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https://www.readbyqxmd.com/read/28994623/exploring-functional-outcomes-and-allied-health-staffing-levels-in-an-inpatient-paediatric-rehabilitation-unit
#1
Penelope J Ireland, Amanda Francis, Shani Jackman, Kim McLennan
PURPOSE: This study provides data from a paediatric tertiary hospital on the length of stay, functional improvement and allied health workload for children and adolescents on active inpatient rehabilitation programs. METHODS: An audit was conducted of records of patients managed through an inpatient rehabilitation program at a 359 bed tertiary children's hospital in Brisbane, Australia between December 2014 and December 2015. Data relating to diagnosis, length of stay, functional change, occasions of allied health service and hours of patient attributable allied health professional time were collected...
October 10, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28982808/cost-effectiveness-of-stroke-care-in-aboriginal-and-non-aboriginal-patients-an-observational-cohort-study-in-the-northern-territory-of-australia
#2
Yuejen Zhao, Steven Guthridge, Henrik Falhammar, Howard Flavell, Dominique A Cadilhac
OBJECTIVE: To assess cost-effectiveness of stroke care for Aboriginal compared with non-Aboriginal patients in the Northern Territory (NT), Australia. DESIGN: Cost-effectiveness analysis using data from a cohort-based follow-up study of stroke incidents. SETTING: Public hospitals in the NT from 1992 to 2013. PARTICIPANTS: Individual patient data were extracted and linked from the hospital inpatient and primary care information systems...
October 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28967376/a-very-early-rehabilitation-trial-after-stroke-avert-a-phase-iii-multicentre-randomised-controlled-trial
#3
Peter Langhorne, Olivia Wu, Helen Rodgers, Ann Ashburn, Julie Bernhardt
BACKGROUND: Mobilising patients early after stroke [early mobilisation (EM)] is thought to contribute to the beneficial effects of stroke unit care but it is poorly defined and lacks direct evidence of benefit. OBJECTIVES: We assessed the effectiveness of frequent higher dose very early mobilisation (VEM) after stroke. DESIGN: We conducted a parallel-group, single-blind, prospective randomised controlled trial with blinded end-point assessment using a web-based computer-generated stratified randomisation...
September 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28951392/insights-into-variations-in-preferred-selection-criteria-for-acute-stroke-endovascular-therapy
#4
Feng Wang, Bruce C V Campbell, Leonid Churilov, Peter Mitchell, Richard Dowling, Ziyuan Chen, Stephen M Davis, Bernard Yan
BACKGROUND: Endovascular thrombectomy (ET) is safe, effective, and cost-effective for large artery occlusion ischemic stroke, even if under different selection criteria. PURPOSE: To study the preferences for ET selection criteria by surveying clinicians and consumers, where number needed to treat to achieve functional independence is the only factor being considered. METHODS: A survey providing visual representation of the proportion of patients treated and expected functional outcomes, based on the selection criteria in each of the recent randomized trials of ET, was distributed nationwide in Australia and New Zealand to clinicians and consumers...
September 26, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28946831/the-potential-health-and-economic-impact-of-improving-stroke-care-standards-for-australia
#5
Joosup Kim, Nadine E Andrew, Amanda G Thrift, Julie Bernhardt, Richard I Lindley, Dominique A Cadilhac
Background Evidence of the burden of suboptimal stroke care should expedite quality improvement. We aimed to estimate the health and economic impact of improving acute stroke management to best practice standards using Australia as a case study. Methods Hospital performance in Australia was estimated using data from the National Stroke Audit of Acute Services 2013. The percentage of patients provided evidence-based therapies in all hospitals was compared to that achieved in the aggregate of top performing benchmark hospitals (that included between them, a minimum contribution of 15% of all cases audited)...
October 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28939954/bleeding-related-admissions-in-patients-with-atrial-fibrillation-receiving-antithrombotic-therapy-results-from-the-tasmanian-atrial-fibrillation-taf-study
#6
Endalkachew Admassie, Leanne Chalmers, Luke R Bereznicki
PURPOSE: Limited data are available from the Australian setting regarding bleeding in patients with atrial fibrillation (AF) receiving antithrombotic therapy. We aimed to investigate the incidence of hospital admissions due to bleeding and factors associated with bleeding in patients with AF who received antithrombotic therapy. METHODS: A retrospective cohort study was conducted involving all patients with AF admitted to the Royal Hobart Hospital, Tasmania, Australia, between January 2011 and July 2015...
September 22, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28925418/mhealth-application-areas-and-technology-combinations-a-comparison-of-literature-from-high-and-low-middle-income-countries
#7
Haitham Abaza, Michael Marschollek
BACKGROUND: With the continuous and enormous spread of mobile technologies, mHealth has evolved as a new subfield of eHealth. While eHealth is broadly focused on information and communication technologies, mHealth seeks to explore more into mobile devices and wireless communication. Since mobile phone penetration has exceeded other infrastructure in low and middle-income countries (LMICs), mHealth is seen as a promising component to provide pervasive and patient-centered care. OBJECTIVES: The aim of our research work for this paper is to examine the mHealth literature to identify application areas, target diseases, and mHealth service and technology types that are most appropriate for LMICs...
August 8, 2017: Methods of Information in Medicine
https://www.readbyqxmd.com/read/28914187/improving-quality-and-outcomes-of-stroke-care-in-hospitals-protocol-and-statistical-analysis-plan-for-the-stroke123-implementation-study
#8
Dominique A Cadilhac, Nadine E Andrew, Monique F Kilkenny, Kelvin Hill, Brenda Grabsch, Natasha A Lannin, Amanda G Thrift, Craig S Anderson, Geoffrey A Donnan, Sandy Middleton, Rohan Grimley
Rationale The effectiveness of clinician-focused interventions to improve stroke care is uncertain. Aims To determine whether an organizational intervention can improve the quality of stroke care over usual care. Sample size estimates To detect an absolute 10% difference in overall performance (composite outcome), a minimum of 21 hospitals and 843 patients per group was determined. Methods and design Before and after controlled design in hospitals in Queensland, Australia. Intervention Externally facilitated program (StrokeLink) using outreach workshops incorporating clinical performance feedback, patient outcomes (survival, quality of life at 90-180 days), local barrier assessments to best practice care, action planning, and ongoing support...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28892278/reflection-on-stroke-deaths-and-end-of-life-stroke-care
#9
Syed Zujajuddin Quadri, Thang Huynh, Cecilia Cappelen-Smith, Nirupama Wijesuriya, Abul Mamun, Roy Beran, Alan Mcdougall, Dennis Cordato
BACKGROUND: The benefit of palliative care referral for severe stroke patients on end-of-life care pathways (EOLCP) is increasingly recognised. Palliative care provides assistance with symptom management and transition to end-of-life care. Advance care planning (ACP) may help accommodate patient/family expectations and guide management. METHOD: Retrospective study of all stroke deaths (2014-2015) at Liverpool Hospital, Sydney, Australia. Data examined included age, co-morbidities, living arrangements, pre-existing ACP, palliative care referral rates and 'survival time'...
September 11, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28872449/the-pre-hospital-stroke-treatment-organization
#10
Heinrich Audebert, Klaus Fassbender, M Shazam Hussain, Martin Ebinger, Guillaume Turc, Ken Uchino, Stephen Davis, Anne Alexandrov, James Grotta
Background The PRE-hospital Stroke Treatment Organization was formed in 2016 as an international consortium of medical practitioners involved in pre-hospital treatment of patients with acute stroke. Aims PRE-hospital Stroke Treatment Organization's mission is to improve stroke outcomes by supporting research and advocacy for pre-hospital stroke treatment in Mobile Stroke Units. PRE-hospital Stroke Treatment Organization will provide a platform to enhance collaborative research across the spectrum of acute stroke management in the pre-hospital setting...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28835194/inequities-in-access-to-inpatient-rehabilitation-after-stroke-an-international-scoping-review
#11
Elizabeth A Lynch, Dominique A Cadilhac, Julie A Luker, Susan L Hillier
Background Inequities in accessing inpatient rehabilitation after stroke have been reported in many countries and impact on patient outcomes. Objective To explore variation in international recommendations regarding which patients should receive inpatient rehabilitation after stroke and to describe reported access to rehabilitation. Methods A scoping review was conducted to identify clinical guidelines with recommendations regarding which patients should access inpatient rehabilitation after stroke, and data regarding the proportion of patients accessing stroke rehabilitation...
August 23, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/28833107/clinical-characteristics-of-fatal-methamphetamine-related-stroke-a-national-study
#12
Shane Darke, Julia Lappin, Sharlene Kaye, Johan Duflou
The study aimed to determine the clinical characteristics of fatal methamphetamine-related stroke in Australia, 2009-2015. There were 38 cases, 60.5% male, with a mean age of 40.3 years. In no case was there evidence that this was the first time methamphetamine had been used by the decedent, and 52.6% had known histories of injecting drug use. The stroke was hemorrhagic in 37 of 38 cases. In 21.1% of cases, the stroke was purely parenchymal and, in 18.4%, involved purely the subarachnoid space. A ruptured berry aneurysm was present in 31...
August 17, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28822254/a-systematic-review-of-hypertension-outcomes-and-treatment-strategies-in-older-adults
#13
REVIEW
Julienne K Kirk, Julie Allsbrook, Maggie Hansell, Emily M Mann
OBJECTIVE: To evaluate the literature regarding blood pressure control and management in older adult patient population over 70 years of age. METHODS: A literature search was conducted using PubMed and capturing the data from 2006 to 2016. Terms used included MeSH headings for hypertension/therapy and antihypertension agents. A systematic review of published studies was performed. Articles including older patients (average age 70 years or older) being treated for hypertension were included...
November 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28809039/juvenile-melanomas-western-australian-melanoma-advisory-service-experience
#14
Jie Xin Xu, Sharnice Koek, Samantha Lee, Mark Hanikeri, Mark Lee, Trevor Beer, Christobel Saunders
BACKGROUND/OBJECTIVES: Juvenile melanoma (before 20 years of age) is a rare condition with poorly defined risk factors. We describe features of juvenile melanoma in Western Australia over the last two decades. METHOD: A retrospective review of juvenile melanomas was conducted from prospectively maintained databases, reviewed for patients' characteristics, clinical information, histology, treatment, recurrence and survival data. RESULTS: Altogether 95 cases of juvenile melanoma were reported to the Western Australian Cancer Registry between 2000 and 2013...
August 15, 2017: Australasian Journal of Dermatology
https://www.readbyqxmd.com/read/28808795/cerebral-venous-thrombosis-continental-disparities
#15
Laith Maali, Sheema Khan, Fares Qeadan, Mahmoud Ismail, Davana Ramaswamy, Vishnumurthy S Hedna
Cerebral venous thrombosis (CVT) usually accounts for < 1% of all strokes. Global disparity and diversity in their demographics, etiology, clinical features, radiological presentation, and mortality have not been previously explored. A systematic search was performed for publications in PubMed using key words "cerebral venous thrombosis," "Cerebral vein thrombosis," and "Cortical vein Thrombosis." A total of 600 relevant studies were abstracted with strict selection criteria, and a total of 7048 patient's data were used for the final analysis...
November 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28781025/changes-in-oral-anticoagulant-prescribing-for-stroke-prevention-in-patients-with-atrial-fibrillation
#16
Endalkachew Admassie, Leanne Chalmers, Luke R Bereznicki
Suboptimal guideline adherence and underuse of anticoagulants in patients with atrial fibrillation (AF) have been reported worldwide. This study aimed to compare anticoagulation practice in Australia during the pre- and postdirect oral anticoagulant (DOAC) eras. Between January 2011 and July 2015, patients with nonvalvular AF (NVAF) admitted to the Royal Hobart Hospital, Tasmania, Australia, were retrospectively reviewed. The pre- and post-DOAC era cohorts included admissions from January 2011 to July 2013 and August 2013 to July 2015, respectively...
October 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28780550/improving-discharge-care-the-potential-of-a-new-organisational-intervention-to-improve-discharge-after-hospitalisation-for-acute-stroke-a-controlled-before-after-pilot-study
#17
Dominique A Cadilhac, Nadine E Andrew, Enna Stroil Salama, Kelvin Hill, Sandy Middleton, Eleanor Horton, Ian Meade, Sarah Kuhle, Mark R Nelson, Rohan Grimley
OBJECTIVE: Provision of a discharge care plan and prevention therapies is often suboptimal. Our objective was to design and pilot test an interdisciplinary, organisational intervention to improve discharge care using stroke as the case study using a mixed-methods, controlled before-after observational study design. SETTING: Acute care public hospitals in Queensland, Australia (n=15). The 15 hospitals were ranked against a benchmark based on a composite outcome of three discharge care processes...
August 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28756617/antioxidant-vitamin-and-mineral-supplements-for-preventing-age-related-macular-degeneration
#18
REVIEW
Jennifer R Evans, John G Lawrenson
BACKGROUND: There is inconclusive evidence from observational studies to suggest that people who eat a diet rich in antioxidant vitamins (carotenoids, vitamins C, and E) or minerals (selenium and zinc) may be less likely to develop age-related macular degeneration (AMD). OBJECTIVES: To determine whether or not taking antioxidant vitamin or mineral supplements, or both, prevent the development of AMD. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2017, Issue 2), MEDLINE Ovid (1946 to 29 March 2017), Embase Ovid (1947 to 29 March 2017), AMED (Allied and Complementary Medicine Database) (1985 to 29 March 2017), OpenGrey (System for Information on Grey Literature in Europe) (www...
July 30, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28752255/the-representativeness-of-direct-oral-anticoagulant-clinical-trials-to-hospitalized-patients-with-atrial-fibrillation
#19
Laura Fanning, Jenni Ilomäki, J Simon Bell, Pēteris Dārziņš
PURPOSE: Trials of the direct oral anticoagulants (DOACs) dabigatran, rivaroxaban and apixaban provide the basis for prescribing for the prevention of stroke and systemic embolism in atrial fibrillation (AF). The objective of this study was to assess the representativeness of the three pivotal DOAC randomized controlled trials of dabigatran, rivaroxaban and apixaban for unselected hospitalized patients with AF. METHODS: A cross-sectional study was undertaken. All patients discharged with AF between 2012 and 2015 from a large public hospital network in Melbourne, Australia, were identified...
July 27, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28719977/the-efficacy-of-interactive-motion-capture-based-rehabilitation-on-functional-outcomes-in-an-inpatient-stroke-population-a-randomized-controlled-trial
#20
John Cannell, Emelyn Jovic, Amy Rathjen, Kylie Lane, Anna M Tyson, Michele L Callisaya, Stuart T Smith, Kiran Dk Ahuja, Marie-Louise Bird
OBJECTIVE: To compare the efficacy of novel interactive, motion capture-rehabilitation software to usual care stroke rehabilitation on physical function. DESIGN: Randomized controlled clinical trial. SETTING: Two subacute hospital rehabilitation units in Australia. PARTICIPANTS: In all, 73 people less than six months after stroke with reduced mobility and clinician determined capacity to improve. INTERVENTIONS: Both groups received functional retraining and individualized programs for up to an hour, on weekdays for 8-40 sessions (dose matched)...
July 1, 2017: Clinical Rehabilitation
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