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Riddle Hartvig posted an update 5 months, 4 weeks ago
To identify health professionals awareness of stroke rehabilitation guidelines, and factors perceived to influence guideline use internationally.
Online survey study. Open-ended responses were thematically analysed, guided by the Consolidated Framework for Implementation Research.
Data from 833 respondents from 30 countries were included. Locally developed guidelines were available in 22 countries represented in the sample. Respondents from high-income countries were more aware of local guidelines compared with respondents from low- and middle-income countries.Local contextual factors such as management support and a culture of valuing evidence-based practice were reported to positively influence guideline use, whereas inadequate time and shortages of skilled staff inhibited the delivery of guideline-recommended care. Processes reported to improve guideline use included education, training, formation of workgroups, and audit-feedback cycles. Broader contextual factors included accountability (or lack thrriers to their implementation. Efforts should be made to raise awareness of local guidelines in low- and middle-income countries. More attention should be paid to addressing local contextual factors to improve guideline use internationally, going beyond traditional strategies focused on individual health professionals.IMPLICATIONS FOR REHABILITATIONSystems are required so people and organisations are held accountable to deliver evidence-based care in stroke rehabilitation.Locally developed stroke rehabilitation guidelines should be promoted to boost awareness of these guidelines in low- and middle-income countries.In all regions, strategies to influence or adapt to the local setting, are required to optimise guideline use.There is a growing interest in understanding tissue organization, homeostasis, and inflammation. However, despite an abundance of data, the organizing principles of tissue biology remain poorly defined. Selleck PDD00017273 Here, we present a perspective on tissue organization based on the relationships between cell types and the functions that they perform. We provide a formal definition of tissue homeostasis as a collection of circuits that regulate specific variables within the tissue environment, and we describe how the functional organization of tissues allows for the maintenance of both tissue and systemic homeostasis. This leads to a natural definition of inflammation as a response to deviations from homeostasis that cannot be reversed by homeostatic mechanisms alone. We describe how inflammatory signals act on the same cellular functions involved in normal tissue organization and homeostasis in order to coordinate emergency responses to perturbations and ultimately return the system to a homeostatic state. Finally, we consider the hierarchy of homeostatic and inflammatory circuits and the implications for the development of inflammatory diseases.In their analysis in a previous issue of Perspectives on Psychological Science, Roberts and colleagues argued that the editors, authors, and participants throughout subfields of psychological science are overwhelmingly White. In this commentary, we consider some of the drivers and consequences of this racial inequality. Drawing on race scholarship from within and outside the field, we highlight three phenomena that create and maintain racial inequality in psychology (a) racial ignorance, (b) threats to belonging, and (c) racial-progress narratives. We close by exploring steps that journals and authors can take to reduce racial inequality in our field, ending with an appeal to consider the experience of scholars of color in race scholarship and in psychological science more broadly.
Elevated serum concentrations of chemerin is a significant factor in the development of metabolic disorders.
This systematic review and meta-analysis evaluated the influence of exercise training on serum concentrations of chemerin in patients with metabolic diseases.
Thirteen studies including 463 participants were included and analysed using a random-effects model to calculate weighted mean differences with 95% confidence intervals.
Results indicated that exercise training significantly decreased serum concentrations of chemerin in patients with metabolic diseases when compared with controls. Subgroup analysis showed that exercise training resulted in decreases in serum concentrations of chemerin in men, however, this was not significant in women. Moreover, subgroup analyses based on the type of exercise did not reveal differential effects on serum concentrations of chemerin.
Exercise training may produce improvements in serum concentrations of chemerin in patients with metabolic diseases. Further longer-term studies are needed to confirm these findings.
Exercise training may produce improvements in serum concentrations of chemerin in patients with metabolic diseases. Further longer-term studies are needed to confirm these findings.
To report initial psychometric evidence on the Measure of Early Vision Use.
Data on performance of the Measure of Early Vision Use scale were collected from 100 parents of children with cerebral palsy aged 0-12 years
online survey. Psychometric evaluation included assessment of scale dimensionality using Classical Test Theory and hypothesis testing for evidence of construct validity.
Principal components analysis of the 14-item parent-rated Measure of Early Vision Use revealed one component with an eigenvalue of 9.343, explaining 66.7% of variance; internal consistency was high (Cronbach’s α = 0.96). Total scores ranged from 15-56 (Mean 42.8, standard deviation = 10.6). The results support seven pre-defined hypotheses including statistically significant differences in MEVU-total scores between children with and without parent-reported cerebral visual impairment.
Measure of Early Vision Use is the first assessment tool to describe ‘how vision is used’ in children with cerebral palsy. Results provide is used’ in children with cerebral palsy. Results provide preliminary evidence that the measure comprises a unidimensional construct, sufficient construct validity, and feasibility as a parent-completed online assessment. Findings on internal structure provide foundational evidence and require further testing with Confirmatory Factor Analysis or Rasch Analysis.IMPLICATIONS FOR REHABILITATIONThe Measure of Early Vision Use is a new instrument to describe the use of basic visual abilities and is feasible to use as a parent-completed online questionnaire.The Measure of Early Vision Use is a unidimensional scale with sufficient construct validity to supports its use as a measure of ‘how vision is used’ without confounding visual ability with the reason why it might be impaired (e.g., cerebral vision impairment, motor limitations, or cognition).There is potential for the Measure of Early Vision Use to support early intervention planning for children with (or at high risk of) cerebral palsy.
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