Prevention of Stroke and Post-stroke Dementia: A Public Health Approach

Review Article | DOI: https://doi.org/10.31579/2642-973X/178

Prevention of Stroke and Post-stroke Dementia: A Public Health Approach

  • Abba Musa Abdullahi 1*
  • Jeevan Gautam 2

1University of South Wales, UK.

2Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

*Corresponding Author: Abba M Abdullahi. University of South Wales, UK. Email: amusabdullahi48@gmail.com

Citation: Abba Musa Abdullahi, Jeevan Gautam, (2026). Prevention of Stroke and Post-stroke Dementia: A Public Health Approach, J. Brain and Neurological Disorders, 9(3): DOI:10.31579/2642-973X/178.

Copyright: © 2026, Abba Musa Abdullahi. This is an open-access article distributed under the terms of The Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Received: 27 May 2026 | Accepted: 03 June 2026 | Published: 10 June 2026

Keywords: stroke; post-stroke dementia; health promotion; stroke prevention; risk factor modification; lifestyle intervention; vascular risk factors; health literacy; public health policy; community-based prevention

Abstract

Stroke is a debilitating neurological emergency with high morbidity and mortality causing serious disabilities among survivors. It is a largely preventable condition, primarily with modifications of risk factors. Post-stroke dementia is a clinical entity that includes any form of dementia which occurs following stroke. It comprises of vascular, degenerative or mixed dementia affecting about one-third of stroke survivors. However, no effective therapeutic strategies thus far exist to prevent the development of stroke or post-stroke dementia. The primary means of reducing the burden is through control of vascular risk factors and prevention of recurrent stroke, best achieved through a health promotion intervention which involve actions enabling people to improve and have a control upon their health. In this article, we have reviewed Health Promotion Interventions and their roles in the prevention of stroke and post-stroke dementia, discussed the policies and practices that are currently employed in the prevention of the menace as well as potential barriers to the prevention.

Introduction

Stroke is a preventable disease but also a medical emergency that has high morbidity and mortality, causing both physical and mental disability. Globally, it is the second leading cause of death and the third most common cause of disability with a significant burden on health systems, populations, and individuals. The incidence of stroke is estimated to have been increasing over the last 25 years and would probably continue to increase, over the next few decades [1]. As of 2013, about 25.7 million people are living with stroke globally, with 6.5 million deaths, and 113 million people still living with a stroke-related disability with 10.3 million new cases of stroke with the majority of the cases coming from the developing nations [2]. The age distribution of stroke patients is different in the developing and developed countries. In developed nations, more than half of the stroke patients are 70yrs or above, whereas, in developing nations, less than half of the patients are 70yrs or above [1]. Stroke is defined by the World Health Organization (WHO) in 1970 as “rapidly developed clinical signs of focal (or global) disturbance of cerebral function, lasting more than 24 hours or leading to death, with no apparent cause other than of vascular origin” [3]. There are two main classes of stroke: ischemic stroke (80% of cases) and hemorrhagic stroke (15-20% of cases). Ischemic stroke occurs as a result of occlusion of cerebral blood vessels usually caused by either thrombosis or embolism, whereas hemorrhagic stroke occurs due to rupture of cerebral blood vessels or aneurysm [4].

The development of dementia following stroke is not uncommon due to close relationship between dementia and stroke. The prevalence of post-stroke dementia (PSD) is between 7% and 41% at one year and increases at an average rate of 3% per year. Many prevalence studies have reported one to one relationship between stroke and dementia in which one in each ten patients have pre-stroke dementia, one in ten will develop dementia following stroke and one in ten will develop dementia after stroke recurrence [5]. The risk of dementia after stroke was identified to be highest within the first few months following stroke, possibly due to unidentified pre-stroke cognitive decline with cumulative incidence increasing proportionally at a rate of 3% and 1.7% per year in hospital-based and population-based studies, respectively. In one of the longest observational population-based study, the cumulative incidence of post-stroke dementia was found to be 48% at 25 years [6]. Studies have shown that even a minor form of stroke may present with varying forms of cognitive dysfunction ranging from impaired executive function and affectation of daily functioning to impaired cognition affecting social participation and quality of life [7]. Post stroke dementia (PSD) can be defined as any form of dementia that occurs after a diagnosis of symptomatic stroke, usually within three months of stroke onset. It overlaps the criteria for vascular dementia, which is dementia in patients who have evidence of cerebrovascular disease, but not necessarily following a symptomatic stroke [7,8].

As with stroke, the development of PSD has been associated with well-known modifiable risk factors such as hypertension, diabetes, dyslipidemia, obesity, low physical activity, unhealthy diet, smoking, or excessive alcohol consumption [9]. Therefore, the most important strategy to prevent stroke as well as cognitive decline after acute stroke is by lifestyle or multiple risk factor modification which can be achieved through health promotion, a process of enabling people to increase control over, and to improve their health through encouraging healthy life styles, creating supportive environments for health, strengthening community action, orienting health services to place primary focus on promoting health and preventing disease, and building healthy public policies [10]. Once these risk factors are identified, targeted, and then controlled via health promotion strategies, then stroke and PSD prevention are ensued. Therefore, the aim of this review was to encourage population-wide preventive strategies for the prevention of both stroke and post-stroke dementia.

Population-Wide Prevention Strategies

Scope

The population-wide prevention strategy was one of the most important strategies of preventing chronic diseases. Any small change in the distribution of risk factors has been shown to have caused major reductions in vascular diseases like stroke and its associated dementia. It was considered by Sir Geoffrey Rose (1985) as the most effective approach to primary prevention of vascular diseases. The emphasis on prevention of stroke and PSD should be shifted from the high-risk approach to a more encompassing and promising approach that includes aggressive control of modifiable risk factors as well as behavioral and lifestyle modification [10]. This approach was prioritized by World Health Organization (WHO) in the prevention of chronic diseases like stroke and dementia through disease surveillance, preventive, and health promotion programs. The most important population-wide prevention strategy is health promotion, defined as the process of enabling people to increase control over, and to improve their health through developing personal skills, creating supportive environments for health, strengthening community action, re-orienting health services to place primary focus on promoting health and preventing disease, and building healthy public policies. These were the five key action areas of health promotion created by WHO during the first International Conference on Health Promotion held in Ottawa, Canada, in 1986. It can be achieved through three health promotion strategies: to enable, to mediate, and to advocate [11]. Figure 1 below summarizes the health promotion action areas and strategies:

                                                                                        Figure 1: Health Promotion Action Areas and Strategies

Developing Personal Skills

Developing personal skills entails ability of individuals to make healthy decisions. There are many intervention programs for stroke and subsequent PSD prevention that give information and education, which help develop health literacy and understanding of unhealthy behavior and development of personal stroke preventive strategies with consequent attainment of personal life skills. In a Simmons et al. study (2009), ANGELO (Analysis Grid for Elements Linked to Obesity) Framework was used to organize a workshop for many communities in Australia with the aim of enhancing knowledge regarding preventing obesity, which is an important risk factor for both stroke and dementia. After the workshop, the communities were found to have gained considerable skills to promote healthy eating and physical activity [12]. Additionally, due to the high prevalence of stroke in Australia with the high blood pressure as the most significant risk factor, a program termed ‘Know Your Numbers’ program was instituted to increase community knowledge and awareness regarding their blood pressure and other cardiovascular risk factors for stroke. At the end of the program, improved knowledge and awareness regarding risk factors for hypertension and cardiovascular risk factors were found among the participants [13]. In another study by Ravenell et al. (2015) in New York, increased stroke literacy was found following stroke education films on changing behavior patterns of calling 911 in a suspected stroke. The films targeted awareness of stroke symptoms and its severity, consequences like dementia, the therapeutic benefits of timely hospital presentation, and calling 911 [14]. Therefore, any intervention, like the ones cited, that will help community or individuals to acquire health-related knowledge regarding the risk factors and symptoms of stroke and its consequent post-stroke dementia, as well as awareness on the importance of the early hospital presentation would contribute to the effective prevention of PSD and modification of its risk factors.

Creating Supportive Environment for Health

Environmental risk factors have long been linked with the development of chronic diseases like stroke and dementia. Living and working conditions should promote health, and environments (work, home and leisure) that would support healthy living such as healthy food choices, smoke free work sites, and healthy social norms should be created. Thus, creating a supportive environment would immensely impact on the prevention of stroke and PSD [15]. Interventions that would transform the physical, social, communication, and economic environments from unhealthy to healthy should be employed in the prevention of stroke risk factors. These interventions should support and provide opportunities for people to develop healthier behaviors and alter individual behaviors to healthy lifestyle like reduced tobacco consumption, or even alter unhealthy social norms. Some of the environmental policies that are used in the prevention of chronic diseases like stroke and dementia include clean indoor air and access to healthy food policies for the physical environment; high tobacco cost and affordable fruits and vegetables for the economic environment; awareness-raising and defacing unhealthy behaviors for communication environment [16].

Strengthening Community Action

Health promotion aims to enable and empower communities, provide them with resources so that they actively participate in health decisions which lead to better health outcomes. They can apply those skills acquired to other situations to determine what their needs are and how best they can achieve them. Therefore, any intervention program can only become successful if the community is encouraged to fully involve in the planning, evaluation, and execution of the program [11]. Many health promotion interventions are currently in use for the prevention of stroke and its subsequent PSD, which involves enabling the community to take care of their health. For example, self-measured blood pressure was employed in the monitoring of blood pressure to enable people to participate and take care of their health condition. The US formulated guidelines for self-measured blood pressure, which aim for the diagnosis and management of hypertension, the most significant risk factors for stroke [17]. Giachello and colleagues conducted a study in Chicago of United States, which actively involved the community in a program aimed at mitigation of diabetes-related morbidity and mortality. This involvement of the community was shown to have enhanced the community’s understanding of the intricacies of diabetes and its associated morbidities like stroke and PSD, pertinent social causes, and potential solutions. Along with preparing them for social action, this participatory process also resulted in voluntary involvement of many stakeholders within the community, with efforts to identify and address the existing sociopolitical problems [18]. These demonstrated the importance of strengthening community action for their health which could immensely modify risk factors and prevent chronic diseases like stroke and dementia.

Re-orienting Health Services

For effective stroke and PSD prevention, health services must be designed in a way that will result in increasing the pursuit of health and also address the general needs of a person, and not only his disease conditions. The intervention programs must take into cognizance the cultural and societal norms of the community to help them achieve a healthy lifestyle [11]. In the United States, Worksite Health Program laws were already enacted, which mandated employers to incorporate health promotion programs in their workplaces. This can be either onsite programs or insurance programs. The former involves the creation of programs directly into the worksite like provision of fitness sites, work schedules allowing exercise during working hours, and provision of healthy diets in the worksite cafeterias whereas, insurance program entails the provision of insurance by employers to their employees like coverage for gym memberships or any preventive health care services [19]. All these services are essential preventive measures that involve health services reorientations, which would significantly reduce or eliminate cardiovascular risk and other risk factors for stroke and PSD.

Build a Healthy Public Policy

The WHO has taken many steps in developing government-driven health policies in many regions and countries all over the globe for the prevention and management of chronic diseases like stroke and dementia. At the 9th Global conference on health promotion, WHO urges the governments to formulate policies that will reduce unhealthy living such as taxing the companies that produce sugar-sweetened beverages to reduce their significant contribution to obesity and diabetes which contribute to stroke and PSD [20]. In Australia, the government health policies include increasing taxation on tobacco and alcohol products with price monitoring of healthy food products. Healthy eating and physical activity were introduced into the community, schools, and workplaces to modify risk factors aimed at preventing stroke and its consequences like PSD. Additionally, in May 2010, the Men’s Health Policy was introduced and the Women’s Health Policy of 1989 was updated, and they both stress on the prevention of cardiovascular disease and stroke risk factors [21]. Similarly, in the year 2000, the Healthy People 2010 goal was formulated by the United States (US) government which prioritize heart disease and stroke prevention with the main objective “to improve cardiovascular health and quality of life through the prevention, detection, treatment, and control of risk factors; early identification and treatment of heart attacks and strokes; and prevention of recurrent cardiovascular events” [22]. Also, the US government makes many policies and environmental changes that affect its population through ‘The Public Health Action Plan to Prevent Heart Disease and Stroke’ (2003) and the 2010 ‘Affordable Care Act’ (US Healthcare Reform Legislation), both aimed at lifestyle modification changes with the main goal of preventing cardiovascular diseases and stroke [23]. Generally, healthy public policy for stroke and PSD prevention aimed at replacing unhealthy lifestyles among the population with alternative healthy ones. There are currently many healthy public policies that focus on reducing stroke risk factors or eliminating them, and these include US Dietary Guidelines, Physical Activity Guidelines for Americans, and financial policies that increase the cost of smoking among others [23]. 

Potential Barriers

Health promotion interventions such as stroke literacy and awareness, control of hypertension and lifestyle modifications like physical activity, smoking cessation, moderation in alcohol consumption, healthy diet, healthy weight and living stress-free life significantly reduce and eliminate stroke risk factors and thus prevent the development of stroke and PSD. However, many factors can potentially prevent targeted community from accessing and adopting these interventions. These barriers can be at an individual level, community level, or a healthcare provider level [24]. Figure 2 below shows the various levels of health promotion barriers for stroke prevention:

                                                                                                           Figure 2: Levels of Health Promotion Barriers

The Individual Level Barriers

Individual level barriers entail a lack of psychological orientation of an individual in which a person might have difficulty perceiving the relative importance of these health promotion interventions and complying with the proscribed actions as compared to the services that give an immediate effect like pain relief. Additionally, many people have knowledge barriers as they are unaware of their risk factors and thus unable and undetermined to undergo healthy lifestyle modifications. In some instances, people underutilized stroke preventive services due to fear (social insecurity), lack of insurance (financial insecurity), and sometimes denial [25]. Furthermore, the socioeconomic status of an individual serves as a barrier to attaining a healthy lifestyle. For example, in a study by Yeah and colleagues, it was found out that some of the US’S population do not take the recommended amount of fruits and vegetables and this was shown to be partly related to the high cost and low socioeconomic status of the study population despite awareness of the health benefits of fruits and vegetable consumption [26]. In another study by Williams and colleagues regarding the perceptions of primary care physicians in Indonesia concerning barriers to screening and patient education to reduce stroke risks, the physicians believe that among the common barriers were patient misconceptions with regards to their stroke risk factors as well as patient unwillingness to adopt behavioral modifications for healthy lifestyle coupled with their low level of education [27].

The Community Level Barriers

Community level barriers include factors like cultural and societal disharmony. Many stroke prevention interventions do not succeed due to potential disharmony between the interventions and the societal values, norms or perceptions. Therefore, to prevent these barriers, the interventions should not be in such a way that the community might perceive it as parallel to their culture and norms. Furthermore, stroke prevention intervention might lack community support as in lack of participation by the community stakeholders and individuals, especially when they were not involved right from the point of decision making to the planning and implementation [24]. Many studies have demonstrated the association between the incorporation of culture in health promotion interventions and the attainment of healthier lifestyles. In African-American communities, for example, communication programs that incorporated their cultural norms and values have yielded more impact on stroke prevention than the conventional approaches. Therefore, for a stroke and PSD prevention programs to be effective, it should consider and address the cultural characteristics of the target community [28].

The Healthcare Provider Barriers

Healthcare provider barriers simply mean the reluctance of the health care providers to assume responsibility for stroke and PSD prevention services. Many health care providers assumed that, it was the individual patient’s responsibility to promote his health condition, modify his stroke and PSD risks, and prevent the development of stroke and PSD. Healthcare provider barrier is more so with regard to specialists like neurologists who do not perceived stroke and PSD preventive services as their role, but the primary care physicians’ responsibilities. Additionally, many health care providers lack the knowledge and expertise in the identifications of stroke risk factors, symptoms, and symptoms severity and, therefore, are unable to provide proper stroke literacy information to individual patients or communities. Similarly, the health care provider may underestimate the perceived stroke or PSD risks in an individual or community and thus become unwilling to offer a health promotion intervention program for the prevention of stroke occurrence and its consequent PSD [25]. Table 2 below shows examples of some barriers at various levels:

                                                                                              Table 1: Showing some examples of barriers at various levels.

Conclusions

Stroke and post-stroke dementia are serious neurological diseases with devastating consequences that affect many communities causing high burden on the health care system and high economic cost. It has high mortality with many years of disability among survivors. However, they are highly preventable through early detection, screening, and modification of risk factors. Health promotion intervention programs should be adopted as strategies for primary prevention of PSD through healthy public policies, strengthening community participation in any intervention program, creating a supportive environment for stroke and PSD prevention interventions, helping individuals and communities develop skills for preventive measures, and then reorienting unhealthy health services. However, potential barriers at individual, community or healthcare provider level could have deterred successful achievement of these intervention programs and should always be considered in the design and conduction of preventive services.

References

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Hala Al Shaikh

Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD

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Dr Eric S Nussbaum

Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.

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Dr Susan Anne Smith

Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.

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Dr Victor Olagundoye

Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.

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Dr Farahnaz Fallahian

Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.

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Dr Susan Anne Smith

Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.

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Dr Oleg Golyanovski

To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina

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Dr Elvira Farina

My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.

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Gertraud Teuchert-Noodt

We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.

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Dr David Vinyes

Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.

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Dr Anyuta Ivanova

I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.

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Dr Farooq Wandroo

"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".

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Dr Shweta Tiwari

To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.

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Dr Tewodros Kassahun Tarekegn

I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.

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Cristina Berriozabal

Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."

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Thomas Urban

I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.

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Zhao Jia

My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.

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Luiz Sellmann

My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.

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Sonila Qirko

My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.

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Lin-Show Chin

Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner

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Dr Susan Weiner

Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”

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Zsuzsanna Bene

Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.

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Dr Maria Regina Penchyna Nieto

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.

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Dr Maria Dolores Gomez Barriga

Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.

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Maria Dolores Gomez Barriga

The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.

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Lin Shaw Chin

Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.

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Gomez Barriga Maria Dolores

Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.

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Khurram Arshad

Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.

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Rui Tao

“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.

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George Varvatsoulias

Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.

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Tania Munoz

I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.

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S Munshi

I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.

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Husain Taha Radhi

I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.

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Dr Tong Ming Liu

We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.

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Dr Griffith

I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.

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Douglas Miyazaki

"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".

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Jesus Simal-Gandara

I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!

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Baheci Selen

Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.

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Bruno Chauffert

Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.

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Dr Suramya Dhamija

International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.

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Andreas Filippaios

Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.

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Raed Mualem

As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.

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Dr Shiming Tang

Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.

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Hao Jiang

This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.

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Prof Sherif W Mansour

Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.

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Bernard Terkimbi Utoo

Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.

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Pedro Marques Gomes

Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.

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Anthony Kodzo-Grey Venyo

Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.

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Katarzyna Byczkowska

Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.

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Orlando Villarreal

The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.

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Sing-yung Wu

We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.

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Layla Shojaie

Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.

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Mina Sherif Soliman Georgy

Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.

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Ziemlé Clément Méda

Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.

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Delcio G Silva Junior

Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.

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Virginia E. Koenig