Stroke prevention and control system in China: CSPPC-Stroke Program

2020 ◽  
pp. 174749302091355
Author(s):  
Bao-Hua Chao ◽  
Feng Yan ◽  
Yang Hua ◽  
Jian-Min Liu ◽  
Yi Yang ◽  
...  
Keyword(s):  
Stroke Prevention ◽  
Prevention And Control ◽  
Mainland China ◽  
Stroke Care ◽  
Prevention Project ◽  
Hospital Transfer ◽  
Stroke Center ◽  
And Control

In China, stroke is a major cause of mortality, and long-term physical and cognitive impairment. To meet this challenge, the Ministry of Health China Stroke Prevention Project Committee (CSPPC) was established in April 2011. This committee actively promotes stroke prevention and control in China. With government financial support of 838.4 million CNY, 8.352 million people from 536 screening points in 31 provinces have received stroke screening and follow-up over the last seven years (2012–2018). In 2016, the CSPPC issued a plan to establish stroke centers. To shorten the pre-hospital period, the CSPPC established a stroke center network, stroke map, and stroke “Green Channel” to create three 1-h gold rescue circles, abbreviated as “1-1-1” (onset to call time <1 h; pre-hospital transfer time < 1 h, and door-to-needle time < 1 h). From 2017 to 2018, the median door-to-needle time dropped by 4.0% (95% confidence interval (CI), 1.4–9.4) from 50 min to 48 min, and the median onset-to-needle time dropped by 2.8% (95% CI, 0.4–5.2) from 180 min to 175 min. As of 31 December 2018, the CSPPC has established 380 stroke centers in mainland China. From 1 November 2018, the CSPPC has monitored the quality of stroke care in stroke center hospitals through the China Stroke Data Center Data Reporting Platform. The CSPPC Stroke program has led to a significant improvement in stroke care. This program needs to be further promoted nationwide.

Strengthening of occupational health promotion by the German Prevention Health Care Act

2019 ◽  
pp. 188-190
Author(s):  
Diana Hart
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Promotion ◽  
Primary Prevention ◽  
Occupational Health ◽  
Life Expectancy ◽  
Prevention And Control ◽  
Occupational Health Promotion ◽  
And Control

All countries are faced with the problem of the prevention and control of non-communicable diseases (NCD): implement prevention strategies eff ectively, keep up the momentum with long term benefi ts at the individual and the population level, at the same time tackling hea lth inequalities. Th e aff ordability of therapy and care including innovative therapies is going to be one of the key public health priorities in the years to come. Germany has taken in the prevention and control of NCDs. Germany’s health system has a long history of guaranteeing access to high-quality treatment through universal health care coverage. Th r ough their membership people are entitled to prevention and care services maintaining and restoring their health as well as long term follow-up. Like in many other countries general life expectancy has been increasing steadily in Germany. Currently, the average life expectancy is 83 and 79 years in women and men, respectively. Th e other side of the coin is that population aging is strongly associated with a growing burden of disease from NCDs. Already over 70 percent of all deaths in Germany are caused by four disease entities: cardiovascular disease, cancer, chronic respiratory disease and diabetes. Th ese diseases all share four common risk factors: smoking, alcohol abuse, lack of physical activity and overweight. At the same time, more and more people become long term survivors of disease due to improved therapy and care. Th e German Government and public health decision makers are aware of the need for action and have responded by initiating and implementing a wide spectrum of activities. One instrument by strengthening primary prevention is the Prevention Health Care Act. Its overarching aim is to prevent NCDs before they can manifest themselves by strengthening primary prevention and health promotion in diff erent sett ings. One of the main emphasis of the Prevention Health Care Act is the occupational health promotion at the workplace.

scholarly journals Legal Requirements for Infection Prevention and Control Training Among Healthcare Personnel

2020 ◽  
Vol 41 (S1) ◽  
pp. s70-s70
Author(s):  
Lauren Weil ◽  
Alexa Limeres ◽  
Astha KC ◽  
Carissa Holmes ◽  
Tara Holiday ◽  
...  
Keyword(s):  
Prevention And Control ◽  
Infection Prevention ◽  
Healthcare Personnel ◽  
Infection Prevention And Control ◽  
Content Areas ◽  
Training Requirements ◽  
Training Content ◽  
And Control ◽  
Dental Professionals

Background: When healthcare providers lack infection prevention and control (IPC) knowledge and skills, patient safety and quality of care can suffer. For this reason, state laws sometimes dictate IPC training; these requirements can be expressed as applying to various categories of healthcare personnel (HCP). We performed a preliminary assessment of the laws requiring IPC training across the United States. Methods: During February–July 2018, we searched WestlawNext, a legal database, for IPC training laws in 51 jurisdictions (50 states and Washington, DC). We used standard legal epidemiology methods, including an iterative search strategy to minimize results that were outside the scope of the coding criteria by reviewing results and refining search terms. A law was defined as a regulation or statute. Laws that include IPC training for healthcare personnel were collected for coding. Laws were coded to reflect applicable HCP categories and specific IPC training content areas. Results: A total of 278 laws requiring IPC training for HCP were identified (range, 1–19 per jurisdiction); 157 (56%) did not specify IPC training content areas. Among the 121 (44%) laws that did specify IPC content, 39 (32%) included training requirements that focused solely on worker protections (eg, sharps injury prevention and bloodborne pathogen protections for the healthcare provider). Among the 51 jurisdictions, dental professionals were the predominant targets: dental hygienists (n = 22; 43%), dentists (n = 20; 39%), and dental assistants (n = 18; 35%). The number of jurisdictions with laws requiring training for other HCP categories included the following: nursing assistants (n = 25; 49%), massage therapists (n = 11; 22%), registered nurses (n = 10; 20%), licensed practical nurses (n = 10; 20%), emergency medical technicians and paramedics (n = 9; 18%), dialysis technicians (n = 8; 18%), home health aides (n = 8;16%), nurse midwives (n = 7; 14%), pharmacy technicians (n = 7; 14%), pharmacists (n = 6; 12%), physician assistants (n = 4; 8%), podiatrists (n = 3; 6%), and physicians (n = 2; 4%). Conclusions: Although all jurisdictions had at least 1 healthcare personnel IPC training requirement, many of the laws lack specificity and some focus only on worker protections, rather than patient safety or quality of care. In addition, the categories of healthcare personnel regulated among jurisdictions varied widely, with dental professionals having the most training requirements. Additional IPC training requirements exist at the facility level, but this information was not analyzed as a part of this project. Further analysis is needed to inform our assessment and identify opportunities for improving IPC training requirements, such as requiring IPC training that more fully addresses patient protections.Funding: NoneDisclosures: None

scholarly journals Coronavirus disease 2019 is threatening stroke care systems: a real-world study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiawei Xin ◽  
Xuanyu Huang ◽  
Changyun Liu ◽  
Yun Huang
Keyword(s):  
Real World ◽  
Mainland China ◽  
Stroke Care ◽  
Hospital Length ◽  
Real World Data ◽  
Care Systems ◽  
Long Term Prognosis ◽  
Comprehensive Stroke Center ◽  
Stroke Center ◽  
Medical Burden

Abstract Background Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, the stroke care systems have been seriously affected because of social restrictions and other reasons. As the pandemic continues to spread globally, it is of great significance to understand how COVID-19 affects the stroke care systems in mainland China. Methods We retrospectively studied the real-world data of one comprehensive stroke center in mainland China from January to February 2020 and compared it with the data collected during the same period in 2019. We analyzed DTN time, onset-to-door time, severity, effects after treatment, the hospital length of stays, costs of hospitalization, etc., and the correlation between medical burden and prognosis of acute ischemic stroke (AIS) patients. Results The COVID-19 pandemic was most severe in mainland China in January and February 2020. During the pandemic, there were no differences in pre-hospital or in-hospital workflow metrics (all p>0.05), while the degree of neurological deficit on admission and at discharge, the effects after treatment, and the long-term prognosis were all worse (all p<0.05). The severity and prognosis of AIS patients were positively correlated with the hospital length of stays and total costs of hospitalization (all p<0.05). Conclusions COVID-19 pandemic is threatening the stroke care systems. Measures must be taken to minimize the collateral damage caused by COVID-19.

Baduanjin Exercise for Adults Aged 65 Years and Older: A Systematic Review and Meta-Analysis of Randomized Controlled Studies

2021 ◽  
pp. 073346482110593
Author(s):  
Cindy Jones ◽  
Meiling Qi ◽  
Zihui Xie ◽  
Wendy Moyle ◽  
Benjamin Weeks ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Mainland China ◽  
Walking Ability ◽  
Search Terms ◽  
Randomized Controlled Studies ◽  
Chinese Studies ◽  
Older Chinese

This study performed a systematic review and meta-analysis to evaluate the health effects of Baduanjin exercise on adults aged 65 years and older. Chinese and English databases were electronically searched using search terms related to the PICO model from inception through June 2021. The study quality assessment and meta-analysis were conducted using the PEDro scale and RevMan 5.4 software. Eleven included Chinese studies, published between 2015 and 2021, recruited participants from the mainland of China. The aggregated results showed significant benefits of Baduanjin on physical function, walking ability, balance, and anxiety. A long-term Baduanjin intervention could also improve quality of life and reduce falls and pain. Baduanjin appears to have the potential to improve the health of older adults, but conclusions are limited due to the lack of rigorous and robust studies within and outside of mainland China. Larger, well-designed RCTs are needed to confirm these findings.

The Effect of Telerehabilitation on Quality of Life, Exercise Capacity, and Spirometry Indexes in Patients with Chronic Obstructive Pulmonary Disease in Masih Daneshvari Hospital

2021 ◽  
Author(s):  
Somayeh Ghadimi ◽  
Atefeh Fakharian ◽  
Mohsen Abedi ◽  
Reyhaneh Zahiri ◽  
Mahsan Norouz Afjeh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
And Control

Background: Chronic Obstructive Pulmonary Disease (COPD) leads to limited activity and reduced quality of life. Treatment of this disease is a long-term process that requires the cooperation of patients in monitoring and treatment. Methods: In the present study which was conducted from April 2019 to March 2021 in Masih Daneshvari Hospital, Tehran, Iran, 75 patients were randomly divided into telerehabilitation and control groups. Patients in the control group received pulmonary rehabilitation including respiratory, isometric, and aerobic exercises for 8 weeks, three times per week. In the second group, patients were given a lung rehabilitation booklet and asked to repeat the exercises three times a week for four weeks according to a specific schedule. In addition, patients installed Behzee care application on the mobile phone that recorded various indicators such as heart rate, SpO2, dyspnea, fatigue, and daily activities. This application reminded the patient of the program every day and at a specific time. Finally, the patients’ conditions were compared in the two groups after 8 weeks using CAT and mMRC questionnaires and 6-Minute Walk (6MW) exercise indices as well as spirometry tests. Results: In all four indicators (6MW, CAT,  and mMRC questionnaires as well as spirometry), patients showed improvement after rehabilitation (p<0.001). This improvement was significantly higher in the telemedicine group compared to the other group (p<0.01). Conclusion: The use of telerehabilitation in COPD patients is effective in improving spirometry indices, quality of life, as well as activity and sports indices.

Abstract T MP75: Facilities Available in Chinese Hospitals From China Stroke Research Network

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Chunjuan Wang ◽  
Zixiao Li ◽  
Yilong Wang ◽  
Yong Jiang ◽  
Xingquan Zhao ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Mainland China ◽  
Stroke Care ◽  
Research Network ◽  
Level Of Care ◽  
Minimum Level ◽  
Stroke Patients ◽  
Stroke Research ◽  
Primary Stroke Center ◽  
Stroke Center

Background and Purpose: Stroke is the first leading cause of death in China and millions of patients were admitted to various levels of hospitals each year. However, it is unknown how many of these hospitals are able to provide an appropriate level of care for stroke patients since the certification program of comprehensive stroke center (CSC) and primary stroke center (PSC) has not been initiated in China. Method: In 2012, we selected all 554 hospitals that joined into the China Stroke Research Network (CSRN) to start a survey. These hospitals were from 31 provinces or municipalities, covered nearly the entire Mainland China. A six-page questionnaire was sent to each of them to obtain the stroke facility information. We used the same criteria and definitions for CSC, PSC, and minimum level for any hospital ward (AHW) admitting stroke patients with that of the European Stroke Facilities Survey. Results: For all the hospitals in CSRN, 521 (94.0%) returned the questionnaire, 20 (3.8%) met criteria for CSC, 179 (34.4%) for PSC, 64 (12.3%) for AHW, and 258 (49.5%) met none of them and provided a lower level of care. Hospitals meeting criteria for CSC, PSC, AHW, and none of them admitted 70 052 (8.8%), 334 834 (42.2%), 88 364 (11.1%), and 299 806 (37.8%) patients in the whole of last year. There was no 24-hour availability for brain CT scan in 4.3% of hospitals not meeting criteria for AHW, while neither stroke care map nor stroke pathway for patients admission in 81.0% of them. Conclusions: Less than two fifths of Chinese hospitals admitting acute stroke patients have optimal facilities, and nearly half even the minimum level is not available. Our study suggests that only one half acute stroke patients are treated in appropriate centers in China, facilities for hospitals admitting stroke patients should be enhanced and certification project of CSCs and PSCs may be a feasible choice.

scholarly journals Method for Mid-Long-Term Prediction of Landslides Movements Based on Optimized Apriori Algorithm

2019 ◽  
Vol 9 (18) ◽  
pp. 3819 ◽  
Author(s):  
Wenhao Guo ◽  
Xiaoqing Zuo ◽  
Jianwei Yu ◽  
Baoding Zhou
Keyword(s):  
Prediction Model ◽  
Early Warning ◽  
Computational Efficiency ◽  
Prevention And Control ◽  
Apriori Algorithm ◽  
Mapreduce Framework ◽  
Frequent Item ◽  
And Control ◽  
Frequent Item Sets

In the study of the mid-long-term early warning of landslide, the computational efficiency of the prediction model is critical to the timeliness of landslide prevention and control. Accordingly, enhancing the computational efficiency of the prediction model is of practical implication to the mid-long-term prevention and control of landslides. When the Apriori algorithm is adopted to analyze landslide data based on the MapReduce framework, numerous frequent item-sets will be generated, adversely affecting the computational efficiency. To enhance the computational efficiency of the prediction model, the IAprioriMR algorithm is proposed in this paper to enhance the efficiency of the Apriori algorithm based on the MapReduce framework by simplifying operations of the frequent item-sets. The computational efficiencies of the IAprioriMR algorithm and the original AprioriMR algorithm were compared and analyzed in the case of different data quantities and nodes, and then the efficiency of IAprioriMR algorithm was verified to be enhanced to some extent in processing large-scale data. To verify the feasibility of the proposed algorithm, the algorithm was employed in the mid-long-term early warning study of landslides in the Three Parallel Rivers. Under the same conditions, IAprioriMR algorithm of the same rule exhibited higher confidence than FP-Growth algorithm, which implied that IAprioriMR can achieve more accurate landslide prediction. This method is capable of technically supporting the prevention and control of landslides.

scholarly journals Frequently Identified Infection Control Gaps Related to Hand Hygiene in Long-Term Care Facilities

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S407-S407
Author(s):  
Kate Tyner ◽  
Regina Nailon ◽  
Sue Beach ◽  
Margaret Drake ◽  
Teresa Fitzgerald ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Infection Control ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Long Term Care ◽  
Infection Prevention And Control ◽  
Term Care ◽  
Care Facilities ◽  
And Control

Abstract Background Little is known about hand hygiene (HH) policies and practices in long-term care facilities (LTCF). Hence, we decided to study the frequency of HH-related infection control (IC) gaps and the factors associated with it. Methods The Nebraska (NE) Infection Control Assessment and Promotion Program (ICAP) in collaboration with NE Department of Health and Human Services conducted in-person surveys and on-site observations to assess infection prevention and control programs (IPCP) in 30 LTCF from 11/2015 to 3/2017. The Centers for Disease Control and Prevention (CDC) Infection Prevention and Control Assessment tool for LTCF was used for on-site interviews and the Centers for Medicare and Medicaid (CMS) Hospital IC Worksheet was used for observations. Gap frequencies were calculated for questions (6 on CDC survey and 8 on CMS worksheet) representing best practice recommendations (BPR). The factors studied for the association with the gaps included LTCF bed size (BS), hospital affiliation (HA), having trained infection preventionists (IP), and weekly hours (WH)/ 100 bed spent by IP on IPCP. Fisher’s exact test and Mann Whitney test were used for statistical analyses. Results HH-related IC gap frequencies from on-site interviews are displayed in Figure 1. Only 6 (20%) LTCF reported having all 6 BPR in place and 10 (33%) having 5 BPR. LTCF with fewer gaps (5 to 6 BPR in place) appear more likely to have HA as compared with the LTCF with more gaps but the difference didn’t reach statistical significance (37.5% vs. 7.1%, P = 0.09). When analyzed separately for each gap, it was found that LTCF with HA are more likely to have a policy on preferential use of alcohol based hand rubs than the ones without HA. (85.7%, vs. 26.1% P = 0.008). Several IC gaps were also identified during observations (Figure 2) with one of them being overall HH compliance of &lt;80%. LTCF that have over 90% HH compliance are more likely to have higher median IP WH/100 beds dedicated towards IPCP as compared with the LTCFs with less than 90% compliance (16.4 vs. 4.4, P &lt; 0.05). Conclusion Many HH-related IC gaps still exist in LTCF and require mitigation. Mitigation strategies may include encouraging LTCF to collaborate with IP at local acute care hospitals for guidance on IC activities and to increase dedicated IP times towards IPCP in LTCF. Disclosures All authors: No reported disclosures.

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