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Aims: To critically review, summarise, and discuss the implementation literature in the field of aphasiology to date, in order to guide clinical aphasiologists to work towards closing the evidence-practice gaps in aphasia management.
Main contribution: A review of the literature in this developing area of expertise in the field of aphasiology, with examples of practical applications.
Conclusions: Only six implementation studies have been published in aphasia (related to conversation partner training, discourse analysis, information provision, and collaborative goal-setting practices), showing there is a need for capacity building in this area. Therefore, we are not yet able to state what interventions are effective in which context, nor fully understand how behaviour change occurs for clinicians providing aphasia management. Implications for speech-language pathologists are discussed. An overarching call to action is the need for clinicians and researchers to work together to drive future implementation efforts that can succeed in closing the aphasia management evidence-practice gaps. 相似文献
Introduction
Transplant units are exploring strategies to increase the availability of donor kidneys. The use of en-bloc kidney transplantation (EBKT) from paediatric donors represents one potential solution. We present our long-term experience with paediatric EBKT among adult recipients.Methods
Twenty-three paediatric to adult EBKTs were performed by the Irish National Kidney Transplant Service between 1990 and 2016. The primary outcome variable was long-term en-bloc allograft survival rate. Secondary outcome variables were incidence of allograft thrombosis, incidence of delayed graft function, overall patient survival and serum creatinine at most recent follow-up. Outcomes were compared to single kidney transplant recipients from the same time period.Results
Mean donor age was 1.8 ± 0.97 years (range: 7 months to 3 years). Recipient age was 46 ± 12 years. Mean follow-up was 133 ± 64 months (range: 36–264). Overall graft survival was 100%, 91% and 80% after 1, 5 and 10 years respectively, compared to 92%, 79% and 61% in single kidney transplant recipients (p = 0.04). There were 5 cases of allograft failure, 3 due to death from unrelated causes. Median time to graft failure was 108 months (range: 36–172). Mean serum creatinine was 72.6 ± 21.6 μmol/l after the follow-up period. There were no cases of graft thrombosis or delayed graft function. Overall survival was 96.4%, 88.0%, 76.23% and 50.5% at 1, 5, 10 and 20 years respectively.Conclusion
En-bloc paediatric kidney transplantation is associated with excellent long-term allograft and patient survival and is a feasible strategy for increasing the transplant donor pool in carefully selected recipients. 相似文献Methods Crossover studies and double blind experiments were designed using volunteers with informed consent. The trial was done twice per volunteer, that is, they had a tablet with or without the addition of protease from kiwifruits (test and placebo) with intervening washout periods of at least 2 weeks. The degree of change in tongue coating was evaluated visually using a tongue coating score which consisted of an area component (0–3) and a thickness component (0–3). An image analyzer was also used to measure the changing in actual area of coating.
Results The average value of the tongue coating scores after taking a test tablet (11.4 ± 5.2) was significantly smaller ( P < 0.01) than before taking the tablet (18.8 ± 7.0). Image analyzer measurements also showed significant reduction ( P < 0.01) of tongue coating by taking test tablet. On the other hand, a placebo tablet showed no significant effects in both analyses.
Conclusions This study indicated that taking protease tablets could reduce tongue coating. We are planning further clinical trials that can show reduced VSC concentrations in mouth air with decreasing tongue coating. 相似文献