Brazilian guidelines for endovascular treatment of patients with acute ischemic stroke

ABSTRACT These guidelines are the result of a joint effort from writing groups of the Brazilian Stroke Society, the Scientific Department of Cerebrovascular Diseases of the Brazilian Academy of Neurology, the Brazilian Stroke Network and the Brazilian Society of Diagnostic and Therapeutic Neuroradiology. Members from these groups participated in web-based discussion forums with predefined themes, followed by videoconference meetings in which controversies and position statements were discussed, leading to a consensus. This guidelines focuses on the implications of the recent clinical trials on endovascular therapy for acute ischemic stroke due to proximal arterial occlusions, and the final text aims to guide health care providers, health care managers and public health authorities in managing patients with this condition in Brazil.

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Abstract TP251: Onset-to-Door Times and Means of Transportation for Acute Ischemic Stroke Patients Attending a Public Hospital in Bogota DC, Colombia. Is an Ambulance the Fastest Way to Reach the Hospital?

Stroke ◽

10.1161/str.47.suppl_1.tp251 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Javier Vicini-Parra ◽

Jenny Ospina ◽

Cristian Correa ◽

Natalia Gomez ◽

Stephania Bohorquez ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Public Transportation ◽

Public Hospital ◽

Descriptive Analysis ◽

First Year ◽

Stroke Patients ◽

Health Authorities ◽

Public Health Authorities ◽

Ischemic Attack

Introduction: A prospective stroke database was implemented as part of a still-growing comprehensive stroke centre (CSC). This CSC is located within a referral public hospital (Hospital Occidente de Kennedy) in Bogota DC, Colombia , that serves 2.3 million people of mainly low economic income. In this abstract, we present the data pertaining patients who were thrombolysed in our institution during the first year of data collection, and specify onset-to-door (OTD) times as they relate to the means of transportation used. Hypothesis: Acute stroke patients who arrive in ambulance have the shortest onset-to-door times. Methods: Printed forms were filled for every patient who arrived with diagnosis of acute ischemic stroke (AIS) or transient ischemic attack (TIA). Data was transcribed to an electronic database (Numbers, Apple Inc.) and analyzed with SPSS Statistics version 23 (IBM Corporation). A retrospective descriptive analysis was performed for central tendency and dispersion measures. Results: Since August 1st 2014 until July 31st 2015, 39 patients (17.7% of AIS patients) were thrombolysed. Mean onset-to-door times are shown in table 1. Prenotification was received for only 1 patient. All patients came from their homes. Conclusions: Almost half of our thrombolysed patients arrived in taxi to our institution. Taxi was the fastest means of transportation, ambulance was the slowest and private cars were in the middle of those. This confirmed our suspicion that the state-owned emergency medical services (SEMD) are suboptimal and that stroke patients prefer to use public transportation rather than SEMD. This should warn public health authorities on he urgent need to improve our SEMD. In the meantime, this finding prompts us to include taxi drivers in our periodic stroke campaigns.

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Use and Effects of Patient Access to Medical Records in General Practice Through a Personal Health Record in the Netherlands: Protocol for a Mixed-Methods Study

JMIR Research Protocols ◽

10.2196/10193 ◽

2018 ◽

Vol 7 (9) ◽

pp. e10193 ◽

Cited By ~ 1

Author(s):

Maria MT Vreugdenhil ◽

Rudolf B Kool ◽

Kees van Boven ◽

Willem JJ Assendelft ◽

Jan AM Kremer

Keyword(s):

Health Care ◽

General Practice ◽

Health Care Providers ◽

Personal Health Record ◽

Mixed Methods Study ◽

Personal Health ◽

Care Providers ◽

Group Discussions ◽

Web Based ◽

Staff Level

Background In the Dutch health care system, general practitioners hold a central position. They store information from all health care providers who are involved with their patients in their electronic health records. Web-based access to the summary record in general practice through a personal health record (PHR) may increase patients’ insight into their medical conditions and help them to be involved in their care. Objective We describe the protocol that we will use to investigate the utilization of patients’ digital access to the summary of their medical records in general practice through a PHR and its effects on the involvement of patients in their care. Methods We will conduct a multilevel mixed-methods study in which the PHR and Web-based access to the summary record will be offered for 6 months to a random sample of 500 polypharmacy patients, 500 parents of children aged <4 years, and 500 adults who do not belong to the former two groups. At the patient level, a controlled before-after study will be conducted using surveys, and concurrently, qualitative data will be collected from focus group discussions, think-aloud observations, and semistructured interviews. At the general practice staff (GP staff) level, focus group discussions will be conducted at baseline and Q-methodology inquiries at the end of the study period. The primary outcomes at the patient level are barriers and facilitators for using the PHR and summary records and changes in taking an active role in decision making and care management and medication adherence. Outcomes at the GP staff level are attitudes before and opinions after the implementation of the intervention. Patient characteristics and changes in outcomes related to patient involvement during the study period will be compared between the users and nonusers of the intervention using chi-square tests and t tests. A thematic content analysis of the qualitative data will be performed, and the results will be used to interpret quantitative findings. Results Enrollment was completed in May 2017 and the possibility to view GP records through the PHR was implemented in December 2017. Data analysis is currently underway and the first results are expected to be submitted for publication in autumn 2019. Conclusions We expect that the findings of this study will be useful to health care providers and health care organizations that consider introducing the use of PHR and Web-based access to records and to those who have recently started using these. Trial Registration Netherlands Trial Registry NTR6395; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6395 (Archived by WebCite at http://www.webcitation.org/71nc8jzwM) Registered Report Identifier RR1-10.2196/10193

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Web‐based Resources for Health Care Providers and Women Following Pregnancy Loss

Journal of Obstetric Gynecologic & Neonatal Nursing ◽

10.1111/j.1552-6909.2006.00065.x ◽

2006 ◽

Vol 35 (4) ◽

pp. 523-532 ◽

Cited By ~ 18

Author(s):

Pamela A. Geller ◽

Christina Psaros ◽

Danielle Kerns

Keyword(s):

Health Care ◽

Health Care Providers ◽

Pregnancy Loss ◽

Care Providers ◽

Web Based

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Health care providers’ attitudes towards transfer and transition in young persons with long term illness- a web-based survey

BMC Health Services Research ◽

10.1186/s12913-017-2192-5 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 7

Author(s):

Carina Sparud-Lundin ◽

Malin Berghammer ◽

Philip Moons ◽

Ewa-Lena Bratt

Keyword(s):

Health Care ◽

Health Care Providers ◽

Care Providers ◽

Web Based

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Multilingual Global E-Learning Pediatric Endocrinology and Diabetes Curriculum for Front Line Health Care Providers in Resource-Limited Countries: Development Study

JMIR Formative Research ◽

10.2196/18555 ◽

2020 ◽

Vol 4 (11) ◽

pp. e18555

Author(s):

Evangelia Kalaitzoglou ◽

Edna Majaliwa ◽

Margaret Zacharin ◽

Carine de Beaufort ◽

Jean-Pierre Chanoine ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

Health Workers ◽

Low Cost ◽

Care Providers ◽

Pediatric Endocrinology ◽

Web Based ◽

Learning Module ◽

Resource Limited ◽

E Learning

Background Electronic learning (e-learning) is a widely accessible, low-cost option for learning remotely in various settings that allows interaction between an instructor and a learner. Objective We describe the development of a free and globally accessible multilingual e-learning module that provides education material on topics in pediatric endocrinology and diabetes and that is intended for first-line physicians and health workers but also trainees or medical specialists in resource-limited countries. Methods As complements to concise chapters, interactive vignettes were constructed, exemplifying clinical issues and pitfalls, with specific attention to the 3 levels of medical health care in resource-limited countries. The module is part of a large e-learning portal, ESPE e-learning, which is based on ILIAS (Integriertes Lern-, Informations- und Arbeitskooperations-System), an open-source web-based learning management system. Following a review by global experts, the content was translated by native French, Spanish, Swahili, and Chinese–speaking colleagues into their respective languages using a commercial web-based translation tool (SDL Trados Studio). Results Preliminary data suggest that the module is well received, particularly in targeted parts of the world and that active promotion to inform target users is warranted. Conclusions The e-learning module is a free globally accessible multilingual up-to-date tool for use in resource-limited countries that has been utilized thus far with success. Widespread use will require dissemination of the tool on a global scale.

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Measuring research mistrust in adolescents and adults: Validity and reliability of an adapted version of the Group-Based Medical Mistrust Scale

PLoS ONE ◽

10.1371/journal.pone.0245783 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245783

Author(s):

Amelia S. Knopf ◽

Peter Krombach ◽

Amy J. Katz ◽

Rebecca Baker ◽

Gregory Zimet

Keyword(s):

Health Care ◽

Ethnic Groups ◽

Health Care Providers ◽

Summary Score ◽

Medical Mistrust ◽

Care Providers ◽

Validity And Reliability ◽

Internal Reliability ◽

Web Based ◽

Adolescents And Adults

Mistrust of health care providers among persons of color is a significant barrier to engaging them in research studies. Underrepresentation of persons of color is particularly problematic when the health problem under study disproportionately affects minoritized communities. The purpose of this study was to test the validity and reliability of an abbreviated and adapted version of the Group Based Medical Mistrust Scale. The GBMMS is a 12-item scale with three subscales that assess suspicion, experiences of discrimination, and lack of support in the health care setting. To adapt for use in the research setting, we shortened the scale to six items, and replaced “health care workers” and “health care” with “medical researchers” and “medical research,” respectively. Using panelists from a market research firm, we recruited and enrolled a racially and ethnically diverse sample of American adults (N = 365) and adolescents aged 14–17 (N = 250). We administered the adapted scale in a web-based survey. We used Cronbach’s alpha to evaluate measure internal reliability of the scale and external factor analysis to evaluate the relationships between the revised scale items. Five of the six items loaded onto a single factor, with (α = 0.917) for adolescents and (α = 0.912) for adults. Mean scores for each item ranged from 2.5–2.9, and the mean summary score (range 6–25) was 13.3 for adults and 13.1 for adolescents. Among adults, Black respondents had significantly higher mean summary scores compared to whites and those in other racia/ethnic groups (p<0.001). There was a trend toward significance for Black adolescents as compared to white respondents and those in other racial/ethnic groups (p = 0.09). This five-item modified version of the GBMMS is reliable and valid for measuring research mistrust with American adults and adolescents of diverse racial and ethnic identities.

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Development of a qualitative real-time RT-PCR assay for the detection of SARS-CoV-2: A guide and case study in setting up an emergency-use, laboratory-developed molecular assay

10.1101/2020.08.26.20157297 ◽

2020 ◽

Cited By ~ 1

Author(s):

Melis N. Anahtar ◽

Bennett Shaw ◽

Damien Slater ◽

Elizabeth H Byrne ◽

Yolanda Botti-Lodovico ◽

...

Keyword(s):

Nucleic Acid ◽

Health Care Providers ◽

Diagnostic Testing ◽

Care Providers ◽

Effective Response ◽

Diagnostic Assays ◽

Health Authorities ◽

Public Health Authorities ◽

Set Up ◽

Crisis Conditions

Developing and deploying new diagnostic tests is difficult, but the need to do so in response to a rapidly emerging pandemic such as COVID-19 is crucially important for an effective response. In the early stages of a pandemic, laboratories play a key role in helping health care providers and public health authorities detect active infection, a task most commonly achieved using nucleic acid-based assays. While the landscape of diagnostics is rapidly evolving, polymerase chain reaction (PCR) remains the gold-standard of nucleic acid-based diagnostic assays, in part due to its reliability, flexibility, and wide deployment. To address a critical local shortage of testing capacity persisting during the COVID-19 outbreak, our hospital set up a molecular based laboratory developed test (LDT) to accurately and safely diagnose SARS-CoV-2. We describe here the process of developing an emergency-use LDT, in the hope that our experience will be useful to other laboratories in future outbreaks and will help to lower barriers to fast and accurate diagnostic testing in crisis conditions.

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