583 research outputs found
Incidence and associations of hemiplegic shoulder pain poststroke: prospective population-based study
No full textAbstract not availableZoe Adey-Wakeling, Hisatomi Arima, Maria Crotty, James Leyden, Timothy Kleinig, Craig S. Anderson, Jonathon Newbury on behalf of the SEARCH Study Collaborativ
Upper limb rehabilitation following stroke: current evidence and future perspectives
No full textAuthor Version made available in accordance with the publisher's policy.
This item is under embargo for a period of 12 months from the date of publication, in accordance with the publisher's policy.Stroke is a leading cause of disability worldwide, with risk increasing with age. Upper limb hemiparesis is common and associated with persistent impairments and associated disabilities. Older stroke populations often suffer multiple co-morbidities and restoring independence is complex. Recovery of upper limb function can be crucial for them to return to independent living and to participate in community life.
This review describes upper limb recovery post stroke, and some of the new therapeutic approaches available to promote recovery. Technologies (including virtual reality and telehealth) offer the opportunity for more home based therapies, longer programs, greater access to rehabilitation for older people however the trials continue to exclude older people so acceptability is poorly understood.
Hemiplegic shoulder pain reduces quality of life after acute stroke: a prospective population-based study
No full textHemiplegic shoulder pain is a common complication of stroke. The primary aim of this study was to determine the association of hemiplegic shoulder pain with health-related quality of life at 12 months after first stroke in a population-based registry. The secondary aim was to identify other factors associated with health-related quality-of-life outcomes.A prospective population-based study in a geographically defined region of Adelaide, South Australia was conducted. Multiple ascertainment methods identified all cases of stroke within a 12-month period. Objective and subjective measures were undertaken at baseline and at 4 and 12 months' follow-up. Multiple regression analyses identified independent variables (including exposure to shoulder pain and depression, 12-month dependence, access to formal rehabilitation) associated with health-related quality of life, defined by the summary index score derived from EuroQol-5D-3L at 12 months post-stroke.Hemiplegic shoulder pain, depression, increased dependency, stroke severity, and absence of initial rehabilitation were each associated with reduction in quality of life. Age, sex, stroke type, Oxfordshire classification, and discharge destination were not related to quality of life.Hemiplegic shoulder pain reduces health-related quality of life at 12 months. More effort should be directed towards screening and management of this frequent complication of stroke.Zoe Adey-Wakeling, Enwu Liu, Maria Crotty, James Leyden, Timothy Kleinig, Craig S. Anderson, Jonathon Newbur
Author Spotlight: Zoe Larghi Laureiro
No full textZoe Larghi Laureiro is currently at her 4th year of General Surgery Residency at Umberto I Hospital, La Sapienza
University of Rome. She will become a general surgeon following her graduation on December 2021. Her clinical and
research interests include hepato-pancreatic-biliary surgery
and liver transplantation
Deconstructing Zoe: Performing Race
No full text“When I’m driving as a man, nobody notices me, everyone goes Chink, but when I’m Zoe people are honking me, winking at me, tailing me and she’s like voom, speeding down the West Way.” What is it that makes Chinese men mostly invisible in the West? Why, by contrast, are Chinese women nearly always seen as desirable? Zoe has grappled with this question in her work as an actor on stage. As a Chinese man he often passes unnoticed, but as a Chinese woman, Zoe attracts attention and feels empowered. Deconstructing Zoe is a vivid and intimate portrait of a transgender actor. We trace the journey from boyhood in a small town in Malaysia to the West-end stage via the trans scene of London. The accompanying commentary describes the filmmaking process and discusses how Deconstructing Zoe, explores the intersection between gender, race and sexuality, in the postcolonial geographical spaces of her world stage. It questions how Zoe, by performing race, is able to create agency and become the author of her own identit
Deconstructing Zoe: Performing Race
No full text“When I’m driving as a man, nobody notices me, everyone goes Chink, but when I’m Zoe people are honking me, winking at me, tailing me and she’s like voom, speeding down the West Way.” What is it that makes Chinese men mostly invisible in the West? Why, by contrast, are Chinese women nearly always seen as desirable? Zoe has grappled with this question in her work as an actor on stage. As a Chinese man he often passes unnoticed, but as a Chinese woman, Zoe attracts attention and feels empowered. Deconstructing Zoe is a vivid and intimate portrait of a transgender actor. We trace the journey from boyhood in a small town in Malaysia to the West-end stage via the trans scene of London. The accompanying commentary describes the filmmaking process and discusses how Deconstructing Zoe, explores the intersection between gender, race and sexuality, in the postcolonial geographical spaces of her world stage. It questions how Zoe, by performing race, is able to create agency and become the author of her own identit
The role of actor associations in understanding the implementation of lean thinking in healthcare
No full textPurpose: The importance of networks in effecting the outcomes of change processes is well-established in the literature. Whilst extant literature focuses predominantly on the structural properties of networks, our purpose is to explore the dynamics of network emergence that give rise to the outcomes of process interventions. We show how Actor Network Theory (ANT) may be used as a lens for interrogating the way in which management interventions play out in the complex organisational setting of a UK National Health Service Trust, providing insights for management of process change initiatives. Design/methodology/approach: This is a rich qualitative study in the Pathology Unit of a UK National Health Service Trust, using ANT as the theoretical lens for tracking the emergence and transformation of networks of individuals over the course of a management intervention to promote “lean thinking” for performance improvements.Findings: ANT is useful for explicitly tracking how organisational players shift their positions and network allegiances over time, and identifying objects and actions that are effective in engaging individuals in networks enabling transition to a lean process. It is important to attend to the dynamics of the process of change and devise appropriate timely interventions enabling actors to shift their own positions towards a desired outcome.Research limitations/implications: We make the case for using of theoretical frameworks developed outside the operations management to develop insights for designing process interventions.Originality/value: By understanding the role of shifting networks managers can use timely interventions during the process implementation to facilitate the transition to lean processes: e.g. using demonstrable senior leadership commitment and visual communication.<br/
Being a Freshman, Being an Author: An Interview With Teen Author Zoe Trope
No full textWhile most fourteen year old girls are hanging out at the mall spending their hard-earned allowance on new clothes and quarters for an all-day marathon of Dance Dance Revolution at the video arcade, Portland-based author Zoe Trope was muddling through her freshman year of high school and composing a diary, which would later be turned into a much praised work of young adult literature, Please Don’t Kill the Freshman: A Memoir. In the opening pages of
the book, Trope displays her rare and witty teenage insight into the world of librarianship, insisting of the school media specialist, “You’re the one got stuck working in a high school library. No one chooses that profession, I’m sure.
Being a Freshman, Being an Author: An Interview With Teen Author Zoe Trope
No full textWhile most fourteen year old girls are hanging out at the mall spending their hard-earned allowance on new clothes and quarters for an all-day marathon of Dance Dance Revolution at the video arcade, Portland-based author Zoe Trope was muddling through her freshman year of high school and composing a diary, which would later be turned into a much praised work of young adult literature, Please Don’t Kill the Freshman: A Memoir. In the opening pages of
the book, Trope displays her rare and witty teenage insight into the world of librarianship, insisting of the school media specialist, “You’re the one got stuck working in a high school library. No one chooses that profession, I’m sure.
Suprascapular nerve block for shoulder pain in the first year after stroke: a randomized controlled trial
No full textAuthor version made available in accordance with the publisher's policyBackground and Purpose: Shoulder pain is a common complication after stroke which can impede participation in rehabilitation and has been associated with poorer outcomes. Evidence based treatments for hemiplegic shoulder pain are limited. Suprascapular nerve block (SSNB) is a safe and effective treatment of shoulder pain associated with arthritic shoulder conditions, but its usefulness in a stroke population is unclear.
Methods: We undertook a randomised controlled trial assessing the effectiveness of SSNB in a population of 64 stroke patients (onset < 1 year) with hemiplegic shoulder pain. The primary outcome was pain measured on a visual analogue scale (VAS). Secondary outcomes were disability (Modified Rankin Scale, Croft Disability Index) and quality of life (EuroQol Health Questionnaire). All participants were assessed prior to randomisation, and at 1, 4 and 12 weeks post intervention. Both groups continued with routine therapy.
Results: Whilst both intervention and control groups demonstrated reduction in pain score, participants who received SSNB consistently demonstrated superior, statistically significant pain reduction compared to placebo. Mean VAS reduction in the SSNB group was over 18mm greater than participants receiving placebo injection. The number needed to treat with SSNB to reduce one stroke survivor’s pain by 50% at four weeks is 4. No significant differences in function or quality of life were observed. No adverse events were reported.
Conclusions: Suprascapular nerve block is a safe and effective treatment for patients with hemiplegic shoulder pain
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