Considerations for the Implementation of a Telestroke Network: A Systematic Review.

The application of telestroke has matured considerably since its inception in 1999. The use of telestroke is now recommended in several published guidelines. Consequently, jurisdictions without a telestroke service are seeking practical information on the best approach to implement telestroke. French et al. (2013) reviewed the challenges of implementing a telestroke network including studies between 2000 and 2010. At the time, telestroke networks were largely limited to the UK, USA, Canada and Europe and only one process evaluation had been conducted. Given the prolific expansion of telestroke services since 2010, we conducted a systematic review to determine factors associated with successful establishment, management, and sustainability of a contemporary telestroke services. A comprehensive search of telestroke studies was conducted in July 2021. Empirical studies published between 2010 and 2021 were included if they contained descriptive, evaluation or operational data on the implementation of a telestroke network. Studies were subsequently evaluated using the Consolidated Framework for Implementation Research (CFIR). The initial literature search revealed a total of 7415 potential studies; 38 of which met the inclusion criteria. The past decade of process evaluation studies has enabled a more nuanced investigations into how to implement and sustain a telestroke network. Pre-implementation planning is crucial to ensure clear telestroke processes, governance structures and stakeholder engagement. Sustainability of networks relies on securing long-term investment, providing adequate resources, and maintaining staff motivation and willingness. Recommendations are provided to overcome commonly identified barriers related to technology, staffing, planning and standardisation of processes, evaluation, and sustainability and scale-up. Further research needs to explore how new advancements in stroke care such as endovascular clot retrieval (EVT) and advanced brain imaging can be considered and planned for during the implementation of a new telestroke service.

Framing diabetes public health information during Ramadan - a newspaper content analysis.

Objective To evaluate health-related messages in printed media pertaining to diabetes care in Qatar during Ramadan. Methods Qatar national newspapers (Arabic and/or English) published 6 weeks prior to and 4 weeks during Ramadan 2012 were reviewed. Health-related content was identified and characterized according to four different categories including presence of messages pertaining to both diabetes and Ramadan. Articles describing diabetes and Ramadan combined were further evaluated according to specific features of prominence (surrogates for perceived reader importance). Newspapers were grouped by language, and volume and content of coverage were compared between groups. Results A total of 1 467 newspaper issues published during the 2012 review period (781 in Arabic and 686 in English) were analysed. Health-related articles appeared consistently throughout the study period, but few were specifically diabetes-related (66/1095 [6%] Arabic articles versus 34/1250 [2.7%] English articles; P = 0.008). Only 34/1095 (3.1%) Arabic and 23/1 250 (1.8%) English ( P = 0.05) articles pertaining specifically to diabetes management during Ramadan were published. Twenty/34 (59%, Arabic) and 6/23 (26%, English) were published in high prominence positions. Conclusions Opportunity exists to augment the relatively low coverage of diabetes health-related messages in print media during Ramadan.