Two steps forward, one step back? A commentary on the disease-specific core sets of the international classification of functioning, Disability and Health (ICF)

The International Classification of Functioning, Disability and Health (ICF) is advocated as a biopsychosocial framework and classification and has been received favourably by occupational therapists, disability rights organisations and proponents of the social model of disability. The success of the ICF largely depends on its uptake in practice and it is considered unwieldy in its full format. Therefore, to make the ICF user friendly, the World Health Organisation (WHO) have condensed the original format and developed core sets, some of which are disease specific. The authors use the ICF Core Set for stroke as an example to debate if by reverting to classification according to disease, the ICF is at risk of taking two steps forward, one step back in its holistic portrayal of health

Using the ICF to clarify team roles and demonstrate clinical reasoning in stroke rehabilitation

Purpose: The International Classification of Functioning, Disability and Health (ICF) is advocated as a tool to structure rehabilitation and a universal language to aid communication, within the multi-disciplinary team (MDT). The ICF may also facilitate clarification of team roles and clinical reasoning for intervention. This article aims to explore both factors in stroke rehabilitation. Method: Following a review of the literature, a summary was presented and discussed with clinicians working within stroke rehabilitation, to gather expert opinions. The discussions were informal, being part of service development and on-going education. The clinicians summarised key themes for the potential use of the ICF within clinical practice. Results: Two key themes emerged from the literature and expert opinion for the potential use of the ICF in stroke rehabilitation: i) to aid communication and structure service provision ii) to clarify team roles and aid clinical reasoning. Expert opinion was that clarification of team roles needs to occur at a local level due to the skill mix, particular interests, setting and staffing levels within individual teams. The ICF has the potential to demonstrate/ facilitate clinical reasoning, especially when different MDT members are working on the same intervention. Conclusion: There is potential for the ICF to be used to clarify team roles and demonstrate clinical reasoning within stroke rehabilitation. Further experiential research is required to substantiate this vie

Restoration of eucalypt grassy woodland: effects of experimental interventions on ground-layer vegetation

We report on the effects of broad-scale restoration treatments on the ground layer of eucalypt grassy woodland in south-eastern Australia. The experiment was conducted in two conservation reserves from which livestock grazing had previously been removed. Changes in biomass, species diversity, ground-cover attributes and life-form were analysed over a 4-year period in relation to the following experimental interventions: (1) reduced kangaroo density, (2) addition of coarse woody debris and (3) fire (a single burn). Reducing kangaroo density doubled total biomass in one reserve, but no effects on exotic biomass, species counts or ground cover attributes were observed. Coarse woody debris also promoted biomass, particularly exotic annual forbs, as well as plant diversity in one of the reserves. The single burn reduced biomass, but changed little else. Overall, we found the main driver of change to be the favourable growth seasons that had followed a period of drought. This resulted in biomass increasing by 67%, (mostly owing to the growth of perennial native grasses), whereas overall native species counts increased by 18%, and exotic species declined by 20% over the 4-year observation period. Strategic management of grazing pressure, use of fire where biomass has accumulated and placement of coarse woody debris in areas of persistent erosion will contribute to improvements in soil and vegetation condition, and gains in biodiversity, in the future.Funding and in-kind logistic support for this project was provided by the ACT Government as part of an Australian Research Council Linkage Grant (LP0561817; LP110100126). Drafts of the manuscript were read by Saul Cunningham and Ben Macdonald

Rapid virological surveillance of community influenza infection in general practice

No abstract available

Cooperative Jahn-Teller Distortion in PrO2

We report neutron diffraction data on single crystal PrO2 which reveal a cooperative Jahn-Teller distortion at TD = 120 +/- 2 K. Below this temperature an internal distortion of the oxygen sublattice causes the unit cell of the crystallographic structure to become doubled along one crystal axis. We discuss several possible models for this structure. The antiferromagnetic structure below TN = 13.5 K is found to consist of two components, one of which shares the same doubled unit cell as the distorted crystallographic structure. We also present measurements of the magnetic susceptibility, the specific heat capacity and the electrical conductivity of PrO2. The susceptibility data show an anomaly at a temperature close to TD. From the specific heat capacity data we deduce that the ground state is doubly degenerate, consistent with a distortion of the cubic local symmetry. We discuss possible mechanisms for this. The conductivity shows an activated behaviour with an activation energy Ea = 0.262 +/- 0.003 eV.Comment: 12 pages, 14 figures, 2 tables. Additional suggested structure in v

Confinement of the Sun's interior magnetic field: some exact boundary-layer solutions

High-latitude laminar confinement of the Sun's interior magnetic field is shown to be possible, as originally proposed by Gough and McIntyre (1998) but contrary to a recent claim by Brun and Zahn (A&A 2006). Mean downwelling as weak as 2x10^-6cm/s -- gyroscopically pumped by turbulent stresses in the overlying convection zone and/or tachocline -- can hold the field in advective-diffusive balance within a confinement layer of thickness scale ~ 1.5Mm ~ 0.002 x (solar radius) while transmitting a retrograde torque to the Ferraro-constrained interior. The confinement layer sits at the base of the high-latitude tachocline, near the top of the radiative envelope and just above the `tachopause' marking the top of the helium settling layer. A family of exact, laminar, frictionless, axisymmetric confinement-layer solutions is obtained for uniform downwelling in the limit of strong rotation and stratification. A scale analysis shows that the flow is dynamically stable and the assumption of laminar flow realistic. The solution remains valid for downwelling values of the order of 10^-5cm/s but not much larger. This suggests that the confinement layer may be unable to accept a much larger mass throughput. Such a restriction would imply an upper limit on possible internal field strengths, perhaps of the order of hundreds of gauss, and would have implications also for ventilation and lithium burning. The solutions have interesting chirality properties not mentioned in the paper owing to space restrictions, but described at http://www.atmos-dynamics.damtp.cam.ac.uk/people/mem/papers/SQBO/solarfigure.htmlComment: 6 pages, 3 figures, to appear in conference proceedings: Unsolved Problems in Stellar Physic

Lattice and magnetic instabilities in CaFe2As2: A single crystal neutron diffraction study

Neutron diffraction measurements of a high quality single crystal of CaFe2As2 are reported. A sharp transition was observed between the high temperature tetragonal and low temperature orthorhombic structures at TS = 172.5K (on cooling) and 173.5K (on warming). Coincident with the structural transition we observe a rapid, but continuous, ordering of the Fe moments, in a commensurate antiferromagnetic structure is observed, with a saturated moment of 0.80(5)muB/Fe directed along the orthorhombic a-axis. The hysteresis of the structural transition is 1K between cooling and warming and is consistent with previous thermodynamic, transport and single crystal x-ray studies. The temperature onset of magnetic ordering shifts rigidly with the structural transition providing the clearest evidence to date of the coupling between the structural and magnetic transitions in this material and the broader class of iron arsenides.Comment: submitted to PR

Connecting the Dots: Stages of Implementation, Wraparound Fidelity and Youth Outcomes

Several necessary system and organizational support conditions for wraparound have been identified (Walker et al. 2003). Yet, the relationship between these necessary system level conditions and wraparound fidelity has only recently begun to be examined. Similarly, few studies have included a measure of wraparound fidelity when examining the relationship between wraparound implementation and youth outcomes. The statewide implementation of a wraparound demonstration grant offers the opportunity to explore these relationships and to identify factors that predict improvement in functioning for youth receiving wraparound. Findings suggest that significant relationships exist between (1) the stage of development of necessary support conditions for wraparound and wraparound fidelity and (2) wraparound fidelity and improvement in youth outcomes. Specific elements of wraparound (i.e., outcomes based and community based) and baseline needs and strengths (e.g., high levels of anxiety and conduct issues, poor functioning at home and in school, judgment, and risks) were found to predict a reduction in youth needs. Other unexpected relationships between youth outcomes and the cultural competence element of wraparound and being multi-racial were also discovered. These findings reinforce the importance of supporting high fidelity wraparound for youth and their families in a recovery focused behavioral health system