BackgroundRecovery after stroke is dependent on how much time can be spent on rehabilitation. Recently, we found that therapy time for older stroke patients on a rehabilitation unit of a nursing home could be increased significantly from 8.6 to at least 13 hours a week. This increase was attained by the implementation of interventions, focused on strength, mobility and balance. Nurses carried out these exercises with the patients during their daily activities. The aim of the present study is to investigate if increased therapy time has a positive effect on cognition, mood (depression and anxiety), and ADL in stroke patients.MethodsA comparative single blind controlled study will be applied. Patients suffering from a stroke and staying on one of the rehabilitation units of the nursing homes are eligible for participation. Participants belong to the intervention group if they stay in two nursing homes where four interventions of the Clinical Nursing Rehabilitation Stroke Guideline were implemented. Participants who stay in two nursing homes where therapy is given according to the Dutch stroke Guideline, are included in the control group. Clinical neuropsychologists will assess patients’ cognitive functioning, level of depression (mood) and anxiety. Nurses will assess a Barthel Index score on a weekly basis (ADL). These variables are measured at baseline, after 8 weeks and at the moment when participants are discharged from the nursing home.DiscussionThe present study evaluates the effect of increased therapy time on cognition, mood (level of depression and anxiety), and ADL in stroke patients. When positive effects will be found this study can guide policy makers and practitioners on how to implement more therapy time on rehabilitation wards of nursing homes.Trial registrationTNR Our study has been documented in the Dutch Trial Registration, TC = 3871.
Once upon a time, probably in the first half of the seventeenth century, David Curiel, a prominent member of the Amsterdam Sephardi community, was attacked by a German robber. Although seriously wounded, Curiel managed to overcome his attacker with the help of his Christian neighbours. The robber was tried and sentenced. After his execution, the States of Holland sent Curiel a letter expressing their regret at the incident and inviting him to witness the medical lesson on the corpse of the robber in the anatomical theatre of Leiden University. This legend has been handed down in at least five different manuscripts, preserved in Jewish libraries. It was probably read at the feast of Purim, which, of course, commemorates an earlier attack on the Jews and the spectacular destruction of their enemy.
In 1807 Carolus Boers published his Manual for Young Clergymen. He started this introduction to the ministry with an overview of prerequisites for theological students. Physical requirements come first. A strong body, a good voice, a hardy constitution are necessary. Bodily disfigurements will expose a minister to ridicule. A weak or sickly clergyman will perhaps be pitied, but certainly not respected by his flock. The body bearing these physical perfections is male. This, for Boers, went without saying. Dutch Protestants did not seriously discuss opening the ministry to women before the twentieth century; and even then it was solely the growing number of women having finished their studies in theology that made this an issue at all. The Dutch minister around 1800 was a man. Yet maleness is not the same thing as masculinity. What kind of man was the minister supposed to be?
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