State of Evidence for Everyday Technology Use in Upper Extremity Motor Recovery Post-Stroke

The research team, in consultation with collaborating clinician Sarah Bicker, an OTR/L at Harborview Medical Center, researched everyday technology applications. The team conducted a systematic review considering what evidence exists about the effectiveness of commercially available everyday technology (ET) for improving upper extremity motor control and/or motivation to participate in therapy in clients post-stroke. The evidence was promising in support of the use of ET as indicated by improved upper extremity motor control outcomes and client and clinician reports of satisfaction, motivation, and engagement in post-stroke rehabilitation. Clinicians should consider the benefits of implementing ET for upper extremity motor recovery for clients post-stroke. Due to the changing nature of ET, the research team chose to minimize recommendations of specific applications. Instead, the team created a decision chart to help therapists identify what elements to consider when choosing a technology application to address the upper extremity motor control conditions/impairments with clients post-stroke. The decision tree considers performance skills according to the Occupational Therapy Practice Framework (OTPF), and includes current applications as examples. The research findings and decision chart were presented as an in-service to occupational therapy (OT) practitioners at Harborview Medical Center. Feedback from the in-service indicated that practitioners were positively receptive to the information provided and were more likely to incorporate ET into rehabilitation with their clients as a result of learning the research findings. Reviewing the literature indicates the need for more research regarding technology use for rehabilitation of individuals post-stroke

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

Who's Asking? Interviewer Coethnicity Effects in African Survey Data

Face-to-face interviews constitute a social interaction between interviewer and respondent, and in the African context, social interactions are strongly shaped by ethnicity. Yet research using African survey data typically fails to account for the effect of shared ethnicity on survey responses. We find that respondents give systematically different answers to coethnic and noncoethnic interviewers across surveys in 14 African countries, but with significant variation in the degree of bias across question types and types of noncoethnic dyads, with the largest effects occurring where both the respondent and interviewer are members of ethnic groups with a history of political competition and conflict, and where the respondent or interviewer shares an ethnicity with the head of state. Our findings have practical implications for consumers of African survey data and underscore the context dependence of the social interaction that constitutes the survey experience