Stroke is the second leading cause of death worldwide, with the greatest burden in low- and middle-income countries (LMICs). Haemorrhagic stroke or spontaneous intracranial haemorrhage (sICH), including intraparenchymal haemorrhage (IPH) and subarachnoid haemorrhage (SAH), has the highest mortality and morbidity. Local management practices for haemorrhagic stroke vary greatly between geographical regions. The Planetary Outcomes after Intracranial Haemorrhage study aims to provide a global snapshot of the patient characteristics, processes of care and short-term outcomes of patients being treated for sICH across high- and low-income settings. It will also describe variation seen in care processes and available resources and time delays to receiving care. A greater understanding of the current state of sICH care is essential to identify possible interventions and targets for improved standards of care in all settings.
We describe a planned prospective, multicentre, international observational cohort study of patients admitted to hospital for management of sICH. We will include patients of all ages presenting to hospital with imaging evidence of sICH (IPH, intraventricular haemorrhage and/or SAH). The study will collect patient, care process and short-term outcome data, following patients for up to 30 days (or until discharge or death, whichever occurs first). Any centre globally where patients with sICH are admitted and managed can participate, targeting a sample size of 712 patients. The study will recruit centres worldwide through pre-existing research networks and by dissemination through neurosurgical and stroke conferences and courses. Each participating centre will complete a site questionnaire alongside patient data collection.
The study has received ethical approval by the University of Cambridge (PRE.2024.070). Participating centres will also confirm that they have undergone all necessary local governance procedures prior to starting local data collection. The findings will be disseminated via open access peer-reviewed journals, relevant conferences and other professional networks and lay channels, including the study website (https://plotich.org/) and social media channels (@plotichstudy).
Commentary on: Feo R, Young JA, Urry K, Lawless M, Hunter SC, Kitson A, Conroy T. ‘I wasn’t made to feel like a nut case after all’: A qualitative story completion study exploring healthcare recipient and carer perceptions of good professional caregiving relationships. Health Expect. 2023 Oct 19;27(1):e13871. doi: 10.1111/hex.13871. Epub ahead of print.
Healthcare providers can foster effective patient–provider relationships by addressing concerns early on and adopting key behaviours, such as showing interest in understanding the patient’s issues, validating their concerns and respecting their choices. Future research should focus on identifying strategies to help healthcare providers develop effective patient–provider relationships. This requires a thorough understanding of these relationships from the perspectives of all involved parties, including healthcare providers, patients and their informal caregivers.
The patient–provider relationship is at the core of effective disease management.
Commentary on: Kristiansen D, Boyle EH, Svec J. The impact of local supply of popular contraceptives on women’s use of family planning: findings from performance-monitoring-for-action in seven sub-Saharan African countries. Reprod Health. 2023 Nov 21;20(1):171.
Implications for practice and research The concept of ‘demand’ and ‘supply’, from the perspective of individual preferences shaped by cultural and societal norms, can be incorporated by health practitioners and policymakers when addressing the root causes of unmet health needs. Understanding women’s empowerment and agency in family planning requires a rights-based community-engaged research approach. Community-level data can illuminate the underlying mechanisms of healthcare utilisation preferences.
The issue of unmet contraceptive needs remains a gap in global healthcare, despite various contraceptive options available now more than ever.
Commentary on: Lo Faro V, Johansson T, Johansson Å. The risk of venous thromboembolism in oral contraceptive users: the role of genetic factors—a prospective cohort study of 2 40 000 women in the UK Biobank. Am J Obstet Gynecol. 2024;230:360.e1-13
Implications for practice and research Currently, venous thromboembolism (VTE) risk assessment for contraceptive counselling is based on clinical characteristics and family history. Incorporating genetic risk assessment into current practice can significantly enhance the screening of oral contraceptive users at high risk for VTE. Further research is needed to develop a comprehensive model, explore the cost-effectiveness and implementation of genetic risk assessment in contraceptive counselling, address challenges in communicating genetic information and evaluate its applicability across diverse populations.
Venous thromboembolism (VTE) is a complex disorder influenced by both acquired and inherited factors. Oral contraceptive use, an acquired factor, has been linked to an increased risk of...
Las úlceras por presión y las heridas crónicas son dos de las patologías más tratadas por el personal de enfermería en las salas de curas de atención primaria, especializada y atención domiciliaria. La correcta elección del material de cura es uno de los factores clave en el abordaje de estas lesiones. El objetivo de este artículo es brindar a los profesionales de enfermería de una herramienta para realizar la elección del material de cura basándose en su principio más básico: la situación del lecho de la herida.
Para ello, se han revisado los protocolos de cura de heridas de los principales sistemas de salud y sociedades científicas, y se han elaborado un diagrama que categoriza los lechos de las heridas en 16 tipologías basadas en la clasificación TIME y ofrece 13 combinaciones de apósitos y productos de cura.