scholarly journals Lessons learned in stroke care during COVID-19 pandemic and preparing for future pandemics in the MENA+ region: A consensus statement from the MENA+-SINO

2021 ◽  
pp. 120060
Author(s):  
Amal .M. Al Hashmi ◽  
Stephan von Bandemer ◽  
Ashfaq Shuaib ◽  
Ossama Yassin Mansour ◽  
Mohammed Wassy ◽  
...  
Keyword(s):  
Consensus Statement ◽  
Stroke Care ◽  
Lessons Learned ◽  
Mena Region

A Blueprint for the Conduct of Large, Multi-Site Trials in Telemedicine (Preprint)

2021 ◽  
Author(s):  
Patricia Commiskey ◽  
April W Armstrong ◽  
Tumaini Rucker Coker ◽  
Earl Ray Dorsey ◽  
John Fortney ◽  
...  
Keyword(s):  
Skin Diseases ◽  
Care Delivery ◽  
Mental Healthcare ◽  
Stroke Care ◽  
Lessons Learned ◽  
Patient Centered ◽  
Implementation Challenges ◽  
Home Based ◽  
Family Based ◽  
Key Aspects

BACKGROUND Recent literature supports the efficacy and efficiency of telemedicine in improving various health outcomes, despite the wide variability in results. OBJECTIVE Understanding site-specific issues in the implementation of telemedicine trials for broader replication and generalizability of results is needed. Lessons can be learned from existing trials, and a blueprint can guide researchers to conduct these challenging studies using telemedicine more efficiently and effectively. METHODS This viewpoint presents relevant challenges and solutions for conducting multi-site telemedicine trials using seven ongoing and completed studies funded by the Patient Centered Outcomes Research Institute (PCORI) portfolio of large multi-site trials to highlight the challenges in implementing telemedicine trials. RESULTS Implementation challenges related to clinical, informatics, regulatory, legal, quality and billing were identified and described. CONCLUSIONS Lessons learned from these studies were used to create a blueprint of key aspects to consider for the design and implementation of multi-site telemedicine trials. CLINICALTRIAL NCT02358135: Improving Specialty-Care Delivery in Chronic Skin Diseases (PI: AWArmstrong) NCT02396576: Using Telehealth to Deliver Developmental, Behavioral, and Mental Health Services in Primary Care Settings for Children in Underserved Areas (PI: TRCoker) NCT02038959: Connect.Parkinson (PI: RDorsey) NCT04000971: C3FIT (Coordinated, Collaborative, Comprehensive, Family-based, Integrated, Technology-enabled Care) Stroke Care Trial (PI: KGaines) NCT03694431: Noninferiority Comparative Effectiveness Trial of Home-Based Palliative Care (HomePal) Trial (PI: HNguyen, KMularski) NCT04153864: SUMMIT (Scaling Up Maternal Mental healthcare by Increasing access to Treatments) Trial (PI: DRSingla) NCT03985800: Specialty Medical Homes to Improve Outcomes for Patients with Inflammatory Bowel Disease (IBD) and Behavioral Health Conditions Trial (PI: ESzigethy)

What does it mean to have a stroke?

2020 ◽  
pp. 1-8
Author(s):  
Ossie Newell
Keyword(s):  
Stroke Care ◽  
Lessons Learned ◽  
Fundamental Issue ◽  
Stroke Event ◽  
Care Services

‘What does it mean to have a stroke’ is the first chapter of the book. It is written by a ‘Stroke Conqueror’, someone who suffered a stroke more than 20 years ago and is now attempting to impart a little of the flavour, drama, and trauma a stroke event brings, not only to the person suffering the stroke, but also to everyone in that persons family and beyond. Nothing is ever the same again, stroke is for life. The fundamental issue is that everyone on this planet of ours should, if required, have the same opportunity and access to the best possible stroke care services should such an event occur to them. The chapter explores the lessons learned, the consequences, and the perspective of the patient and the carers.

Studying Stroke Thrombus Composition After Thrombectomy: What Can We Learn?

Stroke ◽  
2021 ◽  
Author(s):  
Senna Staessens ◽  
Olivier François ◽  
Waleed Brinjikji ◽  
Karen M. Doyle ◽  
Peter Vanacker ◽  
...  
Keyword(s):  
Endovascular Procedures ◽  
Stroke Care ◽  
Lessons Learned ◽  
Success Rates ◽  
Complex Composition ◽  
Comprehensive Overview ◽  
Endovascular Thrombectomy ◽  
Extracellular Traps ◽  
Von Willebrand ◽  
Willebrand Factor

The composition of ischemic stroke thrombi has gained an increasing amount of interest in recent years. The implementation of endovascular procedures in standard stroke care has granted researchers the unique opportunity to examine patient thrombus material. Increasing evidence indicates that stroke thrombi are complex and heterogenous, consisting of various biochemical (eg, fibrin, von Willebrand factor, and neutrophil extracellular traps) and cellular (eg, red blood cells, platelets, leukocytes, and bacteria) components. This complex composition may explain therapeutic limitations and also offer novel insights in several aspects of stroke management. Better understanding of thrombus characteristics could, therefore, potentially lead to improvements in the management of patients with stroke. In this review, we provide a comprehensive overview of the lessons learned by examining stroke thrombus composition after endovascular thrombectomy and its potential relevance for thrombectomy success rates, thrombolysis, clinical outcomes, stroke etiology, and radiological imaging.

Abstract TMP55: Understanding Cultural and Knowledge Barriers to Acute Stroke Care in the Filipino American Community

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Antonio L Moya ◽  
Vincent Grospe ◽  
Julia Brock ◽  
Linh Nhat-Doan Vo ◽  
Eric Cheng ◽  
...  
Keyword(s):  
Social Media ◽  
Los Angeles ◽  
Focus Groups ◽  
Acute Stroke ◽  
Stroke Risk ◽  
Stroke Care ◽  
The Philippines ◽  
Lessons Learned ◽  
Community Leaders ◽  
Acute Stroke Care

Introduction: Filipino Americans (FilAms) in Los Angeles make up the largest Filipino community outside of the Philippines and 2nd largest Asian subgroup in L.A. County. FilAms also have higher rates of stroke, high blood pressure, and diabetes not only compared to other Asian subgroups but also to African American and Latino communities. Little is known about FilAm knowledge and cultural barriers in accessing acute stroke care. Methods: Using a qualitative descriptive design, we studied knowledge, attitudes, and health behaviors of the L.A. FilAm community with regard to acute stroke care by conducting 5 focus groups of 5-7 people each and 6 semi-structured interviews with key community leaders. Participants were recruited through L.A. FilAm community organizations. Focus groups were organized as follows: 1st: elderly community members at high stroke risk; 2 nd : spouses of those at high stroke risk; 3 rd : paid caregivers of those with stroke risk; 4 th : unpaid caregivers of those with stroke risk; 5 th : young FilAms with family members with stroke risk. Six individual interviews were with elderly FilAms identified as exceptionally healthy by community leaders. We conducted thematic analysis, coding for themes on barriers to acute stroke care. Results: Two key themes have emerged: 1) spiritualistic fatalism and the belief that God is in control of all outcomes despite an individual’s will and 2) fear of calling 911, specifically linked to shame in being perceived as unhealthy by neighbors, fear of deportation among undocumented FilAms, and fear of high ambulance cost. Elderly participants perceived social media as one of the most effective ways to widely engage FilAms on stroke. Conclusion: Beliefs related to spiritualistic fatalism as well as fear of calling 911 are powerful barriers to acute stroke care among FilAms. The results can inform a culturally-relevant intervention for the community using social media, the Internet, and Filipino television programs to encourage FilAms to obtain acute stroke care. Data collected is currently being integrated into a FilAm stroke media tool. Lessons learned from this project will also be used to create stroke education for other U.S. Asian Pacific Islander communities.

Acute Stroke Care in a Neurologically Underserved State: Lessons Learned from the Iowa Stroke Survey

2009 ◽  
Vol 18 (3) ◽  
pp. 203-207 ◽  
Author(s):  
Karen C. Albright ◽  
Todd C. Schott ◽  
Debbie F. Boland ◽  
Leslie George ◽  
Kevin P. Boland ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Stroke Care ◽  
Lessons Learned ◽  
Acute Stroke Care

Stroke Care During the COVID-19 Pandemic: Asian Stroke Advisory Panel Consensus Statement

2021 ◽  
pp. 251660852110009
Author(s):  
Jeyaraj D. Pandian ◽  
Yohanna Kusuma ◽  
Lyna Soertidewi Kiemas ◽  
Tsong-Hai Lee ◽  
Jose C. Navarro ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Stroke Unit ◽  
Consensus Statement ◽  
Mechanical Thrombectomy ◽  
Stroke Care ◽  
Advisory Panel ◽  
Stroke Patients ◽  
Number Of Patients ◽  
The Impact

The COVID-19 pandemic has impacted the health system worldwide. Stroke is one of the leading causes of death and disability in the world. Asia has a diverse health system and more than two-thirds of strokes occur in this region. The Asian Stroke Advisory Panel (ASAP) conducted a survey among the member countries to explore the impact of COVID-19 on stroke care. The stroke admission numbers have fallen, as have the number of patients who received thrombolysis and mechanical thrombectomy. The stroke unit and rehabilitation beds have been reallocated for COVID-19 care. ASAP recommends emergency department screening of stroke patients for COVID-19 and protected stroke code to be activated for COVID-19 suspect stroke patients. Noncontrast computed tomography (CT), CT angiography, and CT chest are the imaging modalities of choice. All health care professionals involved in triaging, imaging, and stroke care should wear appropriate personal protective equipment. All eligible stroke patients (COVID suspect/positive/non-COVID) should receive intravenous thrombolysis/mechanical thrombectomy. Mobile stroke units and robots can be used wherever available for evaluation and triaging. All stroke patients should receive standard stroke unit care. Limited rehabilitation should be offered to patients and training of caregivers if needed. Telemedicine/telestroke should be used for rehabilitation and follow-up. The ASAP consensus statement can be adapted to suit local and national health care systems.

Lessons Learned From Coaching Postsecondary Students With Traumatic Brain Injury

2020 ◽  
Vol 5 (1) ◽  
pp. 88-96
Author(s):  
Mary R. T. Kennedy
Keyword(s):  
College Students ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sense Of Self ◽  
Scientific Evidence ◽  
Sudden Onset ◽  
Lessons Learned ◽  
Speech Language Pathologists ◽  
The Brain ◽  
Exhaustive List

Purpose The purpose of this clinical focus article is to provide speech-language pathologists with a brief update of the evidence that provides possible explanations for our experiences while coaching college students with traumatic brain injury (TBI). Method The narrative text provides readers with lessons we learned as speech-language pathologists functioning as cognitive coaches to college students with TBI. This is not meant to be an exhaustive list, but rather to consider the recent scientific evidence that will help our understanding of how best to coach these college students. Conclusion Four lessons are described. Lesson 1 focuses on the value of self-reported responses to surveys, questionnaires, and interviews. Lesson 2 addresses the use of immediate/proximal goals as leverage for students to update their sense of self and how their abilities and disabilities may alter their more distal goals. Lesson 3 reminds us that teamwork is necessary to address the complex issues facing these students, which include their developmental stage, the sudden onset of trauma to the brain, and having to navigate going to college with a TBI. Lesson 4 focuses on the need for college students with TBI to learn how to self-advocate with instructors, family, and peers.

Experiences With and Lessons Learned From Developing, Implementing, and Evaluating a Support Program for Older Hearing Aid Users and Their Communication Partners in the Hearing Aid Dispensing Setting

2020 ◽  
Vol 29 (3S) ◽  
pp. 638-647 ◽  
Author(s):  
Janine F. J. Meijerink ◽  
Marieke Pronk ◽  
Sophia E. Kramer
Keyword(s):  
Large Scale ◽  
Hearing Aid ◽  
Critical Discussion ◽  
Lessons Learned ◽  
Research Note ◽  
Support Program ◽  
Large Sample Size ◽  
Long Term Effects ◽  
Communication Program ◽  
Communication Partners

Purpose The SUpport PRogram (SUPR) study was carried out in the context of a private academic partnership and is the first study to evaluate the long-term effects of a communication program (SUPR) for older hearing aid users and their communication partners on a large scale in a hearing aid dispensing setting. The purpose of this research note is to reflect on the lessons that we learned during the different development, implementation, and evaluation phases of the SUPR project. Procedure This research note describes the procedures that were followed during the different phases of the SUPR project and provides a critical discussion to describe the strengths and weaknesses of the approach taken. Conclusion This research note might provide researchers and intervention developers with useful insights as to how aural rehabilitation interventions, such as the SUPR, can be developed by incorporating the needs of the different stakeholders, evaluated by using a robust research design (including a large sample size and a longer term follow-up assessment), and implemented widely by collaborating with a private partner (hearing aid dispensing practice chain).

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