Feasibility and Safety of Sequential Transcranial Direct Current Stimulation and Physical Therapy in Older Adults at Risk of Falling: A Randomized Pilot Study.

Objective: To establish the feasibility and safety of administering transcranial direct current stimulation (tDCS) immediately prior to physical therapy (PT) sessions in older adults at risk of falls.

Design: A pilot randomized controlled study.

Setting: Outpatient geriatric physical therapy clinic.

Transfer of Mexiletine into Breast Milk: A Case Report.

Mexiletine is a class 1B antiarrhythmic agent, used to treat ventricular arrhythmias, and noncardiac-related problems such as myotonia. Limited safety data are available on the transfer of this drug into breast milk. We report the case of a woman diagnosed with myotonia congenita who breastfed two children after two consecutive pregnancies.

Implementation of an intersectoral outreach and community nursing care intervention with refugees in Quebec: A protocol study.

Aim: To establish and assess an intersectoral local network focused on the roles of registered nurses and primary healthcare nurse practitioners to ensure the continuity of care and service pathways for refugees in Quebec.

Design: Developmental evaluation with a mixed methodology.

Methods: The qualitative component will include: (1) a document review; (2) observations of participants during meetings of different governance structures; (3) semi-structured interviews with key actors (n = 40; 20/neighbourhood interventions); and (4) focus groups with end users of the services (refugees) (n = 4; 6 to 8 participants per group).

Shear wave elastography potential to characterize spastic muscles in stroke survivors: Literature review.

Background: Post-stroke spasticity contributes to impairments, disabilities and decline in quality of life. Quantitative measurements of spasticity are needed in order to assess the impact of specific treatments and to choose the more accurate technique for each patient. The aim of this review is to examine the use of shear wave ultrasound elastography as a quantitative tool for monitoring biomechanical muscle properties such as stiffness and to determine whether it is a reliable method to assess spastic muscle in stroke survivors.

A Delphi-Based Consensus Statement on the Management of Anticoagulated Patients With Botulinum Toxin for Limb Spasticity.

Objective: To create a consensus statement on the considerations for treatment of anticoagulated patients with botulinum toxin A (BoNTA) intramuscular injections for limb spasticity.

Design: We used the Delphi method.

Setting: A multiquestion electronic survey.

A physician-centred intervention to shorten hospital stay: a pilot study.

Background: Studies of length of stay (LOS) in hospital usually focus on physician-independent factors. In this study, the authors identified physician-dependent factors and tested an intervention aimed at them to determine its effect on LOS.

Methods: A prospective comparison of LOS on 2 general medical wards in a tertiary care teaching hospital before and after the intervention.

Managing patient length of stay better using an appropriateness tool.

A multidisciplinary group from two medical floors at the Royal Victoria Hospital chose the Managed Care Appropriateness Program (MCAP) to evaluate the appropriateness of the days of stay for their patients. Of 100 charts of consecutive patients examined by the nurse reviewer (comprising 1,095 patient days), 33 percent of the days were deemed inappropriate. The reasons for each of these inappropriate days were documented, and strategies were implemented to address the issues.