System-integrated technology-enabled model of care to improve the health of stroke patients in rural China: protocol for SINEMA--a cluster-randomized controlled trial

This study aims to develop a system-integrated technology-enabled intervention model of care (SINEMA) for the secondary prevention of stroke in rural China and to evaluate the effectiveness of the model compared with usual care.MethodsThe SINEMA model is being implemented and evaluated through a one-year cluster-randomized controlled trial in Nanhe County, Hebei Province in China. Fifty villages from five townships are randomized in a 1:1 ratio to either the intervention or the control arm (usual care) with a target to enroll 25 stroke survivors per village. Village doctors in the intervention arm 1) receive systematic cascade training by stroke specialists on clinical guidelines, essential medicines and behavior change; 2) conduct monthly follow-up visits with the support of a mobile phone application designed for this study; 3) participate in virtual group activities with other village doctors; 4) receive performance feedback and payment. Stroke survivors participate in a health education and project briefing session, receive monthly follow-up visits by village doctors and receive a voice message call daily as reminders for medication use and physical activities. Baseline and one-year follow-up survey will be conducted in all villages by trained staff who are blinded of the randomized allocation of villages. The primary outcome will be systolic blood pressure and the secondary outcomes will include medication adherence, mobility, physical activity level and quality of life....
Source: American Heart Journal - Category: Cardiology Source Type: research

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Drinking alcohol causes damage to your health in both the short term and long term, even for moderate drinkers. For individuals who suffer from addiction to alcohol and frequently drink in excess, these risks become higher. Knowing the risks of drinking alcohol is important to help avoid drinking to excess and reduce the likelihood of these risks. Short-Term Risks of Drinking Alcohol There are many short-term risks that occur when drinking alcohol. These risks can happen to anyone, including individuals suffering from alcohol use disorder, or individuals who are drinking for the very first time. Injuries When you drink al...
Source: Cliffside Malibu - Category: Addiction Authors: Tags: Alcoholism alcohol abuse alcohol dependence alcohol dependency alcohol detox alcohol treatment alcohol treatment center alcohol treatment facility alcohol use risks Source Type: blogs
Discussion From Beth Israel Deaconess Medical Center. Ann Intern Med. 2019 Dec 03;171(11):828-836 Authors: Burns RB, Zimetbaum P, Lubitz SA, Smetana GW Abstract Atrial fibrillation (AFib) is the most common type of cardiac arrhythmia, affecting 2.7 million to 6.1 million persons in the United States. Although some persons with AFib have no symptoms, others do. For those without symptoms, AFib may be detected by 12-lead electrocardiogram (ECG), single-lead monitors (such as ambulatory blood pressure monitors and pulse oximeters), or consumer devices (such as wearable monitors and smartphones). Pulse pa...
Source: Annals of Internal Medicine - Category: Internal Medicine Authors: Tags: Ann Intern Med Source Type: research
This study aims to investigate the indications, findings and outcomes of neuroimaging studies performed for burn injured patients.MethodsA retrospective case series study of adult burn patients admitted over an 8 year period was completed in the National Burns Centre at St James’s Hospital, Dublin. Neuroimaging studies carried out for patients admitted during the study period were reviewed by a Consultant Radiologist and Consultant Stroke Physician. Outcomes included neuroimaging findings, prevalence of white matter disease (Fazekas scale), length of stay, discharge destination, predicted and observed mortalit...
Source: Burns - Category: Dermatology Source Type: research
Photo credit Melanie Wasser Dear Carol: My mother developed vascular dementia, personality issues, and speech problems after a stroke three years ago. She lives with me, and because of her difficult personality, my daughter no longer wants to bring my grandchildren here to visit. I retired early to care for Mom, but now I feel trapped. Nothing I do for her is right. I’ve suggested that she might have a better life if she moved to assisted living and, surprisingly, she isn’t resistant — though I know she’ll complain about them, too, if she moves. My sisters live out of the area, so they are limi...
Source: Minding Our Elders - Category: Geriatrics Authors: Source Type: blogs
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Source: Ethnicity and Health - Category: International Medicine & Public Health Authors: Source Type: research
A new blood filtration technology may prove to be life-saving for patients whose normally healthy inflammatory response to injury or illness has gone into overdrive, resulting in fatally high levels of cytokines in their blood. In an interview with MD+DI, Dr. Phillip Chan, MD, PhD, CEO of CytoSorbents Corp., explained that inflammation, and the production of substances called cytokines that drive inflammation, are the body’s natural response to heal injury or infection. But sometimes, the inflammatory response is so severe in such conditions as sepsis and infection, burn injuries, trauma, pancreatitis, li...
Source: MDDI - Category: Medical Devices Authors: Tags: Cardiovascular Source Type: news
From SWOLF through EDA until heart rate, heart rate variability, respiratory rate, single-lead ECG, period tracking, sleep pattern analyzing: dozens of vital signs demonstrate that there’s no single square centimeter of the human body without quantifiable data. As an experiment, we tried to collect every trackable parameter to draw the boundaries of your “health data self”. Let us know if there’s anything left out. Why is measurement useful? To know thyself The famous ancient Greek aphorism was inscribed on a wall in the Temple of Apollo at Delphi, the oracle, which was believed to tell human...
Source: The Medical Futurist - Category: Information Technology Authors: Tags: Health Sensors & Trackers Personalized Medicine Portable Diagnostics activity blood body brain breathing data fitness health data heart health heart rate lifestyle lung measure measurement meditation quantified self s Source Type: blogs
Every day between countless mouse clicks and key strokes, I evaluate and treat patients, and teach residents and fellows how to do the same. The clinical and patient care activities make it well worth the long hours spent at the office and hospital, the on-call weeks, and the highly anxious patients and families that make decisions and carry out interventions based on my advice. Thankfully I have an excellent team of residents and fellows, and dedicated office and hospital staff personnel who help me maintain a heated pace throughout the day.
Source: Journal of Foot and Ankle Surgery - Category: Orthopaedics Authors: Tags: Editorial Source Type: research
Dear Candid Caregiver: My mom passed two years ago and my dad hasn’t done well since. Recently he had a stroke. My sister, who lives 1,000 miles away, came out for mom’s funeral, and she also visited for a few days after dad’s stroke, but she has a job and a family and couldn’t stay long. Now, dad’s been diagnosed with vascular dementia. Realistically, I’m the sole caregiver. I have two teenaged children, a husband who is, so far, supportive, and a job. I’m already beginning to feel burned out after just a few months.  Read the full article on HealthCentral to learn more ...
Source: Minding Our Elders - Category: Geriatrics Authors: Source Type: blogs
ConclusionsThis review summarizes the results from current studies of I. pubescens, which is one of the valuable medicinal sources from traditional herbs. Some conventional uses have been evaluated by pharmacological investigation. In addition, unresolved issues include molecular mechanisms underlying bioactivities, pharmacokinetics, toxicology and efficacy, which are still being studied and explored before achieving integration into clinical medicines.
Source: Journal of Ethnopharmacology - Category: Drugs & Pharmacology Source Type: research
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