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Background: FAST Heroes is a kindergarten-based educational program that teaches young children and their extended families (parents, grandparents), the main stroke symptoms (Face, Arm, and Speech), and the timely and appropriate steps in the event of a suspected stroke (Time). However, post-campaign knowledge retention remains a challenge., Aims: The purpose of the current study was to investigate whether and to what extent grandparents' stroke knowledge is maintained 44 months after the initial implementation of the program., Methods: Forty-five participants engaged in the present study (35 women, 10 men; 72.8§5.3) and completed an adapted version of the FAST Heroes Stroke Preparedness Questionnaire via phone calls., Results: Compared to immediately post-program implementation, respondents were still able to recall arm weakness (OR = 1.63; p  = 0.246) and slurred speech (OR = 2.02; p  = 0.075) as main stroke symptoms. A decrease was observed in recalling facial drooping (OR = 0.44; p  = 0.042). Reporting of the appropriate course of action, was found to be increased (OR = 4.17; p  < 0.001). Respondents remembered the emergency number to call, i.e., 112 (OR = 0.97; p  = 0.947)., Conclusion: The results showed that awareness regarding the common signs of a stroke and the importance of promptly contacting emergency services following a stroke, in the population group mostly affected by stroke, is retained. Exploring knowledge preservation in a greater sample size is warranted., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Orologa, Baskini, Tsakpounidou, Keramydas and Proios.)

Objectives: In this work we present the results of the implementation of a globally representative educational school-based stroke awareness programme, FAST (Face, Arm, Speech, Time) Heroes during the second year of education (wave 2). We aimed to observe changes in baseline stroke knowledge between wave 1 and wave 2, distinguish the more fine-grained effect of the campaign on society, and evaluate changes before and after the implementation of wave 2., Materials and Methods: In wave 2, parents of school-aged children completed an online stroke preparedness questionnaire before (t1) and after (t2) programme implementation. Results between the time points were analyzed with descriptive statistics alongside changes in baseline knowledge between waves 1 and 2., Results: 1,611 parents participated in wave 2. Parents increased their knowledge of three stroke symptoms from 69% to 87% (p<.001). Their knowledge of the designated emergency number rose from 75% (t1) to 88% (t2) (p<.001). A 17% increase in baseline knowledge occurred in stroke symptoms identified correctly between wave 1 (11 countries) and 2 (18 countries)., Conclusions: Results support the precision and usability of the data collection approach in measuring the change in stroke knowledge between implementation waves. The increased baseline knowledge concerning stroke symptoms in wave 2 needs further examination., Competing Interests: Declaration of Competing Interest The authors Jan van der Merwe, Kalliopi Tsakpounidou, Maria Baskini, Chris Webb, and Hariklia Proios are employed by Boehringer Ingelheim. All authors declare no other competing interests., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Objectives: We describe new findings from the implementation of an educational school-based stroke awareness programme, FAST (Face, Arm, Speech, Time) 112 Heroes, that teaches kindergarten children about stroke symptomatology and the appropriate action plan. The goal of our study was to examine whether the population mostly affected by stroke, i.e. the elderly, can be educated by young children, who have attended the programme., Materials and Methods: The educational programme was implemented face-to-face in a kindergarten in Athens, Greece, once a week for five consecutive weeks for one hour per week. Preschoolers (n = 137, aged 4.1-7, mean age=5.3) were enrolled in the programme and nominated two elderly members of their extended family (grandparents) as their own superheroes. Family members received personalized stroke-related material. Stroke awareness of the grandparents was measured before programme implementation (phase 1), after (prior to receiving the printed personalized stroke-related material, phase 2) and three months after receiving the printed personalized stroke-related material (phase 3)., Results: Data was obtained from 63 grandparents (48 women; aged 60-84, mean age=69.5 years). Family members demonstrated significant increases in stroke symptom knowledge (p < 0.001) and appropriate course of action (p ≤ 0.001) after participating in the program (phase 2) and receiving printed personalized stroke-related material (phase 3). The majority of the participants (86.84%) reported positive feedback about the received material, the programme, and their interaction with their grandchildren during the programme., Conclusions: Elderly family members outside the nuclear family can be successfully educated about stroke through their grandchildren and the FAST 112 Heroes programme., Competing Interests: Declarations of interest None., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Educating the at-risk population about stroke symptoms and requirement of calling an ambulance when stroke strikes is challenging. This exploratory cross-country study provides insights to the FAST Heroes educational campaign and outcomes hitherto achieved., Aims: The primary aim of the study was to measure the transfer of stroke-related knowledge to parents after a global school-based FAST Heroes educational campaign for 5- to 9-year-old children in 14 different countries. The secondary aim was to evaluate parents and teachers' acceptability toward the program., Methods: The duration of the program was 5 h; 1 h per week, joining face-to-face educational sessions with workbooks, cartoons, web-based learning, and other fun activities. Outcomes were measured before implementation (t1), after implementation (t2), and at 6-month follow-up (t3). Program acceptability and stroke knowledge were evaluated by feedback surveys for teachers and parents., Results: Worldwide, 4,202 parents completed the program with their children and answered surveys at t1 and t2. They increased their knowledge of three stroke symptoms from 48 to 83% ( p < 0.001). All three surveys were completed by 86 parents, who improved their knowledge of stroke symptoms, 55% (t1), 79% (t2), and 94% (t3) ( p < 0.001). Overall, the educational messages were successfully passed onward., Conclusions: Findings confirm the primary aim of the study that is knowledge about stroke transfer well from children to their families through the FAST Heroes program. Second, parents and teachers globally consider the program feasible and worthwhile. The results will inform further rollout of the campaign., Competing Interests: KT, JM, CW, and HP are employed by Boehringer Ingelheim. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Tsakpounidou, van der Merwe, Klinke, Webb, Ouriques Martins and Proios.)

Objective: In the present study, we explored numerical problems in individuals with aphasia. We investigate whether numerical deficits, usually accompanying aphasia, can be observed on number comprehension tasks that do not necessarily require an oral response., Method: Individuals with aphasia were classified into anterior, posterior, and global subgroups according to the lesion type. To investigate numerical cognition, we used a relatively recent tool, the Numerical Activities of Daily Living (NADL)., Results: The results showed that individuals with aphasia have problems with tasks of basic number comprehension as well as in most NADL. In the formal part of the NADL, anterior aphasic patients made comparatively more errors than the posterior aphasic patients. Global aphasic patients presented an invariably poor performance on almost all tasks., Conclusion: The results provide insight into how numerical deficits may impair an individual with aphasia in activities of daily living. This study is a preliminary attempt to start the validation process of the NADL for the Greek population.

Background: Young children are often unaware of emergency health conditions, such as stroke, and could serve as important vehicles to save the lives of their grandparents, who are more likely to suffer a stroke. An important aspect for the evaluation of public awareness on stroke signs and related emergency procedures is to examine the level of baseline stroke knowledge children have and whether they understand when to seek medical care on time. Objective: To examine the level of stroke symptomatology knowledge in children as well as evaluate their preparedness in stroke response before their participation in the educational program "FAST (Face, Arms, Speech, Time) 112 Heroes." Methods: For the purpose of this work, a questionnaire was developed and adapted to preschoolers' needs. The present study involved 123 children (65 boys, 58 girls, aged 4-6.5 years; mean age: 5.30, S.D.: 0.59) from two cities in Greece. Five multiple-choice animated pictures, that were age-appropriate, were administrated to each child, along with verbal explanations provided by the investigator. Results: More than half of the participants ( n = 65, 52.8%) could recognize the symptom of face drooping, 53 children (43.1%) could identify the symptom of arm hemiparesis/hemiplegia and 92 children (74.8%) were able to answer the question regarding speech disturbances. However, the number of correct answers to the question regarding the appropriate course of action in case of a stroke was the lowest among all the questions (10.6% of participants gave a correct answer). Furthermore gender and age did not play a significant role ( p = 0.571 and 0.635, respectively). Conclusion: Although more than half of the enrolled preschool children could recognize stroke symptoms before their participation in the educational program, their baseline stroke knowledge, prior to their training, is low. Concurrently, they do not have sufficient knowledge on how to react appropriately in the event of a stroke. Therefore, awareness programs focusing on developing stroke literacy to children are needed, to ensure children will seek urgent medical care in case of a stroke., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Tsakpounidou, Psomiadis, Pourliaka, Akritidou and Proios.)

Background: Stroke is one of the leading causes of death worldwide, especially in developing countries. In China, there is an urgent need to educate people about stroke awareness and the importance of using emergency medical services (EMS) quickly after a stroke has occurred. Objective: We sought to explore the effects of the Stroke 1-2-0 Prehospital Stroke Education System based on the experience of a general practitioner team. Method: We prospectively enrolled 119 community general practitioners to be trained in the procedures advocated by the Stroke 1-2-0 Prehospital Stroke Education System. The training content included early detection of ischemic stroke, first aid for stroke, and intravenous thrombolysis; The effects of the training were later evaluated via a before-and-after comparison. The 119 enrolled physicians formed a Stroke 1-2-0 lecturer group and taught stroke knowledge to community residents. The group remained active for 6 months, during which the medical treatment data of stroke patients (i.e., stroke onset time, prehospital delay, whether an ambulance was called, and whether thrombolytic therapy was performed) in each of 5 jurisdictions were recorded for the month before (January 2021) and that after (August 2021) the 6-month community education program. Finally, the effects of the community education program were evaluated. Results: The participants' understanding of intravenous thrombolysis in the treatment of acute ischemic stroke improved significantly after the training as compared with their earlier understanding (96% vs. 78.99%; P <.001), and their understanding of the time window for intravenous thrombolysis increased from 26.05% before to 72% (P <.001) after the training. Most of the participants (90% vs. 67.23%; P <.001) said that they would immediately call the 120 emergency number of China's emergency phone system if they encountered individuals who appeared to be victims of acute stroke. A total of 82 stroke patients were seen before and 67 after the community education program. As for the use of the emergency call system, more patients with stroke activated that system after the program versus before (21.95% vs. 37.31%; P =.04). The 3-hour arrival rate after the program was nearly three times higher than that before the program (62.69% vs. 19.51%; P <.001). Also, regarding receiving thrombolysis after the occurrence of a stroke, the program triggered a substantial increase compared with the total earlier (19.4% vs. 6.1%; P =.013). Conclusion: We found that the Stroke 1-2-0 Prehospital Stroke Education System significantly improved community residents' knowledge regarding stroke. [ABSTRACT FROM AUTHOR]

Background The global incidence of stroke is on the rise, primarily due to an increase in the aging population and the prevalence of vascular risk factors among the elderly. However, stroke is a treatable condition if promptly recognized and managed effectively. To optimize stroke management, it is crucial to establish a well-prepared infrastructure comprising adequately trained physicians working in collaboration with multidisciplinary teams. Equipped stroke units, easily accessible emergency medical services with a stroke code, and interconnected telestroke networks, further enhance stroke care delivery. Along with the current study, conducted by a task force from the World Stroke Organization's Future Stroke Leaders Program, an assessment of the stroke infrastructure within Matrouh governorate in Egypt for stepwise implementation of stroke services, based on the World Stroke Organization's stroke roadmap took place. The study consisted of two levels: Level One involved analyzing existing gaps that may impede the implementation of stroke services, while Level Two proposed strategies to address these gaps using a problem-solving approach. Results The study identified the Matrouh governorate as a suitable region for stroke service implementation. The region exhibits a blend of urban and rural areas and is geographically distant from major healthcare centers. Matrouh also possesses a diverse population, subject to seasonal variations. Currently, it offers a mix of minimum and essential stroke services, which can be expanded and improved through a step-by-step approach guided by the World Stroke Organization's stroke roadmap. Conclusions Mapping stroke infrastructures allows for the identification of potential gaps to optimize the potential for implementation of stroke services. [ABSTRACT FROM AUTHOR]

Since the first electroencephalogram (EEG) was obtained, there have been many possibilities to use it as a tool to access brain cognitive dynamics. Mathematical (Math) problem solving is one of the most important cortical processes, but it is still far from being well understood. EEG is an inexpensive and simple indirect measure of brain operation, but only recently has low-cost equipment (mobile EEG) allowed sophisticated analyses in non-clinical settings. The main purpose of this work is to study EEG activation during a Math task in a realistic environment, using mobile EEG. A matching pursuit (MP)-based signal analysis technique was employed, since MP properties render it a priori suitable to study induced EEG activity over long time sequences, when it is not tightly locked to a given stimulus. The study sample comprised sixty healthy volunteers. Unlike the majority of previous studies, subjects were studied in a sitting position with their eyes open. They completed a written Math task outside the EEG lab, wearing a mobile EEG device (EPOC+). Theta [4 Hz-7.5 Hz], alpha (7.5 Hz-13 Hz] and 0.5 Hz micro-bands in the [0.5 Hz-20 Hz] range were studied with a low-density stochastic MP dictionary. Over 1-min windows, ongoing EEG alpha and theta activity was decomposed into numerous MP atoms with median duration around 3 s, similar to the duration of induced, time-locked activity obtained with event-related (des)synchronization (ERS/ERD) studies. Relative to Rest, there was lower right-side and posterior MP alpha atom/min during Math, whereas MP theta atom/min was significantly higher on anteriorly located electrodes, especially on the left side. MP alpha findings were particularly significant on a narrow range around 10 Hz-10.5 Hz, consistent with FFT alpha peak findings from ERS/ERD studies. With a streamlined protocol, these results replicate previous findings of EEG alpha and theta activation obtained during Math tasks with different signal analysis techniques and in different time frames. The efficient application to real-world, noisy EEG data with a low-resolution stochastic MP dictionary shows that this technique is very encouraging. These results provide support for studies of mathematical cognition with mobile EEG and matching pursuit., (© 2024. International Federation for Medical and Biological Engineering.)

This paper describes the digitalization process of an originally school-based educational programme to an online version and confirms its efficacy on teaching young children as well as their parents about stroke symptoms and the necessary actions needed to be taken in the event of a stroke. Forty children (20 children with neurodevelopmental disorders (NDDs) and 20 without NDDs), aged 4–9 years, as well as 35 of these children's parents (30–50 years old) participated in the study in Greece. All individuals watched 5 educational videos, designed and produced by the Super Grand League Team. Each video had a mean duration of 15 minutes. Most children had no prior knowledge neither in stroke symptoms nor to the appropriate actions after a stroke. Children's knowledge of stroke symptoms (except the symptom of speech disturbance) and the appropriate actions following stroke improved significantly immediately post training (p < 0.05). Children with NDDs demonstrated no significant differences when compared to their peers without NDDs in regards to the knowledge gains. In the same line, parents showed a significant increase in their knowledge as regards the stroke symptoms (p < 0.001). Only 2 parents (5.7%) knew the correct emergency number before participating in the online programme, while all of them (100%) responded correctly after the programme. The current work using multimodal remote education demonstrates significant improvement in learning about stroke symptomatology and the necessary steps that need to follow. Future work should evaluate the impact of digital interventions in respect of onset-to-door times and stroke outcomes. [ABSTRACT FROM AUTHOR]

Early childhood plays a key role in the formation of healthy habits and the establishment of health literacy. Nonetheless, there are only a few research studies focusing on the health literacy level of children under the age of eight. The aim of our systematic review is to explore empirical research on health literacy related to early childhood. The research was conducted in accordance with the PRISMA protocol. This systematic review examines 12 studies published between 2013–2022. Results show that research focuses on different domains of health literacy for children. In relation to children's food literacy, children understand the relationship between health and nutrition and they realize the health impact of obesity. The habits connected to oral health are strongly associated with parents' knowledge of and behaviours around oral health. Results related to health care situations show that children are able to be actively involved in decision-making processes in connection with their health. Exploring young children's health literacy is essential in order to be able to plan health promotion interventions, embedded into early childhood education. Picture-based messages or story-based messages supported by illustrations can help measure health literacy in early childhood and can support the formation of health literacy. [ABSTRACT FROM AUTHOR]

Specific impairments in numerical functions may cause severe problems in everyday life that cannot be inferred from the available scales evaluating instrumental activities of daily living. The Numerical Activities of Daily living (NADL) is a battery designed to assess the patient's performance in everyday activities involving numbers (Informal Test) and in more scholastic capacities (Formal Test). A downside of this battery is its duration (45 min). The aim of the present study is to build a shorter version of NADL to make it more suitable for clinical and research purposes. The shortening procedure involved only the Formal test, and followed two steps: (i) a correlation of subtests with the general scores, and (ii) an item-analysis within the subtests previously showing higher correlations. Correlations between NADL-Short and NADL original version, and the new cut-offs were calculated. Lastly, the relationship between NADL-Short and other brief cognitive screening tests used in the clinical practice was evaluated in neurological patients and healthy controls. The NADL-Short includes the original Informal Test and the shortened Formal Test. It is a quick and easy clinical tool (15 min) to assess numerical abilities applied to informal and formal situations. It correlates highly with the original battery (Kendall's tau greater than 0.6 across tasks) and the cut-offs correctly identify impaired performance (accuracy of 95% or above). Correlation analysis showed a low positive correlation between NADL-Short and other brief cognitive scales. These findings suggest that it is appropriate to use specific tools to make inferences about a person's numerical abilities. [ABSTRACT FROM AUTHOR]

Background: People with aphasia (PWA) can experience functional numeracy difficulties, that is, problems understanding or using numbers in everyday life, which can have numerous negative impacts on their daily lives. There is growing interest in designing functional numeracy interventions for PWA; however, there are limited suitable assessments available to monitor the impact of these interventions. Existing functional numeracy assessments lack breadth and are not designed to be accessible for PWA, potentially confounding their performance. Additionally, they do not include real-life demands, such as time pressure, which may affect their ecological validity. Thus, there is a crucial need for a new assessment to facilitate further research of PWA's functional numeracy., Aims: To develop, validate and pilot a wide-ranging, aphasia-friendly functional numeracy assessment to investigate how functional numeracy is impacted by aphasia severity and time pressure demands, and to explore predictors of PWA's functional numeracy., Methods & Procedures: To develop the Functional Numeracy Assessment (FNA), 38 items inspired by the General Health Numeracy Test (GHNT) and Excellence Gateway were adapted for suitability for PWA and entered in a computerized psychometric-style test. The final 23 items (FNA23) were selected based on 213 neurotypical controls' performance, and controlled for difficulty, response modality and required numeracy skills. Aphasia-friendly adaptations of the GHNT and Subjective Numeracy Scale were used to examine the FNA23's concurrent validity. Internal consistency reliability and interrater reliability (for spoken responses) were also examined. A novel Time Pressure Task was created by slight adaptation of seven FNA23 questions to explore the effects of time pressure on functional numeracy performance. A total of 20 PWA and 102 controls completed all measures on an online testing platform., Outcomes & Results: The FNA23 demonstrated acceptable internal consistency reliability (KR-20 = 0.81) and perfect interrater reliability (for spoken responses). FNA23 and GHNT scores were positively associated, suggesting satisfactory concurrent validity. PWA demonstrated poorer functional numeracy than controls and took longer to complete assessments, indicating that aphasia impacts functional numeracy. Time pressure did not significantly impact performance. PWA demonstrated a wide range of functional numeracy abilities, with some performing similarly to controls., Conclusions & Implications: The FNA23 is a wide-ranging, valid and reliable assessment which, with further development, will be a useful tool to identify and monitor PWA's functional numeracy difficulties in research and clinical practice. Considering PWA's widespread functional numeracy difficulties evidenced by this study, all PWA would likely benefit from routine evaluation for functional numeracy difficulties as part of their neurorehabilitation journeys., What This Paper Adds: What is already known on this subject Few studies have investigated functional numeracy difficulties in PWA. No published functional numeracy assessments exist that have been specifically designed to be accessible for PWA. What this paper adds to existing knowledge The newly developed FNA23 is a valid and reliable tool to extensively assess PWA's functional numeracy. This study confirmed previous findings of widespread functional numeracy difficulties in PWA that are related to their aphasia severity. What are the potential or actual clinical implications of this work? The FNA23 can be used to assess PWA's functional numeracy to inform areas of strengths and difficulties to target in intervention, and to monitor progress towards achieving intervention objectives. All PWA should be routinely evaluated for functional numeracy difficulties., (© 2023 The Authors. International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.)

Background: FAST (Face, Arm, Speech, Time) 112 Heroes is an educational programme that delivers information to children and their extended families helping them identify the principal signs of stroke and informing them how to respond appropriately in the event of a stroke. Objectives: To examine the baseline stroke literacy that extended families possess, as well as to assess whether children enrolled in FAST 112 Heroes programme effectively convey stroke knowledge to their extended family. Design: Field trial. Setting: Four schools in Northern Greece – two public and two private. Methods: Parents of preschool aged (5–7 years) children completed stroke knowledge questionnaires, before the programme began and one week after the completion of the FAST 112 Heroes programme. Findings were analysed. Results: In total, 240 parents of kindergarten children (146 women, 94 men; 20–59 years old; mean age: 38.81) completed the pre-programme questionnaire, whereas only 80 of them (33.33%) completed the post-programme questionnaire. Before the programme started, 30 out of 80 parents (37.5%) recognised the three rudimentary stroke symptoms, compared to 68 out of 80 (85%) after the completion of the programme (p =.00). Parental awareness of the emergency number 112 and of the FAST acronym before programme implementation was relatively poor. Conclusions: Improvement of stroke knowledge post-implementation was observed in the extended family of preschool children enrolled in the FAST 112 Heroes programme which suggests that the latter delivered stroke information to their families effectively. [ABSTRACT FROM AUTHOR]