Research Articles (Physiotherapy)

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Browsing by Subject "Acute care"

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    Strengthening health systems for persons with traumatic spinal cord injury in South Africa and Sweden: a protocol for a longitudinal study of processes and outcomes
    (Frontiers Media, 2018) Conradsson, David; Rhoda, Anthea; Mlenzana, Nondwe; Wikmar, Lena Nilsson; Wahman, Kerstin; Hultling, Claes; Joseph, Conran
    BACKGROUND: The provision of specialized care in a time-sensitive manner has shown to be crucial for survival and recovery of functioning after a traumatic spinal cord injury (TSCI). However, little is known about the provision of TSCI care in different international contexts; information which is required for strengthening policy and practice. AIMS: The overarching aim of this study will be to explore health care processes and outcomes of TSCI care in South Africa and Sweden. Specific aims will be to: (1) describe acute processes of TSCI care, (2) determine acute- and long-term outcomes of TSCI care, and (3) identify predictors for survival, secondary complications, and functioning 12 months post-injury. METHODS: A prospective (regional), population-based cohort study where adults with an acute TSCI will be recruited over at least a 1-year period from the City of Cape Town, South Africa, and Stockholm, Sweden. The anticipated sample size inclusive of both international contexts will be 200 participants—based on a power calculation for detecting differences in mortality. Information on the nature and timing of processes of acute care (e.g., transfer logistics, spinal surgery, and specialized SCI care) will be collected on acute care admission and discharge using a standardized form. Survival status, secondary complications, neurological symptoms, functional status, activity, and participation as well as health-related quality of life will be collected at discharge from SCI acute care and at 12-months post-injury. Secondary complications and functioning will be compared between South Africa and Sweden using inferential statistics. To address mortality specifically, the indirect standardization method for differences in mortality between contexts will be used whereby Stockholm will serve as standard for specialize care. For the assessment of factors related to mortality and other outcomes (e.g., neurological and secondary health conditions) multivariate regression analyses will be used to determine independent risk factors.CONCLUSION: This study offers a unique investigation of the relationship between health care processes and outcomes of TSCI care with the aim of strengthening management guidelines for SCI in South Africa and Sweden.
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    Stroke in Africa: Profile, progress, prospects and priorities
    (Spring Nature Limited, 2021) Akinyemi, R.O.; Ovbiagele, B.; Adeniji, O.A.; Sarfo, F.S.; Ogah O.S.a, k,Naidoo P.l,Damasceno A.m,Walker R.W.a, n, o,Ogunniyi A.a, c,Kalaria R.N.a, d; Adoukonou, T.; Ogah, O.S.; Naidoo, P.; Damasceno, A.; Walker, R.W.; Ogunniyi, A.; Kalaria, R.N.; Abd-Allah, Foad
    Stroke is a leading cause of disability, dementia, and death worldwide. Approximately 70% of deaths from stroke and 87% of stroke-related disabilities occur in low-income and middle-income countries. At the turn of the century, the most common diseases in Africa were communicable diseases, whereas non-communicable diseases, including stroke, were considered rare, particularly in sub-Saharan Africa. However, evidence indicates that today, Africa could have up to 2–3-fold greater rates of stroke incidence and higher stroke prevalence than western Europe and the USA. In Africa, data published within the past decade show that stroke has an annual incidence rate of up to 316 per 100,000, a prevalence of up to 1,460 per 100,000, and a 3-year fatality rate greater than 80%. Moreover, many Africans have a stroke within the fourth to sixth decades of life, with serious implications for the individual, their family, and society. This age profile is particularly important as strokes in younger people tend to result in a greater loss of self-worth and socioeconomic productivity than in older individuals. Emerging insights from research into stroke epidemiology, genetics, prevention, care, and outcomes offer great prospects for tackling the growing burden of stroke on the continent. In this article, we review the unique profile of stroke in Africa and summarize current knowledge on stroke epidemiology, genetics, prevention, acute care, rehabilitation, outcomes, cost of care, and awareness. We also discuss knowledge gaps, emerging priorities, and future directions of stroke medicine for the more than 1 billion people who live in Africa. © 2021, Springer Nature Limited.