In adult patients with unilateral stroke, is distributed constraint-induced therapy or bilateral arm training more effective in improving upper extremity motor and functional outcomes compared with a routine approach?

Stroke survivors may experience deficits and impairments of upper extremity (UE) function that limit their engagement in meaningful everyday occupations. It is important for occupational therapists to identify and test the effectiveness of interventions targeted to decrease UE learned nonuse, improve functional performance, and increase participation in one’s daily occupations. This study compared the efficacy of distributed constraint-induced therapy (dCIT) and bilateral arm training (BAT) in improving movement strategies and functional abilities of the UE in stroke survivors. Each intervention group participated in the intervention 2 hr/day, five times per week for 3 consecutive weeks. Participants in the dCIT group focused on practicing use of the affected UE during occupational therapy, plus additional functional use of the affected UE in daily activities by restricting the unaffected UE for six hours daily. Participants in the BAT group focused on concurrent movements using both UEs in functional tasks during occupational therapy only. On the basis of the results of the study, both dCIT and BAT may help decrease UE learned nonuse in patients with stroke. Both interventions may facilitate the use of the affected UE, thereby improving the quality of motor control and movement and increasing stroke patients’ self-efficacy and safety during functional activities such as cooking, shaving, and eating. Although BAT may result in greater improvement of force generation during movement initiation, dCIT may result in increased functional ability, including longer time using the affected UE and enhanced quality of movement. Thus, occupational therapists working with patients who have had strokes may use dCIT to increase the quality of functional performance and use BAT to improve force generation in movement With the additional 6 hours/day forced use of the affected arm in the dCIT group, this group had more intervention time than the BAT group. To achieve equality in comparison, future research may focus on providing the participants with the same amount of intervention for both the dCIT and the BAT groups to integrate use of affected UE in daily activities. Furthermore, additional research may place an emphasis on whether the effects after dCIT or BAT can be generalized to daily functional tasks and maintained beyond therapy

Designing programs for eliminating canine rabies from islands: Bali, Indonesia as a case study

<p>Background: Canine rabies is one of the most important and feared zoonotic diseases in the world. In some regions rabies elimination is being successfully coordinated, whereas in others rabies is endemic and continues to spread to uninfected areas. As epidemics emerge, both accepted and contentious control methods are used, as questions remain over the most effective strategy to eliminate rabies. The Indonesian island of Bali was rabies-free until 2008 when an epidemic in domestic dogs began, resulting in the deaths of over 100 people. Here we analyze data from the epidemic and compare the effectiveness of control methods at eliminating rabies.</p> <p>Methodology/Principal Findings: Using data from Bali, we estimated the basic reproductive number, R0, of rabies in dogs, to be ~1·2, almost identical to that obtained in ten–fold less dense dog populations and suggesting rabies will not be effectively controlled by reducing dog density. We then developed a model to compare options for mass dog vaccination. Comprehensive high coverage was the single most important factor for achieving elimination, with omission of even small areas (<0.5% of the dog population) jeopardizing success. Parameterizing the model with data from the 2010 and 2011 vaccination campaigns, we show that a comprehensive high coverage campaign in 2012 would likely result in elimination, saving ~550 human lives and ~$15 million in prophylaxis costs over the next ten years.</p> <p>Conclusions/Significance: The elimination of rabies from Bali will not be achieved through achievable reductions in dog density. To ensure elimination, concerted high coverage, repeated, mass dog vaccination campaigns are necessary and the cooperation of all regions of the island is critical. Momentum is building towards development of a strategy for the global elimination of canine rabies, and this study offers valuable new insights about the dynamics and control of this disease, with immediate practical relevance.</p&gt

The selective perception of managers revisited

Results of a systematic replication of studies by Dearborn and Simon and by Walsh suggest that differences in their conclusions resulted from differences in their experimental procedures. Managers are broader perceivers when they are encouraged to identify more problems. Also, contrary to Walsh's and others' theories, in this replication belief structure did not mediate the relationship between functional experience and selective perception. In addition, predominantly negative relationships were found between areas of experience and perceptions, indicating that functional experience may produce selective imperception as well as selective perception