A newly published audit on stroke services in Scotland shows that no health board was able to meet the Scottish Government target of giving “appropriate care” to 80 per cent of stroke patients.
Overall, only 68 per cent of patients received an “appropriate care bundle” (stroke unit admission, swallow screen, brain scan and aspirin) in 2018 – a slight improvement on the 65% registered in 2017.
But only Ayrshire and Arran came close to the 80 per cent target, with Highland (48 per cent) and Dumfries and Galloway (63 per cent) among the worst performing boards.
The Scottish Stroke Improvement Programme 2019 Annual National Report includes data from the Scottish Stroke Care Audit (SSCA). During 2018, 9,641 stroke patients were admitted to Scottish hospitals, with an additional 1,085 seen at neurovascular (TIA) clinics.
The number of patients receiving thrombolysis was 1,033 in 2018, similar to the number in 2017 (1,056).
Of these patients, 60 per cent were thrombolysed within one hour of arrival at hospital, a similar rate to the rest of the UK (61 per cent).
Two hospitals exceeded the standard of 80% thrombolysed within one hour of arrival at hospital in 2018.
The data is used by the Scottish Government to monitor progress against the Scottish Stroke Care Standards (2016) and the Scottish Stroke Improvement Plan (2014). Health Boards are expected to identify aspects of their stroke services which do not meet the Scottish Standards and to work with their stroke MCNs to improve their standards of care locally.
Andrea Cail, director of the Stroke Association in Scotland said of the findings: “To dramatically improve the stroke bundle standard target, we believe changes are needed to the way acute stroke services are delivered in Scotland.
“Whilst the planning of a thrombectomy service is providing a catalyst for much wider system change and improvement, the complexity of this work is not leading to the rapid change that is now required.
“The report acknowledges that we have no comprehensive stroke centres in Scotland. But the evidence shows that re-shaping stroke services and creating hyper-acute stroke units (HASUs) with the best equipment and experts in one place can save lives, reduce disability and result in greater cost effectiveness for our health and social care services.
“The SSCA report states that our thrombolysis door to needle times have ‘stalled’, this means there are still people who would benefit from thrombolysis not getting timely access. We know in some areas this is because of the transfer times between hospitals, which could be negated.
“We therefore welcome and support the recent announcement of NHS Tayside’s plans to move to a hyper acute stroke care model – the first NHS Board in Scotland to do so. NHS Tayside has taken their decision based on the clear evidence of improved outcomes for patients. Their new model of care will see all acute stroke admissions on a single site with patients stepped down to their local acute stroke unit for ongoing care at around 48-72 hours.”
Video: everyday vs specialist tech
Assistive technology Expert Andy Fell joins Irwin Mitchell law firm for an in-depth exploration of the very latest independence-boosting devices and platforms.
Technology plays a day to day role in our lives and mobile phones, tablets, Alexa and Siri are common place.
Imagine the impact on your life if you were no longer able to interact with a touch screen or keyboard or give voice commands….
In this virtual event, Assistive Technology expert Andy Fell gives practical demonstrations of how everyday technology and specialist technology can be used to help give independence to those who need it most and why specialist technology may be needed.
During the event hosted by Lauren Haas, personal injury solicitor at Irwin Mitchell LLP, Andy goes into detail about what apps and gadgets are on the market, how everyday technology can be optimised such as the Amazon Alexa, and answered a number of questions ranging from touch screen sensitivity to smart watch reminders.
Case managers, ancillary medical professionals, as well as interested members in healthcare, social care, parents and clients may find this recording useful, as well as anyone caring for, working or living with people such as dementia sufferers or sufferers of other conditions which restrict their mobility.
Andy Fell is an independent disability and assistive technology (AT) consultant with almost twenty years’ experience working with all disabilities and age groups.
He is a qualified Rehabilitation Officer for the Visually Impaired and, since qualification, has lectured on the use of assistive technology and role of AT in the life of disabled people.
He has worked with a wide range of charitable organisations including British Dyslexia Association, was head of assistive technology for Guide Dogs for the Blind and National Disability Advisor for the Royal Yacht Association.
He has also worked for blue chip companies, the emergency services and various government departments including Department for Work and Pensions.
Andy is a fellow of the Royal Society of Arts, chairman and founding trustee of the Wetwheels Foundation and sat on the British Dyslexia Association – Workplace Assessors Professional Review Panel.
The relationship between music and running
By Daniel Thomas, joint managing director of Chroma Therapies.
By Daniel Thomas, joint managing director of Chroma Therapies
With its ability to produce new neural pathways, Neurologic Music Therapy is able to encourage movement, co-ordination, improve speech and language, and improve the ability to read/feel emotions, reactions and more, in people living with catastrophic injuries.
This is because music automatically connects to the brain. And this automaticity is what makes music so powerful.
Music also has to ability to push your training capabilities farther and faster especially in running.
This is why a running playlist is the ideal accompaniment to any runner.
Each songs tempo stimulates the brain, evoking a running response of either a faster pace or a steady rhythm depending on what you want to achieve.
For a faster pace, a good running playlist should contain songs with 150-180bpm.
Unfortunately, with not many songs out there using that speed (unless you enjoy rock, metal or speed garage for running) than the other option is to choose songs with 75-90bpm, as this tempo is perfect for a steady rhythm and maximising efficiency.
Do you recall an earlier blog where we discussed cadence and stride length using NMT for preventing falls in the elderly?
We suggested music with a high bpm count promotes movement, good cadence and walking speed, so songs like Nancy Sinatra’s ‘These Boots are Made for Walkin’, which has 85 bpm, is ideal.
BPM strongly correlates to step cadence.
Rhythmic Auditory Stimulation (RAS) is an important aspect of NMT.
Predictable rhythmic structure allows the sensori-motor system to move in sync with the beat.
This is, in essence, why music is important to runners, as it has the ability to communicate with the brain in order to help maintain a steady pace or increase speed depending on the bpm.
When it comes to mental wellbeing, we will always discuss music’s ability to improve mental wellbeing, and its effect can also be attributed to runners.
Music’s ability to improve stride, cadence and style, to produce better and better runs, and enable runners to achieve personal goals also have a positive effect upon mental wellbeing.
A sense of accomplishment. And with the right playlist, runners can end each run on a high.
We also like to discuss how NMT is more effective when it is personalised to that individual.
The same can be said in the case of a runner. A playlist that includes, not only songs with the ideal tempo for them, but also have some personal meaning, have the greatest positive effect upon runners.
The more enjoyable the run, the less fatigue is experienced. This may be due to the fact that music is able to interfere with the parts of the brain that communicate fatigue, essentially causing a distraction, so less fatigue is experienced.
For runners, the relationship between music and running can be seen to be just as effective and important as the relationship between music and recovering from a brain injury.
Its ability to improve running capability, speed, motivation, and promote mental wellbeing is what makes the difference between a run just being a run and reaching ‘Flow State’ – the mental state where the runner is in the moment of running – no distractions, and the run becomes…euphoric.
Concussion could lead to depression, ADHD, dementia and Parkinson’s – study
A new study has revealed a link between concussion and the risk of being diagnosed with attention-deficit hyperactivity disorder, mood and anxiety disorders, dementia and Parkinson’s disease later in life.
Despite ‘clinical recovery’ from concussion typically lasting one week, a team of researchers from the University of Manitoba suspected there may be longer term effects. They used 25 years of population-based health data between 1990 and 2015, involving almost 50,000 cases of concussion from people living in Manitoba, Canada.
They found that concussion was associated with an increased risk of being diagnosed with attention-deficit hyperactivity disorder (ADHD), mood and anxiety disorders (MADs), dementia and Parkinson’s disease.
After analysing the population data, they found that concussion was linked to an increased risk of diagnosis of ADHD, dementia and Parkinson’s.
Women who had a concussion were at greater risk of developing ADHD and MADs, but there were no differences between men and women for the risk of developing dementia or Parkinson’s.
Multiple concussions didn’t affect the risk of later being diagnosed with ADHD, but a second concussion increased the risk of dementia, while exposure to more than three concussions increased the risk of being diagnosed with MADs.
While previous studies have found links between concussion and ADHD, dementia, Parkinson’s and MADs, most have relied on patients self-reporting their symptoms, the researchers write.
However, this study can only show an association, not cause and effect.
The mechanism behind this increased risk is unknown, but the researchers state it’s possible that the pathways of some biomarkers that are dysregulated in ADHD, Mads, dementia and Parkinson’s, namely, cortisol, are also affected after a concussion.
The paper, published in the BMJ journal, states that future research is needed to explore the relationships between concussion and ADHD, MADs, dementia and Parkinson’s in other populations.
- Opinion9 months ago
Biting back against a common threat
- News10 months ago
The next gen-air-ation of sensory spaces
- Opinion12 months ago
How to find the perfect powerchair
- News2 weeks ago
Police must be monitored for brain injury, argue researchers
- Legal2 weeks ago
The family experience of brain injury
- News2 weeks ago
How two community services are making tentative steps to normality
- Legal3 weeks ago
Capacity and sexual relations
- News2 months ago
Brain injury in the new normal: Keeping a check on your wellbeing