Physiotherapy practice patterns in gait rehabilitation for adults with acquired brain injury.

OBJECTIVE: Gait dysfunction is common following acquired brain injury (ABI). Clinical practice guidelines can improve patient outcomes; however, information regarding ABI-specific management of gait dysfunction is limited. This study aimed to describe practice patterns of Canadian physiotherapists regarding gait rehabilitation in adults post-ABI. METHODS: An electronic questionnaire was developed and distributed across Canada to describe physiotherapy assessment methods, outcome measures, and treatment interventions used to manage gait dysfunction in adults with mild-moderate and severe ABI. RESULTS: Of 103 respondents who accessed the questionnaire, 59 met inclusion criteria and participated in the study. Methods most frequently used "often or very often" at initial and discharge assessments included visual observation (≥88.2% for adults with mild-moderate and severe ABI) and the Berg Balance Scale (≥76.3% for adults with mild-moderate ABI). Higher level gait training exercises were used more often for adults with mild-moderate than severe ABI. Physiotherapists commonly reported further research was required to develop and validate gait-specific outcome measures (42.4%) and treatment techniques (76.3%). CONCLUSIONS: Physiotherapists' use of gait-specific treatment interventions, but not assessment methods, differs depending on ABI severity. Future work should investigate factors influencing these practice patterns. In addition, clinician-identified research priorities include ABI gait-specific outcome measures and technology-based interventions.

What is Diverse Enough? How "Intentionally Diverse" Charter Schools Recruit and Retain Students.

School choice has the potential to be a tool for desegregation, but research suggests that choice more often exacerbates segregation than remedies it. In the past several years, hundreds of 'intentionally diverse' charter schools have opened across the country, potentially countering the link between charter schools and segregation. Yet, these schools raise important questions about choice, segregation, and equity. For instance: how do leaders of diverse charter schools prioritize diversity in decisions about location, marketing, and recruitment? What are the implications of these diversity efforts for equity, especially within competitive and marketized educational contexts? We explore the concrete recruiting and marketing strategies schools used to build and retain their diverse communities, drawing on qualitative data from New Orleans, LA and Minneapolis-St. Paul, MN. We identify key strategies used by school leaders, but also note that many strategies were ad-hoc and experimental. Furthermore, we note that schools often did not articulate their goals for diversity, making them susceptible to external pressures that might refocus attention away from equity and diversity, or allow groups with more power to shape agendas within the school. Finally, we find that gentrification and widening economic inequities threatened schools' efforts to recruit and maintain a diverse student body. We discuss implications for leaders of diverse charter schools and other leaders seeking to diversify their student bodies, as well as policymakers and charter authorizers.

La elección de la escuela tiene el potencial de ser una herramienta para desagregación, pero la investigación sugiere que la elección más frecuentemente exacerba la segregación que la remediación. En los últimos años, cientos de escuelas charter "intencionalmente diversas" se han abierto en todo el país, potencialmente contrarrestando el vínculo entre las escuelas charter y la segregación. Sin embargo, estas escuelas plantean cuestiones importantes sobre la elección, la segregación y la equidad. Por ejemplo: ¿cómo los líderes de diversas escuelas charter priorizan la diversidad en las decisiones sobre localización, marketing y reclutamiento? ¿Cuáles son las implicaciones de estos esfuerzos de diversidad para la equidad, especialmente dentro de contextos educativos competitivos y comercializados? Exploramos las estrategias concretas de reclutamiento y marketing utilizadas por las escuelas para construir y mantener sus diversas comunidades, sobre la base de datos cualitativos de Nueva Orleans, LA, y Minneapolis-St. Paul, MN. Identificamos las principales estrategias utilizadas por los líderes de las escuelas, pero también notamos que muchas estrategias fueron ad hoc y experimentales. Además, observamos que las metas escolares en torno a "cuánto" diversidad eran suficientes, a menudo se desarticulan, haciendo que las escuelas susceptibles a presiones externas que podrían redirigir la atención lejos de la equidad y la diversidad o permitir que grupos con más poder formen agendas dentro de la escuela. Finalmente, descubrimos que los contextos de gentrificación y el aumento de las desigualdades económicas amenazaban los esfuerzos de las escuelas para reclutar y mantener un alumnado diversificado. Discutimos las implicaciones para los líderes de diversas escuelas charter y otros líderes que buscan diversificar sus cuerpos estudiantiles, así como los formuladores de políticas y los coordinadores de charter.

A escolha da escola tem o potencial de ser uma ferramenta para desagregação, mas a pesquisa sugere que a escolha mais frequentemente exacerba a segregação do que a remediação. Nos últimos anos, centenas de escolas charter "intencionalmente diversas" foram abertas em todo o país, potencialmente contrabalançando o vínculo entre as escolas charter e a segregação. No entanto, essas escolas levantam questões importantes sobre escolha, segregação e equidade. Por exemplo: como os líderes de diversas escolas charter priorizam a diversidade nas decisões sobre localização, marketing e recrutamento? Quais são as implicações desses esforços de diversidade para a equidade, especialmente dentro de contextos educacionais competitivos e comercializados? Exploramos as estratégias concretas de recrutamento e marketing utilizadas pelas escolas para construir e manter suas diversas comunidades, com base em dados qualitativos de New Orleans, LA, e Minneapolis-St. Paul, MN. Identificamos as principais estratégias utilizadas pelos líderes das escolas, mas também notamos que muitas estratégias foram ad hoc e experimentais. Além disso, notamos que as metas escolares em torno de "quanto" diversidade eram suficientes eram muitas vezes desarticuladas, tornando as escolas suscetíveis a pressões externas que poderiam redirecionar a atenção para longe da equidade e da diversidade ou permitir que grupos com mais poder formassem agendas dentro da escola. Finalmente, descobrimos que os contextos de gentrificação e o aumento das desigualdades econômicas ameaçavam os esforços das escolas para recrutar e manter um corpo discente diversificado. Discutimos as implicações para os líderes de diversas escolas charter e outros líderes que buscam diversificar seus corpos estudantis, bem como os formuladores de políticas e os coordenadores de charter.

Utility of the Roche Cobas 4800 for detection of high-risk human papillomavirus in formalin-fixed paraffin-embedded oropharyngeal squamous cell carcinoma.

Clinical laboratories are expected to reliably identify human papilloma virus (HPV) associated oropharyngeal squamous cell carcinoma (OPSCC) for prognostic and potential therapeutic applications. In addition to surrogate p16 immunohistochemistry (IHC) testing, DNA-based HPV-specific testing strategies are widely utilized. Recognizing the efficiency of the Roche Cobas 4800 platform for testing gynecological cytology specimens for high-risk HPV, we elected to evaluate the potential utility of this platform for testing formalin-fixed paraffin-embedded (FFPE) OPSCC tissue. Using the Roche Linear Array assay for comparison, we tested twenty-eight samples (16 primary OPSCC, 2 lymph node metastases from primary OPSCC, 1 oral tongue carcinoma, 3 benign squamous papillomas, and 3 non-oropharyngeal carcinoma tissues). Excluding two invalid results, the Roche Cobas 4800 testing resulted in excellent inter-assay concordance (25/26, 96.2%) and 100% concordance for HPV-16/HPV-18 positive samples. This data suggests that the Roche Cobas 4800 platform may be a cost-effective method for testing OPSCC FFPE tissues in a clinical molecular pathology laboratory setting.