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Total 201 results found since Jan 2013.

The Taking Charge After Stroke (TaCAS) study protocol: a multicentre, investigator-blinded, randomised controlled trial comparing the effect of a single Take Charge session, two Take Charge sessions and control intervention on health-related quality of life 12 months after stroke for non-Maori, non-Pacific adult New Zealanders discharged to community living
Introduction Stroke is one of the leading causes of disability worldwide. Recent data support the possibility that person-centred, self-management interventions can reduce dependence after stroke. However, there is limited information on the generalisability and optimum dose of these interventions. Methods The Taking Charge After Stroke (TaCAS) study is a multicentre, investigator-blinded, randomised controlled trial recruiting 400 participants following acute stroke from seven hospitals in New Zealand. All patients discharged to community living who have ongoing symptoms at time of discharge (modified Rankin scale>0) ...
Source: BMJ Open - June 1, 2017 Category: General Medicine Authors: Fu, V. W. Y., Weatherall, M., McNaughton, H. Tags: Open access, Rehabilitation medicine Protocol Source Type: research

The association between human herpesvirus infections and stroke: a systematic review protocol
Introduction After primary infection, human herpesviruses establish latency and persist lifelong. Periodic virus reactivation can lead to serious inflammatory complications. Recent research suggests that herpesvirus reactivation may also be linked to acute stroke. An improved understanding of this relationship is vital to inform public health prevention strategies. We will review the evidence regarding the role of human herpesviruses in triggering stroke. Methods and analysis A systematic literature review of published and grey literature studies with a human herpesvirus (infection or reactivation) as an exposure and stro...
Source: BMJ Open - May 29, 2017 Category: General Medicine Authors: Forbes, H. J., Benjamin, L., Breuer, J., Brown, M. M., Langan, S. M., Minassian, C., Smeeth, L., Thomas, S. L., Warren-Gash, C. Tags: Open access, Epidemiology Protocol Source Type: research

1 The use and impact of 12-lead electrocardiograms in acute stroke patients: a systematic review
Conclusion Future studies should be based in the prehospital environment and should investigate whether undertaking an electrocardiogram in the prehospital setting affects clinical management decisions or has an association with mortality or morbidity. Conflict of interest None declared Funding This work was supported by School of Health Sciences PhD bursary – University of Surrey, and South East Coast Ambulance Service NHS Foundation Trust.
Source: BMJ Open - May 21, 2017 Category: General Medicine Authors: Munro, S., Quinn, T., Cooke, D., Joy, M. Source Type: research

Barriers to evidence-based acute stroke care in Ghana: a qualitative study on the perspectives of stroke care professionals
Conclusion Barriers from low/middle-income countries differ substantially from those in high-income countries. For evidence-based acute stroke care in low/middle-income countries such as Ghana, health policy-makers and hospital managers need to consider the contrasts and uniqueness in these barriers in designing quality improvement interventions to optimise patient outcomes.
Source: BMJ Open - April 27, 2017 Category: Journals (General) Authors: Baatiema, L., de-Graft Aikins, A., Sav, A., Mnatzaganian, G., Chan, C. K. Y., Somerset, S. Tags: Research Source Type: research

Long-term use benefits of personal frequency-modulated systems for speech in noise perception in patients with stroke with auditory processing deficits: a non-randomised controlled trial study
Conclusions 10-week use of FMs by adult patients with stroke may lead to benefits in unaided speech in noise perception. Our findings may indicate auditory plasticity type changes and require further investigation. Trial registration number Pre-results; NCT02889107.
Source: BMJ Open - April 7, 2017 Category: Journals (General) Authors: Koohi, N., Vickers, D., Warren, J., Werring, D., Bamiou, D.-E. Tags: Open access, Ear, nose and throat/otolaryngology, Neurology Research Source Type: research

How is rehabilitation with and without an integrated self-management approach perceived by UK community-dwelling stroke survivors? A qualitative process evaluation to explore implementation and contextual variations
Conclusions The findings reflect our theoretical assumptions and possible mechanisms of implementation that rehabilitation with a focus on supporting self-management is reflected in accounts and understandings of stroke survivors. Taken together with our previous research this justifies evaluating the effectiveness of Bridges SMP in a larger sample to further contribute to an understanding of the functioning of the intervention, implementation, contextual factors and mechanisms of impact. Trial registration number ISRCTN42534180; Post-results.
Source: BMJ Open - April 3, 2017 Category: Journals (General) Authors: Jones, F., McKevitt, C., Riazi, A., Liston, M. Tags: Open access, Neurology, Patient-centred medicine, Qualitative research, Rehabilitation medicine Source Type: research

Secondary prevention and cognitive function after stroke: a study protocol for a 5-year follow-up of the ASPIRE-S cohort
Introduction Cognitive impairment is common following stroke and can increase disability and levels of dependency of patients, potentially leading to greater burden on carers and the healthcare system. Effective cardiovascular risk factor control through secondary preventive medications may reduce the risk of cognitive decline. However, adherence to medications is often poor and can be adversely affected by cognitive deficits. Suboptimal medication adherence negatively impacts secondary prevention targets, increasing the risk of recurrent stroke and further cognitive decline. The aim of this study is to profile cognitive f...
Source: BMJ Open - March 27, 2017 Category: Journals (General) Authors: Rohde, D., Williams, D., Gaynor, E., Bennett, K., Dolan, E., Callaly, E., Large, M., Hickey, A. Tags: Open access, Cardiovascular medicine, Epidemiology Protocol Source Type: research

Towards personalised intra-arterial treatment of patients with acute ischaemic stroke: a study protocol for development and validation of a clinical decision aid
Introduction Overall, intra-arterial treatment (IAT) proved to be beneficial in patients with acute ischaemic stroke due to a proximal occlusion in the anterior circulation. However, heterogeneity in treatment benefit may be relevant for personalised clinical decision-making. Our aim is to improve selection of patients for IAT by predicting individual treatment benefit or harm. Methods and analysis We will use data collected in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) trial to analyse the effect of baseline characteristics on outcome and tr...
Source: BMJ Open - March 22, 2017 Category: Journals (General) Authors: Mulder, M. J. H. L., Venema, E., Roozenbeek, B., Broderick, J. P., Yeatts, S. D., Khatri, P., Berkhemer, O. A., Roos, Y. B. W. E. M., Majoie, C. B. L. M., van Oostenbrugge, R. J., van Zwam, W. H., van der Lugt, A., Steyerberg, E. W., Dippel, D. W. J., Lin Tags: Open access, Neurology, Radiology and imaging Protocol Source Type: research

Exploring stroke survivors' and physiotherapists' views of self-management after stroke: a qualitative study in the UK
Conclusions If self-management support approaches are to be used, further work is required to explore the language and strategies used by professionals to support self-management, and the barriers to supporting self-management at different time points after stroke.
Source: BMJ Open - March 10, 2017 Category: Journals (General) Authors: Sadler, E., Wolfe, C. D. A., Jones, F., McKevitt, C. Tags: Open access, Health services research, Qualitative research Source Type: research

Measurement properties of self-report physical activity assessment tools in stroke: a protocol for a systematic review
Discussion This systematic review will provide an extensive review of the measurement properties and clinical utility of self-report physical activity assessment tools used in individuals with stroke, which would benefit clinicians and researchers. Trial registration number PROSPERO CRD42016037146.
Source: BMJ Open - February 13, 2017 Category: Journals (General) Authors: Martins, J. C., Aguiar, L. T., Nadeau, S., Scianni, A. A., Teixeira-Salmela, L. F., Faria, C. D. C. d. M. Tags: Open access, Neurology, Rehabilitation medicine Protocol Source Type: research

144: the physiological information role for stroke patients
Conclusion: Each patient should be individually assessed on his or her readiness to receive information. Healthcare professionals should take a patient's age, gender, educational status and communication support needs into account when assessing their need for information. Information should be offered to patients in a variety of formats, including easy access and repeated and re-offered at appropriate intervals.
Source: BMJ Open - February 8, 2017 Category: Journals (General) Authors: Vahdatpour, T., Pourrasmi-Mamaghani, A. Tags: Open access Poster Source Type: research

154: a pharmacoeconomic evaluation to make decision: is the use of simvastatin 10 mg as an otc medication cost-effective for the primary prevention of stroke amongst women in iran?
Conclusion: In Iran no threshold has been determined but the results were compared with the threshold that WHO recommended (GDP per capita for Iran is $5442.9 for 2014 by World Bank). Considering this threshold, the evaluated intervention could be considered cost-effective.
Source: BMJ Open - February 8, 2017 Category: Journals (General) Authors: Amirsadri, M., Dorri, N. Tags: Open access Oral Source Type: research

162: brisbane evidence-based language test, brisbane eblt: a new diagnostic test for the identification of acute post-stroke language disorders
Conclusion: The Brisbane EBLT is a new reliable, valid, acute post-stroke diagnostic language test. Test development has been guided by EBP principles to ensure it meets sound psychometric standards, meets patient and clinician needs and is suitable for use in the acute hospital environment. This research will directly contribute to the evidence-base of acute stroke care and assist in bringing practice in line with stroke clinical guideline recommendations.
Source: BMJ Open - February 8, 2017 Category: Journals (General) Authors: Alexia, R., Linda, W., Robyn, O., Erin, G., Anna, F. Tags: Open access Oral Source Type: research

Erratum: Validity of self-reported myocardial infarction and stroke in regions with Sami and Norwegian populations: the SAMINOR 1 Survey and the CVDNOR project
Eliassen B-M, Melhus M, Tell GS, et al. Validity of self-reported myocardial infarction and stroke in regions with Sami and Norwegian populations: the SAMINOR 1 Survey and the CVDNOR project. BMJ Open 2016;6:e012717. doi:10.1136/bmjopen-2016 012717 The following changes should have been added to this publication before it was published online. In the abstract the sentence ‘16 865 men and women aged 30 and 36–79 years participated in the Population-based Study on Health and Living Conditions in Sami and Norwegian Populations (SAMINOR) 1 Survey in 2003–2004’ should read ‘16 865 men and women age...
Source: BMJ Open - February 7, 2017 Category: Journals (General) Tags: Open access Correction Source Type: research

Efficiency of physical therapy on postural imbalance after stroke: study protocol for a systematic review and meta-analysis
This study will aim at determining the effects of PT on the function (WBA, COP, LOS), the activity (BBS, PASS) and the independence of patients. Subgroup analyses will be planned according to the location of brain lesion (hemispheric, brainstem or cerebellum), the time since stroke (early, late, chronic), the PT (type, main aim (direct effect or generalisation), overall duration), the type of approaches (top-down or bottom-up) and the methodological quality of studies. Ethics and dissemination No ethical statement will be required. The results will be published in a peer-reviewed journal. This meta-analysis aims at managi...
Source: BMJ Open - January 30, 2017 Category: Journals (General) Authors: Hugues, A., Di Marco, J., Janiaud, P., Xue, Y., Pires, J., Khademi, H., Cucherat, M., Bonan, I., Gueyffier, F., Rode, G. Tags: Open access, Evidence based practice, Rehabilitation medicine Protocol Source Type: research

Efficacy of interventions to improve physical activity levels in individuals with stroke: a systematic review protocol
Discussion This systematic review will provide information on which interventions are effective for increasing physical activity levels of stroke survivors. This evidence may be important for clinical decision-making and will allow the identification of gaps in the literature that may be useful for the definition of future research goals and the planning of new trials. Trial registration number CRD42016037750.
Source: BMJ Open - January 5, 2017 Category: Journals (General) Authors: Aguiar, L. T., Martins, J. C., Nadeau, S., Britto, R. R., Teixeira-Salmela, L. F., Faria, C. D. C. M. Tags: Open access, Neurology, Rehabilitation medicine Protocol Source Type: research

Validity of self-reported myocardial infarction and stroke in regions with Sami and Norwegian populations: the SAMINOR 1 Survey and the CVDNOR project
Conclusions The sensitivity and PPV of SMI were high and moderate, respectively; for SRS, both of these measures were moderate. Our results show that SMI from the SAMINOR 1 Survey may be used in aetiological/analytical studies in this population due to a high IHD-specific PPV. The SAMINOR 1 questionnaire may also be used to estimate the prevalence of acute myocardial infarction and acute stroke.
Source: BMJ Open - November 30, 2016 Category: Journals (General) Authors: Eliassen, B.-M., Melhus, M., Tell, G. S., Borch, K. B., Braaten, T., Broderstad, A. R., Graff-Iversen, S. Tags: Open access, Epidemiology, Research methods Source Type: research

Chronic obstructive pulmonary disease and the risk of stroke: a systematic review protocol
Introduction There is good evidence to suggest that chronic obstructive pulmonary disease (COPD) increases the risk of ischaemic heart disease, in particular myocardial infarction (MI). The relationship between stroke and COPD, however, is not as well established, and studies conducted to date have generated conflicting results. Methods and analysis MEDLINE and Embase will be searched for relevant articles using a prespecified search strategy. We will target observational studies conducted in the general population that employ either a longitudinal cohort or case–control study design to estimate ORs, HRs or incident...
Source: BMJ Open - November 29, 2016 Category: Journals (General) Authors: Morgan, A. D., Sharma, C., Rothnie, K. J., Quint, J. K. Tags: Open access, Cardiovascular medicine, Epidemiology, Respiratory medicine Protocol Source Type: research

Efficacy of two injection-site localisation techniques for botulinum toxin injections: a single-blind, crossover, randomised trial protocol among adults with hemiplegia due to stroke
This study received ethics approval form the CPP of Rhônes-Alpes region. Results will be published in a peer-reviewed journal. Trial registration number NCT01935544; pre-results.
Source: BMJ Open - November 15, 2016 Category: Journals (General) Authors: Morel, C., Hauret, I., Andant, N., Bonnin, A., Pereira, B., Coudeyre, E. Tags: Open access, Neurology, Rehabilitation medicine Protocol Source Type: research

Do acute myocardial infarction and stroke mortality vary by distance to hospitals in Switzerland? Results from the Swiss National Cohort Study
Conclusions The increasing AMI mortality with increasing driving time to the nearest university hospital but not to any nearest hospital reflects a complex interplay of many factors along the care pathway.
Source: BMJ Open - November 1, 2016 Category: Journals (General) Authors: Berlin, C., Panczak, R., Hasler, R., Zwahlen, M., for the Swiss National Cohort Study Group Tags: Open access, Emergency medicine, Health services research, Public health Source Type: research

Primary care interventions and current service innovations in modifying long-term outcomes after stroke: a protocol for a scoping review
Introduction Interventions delivered by primary and/or community care have the potential to reach the majority of stroke survivors and carers and offer ongoing support. However, an integrative account emerging from the reviews of interventions addressing specific long-term outcomes after stroke is lacking. The aims of the proposed scoping review are to provide an overview of: (1) primary care and community healthcare interventions by generalist healthcare professionals to stroke survivors and/or their informal carers to address long-term outcomes after stroke, (2) the scope and characteristics of interventions which were s...
Source: BMJ Open - October 24, 2016 Category: Journals (General) Authors: Pindus, D. M., Lim, L., Rundell, A. V., Hobbs, V., Aziz, N. A., Mullis, R., Mant, J. Tags: Open access, Cardiovascular medicine, Health services research Protocol Source Type: research

Community-based Rehabilitation Training after stroke: protocol of a pilot randomised controlled trial (ReTrain)
Introduction The Rehabilitation Training (ReTrain) intervention aims to improve functional mobility, adherence to poststroke exercise guidelines and quality of life for people after stroke. A definitive randomised controlled trial (RCT) is required to assess the clinical and cost-effectiveness of ReTrain, which is based on Action for Rehabilitation from Neurological Injury (ARNI). The purpose of this pilot study is to assess the feasibility of such a definitive trial and inform its design. Methods and analysis A 2-group, assessor-blinded, randomised controlled external pilot trial with parallel mixed-methods process evalu...
Source: BMJ Open - October 3, 2016 Category: Journals (General) Authors: Dean, S. G., Poltawski, L., Forster, A., Taylor, R. S., Spencer, A., James, M., Allison, R., Stevens, S., Norris, M., Shepherd, A. I., Calitri, R. Tags: Open access, Health services research, Rehabilitation medicine, Sports and exercise medicine Protocol Source Type: research

Early real-world evidence of persistence on oral anticoagulants for stroke prevention in non-valvular atrial fibrillation: a cohort study in UK primary care
Conclusions Observed differential prescribing of OACs can result in channelling bias in comparative effectiveness research. Persistence patterns changed over follow-up time, but there are indications of improved persistence rates with apixaban over other OACs in the UK. A larger study with longer follow-up is needed to corroborate findings. This study is registered on ClinicalTrials.gov (NCT02488421).
Source: BMJ Open - September 26, 2016 Category: Journals (General) Authors: Johnson, M. E., Lefevre, C., Collings, S.-L., Evans, D., Kloss, S., Ridha, E., Maguire, A. Tags: Open access, Cardiovascular medicine, Epidemiology, General practice / Family practice Research Source Type: research

Protocol for process evaluation of a randomised controlled trial of family-led rehabilitation post stroke (ATTEND) in India
We describe the protocol for our process evaluation to encourage the development of in-process evaluation methodology and transparency in reporting. Methods and analysis The realist and RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) frameworks informed the design. Mixed methods include semistructured interviews with health providers, patients and their carers, analysis of quantitative process data describing fidelity and dose of intervention, observations of trial set up and implementation, and the analysis of the cost data from the patients and their families perspective and programme budgets. Th...
Source: BMJ Open - September 15, 2016 Category: Journals (General) Authors: Liu, H., Lindley, R., Alim, M., Felix, C., Gandhi, D. B. C., Verma, S. J., Tugnawat, D. K., Syrigapu, A., Ramamurthy, R. K., Pandian, J. D., Walker, M., Forster, A., Anderson, C. S., Langhorne, P., Murthy, G. V. S., Shamanna, B. R., Hackett, M. L., Maulik Tags: Open access, Health services research, Rehabilitation medicine, Research methods Protocol Source Type: research

Risk of epilepsy in stroke patients receiving acupuncture treatment: a nationwide retrospective matched-cohort study
Conclusions Stroke patients who received acupuncture treatment had a reduced risk of epilepsy compared with those not receiving acupuncture treatment. However, the protective effects associated with acupuncture treatment require further validation in prospective cohort studies.
Source: BMJ Open - July 13, 2016 Category: Journals (General) Authors: Weng, S.-W., Liao, C.-C., Yeh, C.-C., Chen, T.-L., Lane, H.-L., Lin, J.-G., Shih, C.-C. Tags: Open access, Complementary medicine, Epidemiology, Health services research, Neurology, Public health Source Type: research

Dietary sodium-to-potassium ratio as a risk factor for stroke, cardiovascular disease and all-cause mortality in Japan: the NIPPON DATA80 cohort study
Conclusions Dietary Na–K ratio assessed by a 3-day weighing dietary record was a significant risk factor for mortality from haemorrhagic stroke, all stroke, CVD and all causes among a Japanese population.
Source: BMJ Open - July 13, 2016 Category: Journals (General) Authors: Okayama, A., Okuda, N., Miura, K., Okamura, T., Hayakawa, T., Akasaka, H., Ohnishi, H., Saitoh, S., Arai, Y., Kiyohara, Y., Takashima, N., Yoshita, K., Fujiyoshi, A., Zaid, M., Ohkubo, T., Ueshima, H., on behalf of the NIPPON DATA80 Research Group, on beh Tags: Open access, Epidemiology, Nutrition and metabolism Research Source Type: research

Screening for cognitive impairment with the Montreal Cognitive Assessment in Chinese patients with acute mild stroke and transient ischaemic attack: a validation study
Conclusions A MoCA-Beijing cut-off score of 22/23 is optimally sensitive and specific for detecting CI after mild stroke, and TIA in the acute stroke phase, and is recommended for routine clinical practice.
Source: BMJ Open - July 12, 2016 Category: Journals (General) Authors: Zuo, L., Dong, Y., Zhu, R., Jin, Z., Li, Z., Wang, Y., Zhao, X., Sachdev, P., Zhang, W., Wang, Y. Tags: Open access, Genetics and genomics, Geriatric medicine, Mental health, Neurology, Public health Research Source Type: research

Correction: Living in Latvia after stroke: the association between functional, social and personal factors and the level of selfperceived disability--a cross-sectional study
Bērzina G, Smilškalne B, Vētra A, et al. Living in Latvia after stroke: the association between functional, social and personal factors and the level of selfperceived disability—a cross-sectional study. BMJ Open 2016;6:e010327. The last author of this paper, ‘Katharina Stibrant Sunnerhagen’ should be listed as ‘Katharina S Sunnerhagen’ and cited as ‘Sunnerhagen KS’.
Source: BMJ Open - July 7, 2016 Category: Journals (General) Tags: Open access Correction Source Type: research

Living in Latvia after stroke: the association between functional, social and personal factors and the level of self-perceived disability--a cross-sectional study
Conclusions Functional, social and personal factors are of similar importance when explaining self-perceived disability in the chronic phase of stroke. Some, but not all, of the factors are modifiable by the healthcare system. Therefore, a complex approach and involvement of medical, social and political systems is needed.
Source: BMJ Open - June 24, 2016 Category: Journals (General) Authors: Berzina, G., Smilskalne, B., Vetra, A., Stibrant Sunnerhagen, K. Tags: Open access, Neurology, Rehabilitation medicine Research Source Type: research

Tai Chi for stroke rehabilitation: protocol for a systematic review
The objective of this review is to systematically evaluate the efficacy and safety of Tai Chi for rehabilitation in stroke patients. Methods and analysis We will conduct a systematic search of the following electronic databases from their inception to 31 October 2015: MEDLINE, EMBASE, the Cochrane Library, the Chinese BioMedical Literature Database (CBM), the Chinese National Knowledge Infrastructure (CNKI), the Chinese Science and Technology Periodical Database (VIP), Wanfang and the Chinese Dissertation Database. All relevant randomised controlled trials (RCTs) in English and Chinese will be included. The main outcomes ...
Source: BMJ Open - June 16, 2016 Category: Journals (General) Authors: Zhang, Y., Wang, S., Chen, P., Zhu, X., Li, Z. Tags: Open access, Complementary medicine, Rehabilitation medicine Protocol Source Type: research

Dietary flavonoid intake and the risk of stroke: a dose-response meta-analysis of prospective cohort studies
Conclusions Results from this meta-analysis suggest that higher dietary flavonoid intake may moderately lower the risk of stroke.
Source: BMJ Open - June 8, 2016 Category: Journals (General) Authors: Tang, Z., Li, M., Zhang, X., Hou, W. Tags: Open access, Cardiovascular medicine, Evidence based practice, Neurology, Nutrition and metabolism, Public health Research Source Type: research

Service factors causing delay in specialist assessment for TIA and minor stroke: a qualitative study of GP and patient perspectives
Conclusions Primary and emergency care providers need to review how they can best handle patients presenting with symptoms that could be due to stroke or TIA. In general practice, this may include receptionist training and/or triage by a nurse or doctor. Mechanisms need to be established to enable direct referral to the TIA clinic when patients whose symptoms have resolved present to other agencies. Further work is needed to improve diagnostic accuracy by non-specialists.
Source: BMJ Open - May 17, 2016 Category: Journals (General) Authors: Wilson, A., Coleby, D., Regen, E., Phelps, K., Windridge, K., Willars, J., Robinson, T. Tags: Open access, Cardiovascular medicine, Emergency medicine, Health services research, Qualitative research Source Type: research

Stroke survivors', caregivers' and GPs' attitudes towards a polypill for the secondary prevention of stroke: a qualitative interview study
Conclusions Participants acknowledged potential advantages in a polypill approach for secondary prevention of stroke; however, significant concerns remain. Further research on the efficacy of a polypill is needed to reassure practitioners whose concerns around inflexibility and treatment suitability are likely to influence the decision to prescribe a polypill for secondary prevention of stroke. Acceptability among survivors, caregivers and GPs is likely to determine the uptake and subsequent use of a polypill in the future.
Source: BMJ Open - May 13, 2016 Category: Journals (General) Authors: Jamison, J., Graffy, J., Mullis, R., Mant, J., Sutton, S. Tags: Open access, Cardiovascular medicine, Qualitative research Source Type: research

From QASC to QASCIP: successful Australian translational scale-up and spread of a proven intervention in acute stroke using a prospective pre-test/post-test study design
Conclusions We obtained unprecedented statewide scale-up and spread to all NSW stroke services of a nurse-led intervention previously proven to improve long-term patient outcomes. As clinical leaders search for strategies to improve quality of care, our initiative is replicable and feasible in other acute care settings.
Source: BMJ Open - May 6, 2016 Category: Journals (General) Authors: Middleton, S., Lydtin, A., Comerford, D., Cadilhac, D. A., McElduff, P., Dale, S., Hill, K., Longworth, M., Ward, J., Cheung, N. W., D'Este, C., on behalf of the QASCIP Working Group and Steering Committee, on behalf of the QASCIP Working Group and Steeri Tags: Open access, Health policy, Health services research, Neurology, Nursing Source Type: research

Barriers and facilitators to staying in work after stroke: insight from an online forum
Conclusions Despite having been able to return to work after a stroke, people may still experience difficulties in staying in work and risking losing their job. There is a need to improve awareness, in particular of invisible stroke-related impairments, among stroke survivors, work personnel and clinicians. This might be achieved through improved assessments of residual impairments in the workplace and in general practice. Future studies should investigate the effect of unrecognised fatigue and invisible impairments on staying in work following stroke, and explore the potential role for primary care in supporting stroke su...
Source: BMJ Open - April 6, 2016 Category: Journals (General) Authors: Balasooriya-Smeekens, C., Bateman, A., Mant, J., De Simoni, A. Tags: Open access, Cardiovascular medicine, General practice / Family practice, Occupational and environmental medicine, Qualitative research, Rehabilitation medicine, Research methods Source Type: research

Stroke survivors and their families receive information and support on an individual basis from an online forum: descriptive analysis of a population of 2348 patients and qualitative study of a sample of participants
Conclusions Patients' needs expressed in the online forum confirm and widen the evidence from traditional research studies, showing that such forums are a potential resource for studying needs in this population. The forum provided an opportunity for patients and families to give and receive advice and social support.
Source: BMJ Open - April 6, 2016 Category: Journals (General) Authors: De Simoni, A., Shanks, A., Balasooriya-Smeekens, C., Mant, J. Tags: Open access, Cardiovascular medicine, Health informatics, Health services research, Qualitative research, Research methods Source Type: research

Antiplatelet regimens in the long-term secondary prevention of transient ischaemic attack and ischaemic stroke: an updated network meta-analysis
Conclusions Cilostazol was significantly more effective than aspirin and clopidogrel alone in the long-term prevention of serious vascular events in patients with prior non-cardioembolic ischaemic stroke or transient ischaemic attack. Cilostazol was associated with a significantly lower bleeding risk than low-dose aspirin (75–162 mg daily) and aspirin (50 mg daily) plus dipyridamole (400 mg daily). Low-dose aspirin was as effective as higher daily doses. However, further large, randomised, controlled, head-to-head trials are needed, especially in non-Asian ethnic groups.
Source: BMJ Open - March 17, 2016 Category: Journals (General) Authors: Niu, P.-P., Guo, Z.-N., Jin, H., Xing, Y.-Q., Yang, Y. Tags: Open access, Evidence based practice, Neurology, Pharmacology and therapeutics Research Source Type: research

Mortality and use of psychotropic medication in patients with stroke: a population-wide, register-based study
Conclusions All-cause mortality was higher in patients with stroke and controls treated with benzodiazepines, antidepressants and antipsychotics than in their untreated counterparts. Our findings suggest that care should be taken in the use and prescription of such drugs, and that they should be used in conjunction with adequate clinical controls.
Source: BMJ Open - March 8, 2016 Category: Journals (General) Authors: Jennum, P., Baandrup, L., Iversen, H. K., Ibsen, R., Kjellberg, J. Tags: Open access, Epidemiology, Health services research, Neurology, Rehabilitation medicine Source Type: research

Serum erythropoietin and outcome after ischaemic stroke: a prospective study
Conclusions The crude associations between EPO and worse stroke severity and outcome lost significance after multivariate modelling. However, in patients in whom EPO increased, the association with favourable outcome remained after adjustment for multiple covariates.
Source: BMJ Open - February 25, 2016 Category: Journals (General) Authors: Aberg, N. D., Stanne, T. M., Jood, K., Schiöler, L., Blomstrand, C., Andreasson, U., Blennow, K., Zetterberg, H., Isgaard, J., Jern, C., Svensson, J. Tags: Open access, Epidemiology, Neurology, Rehabilitation medicine Research Source Type: research

Rationale and design of Short-Term EXenatide therapy in Acute ischaemic Stroke (STEXAS): a randomised, open-label, parallel-group study
Conclusions As GLP-1 analogues require elevated glucose levels to exert their insulin potentiating activity, the use of exenatide in the management of hyperglycaemia in AIS may reduce the incidence of hypoglycaemia, thereby conferring a benefit in morbidity and mortality for patients in the long term. Trial registration number ACTRN12614001189617.
Source: BMJ Open - February 24, 2016 Category: Journals (General) Authors: McGrath, R. T., Hocking, S. L., Priglinger, M., Day, S., Herkes, G. K., Krause, M., Fulcher, G. R. Tags: Open access, Neurology, Research methods, Diabetes and Endocrinology Protocol Source Type: research

Acupuncture for urinary incontinence after stroke: a protocol for systematic review
Introduction The aim of this study, which will include randomised controlled trials (RCTs), is to assess the efficacy and safety of acupuncture for patients with stroke and urinary incontinence. Methods and analysis RCTs will be searched electronically in the MEDLINE, EMBASE, Cochrane CENTRAL, CINAHL and four Chinese medical databases from their inception to present. Manual retrieval will also be conducted. RCTs will be included if acupuncture was evaluated as the sole or adjunct treatment for patients with stroke and urinary incontinence. The primary outcome will be measured by using the pad-weighing test. The secondary ...
Source: BMJ Open - February 23, 2016 Category: Journals (General) Authors: Sun, Z., Yu, N., Yue, J., Zhang, Q. Tags: Open access, Complementary medicine, Evidence based practice Protocol Source Type: research

Evaluation of the feasibility and acceptability of the 'Care for Stroke intervention in India, a smartphone-enabled, carer-supported, educational intervention for management of disability following stroke
Conclusions Evaluation indicated that the ‘Care for Stroke’ intervention was feasible and acceptable in an Indian context. An assessment of effectiveness is now warranted.
Source: BMJ Open - February 2, 2016 Category: Journals (General) Authors: Sureshkumar, K., Murthy, G., Natarajan, S., Naveen, C., Goenka, S., Kuper, H. Tags: Open access, Geriatric medicine, Global health, Health services research, Public health, Rehabilitation medicine, Research methods Source Type: research

Qualitative focus group study investigating experiences of accessing and engaging with social care services: perspectives of carers from diverse ethnic groups caring for stroke survivors
Conclusions Across ethnic groups there were many similarities in the experiences of people caring for stroke survivors with complex, long-term care needs. Accessing services demands effort and persistence on carers’ part. If carers believe services are unsatisfactory or that they, rather than formal services, should be providing support for stroke survivors, they are unlikely to persist in their efforts. Cultural and language differences add to the challenges black and minority ethnic group carers face.
Source: BMJ Open - January 29, 2016 Category: Journals (General) Authors: Greenwood, N., Holley, J., Ellmers, T., Mein, G., Cloud, G. Tags: Open access, Health services research, Qualitative research Source Type: research

Quantifying the risk of heart disease following acute ischaemic stroke: a meta-analysis of over 50 000 participants
Conclusions One-third of patients with ischaemic stroke with no cardiac history have more than 50% coronary stenosis and 3% are at risk of developing MI within a year. Our findings provide a reliable quantitative measure of the risk of IHD following AIS in patients with no cardiac history.
Source: BMJ Open - January 20, 2016 Category: Journals (General) Authors: Gunnoo, T., Hasan, N., Khan, M. S., Slark, J., Bentley, P., Sharma, P. Tags: Open access, Cardiovascular medicine, Neurology Research Source Type: research

Understanding stroke survivors and informal carers experiences of and need for primary care and community health services--a systematic review of the qualitative literature: protocol
Introduction Despite the rising prevalence of stroke, no comprehensive model of postacute stroke care exists. Research on stroke has focused on acute care and early supported discharge, with less attention dedicated to longer term support in the community. Likewise, relatively little research has focused on long-term support for informal carers. This review aims to synthesise and appraise extant qualitative evidence on: (1) long-term healthcare needs of stroke survivors and informal carers, and (2) their experiences of primary care and community health services. The review will inform the development of a primary care mode...
Source: BMJ Open - January 6, 2016 Category: Journals (General) Authors: Aziz, N. A., Pindus, D. M., Mullis, R., Walter, F. M., Mant, J., Lim, Rundell, Hobbs Tags: Open access, General practice / Family practice, Qualitative research, Research methods Protocol Source Type: research

Acupuncture treatment for ischaemic stroke in young adults: protocol for a randomised, sham-controlled clinical trial
Introduction Stroke in young adults is not uncommon. Although the overall incidence of stroke has been recently declining, the incidence of stroke in young adults is increasing. Traditional vascular risk factors are the main cause of young ischaemic stroke. Acupuncture has been shown to benefit stroke rehabilitation and ameliorate the risk factors for stroke. The aims of this study were to determine whether acupuncture treatment will be effective in improving the activities of daily living (ADL), motor function and quality of life (QOL) in patients of young ischaemic stroke, and in preventing stroke recurrence by controlli...
Source: BMJ Open - January 6, 2016 Category: Journals (General) Authors: Chen, L., Fang, J., Jin, X., Keeler, C. L., Gao, H., Fang, Z., Chen, Q. Tags: Open access, Complementary medicine, Neurology, Rehabilitation medicine Protocol Source Type: research

Feasibility study of an integrated stroke self-management programme: a cluster-randomised controlled trial
Conclusions It was feasible to integrate a stroke self-management programme into community rehabilitation, using key principles. Some data were lost to follow-up, but overall results support the need for conducting further research in this area and provide data to support the design of a definitive trial. Trial registration number ISRCTN42534180.
Source: BMJ Open - January 6, 2016 Category: Journals (General) Authors: Jones, F., Gage, H., Drummond, A., Bhalla, A., Grant, R., Lennon, S., McKevitt, C., Riazi, A., Liston, M. Tags: Open access, Neurology, Patient-centred medicine, Rehabilitation medicine Research Source Type: research

Sickness absence and return to work among Japanese stroke survivors: a 365-day cohort study
Conclusions Cumulative RTW rates depended on the subtype of stroke, and older age was a predictor of resignation.
Source: BMJ Open - January 4, 2016 Category: Journals (General) Authors: Endo, M., Sairenchi, T., Kojimahara, N., Haruyama, Y., Sato, Y., Kato, R., Yamaguchi, N. Tags: Open access, Occupational and environmental medicine, Public health Research Source Type: research

ESCAPS study protocol: a feasibility randomised controlled trial of 'Early electrical stimulation to the wrist extensors and wrist flexors to prevent the post-stroke complications of pain and contractures in the paretic arm
This study aims to evaluate the feasibility of a randomised controlled trial to test the efficacy and cost-effectiveness of delivering early intensive electrical stimulation (ES) to prevent post-stroke complications in the paretic upper limb. Methods and analysis This is a feasibility randomised controlled trial (n=40) with embedded qualitative studies (patient/carer interviews and therapist focus groups) and feasibility economic evaluation. Patients will be recruited from the Stroke Unit at the Nottingham University Hospitals National Health Service (NHS) Trust within 72 h after stroke. Participants will be randomis...
Source: BMJ Open - January 4, 2016 Category: Journals (General) Authors: Fletcher-Smith, J. C., Walker, D.-M., Sprigg, N., James, M., Walker, M. F., Allatt, K., Mehta, R., Pandyan, A. D. Tags: Open access, Neurology, Rehabilitation medicine Protocol Source Type: research

Weekly variations of stroke occurrence: an observational cohort study based on the Kyoto Stroke Registry, Japan
Conclusions Some factors that arise periodically appear to affect the incidence of cerebral infarction, which gradually develops over years, and this suggests an aetiological mechanism different from the conventional cumulative effect of risk factors due to long-term exposure. We propose a hypothesis that there is a ‘triggering factor’ for the development of cerebral infarction.
Source: BMJ Open - March 24, 2015 Category: Journals (General) Authors: Shigematsu, K., Watanabe, Y., Nakano, H., on behalf of the Kyoto Stroke Registry Committee Tags: Open access, Epidemiology, Neurology Research Source Type: research