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Context: Canadian best practice recommendations for identification and treatment of post-stroke depression (PSD) have been established, but whether they have been adopted is not known. Objectives: To compare current with recommended best practice. Methods: A retrospective chart review from 5 inpatient rehabilitation programs in Southwestern Ontario was completed and a short online survey addressing current practices, opinions and attitudes regarding PSD conducted. Results: Screening for PSD was documented in 41 of 294 patient records. Of the 41 patients screened, 16 were referred for assessment and 6 diagnosed with PSD. However, 113 patients (38.9%) received pharmacotherapy. Most staff reported having access to the recommendations (75%) and was somewhat aware of recommendations for PSD (70%). Conclusion: A substantial gap exists between current practice and best practice for the identification and treatment of PSD. Respondents expressed positive attitudes toward best practice and identified few barriers suggesting clinicians may be willing to implement the recommendations.

Whiplash-associated disorder (WAD) represents a significant public health problem, resulting in a substantial socioeconomic burden throughout the industrialized world, wherever costs are documented. While many treatments have been advocated for patients with WAD, scientific evidence of their effectiveness is often lacking. A systematic review was conducted to evaluate the strength of evidence supporting various WAD therapies. Multiple databases (including Web of Science, EMBASE and PubMed) were searched to identify all studies published from January 1980 through March 2009 that evaluated the effectiveness of any clearly defined treatment for acute (less than two weeks), subacute (two to 12 weeks) or chronic (longer than 12 weeks) WAD. The present article, the first in a five-part series, provides an overview of the review methodology as well as a summary and discussion of the review’s main findings. Eighty-three studies met the inclusion criteria, 40 of which were randomized controlled trials. The majority of studies (n=47) evaluated treatments initiated in the chronic stage of the disorder, while 23 evaluated treatments for acute WAD and 13 assessed therapies for subacute WAD. Exercise and mobilization programs for acute and chronic WAD had the strongest supporting evidence, although many questions remain regarding the relative effectiveness of various protocols. At present, there is insufficient evidence to support any treatment for subacute WAD. For patients with chronic WAD who do not respond to conventional treatments, it appears that radiofrequency neurotomy may be the most effective treatment option. The present review found a relatively weak but growing research base on which one could make recommendations for patients at any stage of the WAD continuum. Further research is needed to determine which treatments are most effective at reducing the disabling symptoms associated with WAD.

Whiplash-associated disorder (WAD) represents a significant public health problem, resulting in substantial social and economic costs throughout the industrialized world. While many treatments have been advocated for patients with WAD, scientific support regarding their effectiveness is often lacking. A systematic review was conducted to evaluate the strength of evidence associated with various WAD therapies. Multiple databases (including Web of Science, EMBASE and PubMed) were searched to identify all studies published from January 1980 through March 2009 that evaluated the effectiveness of any well-defined treatment for acute (less than two weeks), subacute (two to 12 weeks) or chronic (more than 12 weeks) WAD. The present article, the fifth in a five-part series, evaluates the evidence for surgical and injection-based interventions initiated during the chronic phase of WAD. Twenty-five studies were identified that met the inclusion criteria, six of which were randomized controlled trials with ‘good’ overall methodological quality (median Physiotherapy Evidence Database score of 7.5). For the treatment of chronic WAD, there was moderate evidence supporting radiofrequency neurotomy as an effective treatment for whiplash-related pain, although relief is not permanent. Sterile water injections have been demonstrated to be superior to saline injections; however, it is not clear whether this treatment is actually beneficial. There was evidence supporting a wide range of other interventions (eg, carpal tunnel decompression) with each of these evaluated by a single nonrandomized controlled trial. There is contradictory evidence regarding the effectiveness of botulinum toxin injections, and cervical discectomy and fusion. The evidence is not yet strong enough to establish the effectiveness of any of these treatments; of all the invasive interventions for chronic WAD, radiofrequency neurotomy appears to be supported by the strongest evidence. Further research is required to determine the efficacy and the role of invasive interventions in the treatment of chronic WAD.

A consistent theme in author Bobbie Ann Mason's short story collection Shiloh and Other Stories is a break from the traditional religious customs of the U.S. South. As children become adults and move away and as marriages crumble, characters' Christian faith fades, entering their minds only frustrated disillusion. Through their scathing, sarcastic quips and references, Mason's characters exhibit distaste for the traditional attitude toward Christianity in the South. Therefore, Mason's stories deconstruct not only the notion of Christianity's role in the South, but that of the communal strength of family. Using Martyn Bone's definition of "postsouthern" literature in his book The Postsouthern Sense of Place in Contemporary Fiction as literature that shatters previous preconceptions of the South, this research seeks to show how Mason's work fits into this burgeoning literary realm although unmentioned in Bone's book.