This is part three of a three-part series looking at autism in Durham Region, including the services available and the experience of Durham families who have children with an autism spectrum disorder diagnosis. DURHAM - With early intervention touted as key to the success of autism therapy, Durham children may be missing out as they languish on wait lists. In Durham, children with autism spectrum disorders (ASD) wait about six months for an assessment, one year for applied behaviour analysis (ABA) therapy and up to four years for intensive behaviour intervention (IBI) therapy. IBI consist of up to 40 hours a week of one-on-one treatment with a therapist and teaches children through positive reinforcement and repetition. ABA is less intensive, offered in weekly sessions over a two to six-month period. "The prime age for IBI is between two and six years old; when kids are older it may not be helpful," said Frances Donovan, program director for autism services at Kinark Child and Youth Services, which delivers IBI services in Durham. Launched in 2000, the Central East IBI program, which covers Durham, initially had capacity for 50 children. With the provincial government quadrupling autism spending to $186 million over the … Continue reading →

KIRKLAND, Wash., May 15, 2013 /PRNewswire/ -- EvergreenHealth has maintained two prestigious advanced certifications from The Joint Commission, for both its inpatient diabetes care and its primary stroke center, following reviews in April 2013. Achieving these certifications signifies EvergreenHealth's dedication to continuous compliance with The Joint Commission's state-of-the-art standards, and to fostering better outcomes for patients. The Primary Stroke Center has maintained its advanced certification since November 2007, demonstrating that its specialized stroke care meets critical elements of performance to achieve long-term success in improving outcomes for stroke patients. The Joint Commission's Primary Stroke Center Certification program, developed in collaboration with the American Stroke Association, is based on the Brain Attack Coalition's "Recommendations for the Establishment of Primary Stroke Centers." Certification is available only to stroke programs in Joint Commission-accredited acute care hospitals. The Inpatient Diabetes Program has been certified since December 2011, in recognition of exemplary standards for health care quality and safety within EvergreenHealth's diabetes education and nutrition services. The Joint Commission's Advanced Certification for Inpatient Diabetes Care provides standards related to staff education, written blood glucose monitoring protocols, plans for the treatment of hypoglycemia and hyperglycemia, data collection of incidences of hypoglycemia and patient education. "These certifications … Continue reading →

http://www.uvabrand.com May 15, 2013 The American Heart Association awarded UVa Health System with the Gold Plus Quality Achievement award that recognizes the quality of care that the hospital gives to people who are suffering a stroke. The hospital has a stroke team on call 24 hours a day and can quickly give treatment. When someone is suffering from a stroke, they should be treated within a few hours and a drug called Intravenous TPA is designed to break up clots that cause strokes. That drug should be given to patients in the first hour of their arrival to an emergency room. "The national average for hospitals is to give 43% of patients TPA within that 60 minutes and here at UVa we're doing it about 73% of the time," says stroke program coordinator Heather Turner. "That was in 2012 and we're doing even better in 2013, so we are really focusing on getting these patients treated as quickly as possible." The hospital's average time in treating a stroke patient is 57 minutes. The stroke program also educates patients on the signs of a stroke, like numbness on one side of the body, difficulty speaking and swallowing as well as vision … Continue reading →

Thrombolysis with alteplase administered within a narrow therapeutic window provides an effective therapy for acute ischaemic stroke. However, mainly because of prehospital delay, patients often arrive too late for treatment, and no more than 18% of patients with stroke obtain this treatment. We recommend that all links in the prehospital stroke rescue chain must be optimised so that in the future more than a small minority of patients can profit from time-sensitive acute stroke therapy. Measures for improvement include continuous public awareness campaigns, education of emergency medical service personnel, the use of standardised, validated scales for recognition of stroke symptoms and for triaging to the appropriate institution, and advance notification to the receiving hospital. In the future, use of telemedicine technologies for interaction between the emergency site and hospital, and the strategy of treatment directly at the emergency site (mobile stroke unit concept), could contribute to more efficient use of resources and reduce the time taken to instigate treatment to within 60 minthe golden hourof the onset of the symptoms of stroke. The rest is here: Streamlining of prehospital stroke management: the golden hour … Continue reading →

Early recanalisation and an increase in collateral blood supply are predictors of favourable outcome in acute ischaemic stroke. Since individual responses to intravenous treatment with alteplase are heterogeneous, additional intra-arterial thrombolytic and mechanical endovascular treatment is increasingly given. Despite encouraging findings from single-centre studies, data from randomised clinical trials have not proven the hypothesis that interventional recanalisation leads to a better outcome. Advanced thrombectomy devices, the effect of ultrasound-enhanced thrombolysis, and imaging-guided selection of patients outside the currently approved time-window are all under investigation. Although neuroprotective agents have not shown benefit in clinical trials, non-pharmacological treatment strategiessuch as decompressive surgery, therapeutic hypothermia, transcranial laser treatment, or augmentation of cerebral collateral perfusion by different means (eg, partial aortic occlusion or sphenopalatine ganglion stimulation)are topics of current research. The future of acute stroke therapy relies on evidence for individually tailored, effective, safe, and rapidly accessible treatment probably consisting of combined pharmacological and improved non-pharmacological approaches. Original post: Non-pharmacological strategies for the treatment of acute ischaemic stroke … Continue reading →