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Introduction: Difficulties in returning to work can significantly impact individuals following a stroke (eg, their sense of purpose and self-esteem), not only financially, but also as they adjust to the change in their situation. Such difficulties may arise from communication disorders as well as physical impairments. Previous reviews on return to work post-stroke have focused on specific aspects, such as interventions, or barriers and facilitators, but have not provided a comprehensive map of the field. Further, no systematic or scoping reviews to date have focused on literature addressing return to work for people with communication disorders post-stroke.Inclusion criteria: This review considered literature that reported on interventions, barriers, and facilitators for return to work for adults (aged 16 years or older) following an ischemic or hemorrhagic stroke. Records focusing on transient ischemic attacks or acquired brain injury were excluded, as were those in which a comorbidity or disability (eg, learning disability, dementia, respiratory disorder) had a significant impact on the individual's ability to work. Methods: This review followed the JBI scoping review methodology. Primary research of any type, systematic and non-systematic reviews, and gray literature from developed countries written in English from 2010 to the present day were identified from 7 databases, 2 gray literature repositories, JBI Evidence Synthesis, and an internet search. Records were screened for relevance to the review topic by 2 independent reviewers, and data relevant to the review questions were extracted. Findings were presented as narrative supported by tables.Results: Of the 106 sources included, 61 addressed demographic-based, socioeconomic-based, impairment-based, or recovery-based factors related to return to work. One of these 61 sources, a narrative review, focused on communication disorders. Thirty-eight sources explored barriers and facilitators for return to work from different stakeholders' perspectives; 3 of these 38 sources, including 2 qualitative studies and 1 narrative review, focused on post-stroke communication disorders. Eleven sources focused on interventions, including 7 studies (reported across 9 sources) that developed or tested return-to-work interventions. Of these primary studies, 1 randomized controlled trial and 1 retrospective cohort study were identified. The remaining intervention studies were case studies or case series. None of these intervention studies addressed communication disorders.Conclusions: While there has been extensive research on factors, barriers, and facilitators for return to work poststroke, there is a lack of research on interventions supporting return to work. There is also a significant gap in the evidence base on returning to work with a post-stroke communication disorder, highlighting the need for further research in this important area.

Background: There is extensive literature on the impact of aphasia on human interactions, with findings including family tension and reduced participation affecting the person with aphasia's ability to adapt to life post-stroke. However research on relationships between people with aphasia and their pets is sparse. Studies in other healthcare fields have found benefits and drawbacks of pet ownership. The presence of a communication disorder adds a unique perspective, with implications for the ability to interact with the animal.Aim: This study explores the experiences that people with aphasia have of dog ownership as they adapt to life post-stroke, from the perspectives of both people with aphasia and close family members or carers.Methods & procedures: Ten semi-structured interviews were conducted with seventeen people with aphasia and/or relatives or carers. Thematic analysis was carried out.Outcomes & results: Three major themes were generated. These were: (i) the adaptation of the dog to the person with aphasia; (ii) the adaptation of the person with aphasia to their dog; (iii) experiences of dog-walking interactions. Positive and negative aspects were reported within each theme. Conclusions:The implications of these findings are significant for rehabilitation professionals: just as the person with aphasia needs support in the context of their human relationships and the challenges and opportunities that these present, their relationship with their dog should also be considered.

The ‘hospital at night’ concept was developed at a joint conference of the London Deanery and Clinical Staff in 2002, as an issue for education and service provision. At the start of the project, our trust had issues with both the structure of the hospital at night handover and the working practices overnight. The vision was to improve team working out of hours, expedite review of sick patients and reorganise care to seek a reduction in bleeps to medical junior doctors overnight in a way that all patients had access to the right person with the right skills for their needs at the right time. The hospital at night project at our hospital was started in 2019 by a multidisciplinary working group. We tried bleep filtering for 4 months and this was later followed on by the development of an electronic out of hour’s task list as part of our hospital at night set-up. The bleep analysis data showed an improved distribution of workload but the process was dependent on individuals. The electronic task management system was built in pre-existing online software. The system helped prioritise and review tasks requested by nurses on medical wards. But it was not without its limitations. We worked with the local information technology (IT) team to improve speed and proposed developing an IT solution that is fast and not desktop based to ensure tasks can be assigned and viewed while on the go. The project was overall a success as it demonstrated positive feedback from junior doctors, improved perception of teamwork and ability to take rest breaks. It also demonstrated a drop in ward-based cardiac arrest rates. The hospital at night project at our trust remains a work in progress, but a lot of positive changes have been delivered.