Rehabilitation professionals can benefit from soliciting reflections and suggestions from individuals who have returned to community living after completing post-stroke rehabilitation programmes. Specific recommendations are provided for tailoring interventions to meet individual goals, for enhancing follow up services provided after inpatient rehabilitation, and for providing early access to available resources in stroke survivors' communities.

Background: The events of 9/11 and the October 2002 National Intelligence Estimate on Iraq’s Continuing Programs for Weapons of Mass Destruction precipitated fundamental changes within the United States Intelligence Community. As part of the reform, analytic tradecraft standards were revised and codified into a policy document – Intelligence Community Directive (ICD) 203 – and an analytic ombudsman was appointed in the newly created Office for the Director of National Intelligence to ensure compliance across the intelligence community. In this paper we investigate the untested assumption that the ICD203 criteria can facilitate reliable evaluations of analytic products.Methods: Fifteen independent raters used a rubric based on the ICD203 criteria to assess the quality of reasoning of 64 analytical reports generated in response to hypothetical intelligence problems. We calculated the intra-class correlation coefficients for single and group-aggregated assessments.Results: Despite general training and rater calibration, the reliability of individual assessments was poor. However, aggregate ratings showed good to excellent reliability.Conclusion: Given that real problems will be more difficult and complex than our hypothetical case studies, we advise that groups of at least three raters are required to obtain reliable quality control procedures for intelligence products. Our study sets limits on assessment reliability and provides a basis for further evaluation of the predictive validity of intelligence reports generated in compliance with the tradecraft standards.

How might analytic reasoning in intelligence reports be substantially improved? One conjecture is that this can be achieved through a combination of crowdsourcing and structured analytic techniques (SATs). To explore this conjecture, we developed a new crowdsourcing platform supporting groups in collaborative reasoning and intelligence report drafting using a novel SAT we call “Contending Analyses.” In this paper we present findings from a large study designed to assess whether groups of professional analysts working on the platform produce better-reasoned reports than those analysts produce when using methods and tools normally used in their organizations. Secondary questions were whether professional analysts working on the platform produce better reasoning than the general public working on the platform; and how usable the platform is. Our main finding is a large effect size (Cohen’s d = 1.37) in favor of working on platform. This provides early support for the general conjecture. We discuss limitations of our study, implications for intelligence organizations, and future directions for the work as a whole.

Background. This is the 2018 Annual Report of the Kansas Poison Control Center at The University of Kansas Health System (KSPCC). The KSPCC serves the state of Kansas 24-hours per day, 365 days a year with certified specialists in poison information and clinical and medical toxicologists.  Methods. All encounters reported to the KSPCC from 01/01/2018 through 12/31/2018 were analyzed. Data recorded for each exposure included caller location, age, weight, gender, exposure substance, nature of exposure, route of exposure, interventions, medical outcome, disposition, and location of care.  Results. There were 21,072 total encounters, including 20,031 human exposure cases. Calls were received from every county and hospital in Kansas. Most of the exposures involved females (51.5%, n = 10,320) and a child less than 19 year of age (64%, n = 12,865). Medical outcomes were 24.5% (n = 4,912) no effect, 17.7% (n = 3,542) minor effect, 9.1% (n = 1,830) moderate effect, and 2.4% (n = 476) major effect. Seven deaths were reported in 2018. The number of exposure calls from healthcare facilities and severity of medical outcomes increased in 2018 compared to 2017.  Conclusions. The 2018 KSPCC annual report demonstrated that the center receives calls from the entire state of Kansas totaling over 20,000 human exposures. While pediatric exposures remain the most common encounter, a trend continued of an increasing number of calls from healthcare facilities and for cases with serious outcomes. This report supported the continued value of the KSPCC to both public and acute health care in the state of Kansas.

INTRODUCTION. This is the 2019 Annual Report of the Kansas Poison Control Center at The University of Kansas Health System (KSPCC). The KSPCC is one of 55 certified poison control centers in the United States and serves the state of Kansas 24-hours a day, 365 days a year with certified specialists in poison information and clinical and medical toxicologists.  The KSPCC receives calls from the public, law enforcement, health care professionals, and public health agencies.  All calls to the KSPCC are recorded electronically in the Toxicall® data management system and uploaded in near real-time to the National Poison Data System (NPDS) which is the data repository for all poison control centers in the United States.   METHODS.  All encounters reported to the KSPCC from 01/01/2019 through 12/31/2019 were analyzed. Data recorded for each exposure includes caller location, age, weight, gender, exposure substance, nature of exposure, route of exposure, interventions, medical outcome, disposition and location of care.  Encounters were further classified as human exposure, animal exposure, confirmed non-exposure or information call (no exposure reported). RESULTS.  The KSPCC logged 20,589 total encounters in 2019, including 19,406 human exposure cases.  The KSPCC received calls from every county in Kansas.  A slim majority of human exposure cases (50.5%, n=9,790) were female.  Approximately 61% (n=11,876) of human exposures involved a child (defined as 19 years of age or less).  Most encounters occurred at a residence (91.6%, n=17,780) and most cases (64.9%, n=12,599) originated from a residence.  The majority of human exposures (85.5%, n=16,589) were acute cases (exposures occurring over 8 hours or less).  Ingestion was the most common route of exposure documented (85.3%, n=16,548).  The most common reported substance in pediatric (children ≤5) encounters was cosmetics/personal care products (n=959) followed closely by household cleaning product (n=943).  For adult encounters, analgesics (n=1,296) and sedative/hypnotics/antipsychotics (n=1,084) were the most frequently involved substances.  Unintentional exposures were the most common reason for exposures (75.4%, n=14,634).  Most encounters (65.9%, n=12,780) were managed in a non-healthcare facility (i.e. a residence).  Among human exposures, 14,591 involved exposures to pharmaceutical agents while 9,439 involved exposure to non-pharmaceuticals.  Medical outcomes were 26.4% (n=5,116) no effect, 18.8% (n=3,652) minor effect, 9.3% (n=1,813) moderate effect, and 3.1% (n=603) major effects.  There were 14 deaths in 2019 reported to the KSPCC.  Cases from healthcare facilities, and cases with moderate or major medical outcomes and increased in 2019 compared to 2018.  The number of deaths reported to the KSPCC increased in 2019 to 14 from 7 in 2018. CONCLUSIONS.  The results of the 2019 Kansas Poison Control Center’s annual report demonstrate that cases are received from the entire state of Kansas totaling over 19,400 human exposures per year.  While pediatric exposures remain the most common encounter, there continues an trend of increasing number of cases from healthcare facilities and for cases with serious outcomes.  The experience of the KSPCC is comparable to national data.  This report supports the continued value of the KSPCC to both public and acute health care in the state of Kansas.