SUMMARY A review of 33 studies identifies the factors of prior stroke, older age, urinary and bowel incontinence, and visuo-spatial deficits as adverse prognostic indicators of function. No relationship is shown between sex, hemisphere of stroke, and functional outcome. Functional admission score is a strong predictor of discharge functional status, but its relationship with improvement in function is unclear. Findings regarding the prognostic value of severity of paralysis and onset-admission delay are ambiguous.Comparison among studies is hindered by differences In patient samples, timing of assessments, criteria by which outcome is measured and measuring instrument used. Future studies should measure function at set tunes post-stroke, use functional scales whose reliability and validity is well established, and be conducted in several treatment centres to ensure that the sample is representative of the population to which the predictor measure is to be applied.

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Background and Purpose-Trials of occupational therapy for stroke patients living in the community have varied in their findings. It is unclear why these discrepancies have occurred. Methods-Trials

This paper examines employment issues for women diagnosed with multiple sclerosis (MS) and their workplace experiences, focusing analysis on the social and institutional dimensions of the environment. The analysis draws on data from a mixed method study using in-depth interviews and a survey. The findings indicate that although severity of symptoms affect employment status, non-medical factors, including modification of work conditions and understanding employers, and a supportive home environment with the possibility of delegating household tasks, can enhance women's ability to work. The specific focus in the paper on the experiences of women managing their disability in the workplace, from the qualitative phase of the study, acts as an analytic device to illustrate how context influences the way in which such factors play out. In high-lighting the issue of disclosure of diagnosis, and associated identity and income concerns for women, the paper demonstrates the importance of the social and institutional dimensions of environment in shaping occupational performance. The findings suggest that inclusion of environmental analysis in clinical practice broadens the range of intervention strategies to be considered and raises the issue of occupational therapists' role in advocacy.

Findings contribute to the TBI literature in showing that it is: (a) the more subjective and not objectively measured nature of participation that is associated with SQOL and (b) positive and negative aspects of quality of life show different relationships with social participation variables. Implications for Rehabilitation A high proportion of individuals with traumatic brain injury (TBI) experiences reduced involvement in social participation (involvement in social and leisure activities and within a social network) and low subjective quality of life (SQOL). This study suggests that, by simply increasing the variety and frequency of social and leisure activities, there may be no positive influences on SQOL. Instead, this study suggests that, to increase SQOL, it is important to increase opportunities for individuals to participate with others and also to enhance their subjective experience of social and leisure activities. The large variance obtained of scores for social participation and SQOL provide a reminder to clinicians to maintain an individualized approach when working with individuals with TBI.

Collaborative decision-making can lead to the selection of assistive technology that is considered needed and right for the individual. Person-centered philosophy associated with assistive technology assessment is contributing to attaining "the right" AT.

To augment the rigor of health promotion research, this perspective article describes how cultural factors impact the outcomes of health promotion studies either intentionally or unintentionally. It proposes ways in which these factors can be addressed or controlled in designing studies and interpreting their results. We describe how variation within and across cultures can be considered within a study, e.g. the conceptualization of research questions or hypotheses, and the methodology including sampling, surveys and interviews. We provide multiple examples of how culture influences the interpretation of study findings. Inadequately accounting or controlling for cultural variations in health promotion studies, whether they are planned or unplanned, can lead to incomplete research questions, incomplete data gathering, spurious results and limited generalizability of the findings. In health promotion research, factors related to culture and cultural variations need to be considered, acknowledged or controlled irrespective of the purpose of the study, to maximize the reliability, validity and generalizability of study findings. These issues are particularly relevant in contemporary health promotion research focusing on global lifestyle-related conditions where cultural factors have a pivotal role and warrant being understood.