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About 40 per cent of working age people who were in paid employment at the time of their stroke believe that their job contributed to their illness, a new study has revealed.

These results of the Psychosocial Outcomes in Stroke (POISE) study will be presented today at the Stroke 2012 Conference in Sydney.

It shows that people who perceived their jobs to be highly stressful were likely to blame work for their stroke despite “little evidential support,” for this belief, according to the researchers.

“This belief was more likely in those with a number of work-related risks, and [among] the more anxious,” the researchers from The University of Sydney and the George Institute, say.

Of 414 working age stroke survivors recruited for the study and interviewed 28 days after their stroke, 208 were working prior to their stroke and 40 percent thought work caused their stroke.

“The novel finding of union membership making this attribution more likely, regardless of job stress, suggests that efforts to improve work rehabilitation need to include this important …group,” they say among their conclusions.

The research was funded by the National Health and Medical Research Council.

More than 700 local and international clinicians and scientists have gathered for the Stroke 2012, running from 29-31 August at the Sydney Convention and Exhibition Centre.

For more on risk factors www.strokefoundation.com.au

People who have suffered a brain injury often find that friends disappear quickly. Some find it too difficult to cope with hospitals and rehabilitation phases, while others may have simply have been ‘fair weather’ friends. In other cases, personality changes or challenging behaviours can drive friends away.

The families caring for someone with a brain injury may find they lose their friends for similar reasons. Added to this can be the fact that a brain injury in the family can be so traumatic that there is little else that you can focus on. Even the best of family friends may find it difficult to share your focus on an event that has changes your life so drastically. Often people are bitter at this desertion by friends who thought would stick with them.

Another issue for families can be the disbelief of friends. For example Sue’s friends simply don’t believe that her husband, Allen, had a raging temper, can no longer control his money and is self centred. They only see his charming witty side that he can still project in short public appearances. Sue is finding it difficult when her best friends are starting to believe she is making up stories about Allen for sympathy.

In these situations you can either provide your friends with information about brain injury (and stroke) or remember your local brain injury association or the National Stroke Foundation or association is always available if you are close to breaking point. Sometimes getting things off your chest to someone who understands can be a great relief!

Some final points worth considering are:

• Look at establishing new friendships in a support group
• Keep your appreciation of support from friends high while keeping your expectations low
• Finding strategies for challenging behaviours to prevent social exclusion
• Try to be understanding if friends come back after the worst phase of hospital and recovery are over
• Carers may need to focus in talking about ‘normal’ things with friends some of the time.

Call StrokeLine to talk to a health professional for free information and advice. 1800 STROKE (787 653) or get help through our website www.strokefoundation/get-help.com.au.

Thank you to The Brain Injury Association of Queensland for the article in Synapse Bridge Magazine the official journal of BIAQ. This article was first printed from the ABIOS fact sheets available at www.health.qld.gov.au/abios.

Results from a James Lind Alliance Priority Setting Project.

The JLA priority setting partneship was established to identfy research priorities relating to stroke, and aims to ensure meaningful patient invlolvement in this process.

For this list of top 10 research priorities, 548 treatment uncertainties were gathered. These came from: 15 stroke groups and clubs, 22 individual survivors, four health professional groups, 61 individual health professonals and three guidelines/ research recommendations in Scotland in 2012.

Top 10 life after stroke ‘research’ priorites.

1. What are the best ways to improve cognition after stroke?

2. What are the best ways of helping people come to terms with the long term consequences of stroke?

3. What are the best ways to help people recover from aphasia?

4. What are the best treatments for arm recovery and function, including visual feedback, virtual reality, bilateral training, repetitive task training, imagery/mental practice, splinting, electromechanical and robot-assisted arm training and botulinum toxin.

5. What are the best ways to treat visual problems after stroke?

6. What are the best ways to manage and/or prevent fatigue?

7. What are the best treatments to improve balance, gait and mobility, including physiotherapy, gait rehabilitation, visual and auditory feedback, electrical stimulation, different types of ankle foot orthoses and electromechanical assisted gait training?

8. How can stroke survivors and families be helped to cope with speech problems?

9. What are the best ways to improve confidence after stroke, including stroke clubs/groups, offering support, one-to-one input and re-skilling?

10. Are exercise and fitness programs beneficial at improving function and quality of life and avoiding subsequent stroke?

Here is an article from the Guardian UK about the research project.

Patients can now look for adverse reaction reports about drugs they are taking, after the Therapeutic Goods Administration made its full events database available online.

As part of ongoing reforms to make the drug regulation agency more transparent, on Wednesday the TGA launched the searchable portal, which contains every adverse event report received since 1971.

There are more than 250,000 events recorded in the database, including 14,000 events reported last year.

The reports cover prescription medicines, over-the-counter medicines sold in pharmacies and supermarkets, and registered complementary medicines.

Consumers can search for medicines by either their brand or generic name, and whittle results down to a particular time period. As well as overall numbers of reactions, the results are broken down into the type of reaction or symptoms experienced.

The agency is already warning patients against knee-jerk reactions if they are concerned about any reports they find on the database.

“The data should not influence a person’s decision to stop taking a medicine,” Parliamentary Secretary for Health and Ageing Catherine King said.

“It is simply meant to give consumers additional information that they can discuss with their healthcare professional if they have any concerns.”

A disclaimer on the portal says that an adverse event report is not confirmation a medicine caused a particular reaction.

“Adverse events are suspected of being related to a medicine, but this relationship is usually not certain — the symptom may be related to the underlying illness or to other factors,” the disclaimer states.

“It may be a coincidence that the adverse event occurred when the medicine was taken.”

The TGA website contains no figures on the total number of people taking a particular drug, so it is not possible to calculate adverse events rates.

Events listed on the database have been reported by members of the public, medical professionals, and drug manufacturers and suppliers.

Each reported event is analysed by the TGA before it goes online. If there is absolutely no suspected link between a drug and a reaction, the report is not included in the database.

Ms King said the launch of the database was a “great advance in transparency”.

“I expect the public and industry will welcome this information resource which will improve reporting of adverse events,” she said.

Remember: Always consult your Doctor about any concerns you have about medication.

Article originally printed in Neurology Update August 8th

When Maryanne Kimpton answered the phone on a Saturday morning in October 2006, it was a friend telling her to take warm clothes when she headed off to a party in Woodend, country Victoria, because it had just started to snow there.

She wanted to tidy up before she left, thinking that she might stay the night in Woodend, about an hour away from her Westmeadows home, rather than drive back in the dark. This is what she told her husband, who was away for the weekend, when she spoke to him. She only had herself to get ready.

Maryanne knows she must have been ahead in her chores that morning because she remembers mowing the lawn. She remembers coming inside the house from mowing the lawn and remembers the time – it was about 10.30 - but doesn’t remember undressing for the shower, although she must have.

The reason she remembers these small details is that they are the last memories she has of her life before stroke. The following night, about 36 hours later, she was discovered on the floor of her bedroom by her husband and her father.
“I came in from mowing the lawn at 10.30 and I had planned to leave for Woodend at 12.30,” Maryanne, an accomplished hockey player, says.

“Some time in there I collapsed and when I was found the next night I apparently looked like I had been heading for the shower but the last thing I remember is the time it was after coming in from the garden.”

She spent two weeks at the Royal Melbourne Hospital, where she had a carotid artery bypass, and five weeks in rehab. At first Maryanne, who fortunately did not lose her speech or use of her arms, could not walk at all. She took her first unaided steps post-stroke on her 40th birthday on 1st December 2006.

“Mum was there, crying,” Maryanne says.

While she was in hospital she met Lyn, a 35-year-old who had suffered a stroke. Lyn was a member of the Young Victorian Stroke Survivor Group and Maryanne went along once – and kept going.

The group, which has about 20 members, meets somewhere central in Melbourne once a month for coffee and activities and is intended for stroke survivors aged 18 – 35.

“It isn’t exclusive but we found there really is a need for younger people to have their own support group,” Maryanne says.
“There can be different social issues having a stroke as a younger person.”

Maryanne is back at work and still lives in her Westmeadows home. Apart from some pain she experiences in her right foot, she has fully physically recovered from her stroke.

You can email MaryAnne info@yvssg.org.au

Young Victorian Stroke Support Group www.yvssg.org.au