When has service provision for transient ischaemic attack improved enough? A discrete event simulation economic modelling study.

Objectives: The aim of this study was to examine the impact of transient ischaemic attack (TIA) service modification in two hospitals on costs and clinical outcomes.

Design: Discrete event simulation model using data from routine electronic health records from 2011.

Participants: Patients with suspected TIA were followed from symptom onset to presentation, referral to specialist clinics, treatment and subsequent stroke.

Receptionist rECognition and rEferral of Patients with Stroke (RECEPTS): unannounced simulated patient telephone call study in primary care.

Background: Stroke is a leading cause of morbidity and mortality. Timely recognition and referral are essential for treatment.

Aim: To examine the ability of receptionists in general practices to recognise symptoms of stroke and direct patients to emergency care.

Decisions and delays within stroke patients' route to the hospital: a qualitative study.

Study Objective: We examine acute stroke patients' decisions and delays en route to the hospital after onset of symptoms.

Methods: This was a qualitative study carried out in the West Midlands, United Kingdom. Semistructured interviews were conducted with 30 patients (6 accompanied by partners).

Receptionist rECognition and rEferral of PaTients with Stroke (RECEPTS) study - protocol of a mixed methods study.

Background: As the first point of contact for patients and witnesses of stroke, General Practice receptionists can be instrumental in deciding the urgency of clinical contact. Despite the considerable complexity of this task, reception staff are not clinically trained. Minimising the time taken to access thrombolysis is crucial in acute stroke as treatment must be initiated within 4.

Cost-effectiveness of optimizing acute stroke care services for thrombolysis.

Background And Purpose: Thrombolysis in acute stroke is effective up to 4.5 hours after symptom onset but relies on early recognition, prompt arrival in hospital, and timely brain scanning. This study aimed to establish the cost-effectiveness of increasing thrombolysis rates through a series of hypothetical change strategies designed to optimize the acute care pathway for stroke.

Health care professionals' views on discussing sexual wellbeing with patients who have had a stroke: a qualitative study.

Objectives: To examine the experiences of health care professionals discussing sexual wellbeing with patients who have had a stroke.

Design: In-depth qualitative interview study with purposive sampling and thematic analysis.

Participants: 30 health care professionals purposively recruited to include different roles and settings along the stroke patient pathway in secondary and primary care.

The association between prehospital care and in-hospital treatment decisions in acute stroke: a cohort study.

Background: Hospital prealerting in acute stroke improves the timeliness of subsequent treatment, but little is known about the impact of prehospital assessments on in-hospital care.

Objective: Examine the association between prehospital assessments and notification by emergency medical service staff on the subsequent acute stroke care pathway.

Methods: This was a cohort study of linked patient medical records.

Recognizing and overcoming challenges of couple interview research.

In this article we discuss some methodological and ethical challenges we faced when conducting a couple-based study on men's role in contraceptive switching, and how we overcame them. The challenges we discuss include recruiting couples with a range of experiences, ensuring informed consent of participants, maintaining confidentiality within interviews, and participants discussing interview content between interviews. As appropriate, we have drawn on study participants' views of these challenges.

Protocol for an observation and implementation study investigating optimisation of the management of stroke and transient ischaemic attack (TIA).

Introduction: Patients benefit from early and intensive treatment in both acute ischaemic stroke and transient ischaemic attack. Recent audits of acute stroke/transient ischaemic attack care suggest that although standards have improved, current services still fall short of optimal care. The aim of this study is to establish a database of patients accessing stroke services.