Background: Cerebrovascular accident (CVA) is an outdated term for describing stroke as it implies stroke is an accident. We conducted an integrative review to examine the use of CVA in terms of (1) frequency in major medical journals over time; (2) associated publication characteristics (e.g., number of authors, senior author country, topic); and (3) frequency in medical records. Methods: We searched Google Scholar for publications in leading neurology and vascular journals (Quartile 1) across two 5-year periods (1998–2002 and 2018–2022) using the terms “cerebrovascular accident” or “CVA.” Two reviewers independently reviewed full-text publications and recorded the frequency of CVA use. Rates of use (per 1,000 articles/year) were calculated for each journal and time period. Associations of publication characteristics with CVA use were determined using multivariable logistic regression models. In addition, admission and discharge forms in the Auckland Regional Community Stroke Study (ARCOS V) were audited for frequency of use of the term CVA. Results: Of the 1,643 publications retrieved, 1,539 were reviewed in full. Of these, CVA was used ≥1 time in 676 publications, and ≥2 times in 276 publications (129 in 1998–2002; 147 in 2018–2022). The terms CVA and stroke both appeared in 57% of publications where CVA was used ≥2 times in 1998–2002, compared to 65% in 2018–2022. Majority of publications were on the topic of stroke (22% in 1998–2002; 20% in 2018–2022). There were no associations between publication characteristics and the use of CVA. The highest rate of CVA use in 2018–2022 was in Circulation, which had increased over time from 1.3 uses per 1,000 publications in 1998–2002 to 1.8 uses per 1,000 publications in 2018–2022. The largest reduction in the use of CVA was in Neuroepidemiology (2.0 uses per 1,000 publications in 1998–2002 to 0 uses in 2018–2022). The term CVA was identified in 0.2% (17/7,808) of stroke admission and discharge forms audited. Conclusion: We found evidence of changes in the use of CVA in the scientific literature over the past two decades. Editors, authors, and clinicians should avoid the use of the term CVA as it perpetuates the use of an ambiguous and inappropriate term.
Food security measurement is a complex task due to difficulty in its definition and the complexity of its determinants. A valid tool to measure food insecurity has not been developed in Australia (apart from the single question used in the National Nutrition Survey NNS)1. While the US measure US Department of Agriculture Community Food Security Assessment (USDA) tool kit is most widely used and validated3; it continues to be altered and updated.
Issue addressed: Each year Australia receives over 12 000 entrants from refugee backgrounds under its Humanitarian Program. A sound nutritional status assists with the immediate demands of settlement. The long term health of refugees is also influenced by the type and amount of food eaten. This study was undertaken as part of the development of a food and nutrition program for newly arrived refugees. Methods: The target populations for the food and nutrition program were refugees from the Horn of Africa, the Middle East and the former Yugoslavia. Focus groups were held with members of the Somali community for this study. They discussed issues related to food beliefs and practices that had occurred since arrival in Australia. A nutritional analysis of the diets of seven Somali women was also undertaken. Results: This study found the issues of importance to the refugees were food access and security, changes in food supply and patterns of purchase, changes within families in responsibility for food preparation, and changes in social network which impacted on food habits and physical activity. The findings point to potential problems due to increase in fat intake and alteration in fatty acid composition of the diet, reduced fibre intake, low levels of physical activity, difficulties in control of body weight and social isolation. Conclusions: Traditional diet and exercise programs change when refugees settle in Australia. This has nutritional consequences that need to be considered when developing a food and nutrition program for refugees. The big lifestyle issues for this population are fatness and a decrease in opportunities for social exchange. So what?: Nutrition interventions for refugees and other new migrants need to take account of difficulties with sourcing familiar foods and the nutritional consequences of substituting local foods for familiar foods. (author abstract)
Accurate coded diagnostic data are important for epidemiological research of stroke.To develop, implement and evaluate an online education program for improving clinical coding of stroke.The Australia and New Zealand Stroke Coding Working Group co-developed an education program comprising eight modules: rationale for coding of stroke; understanding stroke; management of stroke; national coding standards; coding trees; good clinical documentation; coding practices; and scenarios. Clinical coders and health information managers participated in the 90-minute education program. Pre- and post-education surveys were administered to assess knowledge of stroke and coding, and to obtain feedback. Descriptive analyses were used for quantitative data, inductive thematic analysis for open-text responses, with all results triangulated.Of 615 participants, 404 (66%) completed both pre- and post-education assessments. Respondents had improved knowledge for 9/12 questions (p < 0.05), including knowledge of applicable coding standards, coding of intracerebral haemorrhage and the actions to take when coding stroke (all p < 0.001). Majority of respondents agreed that information was pitched at an appropriate level; education materials were well organised; presenters had adequate knowledge; and that they would recommend the session to colleagues. In qualitative evaluations, the education program was beneficial for newly trained clinical coders, or as a knowledge refresher, and respondents valued clinical information from a stroke neurologist.Our education program was associated with increased knowledge for clinical coding of stroke. To continue to address the quality of coded stroke data through improved stroke documentation, the next stage will be to adapt the educational program for clinicians.
Maternal-child nurses are part of a growing number of Americans who have had the opportunity to visit China. An increased understanding of the history and of the health care practices of the Chinese people lends itself to an examination of American values and health practices. The insight developed may aid us as we seek to understand our own health care practices for women and children and to plan for the future in health care.
Pediatric Primary Care Case Studies is a collection of pediatric case studies of common health problems of well, accutely ill, and chronically ill children. This text provides students with the opportunity to assess the scenario, differential diagnoses, treatment and educational plans. The cases include history and physical examination data and provide suggested case solutions. The cases include developmental, behavioral, and disease problems written to include family, cultural, and other contextual issues which must be considered to provide optimal care. Current guidelines and evidence-based research are used to support the care recommendations. Pediatric Primary Care Case Studies provides realistic ambulatory care cases that allows students to develop their critical thinking skills as they work through common situations faced by health care providers.
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