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Total 26 results found since Jan 2013.

Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-Risk
Introduction Current efforts to reduce dementia focus on prevention and risk reduction by targeting modifiable risk factors. As dementia and cardiometabolic non-communicable diseases (NCDs) share risk factors, a single risk-estimating tool for dementia and multiple NCDs could be cost-effective and facilitate concurrent assessments as compared with a conventional single approach. The aim of this study is to develop and validate a new risk tool that estimates an individual’s risk of developing dementia and other NCDs including diabetes mellitus, stroke and myocardial infarction. Once validated, it could be used by the ...
Source: BMJ Open - September 22, 2023 Category: General Medicine Authors: Kootar, S., Huque, M. H., Kiely, K. M., Anderson, C. S., Jorm, L., Kivipelto, M., Lautenschlager, N. T., Matthews, F., Shaw, J. E., Whitmer, R. A., Peters, R., Anstey, K. J. Tags: Open access, Public health Source Type: research

Acupuncture for gait disturbance of patients with subacute and chronic stroke: a systematic review and meta-analysis protocol
Introduction Hemiparetic gait is one of the most common sequelae of a stroke. Acupuncture has shown potential in correcting hemiplegic gait patterns and improving motor function recovery after stroke. However, controversial findings and a lack of supportive evidence on the effectiveness of acupuncture for post-stroke hemiplegia. The intelligent gait analysis system provides a new perspective for the study of hemiparetic gait. This systematic review aims to collect relevant studies and critically evaluate the efficacy and safety of acupuncture in alleviating gait disturbance of post-stroke hemiplegia based on quantified gai...
Source: BMJ Open - June 21, 2023 Category: General Medicine Authors: Sun, Z., Lin, Y.-r., Lu, M.-j., Huang, K.-y., Sun, K., Zhang, J.-b. Tags: Open access, Rehabilitation medicine Source Type: research

Primary healthcare needs and service utilisation of people with disability: a data linkage protocol
Introduction General practitioners (GPs) play a crucial role in the early management and treatment of the comorbidities and complications experienced by people with disability. However, GPs experience multiple constraints, including limited time and disability-related expertise. Knowledge gaps around the health needs of people with disability as well as the frequency and extent of their engagement with GPs mean evidence to inform practice is limited. Using a linked dataset, this project aims to enhance the knowledge of the GP workforce by describing the health needs of people with disability. Methods and analysis This pro...
Source: BMJ Open - April 19, 2023 Category: General Medicine Authors: Douglas, J., Winkler, D., McLeod, A., Oliver, S., Gardner, K., Supple, J., Pearce, C. Tags: Open access, Health services research Source Type: research

Statins for extension of disability-free survival and primary prevention of cardiovascular events among older people: protocol for a randomised controlled trial in primary care (STAREE trial)
Introduction The world is undergoing a demographic transition to an older population. Preventive healthcare has reduced the burden of chronic illness at younger ages but there is limited evidence that these advances can improve health at older ages. Statins are one class of drug with the potential to prevent or delay the onset of several causes of incapacity in older age, particularly major cardiovascular disease (CVD). This paper presents the protocol for the STAtins in Reducing Events in the Elderly (STAREE) trial, a randomised double-blind placebo-controlled trial examining the effects of statins in community dwelling o...
Source: BMJ Open - April 3, 2023 Category: General Medicine Authors: Zoungas, S., Curtis, A., Spark, S., Wolfe, R., McNeil, J. J., Beilin, L., Chong, T. T.-J., Cloud, G., Hopper, I., Kost, A., Nelson, M., Nicholls, S. J., Reid, C. M., Ryan, J., Tonkin, A., Ward, S. A., Wierzbicki, A., On behalf of STAREE investigator group Tags: Open access, Cardiovascular medicine Source Type: research

Promoting adherence to stroke secondary prevention behaviours by imparting behaviour change skills: protocol for a single-arm pilot trial of Living Well After Stroke
Introduction Survivors of stroke have an elevated risk of recurrent stroke. Prompt intervention to support healthy lifestyle modification following an initial stroke is crucial for effective secondary prevention of stroke. However, many patients do not receive adequate postdischarge support for secondary prevention, particularly if not referred to inpatient rehabilitation. Living Well After Stroke is a health promotion programme based on the health action process approach (HAPA), which is designed to support this underserviced group to improve and self-manage secondary prevention behavioural performance (eg, diet, exercise...
Source: BMJ Open - January 24, 2023 Category: General Medicine Authors: Smith, S., Parkinson, J., Caitens, T., Sanders, A., Murphy, L., Hamilton, K. Tags: Open access, Public health Source Type: research

TACTICS - Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship: evaluating the effectiveness of an 'implementation intervention' in providing better patient access to reperfusion therapies: protocol for a non-randomised controlled stepped wedge cluster trial in acute stroke
BMJ Open. 2022 Feb 11;12(2):e055461. doi: 10.1136/bmjopen-2021-055461.ABSTRACTINTRODUCTION: Stroke reperfusion therapies, comprising intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT), are best practice treatments for eligible acute ischemic stroke patients. In Australia, EVT is provided at few, mainly metropolitan, comprehensive stroke centres (CSC). There are significant challenges for Australia's rural and remote populations in accessing EVT, but improved access can be facilitated by a 'drip and ship' approach. TACTICS (Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship) aim...
Source: Rural Remote Health - February 12, 2022 Category: Rural Health Authors: Annika Ryan Christine L Paul Martine Cox Olivia Whalen Andrew Bivard John Attia Christopher Bladin Stephen M Davis Bruce C V Campbell Mark Parsons Rohan S Grimley Craig Anderson Geoffrey A Donnan Christopher Oldmeadow Sarah Kuhle Frederick R Walker Rebecc Source Type: research

TACTICS - Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship: evaluating the effectiveness of an 'implementation intervention in providing better patient access to reperfusion therapies: protocol for a non-randomised controlled stepped wedge cluster trial in acute stroke
Introduction Stroke reperfusion therapies, comprising intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT), are best practice treatments for eligible acute ischemic stroke patients. In Australia, EVT is provided at few, mainly metropolitan, comprehensive stroke centres (CSC). There are significant challenges for Australia’s rural and remote populations in accessing EVT, but improved access can be facilitated by a ‘drip and ship’ approach. TACTICS (Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship) aims to test whether a multicomponent, multidisciplinary impleme...
Source: BMJ Open - February 11, 2022 Category: General Medicine Authors: Ryan, A., Paul, C. L., Cox, M., Whalen, O., Bivard, A., Attia, J., Bladin, C., Davis, S. M., Campbell, B. C. V., Parsons, M., Grimley, R. S., Anderson, C., Donnan, G. A., Oldmeadow, C., Kuhle, S., Walker, F. R., Hood, R. J., Maltby, S., Keynes, A., Delcou Tags: Open access, Health services research Source Type: research

Patient-Led Mass Screening for Atrial Fibrillation in the Older Population Using Handheld Electrocardiographic Devices Integrated With a Clinician-Coordinated Remote Central Monitoring System: Protocol for a Randomized Controlled Trial and Process Evaluation
CONCLUSIONS: By incorporating an integrated health care approach involving patient empowerment, centralized clinician-coordinated ECG monitoring, and facilitation of primary care and specialist services, it is possible to diagnose and treat AF early to reduce stroke risk. This study will provide new information on how to implement AF screening using digital health technology practicably and feasibly for older and frail populations residing in the community.TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12621000184875; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380877.INTERNAT...
Source: Rural Remote Health - February 1, 2022 Category: Rural Health Authors: Kam Cheong Wong Tu N Nguyen Simone Marschner Samual Turnbull Mason Jenner Burns Jia Yi Anna Ne Vishal Gopal Anupama Balasuriya Indrawansa Steven A Trankle Tim Usherwood Saurabh Kumar Richard I Lindley Clara K Chow Source Type: research

Using experience-based codesign to coproduce aphasia rehabilitation services: study protocol
We present a protocol for the development of coproduced aphasia service elements. We will use experience-based codesign (EBCD), an approach that enables service users and providers to collaboratively develop services and care pathways. Drawing on the experiences of people with aphasia, their families and clinicians we will establish priorities for the development of new services and later work together to codesign them. Methods and analysis This research will be coproduced with people with aphasia (n=30–60), their families (n=30–60) and speech pathologists (n=30–60) in Queensland, Australia, using EBCD. ...
Source: BMJ Open - November 18, 2021 Category: General Medicine Authors: Anemaat, L., Palmer, V. J., Copland, D. A., Mainstone, K., Druery, K., Druery, J., Aisthorpe, B., Binge, G., Mainstone, P., Wallace, S. J. Tags: Open access, Rehabilitation medicine Source Type: research

Healing Right Way: study protocol for a stepped wedge cluster randomised controlled trial to enhance rehabilitation services and improve quality of life in Aboriginal Australians after brain injury
This study will test the impact of a research-informed culturally secure intervention model for Aboriginal people with brain injury. Methods and analysis Design: Stepped wedge cluster randomised control trial design; intervention sequentially introduced at four pairs of healthcare sites across Western Australia at 26-week intervals. Recruitment: Aboriginal participants aged ≥18 years within 4 weeks of an acute stroke or traumatic brain injury. Intervention: (1) Cultural security training for hospital staff and (2) local, trial-specific, Aboriginal Brain Injury Coordinators supporting participants. Primary outcome: Qual...
Source: BMJ Open - September 28, 2021 Category: General Medicine Authors: Armstrong, E., Coffin, J., Hersh, D., Katzenellenbogen, J. M., Thompson, S., Flicker, L., McAllister, M., Cadilhac, D. A., Rai, T., Godecke, E., Hayward, C., Hankey, G. J., Drew, N., Lin, I., Woods, D., Ciccone, N. Tags: Open access, Health services research Source Type: research

"Everyone needs rehab, but …": exploring post-stroke rehabilitation referral and acceptance decisions
CONCLUSIONS: Post-stroke rehabilitation decision making in Queensland, Australia involves complex processes and compromise. Decisions are not based solely on patients' rehabilitation needs, and patients and families are not actively involved in the decision-making process. Mechanisms are required to streamline access procedures, and improve shared decision making with patients.IMPLICATIONS FOR REHABILITATIONReferral decision making for post-stroke rehabilitation is complex and not always based solely on patients' needs.Clear and straightforward access procedures and positive relationships between acute and rehabilitation c...
Source: Disability and Rehabilitation - May 11, 2021 Category: Rehabilitation Authors: Kerry Marnane Louise Gustafsson Sally Bennett Ingrid Rosbergen Rohan Grimley Source Type: research