PODCAST RELEASES Sedentary behaviour after stroke: a new target for therapeutic intervention: Sarah Morton

Over the last 10 years evidence has emerged that too much sedentary time (e.g. time spent sitting down) has adverse effects on health, including an increased risk of cardiovascular disease incidence and mortality. A considerable amount of media attention has been given to the topic. The current UK activity guidelines recommend that all adults should minimise the amount of time spent being sedentary for extended periods. How best to minimise sedentary behaviour is a focus of ongoing research. 

Carmen Lahiff-Jenkins, Managing Editor of the International Journal of Stroke spoke to Dr Sarah Morton lead author of the opinion piece Sedentary behaviour after stroke: a new target for therapeutic intervention.

The International Journal of Stroke is the flagship publication of the World Stroke Organization - please consider becoming a member.  https://www.world-stroke.org/membership/join-wso

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http://journals.sagepub.com/doi/full/10.1177/1747493018784505

Kool Kats by Kevin Macleod 

Mobile Stroke Units

Acute stroke is one of the main causes of death and chronic disability globally. In acute stroke management

‘time is brain’; thrombolysis with recombinant tissue plasminogen activator within the first hours after onset of symptoms is an effective therapeutic option for ischemic stroke.

 Professor Klaus Fassbender from Homburg an der Saar suggested over 20 years ago to bring the hospital to the patient. This has become a reality in the form of mobile stroke units. This strategy is based on the use of an ambulance (mobile stroke unit) equipped with an imaging system, a point-of-care laboratory, a telemedicine connection to the hospital, and appropriate medication. Studies of prehospital stroke treatment consistently report a reduction in delays before thrombolysis and cause-based triage in regard to the appropriate target hospital (e.g., primary vs comprehensive stroke centre).

Earlier this year the Royal Melbourne Hospital launched an $8 million pilot project, hosting the first Mobile Stroke Unit in the southern hemisphere.

There are only a dozen Mobile Stroke Units currently operating in the world. All are in the northern hemisphere – including three in Germany and five in USA

The Mobile Stroke Unit team is shown with Andrei Alexandrov, and Anne Alexandrov, the IAC representatives and Dr. Ken Brown, UTHSC’s executive vice chancellor and chief operations officer. This photo belongs to the The University of Tennessee Health Science Center.  

In Houston USA, 70 percent of patients were treated within 90 minutes of symptoms including 40 percent in the first hour, compared to less than one percent of hospital-treated stroke patients being treated in the first hour

We’ve had a real focus on these innovative trials at the World Stroke Organisation, publishing a module on theWorld Stroke Academy, earlier in the year we interviewed Professor James Grotta for a PODCAST for the International Journal of Stroke

as an accompaniment to the article The PRE-hospital Stroke TreatmentOrganization.

Here are some of the MSU published articles in IJS.

Air-Mobile Stroke Unit for access to stroke treatment in rural regions.

Walter S^1,2, Zhao H³, Easton D³, Bil C⁴, Sauer J^4,5, Liu Y¹, Lesmeister M¹, Grunwald IQ^6,7, Donnan GA², Davis SM³, Fassbender K¹.

https://www.ncbi.nlm.nih.gov/pubmed/30071807

Translation of the 'time is brain' concept into clinical practice: focus on prehospital stroke management.

Ragoschke-Schumm A¹, Walter S, Haass A, Balucani C, Lesmeister M, Nasreldein A, Sarlon L, Bachhuber A, Licina T, Grunwald IQ, Fassbender K.

https://www.ncbi.nlm.nih.gov/pubmed/24593156

Dr Silke Walter with the MSU team at
Southend on the Sea. 

Dr Silke Walter with the MSU team at
Southend on the Sea.  

Dr Silke Walter with Geoffrey Donnan
and Stephen Davis from the Melbourne Unit launch.

Dr Silke Walter, Skye Coote and
Managing Editor IJS Carmen Lahiff-Jenkins.

 

Sharon McGowen, CEO National Stroke Foundation
and Ned Lipes from Medtronic.

Dr Silke Walter, Peter Newbry and a rep from Medtronic.

Enough NCDs! Enough Stroke!

In a few weeks world leaders will gather at the UN HLM in New York to review progress toward their commitment to reduce premature deaths from NCDs by 30% by 2030.

The World Stroke Organization, along with our partners in the NCD Alliance, has been active in advocating for increased awareness, access and action on NCD and stroke prevention. Our leadership recently made a statement as part of the UN preparations for the UN HLM which you can read elsewhere on this blog.

From September 3rd, the WSO is getting behind the Enough NCDs Week of Action and advocating for urgent action on stroke prevention and treatment as a mechanism to achieve global health and development goals. 

We have had enough of slow progress and failed promises on stroke prevention and treatment and we know that our impatience is shared by stroke survivors, caregivers, support and professional organisations around the world.  

To add your voice to ours and to increase the pressure on our leaders to take stroke seriously we are calling on the stroke community to get involved in the campaign. Our Enough Stroke! Enough NCDs Campaign Brief provides background information and resources including suggested tweets and Facebook posts to help you put stroke at the centre of the NCD debate. 

Other things you can do

• Check out the campaign resources that can complement your stroke messaging available from NCD Alliance campaign website.
• Find out if your local NCD Alliance has any on the ground activities planned and mobilise stroke supporters to get involved.
• Join the conversation on social media using hashtags #EnoughNCDs #EnoughStroke

Follow us on Facebook and Twitter.

World Heart Federation’s 2018 Update of the 5th Emerging Leaders Seminar on Stroke Prevention, Treatment, and Rehabilitation, in collaboration with the World Stroke Organization

The World Heart Federation’s Salim Yusuf Emerging Leaders Program has trained 123 emerging leaders from 48 countries over the past 5 years in implementation science, health systems, and health policy research (Figure 1). 

The program aims to create a diverse cadre of committed leaders who will help the organization in its work toward the World Health Organization’s goal of reducing the risk of premature mortality from noncommunicable diseases, including cardiovascular diseases, by 25% by 2025.  

For the 2018 cohort (Table 1), the World Heart Federation partnered with the World Stroke Organization to focus on stroke prevention, treatment, and rehabilitation. 

The 2018 seminar was held from June 23-29, 2018 at Duke Kunshan University in Kunshan, China and was hosted by Dr. Lijing Yan (Figure 2). 

The 2018 program was the first time that the World Heart Federation partnered with another professional organization. The 2018 program was sponsored by Boehringer Ingelheim with support from Duke Kunshan University. Previous seminars have been funded by Boehringer Ingelheim (2014-2018), Novartis (2017), BUPA (2015-2016), and AstraZeneca (2014) and have focused on essential medicines, tobacco control, raised blood pressure, and secondary prevention (Table 2). 

In 2018, Dr. Salim Yusuf provided sustainable funding for the program through an endowment, and subsequently the Emerging Leaders Program was renamed the Salim Yusuf Emerging Leaders Program in recognition of his support. Emerging Leaders who receive full support from the World Heart Fed.

The World Heart Federation’s Salim Yusuf Emerging Leaders Program consists of pre-seminar online training, a 5-day seminar with didactic and small group sessions to develop a collaborative research or advocacy project proposal, and subsequent execution of the projects over the ensuring 1 to 2 years. 

The program emphasizes active learning in leadership, communication, team work, and research and supports each of the 3 teams with 25,000 Swiss francs to pursue research and advocacy projects, which is a distinguishing feature of the training program compared with others. Previous cohorts were divided into groups based on experience and interest in implementation science, health systems strengthening, and health policy research, recognizing that overlap is common. For the 2018 cohort, the program divided the Emerging Leaders into groups focusing on stroke prevention, stroke treatment, and stroke rehabilitation. 

The 2018 teams’ projects are listed in the Table 2 and are aligned with the emphasis on implementation science (stroke rehabilitation team), health systems strengthening (stroke treatment team), and health policy research (stroke prevention team). 

The 2014-2017 teams have demonstrated success in global collaborative projects with notable productivity, and the 2018 cohort is well-positioned to continue this trend. 

The Salim Yusuf Emerging Leaders Program is a strategic priority area within the World Heart Federation, and its most recent partnership with the World Stroke Organization is an important step toward work in achieving the World Health Organization’s “25 x 25” goal and other global goals.

Candidates who may be interested in participating in future Emerging Leaders cohorts should visit whfel.org for more information about topic areas and timelines, including plans for the 2019 edition of the Salim Yusuf Emerging Leaders Program, which will focus on heart failure.

Mark D. Huffman,¹ Pablo Perel,^2,3 Jean-Luc Eisele,² David A. Wood,^2,4 Maria F. Grupper,⁵ Christopher Chen,^5,6 Craig Anderson,^5,7 Darwin R. Labarthe,¹ Salim Yusuf,^2,8 Lijing Yan⁹

¹ Northwestern University Feinberg School of Medicine, Chicago, USA

² World Heart Federation, Geneva, Switzerland

³ London School of Hygiene and Tropical Medicine, London, UK

⁴ Imperial College London, London, UK

⁵ World Stroke Organization, Geneva, Switzerland

⁶ National University Singapore, Singapore

⁷ The George Institute for Global Health China, Beijing, China

⁸ Population Health Research Institute, McMaster University, Hamilton, Canada

⁹ Duke Kunshan University, Kunshan, China

Disclosures: MDH receives funding from the World Heart Federation to serve as its senior program advisor for the Emerging Leaders program, which is supported by Boehringer Ingelheim and Novartis with previous support from BUPA and AstraZeneca. MDH also receives support from the American Heart Association, Verily, and AstraZeneca for work unrelated to this research.