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Gulbahar Haitiwaji hoped it would be the last time she would have to betray a family member. She had already denounced her own daughter, her husband, and Uyghur activist leader [...]

Objective. The COVID-19 pandemic has seen a rapid shift to telehealth-delivered physical therapy services. Common impairments after stroke create unique challenges when providing rehabilitation via telehealth, particularly when it involves activities undertaken in weight-bearing or standing positions, including walking training. Our scoping review maps the evidence regarding safety, efficacy, and feasibility of remotely supervised telehealth interventions involving activities undertaken in weight-bearing or standing positions for people after stroke. Methods. Searches of relevant databases for primary research studies were conducted using keywords relating to exercise and telehealth. Studies of stroke survivors undertaking interventions involving activities in weight-bearing or standing positions, supervised in real-time via telehealth were included. Two reviewers independently appraised all studies. Data were charted by one reviewer, checked by another, and results synthesized narratively. Results. Seven studies (2 randomized trials, 1 mixed-methods, and 4 pre-post studies) were included, involving 179 participants. Some studies included stroke survivors with cognitive impairment, and 2 (29%) studies included only participants who walked independently. Adherence (reported in 3 studies) and satisfaction (reported in 4 studies) were good, and no serious adverse events (data from 4 studies) related to interventions were reported. Strategies to overcome technological barriers were used to optimize intervention safety and feasibility, along with physiological monitoring, caregiver assistance, and in-person exercise prescription. However, there is limited high-quality evidence of efficacy. Conclusions. We identified strategies used in research to date that can support current practice. However, urgent research is needed to ensure that stroke survivors are receiving evidence-based, effective services. Impact. The COVID-19 pandemic has necessitated a rapid shift to telerehabilitation services for people with stroke, but there is little evidence to guide best practice. Our review provides practical guidance and strategies to overcome barriers and optimize safety and adherence for telehealth interventions involving activities in weight-bearing or standing positions. Keywords: COVID-19, Exercise, Physical Therapy Modalities, Rehabilitation, Stroke, Telemedicine, Introduction Our world is currently amid the coronavirus disease 2019 (COVID-19) pandemic. Health systems are under pressure and are implementing practices to minimize transmission and rationalize services to cope with [...]

Early last December, a group of nine British lawyers and humanrights specialists gathered in a wood-paneled room under the glass dome of Church House, near Westminster Abbey in downtown London. [...]

Every so often, I witness a scene in my neighborhood that's all too common in New York City. A single car is double-parked on a narrow side street in front [...]

Three days before China's twentieth Communist Party Congress in October, a man dressed in an orange jumpsuit and yellow hard hat unfurled two large banners on a highway overpass in [...]

About three years ago, before the onset of the COVID pandemic, I attended a talk in New York City given by a Hong Kong activist. Back then the city was [...]

Physical function (PF) limitations are common in aging. However, there is a dearth of interventions focused on addressing PF limitations in community-based settings, particularly in minoritized communities. To guide intervention development, we conducted focus groups to understand perceptions of PF limitations, gauge intervention interest, and identify potential intervention strategies as part of a large health partnership of African American churches in Chicago, IL. Participants were age 40+ years with self-reported PF limitations. Focus groups (N=6 focus groups; N=40 participants) were audio recorded, transcribed, and analyzed using thematic analysis methods.

The article focuses on Caroline Cole's ceramic works, which are inspired by her architectural and mathematical background, showcasing her intricate designs and geometric precision. The topics include her creative journey, working methods, casting techniques, and the incorporation of color and patterns into her pieces.

It is of critical importance that findings from the wealth of clinical physical therapist research are transferred into clinical practice without unnecessary delays. There is a lack of knowledge about strategies that can be used to effectively implement physical therapist research findings and evidence-based practice (EBP) into everyday clinical practice in different national settings and contexts. The purpose of this article is to contribute to knowledge about effective strategies for implementing EBP that have been studied in different national physical therapy settings. The specific aims of this article are to share experiences and provide a current multinational perspective on different approaches and strategies for implementing EBP and to highlight important considerations and implications for both research and practice. Six research studies from various settings in 3 countries are described and synthesized. Key characteristics of the studies and intervention components are tabulated and mapped to the Cochrane Effective Practice and Organisation of Care taxonomy. Commonalities and differences are presented. The implementation strategies described were: a theory-based guideline implementation tailored to identified barriers and facilitators; a multifaceted EBP training package; journal clubs; a multifaceted strategy comprising contextualized procedures, protocols, and standardized resources; barrier identification, education, audit, feedback, and reminders; and contextualized guidelines. Commonalities were the use of a multifaceted approach, educational measures, and clinical guidelines. Key outcomes across the studies were improved attitudes and increased awareness, knowledge, skills, and confidence in EBP; better access to clinical practice guidelines and other EBP resources; identification of barriers that could be targeted in future implementation activities; earlier referrals; and use of recommended outcome measures. The article can serve as a template for other physical therapist researchers in designing implementation studies, as well as to inform policies and practice for health care managers and decision makers who are looking for ways to implement research findings in their organizations., In 1972, the British physician and epidemiologist Archie Cochrane challenged medical practitioners to enhance their effectiveness and efficiency in clinical practice by integrating current best evidence into their decision making. [...]

One of the few happy memories Ann would share from her childhood was the time she spent in a Dutch orphanage. She talked about it often--the endless fields of red [...]

Background: The COVID-19 pandemic has highlighted and exacerbated health inequities, as demonstrated by the disproportionate rates of infection, hospitalization, and death in marginalized racial and ethnic communities. Although non-English speaking (NES) patients have substantially higher rates of COVID-19 positivity than other groups, research has not yet examined primary language, as determined by the use of interpreter services, and hospital outcomes for patients with COVID-19. Methods: Data were collected from 1,770 patients with COVID-19 admitted to an urban academic health medical center in the Chicago, Illinois area from March 2020 to April 2021. Patients were categorized as non-Hispanic White, non-Hispanic Black, NES Hispanic, and English-speaking (ES) Hispanic using NES as a proxy for English language proficiency. Multivariable logistic regression was used to compare the predicted probability for each outcome (i.e., ICU admission, intubation, and in-hospital death) by race/ethnicity. Results: After adjusting for possible confounders, NES Hispanic patients had the highest predicted probability of ICU admission (p-value < 0.05). Regarding intubation and in-hospital death, NES Hispanic patients had the highest probability, although statistical significance was inconclusive, compared to White, Black, and ES Hispanic patients. Conclusions: Race and ethnicity, socioeconomic status, and language have demonstrated disparities in health outcomes. This study provides evidence for heterogeneity within the Hispanic population based on language proficiency that may potentially further contribute to disparities in COVID-19-related health outcomes within marginalized communities.

Medulloblastoma is a primitive brain tumor, which occurs in the cerebellum of children. Like most brain tumors, it is treated with radiation and/or surgery. Most chemotherapeutic drugs do not enter the brain effectively and are therefore of little value in treating cancer in this location. However, medulloblastoma sometimes spreads (metastasizes) to the bone, and systemic chemotherapy may be valuable in preventing bone metastases, even if it does little to fight the primary tumor. A review was conducted of 89 cases of medulloblastoma. Fifty cases occurred between 1970 and 1983; these patients were treated with surgery followed by radiation. The remaining 39 patients were treated since 1983; these patients received chemotherapeutic treatment in addition to the surgery and radiation therapy. Relapses in the central nervous system (CNS) occurred in 19 of the 50 (38 percent) earlier patients, and in nine of the 39 (23 percent) later patients. Relapse occurring in the central nervous system was found to be strongly related to the dose of radiation. CNS relapses occurred in 50 percent of the patients who received less than 5,300 cGy radiation treatment, but in only 18 percent of the patients who received more than this amount. (A Gy, or Gray, is a dose of radiation equivalent to one joule of energy absorbed per kilogram of tissue. It is equal to 100 rads.) A total of six bone relapses were seen. Not a single bone relapse was observed in patients who had received systemic chemotherapy. The five-year survival was 55 percent for the patients treated during the earlier period. The five-year survival was 72 percent for the patients treated more recently, although the difference in survival between the two groups was not considered statistically significant. (Consumer Summary produced by Reliance Medical Information, Inc.)

Background While attending the Tennessee Arts Academy, I was honored to work with the sculptor Jim Myford. He introduced students in his class to site-specific sculptures. My first thought was […]

Background: Older Black adults face a disproportionate burden of HIV prevalence, but less is known about racial disparities in age-related outcomes in HIV. We assessed the effect of HIV status and race on motor and pulmonary function, as well as how they contribute to mobility disability. Setting: Community-based study; Chicago, IL Methods: Participants were 363 community-dwelling adults age ≥ 50 years, 48% living with HIV, and 68% Black. Participants with HIV were recruited from a specialty HIV clinic, and participants without HIV (comparable on key demographic, lifestyle, and behavioral characteristics) were recruited from the community. Measures included motor function summarized by 10 motor performance measures, pulmonary function summarized by 3 measures assessed using handheld spirometry, and self-reported mobility disability. Results: In fully adjusted linear models, HIV was associated with better motor (β= 9.35, p< 0.001) and pulmonary function (β= 16.34, p< 0.001). For pulmonary function, the effect of HIV status was moderated by race (interaction between Black race and HIV status: β=  − 11.66, p= 0.02), indicating that better pulmonary function among participants with HIV was less evident among Black participants. In fully adjusted models, odds of mobility disability did not differ by race, HIV status, or pulmonary function; better motor function was associated with lower odds of mobility disability (OR = 0.91 per 1-point higher, 95% CI 0.88–0.93). Conclusion: Better motor and pulmonary function exhibited by participants with HIV could reflect access to medical care. Racial differences in lung function among participants with HIV indicate potential disparities in prevention or treatment of pulmonary disease or underlying risk factors.

The article features ceramist and illustrator Polly Fern and her works that were inspired by vintage plates and nostalgic illustrations. Also cited are the artistic abilities of Fern's mother, who is a gardener, and her father, who is a cabinet maker, her love of shopping at antique shops like Richard Scott's Antique shop in Holt, North Norfolk, England, and her Fine Art education at Norwich University of the Arts.

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•Summarization of the most recent TPS applied studies with focus on rates of atypical diagnosis.•An overview of current clinical triage of urothelial carcinoma and role of urine cytology.•A review of performance of TPS in Upper Tract disease in most recent, post TPS studies.•Poignant summary of problematic areas of high grade urothelial carcinoma especially of the upper tract in this post TPS era.•Updates and succinct summaries of important ancillary tests that can be done on voided urine.•Photomicrographs illustrating difficulty with N:C ratios and rare variant morphology of HGUC.•An overview of AI and AIML in the arena of urine cytology.

Background Conferences are a widespread method of research dissemination; however, their impact on practice is not well understood empirically. We aimed to investigate how conference participation influences clinical and research practice in the stroke field and to explore which presentation formats are most impactful. Methods Clinicians, researchers and doctoral students who attended a multidisciplinary stroke conference were invited to participate. Surveys were administered at the conference and 3 months later. Both surveys contained questions about how respondents remember and apply information learnt at conferences in their clinical and/or research practice. Results Baseline survey responses from 120 conference participants were analysed (80.8% female, 69.0% clinicians, 60.8% aged 31–50 years), and 53 participants completed the follow-up survey. Of the 87 clinician respondents, 73 (83.9%) reported that their clinical practice had changed as a result of attending conferences. Workshops incorporating skill demonstrations were rated most useful for changing clinical practice, whereas oral presentations detailing methodology were more influential on research practice. Attending conferences was rated more impactful on clinical practice than reading journal articles or textbooks. Conclusion Conference presentations can be a useful method for disseminating research findings to influence clinical practice and should be considered by researchers to maximise the translation and impact of their work.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.annemergmed.2006.03.031 Byline: Michelle Gill, Kevin Martens, Elizabeth L. Lynch, Ahmad Salih, Steven M. Green Abstract: The Simplified Motor Score was recently found to exhibit equal test performance to the Glasgow Coma Scale (GCS) when predicting 4 clinically important trauma outcomes. The present study tests the interrater reliability of the Simplified Motor Scale, the GCS and its components, and 2 other simplified neurologic scales when applied to patients presenting to the emergency department with altered levels of consciousness from any cause. Author Affiliation: Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, CA. Article History: Received 4 January 2006; Revised 6 March 2006; Revised 20 March 2006; Accepted 31 March 2006 Article Note: (footnote) Supervising editor: E. John Gallagher, MD Author contributions: MG and SG conceived of the study idea. MG, KM, ELL, and AS compiled the study data. MG and SG performed the data analyses, and all authors contributed to the writing and revision of the paper. MG takes responsibility for the paper as a whole. Funding and support: The authors report this study did not receive any outside funding or support. Available online June 6, 2006. Reprints not available from the authors.

Short sleep duration and poor sleep quality are more prevalent among African Americans (AAs) and may be a modifiable risk factor for cardiometabolic disorders. However, research is limited about sleep-related attitudes, beliefs, and practices among AAs. Our objective was to evaluate these practices and beliefs surrounding sleep among urban-dwelling AAs.

To identify factors associated with receiving acute goal‐directed treatment, being assessed for ongoing rehabilitation, and receiving post‐acute rehabilitation after having a stroke. Retrospective analysis of National Stroke Audit data for patients with acute stroke treated at Australian hospitals during 1 September 2014 – 28 February 2015. 112 Australian hospitals that admit adults with acute stroke. Associations between patient‐related and organisational factors and the provision of rehabilitation interventions. Data for 3462 patients were eligible for analysis; their median age was 74 years, 1962 (57%) were men, and 2470 (71%) had received care in a stroke unit. 2505 patients (72%) received goal‐directed treatment during their acute admission; it was not provided to 364 patients (10.5%) who were responsive, had not fully recovered, and did not refuse treatment. Factors associated with higher odds of receiving goal‐directed treatment included goal‐setting with the patient and their family (odds ratio [OR], 6.75; 95% CI, 5.07–8.90) and receiving care in a stroke unit (OR, 2.08; 95% CI, 1.61–2.70). 1358 patients (39%) underwent further rehabilitation after discharge from acute care; factors associated with receiving post‐acute rehabilitation included care in a stroke unit (OR, 1.73; 95% CI, 1.34–2.22) and having an arm or speech deficit. Dementia was associated with lower odds of receiving acute goal‐directed treatment (OR, 0.49; 95%, 0.33–0.73) and post‐acute rehabilitation (OR, 0.43; 95%, 0.30–0.61). Access to stroke units and to early and ongoing rehabilitation for patients after stroke can be improved in Australia, both to optimise outcomes and to reduce the burden of care on underresourced community and primary care providers.

On the first day of any beginning level art course I have ever taught, one of the first questions my students consistently ask is, 'When are we going to do [...]

The article offers information on the services for teenagers in libraries and provides suggestions for librarians to interact with them. Topics discussed include the need to show respect and relatedness to teenagers, the need incorporate open communication atmosphere, and the need to evaluate the feedback provided by them.

BackgroundSubstantial disparities in life expectancy exist between Chicago’s 77 defined community areas, ranging from approximately 69 to 85 years. Prior work in New York City and Boston has shown that community-level racial and economic segregation as measured by the Index of Concentration at the Extremes (ICE) is strongly related to premature mortality. This novel metric allows for the joint assessment of area-based income and racial polarisation. This study aimed to assess the relationships between racial and economic segregation and economic hardship with premature mortality in Chicago.MethodsAnnual age-adjusted premature mortality rates (deaths <65 years) from 2011 to 2015 were calculated for Chicago’s 77 community areas. ICE measures for household income (

In southeastern Colorado, bedrock ground stone (BGS) features, also called bedrock metates or mortars, are a well-recognized part of the archaeological record. Although sometimes documented or recorded, they are rarely studied. However, elsewhere BGS are considered an important aspect of subsistence strategies, landscape adaptation, and symbolic ideology. A critical examination of any aspect of material culture begins with an unbiased description, and subsequent development of methods to scientifically examine the phenomena. This paper offers a methodology for recording BGS features to encourage reporting in the region. Results underscore the importance of developing accurate feature planviews, but also illustrate that minimal metric data (length, width, and depth) offer insight into how the landscape was inhabited by ancient peoples.

Bedrock ground stone features, found throughout the world, are particularly concentrated in the canyons of the Southern Plains of North America. Morphological analysis offers powerful tools for developing descriptions of bedrock ground stone (BGS) which can be used to discuss how prehistoric landscapes were inhabited. Metric representations of morphological variation can be used to test hypotheses about the nature of BGS features, which are often difficult to investigate and analyze. This paper presents a morphological approach to describe and analyze BGS surfaces in a side canyon of southeastern Colorado which can be applied by researchers to datasets in other regions. Results indicate that while variation exists, the BGS design (as determined by shape and size) are similar across the side canyon supporting the hypothesis that the canyon was occupied by a group of closely related people through time; although not all sites were used in the same manner.

Changes in reproductive hormones during menopause are associated with accumulation of intra-abdominal adipose tissue (IAAT), a subclinical indicator of cardiometabolic disease risk. Independent of reproductive hormones, unhealthy lifestyle contributes to IAAT gain. The Women in the Southside Health and Fitness (WISHFIT) Study aims to develop a lifestyle approach to slowing IAAT accumulation as women begin the menopausal transition.

The article reports that according to according to the U.S. Department of Health and Human Services, adverse outcomes for adolescent parents and their children can be felt across multiple generations in health, socioeconomic status, and social-emotional development. It mentions that significant research showing that both teen parents and their children are especially vulnerable to adverse childhood experiences (ACEs).

Several letters to the editor are presented in response to articles in previous issues including "Midnight Idol" in the May 19, 1967 issue, one on a cover story about an African American in Vietnam that appeared in the May 26, 1967 issue, and one on an issue about Taiwan as a model for Asian economic development in the May 12, 1967 issue.

The purpose of this research is to investigate long term effects of cognitive skill degradation through the use of automation. Even though advanced studies have looked into information automation (IA) in aviation, the amount of empirical data on the effects of these systems on the retention of cognitive skills is less deeply examined. Measurement and analysis of the effects of IA on cognitive performance is an important first step in understanding cognitive skill degradation, which should be considered during the design of these systems. The use of an automation aid is expected to result in a high level of performance degradation over time. Participants were randomly placed into three experimental groups (manual, alternating, or automation) and asked to perform flight planning calculations as an experiment task. Participants performed the task five times, once every two weeks. The manual group used the manual method throughout the experiment, the alternating group switched between the manual and automated method every trial. The automation group used the manual method for the first trial, the automated method for the three consecutive trials and then went back to using the manual method during the last trial. The automation group showed the most performance degradation and highest workload, while the alternating group presented reduced performance degradation and workload, and the manual group showed the least performance degradation and workload. This work provides the foundation for the design of guidelines and recommendations for IA systems in order to prevent cognitive skill degradation.

Factors at multiple ecological levels, including the child, family, home, medical care, and community, impact adolescent asthma outcomes.

[ILLUSTRATION OMITTED] Can you imagine my surprise going to the nest boxes to gather eggs and finding kittens that "hatched?" At least it looked like they had. If this wasn't […]

THE PLACE IN MY HEART It's a small thing. Nothing of importance. Something only my twin and I can say is ours. It holds its small head tall and proud […]

The article discusses about an experience of Ann Buchsbaum of surviving holocaust. It further discusses that Chinese government has forcibly detained millions of Uyghurs and other Turkic Muslims, without due process, in concentration camps in Xinjiang province while destroying thousands of mosques, evoking a present-day Kristallnacht.

For Goshen, N.Y., farmer John Glebocki, a day at the market begins at 3:30 A.M., when he packs his truck with fresh vegetables for the two-hour drive to New York [...]

The research in the management of severe sepsis and septic shock has resulted in a number of therapeutic strategies with significant survival benefits. These results also emphasize the primary importance of early hemodynamic resuscitation, or early goal‐directed therapy (EGDT), and place the emergency physician in the center of the multidisciplinary team caring for patients with this disease. However, in a busy emergency department, the translation of research into clinical practice is far from ideal. While the benefits are significant, the successful implementation of EGDT is filled with challenges and obstacles. In this article, we will discuss the steps taken at our institution to create, implement, measure, and improve on a six‐hour severe sepsis and septic shock treatment bundle incorporating EGDT in the emergency department setting, resulting in significant mortality benefit.

Manmade disasters have risen over the past decaFde. Specifically, chemical weapons used in acts of aggression pose an increasing threat to our society. These potential disaster situations raise concerns regarding preparedness for both adults and children. This article's purpose is to review general principles of chemical exposure and treatment of specific chemical agents, and to identify specific pediatric considerations involved.

The aim of this study was to seek opinions regarding the perceived advantages and disadvantages of the two main models of clinical education used in Australia. A questionnaire was designed specifically for this study and distributed to physiotherapists involved in clinical education at health units throughout Australia. There were 343 respondents (giving an approximate response rate of 74.5%). In most health units (78.4%) the model of clinical education currently used involves a number of physiotherapists sharing responsibility for the clinical education of students (SR model). Only a minority reported employing a designated clinical educator (DCE) to provide clinical education. Overall, respondents preferred the DCE model to the SR model. The perceived advantages of the DOE model included an increased time to devote to clinical education, improved consistency of supervision and decreased stress levels for staff.

Purpose. We examined the cardiovascular health profiles of benefit-eligible hospital employees who participated in an incentive screen program for 4 years. We also determined if cardiovascular health changes differed between participants (CHAP) who enrolled in structured follow-up risk reduction programs (CHAPplus) compared with those who chose less formal options (CHAPonly).Methods. CHAP consisted of cardiovascular screens, results counseling, and encouragement to participate in education and behavioral support programs. After adjusting for gender, medication use, and baseline levels of adiposity and physical activity, cardiovascular health changes were tested with repeated-measures analysis of covariance (ANCOVA) among CHAP participants and by CHAP type.Results. CHAP 4-year members (n = 278) were generally healthy and mostly women (87%) with an average age of 40.6 ± .5 years at baseline. Despite increases in overall (p = .034) and central adiposity (p = .001), cardiovascular health improvements were found for the total cholesterol/high-density lipoprotein ratio (TCHOL/HDL; p = .007), low-density lipoprotein (p = .009), and blood glucose (p = .018) among 4-year CHAP members. CHAPonlyemployees showed greater improvements in most cardiovascular health indicators than CHAPplusparticipants, although these differences did not achieve statistical significance.Discussion. Cardiovascular health improvements were associated with long-term participation in a hospital worksite incentive screen program. The cardiovascular health benefits tended to be greatest for CHAP employees who chose informal follow-up risk reduction options (CHAPonly) than those who enrolled in structured programs (CHAPplus).

Although the dissociative sedative ketamine is used commonly for pediatric procedural sedation in other settings, the safety of this agent in pediatric gastroenterology is not well-studied. A 5-year experience with ketamine sedation for pediatric gastroenterology procedures was reviewed to document the safety profile of this agent and to identify predictors of laryngospasm during esophagogastroduodenoscopy (EGD).