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Simulation Training in Early Emergency Response (STEER).
This study aimed to test a simulation curriculum based on institutional priorities using high-intensity, short-duration, frequent in situ content delivery based on deliberate practice. The study design was a prospective, single-center, mixed-methods quasi-experimental study. Scenarios used in this study were ventricular fibrillation, opiate-related respiratory depression, syncopal fall, and hemorrhagic stroke. The convenience sample included 41 teams (147 participants). Improvements were noted in initiating chest compressions (p = .018), time to check blood glucose (p = .046), and identification of heparin as a contributor...
Source: Journal of Continuing Education in Nursing - May 29, 2016 Category: Nursing Authors: Generoso JR, Latoures RE, Acar Y, Miller DS, Ciano M, Sandrei R, Vieira M, Luong S, Hirsch J, Fidler RL Tags: J Contin Educ Nurs Source Type: research

Journal Club: Time trends in incidence, case fatality, and mortality of intracerebral hemorrhage
Intracerebral hemorrhage (ICH) remains one of the most catastrophic stroke subtypes, with high case-fatality rate and poor functional outcomes. In the Journal Club article "Time trends in incidence, case fatality, and mortality of intracerebral hemorrhage" by Jolink et al.,1 hospital and population registries were used to assess age- and sex-specific trends in incidence and case fatality of patients with ICH in the Netherlands. The study provides a significant epidemiologic contribution examining a large cohort of patients with ICH from 1980 to 2010. The authors report a decline in incidence, case-fatality, and mortality r...
Source: Neurology - May 15, 2016 Category: Neurology Authors: Charidimou, A., Morotti, A., Valenti, R., Giese, A.-K., Boulouis, G., Pasi, M., Roongpiboonsopit, D., Lauer, A., Xiong, L., Van Harten, T. W., Karadeli, H., Fotiadis, P., Jessel, M. J., Viswanathan, A. Tags: All Cerebrovascular disease/Stroke, All Education, Intracerebral hemorrhage RESIDENT AND FELLOW SECTION Source Type: research

Long-term outcome after cerebral venous thrombosis: analysis of functional and vocational outcome, residual symptoms, and adverse events in 161 patients
Abstract Cerebral venous thrombosis (CVT) affects mainly working-aged individuals. Functional recovery after CVT is generally considered good with about 3/4 of patients achieving short-term independence. However, vascular events, long-term functional outcome, and employment after CVT remain poorly investigated. We identified consecutive adult CVT patients treated at the Helsinki University Hospital (1987–2013) and invited them to a follow-up visit. Each clinical examination was combined with interview. We also recorded recurrent venous thromboembolism (VTE) and hemorrhagic events during follow-up and antithrombo...
Source: Journal of Neurology - January 2, 2016 Category: Neurology Source Type: research

Influence of neurologists’ experience on the outcome of patients treated by intravenous thrombolysis for cerebral ischaemia
Abstract Intravenous (i.v.) recombinant tissue plasminogen activator (rt-PA) should be available on a 24/7 basis in hospitals admitting patients with stroke. We aimed at evaluating the influence of the number of patients previously treated with i.v. rt-PA by neurologists on patients’ outcome. For each patient consecutively treated with i.v. rt-PA for cerebral ischaemia at the Lille University Hospital, we determined the number of previous treatments with rt-PA administered by the neurologist. We performed logistic regression analyses to determine the influence of the experience on the outcome evaluated by th...
Source: Journal of Neurology - March 5, 2015 Category: Neurology Source Type: research

Risk Factors Assessed in Adolescence and the Later Risk of Stroke in Men: A 33-Year Follow-Up Study
Background: Stroke is a common cause of death, and a leading contributor to long-term disability. The cost associated with the disease is great. Several modifiable risk factors for stroke have been found in older cohorts; however, no study to date has investigated the effects of these risk factors from late adolescence. Methods: The study cohort comprised 811,579 Swedish men (mean age, 18 years) that participated in the mandatory military conscription service in Sweden between 1969 and 1986. Some risk factors for stroke, such as body mass index, systolic and diastolic blood pressure, and cognitive function, were assessed a...
Source: Cerebrovascular Diseases - December 23, 2014 Category: Neurology Source Type: research

Aspirin risks in perspective: A comparison against marathon running
Aspirin has public health potential to reduce the risk of ischaemic vascular events and sporadic cancer. One objection to the wider use of aspirin for primary prevention, however, is the undesirable effects of the medicine, which include increasing risk of bleeding and haemorrhagic stroke. Marathons also carry risks of serious events such as cardiac arrests and sudden death. Based on epidemiological estimates, a person running a marathon might be 20 to 100 times more likely to end up in hospital than a person who is taking an aspirin tablet. Yet the cumulative risk of daily aspirin use for primary prophylaxis may be import...
Source: Health Education Journal - June 10, 2014 Category: Health Management Authors: Morgan, G. Tags: Short Report Source Type: research

The Impact of Comprehensive Stroke Care Capacity on the Hospital Volume of Stroke Interventions: A Nationwide Study in Japan: J-ASPECT Study
We examined the effect of hospital characteristics, having a t-PA protocol, and the number of fulfilled CSC items (total CSC score) on the hospital volume of t-PA infusion, removal of intracerebral hemorrhage, and coiling and clipping of intracranial aneurysms performed in 2009.Results: Approximately 55% of hospitals responded to the survey. Facilities with t-PA protocols (85%) had a significantly higher likelihood of having 23 CSC items, for example, personnel (eg, neurosurgeons: 97.3% versus 66.1% and neurologists: 51.3% versus 27.7%), diagnostic (eg, digital cerebral angiography: 87.4% versus 43.2%), specific expertise...
Source: Journal of Stroke and Cerebrovascular Diseases - October 7, 2013 Category: Neurology Authors: Koji Iihara, Kunihiro Nishimura, Akiko Kada, Jyoji Nakagawara, Kazunori Toyoda, Kuniaki Ogasawara, Junichi Ono, Yoshiaki Shiokawa, Toru Aruga, Shigeru Miyachi, Izumi Nagata, Shinya Matsuda, Koichi B. Ishikawa, Akifumi Suzuki, Hisae Mori, Fumiaki Nakamura, Tags: Original Articles Source Type: research

Determinants of early case‐fatality among stroke patients in Maputo, Mozambique and impact of in‐hospital complications
The burden of stroke is increasing in developing countries that struggle to manage it efficiently. We identified determinants of early case‐fatality among stroke patients in Maputo, Mozambique, to assess the impact of in‐hospital complications. Patients admitted to any hospital in Maputo with a new stroke event were prospectively registered (n = 651) according to the World Health Organization's STEPwise approach, in 2005–2006. We assessed the determinants of in‐hospital and 28‐day fatality, independently of age, gender and education, and computed population attributable fractions. In‐hospital mortality was ...
Source: International Journal of Stroke - January 1, 2013 Category: Neurology Authors: Joana Gomes, Albertino Damasceno, Carla Carrilho, Vitória Lobo, Hélder Lopes, Tavares Madede, Pius Pravinrai, Carla Silva‐Matos, Domingos Diogo, Ana Azevedo, Nuno Lunet Tags: Panorama Source Type: research

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