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https://www.readbyqxmd.com/read/28422448/the-benefits-of-clinical-facilitators-on-improving-stroke-care-in-acute-hospitals-a-new-program-for-australia
#1
Tara Purvis, Karen Moss, Linda Francis, Karen Borschmann, Monique F Kilkenny, Sonia Denisenko, Christopher F Bladin, Dominique A Cadilhac
BACKGROUND: Care gaps for stroke lead to preventable disability and deaths. The Victorian State Government implemented a program of employing clinical Facilitators on a fixed-term basis for up to three years (2008-2011) in eight hospitals to improve stroke care. The Facilitators were to establish stroke units where absent, implement evidence-based management protocols and provide staff education within an agreed work plan. The aim of this study was to determine if the Facilitator role was associated with improved stroke care, and to describe factors supporting or mitigating enhancements to care...
April 19, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28407069/managing-transient-ischaemic-attacks-in-australia-a-qualitative-study
#2
Andrew R Davey, Daniel S Lasserson, Christopher R Levi, Parker J Magin
Background.: Stroke risk after transient ischaemic attack (TIA) is highest in the first few days. It is greatly reduced by commencing commonly used medications. Current Australian guidelines recommend that all TIAs be managed urgently by secondary-care specialists (mandatory for high-risk TIAs). The majority of TIAs present to general practice which creates a dilemma when specialist care is not readily accessible. There is a lack of evidence relating to the determinants of general practitioners' (GPs) actions in this situation...
April 12, 2017: Family Practice
https://www.readbyqxmd.com/read/28389609/mortality-reduction-for-fever-hyperglycemia-and-swallowing-nurse-initiated-stroke-intervention-qasc-trial-quality-in-acute-stroke-care-follow-up
#3
Sandy Middleton, Kelly Coughlan, George Mnatzaganian, Nancy Low Choy, Simeon Dale, Asmara Jammali-Blasi, Chris Levi, Jeremy M Grimshaw, Jeanette Ward, Dominique A Cadilhac, Patrick McElduff, Janet E Hiller, Catherine D'Este
BACKGROUND AND PURPOSE: Implementation of nurse-initiated protocols to manage fever, hyperglycemia, and swallowing dysfunction decreased death and disability 90 days poststroke in the QASC trial (Quality in Acute Stroke Care) conducted in 19 Australian acute stroke units (2005-2010). We now examine long-term all-cause mortality. METHODS: Mortality was ascertained using Australia's National Death Index. Cox proportional hazards regression compared time to death adjusting for correlation within stroke units using the cluster sandwich (Huber-White estimator) method...
April 7, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28356438/googling-service-boundaries-for-endovascular-clot-retrieval-hub-hospitals-in-a-metropolitan-setting-proof-of-concept-study
#4
Thanh G Phan, Richard Beare, Jian Chen, Benjamin Clissold, John Ly, Shaloo Singhal, Henry Ma, Velandai Srikanth
BACKGROUND AND PURPOSE: There is great interest in how endovascular clot retrieval hubs provide services to a population. We applied a computational method to objectively generate service boundaries for such endovascular clot retrieval hubs, defined by traveling time to hub. METHODS: Stroke incidence data merged with population census to estimate numbers of stroke in metropolitan Melbourne, Australia. Traveling time from randomly generated addresses to 4 endovascular clot retrieval-capable hubs (Royal Melbourne Hospital [RMH], Monash Medical Center [MMC], Alfred Hospital [ALF], and Austin Hospital [AUS]) estimated using Google Map application program interface...
March 29, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28350246/frequency-presentation-and-outcome-of-takayasu-arteritis-in-western-australia
#5
Krista Makin, Maxine Isbel, Johannes Nossent
OBJECTIVES: Takayasu arteritis (TAK) is large-vessel vasculitis that predominantly affects young women. There is worldwide variation in the frequency of TAK depending on genetic and/or environmental factors. With Australian data lacking, we describe the epidemiology, clinical features and outcomes of TAK in Western Australia (WA). METHODS: Retrospective case cohort study of incident TAK cases between 1 January 2000 and 30 June 2015 in WA identified from multiple sources...
March 28, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28341580/efficacy-and-safety-of-sildenafil-in-men-with-sexual-dysfunction-and-spinal-cord-injury
#6
REVIEW
Dana A Ohl, Martin Carlsson, Vera J Stecher, Gregory A Rippon
INTRODUCTION: Spinal cord injury (SCI) is estimated to affect approximately 276,000 individuals in the United States. Since 2010, the mean age of individuals at the time of the SCI has been 42 years, with nearly 80% of cases involving men. This means that individuals with SCI generally are young men who typically place a great deal of importance on normal sexual and reproductive function. AIM: To assess the effect of sildenafil treatment on erectile function and the frequency of ejaculation in men with SCI...
March 21, 2017: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/28320068/thoracic-electrical-bioimpedance-versus-suprasternal-doppler-in-emergency-care
#7
Mohammed H Elwan, Jeremy Hue, Samira J Green, Salah M Eltahan, Mark R Sims, Timothy J Coats
OBJECTIVE: There are a number of cardiac output (CO) monitors that could potentially be used in the ED. Two of the most promising methods, thoracic electrical bioimpedance and suprasternal Doppler, have not been directly compared. The aim of this study was to investigate the feasibility of CO monitoring using suprasternal Doppler and bioimpedance in emergency care and compare haemodynamic data obtained from both monitors. METHODS: Haemodynamic measurements were made on the same group of patients using bioimpedance (Niccomo, Medis, Germany) and suprasternal Doppler (USCOM, Sydney, Australia)...
March 20, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28302181/hospitals-admitting-at-least-100-patients-with-stroke-a-year-should-have-a-stroke-unit-a-case-study-from-australia
#8
Dominique A Cadilhac, Monique F Kilkenny, Nadine E Andrew, Elizabeth Ritchie, Kelvin Hill, Erin Lalor
BACKGROUND: Establishing a stroke unit (SU) in every hospital may be infeasible because of limited resources. In Australia, it is recommended that hospitals that admit ≥100 strokes per year should have a SU. We aimed to describe differences in processes of care and outcomes among hospitals with and without SUs admitting at least 100 patients/year. METHODS: National stroke audit data of 40 consecutive patients per hospital admitted between 1/7/2010-31/12/2010 and organizational survey for annual admissions were used...
March 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28288937/incidence-of-fatal-snake-bite-in-australia-a-coronial-based-retrospective-study-2000-2016
#9
Ronelle E Welton, Danny Liew, George Braitberg
INTRODUCTION: It has been over 20 years since a national review of recorded deaths from snake envenoming. The present study aimed to provide an updated review of the epidemiology of deaths from snake bites in Australia. METHODS: Deaths were identified from January 2000 to December 2016 from the National Coronial Information System. Cases identified due to snakes were extracted with data on coronial findings, autopsy and police records. RESULTS: Thirty five deaths (2...
March 10, 2017: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/28265093/common-coding-variant-in-serpina1-increases-the-risk-for-large-artery-stroke
#10
Rainer Malik, Therese Dau, Maria Gonik, Anirudh Sivakumar, Daniel J Deredge, Evgeniia V Edeleva, Jessica Götzfried, Sander W van der Laan, Gerard Pasterkamp, Nathalie Beaufort, Susana Seixas, Steve Bevan, Lisa F Lincz, Elizabeth G Holliday, Annette I Burgess, Kristiina Rannikmäe, Jens Minnerup, Jennifer Kriebel, Melanie Waldenberger, Martina Müller-Nurasyid, Peter Lichtner, Danish Saleheen, Peter M Rothwell, Christopher Levi, John Attia, Cathie L M Sudlow, Dieter Braun, Hugh S Markus, Patrick L Wintrode, Klaus Berger, Dieter E Jenne, Martin Dichgans
Large artery atherosclerotic stroke (LAS) shows substantial heritability not explained by previous genome-wide association studies. Here, we explore the role of coding variation in LAS by analyzing variants on the HumanExome BeadChip in a total of 3,127 cases and 9,778 controls from Europe, Australia, and South Asia. We report on a nonsynonymous single-nucleotide variant in serpin family A member 1 (SERPINA1) encoding alpha-1 antitrypsin [AAT; p.V213A; P = 5.99E-9, odds ratio (OR) = 1.22] and confirm histone deacetylase 9 (HDAC9) as a major risk gene for LAS with an association in the 3'-UTR (rs2023938; P = 7...
April 4, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28211060/shifting-gears-an-inpatient-medical-record-audit-and-post-discharge-survey-of-return-to-driving-following-stroke-transient-ischaemic-attack
#11
Janet Frith, Helen Warren-Forward, Isobel Hubbard, Carole James
BACKGROUND/AIM: In Australia, all stroke survivors should not drive for four weeks and transient ischaemic attack (TIA) survivors should not drive for two weeks. This study investigates the provision of return-to-driving education in the acute hospital setting and the use of this education by a cohort of Australian patients who have experienced a mild stroke or TIA and who are discharged directly home from their acute hospital admission. METHODS: A medical record audit was conducted of stroke patients discharged home from a regional hospital in Australia...
February 16, 2017: Australian Occupational Therapy Journal
https://www.readbyqxmd.com/read/28198732/intensive-blood-pressure-lowering-in-chronic-kidney-disease-the-time-has-come
#12
Marcel Ruzicka, Swapnil Hiremath
PURPOSE OF REVIEW: Release of the findings from the Systolic Blood Pressure Intervention Trial has resulted in a renewed examination of intensive blood pressure (BP) lowering. Only a few national hypertension guidelines (Canada and Australia) have changed recommendations, but considerable heterogeneity still exists with respect to the patient population to whom intensive BP lowering may apply. RECENT FINDINGS: There is fairly robust evidence that lower BP targets in nondiabetic chronic kidney disease (CKD) results in a decrease in heart failure and mortality...
May 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28177198/the-tasmanian-atrial-fibrillation-study-transition-to-direct-oral-anticoagulants-2011-2015
#13
Endalkachew Admassie Alamneh, Leanne Chalmers, Luke R Bereznicki
INTRODUCTION: Contemporary Australian data regarding antithrombotic prescribing patterns following approval of direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) are limited. AIM: The aim of the present study was to assess antithrombotic prescribing patterns before, during and after the clinical introduction of DOACs. METHODS: Using digital medical records, this retrospective cohort study included all patients with AF as a primary or secondary diagnosis who were admitted to the Royal Hobart Hospital, Tasmania, Australia, between January 2011 and July 2015...
February 8, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28150313/improved-outcomes-and-reduced-costs-associated-with-a-health-system-wide-patient-blood-management-program-a-retrospective-observational-study-in-four-major-adult-tertiary-care-hospitals
#14
Michael F Leahy, Axel Hofmann, Simon Towler, Kevin M Trentino, Sally A Burrows, Stuart G Swain, Jeffrey Hamdorf, Trudi Gallagher, Audrey Koay, Gary C Geelhoed, Shannon L Farmer
BACKGROUND: Patient blood management (PBM) programs are associated with improved patient outcomes, reduced transfusions and costs. In 2008, the Western Australia Department of Health initiated a comprehensive health-system-wide PBM program. This study assesses program outcomes. STUDY DESIGN AND METHODS: This was a retrospective study of 605,046 patients admitted to four major adult tertiary-care hospitals between July 2008 and June 2014. Outcome measures were red blood cell (RBC), fresh-frozen plasma (FFP), and platelet units transfused; single-unit RBC transfusions; pretransfusion hemoglobin levels; elective surgery patients anemic at admission; product and activity-based costs of transfusion; in-hospital mortality; length of stay; 28-day all-cause emergency readmissions; and hospital-acquired complications...
February 2, 2017: Transfusion
https://www.readbyqxmd.com/read/28121336/reduction-in-retained-activity-participation-is-associated-with-depressive-symptoms-3-months-after-mild-stroke-an-observational-cohort-study
#15
Tamara Tse, Jacinta Douglas, Primrose Lentin, Thomas Lindén, Leonid Churilov, Henry Ma, Stephen Davis, Geoffrey Donnan, Leeanne M Carey
OBJECTIVE: To quantify the association of depressive symptoms with retained activity participation 3 months post-stroke, after adjusting for neurological stroke severity and age. DESIGN: A cross-sectional observational study of retained activity participation and depressive symptoms in stroke survivors with ischaemic stroke. PARTICIPANTS: One hundred stroke survivors with mild neurological stroke severity. METHODS: One hundred stroke survivors were recruited from 5 metropolitan hospitals and reviewed at 3 months post-stroke using measures of activity participation, Activity Card Sort-Australia, and depressive symptoms, Montgomery-Asberg Depression Rating Scale Structured Interview Guide (MADRS-SIGMA)...
January 31, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28087508/international-variation-in-outcomes-among-people-with-cardiovascular-disease-or-cardiovascular-risk-factors-and-impaired-glucose-tolerance-insights-from-the-navigator-trial
#16
Marilia Harumi Higuchi Dos Santos, Abhinav Sharma, Jie-Lena Sun, Karen Pieper, John J V McMurray, Rury R Holman, Renato D Lopes
BACKGROUND: Regional differences in risk of diabetes mellitus and cardiovascular outcomes in people with impaired glucose tolerance are poorly characterized. Our objective was to evaluate regional variation in risk of new-onset diabetes mellitus, cardiovascular outcomes, and treatment effects in participants from the NAVIGATOR (Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research) trial. METHODS AND RESULTS: NAVIGATOR randomized people with impaired glucose tolerance and cardiovascular risk factors or with established cardiovascular disease to valsartan (or placebo) and to nateglinide (or placebo) with a median 5-year follow-up...
January 13, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28079400/dysphagia-therapy-post-stroke-an-exploration-of-the-practices-and-clinical-decision-making-of-speech-language-pathologists-in-australia
#17
Olivia Jones, Jade Cartwright, Anne Whitworth, Naomi Cocks
PURPOSE: A variety of dysphagia management options are available for the treatment of dysphagia following a stroke, however, it is unknown which of these approaches are most commonly utilised by Australian speech-language pathologists (SLPs) and whether particular factors influence decision-making. METHOD: The aim of this study was to investigate, through an online survey, the treatment practices of SLPs in Australia for the treatment of dysphagia post-stroke and identify the factors influencing treatment decisions...
January 12, 2017: International Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/28070883/pilot-of-a-computerised-antithrombotic-risk-assessment-tool-version-2-caratv2-0-for-stroke-prevention-in-atrial-fibrillation
#18
Yishen Wang, Beata Bajorek
BACKGROUND: The decision-making process for stroke prevention in atrial fibrillation (AF) requires a comprehensive assessment of risk vs. benefit and an appropriate selection of antithrombotic agents (e.g., warfarin, non-vitamin K antagonist oral anticoagulants [NOACs]). The aim of this pilot-test was to examine the impact of a customised decision support tool - the Computerised Antithrombotic Risk Assessment Tool (CARATV2.0) using antithrombotic therapy on a cohort of patients with AF...
January 10, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28068791/the-utilization-of-antithrombotic-therapy-in-older-patients-in-aged-care-facilities-with-atrial-fibrillation
#19
Bridget Frain, Ronald Castelino, Luke R Bereznicki
Oral anticoagulants are essential drugs for the prevention of thromboembolic events in patients with atrial fibrillation (AF). Anticoagulants are, however, commonly withheld in older people due to the risk and fear of hemorrhage. Although the underutilization of anticoagulants in patients with AF has been demonstrated internationally, few studies have been conducted among aged care residents. The aim of this study was to determine the utilization of anticoagulants among people with AF residing in aged care facilities...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28042264/the-effect-of-education-on-oral-health-students-attitudes-in-australia-and-new-zealand
#20
Liyana Tanny, Takashi Komabayashi, D Leann Long, Yoshio Yahata, Susan M Moffat, Helen Tãne
OBJECTIVE: The aim of this study was to evaluate the oral health attitudes and behavior of students in the oral health curriculum in Australia and New Zealand. MATERIALS AND METHODS: The Hiroshima University - Dental Behavioral Inventory was administered to students in the first (year 1) and final years (year 3) of the oral health curriculum at Charles Sturt University in Australia and the University of Otago in New Zealand. A total of fifty-two year 1 students and forty-five year 3 students completed English version of the questionnaire in 2013...
October 2016: European Journal of Dentistry
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