Background: Atrial fibrillation (AF) is highly prevalent (10-20%) in patients with end-stage renal disease who receive maintenance dialysis. The prevention of embolic stroke, the most devastating consequence of AF, with oral anticoagulation (OAC) is one of cornerstones of caring for patients with AF.  However, as patients with advanced chronic kidney disease (CKD) have been systematically excluded from seminal trials of stroke prevention in AF, there is insufficient evidence regarding the safety and efficacy of OAC in dialysis recipients with AF. Though OAC may reduce the risk of embolic stroke in dialysis recipients with AF, the risk may outweigh the benefits in this complex population.  Patients with advanced CKD have a higher risk of bleeding, and the mechanism of stroke associated with AF may also be different from patients with preserved kidney function.  Accordingly, clinical equipoise exists about the use of OAC in dialysis recipients with AF. Prior to undertaking a definitive tria

The high mortality and disability rates of stroke has brought a heavy burden of disease to the world.  The burden of stroke is particular high in China due to the large and high risk population, such that stroke is the leading cause of death in recent years. For acute stroke, which is a critical illness, the benefits of acute treatment are extremely time dependent.  It is vital that new interventional measures can be tested rigorously for widespread acceptance to improve outcome from stroke.  Shortening the initial treatment time and improving access are important goals for patients with acute stroke. INTERACT4 is such a research project which is aimed at exploring the efficiency and safety of initiating hyper-early intensive blood pressure reduction treatment for patients with suspected acute stroke in the ambulance,.  The study will also assess the cost-effectiveness of this intervention over conventional management, with the hope of providing evidence for patients, health policy make

Aim： EduSaltS will develop a feasible, sustainable and adaptable scale-up package to reduce salt intake in schoolchildren and their families, with the ultimate goal of lowering the risk of developing of hypertension and cardiovascular diseases in the Chinese population. Methods： EdusaltS will be implemented in three regions of Beijing, Shijiazhuang and Zhenjiang. A pilot phase will develop a feasible and scalable school-based salt reduction package and conduct a pilot scale-up study in six schools of the three cities, including urban and rural areas. The program will be scaled up in all schools of the three cities with support from local education and health authorities. The effectiveness and efficiency of the program will be evaluated, as well as any barriers of facilitators to implementation. EduSaltS will be rolled out nationally, in combination with the existing school health education system and health promotion platforms

Cardiovascular disease, including stroke, is a leading killer-disease, threatening the health and wellbeing of millions of Chinese people. China has a particular high share of the global burden of stroke because of the large ‘high-risk’ population. Acute spontaneous non-traumatic intracerebral hemorrhage (ICH), or bleeding from a ruptured blood vessel within the brain, is the most serious and difficult-to-treat type of stroke. How best to manage various physiological abnormalities, such as elevated blood pressure and glucose (‘sugar’) in the blood, of patients with ICH is a hot topic at home and abroad.   Co-sponsored and implemented by West China Hospital and The George Institute China, INTERACT3 is a clinical research project to tackle the increasing challenge imposed by ICH, the most serious type of acute stroke due to bleeding in the brain.  It was initiated to determine the effects of a ‘care bundle’, or package of treatment involving systems of care to ensure rapid use of int

Drowning is emerging as an important global health issue. In 2018, the World Health Organization reported 320,000 drowning deaths globally, with an estimated 90% of drownings occurring in low-and middle-income countries (LMICs). 62,000 deaths, or almost one fifth of the burden, is in India. Children aged 1-9 are most at risk of drowning. Children in some coastal regions of India such as the Sundarbans in the northern state of West Bengal are at a high risk of drowning, due to poor infrastructure, rurality, presence of unregulated open water, lack of safety awareness and inadequate health systems. The World Health Organization has recommended four community-based interventions in rural LMIC settings to reduce drowning in young children. These interventions are: the installing barriers controlling access to water (such as playpens and fencing), the provision of safe spaces away from children with capable child care, teaching school-aged children basic swimming and rescue skills and training adult bystande

Background Globally, burns are a leading cause of disability, with over 8 million years of life lost each year. The burden of burns falls disproportionately on the poorest. It is estimated that 114,000 deaths every year are caused by fire-related injury, the majority of which occur in low- and middle-income countries. In 2019, 23000 fire-related deaths were estimated to burns in India, which is around 20% of the global mortality burden. Around 1.5 million disability-adjusted life years were estimated to be due to fire-related injuries. Burns statistics in India reflect gender and social inequality. Mortality due to burning is three times higher among women aged between 15-49 years, and four times higher among women aged between 15-34 years. The lack of effective quality burns services, and the absence of coordinated efforts within the health system, contribute to high mortality and morbidity rates. The burden of incurring high out-of-pocket costs and catastrophic expenditure for the family is highest in

Background Geographic clusters with high burden of CKD of unknown cause (CKDu) have been identified in several parts of the world. In Sri Lanka and Central America (Mesoamerican nephropathy), manual labour under very hot conditions in agricultural fields leading to heat stress has been established as the cause. The role of heat exposure on kidney health has not been evaluated in patients with CKDu in the Uddanam region of Andhra Pradesh.  Andhra Pradesh has experienced repeated heat waves for the past 4 to 5 years, and so evaluating the effect of heat stress on kidney function provides a unique opportunity to understand if prolonged exposure to heat is responsible for the high burden of CKD in this region. This study will pave the path for better insights into the role that heat stress plays in the development of on kidney disease in the Indian population. The interventional component of the study will help identify public health strategies towards implementing preventive approaches to mini

Chronic Obstructive Pulmonary Disease (COPD) is the third-leading cause of global health-related disease and deaths. Heart disease is very common in people diagnosed with COPD, and is often the cause of health-related sickness and hospitalisations, causing 30-50% of deaths. Studies repeatedly show that cardiovascular disease in patients with COPD is under-recognised and under-treated yet patients with COPD are frequently not included in clinical trials of drugs which treat heart disease and reduce cardiac deaths.Beta (β)-blockers are medications often used to treat heart disease.  In this study, we will be investigating whether pro-active treatment with a β-blocker in participants with COPD can reduce cardiac events, such as stroke and heart attacks from occurring in the future, compared to placebo. This is important for people with COPD with either known or unknown underlying heart disease. The study also aims to investigate whether this treatment reduces the number of episodes of respiratory exacerba

This research is building on the Ironbark: Standing Strong and Tall project conducted by TGI in 2015 – 2016.  This project found that there was a lack of Aboriginal specific falls prevention and other healthy ageing programs for older Aboriginal and Torres Strait Islander people in Australia. The Ironbark: Standing Strong and Tall program was developed to address this gap.      The Ironbark trial is a cluster randomised control trial comparing the health outcomes of the Ironbark: Standing Strong & Tall program (a weekly exercise and yarning circle) to the Ironbark: Healthy Community program (a weekly social program) among groups of Aboriginal people aged 45 years and older.   The research includes funding local Aboriginal services to deliver one of the programs for 10 – 15 Aboriginal people for 12 months.  We aim to recruit 60 services and around 600 participants (both men and women) into the trial over the next 4 years.  We are working with collaborators i