2,064 research outputs found

    'TIDieR-ing up' the reporting of interventions in stroke research:The importance of knowing what is in the 'black box'

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    Evidence-based interventions cannot be provided unless there is a clear understanding of what the intervention is. Many published randomized trials, systematic reviews, and guidelines contain incomplete intervention descriptions. For non-pharmacological interventions, such as stroke rehabilitation, the reporting is particularly poor. Contributors to this problem include lack of attention to this issue and awareness of what constitutes a complete intervention description by authors, reviewers, journals, and editors. Part of the solution is for authors to follow guidance about how to describe interventions, such as the Template for Intervention Description and Replication statement. Improving stroke interventions reporting will remove one of the current barriers to evidence-based care. </jats:p

    Alien Registration- Walker, Marion (Bingham, Somerset County)

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    Walt Whitman and Mrs. G.

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    Explores in detail the life of Anne Gilchrist, especially in relation to her correspondence and encounters with Whitman; reprints images of Whitman and Gilchrist from paintings by Herbert Gilchrist; concludes that "(Whitman\u27s) relationship with Mrs. G (…) was one of the most enduring and all-nurturing relationships that he ever experienced with any woman.

    An audit of dressing practice by occupational therapists in acute stroke settings in England

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    Introduction Dressing independence is commonly affected after stroke, with clinical guidelines recommending that dressing practice should routinely be provided for those with dressing difficulties. The aim of this study was to update the literature on current practice in the treatment of dressing problems in stroke rehabilitation units. Method A questionnaire survey of occupational therapists experienced in stroke care was sent to 157 stroke units in England. Results Responses were received from 70 stroke units. Frequency and duration of dressing practice varied substantially between units, with respondents typically providing dressing practice for six to 10 patients per week and spending 30 to 45 minutes per treatment session. Only 17 respondents (24.3%) stated that they regularly used standardised assessments of dressing ability. The functional approach was used more widely than the remedial approach. Service priorities, working environment and limitations of time and staffing were reported to influence dressing practice. Conclusion There is widespread variability in dressing practice. There is a lack of use of standardised dressing assessments, and therapists’ rationale for their choice of approach is unclear

    'It was like an animal in pain': Institutional thoughtlessness and bereavement in prison

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    Using the concept of institutional thoughtlessness, this article examines a range of issues embedded within daily prison life which have a detrimental effect upon the lives of those bereaved during a prison sentence. Drawing on in-depth qualitative research undertaken with bereaved prisoners, staff members and volunteers at a male prison in the North of England, the article explores how individual and institutional goals compete, compounding bereavement experiences and the management of grief. Findings demonstrate the tension between the policies and protocols prisons are tasked to follow, and unintended consequences for the individually bereaved. This article illuminates the need for far greater understanding of bereavement in the prison population and explores how a universal life experience can be particularly debilitating within the prison setting with the potential to exacerbate what is often cumulative loss among prisoners

    Multicenter prospective cohort study of the Strata valve for the management of hydrocephalus in pediatric patients

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    Journal ArticleObject. Previous reports suggest that adjustable valves may improve the survival of cerebrospinal fluid shunts or relieve shunt-related symptoms. To evaluate these claims, the authors conducted a prospective multicenter cohort study of children who underwent placement of Strata valves. Methods. Patients undergoing initial shunt placement (Group 1) or shunt revision (Group 2) were treated using Strata valve shunt systems. Valves were adjustable to five performance level settings by using an externally applied magnet. The performance levels were checked using an externally applied hand tool and radiography. Patients were followed for 1 year or until they underwent shunt revision surgery. Between March 2000 and February 2002, 315 patients were enrolled in the study. In Group 1 (201 patients) the common causes of hydrocephalus were myelomeningocele (16%), aqueductal stenosis (14%), and hemorrhage (14%). The overall 1-year shunt survival was 67%. Causes of shunt failure were obstruction (17%), overdrainage (1.5%), loculated ventricles (2%), and infection (10.6%). Patients in Group 2 (114 patients) were older and the causes of hydrocephalus were similar. Among patients in Group 2 the 1-year shunt survival was 71%. There were 256 valve adjustments. Symptoms completely resolved (26%) or improved (37%) after 63% of adjustments. When symptoms improved or resolved, they did so within 24 hours in 89% of adjustments. Hand-tool and radiographic readings of valve settings were the same in 234 (98%) of 238 assessments. Conclusions. The 1-year shunt survival for the Strata valve shunt system when used in initial shunt insertion procedures or shunt revisions was similar to those demonstrated for other valves. Symptom relief or improvement following adjustment was observed in 63% of patients. Hand-tool assessment of performance level settings reliably predicted radiographic assessments

    Juvenile pilocytic astrocytoma of the brainstem in children

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    Journal ArticleObject. In reports involving the operative treatment of brainstem tumors, multiple histological types are often grouped together. To determine prognosis after resection, histology-specific data may be helpful. Methods. Twenty-eight patients with juvenile pilocytic astrocytoma (JPA) of the brainstem (six in the midbrain, four in the pons, and 18 in the medulla) were identified from the medical records. Initial treatment was resection in 25 and biopsy sampling in three. Postoperative imaging revealed gross-total resection (GTR) or resection with linear enhancement (RLE) in 12 of 25 patients and solid residual tumor in the other 13. In 10 of the 13 patients harboring solid residual tumor, observation was undertaken; the residual lesion disappeared in one, was stable in four, and progressed in five. Of the 12 patients with complete excision or RLE only, seven underwent no further treatment, with tumor progression occurring in one. All patients were alive at last follow-up examination (range 0.3-20.4 years, mean 6 years). New neurological deficits commonly appeared immediately after resection but often resolved. In six of the 28 patients, the new postoperative deficit was still present at last follow-up visit. The 5- and 10-year progression-free survival was 74 and 62%, respectively, after GTR or RLE and 19 and 19%, respectively, when solid residual tumor was present. Conclusions. Long-term survival after resection of JPAs of the brainstem has been observed and appears to be related to the extent of initial excision

    Return to work after stroke: recording, measuring, and describing occupational therapy intervention

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    Introduction: Existing research on vocational rehabilitation following stroke has been criticised for not describing intervention in sufficient detail for replication or clinical implementation. The purpose of this study was to test the feasibility of recording and measuring the content of an early stroke-specific vocational rehabilitation intervention delivered to participants in a feasibility randomized controlled trial, using a proforma previously developed for a study of vocational rehabilitation following traumatic brain injury. Method: The proforma was adapted for use in stroke with input from an expert panel and was used to record intervention content, in 10-minute units, following each intervention session. Findings: Twenty-five people, working or in education at the time of stroke, participated in the study. Two thirds of the therapists' time was spent in face-to-face contact (43%) and liaison with the patient and others (20%). Intervention mainly focused on work preparation (21%) and the return to work process (24%). The remaining time was consumed by administration (19%) and travel (18%). Conclusion: The proforma was quick and easy to use and captured the main focus of intervention. This study suggests that it can be used to record stroke-specific vocational rehabilitation intervention content and has potential for wider use in research and clinical practice

    The international closely graded series during adolescent years

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    This item was digitized by the Internet Archive. Thesis (M.A.)--Boston University N.B.: author was later known as Doren, Marion Walker.https://archive.org/details/theinternational00dor
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