Seven minutes in stroke - Dipes Mandel, Founder President Stroke Foundation of Bengal

We would like to congratulate Dipes Mandal for winning an individual achievement award for his work with the Stroke Association of Bengal.

What inspires you to advocate for stroke education? 

The helpless and hapless condition  of millions of stroke afflicted  people, most of whom could have been prevented is the most important factor which ignited me to work  in  the most easy way to save them from physical and economic devastation.  As India,  with a population of about  1.3billion with an annual stroke  incidence being about  2 million, the most important way to save them is stroke prevention through Stroke Awareness and Stroke Education, which was not properly  looked into till few years back. This is more important where the infrastructure for stroke care service is very insufficient, more so in rural areas, where two thirds of Indians  reside.

What does stroke care look like in your country?

Stroke care service is most neglected among the leading devastating disorders in India and needs immediate attention of all  stake holders. India  is a vast country with people of many faiths and cultural divides. The divide between the urban and rural is also big. Health care facilities are not equally available to all. Ideal stroke care is available only in a few big cities – in few  tertiary centres and only shows the the tip of the ice berg in stroke care service for those who can afford care in private hospitals.  In India   about 2million people are afflicted annually of which over 6 lakh die and many more are disabled after immediate crisis. Stroke is on the rise in developing countries where lifestyle diseases are becoming an epidemic  due rapid urbanization and fast life. However stroke occurs equally in  the rural areas where food types,  salt intake, tobacco addictions  (smoking and chewing) add to the undiagnosed hypertension and diabetes.  >85% strokes occur in developing countries like India which lack infrastructure and finances to tackle the malady. In India the alarming fact is that stroke strikes people about 15  years earlier than  those in the Western world. This means it affects the people in the most productive years of life. If the main bread winner, usually  the male here, is affected the family suffers enormously. In eastern India, there is high incidence  of hemorrhagic stroke in contrast to the western world. In our place, it has been observed that  people in the 40s and 50s have high incidence of hemorrhagic strokes. Uncontrolled/undiagnosed high blood pressure ( hypertension) is the commonest cause of all strokes especially hemorrhagic strokes. Proper data is lacking in India. What is a fact is that >70% people live in rural India and lack uniformity and accessibility to even basic health care facilities. The cost of stroke management is quite high in terms of acute management and also in subsequent  post stroke follow-up. there is no dedicated Stroke Institute existing in West Bengal which may  cater all aspects of management to a large number of stroke patients and stroke-prone individuals – Rural &  Urban, the  Rich and the Poor irrespective of age, gender, race, religion and region.

  

What element of stroke care are you most proud of?

That stroke is by and large preventable in > 85% cases has  to be ingrained in all stroke care facilities and programs. In India most people stop their blood pressure medications and chew tobacco or smoke.  With  our continuous campaign we have been able to make people realize ill effects of these addiction on the high incidence of stroke and heart attack. The importance of  proper rehabilitation and  required medication have been established among most of the cases and the caregivers. Moreover, there has been rapid awareness about recognition of stroke and  its early hospital management.

What have been the highs so far?

Very rapid spread of Awareness among the general public   about the  term “Stroke” which means Brain Attack , and not Heart Attack through intensive  uninterrupted stroke awareness  is  a very important development in Stroke  Awareness  and its management. People now realize the  importance of acute stroke management in a stroke centre. Importance of rehabilitation is also gaining grounds, even in rural areas.

             Stroke Foundation of Bengal (SFB), the only non-profit registered organization in India and a member of World Stroke Organization (WSO) is committed to fight stroke malady in our country with minimal resources and aids, in the guidelines adopted by World Stroke Organization. As stroke is very much a preventable disease and is better prevented (esp. By controlling high blood pressure and stopping tobacco addiction) than treated,  our Stroke Foundation started its stroke prevention campaign since its inception in 2006. Before  the inception of stroke Foundation, the different programs on stroke awareness was started  in the Mdedical College, Kolkata since 2000. Along with awareness,  a study was  conducted in 2003, to assess the level of awareness of stroke among the general people, which revealed about 65% of participant considered Stroke as  Heart attack. Following awareness programs, there are significant rise in stroke information   in all section of the society.

The standard conventional modalities of stroke education  include  seminars, meetings, leaflets distribution, articles in papers, magazines,  Bulletins, Stroke Documentary (with English subtitles) souvenir, etc., and also the  publication of quarterly stroke bulletin in both Bengali and English. The more recent modalities include regularly updated website (www.strokefoundationbengal.org),  Facebook etc.  We have received enough helps from print and electronic media in stroke awareness campaign .Stroke Foundation is also taking  care of rehabilitation program of the post-stroke disabled patients and also has formed Stroke Support Group (the second in India) for overall benefits of the stroke victims and their family members. The introduction of Stroke  awareness  about its risk factors and  future predictability  through smartphone  by installing Stroke Riskometer app  is the latest and most innovative tool  in  stroke care.  All these  works are moving slowly but steadily, and that is really very high  in  a vast country with so much population with significant lack of awareness.

The activities of the Stroke Foundation are appreciated by the leaders of the World Stroke Organization (which was also established in 2006) and as a recognition of its stroke campaign activities,  the Stroke Foundation of Bengal has won First Honorable Mention  in the WSO World Stroke Day 2010 & 2012 awards. SFB has included people from all walks of life in its campaign – a very positive aspect.

What have been the lows?

It is the apathy of the many people, due to lack of stroke awareness - both general and professional- which has hampered development of stroke care in India. The priority of Stroke care is much less than Tuberculosis, AIDS and Malaria, although stroke kills more people than all the other three do together, not to talk of post stroke devastating disability.   Even among  the NCDs , stroke gets minimum attention in public health program. There is no government grants forthcoming smoothly. There is no nationalized health insurance, there is no government initiated rehabilitation facilities. prevention clinics which are of utmost importance in developing countries.  Government  institutions offering comprehensive stroke care are few in number and unavailable to the vast expanse of population. Of concern is the apathy of the professional bodies and medical fraternity itself towards prevention and rehabilitation of stroke care. SFB for that matter has taken the leadership in the  single handed campaign with  minimal help whatsoever, and the results are promising.

What is your greatest hope for stroke survivors?

There is always a ray of hope for stroke survivors. SFB has so far successfully spread stroke education to most areas of eastern India and will continue its crusade.  It has received great support from the international stroke leaders and WSO. I am sure with such encouragement and appropriate support , it is possible  to achieve  the targeted goal of  holistic  affordable stroke care in approachable places. By the influence of media and other modalities in  program,  a  section of people, mostly young educated and rich have  taken much interests in this stroke devastation and extending all possible help to the stroke survivors.  The government   has  also shown some interests in stroke care centres, although it will take some time to implement because of huge stroke burden and paucity of funds.

What were the major elements of your stroke campaign?

Stroke Foundation started its stroke prevention campaign since its inception in 2006. The modalities adopted for the campaign are seminars, meetings, leaflets distribution, articles in papers, magazines, Stroke Documentary (with English subtitles) souvenir, etc., publication of quarterly stroke bulletin in both Bengali and English and also regularly updated website (www.strokefoundationbengal.org) and facebook.  The activities of Stroke Support Group (the second in India) for overall benefits of the stroke victims and their family members are quite encouraging.  Recently the Stroke Foundation has been able to convince the  persons  in the Government and administration  to set  up a  stroke care service centre  in a remote underdeveloped district with necessary financial help.  The supports of the public, media and the government are the major elements of the present stroke campaign

Seven minutes in stroke with Dr. Nneka Ifejika

1. What inspired you towards neuroscience?

The concept of cortical reorganization. I likened it to learning the world is round after centuries of believing the world is flat.

2. Why stroke?
Family history. My maternal grandfather died of a likely ICH during my mother's first year of medical school.
My mother had a right PCOMM aneurysm coiling during my fourth year of medical school, and a clipping during my second year as an attending physician.
My family isn't alone, there's a critical need to stop the cycle of stroke.

3. What have been the highs so far?
Being included as a part of the family by stroke survivors.
It is an honor that has enriched my life and given me an intimate perspective on cultural dynamics, food preferences and customs among different ethnic groups.

4. What have been the lows?
Having a research idea that is a little premature.
Sometimes you have a concept that is cutting edge, but the technology hasn't caught up to accomplish the protocol.

5. What do you believe is unique about your work?
The combination of social, cultural and behavioral aspects of healthcare with mobile information technology.
We use apps for everything, from banking to social networking. Why not use it for healthcare?

6. Who are your most important mentors and how did you find them?
Dr. James C Grotta - as a resident, I cared for the rehabilitation unit patients on weekends to earn supplemental income.
Dr. Grotta, at that time the newly appointed Chairman of Neurology, noticed that I worked a disproportionate amount of weekends compared to my colleagues (medical licenses can be quite expensive)!

Within a few months, he hired me as the junior Neurorehabilitation faculty member. When I took an interest in stroke outcomes, he encouraged me to complete the 2 year UTHealth Clinical Research Curriculum, providing the foundation for my first NIH award.

I meet with Dr. Grotta every two to three weeks.  We talk about a variety of topics - he has worked in the Native American Health Service, volunteered during the American Civil Rights Movement and held NIH funding for decades.  He has taught me to have breadth and depth to my life experience.
To expect the unexpected.
To face adversity with grace and dignity.
And sometimes, to ask for forgiveness, not for permission, when going after something you believe in.


Dr. Jon E Tyson - He is the Director of the Center for Clinical Research & Evidence-Based Medicine at UTHealth.
I conceived the idea for Swipe out Stroke as a student in his Advanced Clinical Trial Design class.
 He is my mentor for the Masters' of Science in Clinical Research program and my institutional career development award.
Dr. Tyson is tough, yet kind and immensely supportive.
He inspires me to work smarter, utilize creative interventions and to take time to give back and mentor others.

Dr. Sean I Savitz - Dr. Savitz is an elegant example of an academician.
He's evenly keeled, brilliant and perceptive. Dr. Savitz's mind works in a stream of consciousness - he can see the structure of a manuscript from a single PowerPoint presentation.
We speak several times a week - I grab either my "Sean" notepad or my Smartphone to rigorously scribble ideas.
He's a mentor that is a wonderful example of where I want to be.

7. What are your most important collaborations and how have you built
them?
Dr. Elizabeth Noser has been my clinical partner since recruiting me to join the UTHealth Stroke Team. She is the Director of  Community Outreach, which is a key component of my work serving minority populations.  We sponsor the annual UTHealth Stomp out Stroke event, which provides free health screenings, stroke education and entertainment to thousands of Houstonians.

Dr. David E Rivers at the Medical University of South Carolina chairs the National Conference on Health Disparities.  The annual symposium has provided a platform for my work, and I joined the Advisory Board in 2015.  This year I'll give the Keynote Speech to the undergraduate and graduate students on "Successes (and failures) in Conducting Clinical Research".

As a member of the inaugural class of the American Academy of Physical Medicine and Rehabilitation (AAPM&R) Leadership Program, I received two years of training in health advocacy, strategic planning and  media skills, which has helped me spread the message of caring for underserved populations using mobile applications.
I presently serve on the AAPM&R's Health Policy and Legislation Committee, taking our message of health equity to members of the United States Congress.
As a Washingtonian, it's an honor to come home, and hopefully effect change.

Wang Jing - World Stroke Day 2015 'Best Campaign in a Low or Middle Income Country' Award

1. What inspires you to advocate for stroke education?
China has entered the aging society. The number of potential stroke patients are becoming huge and up to millions. The rapid economic development in china has brought the big changes in peoples’ lifestyles, habits. However, because of the lack of health education, a lot of Chinese people do not have the awareness of stroke prevention and the right emergency treatment after stroke. All these cause the high rate of stroke incidence, mortality and recurrence.
Under this serious situation, CSA has recognized that only committing to the stroke education, it can help the people to improve stroke prevention awareness and ability, reduce morbidity in patients after treatment delay phenomenon occurs, so as to improve the success rate of treatment for the patients, reduce the loss and harm to society and family.

2. What does stroke care look like in your country?
The Chinese government pays much attention to the stroke prevention and care. A project of “High risk of non-disability of ischemic cerebrovascular events” (HR-NICE) proposed by CSA has been brought into the national science and technology development plan.
The stroke high risk group screening has started in some areas in China, but the stroke prevention education, pre hospital first aid, hospital green corridor construction work are still in the initial stage.
Because China is the largest developing country in the world, there are the big differences of economy and culture development among the local regions. The medical level in many areas is not ideal, stroke prevention education has not got the attention it deserves, the people's awareness of stroke is still blank.

3. What element of stroke care are you most proud of?
Proposed by CSA, HR-NIC project has been included into the national science and technology development plan and already started related works on clinical research, training, public and patients education as well as has established patient self-test and emergency call mobile platform.
Initiated by CSA, a Red Bracelet Volunteers Service Corps was established in year 2015 and has recruited over 10,000 volunteers within half a year. Instructed by CSA, the service corps have made the activity plans, regularly carry out activities.  We can say CSA provides a platform and incentive system, to motivate the enthusiasm and the capability of the Chinese stroke physicians to devote into the public science education.

4. What have been the highs so far?
CSA was founded just over a year with more than 12000 members and eight academic branches.  Hundreds of various academic exchanges, training courses were held all over the county. Nearly 20,000 doctors have participated in the these meetings and training, in which 12000 doctors focus in the CSA first academic annual meeting and have made an important contribution to promote academic progress.

We have launched an eLearning portal named “China Academy of Stroke” which has provided an online platform for the medical professionals to get continue learning and education as well as for the late-breaking medical information sharing.
We have formulated the “Chinese Stroke Center Construction Guide” and established the "China Stroke Center Alliance". More than 1300 hospitals have joined and begun continually to report the disease information of the stroke patients to CSA data center.
Having cooperated with the domestic scientific research institutions CSA has begun working on several scientific research projects, and has supported dozens of outstanding young researchers on the skills training, research funding and etc., in which part of the funds come from the Chinese government.
We also have some journals to be published which include: Chinese 2 academic journals, 1 English journals and 1 popular science periodical.

5. What have been the lows?
Since CSA has founded only one year, we are still being on the initial stage and need to learn more from the outstanding and experienced international organizations to formulate effective and national stroke prevention and control strategy and implementation measures under the current condition of China. We also need the manpower and material support especially in the underdeveloped areas to carry out the training for the professionals, and the popular science work.

6. What is your greatest hope for stroke survivors?
We are expecting more financial support for the stroke survivors from the national health insurance and commercial insurance. Medical rehabilitation is yet to be popular in China, We hope more patients can receive the professional rehabilitation training.

7. What were the major elements of your stroke campaign?
Government:  the support from the government departments enable the activities to be carried out smoothly in the country.
Hospital and physician: the importance of stroke prevention is becoming the common view in the hospitals and doctors, so that many regional hospitals have made the contribution on the manpower and finance in the activities.
Media: great support from the national, provincial and municipal TV stations, as well as the newspapers, websites, radio broadcasting. These reports have been spreading fast all over the country.
Variety of activities:  including putting up the posters, display rack, giving out popular data, complimentary popular science books, open health lectures in the public place, science video playback, clinic and health consultation, risk factor screening etc.
The campaigns have involved nearly 1000 hospitals and more than 10000 volunteers. Have organized approx 1000 stroke education activities, issued nearly 400 thousand copies of books and handouts; millions of people have got the information of stroke via TV, broadcasting, newspapers and internet.

Seven minutes in stroke- Rita Melifonwu

Rita Melifonwu is the founder of the Stroke Action UK and Stroke Action Nigeria, she is the UK Department of Health Mary Seacole Scholar and the secretary of the Nigeria Stroke Reference Group. We congratulate Ms Melifonwu for being awarded the World Stroke Day 2015 ' Individual Achievement Award', from the World Stroke Organisation. 

What inspires you to advocate for stroke education?

In 1998 I was employed as a new senior nursing sister at my local hospital within the London region. The Sisters Forum was dynamic in lobbying for Consultant based wards to maximize the patient care milieu. My ward had two Consultant Endocrinologist with specialist interests, one diabetes, the other Hypertension. I soon realized that when a patient is admitted with a stroke to accident and emergency they were allocated to my ward Consultant Physicians because they were also diagnosed with either diabetes or hypertension, or both. Furthermore, the stroke survivors were quite often of a black and minority ethnic background and both themselves and their families had little or no understanding about strokes.

Suddenly, my ward was filled with stroke patients. There was no stroke unit in the hospital, and, the nurse training we received did not quite prepare us to provide such specialist care. I also realized that there is a strong family history of strokes and stroke risk factors in my family in Nigeria. I quickly became aware of key stroke risk factors and the apparent lack of stroke awareness at the time not only in the UK but also in Nigeria. So I decided to take pragmatic action to become a strategic stroke advocate, taking the 1999 Department of Health’s (DH) Mary Seacole Nursing Leadership Award in my stride, and, establishing Stroke Action in UK (SAUK).

 What does stroke care look like in your country?

In Nigeria, stroke is said to affect 168,000 people annually although this is an estimate since we do not have effective stroke registry to capture national incidence data on stroke. No one has adequate information about the prevalence or economic and social ramifications of this NCD in Nigeria. There is an URGENT need for valid evidence of the prevalence of stroke in Nigeria. A stroke registry will address this.

Despite the increasing incidence of strokes in Nigeria there are only 5 small stroke units (notably in Benin City, Ile Ife, Ibadan, Enugu and Illorin). These are not sufficiently equipped; have over stretched MDT, and lack of adequate stroke education for healthcare professionals. The cost of caring for a stroke patient is prohibitive and this may lead to compromised diagnosis, management and outcome. Funding from sources such as private industries, NHIS and international organizations would need to be explored in addition to increased government spending. In addition, there is still a lack of general public awareness of what stroke is, its causes and management. Most people still refer to stroke as the effects of witch craft, evil spirit or an arrow from God.

In 2012 however, Stroke Action Nigeria (SAN) launched a Stroke Support Toolkit based on the WSO model and trained 28 Volunteer Stroke Ambassadors (professionals, stroke survivors, carers) to establish stroke support groups across eight states (Abuja FCT, Anambra, Benue, Delta, Edo, Imo, Lagos, Ogun). The Stroke Ambassadors are doing the best they can to provide hospital befriending for survivors and community stroke awareness outreach without any funding.

Furthermore, in 2013, SAN signed an important Memorandum of Understanding (MOU) with the Federal Ministry of Health (FMOH) to collaborate in mitigating strokes and developing quality stroke care in the country. In 2015, Stroke Action formed an alliance with the Medical Association of Nigerians Across Great Britain (MANSAG) to collaborate with pushing the MOU implementation.  As a result of this, the Nigeria Stroke Reference Group (NSRG) was inaugurated on 15th September 2015 by Mr Linus Awute, Permanent Secretary FMOH on behalf of His Excellency, President Muhammadu Buhari. The NSRG is made up of experts in Nigeria and in the Diaspora, stroke survivors, carers, as well as key stakeholders in the prevention and management of stroke and its effects. The MOU between the FMOH and SAN; and the partnership between MANSAG and Stroke Action were the key events leading to the formation of the NSRG. The principal objectives of the NSRG are:

What element of stroke care are you most proud of?

For me, I believe that ‘prevention’ is better than cure and that ‘health is wealth’. What the stroke survivors tell us is that ‘frankly having had a stroke, they don’t want to have another one’. Our stroke advice clinic helps us to support stroke survivors in preventing re-current strokes. In SAUK and SAN, we invest significant amount of time and resources on our ‘Community and Faith Groups’ stroke awareness outreach, which involves stroke and FAST awareness and BP stations. This approach has progressed into our fun filled annual ‘Power to Stop Strokes Campaign’ during the stroke months involving stakeholder conferences (‘Action on Strokes’ in UK, and, ‘Stroke Assembly’ in Nigeria), and a walk and run against strokes to promote physical activity. We are thankful to the departments of Public Health and NCD that collaborate to make this happen.

It is refreshing to observe the progress that stroke survivors make in our Life After Stroke Centre and stroke support groups as they gain confidence to become socially re-integrated in their own communities, re-gain life roles, ability and function. Most exciting is our Volunteer Stroke Ambassadors’ development program that promotes ‘peer-led’ activities including befriending, exercise class, holiday clubs and returning back to work life. I am so proud of the progress that has been made in acute stroke management in recent years resulting in stroke patients recovering better and less stress and burden for carers.

What have been the highs so far?

When I was a senior nursing sister, I went to the UK Stroke Association to see the Chief Executive, Margaret Goose, for advice on where I can get a decent stroke nurse training. She said, “Rita, you are the type of nurse we are looking for and we are going to support you”. I received prompt sponsorship as part of the first tranche of stroke nurses trained at the Liverpool Metropolitan University in 2002 where I gained an advanced diploma in stroke care. Sustaining Stroke Action was my course project and look where we are today. We even won the DH’s Health and Social Care Volunteering Fund Team recognition for our Stroke Ambassadors’ Development program in 2015: https://www.youtube.com/watch?v=yhzGfGkSmQw

We are thankful to Prof. Anthony Rudd, the NHS England’s National Clinical Director for Stroke who spoke at our conferences in Enfield, at the onset, and, having seen and spoken to the stroke survivors and carers gave us the encouragement that we are proceeding in the right direction. This gave us the impetus to advocate for the Enfield Stroke Pathway, and lobby several Enfield Mayor’s and MP to become our Stroke Champions. We have not looked back!

The formation of the NSRG in collaboration with MANSAG and the FMOH is the culmination of the highs we celebrate and a key development in the fight against strokes in Nigeria.

 What have been the lows?

For years one of the outcomes we are proud of is that stroke survivors that come to Stroke Action do not have re – current strokes. Most recently however, we have seen a different kind of challenge as some stroke survivors progress to having vascular dementia resulting in so much stress for the carer, un-anticipated hospitalization, institutionalization to care homes, and, unfortunately for some, untimely death. Coping with life after a stroke is hard for the carer but dementia compounds the problem for them. This is a low we are all learning how to cope with.

What is your greatest hope for stroke survivors?

A day when every stroke patient will have the opportunity to receive tPA at the appropriate time window and be cared for in an organized stroke unit and by specialist multi-disciplinary stroke teams within the acute and community settings. I will also look forward to celebrating when stroke survivors and their carers will have access to local ‘Life After Stroke Centers’ sufficiently equipped and resourced to support their stroke recovery journeys.

Above all, I hope for a world where every citizen is Stroke and FAST aware and there will be a significant global reduction in stroke incidence.

What were the major elements of your stroke campaign?

Collaboration and partnerships make our annual ‘Power to Stop Strokes Campaigns’ hugely successful. We have the opportunity to innovatively engage and work jointly with key Trustees: Dr Theva Nathan – Consultant in Stroke Medicine, Cllr Anne Marie Pearce – Former Mayor of Enfield and vice chair of the Health Scrutiny Panel, Dr Ogo Okoye – Public Health Consultant, Dr Biodun Ogungbo – Consultant Neurosurgeon and NN’emeka Maduegbuna – Chairman and CEO of C&F Porter Novelli in Nigeria which provides all our media publicity pro bono. We also partner with statutory and non-statutory agencies, stroke survivors and carers to achieve a common goal – ‘stroke advocacy and awareness’. Our joint working with Enfield Council and Public Health in UK, MANSAG in UK and Nigeria, the Police Force and FMOH in Nigeria helped Stroke Action to achieve a milestone in the last year. For WSD 2015, we supported female stroke survivors to promote the WSC theme ‘I am Woman, Stroke Affects Me’ with excellent outcomes. SAN also launched the first ever Stroke Handbook for Nigeria.

We are now looking for sponsorship to translate it into several indigenous languages

Seven Minutes in Stroke - Claus Ziegler Simonsen

This week we asked Claus Ziegler Simonsen to share seven minutes in stroke with us. The idea behind the 'Seven Minutes in Stroke' series is to help build a stroke community of early career researchers, who can learn about each other, share what they're working on, potential collaborations and to advance science. Thank you to everyone who has contributed so far!

1. What inspired you towards neuroscience?

My answer is ordinary, but true. It was Oliver Sacks' book "The Man Who Mistook His Wife for a Hat."

2. Why stroke?

The combination of interesting neurological deficits, estimating the location, getting the result (by scanning), treating and often seeing that the treatment benefits the patient. And all this often occurring in a very short time span.

3. What have been the highs so far?

In medical school I did a research year where I was part of a team who developed a stroke model in the pig. We performed one of the first diffusion weighted scans at our hospital. (Just one image slice.) Seeing the stroke and realizing that the model worked was very exciting. Another high was when endovascular treatment became evidence based. What many felt was the right thing to do, was now proven.

4. What have been the lows?

When we can't help a patient.

5. How do you balance work life with the needs of home life?

By working when the kids are asleep.

6. Who are your most important mentors and how did you find them?

Grethe Andersen (Aarhus University Hospital), who is my mentor and closest work colleague. Leif Østergaard (Aarhus University Hospital), who introduced me to MRI and who was my supervisor at my PhD. Jonathan Rosand (Massachusetts General Hospital), who gave me the opportunity to work in Boston. Albert J. Yoo (Texas Stroke Institute), who taught me a lot about thrombectomy and imaging. All found by coincidence and luck.

7. What are your most important collaborations and how have you built them?

Thabele Leslie-Mazwi (Massachusetts General Hospital) and Ronil V. Chandra (Monash University). Built on common interest and friendship.

Geoffrey Donnan and Richard Hughes talk IRIS

Seven minutes in stroke - Meaghan McAllister

Seven minutes in stroke - Meaghan McAllister 

1.     What inspired you towards stroke?

As a student of speech pathology I was fascinated by the subjects of neurosciences and linguistics.  For me these two interest areas came together in the study of communication disorders acquired after stroke or traumatic brain injury.  I was hooked even further when I started working in the area of brain injury rehabilitation.  The life changing nature of acquired communication disorders and the positive impact rehabilitation can have continue to inspire me after many years of practice.

2.     What was your springboard into this field?

Inspirational clinical supervisors at university and an opportunity to work in brain injury rehabilitation early in my clinical speech pathology career were perfect springboards.  My focus was broadened and enriched immeasurably during my experiences of living and working in Aboriginal communities in the Northern Territory of Australia. Spending time to understand health and wellbeing from another perspective and sharing experiences and knowledge to reimagine what rehabilitation could be, has inspired my journey into research.

3.     What have been the highs so far?

The experiences of Aboriginal people with acquired communication disorders and their journeys through brain injury rehabilitation have been missing from research and also health service planning. I’ve been incredibly fortunate to listen to the stories of Aboriginal people from around Western Australia living with acquired communication disorders as part of the Missing Voices project (led by Professor Beth Armstrong from Edith Cowan University in Western Australia). This work will contribute to identifying the gaps in stroke rehabilitation services for Aboriginal people in WA, and will also indicate solutions.  This is a first for the community, for speech pathology and has the potential to greatly inform stroke services. 

   

4.     What have been the lows?

As a clinician, there is a frequent conflict when delivering services in a resource-constrained health service.  It is difficult to deliver a speech pathology service that is evidence-based in the context of real word funding.

5.     What do you believe is unique about your work?

The aspects of my work that are unique are also those aspects I gain the most joy from.  These include working together with Aboriginal academics and Aboriginal people and communities and also the opportunity to be both a clinician and involved in research.  I wish that more clinicians had similar opportunities.

6.     Who are your most important mentors and how did you find them?

Professor Beth Armstrong provides mentorship in a way that inspires and teaches.  I met Professor Armstrong at a conference in aphasia rehabilitation after mustering the courage to ask questions after a presentation she gave.  Wanta Steve Jampijinpa Patrick is a Warlpiri elder in Lajamanu, an Aboriginal community in the Tanami Desert.  He guided my learning about Warlpiri worldview and gave me grounding for imagining how Aboriginal and non-Aboriginal people can share a world.  I was fortunate to be introduced to Wanta when I lived on his country in 2009 and frequently return to his teachings. 

7.     What are your most important collaborations and how have you built them? 
The most important collaboration for me has been with participants and people involved with the Missing Voices project.  Without sincere collaborative relationships with Aboriginal people who have experienced an acquired communication disorder, research assistants and with people who deliver therapy and health services to the Aboriginal community, the work would not be accurate or genuine. 

Seven minutes in stroke - Lauren Sheppard

Seven minutes in stroke

Lauren Sheppard Deacon University 

1. What inspired you towards neuroscience?

My specialty is in health economics which has then led me to working in stroke. It’s been a long-standing interest for the research group I’m part of and I am fortunate enough to be involved in some amazing projects.

2. Why stroke?

See above! I hope the work I contribute will inform investment in stroke programs which provide good patient outcomes and value for money.

3. What have been the highs so far?

Working with colleagues who are experts in the field.

4. What have been the lows?

Accepting critique and the occasional rejection letter for things you have poured hours into!

5. How do you balance work life with the needs of home life?

It’s fair to say some days I’m better at doing this than others. I have learnt that if I have the time to do something then don’t delay – sending an email, reading a book, going for a walk etc. Ten times out of ten, that opportunity won’t come up again.

6. Who are your most important mentors and how did you find them?

I’m lucky that my teachers at uni are now my colleagues, studying was the best introduction.

7. What are your most important collaborations and how have you builtthem?

I feel like I am just starting out so I can probably answer this better in maybe 5 years. Attending conferences and training, co-authoring publications and taking any new opportunity possible is the approach I’m taking.