bbc.co.uk

PUBLIC LECTURE
by Dr Malcolm Macleod, Centre for Clinical Brain Sciences, University of Edinburgh
Allan and Maria Myers International Fellow 2011, Florey Neuroscience Institutes

Saving brains: developing new treatments for old diseases

Dr Malcolm Macleod is Reader and Head of Experimental Neuroscience at the Centre for Clinical Brain Sciences, University of Edinburgh and President of the European Stroke Research Network for Hypothermia. His broad area of neurological research is stroke, and specifically clinical trials testing the benefits of mild hypothermia in stroke patients. Other research focuses on the use of systematic review and meta-analysis of information from animal models of neurological disease to improve the effectiveness of the ways we develop new drugs.

Monday 8 August 2011, 5–6pm
Venue
The Oratory, Newman College, University of Melbourne
887 Swanston Street, Parkville

The National Stroke Foundation is committed to funding high quality research and supporting innovative stroke research to improve stroke prevention and management. The Research Advisory Committee has developed a research strategy. which addresses gaps in both knowledge and evidence in stroke care to build capacity among stroke researchers in Australia.

Thanks to our friends at Florey for holding the lecture.

Article by Michael Slezak in Neurology Update

Despite limited funding, the National Stroke Foundation’s public awareness campaigns have successfully changed behaviours, potentially saving thousands of lives, an independent study published in Stroke finds.

Examining the monthly proportions of ambulance dispatches in Melbourne that were designated for strokes between 1999 and 2010, researchers found the proportion increased since 2004 when the NSF began its public awareness campaign. The increase became significant since the ‘call an ambulance’ message was added to the campaign in 2007.

Over the period of the study, the proportion increased from 2.1% of dispatches to 2.95%. Prior to the start of the campaign, the highest proportion of dispatches for stroke was in winter, the wellknown peak season for stroke. After the campaign started, the highest proportion moved to spring, following the yearly campaign push during National Stroke Week.

The program still relies heavily on individual donations and pro-bono advertising, even in Victoria where the state government provides the most funding of any state ($200,000 to $300,000 annually).

“Given the level of funding the program received we were surprised just how big an impact the program had on calls to ambulance,” said lead author Janet Bray, senior research fellow at Ambulance Victoria.

“Campaigns like this do appear to be successful at directing appropriate behaviour,” she said.

Pleased with the findings, Dr Bruce Bolam, divisional director of prevention and awareness at the NSF, said the Foundation was already planning on running the FAST (Face, Arm, Speech, Time) message year-round and focussing on a new message during National Stroke Week.

During this spring’s stroke week the message was going to be “one in six”, he said. “It’s saying one in six people world-wide will experience a stroke at some time in their lifetime, but most of those strokes are preventable… People need to know more about it and how to prevent it.”

Dr Bolam said the study results provided a good case for the program to receive more consistent government funding around the country.

Mr David Brownbill

Helen Glare did not know anything of the National Stroke Foundation until she was asked to give a donation in lieu until after her aunt died many years ago.

When her beloved mother Katrine, who Helen describes as “adored – she was my best friend”, also died of a stroke in1998, reliving the devastating experience of stroke led her to become a regular donor and volunteer with the NSF.

Sometime in the evening after Helen’s regular visit to her mother, Katrine suffered a severe stroke.

She was found the next morning. Helen feels that if her mother had the opportunity to get help quickly, she may have survived.

Helen has recently made provision in her will, in honour ofher mother, to leave a bequest to the NSF, boosting her contribution to what she describes as “a very important organisation doing great work.”

Helen says she is proud to be a donor and to contribute to a better life for future generations of Australians. By leaving a bequest to the NSF, Helen joined the David Brownbill Society.

As a member of this group she enjoys regular lunches and afternoon teas with a variety of interesting guest speakers.

“I believe stroke as a condition is chronically overlooked,”Helen says. “Something like breast cancer has so much support and gets so much publicity … I would like to see more support and publicity for stroke as it kills more people.”

Helen has worked as a volunteer for the NSF as a Strokesafe ambassador – educating community groups about stroke, how to prevent it and the FAST message.

Helen says she is passionate about making sure as many people as possible know that a stroke is preventable and acting fast can save a life or reduce disability.

A proud mother and grandmother, Helen, who lives at Laranear Geelong in Victoria, was a theatre nurse before she retired and so saw stroke in her work.

“What happens to the families afterwards is so devastating,” Helen says. “I’m determined to do my best to improve outcomes for everyone by supporting the NSF.”

Donors who leave a bequest to the NSF as part of their will may choose to leave a percentage of their estate or a specific dollar amount. If you would like more information about leaving a bequest or attending a David Brownbill Society function in your area, please call our donor liaison team on1300 194 196 or email bequest@strokefoundation.com.au

To find our more about stroke go to www.strokefoundation.com.au.

Yvonne Thompkins of Perth, WA, tells her story of stroke and recovery:

“In my world, everything was perfect. My wonderful husband, my beautiful three-year-old son whom we both adored, and now our newborn baby was already melting our hearts.

On the fourth day after her birth life as we knew it was about to explode.

I had been transformed from a fun-loving wife and mother of two into a partly paralysed, bewildered, traumatized mess, hanging on to life by a thread, not knowing why or how it happened.

Surely it was a bad dream. But no, it was true all right. Painstaking true and the next 48 hours were critical.

Apparently I had rheumatic fever at an earlier age and it went undiagnosed. It had affected the mitral valve in my heart which threw off a clot which then lodged in my neck. Then with the pressure of childbirth it travelled to my brain.

When I became aware of my surroundings I found I would simply break down and sob. I couldn’t bear to be separated from my devastated hubby, our confused three-year-old son or our beautiful newborn daughter.

Then the real struggle began.

My husband would appear with his wonderful warm grin and give me such a tender embrace I just longed to lose myself among his woolen sleeves. He would quiz me as to what I had for breakfast. I could see it in my head, but do you think I could name it? Morning after morning it became a ritual. Sometimes I would correctly answer and other times I would throw my hand over my eyes and laugh, cry or whatever emotion I could muster up at that time.

I stayed in hospital and had physio about three times a week. Sitting on a mat, rolling a ball, trying to push or pull with my afflicted right side.

I wanted more therapy but they didn’t have the resources at that hospital so I asked to be transferred to Shenton Park. I had heard they had a pool and more intense regime.

I went into ward 2. It was grey. Grey curtains, grey walls. Grey everywhere. I was in a ward of four or six people. The other patients were elderly. I was 21. That did not deter me because I was hungry for therapy.

I learnt the pool was not available for our use and physio sessions were just 40 minutes five days a week, occupational therapy only two hours a week and speech therapy one hour a week. I felt so let down that I arranged to go home and attend as a day patient.

I attended Shenton Park outpatient for a few weeks before I suffered from chest pains. The doctors listened to my heart but couldn’t hear anything new. The pain eventually wore me down so on our insistence Shenton Park arranged for chest x-rays. A spot showed up on one of my lungs. A scan revealed a clot. After another stint in hospital it was dissolved and eventually I was able to go home again. We didn’t qualify for any government support despite our applications. We were on our own, with an enormous task ahead of us.

I am now 59 years young and have had more years post stroke than I had before it. I thank God every day for everything I have and try not to dwell on what I don’t have.”

Don’t hide your light now – let it shine

Don’t hold back on love now – let it flow

Don’t temper your joy – let it inspire

Don’t deny your truth – let it be

Don’t imprison your imagination – set it free

Don’t reign in your creativity – let it go

Don’t mask your playfulness – let it play

Don’t resist your spirit – let it heal.

Response from NSF Clinical Council to question on Stroke Foundation Facebook

The paper published online by Sonal Singh and colleagues in the Canadian Medical Association Journal looked at the risks of cardiovascular events (e.g. heart attacks, strokes, transient ischaemic attacks, angina etc.) in those taking the medication varenicline (trade name Champix) to help give up smoking. The use of varenicline can double the chance of quiting smoking, which will reduce the chance of future strokes if sustained. The study by Singh has identified an increased risk of cardiovascular events during treatment with varenicline, although the risks of such an event remained low (about 1 in 100 people). There were very few fatal events overall, and there was no evidence of an increase in fatal events with the use of varenicline. Overall, the potential low, but probably definite increase in cardiovascular events in those taking varenicline needs to be balanced with the potential benefits of quitting smoking. Quitting smoking will half your risk of future stroke and is therefore very worthwhile.

The potentials risks of varenicline have been known for some time and therefore the decision to use varenicline to help quit smoking needs to be made after careful discussion with your doctor.

www.strokefoundation.com.au

HIGHER RISK OF STROKE IN POOR AREAS

The research finding that people who live in poorer areas are 70 per cent more likely to suffer a stroke than people who live in wealthier areas, published recently in the Medical Journal of Australia www.mja.com.au, is in line with a recent Australian Institute of Health and Welfare report that showed people from poor backgrounds are 1.8 times more likely to have a stroke than people from more affluent backgrounds.

This new research adds to a growing body of evidence that links social disadvantage with ill health, particularly stroke. As stroke is Australia’s second biggest killer and a leading cause of disability, these and other reports highlight the need for continued, targeted stroke awareness and prevention campaigns, as well as the need for stroke units in those areas where we now know there is a heightened risk of stroke in the community.

According to the AIHW, of the 34,945 stroke hospitalisations in Australia between 2007 and 2008, only half were treated in a specialist stroke unit.

Research shows that when patients are treated at hospitals with a stroke unit, as opposed to those without, there is a 20 per cent reduction in risk per patient of death and disability but according to the National Stroke Foundation, there remains a shortfall of 17 stroke units across the nation.

To read the article in Medical Journal of Australia.

To recognise the ’signs of stroke’.

Stroke can occur in an instant and unlike some other conditions it can strike without any warning.

Accepting that a loved one has become sick is difficult at the best of times but with an illness like stroke which is so sudden, and sometimes so severe, it can be very confusing and hard to adjust to the changes that follow, especially if you are a child. Nevertheless it is important they have the opportunity to understand what has happened to their loved one.

The NSF social media sites, the StrokeConnect online forum and StrokeLine have all attracted questions about how best to explain stroke, and its aftermath, to children.

It can be hard enough to explain to adults the causes and effects of a stroke, so after a little research we have put together a few general points for explaining the inexplicable to a child – although we also encourage you to talk to your health professional and other family members if you are in any doubt about the best approach to take with your little one.

1. Explain what a stroke is in language that is not misleading but in words that the child can comprehend (eg, a blood vessel taking blood to the brain wasn’t healthy and it bled or burst which meant the brain didn’t get enough blood for a while)
2. Explain the consequences – the brain controls the way we move, think and talk, so after a stroke people often move, think and talk differently
3. Even when the person who has had a stroke comes home from hospital they might have to see the doctor, or other people who can help them, a lot and they may not be able to do the same things they did before the stroke
4. Fatigue post-stroke is a major issue for many stroke survivors – make sure the child knows that the family member might need a lot of rest to get better
5. It can take a long time for someone to get better after a stroke

Children often blame themselves for adversity in a family. It is important to explain that the stroke wasn’t anybody’s fault, that it was caused by a medical problem and they didn’t cause it because they were naughty or by anything else they did.

There are some books that might be useful in explaining stroke to your child - ‘Grandpa’s had a Stroke - a book for children’ was written by Australian stroke survivor Helen McIntosh. To obtain copies of Helen McIntosh’s books or for further information, contact Helen at   hmcintosh@optusnet.com.au

The Stroke Association in the UK also has a factsheet full of useful tips for explaining stroke to children that you can download from the internet: go to www.stroke.org.uk.