What aspects of rehabilitation provision contribute to self-reported met needs for rehabilitation one year after stroke - amount, place, operator or timing?

BACKGROUND AND OBJECTIVE: To a large extent, people who have suffered a stroke report unmet needs for rehabilitation. The purpose of this study was to explore aspects of rehabilitation provision that potentially contribute to self-reported met needs for rehabilitation 12 months after stroke with consideration also to severity of stroke. METHODS: The participants (n = 173) received care at the stroke units at the Karolinska University Hospital, Sweden. Using a questionnaire, the dependent variable, self-reported met needs for rehabilitation, was collected at 12 months after stroke. The independent variables were four aspects of rehabilitation provision based on data retrieved from registers and structured according to four aspects: amount of rehabilitation, service level (day care rehabilitation, primary care rehabilitation and home-based rehabilitation), operator level (physiotherapist, occupational therapist, speech therapist) and time after stroke onset. Multivariate logistic regression analyses regarding the aspects of rehabilitation were performed for the participants who were divided into three groups based on stroke severity at onset. RESULTS: Participants with moderate/severe stroke who had seen a physiotherapist at least once during each of the 1st, 2nd and 3rd-4th quarters of the first year (OR 8.36, CI 1.40-49.88 P = 0.020) were more likely to report met rehabilitation needs. CONCLUSION: For people with moderate/severe stroke, continuity in rehabilitation (preferably physiotherapy) during the first year after stroke seems to be associated with self-reported met needs for rehabilitation.

The place of writing in the poetry of W.B Yeats and Patrick Kavanagh

This article addresses the theme of place in the poetry of W. B. Yeats and Patrick Kavanagh, focusing on the concept of place as a physical and psychological entity. The article explores place as a creative force in the work of these two poets, in relation to the act of writing. Seamus Heaney, in his essay “The Sense of Place,” talks about the “history of our sensibilities” that looks to the stable element of the land for continuity: “We are dwellers, we are namers, we are lovers, we make homes and search for our histories” (Heaney 1980: 148-9). Thus, in a physical sense, place is understood as a site in which identity is located and defined, but in a metaphysical sense, place is also an imaginative space that maps the landscapes of the mind. This article compares the different ways in which Yeats and Kavanagh relate to their place of writing, physically and artistically, where place is understood as a physical lived space, and as a liberating site for an exploration of poetic voice, where the poet creates his own country of the mind.