Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Showing posts with label Mumbo jumbo. Show all posts
Showing posts with label Mumbo jumbo. Show all posts

Thursday, November 8, 2018

Association of change in cardiovascular risk factors with incident cardiovascular events

I got absolutely nothing out of this. Lots of mumbo jumbo statistics.

Association of change in cardiovascular risk factors with incident cardiovascular events


JAMAvan Sloten TT, et al. | November 08, 2018
Researchers investigated the association of changes in cardiovascular health with incident cardiovascular events in this prospective cohort study that included 9256 participants without cardiovascular disease (CVD) who received follow-up over a median 18.9 years. Finding revealed the direction of change in category of a composite metric of cardiovascular health was not consistently associated with the risk of CVD.


Methods

  • Researchers performed a prospective cohort study in a UK general community (Whitehall II); examinations of cardiovascular health from 1985/1988 (baseline) and every 5 years thereafter until 2015/2016 and follow-up for incident CVD until March 2017 were performed.
  • They used the 7 metrics of the American Heart Association (nonsmoking; and ideal levels of body mass index, physical activity, diet, blood pressure, fasting blood glucose, and total cholesterol) to categorized participants with 0 to 2, 3 to 4, and 5 to 7 ideal metrics as having low, moderate, and high cardiovascular health.
  • Consideration was given to cardiovascular health change over 10 years between 1985/1988 and 1997/1999.
  • Incident CVD (coronary heart disease and stroke) was mainly assessed.

Results

  • The study population comprised 9256 participants without prior CVD (mean [SD] age at baseline, 44.8 [6.0] years; 2941 [32%] women); data about cardiovascular health change was available for 6326 of these patients.
  • They recognized 1114 incident CVD events over a median follow-up of 18.9 years after 1997/1999.
  • In multivariable analysis and compared with individuals with persistently low cardiovascular health (consistently low group, 13.5% of participants; CVD incident rate per 1000 person-years, 9.6 [95% CI, 8.4-10.9]), CVD risk was not observed to be significantly correlated with the low to moderate group (6.8% of participants; absolute rate difference per 1000 person-years, −1.9 [95% CI, −3.9 to 0.1]; HR, 0.84 [95% CI, 0.66-1.08]), the low to high group, (0.3% of participants; absolute rate difference per 1000 person-years, −7.7 [95% CI, −11.5 to −3.9]; HR, 0.19 [95% CI, 0.03-1.35]), and the moderate to low group (18.0% of participants; absolute rate difference per 1000 person-years, −1.3 [95% CI, −3.0 to 0.3]; HR, 0.96 [95% CI, 0.80-1.15]).
  • They identified a lower CVD risk in the consistently moderate group (38.9% of participants; absolute rate difference per 1000 person-years, −4.2 [95% CI, −5.5 to −2.8]; HR, 0.62 [95% CI, 0.53-0.74]), the moderate to high group (5.8% of participants; absolute rate difference per 1000 person-years, −6.4 [95% CI, −8.0 to −4.7]; HR, 0.39 [95% CI, 0.27-0.56]), the high to low group (1.9% of participants; absolute rate difference per 1000 person-years, −5.3 [95% CI, −7.8 to −2.8]; HR, 0.49 [95% CI, 0.29-0.83]), the high to moderate group (9.3% of participants; absolute rate difference per 1000 person-years, −4.5 [95% CI, −6.2 to −2.9]; HR, 0.66 [95% CI, 0.51-0.85]), and the consistently high group (5.5% of participants; absolute rate difference per 1000 person-years, −5.6 [95% CI, −7.4 to −3.9]; HR, 0.57 [95% CI, 0.40-0.80]).
Read the full article on JAMA

Monday, October 17, 2016

Evaluating use of the Siebens domain management model during inpatient rehabilitation to increase functional independence and discharge rate to home in stroke patients

Mumbo jumbo statistic reciting, totally fucking useless.
http://search.naric.com/research/rehab/redesign_record.cfm?search=2&type=all&criteria=J74456&phrase=no&rec=131638&article_source=Rehab&international=0&international_language=&international_location=

NARIC Accession Number: J74456.  What's this?
ISSN: 1934-1482.
Author(s): Kushner, David S.; Peters, Kenneth M.; Johnson-Greene, Doug.
Project Number: 90DP0046 (formerly H133A120099).
Publication Year: 2015.
Number of Pages: 11.
Abstract: Study evaluated the use of the Siebens Domain Management Model (SDMM) during stroke inpatient rehabilitation (IR) to increase functional independence and rate of discharge to home. The SDMM involved weekly adjustments of IR care focused on potential barriers to discharge home including medical/surgical issues, cognitive/emotional coping issues, physical function, and living environment/community re-entry needs. This study entailed a comparison of pre-intervention and post-intervention participant outcome metrics for the purpose of assessing the use of SDMM in stroke IR. The pre-intervention group included 154 patients with ischemic/hemorrhagic strokes who were, on average, admitted to an IR facility 9.1 days after receiving acute care in 2010. The post-intervention group included 151 patients with ischemic/hemorrhagic strokes who were, on average, admitted to IR 7.3 days after receiving acute care in 2012. Results showed that pre-intervention Functional Independence Measure (FIM) score change during IR length of stay (FIM-LOS efficiency) was 1.44 and post-intervention FIM-LOS efficiency of 2.24, which was significant. Comparison of the 2012 Uniform Data System for Medical Rehabilitation (UDSMR) national FIM-LOS efficiency score (1.72) to the post-intervention score of 2.24 also reached significance. In the pre-intervention group, 57.8 percent were discharged to home/community, 14.9 percent to long-term care (LTC), and 27.3 percent back to acute care whereas in the post-intervention group, 81.2 percent were discharged to home/community, 9.4 percent to LTC, and 9.4 percent back to acute care. Comparison of 2010 to 2012 facility data then showed a 23.4 percent increase in discharge to the community compared with an increase of 5.8 percent for the UDSMR 2010 to 2012 data, representing a community discharge rate that is 4 times greater for the post-intervention group. Findings suggest that use of the SDMM during stroke IR may convey improvement in functional independence and is associated with an increased discharge rate to home/community and a reduction in institutionalization and acute-care transfers.
Descriptor Terms: CASE MANAGEMENT, FUNCTIONAL STATUS, HEALTH CARE, OUTCOMES, REHABILITATION FACILITIES, SERVICE DELIVERY, STROKE, SYSTEMS CHANGE.


Can this document be ordered through NARIC's document delivery service*?: Y.

Citation: Kushner, David S., Peters, Kenneth M., Johnson-Greene, Doug. (2015). Evaluating use of the Siebens domain management model during inpatient rehabilitation to increase functional independence and discharge rate to home in stroke patients.  PM & R , 7(4), Pgs. 354-364. Retrieved 10/15/2016, from REHABDATA database.