ObjectivesTo synthesise evidence on longer term unmet needs perceived by stroke survivors, and psychometric properties of the tools used to evaluate unmet care needs after stroke.DesignSystematic review.SettingCommunity or patients’ home.ParticipantsStroke survivors.MethodsWe searched PubMed, PsycINFO, CINAHL, EMBASE from inception to 31 March 2018 to identify survey studies that evaluated unmet needs perceived by stroke survivors after hospital discharge. Reported unmet needs were categorised under three domains: body functioning, activity/participation and environmental factors. Ranges of prevalence rates of unmet needs reported in studies were presented.ResultsWe included 19 eligible studies, with considerable heterogeneity in patients, survey methods and results. Psychometric properties of two stroke-specific tools were formally evaluated, indicating their moderate reliability and content/concurrent validity. The median number of reported unmet needs per stroke survivor was from two to five, and the proportion of stroke survivors with at least one unmet needs was on average 73.8% (range 19.8%– 91.7%). Unmet needs perceived by stroke survivors included 55 records of unmet body functioning needs, 47 records of unmet activities/participatory needs and 101 records of unmet environmental needs. Common unmet service needs were unmet information needs (3.1%– 65.0%), transport (5.4%–53.0%), home help/personal care (4.7%–39.3%) and therapy (2.0%–35.7%).ConclusionsThe prevalence of unmet long-term needs is high among stroke survivors, and there is considerable heterogeneity in type and frequency of specific unmet needs. More research is required to link regular assessment of long-term unmet needs of stroke survivors with the provision of cost-effective patient-centred health and social care services.
In this paper, a computational approach based on a new exact penalty function method is devised for solving a class of continuous inequality constrained optimization problems. The continuous inequality constraints are first approximated by smooth function in integral form. Then, we construct a new exact penalty function, where the summation of all these approximate smooth functions in integral form, called the constraint violation, is appended to the objective function. In this way, we obtain a sequence of approximate unconstrained optimization problems. It is shown that if the value of the penalty parameter is sufficiently large, then any local minimizer of the corresponding unconstrained optimization problem is a local minimizer of the original problem. For illustration, three examples are solved using the proposed method. From the solutions obtained, we observe that the values of their objective functions are amongst the smallest when compared with those obtained by other existing methods available in the literature. More importantly, our method finds solution which satisfies the continuous inequality constraints.
The Yulong-Haba Xue Shan range, in the northwestern part of Yunnan (China), is a large N-S antiform that folds the Paleozoic series of the Yangzi platform. The upper Yangzi River (Jinsha Jiang) has cut a 3500 m-deep valley (Hu Tiao gorge) across this antiform, thus exposing folded, bedding-parallel, ductile shear zones (d6collements), with transport toward the SSW (in the present geographical coordinates). The large finite shear strain implies tens of kilometers of transport, pointing to the regional significance of these d6collements. R b/Sr radiometric dating of phlogopites that crystallized in marbles within the foliation planes yields the age of the metamorphic and deformation event (35.9 + 0.3 (2{5) Ma). The age derives from an internal Rb-Sr isochron, made on different size fractions of the same mineral, which provides a novel demonstration of the feasibility of such plots. Transport on the d6collement and related shortening occurred prior to, or at the onset of, extrusion of Indochina along the Ailao Shan-Red River shear zone, --80 km west of the Yulong Shan. The 3OAr / 4øAr age spectra of K-feldspar from the core of the Yulong Shan suggest uplift by antiformal folding around 17 Ma, as Indochina's extrusion came to an end. We infer that other large-scale Cenozoic d6collements such as that exhumed in the Yulong Shan underlie some of the vast, folded areas that surround the eastern Himalayan syntaxis. Transport on such d6collements, first toward the south and then toward the east, and folding above them, might have occurred during two principal shortening phases, whose ages bracket Indochina's escape toward the SE.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.