The effectiveness of group exercise for improving activity and participation in adult stroke survivors: a systematic review

BackgroundFollowing post stroke rehabilitation, group exercise interventions can be used to continue improving cardiovascular fitness, activity levels, balance, gait, movement efficiency, and strengthening. However, little is known of the effectiveness of group exercise for improving activity and participation in stroke survivors.ObjectivesThis review aims to assess the effectiveness of group exercise for improving activity and participation in adult stroke survivors.Data sourcesDatabases searched were MEDLINE, Web of Science (Core collection), CINAHL, and the Cochrane Library.Study eligibility criteriaRandomised controlled trials (RCTs) of group exercise using validated outcome measures of activity and participation for post stroke rehabilitation. Two independent reviewers assessed all abstracts, extracted data, conducted a narrative synthesis and assessed the quality of all included articles. The Cochrane Risk of Bias Tool assessed methodological quality and included outcome measure quality was assessed.Results14 RCTs were included (n = 624 chronic stroke survivors collectively). Studies ranged between 12 and 243 stroke participants with an average of left:right hemisphere lesions of 32:39 and average age was 66.7 years. Although intervention and control groups improved, no significant difference between group differences were evident.Conclusionand implications of key findings: The review found improvements are short-term and less evident at long-term follow up with little improvements in participation after 6 months. However, this review was limited to the standard of intervention reporting. Further research should consider consistency in measuring underpinning mechanisms of group exercise interventions, which may explain the lack of activity changes in long-term follow-up.
Systematic review registration number PROSPEROCRD42017078917.     

PBL医学教学模式在中等专业学校病理学教学中的应用

为提高病理学的教学质量,培养学生自主学习、开拓创新能力,养成良好的学习习惯,增强其团队合作精神,笔者在病理学课程的部分章节中采取了PBL教学法,取得了良好的教学效果.     

PBL教学法在神经内科见习中的应用研究

目的：探讨PBL教学法在神经内科见习中的应用效果。方法：将我校2009级临床专业神经病学见习学生随机分为实验组（60人）和对照组（59人）,对照组沿用传统的教学方法,实验组采用以问题为基础的教学方法。结果：对照组的理论成绩优于实验组,而实验组的病例分析级神经系统查体成绩优于对照组。实验组在学习积极性,扩大知识面方面等主观评价优于对照组。结论：PBL教学模式在神经内科见习中能取得较好的教学效果,但在运用过程中要加强系统基础知识的学习。     

Can we enhance the training of clinical supervisors? A national pilot study of an evidence‐based approach

Clinical supervision plays an essential part in maintaining professional standards and in achieving the National Health Service's objective of a modern workforce. Paradoxically, little is known about how supervisors themselves acquire competence, leading to lament that ‘something does not compute’. To contribute to a solution, a supervisor training manual that guided trainers in delivering continuing professional development to supervisors in an evidence‐based approach to clinical supervision was piloted nationally, in terms of the reactions of trainers (N = 25 tutors from clinical psychology courses) and their workshop delegates (N = 256 clinical psychology supervisors). Trainers were allocated randomly to either manual‐alone or to a manual‐plus consultancy group. The trainers all rated the manual favourably (mean rating of 78%), but there was no significant difference between the two groups. However, the supervisors within the consultancy group rated the sessions significantly more highly than their counterparts. It is concluded that brief training in an evidence‐based approach appears feasible and acceptable, making more rigorous evaluations appropriate. Copyright © 2009 John Wiley & Sons, Ltd. Key Practitioner Message:

• Clinical supervision is now recognised as essential, yet supervisors tend to receive little or no training, which tends not to be evidence based.
• A training guide in evidence‐based clinical supervision has been disseminated and evaluated, in terms of the acceptability of the approach taken to supervision.
• The reactions of trainers and supervisors (all associated with clinical psychology training programmes) to this guide were positive, indicating that it merits further development and more rigorous evaluation.

     

Students’ perceptions of using Problem-Based Learning (PBL) in teaching cognitive communicative disorders

Problem-Based Learning (PBL) is an educational model that is characterized by student-centered learning and classroom discussion using clinically based problems. This study examines students’ perceptions of PBL as an alternative approach of learning in speech-language pathology and investigates if these perceptions change over time as a function of students’ learning experience with PBL. Written reflections by 96 graduate-students in a graduate elective course on cognitive-communicative disorders were analyzed using content analysis. Common words or phrases in each reflection paper were identified, grouped and coded into consistent themes. Percentage changes of these themes across a semester were also followed. A total number of 883 positive and 165 negative comments were identified. Thirteen positive and seven negative themes relative to students’ perception of the inclusion of PBL were yielded. The advantages of PBL were found to outweigh its disadvantages. Moreover, accumulated experience with this approach was found to eliminate some initial perceived drawbacks about PBL. The extra efforts to engage students in interactive discussion as well as higher order critical thinking and knowledge application were acknowledged through student feedback. Future studies should investigate how PBL can be of greater use in other areas in communication sciences and disorders.     

Psychometric testing of the Chinese evidence-based practice scales

wang s.-c., lee l.l., wang w.-h., sung h.-c., chang h.-k., hsu m.-y., chang s.-c. & tai c.-h. (2012)?Psychometric testing of the Chinese evidence-based practice scales. Journal of Advanced Nursing68(11), 2570-2577. ABSTRACT: Aim. This article is a report of the psychometric testing of the Chinese version of Evidence-Based Practice Implementation and Beliefs, and Barriers to, and Facilitators of Research Utilization scales. Background. Investigations into the effect of evidence-based practice on clinical care could be facilitated by instruments for measuring the levels of evidence-based practice implementation; the strength of beliefs in evidence-based practice; the barriers to, and the facilitators of research utilization. An English version of the scales measuring the above constructs has been tested whereas the Chinese one has not. Design. Instrument development. Methods. Psychometric analyses of the four evidence-based scales were conducted on a sample of 361 nurses from a medical centre in Taiwan. Both the internal consistency and squared multiple correlation coefficients were used to examine reliability. The validity testing for the four scales was estimated by examining their construct and concurrent validity. Data were collected between December 2008-January 2009. Findings. Internal consistencies exist for the Chinese Evidence-Based Practice Implementation, Beliefs, and Barriers to, and Facilitator of Research Utilization scales (≥0·85); some were greater than 0·9, which may indicate redundancy in items. Construct validity of the four scales was supported by hypotheses testing. Concurrent validity of the four scales was supported by known-group analysis, in which experienced nursing researchers had higher scores compared with clinical nurses. Conclusion. These scales may have value in discrimination between implementation of EBP and perception of barriers to, and facilitators of research utilization among nurses with different education levels, research experiences or working years in clinical setting.     

正念认知疗法在强迫症治疗中的研究现状

强迫症是一组以强迫思维和强迫行为主要临床表现的心理障碍。正念认知疗法(MBCT)作为一种新兴的心理治疗方法,在强迫症的治疗中有着积极作用。本文通过对MBCT在强迫症治疗中的现状和效果进行综述,为强迫症的临床心理治疗提供参考。     

原发性高血压病的辨证施护

根据原发性高血压病的病理特点,结合中医治疗高血压病的辨证分型,着重于宏观与微观相结合、辨证与辨病施护相结合,药物与非药物疗法相结合的护理原则,强调高血压病患者护理个体化,以人为本,突出中医护理特色。