Friday, April 15, 2011

Discoveries need dollars

Last week the Australian government announced they will be slicing 400 million dollars off NHMRC funding in the coming budget. Of course, it goes without saying that a loss of 400 million dollars to the Australian medical research community means lost jobs, defunded projects and ultimately the loss of lives and quality of life for Australians. In terms of CVD in the Australian community, in our cities we are well funded and stroke fatality is in decline; however, the vast land mass that is this enormous island has extreme health disparity. Remote populations in cities as large as Broome on Australia's west coast have access to one part-time GP; options like telemedicine are imperative in these communities but the funding behind these concepts must be continued. It is common knowledge among stroke practitioners that neuro-protectants are as yet ineffectual in humans, but animal model testing has shown possibilities of protection. Imagine a world where a potential stroke could be avoided all together; this is only possible with continued trial funding. Sex, depression, dementia and rehabilitation post stroke are burgeoning ares of study, these clinical and observational studies have enough difficulty in clinically dominant environments receiving funding for best practice trials. In Melbourne, the new amalgamated Florey Neuroscience Institute has two fabulous purpose built buildings,  state of the art labs and collaborations with some of the best practitioners in the field of stroke. What was the point of the government funding these amazing spaces if there is a thinning stream of research outcomes, does it make it worth the communities money, because ultimately in every respect that's who pays for this enormous budget cut.

Wednesday, April 6, 2011

What's coming up in April on IJS Early view

Predictors of mobility after stroke: a systematic review
Craig, Louise  Wu, Olivia; Bernhardt, Julie; Langhorne, Peter

Regaining post stroke mobility is considered a primary goal of the stroke patient in early rehabilitation. The ability to predict the recovery of post stroke mobility is of great clinical importance, providing information to healthcare professionals, patients and their families. We conducted a systematic review aimed at identifying the baseline factors, assessed within one week of stroke onset that are predictive of, or associated with, the recovery of mobility within 30 days post stroke. A comprehensive search strategy was applied to all major electronic databases to identify potentially relevant studies.

Included in the review were two studies that evaluated the predictive value of baseline factors by developing a prognostic model, and three studies that assessed baseline factors that were associated with the outcome by univariate analysis. Walking was the most commonly assessed mobility outcome; age, the severity of paresis, reduced leg power, presence of hemianopia, size of brain lesion and type of stroke were shown to be predictive or associated with walking within 30 days post stroke.
 This review has identified potential predictors of the recovery of mobility post stroke. There is a need to explore and validate these predictors in other patient cohorts and consider additional factors believed to be associated with mobility. The recovery of mobility other than walking also needs investigation. In order to move prognostic research in stroke forward a collaborative approach in the collecting and sharing of data is recommended

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