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.