May 31, 2019
The European Chronic Disease Alliance (ECDA), the European Public Health Alliance (EPHA) and the NCD Alliance publish the paper “Towards an EU-Strategic Framework for the Prevention of Non-communicable Diseases” concluding that a new EU strategic framework to prevent non-communicable diseases (NCDs) is needed to address chronic diseases, the 21st century’s foremost health threat.
With 70% of respondents to a recent EU Barometer survey wanting to see more EU action on health and with epidemic levels of NCDs undermining people’s well-being, healthcare systems, and Europe’s economic and social prosperity, preventing NCDs should be a main priority for the next European Commission.
The mandate 2019-2024 is an opportunity to act upon commitments made at the UN High Level Meeting on NCDs in September 2018 and follow on the EU Reflection Process on Chronic Diseases to deliver concrete solutions to respond to the main common risk factors. While progress is made on reducing premature mortality from NCDs, longer lives do not necessarily translate into healthy lives.
With stroke being such an important topic among other non-communicable diseases, SAFE and ESO recently organised a panel discussion in the Committee of Regions in Brussels, under the Patronage of The Romanian Presidency, exploring the role of policy in tackling stroke. During the panel discussion, patient representatives and clinical experts called on the EU Institutions to recognize the burden of stroke as its own incredibly important entity, rather than diluting it in the wider classification of cardiovascular diseases. Panelists representing patients and clinicians also called for the EU to facilitate discussions between its Member States on the implementation of the Stroke Action Plan for Europe. As a next step to this meeting, SAFE and ESO begun a follow-up with speakers and participants to move forward with the identified opportunities. The immediate action that came as a result of this panel discussion was SAFE’s participation in the CHRODIS+ Conference, held in Budapest, Hungary on 15 May 2019. At this important meeting, SAFE was represented by Grethe Lunde, SAFE Board Member and a stroke survivor from Norway. SAFE actively participated in discussions on topics such as patient involvement, multi-morbidity, integrated care and employment.
Europeans spend between a quarter and a fifth of their lives in ill-health. 700 billion EUR is spent on treating NCDs in the EU each year – although many chronic diseases are to a considerable degree preventable. The paper proposes basic principles, priorities and actions for such an EU strategic framework, setting out a roadmap to make change happen. For more information, please contact: info@alliancechronicdiseases.org or epha@epha.org.
May 31, 2019
“In our country, our patients are facing several problems after stroke. The number of physical therapy units is adequate, however, we should pay extra attention for the subjects such as lack of training and methods, inadequate speech rehabilitation therapy, lack of environmental physical conditions for stroke cases, and often overlooked dementia and depression after stroke” said Füsun Mayda Domaç, Assoc. Prof, MD, Msc and Vice President of BEYINDER, Turkish Stroke Support Organisation.
SAFE: What is one issue related to the life after stroke in your country that you think needs special attention?
FMD: One of the most noteworthy issues is the establishment of a number of rehabilitation centers by government incentives in Turkey. Although the physical facilities and numbers of the centers are adequate, the lack of physical therapists and physiotherapists, who are well equipped for neurorehabilitation and especially for stroke rehabilitation, is quite lacking. The number of physical therapy sessions that the Ministry of Health has provided free of charge in patients after stroke is insufficient. Although the physicians are willing to start treatment in patients in the early period, the number of free sessions and an inadequate number of equipped personnel negatively affect the success rates. In our country, physical factors create difficulties for the cases of stroke. It is extremely important to reintroduce stroke survivors to an active, disability-free life with an intensive rehabilitation program.
Other important issues we have come across in most stroke survivors are the isolation of social and work environment, fear of not recovering, and psychiatric problems such as depression and anxiety. Besides, vascular dementia can develop due to localization and severity of stroke. However, because we need to examine a large number of patients in a short time due to health policies in outpatient clinics, urgent and important complaints are considered at the forefront and psychiatric cognitive problems can be ignored. This situation complicates and delays clinical recovery in patients.
SAFE: What would be the solution, i.e. what is your organisation’s position regarding this issue?
FMD: The short duration of rehabilitation treatment and lack of adequate qualified personnel negatively affect the healing process even though the physical therapy centers are sufficient. In this context, in the neurorehabilitation, it will be helpful to prepare a training CD of physical therapy applications for stroke which explains practices in detail. In addition, neurology and physical therapy branches need to come together and exchange information on neurorehabilitation with joint meetings. Training sets can be prepared in cooperation with the Ministry of Health, and detailed brochures about hints and issues to be considered during physical therapy can be prepared and distributed. The Ministry of Health may be asked to supervise physical therapy centers in more detail and to support fully-equipped rehabilitation centers for stroke rehabilitation. The number of free service periods and sessions can be increased by discussing the necessity of having a long-term and intensive treatment protocol after stroke with the Ministry of Health. Beyinder works intensively on all these solutions.
Due to the health policies in our country, there is not enough time to examine stroke patients in the outpatient clinics. In addition, it is not easy to make detailed evaluations except for the basic complaints. In this respect, assessment forms for depression, anxiety, and cognitive problems can be prepared and asked to fill it with the help of a patient and/or their relatives before their visit and these forms can be evaluated guickly in the outpatient clinics. Assessment forms should be developed and implemented easy-to-read taking into account the health literacy of patients so that they can fill forms on their own. In order to raise awareness among neurologists, information brochures about post-stroke psychiatric and cognitive situations can be prepared and distributed.
SAFE: Please tell us more about your organisation.
FMD: Stroke patients are not alone anymore in Turkey. “BEYİNDER” which is Turkish cerebrovascular diseases patients’ society was established in August 2017 in Istanbul. BEYİNDER is a non-profit, national society for stroke patients, their families, caregivers and also for health professionals. Our aim is to provide help and support for all stroke patients in Turkey and provide public education by accurate information about cerebrovascular diseases.
Our society has a website (link: http://www.beyinder.org/). The web site of our society provides information about our society, understandable information about clinical signs and symptoms, primary and secondary prevention, therapy and rehabilitation of stroke for patients and care givers, information about communication and news about stroke in media. Our society also has several social media accounts including Facebook, Instagram and twitter in order to make people aware of the society and its website.
Official journal of the association began publishing in 2018 and the 4th issue is on the way. Editor of the journal is Prof. Uludüz. The journal provides general information on vascular health of brain for patients. We also send journal to hospitals in order to give patients and relatives at out-patient or in-patient clinics. The online version of our journal is also available on the website.
May 30, 2019
We would like to recommend to your attention a Round-Table discussion that held place at last year’s WSC in Montreal, Canada.
This Round Table Discussion reviews strategies for secondary prevention strategies in ESUS and the implications of the recent RE-SPECT ESUS results for clinical practice.
Following completion of this activity, learners will be able to:
- Describe RE-SPECT ESUS clinical trial results
- Outline the benefits and risks of NOACs in ESUS
- Discuss the implications of RE-SPECT ESUS for clinical practice
RE-SPECT ESUS: Optimizing Prevention of Embolic Stroke of Undetermined Source
Moderator:
Mike Sharma MD, MSc, Associate Professor, Division of Neurology, Department of Medicine, McMaster University, Ontario, Canada
Faculty:
Richard A. Bernstein MD, PhD, Professor of Neurology, Feinberg School of Medicine, Northwestern University, Illinois, USA
Hans-Christoph Diener MD, PhD, Professor of Neurology, University of Duisburg-Essen, Germany
Please click here to view video.
May 27, 2019
This article was first published on ScienceDaily.com
Although the occurrence of first-ever ischemic stroke (strokes due to a blood clot that blocks a blood vessel in the brain) at middle age has been decreasing over time, researchers have found that the decline is not as steep as seen in older adults.
The risk for stroke at midlife declined by approximately 39 percent, while risk of stroke at older age declined by 53 percent, when comparing a recent time period (1998-2005) to a previous time period (1962-67).
“Most strokes at midlife were due to diseases of the arteries (atherosclerosis) caused by a clot migrating from the heart. We also looked at vascular risk factors, such as hypertension and smoking, which have been declining among both age groups over time,” explained corresponding author Hugo J. Aparicio, MD, MPH, assistant professor of neurology at Boston University School of Medicine.
The researchers studied trends in the rate of ischemic stroke among two age groups in the Framingham Heart Study: middle age-35-55 years old and older age-above 55 years old. They estimated the rate of stroke occurring in four time periods, 1962-67, 1971-76, 1987-1991 and 1998-2005. They also looked at risk for stroke calculated using the Framingham Stroke Risk Profile, which gives an estimate for how likely a stroke will occur over the ensuing 10 years.
You can read the full article here.
Image source: Pixabay.com
May 25, 2019
The 5th European Stroke Organisation Conference (ESOC), took place in Milan, Italy, from 22 to 24 May 2019.
ESOC 2019 was attended by more than 5,600 participants from all over the world. Stroke Alliance for Europe had a stand at this important event, providing information on the latest stroke advocacy activities.
One of the highlights of ESOC 2019 was the constitution of the Steering Committee for the “Stroke Action Plan for Europe 2018-2030” implementation, in which SAFE will take active participation, representing the voice of stroke patients from 33 European countries.
SAFE promoted the Stroke Action Plan on its stand, now available in additional seven European languages (French, Polish, Spanish, Portuguese, Russian, Ukrainian and Greek) with many more translations to come. The Stroke Action Plan’s translation will increase its reach throughout Europe and significantly help stroke support organisations in with their further advocacy work.
Two of the SAFE Board members, Anita Arsovska from North Macedonia and Hariklia Proios from Greece held important lectures as part of ESOC Scientific Programme. SAFE’s President, Jon Barrick, co-chaired a session on the last days of the congress, covering the topic of the burden of stroke in Europe and the Life After Stroke issues.
Apart from the Board members, other SAFE organisations’ members from Turkey, Italy, Croatia, Hungary, Portugal and many other countries took active part in the ESOC 2019 programme within their fields of expertise.
Video credits: Turkish Stroke Support Organisation BEYINDER.
