Using the TIDieR checklist to standardize the description of a functional strength training intervention for the upper limb after stroke

Background and Purpose: Published reports of intervention in randomized controlled trials are often poorly described. The Template for Intervention Description and Replication (TIDieR) checklist has been recently developed to improve the reporting of interventions. The aim of this article is to describe a therapy intervention used in the stroke rehabilitation trial, "Clinical Efficacy of Functional Strength Training for Upper Limb Motor Recovery Early After Stroke: Neural Correlates and Prognostic Indicators" (FAST-INdICATE), using TIDieR. Methods: The functional strength training intervention used in the FAST-INdICATE trial was described using TIDieR so that intervention can be replicated by both clinicians, who may implement it in practice, and researchers, who may deliver it in future research. The usefulness of TIDieR in the context of a complex stroke rehabilitation intervention was then discussed. Results and Discussion: The TIDieR checklist provided a systematic way of describing a treatment intervention used in a clinical trial of stroke rehabilitation. Clarification is needed regarding several aspects of the TIDieR checklist, including in which section to report about the development of the intervention in pilot studies, results of feasibility studies; overlap between training and procedures for assessing fidelity; and where to publish supplementary material so that it remains in the public domain. Summary: TIDieR is a systematic way of reporting the intervention delivered in a clinical trial of a complex intervention such as stroke rehabilitation. This approach may also have value for standardizing intervention in clinical practice. Video abstract is available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A131)

INDIAN BASKETRY IN YOSEMITE VALLEY, 19th-20th Century: Gertrude “Cosie” Hutchings Mills, Tourists and the National Park Service

Basketry is the highest art form of Native Americans in California. I will focus on Yosemite Valley starting in the 1850s when Native Americans adapted progressively to contact with miners, settlers, and tourists. As a Research Associate at the Peabody Museum, Andover, Massachusetts, I inventoried the Native American Basket Collection. The unpublished Hutchings Mills Collection, acquired by Gertrude ‘Cosie’ Hutchings in Yosemite prior to 1900, caught my attention. In 1986, the Department of the Interior requested the collection be loaned, exchanged, or purchased as “the single most important assemblage from that period.” The collection did not leave Andover; however, one basket by Dulce, an activist whose signature appears on the Indian Petition of 1891, was published by the Yosemite Museum in 1991. James Mason Hutchings (1824-1902) was among the first settlers to remote Yosemite Valley and opened a hotel. His daughter, Gertrude ‘Cosie’ Hutchings (1867-1956) was born in the Yosemite Village and collected baskets. The Gertrude Hutchings Mills Collection of 53 baskets is significant because she acquired them from “friends and faithful allies of her family. Those from the Mono and Owens River country were packed mule-back across the Sierras to Yosemite by myself.” Some basket makers are identified by name and location; such record keeping was very rare. My timeline for Yosemite will include the following events: Proclamation as a state park, 1864; eviction of the Hutchings family, 1874; designation as a National Park, 1890; and the Indian Petition, 1891. In the 20th century, the National Park promoted non-traditional Indian events and featured demonstrations by basket makers until the Native American were gradually expelled. My presentation will contrast basket makers in contact with Hutchings and the National Park Service

Postpartum Psychosis: A Foucauldian analysis of women’s experiences of living with this diagnosis

Postpartum psychosis is thought to affect one or two women per 1000 deliveries (Kendell, Chalmers & Platz, 1987). The construction of this diagnosis as ‘rare’ has served to marginalise women who experience ‘psychosis’ in the postpartum period. This has been demonstrated not only in policy and service provision, but also in the paucity of academic research and the development of psychological interventions. This study sets out to explore how women are able to construct their experiences of postpartum psychosis, illustrating how material and discursive practices enable or constrain the telling of their stories. Ten women who had experienced a diagnosis of postpartum psychosis were interviewed. A discourse analytic approach, aligned with critical realist epistemology and informed by the work of Michel Foucault was used. Following analysis of the women’s talk, four discursive sites were identified, namely: Institutional Framing: Constructing Motherhood and Madness’; ‘Postpartum Psychosis: The Problematic Self’; ‘Lived Experience of a Duality: The Fragmented Self’ and ‘Survivors Story: A Mad Mum Reclaiming a Sense of Self and Educating Others’. The construction of a ‘survivor’ position served to reframe women’s experiences of postpartum psychosis, offering a more comfortable position to inhabit, other than identification as a ‘mad mum’. This study has demonstrated that the experience of postpartum psychosis is complex. The ways in which women talk about and make sense of their experience has been created and sustained through powerful institutions such as health and social care agencies that have set up the discursive positions of a mother and a mental health patient as antithetic to each other. The identified implications of this study have been highlighted for those who provide services, suggesting that they should be better informed to respond appropriately to women diagnosed with postpartum psychosis and their families

Design of a Debridement Device Using Impinging Jets

Chronic wound care is a significant burden on the healthcare system, affecting an estimated three to six million Americans, manifesting as ulcers associated with restricted blood flow, diabetes mellitus, or pressure. Treatment is frequently unsuccessful, with only an estimated 25–50% of venous and diabetic ulcers closing after 20 weeks of treatment. Debridement, the removal of necrotic tissue and foreign materials from the wounds, is a crucial component in the chronic wound care. While there exist many debridement techniques, the search for new and more effective methods is ongoing. The existing methods of debridement include surgical, the industry gold standard, as well as the mechanical, autolytic, enzymatic, and hydrosurgery (VersaJet™). The VersaJet™ uses a single high-speed jet directed parallel to the wound surface to remove soft necrotic tissue. This paper presents the design of a debridement device that uses two narrow, high-speed impinging fluid jets to excise necrotic tissue. The handheld device can be used to remove strips of necrotic tissue of a predetermined width and depth and was tested on samples of simulated slough, the soft necrotic tissue, and eschar, the hard, scablike necrotic tissue. The preliminary tests indicate that the technique removes necrotic tissue quickly and with good control, suggesting that, with further development, the technique may provide a time-saving alternative to surgical debridement. Further testing, however, is required to ensure that the jets do not damage the surrounding healthy tissues and to quantitatively analyze the effectiveness of the technique relative to other debridement strategies

Benefits and Success of an Interdisciplinary Wellness Interest Group (iWIG) at a Modern Jesuit University

Aim: To highlight the early achievements and discuss the benefits of forming an Interdisciplinary Wellness Interest Group (iWIG) on a modern Jesuit University campus. Background: While wellness programs have a place in academic communities, universal perspectives on the best way to lead Wellness initiatives is lacking. An iWIG gives a common platform to share ideas, communicate across audiences, and provide important information to the campus community about health promotion and health patterns of the campus community. Methods: After assembling the iWIG team, on-campus meetings were held with members of the interdisciplinary group. These meetings include faculty, staff, and students from various departments. The iWIG continues to meet regularly to expand and develop wellness initiatives, research opportunities and to ensure a presence on campus. Results: The iWIG has impacted many initiatives on campus, a select few which are profiled in this manuscript. The group is involved in funded research studies, has received a Healthy Workplace designation, and continues to expand health and wellness into various departments on campus. Conclusions: The interdisciplinary group has provided those with an interest in health and wellness with a formal platform to express ideas and implement initiatives for all individuals to better the overall well-being of the university community

The Transmogrification of St Bunnycrisp

Into the life of cowardly Poppy comes a scary 6 foot tall talking rabbit whose job it is to give bullies a taste of their own medicine. But Poppy is a good girl, it's Jessica who's mean, who makes Poppy's life miserable, who gave Poppy the stupid rabbit as a 10th birthday present in the first place! But then he was just a soft-toy; not this monster in her closet. Did St. Bunnycrisp get sent to the wrong girl? On the way to finding the answers to these questions Poppy and St. Bunnycrisp become best friends and go on adventures in a parallel fantasy realm. That is until St. Bunnycrisp's fate is threatened by the cruel Icemaiden, and Poppy will have to find the courage to save her friends' lives on her own