, job competency standards have yet to be defined. This study aims to clarify the job competency of Korean RTs. Methods: A task force team of 11 professional RTs were recruited in order to analyze the job competency of domestic and international RTs. A draft for the job competency of Korean RTs was prepared. A survey was then conducted sampling RTs and the attitudes of their competencies were recorded from May 21 to July 30, 2016. Results: We identified five modules of professionalism, patient management, health and safety, operation of equipment, and procedure management and 131 detailed job competencies for RTs in Korea. “Health and safety” had the highest average score and “professionalism” had the lowest average score for both job performance and importance. The content validity ratios for the 131 subcompetencies were mostly valid. Conclusion: Establishment of standard guidelines for RT job competency for multidisciplinary healthcare at medical institutions may be possible based on our results, which will help educators of RT training institutions to clarify their training and education.

BACKGROUND: Instrumental assessments are typically used to assess swallowing function in stroke patients with dysphagia, but these tests cannot be used for all patients or for continuous monitoring. Hence, an adjunctive method is necessary for screening patients who may require such tests. AIM: The purpose of this study was to analyze tongue strength with respect to the presence or absence of penetration and aspiration, using instrumental assessments, to provide a basis for clinical decision-making. DESIGN: Prospective observational study. SETTING: University Hospitals in Gwangju, South Korea. POPULATION: Seventy-nine subjects with dysphagia underwent video fluoroscopic swallowing study (VFSS) and Iowa Oral Performance Instrument evaluations. METHODS: VFSS results were assessed for the presence of penetration and aspiration, according to the penetration-aspiration scale. Receiver operating characteristic curve analysis was conducted with tongue strengths based on penetration and aspiration. RESULTS: During the swallowing of pureed, liquid, and solid foods, cut-off values of tongue strength for the anterior and posterior elevation and for the protrusion of tongue were suggested in cases of penetration and aspiration, among patients with dysphagia. These criteria had positive and negative predictive values of 54.6-90.2% and 57.5-96.9%, respectively. CONCLUSIONS: This study found that tongue strength has predictive abilities similar to clinical and bedside tests to screen penetration and aspiration in stroke patients with swallowing disorders. Therefore, it is a new screening test that clinical practitioners can choose to reduce the risk of pneumonia caused by post-stroke disorders. CLINICAL REHABILITATION IMPACT : As a new screening tool, tongue strength can be combined with other clinical and instrumental assessments to predict penetration and aspiration in stroke patients with dysphagia.

[Purpose] This study examined the usefulness of the DriveABLE cognitive assessment tool (DCAT) in predicting the driving risk factor of stroke patients, and compared the cognitive and driving functions of two groups discriminated by DCAT. [Subjects and Methods] A total of forty-two stroke patients with a driver's license participated in this study. Two participants with communication problems were excluded. DCAT was used to evaluate the risk potential to the driver, and the subjects were classified into two groups according to the probability of driving risk estimated by the DCAT evaluation. The safe driver group (SDG) and unsafe driver group (USDG) underwent a driving simulator and cognitive function assessments. [Results] The results of the SDG and USDG were compared. The SDG showed higher cognitive function than the USDG. In addition, the SDG showed higher ability than the USDG in most of the tests associated with the driving function (pedal reaction time, average reaction time, centerline crossing, road edge excursion, off-road accidents, collisions). [Conclusion] DCAT is a useful tool for predicting the risk of driving. In addition, it can predict the driving ability of stroke patients related to the cognitive function. Nevertheless, a multi-faceted study of associated with driving and cognitive functions for safe driving will be needed.

Although many countries restrict the use of smartphones while driving, smartphones are utilized in various ways as there are limits to enforcement. Accordingly, efforts are made to determine the risks of novice drivers with low safety awareness and higher risk. This study observed and analyzed changes in visual attention and driving risks according to the way smartphones are used while driving and the scientific relationship between the 2 variables. Forty-five novice drivers were asked to simultaneously perform 4 types of tasks during a driving simulation: hand-held calls, portable hands-free (Bluetooth) calls, sending messages, and not using smartphones. In this process, visual attention was tested using an eye tracker, and the driving function was examined using scenario driving results. Afterward, the differences in visual attention and driving function by task category and the correlation between the 2 variables were analyzed. Significant differences were confirmed in the following categories of novice drivers’ smartphone use while driving: eye blink duration, eye fixation frequency, average eye fixation duration, frequency of saccadic eye movement, average saccade duration, and amplitude and speed of saccade. Additionally, there was a significant relationship between driving risk in speeding rate, centerline crossing rate, road edge excursion rate, average deviation rate, number of off-road accidents, and the number of collision accidents. Lastly, visual attention indices had different significant positive or negative correlations with driving functions. When novice drivers use smartphones while driving compared to when they do not use smartphones, changes in visual attention characteristics in the number and duration of eye blinks, eye fixations, and saccades increased the risk of accidents due to deceleration and lane departure. In particular, the risk increased the most when sending messages, and the risk of accidents continued although the increased burden due to smartphone use was compensated for by slowing down the speed. We hope that the findings of this study will be actively used in efforts to change novice drivers’ traffic safety attitudes while driving.