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For many people, working after beginning retirement benefit collection is a way to enhance financial security by increasing income. Existing research has shown that retirees are sensitive to the Social Security earnings test, which restricts the amount of earnings some beneficiaries can receive. However, little is known about the effects of other types of policies on post-retirement employment. Instead of restricting earnings, many public pension plans restrict the number of hours beneficiaries can work. I use return-to-work rules limiting the number of hours of employment in a state's public pension plan and administrative data on employment and retirement to determine the rules’ effects on retirement decisions and post-retirement labor supply. I find that the increases in the maximum number of hours of post-retirement employment lead to no change in retirement benefit collection and to increases in part-time work among retirees. As such, these policies appear to be binding on the labor supply decisions of some employees. These results are relevant for designing policies aimed at extending work-lives or improving the health of pension systems.

Made available in DSpace on 2019-10-04T12:41:37Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-07-02 National Health and Medical Research Council of Australia Background-The uptake of proven stroke treatments varies widely. We aimed to determine the association of evidence-based processes of care for acute ischemic stroke (AIS) and clinical outcome of patients who participated in the HEADPOST (Head Positioning in Acute Stroke Trial), a multicenter cluster crossover trial of lying flat versus sitting up, head positioning in acute stroke. Methods and Results-Use of 8 AIS processes of care were considered: reperfusion therapy in eligible patients; acute stroke unit care; antihypertensive, antiplatelet, statin, and anticoagulation for atrial fibrillation; dysphagia assessment; and physiotherapist review. Hierarchical, mixed, logistic regression models were performed to determine associations with good outcome (modified Rankin Scale scores 0-2) at 90 days, adjusted for patient and hospital variables. Among 9485 patients with AIS, implementation of all processes of care in eligible patients, or defect-free care, was associated with improved outcome (odds ratio, 1.40; 95% CI, 1.18-1.65) and better survival (odds ratio, 2.23; 95% CI, 1.62-3.09). Defect-free stroke care was also significantly associated with excellent outcome (modified Rankin Scale score 0-1) (odds ratio, 1.22; 95% CI, 1.04-1.43). No hospital characteristic was independently predictive of outcome. Only 1445 (15%) of eligible patients with AIS received all processes of care, with significant regional variations in overall and individual rates. Conclusions-Use of evidence-based care is associated with improved clinical outcome in AIS. Strategies are required to address regional variation in the use of proven AIS treatments. Univ New South Wales, Fac Med, George Inst Global Hlth, Sydney, NSW, Australia Ctr Estudios Clin, Inst Ciencias & Innovac Med, Santiago, Chile Clin Alemana Univ Desarrollo, Fac Med, Serv Neurol, Dept Neurol & Psiquiatria, Santiago, Chile Peking Univ, Hlth Sci Ctr, George Inst Global Hlth, Beijing, Peoples R China Australian Catholic Univ, Nursing Res Inst, St Vincents Hlth Australia Sydney, Sydney, NSW, Australia Univ Cent Lancashire, Fac Hlth & Wellbeing, Preston, Lancs, England Univ Chile, Fac Med, Dept Ciencias Neurol, Santiago, Chile Univ Sao Paulo, Ribeirao Preto Med Sch, Stroke Serv Neurol Div, Ribeirao Preto, Brazil Fukuoka Univ, Fac Med, Dept Prevent Med & Publ Hlth, Fukuoka, Fukuoka, Japan Univ Leicester, Dept Cardiovasc Sci, Leicester Biomed Res Ctr, Leicester, Leics, England Univ Leicester, Natl Inst Hlth Res, Leicester Biomed Res Ctr, Leicester, Leics, England Univ Edinburgh, Ctr Clin Brain Sci, Edinburgh, Midlothian, Scotland George Inst Global Hlth, Sydney, NSW, Australia Univ Desarrollo, Serv Neurol, Dept Neurol & Psiquiatria Clin Alemana Santiago, Santiago, Chile St Vincents Hlth Australia Sydney, Sydney, NSW, Australia Australian Catholic Univ, Sydney, NSW, Australia Univ Cent Lancashire, Stroke Practice Res Unit, Sch Hlth, Lancashire Clin Trials Unit, Preston, Lancs, England Univ Leicester, Dept Cardiovasc Sci, Cardiovasc Res Ctr, British Heart Fdn, Leicester, Leics, England Univ Kelaniya, Dept Pharmacol, Fac Med, Colombo, Sri Lanka Christian Med Coll & Hosp, Dept Neurol, Ludhiana, India Kaohsiung Med Univ & Hosp, Dept Neurol, Kaohsiung, Taiwan Linkou Chang Gung Mem Hosp, Dept Neurol, Taipei, Taiwan Peking Union Med Coll Hosp, Beijing, Peoples R China Univ Sao Paulo, Ribeirao Preto Sch Med, Ribeirao Preto, Brazil Monash Univ, Dept Epidemiol & Prevent Med, Melbourne, Vic, Australia Univ Cent Lancashire, Sch Hlth Sci, Coll Hlth & Wellbeing, Preston, Lancs, England Univ Desarrollo, Santiago, Chile Univ New South Wales, Neurosci Res Australia, Sydney, NSW, Australia Natl Univ Singapore, Dept Pharmacol, Singapore, Singapore Bradford Royal Infirm, Bradford Inst Hlth Res, Leeds, W Yorkshire, England Christian Med College, Ludhiana, Punjab, India RemediumOne Pvt Ltd, Kandy, Sri Lanka Kaohsiung Med Univ, Chung Ho Mem Hosp, Kaohsiung, Taiwan Calvary Publ Hosp Bruce, Bruce, Australia Royal North Shore Hosp, St Leonards, NSW, Australia Royal Prince Alfred Hosp, Camperdown, NSW, Australia Concord Repatriat Gen Hosp, Camperdown, NSW, Australia Fiona Stanley Hosp, Camperdown, NSW, Australia Macquarie Base Hosp, Melbourne, Vic, Australia Univ Sao Paulo, Fac Med Ribeirao Preto, Hosp Clin, Sao Paulo, Brazil Hosp Governador Celso Ramos, Florianopolis, SC, Brazil Sao Paulo State Univ, Hosp Fac Med Botucatu, UNESP, Sao Paulo, Brazil Yangquan Coalmine Grp Gen Hosp, Yangquan, Peoples R China Nanjing Med Univ, Nanjing Hosp 1, Nanjing, Jiangsu, Peoples R China 85 Hosp Peoples Liberat Army, Beijing, Peoples R China Chifeng Univ, Affiliated Hosp, Chifeng, Peoples R China Beijing Pinggu Hosp, Beijing, Peoples R China Wenzhou Med Univ, Affiliated Hosp 1, Wenzhou, Peoples R China Soochow Univ, Affiliated Hosp 2, Suzhou, Peoples R China Hebei Med Univ, Hosp 3, Shijiazhuang, Hebei, Peoples R China Capital Med Univ, Xuanwu Hosp, Beijing, Peoples R China Jining Med Univ, Affiliated Hosp, Jining, Peoples R China Third Peoples Hosp Huizhou, Huizhou, Peoples R China Second Cangzhou Cent Hosp, Cangzhou, Peoples R China Shanghai Jiao Tong Univ, Hosp Affiliated, Sch Med, Shanghai, Peoples R China Baogang Hosp, Baotou, Peoples R China Harbin Med Univ, Affiliated Hosp 1, Harbin, Heilongjiang, Peoples R China Shanghai Jiao Tong Univ Sch, Tong Ren Hosp, Peoples Hosp Hejian City, Shanghai, Peoples R China Peking Univ, Shougang Hosp, Beijing, Peoples R China Guangzhou Med Univ, Affiliated Hosp 3, Guangzhou, Guangdong, Peoples R China Second Hosp Nanchang, Nanchang, Jiangxi, Peoples R China Bethune Int Peace Hosp, Beijing, Peoples R China Hua Henan Prov Peoples Hosp, Beijing, Peoples R China Hua Henan Prov Peoples Hosp, Zhengzhou, Henan, Peoples R China Shanghai Jiao Tong Univ, Sch Med, Shanghai Ninth Peoples Hosp, Shanghai, Peoples R China Shijiazhuang Cent Hosp, Shijiazhuang, Hebei, Peoples R China Hosp Base San Jos de Osorno, Osorno, Chile Christian Med Coll & Hosp, Ludhiana, Punjab, India Unit Narayana Hrudayalaya Ltd, Mazumdar Shaw Med Ctr, Bangalore, Karnataka, India Dr Ramesh Cardiac & Multispecial Hosp Pvt Ltd, Guntur, India Post Grad Inst Med Educ & Res, Chandigarh, India Baby Mem Hosp Ltd, Calicut, Kerala, India Sree Chitra Tirunal Inst Med Sci & Technol, Thiruvananthapuram, Kerala, India Sri Jayawardenepura Gen Hosp, Sri Jayawardenepura Kott, Sri Lanka Colombo North Teaching Hosp, Colombo, Sri Lanka Colombo South Coching Hosp, Colombo, Sri Lanka Linkou Chang Gung Mem Hosp, Taoyuan, Taiwan Taipei Med Univ, Shuang Ho Hosp, Taipei, Taiwan En Chu Kong Hosp, New Taipei, Taiwan Natl Cheng Kung Univ Hosp, Tainan, Taiwan Queen Alexandra Hosp, Portsmouth, Hants, England Portsmouth Hosp NHS Natl Hlth Serv iTrust, Portsmouth, Hants, England Univ Coll London Hosp NHS Fdn Trust, London, England Univ Hosp Birmingham NHS Fdn Trust, Queen Elizabeth Hosp Birmingham, Birmingham, W Midlands, England Southend Univ Hosp NHS Fdn Trust, Southend On Sea, England Kings Coll Hosp London, London, England York Teaching Hosp NHS Fdn Trust, York, N Yorkshire, England Nottingham Univ Hosp NHS Trust, Nottingham, England Blackpool Teaching Hosp NHS Fdn Trust, Blackpool, England Gloucestershire Hosp NHS Fdn Trust, Gloucestershire Royal Hosp, Gloucester, England Teaching Hospi NHS Fdn Trust, London, England Royal Cornwall Hosp NHS Trust, Truro, England Royal London Hosp, Barts Hlth NHS Trust, London, England Sheffield Teaching Hosp NHS Fdn Trust, Sheffield, S Yorkshire, England Cambridge Univ Hosp NHS Fdn Trust, Addenbrookes Hosp, Cambridge, England Royal Victoria Hosp, Belfast Hlth & Social Care Trust, London, England Pinderfields Gen Hosp, Mid Yorkshire Hosp NHS Trust, Wakefield, England Royal Devon & Exeter NHS Fdn Trust, London, England Bradford Teaching Hosp NHS Fdn Trust, Bradford, W Yorkshire, England Great Western Hosp NHS Fdn Trust, Swindon, Wilts, England Watford Dist Gen Hosp, Watford, England Imperial Coll Healthcare NHS Trust, London, England Medway NHS Fdn Trust, Gillingham, England Royal Liverpool & Broadgreen Univ NHS Trust, Liverpool, Merseyside, England Calderdale & Huddersfield NHS Fdn Trust, Huddersfield, W Yorkshire, England Hywel Dda Univ Hlth Board, Haverfordwest, Wales Chesterfield Royal Hosp NHS Fdn Trust, Calow, England Luton & Dunstable Univ Hosp NHS Fdn Trust, Luton, Beds, England Countess Chester Hosp NHS Fdn Trust, Chester, Cheshire, England Peterborough City Hosp, Peterborough, Cambs, England Univ Hosp Leicester NHS Trust, Leicester Royal Infirm, Leicester, Leics, England Dist Hosp NHS Fdn Trust, London, England Barnsley Hosp NHS Fdn Trust, Barnsley, England Dorset Cty Hosp NHS Fdn Trust, Dorchester, England Royal Bournemouth & Christchurch Hosp NHS Fdn Tru, Royal Bournemouth Hosp, Bournemouth, Dorset, England Southern Hlth & Social Care Trust, Craigavon Area Hosp, Portadown, England United Lincolnshire Hosp NHS Trust, Pilgrim Hosp, Lincoln, England Bedford Hosp NHS Trust, Bedford, England Sao Paulo State Univ, Hosp Fac Med Botucatu, UNESP, Sao Paulo, Brazil National Health and Medical Research Council of Australia: 1066966

Over the past two decades, stroke care has been directed toward a rehabilitation and social focus. Initially, much attention was paid to what can be done for a patient in the days after their admission, with little attention given to the ‘hyper acute’ stage of admission. A diagnosis of stroke formerly elicited a nihilistic approach, but this has substantially changed in the past decade. Currently ‘time is brain’, and it is important for all disciplines to work together to initiate acute stroke protocols in the emergency department and identify patients within the therapeutic time window for thrombolytic and neuro-protective therapies. Evolving protocols, management, and nursing care all have important implications during the acute phase of ischaemic stroke. In the past few years, timely assessments and interventions have been the focus of government strategies. With recent research emphasising ways to reduce length of stay and post-stroke complications, the spotlight is now on providing stroke care in centres with the appropriate equipment and trained staff. This new research focus addresses an important need in stroke care and provides challenges and opportunities that can be used to improve patient outcomes.

Over the past two decades, stroke care has been directed toward a rehabilitation and social focus. Initially, much attention was paid to what can be done for a patient in the days after their admission, with little attention given to the ‘hyper acute’ stage of admission. A diagnosis of stroke formerly elicited a nihilistic approach, but this has substantially changed in the past decade. Currently ‘time is brain’, and it is important for all disciplines to work together to initiate acute stroke protocols in the emergency department and identify patients within the therapeutic time window for thrombolytic and neuro-protective therapies. Evolving protocols, management, and nursing care all have important implications during the acute phase of ischaemic stroke. In the past few years, timely assessments and interventions have been the focus of government strategies. With recent research emphasising ways to reduce length of stay and post-stroke complications, the spotlight is now on providing stroke care in centres with the appropriate equipment and trained staff. This new research focus addresses an important need in stroke care and provides challenges and opportunities that can be used to improve patient outcomes.

Transfer of care from hospital to the community after acute treatment for a stroke has been recognized as having a critical place in the stroke patient's pathway. Seamless transfer of care is a quality marker of the National Stroke Strategy. It is vitally important that patients receive good information and support after discharge from hospital because a failure to provide effective transfer of care can be detrimental to the long-term prognosis of the person with stroke and can compromise the care given in the acute setting. Effective transfer of care relies on good communication between health and social care providers in all settings, involvement of the patient and his/her family or carers in discharge planning, and the provision of appropriate information to the patient and his/her family.

Spasticity is a common symptom of neurological diseases including cerebral palsy, multiple sclerosis, traumatic brain injury, stroke and spinal cord injury. Spasticity has many components including increased muscle tone, exaggerated reflexes, weakness and contractures. It is a symptom that is not isolated, and can cause pain, stiffness and spasm resulting in a massive impact on a person's physical and emotional lifestyle. The management of spasticity requires a multidisciplinary approach including nurses, physicians, physiotherapists and occupational therapists working together to provide a variety of treatments tailored to the needs of the individual.

Urge incontinence is common in post-stroke and neurology patients as a result of overactive bladder. It is usually resistant to available treatments such as biofeedback, pharmacotherapy and behavioural therapies. A number of studies have proven the efficacy and safety of sacral nerve stimulation in the treatment of refractory urinary incontinence. A systematic literature search was undertaken to identify randomized controlled trials on the efficacy of sacral nerve stimulation in refractory cases of urinary incontinence. Two trials fulfilled the criteria for inclusion in this review. The meta-analysis indicated that sacral nerve stimulation is an efficient means of treating refractory urinary incontinence. Although the review of limited data suggests that sacral nerve stimulation is an effective and safe treatment for refractory urge incontinence, further research is needed to strengthen these findings.

Patients who have already suffered a stroke or transient ischaemic attack (TIA) are 10–15 times more likely than the general population to have another episode in the following year. The risk is greatest soon after the first event. This article describes approaches to secondary prevention of stroke, outlining specific lifestyle changes and treatment options that can lower a patient's risk. The specialist stroke nurse plays a central role in the successful implementation of these strategies, particularly with regard to patient education, monitoring and compliance.

This article describes thrombolysis for acute ischaemic stroke as an emerging treatment modality. National clinical guidelines emphasized the need to identify acute stroke as a clinical priority and to develop protocols for the early assessment and treatment of stroke patients. Fast-track services developed in other clinical scenarios have proven successful and this article outlines the potential benefits a fast-track service for acute stroke. The role of the clinical nurse specialist in stroke is central to this service; this role includes development and implementation of fast-track protocols in accident and emergency, rapid assessment for eligibility of thrombolysis and coordinating post-thrombolysis monitoring and acute stroke care.

Knowing whether time spent in formal schooling increases student achievement, and by how much, is important for policymakers interested in determining efficient use of resources. Using the ECLS-K, we exploit quasi-randomness in the timing of assessment dates to examine this question. Conservative estimates suggest a year of school results in gains of about one standard deviation above normal developmental gains in both reading and math test scores. The results are statistically significant and extremely robust to specification choice, supporting quasi-randomness of test dates. Estimates of skill accumulation due to formal schooling do not vary based on socioeconomic characteristics.

Three states (Georgia, Oklahoma and Florida) recently introduced Universal Pre- Kindergarten (Universal Pre-K) programs offering free preschool to all age-eligible children, and policy makers in many other states are promoting similar policies. How do such policies affect the participation of children in preschool programs (or do they merely substitute for preschool offered by the market)? Does the implicit child care subsidy afforded by Universal Pre-K change maternal labor supply? I present a model that includes preferences for child quality and shows the directions of change in preschool enrollment and maternal labor supply in response to Universal Pre-K programs are theoretically ambiguous. Using restricted-access data from the Census, together with year and birthday based eligibility cutoffs, I employ a regression discontinuity framework to estimate the effects of Universal Pre-K availability. Universal Pre-K availability increases preschool enrollment by 12 to 15 percent, with the largest effect on children of women with less than a Bachelor’s Degree. Universal Pre-K availability has little effect on the labor supply of most women. However, women residing in rural areas in Georgia increase their children’s preschool enrollment and their own employment by 22 and 20 percent, respectively, when Universal Pre-K is available.

This section presents a synopsis of a selection of recently published research articles of interest to those nurses working in the field of the neurosciences. The aim of this roundup is to provide a brief overview, rather than a detailed critique, of the research papers selected. A full reference is provided for those who wish to look at the research in further detail.

Stroke is common, affecting approximately 150 000 people every year in the UK, of which 10 000 people are of working age. While most strokes occur as a result of atherosclerosis and other major risk factors, there are a minority of patients in whom rare causes of stroke are present. Of these, patent foramen ovale (PFO) is becoming increasingly important, especially in younger patients presenting with embolic stroke, who have no vascular risk factors, are in normal sinus rhythm and do not have valvular heart disease.

I read Andy McCann's book on a brief break on the south coast. As a June 2004 stroke survivor, I wondered at the outset whether it was really the right kind of holiday reading. However, I swiftly found the account of a sudden, unexpected life change compelling, informative, enjoyable and, perhaps, above all, a positive experience.

The use of physical restraint in the UK remains a controversial and emotive topic for patients and health professionals. Mary Braine discusses some of the legal and ethical issues surrounding this subject (Br J Neurosci Nurs 1(4): 177-83). In the field of neuroscience nursing restraint may be used to ensure the patient receives the appropriate treatment and to provide a safe environment. As a clinical nurse specialist for stroke, I have often had to consider this issue, and after contacting other stroke units and conducting a detailed literature search to review current practice around the use of restraint I found that no clear guidelines were available. I therefore developed a policy for the use of physical restraint for patients in the acute phase of stroke to prevent them from pulling and dislodging their nasogastric tube. The trust′s legal department and senior nurses were involved in reviewing this policy.

Body-part centric response fields are pervasive: they are observed in single neurons, fMRI, EEG, and multiple behavioural measures. This prevalence across scales and measures makes them excellent candidates for studying systems-level neuroscience. Nonetheless, they remain poorly understood because we lack a unifying formal explanation of their origins and role in wider brain function. Here, we provide such explanation.We use reinforcement learning to analytically explain the existence of body-part centric receptive fields, also known as peripersonal field. We then simulate multiple experimental findings considered foundational in the peripersonal space literature. Our results demonstrate that peripersonal fields naturally arise from two simple and plausible assumptions about living agents: 1) they experience reward when they contact objects in the environment, and 2) they act to maximise reward. These simple assumptions are enough to explain empirical findings on stimulus kinematics, tool use, valence, and network-architecture.Our explanation provides further insight. First, it offers multiple empirically testable predictions. Second, it offers a formal description of the notion that the world-agent state is encoded in parieto-premotor cortices, using motor primitives: peripersonal fields provide building blocks that together create a short-term model of the world near the agent in terms of its future states; a successor representation. This short-term, close-range egocentric peripersonal map is analogous to the long-term, long-range allocentric spatial map of place and grid cells, which underlie locomotion and navigation to reach distant objects. Together, these allocentric and egocentric maps allow efficient interactions with a changing environment across multiple spatial and temporal scales.Abstract Figure