PracticeCALM: Coaching Anxiety Lessening Methods for Radiation Therapists: A Pilot Study of a Skills-Based Training Program in Radiation Oncology.

PracticeCALM is an 8-week on-the-job training program to teach radiation therapists (RTs) techniques for assisting patients who are experiencing treatment-related anxiety. Twelve clinical RTs in a regional oncology program were recruited on a volunteer basis to participate in the training. A mixed-method approach was undertaken to evaluate perceived benefits to clinical practice.

Pharmacotherapy for Depression Posttraumatic Brain Injury: A Meta-analysis.

Objective: To examine the effectiveness of pharmacotherapy for the treatment of depression following traumatic brain injury (TBI).

Design: Systematic review and meta-analysis. Multiple electronic databases were searched to identify relevant studies examining effectiveness of pharmacotherapy for depression post-TBI.

Using realist evaluation to open the black box of knowledge translation: a state-of-the-art review.

Background: In knowledge translation, complex interventions may be implemented in the attempt to improve uptake of research-based knowledge in practice. Traditional evaluation efforts that focus on aggregate effectiveness represent an oversimplification of both the environment and the interventions themselves. However, theory-based approaches to evaluation, such as realist evaluation (RE), may be better-suited to examination of complex knowledge translation interventions with a view to understanding what works, for whom, and under what conditions.

Prevention of poststroke depression: does prophylactic pharmacotherapy work?

Background: Given the negative influence of poststroke depression (PSD) on functional recovery, cognition, social participation, quality of life, and risk for mortality, the early initiation of antidepressant therapy to prevent its development has been investigated; however, individual studies have offered conflicting evidence. The present systematic review and meta-analysis examined available evidence from published randomized controlled trials (RCTs) evaluating the effectiveness of pharmacotherapy for the prevention of PSD to provide updated pooled analyses.

Methods: Literature searches of 6 databases were performed for the years 1990 to 2011.

A review of the relationship between dysphagia and malnutrition following stroke.

Objective: To clarify the relationship between malnutrition and dysphagia following stroke.

Design: Systematic review.

Methods: All published trials that had examined both the swallowing ability and nutritional status of subjects following stroke were identified.

A scale for distinguishing efficacy from effectiveness was adapted and applied to stroke rehabilitation studies.

Objectives: To apply a tool that purports to differentiate between efficacy and effectiveness studies to stroke rehabilitation trials and to evaluate its applicability and reliability.

Study Design And Setting: Three raters developed item operational definitions before independently applying the seven-item scale to 151 randomized controlled trials (RCT), published during or after 1997, that evaluated either a pharmacologic (P, n=78) or a nonpharmacologic (NP, n=73) intervention. Inter-rater reliability was assessed for both individual items and total scores, separately for P and NP trials.

Which reported estimate of the prevalence of malnutrition after stroke is valid?

Background And Purpose: The reported prevalence of malnutrition after stroke varies widely, whereas it remains unclear which of the estimates is most accurate. The aim of this review was to explore possible sources of this heterogeneity among studies and to evaluate whether the nutritional assessment techniques used were valid.

Methods: A literature search was conducted to identify all studies in which the nutritional state of patients was assessed after inpatient admission for stroke.

In a review of stroke rehabilitation studies, concealed allocation was under reported.

Objective: The objective of this two-phase study was to assess the adequacy of the reporting of concealed allocation (CA) in randomized controlled trials (RCTs) evaluating interventions associated with stroke rehabilitation.

Study Design And Setting: In phase I of the study, 50 RCTs included in a systematic review were selected to establish agreement between two raters. Two investigators determined if the method described to conceal the randomization schedule was adequate, inadequate, or not reported.

Health-related quality of life after stroke: what are we measuring?

As there is no single, accepted definition of health-related quality of life (HRQOL), it is assumed to be a broad, multidimensional construct referring to those aspects of people's lives that reasonably relate to their health. Although many scales are used to assess HRQOL, the operationalization of this construct within each tool is unclear. To clarify what each tool is measuring, this study reviewed eight scales commonly used to evaluate HRQOL after stroke.

A blueprint for transforming stroke rehabilitation care in Canada: the case for change.

Stroke is a major source of disability in Canada and other developed countries, which carries with it a high toll in terms of personal suffering for the stroke survivor and their family in addition to the associated economic costs. Despite the impressive body of evidence describing effective and feasible stroke rehabilitation practices, stroke survivors, their families, and health professionals currently do not benefit from a rehabilitation system that is well organized and evidence based. Using the principles of best evidence, we make the case for needed changes to the current system based on 5 processes of care known to be important in the pursuit of optimal outcomes: (1) admission to specialized stroke rehabilitation units, (2) early admission to stroke rehabilitation units, (3) intensive stroke rehabilitation therapies, (4) task-specific rehabilitation therapies, and (5) well-resourced outpatient programs.

Assessment of participation outcomes in randomized controlled trials of stroke rehabilitation interventions.

In recent years, the importance of understanding the impact of interventions on an individual's ability to participate in social roles after a stroke event has gained much attention. Comprehensive assessment of treatment effectiveness should include a broader range of outcomes, including social participation. This study attempted to determine the degree to which the assessment of social participation has been included in randomized controlled trials of stroke rehabilitation.

Outcome assessment in randomized controlled trials of stroke rehabilitation.

The lack of a unified approach to outcome assessment in stroke rehabilitation limits our ability to interpret evidence provided by randomized controlled trials (RCTs). The purpose of this review was to identify outcomes and assessment tools reported in RCTs of stroke rehabilitation interventions as a first step toward consistent assessment of outcomes. Given that the validity of research is linked to reliability and validity of measurement, the relationship between the use of previously developed outcome measures and the methodological quality of RCTs was explored.