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.

International Women's Day

Seven Minutes in Stroke - Luciano Sposato

Luciano Sposato

London Health Sciences Centre, London Schulich School of Medicine & Dentistry, Western University, Clinical Neurological Sciences, London, Ontario, Canada

1. What inspired you towards neuroscience?

The brain intrigued me since I was a medical student. With the exception of neurology and cardiology, I actually found medical school quite boring. Because of how medicine was taught in Argentina, I wasn’t able to understand the use of what I was studying.  The only topics that were really straightforward to me were those related to the brain. 

2. Why stroke? 

When I was in my second year of Internal Medicine residency, one of my first teaching assignments was to prepare a stroke lecture for first year residents and students. Since that single day in which I lectured during about 90 very boring minutes, I devoted all my passion to stroke. I will always be grateful to my former Internal Medicine chief resident Dr. Marichu Arriola, who encouraged me do it.

3. What have been the highs so far?

There have been many highs. Perhaps one of the most meaningful ones was moving from Argentina to Canada to practice stroke neurology and to continue pursuing my research career in 2013.  Recently, I had the fascinating experience of delivering a Ted Talk about the Heart and Brain Connection in Argentina (https://www.youtube.com/watch?v=c1iMoel2LxA). It was a totally different experience, in a stadium with 10.000 attendees and other 40.000 people watching the talk through online live streaming.

4. What have been the lows?

Perhaps the lows are related to the difficulties that researchers face in Argentina and other South American countries because of very limited resources. 

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

I have two young children, Augusto (4 years old) and Emma (2 years old), and a wonderful fully supportive wife, Patricia, who is also a neurologist. I try to be at home with my kids as much as possible and so far I think I have managed to be with them a lot more than I suspected before they were born.

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

Real mentorship is a complex matter. My greatest mentor was Prof. Jorge L. Ferreiro in Argentina. He was the Head of Neurology at the Hospital de Clínicas “José de San Martín”, Buenos Aires University, Argentina, where I completed my residencies in Internal Medicine and Neurology. He was the first who believed in my potential as a young physician.

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

Within the last few years I have had the chance and pleasure of collaborating with amazing researchers in the field of cerebrovascular disease and epidemiology. I was able to develop and conduct ReNACer, the Argentinean Stroke Registry, and PrEViSTA, a population-based study of stroke incidence, risk factors, recurrence and mortality in Argentina. We invited recognized experts in the field to join the team. I was also very lucky to be able to work with already existing datasets from very important studies, trials, and cohorts. I am very grateful to many top researchers who have kindly allowed me to work with them and shared their data: Peter Rothwell and Sarah Pendlebury (Oxford Vascular Study); Joanna Wardlaw, Peter Sandercock, Richard Lindley, and Martin Dennis (IST-3 Trial); Bud Kukull and John Trojanovsky (National Alzheimer’s Coordinating Centre), Moira Kapral (Registry of the Canadian Stroke Network and the Institute o Clinical Evaluative Sciences), among others. Vladimir Hachinksi was who initiated the collaborations. 

Seven Minutes in Stroke - Thalia Field

Thalia Field MD FRCPC MHSc

Assistant Professor, Faculty of Medicine, University of British Columbia

Stroke Neurologist, Vancouver Stroke Program

1 - I don’t know if I was so much inspired towards neuroscience as I was running away from geology! I did my undergraduate program in geology because I though mountains were pretty to look at and I could go on field trips instead of sitting in class. I quickly realized that I did not have the appropriate temperament - on fieldwork trips, my classmates were much more interested in filling their backpacks with shiny, interesting (and very heavy!) rocks while I was more interested in eating and drinking anything heavy as quickly as I could, finding the warmest spot possible, and waiting for the day to be over. I applied for summer research jobs to be close to my family in Calgary, and by luck a young Michael Hill was finishing his fellowship and was looking for an Earth Sciences-inclined student to look at weather data to define Chinooks, a warm wind phenomenon that can trigger migraines and, as he wondered, possibly strokes. My alternative gig was searching for meteorites on my own in Northern Alberta (my interviewer took one look at me and said, “we work in all sorts of weather, even the pouring rain…you don’t want to work in the pouring rain, do you?” I didn’t!) and the rest is history.

2 - Stroke seemed to me the diametric opposite of geology - instead of looking at change over millions and billions of years, the Calgary Stroke Program was focusing on that critical moment where one minute you are independent and enjoying your life and the next you are hemiplegic and unable to speak. tPA had recently been introduced and the Calgary Stroke Program had a dynamic group of young, enthusiastic clinician-researchers who were changing clinical practice and making people better. I wanted to be a part of that.

3- The highs are always patients with excellent outcomes and students working with me who achieve successes like grants, abstracts, and manuscripts - the future of stroke depends on training more young talent and I want to continue that tradition.

4 - The lows are having to give bad news to patients and families, and being excessively tired after a week of service - I once tried to brush my teeth with lipstick.

5- It’s tricky- you’ll have to ask my partner and my friends whether I really pull off this balance - but on a weekly basis I work out, try to read one novel and month and get sucked into Podcasts and Netflix - my current favourites, respectively, are “Grownups Read Things they Wrote as Kids” and “Fargo.” And I am committed to taking vacations twice a year- I find the time off allows my brain to work in different ways and actually helps me to consolidate ideas with regards to my research.

6 - I have been incredibly lucky to have the support of a number of key mentors. My most important mentors during my training have been Michael Hill, who inspired me to go into stroke neurology and who I still rely on for honest advice and clarity of thought; Gord Gubitz and Steve Phillips in Halifax, who were models of clinical excellence and patient rapport while I was a medical student; Oscar Benavente, who inspired my interest in clinical research and clinical trials, developed and supported my interest in secondary prevention and lacunar stroke, and never fails to make me laugh; and Eric Smith and Joanna Wardlaw, who have led me to ask new questions about the natural history of cerebral small vessel disease and how we can develop new treatments, and have generously integrated me into the international network of small vessel disease researchers. The stroke community is small, and I’ve found my mentors through the support and generosity of my other mentors.

7 - I’m currently trying to forge connections outside of stroke, as I feel that we might learn valuable lessons and strategies by looking outwards: big data and machine learning may give important tools for risk prediction and selection of optimal patients to enrich future clinical trials; other systemic conditions that advance brain aging may teach us about the mechanisms of cerebral small vessel disease; cardiology remains a model for how stroke can expand research funding and instrastructure. But my most important collaboration is with my partner, Glenn, who ensures that I close my laptop from time to time and tries to keep my feet just a millimetre off the ground. 

CALL FOR APPLICATIONS WSO Young Stroke Professionals Brief Clinical Exchange Scholarship Program

CALL FOR APPLICATIONS

WSO Young Stroke Professionals Brief Clinical Exchange Scholarship Program

Purpose:

To support young stroke professionals from any discipline to spend a 1-2 week observership at an international center of excellence in order to foster best clinical practice benchmarking and collaborative research.

Nature of support:

Up to 5 scholarships will be awarded each year to cover travel and accommodation up to US$2000 per scholarship, to be reimbursed by WSO on presentation of receipts and short travel reports from both observer and host. The host institution is expected to waive any observership fees.

Application and selection process:

Applications are restricted to current WSO members. Applications will be judged by the WSO Young Stroke Professionals Committee based on merit with 2 of the 5 positions weighted towards young stroke professionals from low-middle income countries. The applicants should generally be below 40 years of age.

The application should include:

• curriculum vitae 
• provisional budget for travel and accommodation to the proposed institution 
• written confirmation from the proposed institution agreeing to the visit 
• a 500 word statement explaining how this visit will aid the young stroke professional’s career

Closing Date:

Applications for the 2016 round (for travel by end of 2016) must be lodged with the WSO via email (admin@world-stroke.org) by 5th February 2016

For further information contact Dr Bruce Campbell, WSO Young Stroke Professionals Committee (bruce.campbell@mh.org.au)

Seven Minutes in Stroke - Liam Johnson

Seven minutes in stroke 

1. What inspired you towards neuroscience?

During my undergraduate studies in Exercise and Sports Science, I completed a motor control and development unit where I studied the link between movement and the central nervous system (CNS), and what happens when the CNS, and in particular the brain, is injured or diseased. This ignited a passion in me to try to understand as much as I could about this link between the brain and movement, and in particular, how exercise can be used to help people recover from, or deal with, neurological or neuromuscular conditions.

2. Why stroke? 

One in 6 Australians will experience a stroke in their lifetime, and many of them will be left with long-lasting disability and at an increased risk of suffering a recurrent stroke. So few patients get the rehabilitation they need, and what they do get does little to improve their fitness, muscle strength and endurance, or reduce vascular risk factors. There is an urgent need for evidence-based rehabilitation interventions that promote recovery and reduce the risk of recurrent stroke. Exercise and physical activity is recommended after stroke, but unfortunately, it remains unclear what should be prescribed and when. Given my expertise in exercise physiology, I have a significant opportunity to make important contributions to the knowledge about exercise prescription and establishing a pathway from acute care to long-term health and well-being after stroke. This is a critical need for stroke survivors and will potentially transform the current rehabilitation landscape.

3. What have been the highs so far?

Stroke survivors want answers to questions such as what exercise they should be doing, how much and how hard they should exercise, and when should they begin exercise training. The fact that I am leading research that will hopefully answer these questions gives me enormous satisfaction. I also very much enjoy engaging with the participants in my studies – their support of my research is very humbling.

I also feel incredibly privileged to be working in a Research Institute that is the foremost stroke research centre in Australia. I am surrounded by amazing researchers and scientists that are passionate about finding ways of helping people with neurological and mental health conditions – every day is inspiring.

4. What have been the lows?

Navigating the challenges of being in research is a persistent battle. It has never been tougher to win grants to support your research, particularly for early career researchers. Knowing that your livelihood is dependent on that next grant is something I find very stressful.

I also struggle to deal with rejections from scientific publishers and near-misses from grant funders. The feeling of failure and not being good enough is pervasive in this line of work and can at times be overwhelming.

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

With difficulty actually! Firstly, I should say that I have tremendous support from my wife to do what I do, but I think, like many, I find this to be one of the most challenging aspects of research. I think just being mindful of trying to maintain a balance is important – and then putting in place some strategies to keep work and home life separate works reasonably well for me. I try to maintain pretty rigid routines with what I dedicate my time to and when, and I exercise every day which I find is super important for my physical and mental health. Weekends are primarily time for me and my family, and I make sure I take at least one-week away from work a couple of times a year, not only for me to refresh and recharge, but also to dedicate time to my marriage and fur-babies.

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

I have been very fortunate to be mentored by a number of people, though mainly in informal arrangements, whereby I have come to them, as leaders in research I am interested in, for guidance. It is really only in hindsight that I consider people like Professors Frank Mastaglia, Gary Thickbroom and Dylan Edwards to have been fantastic mentors. Since moving to The Florey Institute, I have been incredibly fortunate to be supervised by Professor Julie Bernhardt, who I consider to be a mentor as much as my supervisor. Julie has been tremendously influential of me – her care, guidance and support drives me every single day to give the very best of myself to my work. Via the Florey Institute’s formal mentoring program, I have also been lucky to be mentored by Dr Lachlan Thompson more recently, which I am finding to be very helpful also.

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

Building on the hard work and leadership of people like Professor Bernhardt, I have been privileged to access an extensive network of collaborators, in particular within the Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery. I also collaborate with a number of other groups, including a group based in New York, USA, focussing on telemedicine and virtual rehabilitation, and a group researching exercise training for people with Parkinson’s disease at Deakin University. I believe that having a strong reputation for excellence and integrity in your research, being willing to work with others and open to opportunities, and being generous in the collaboration are some of the more important ingredients for initiating and establishing healthy collaborations.

Seven Minutes in Stroke: Valeria Caso

The International Journal of Stroke has incredible author and reviewer support from stroke experts around the world. Over the years I've interviewed, met with, emailed, conversed and conferenced with so many amazing people who's career path and study interest are so interesting these wonderful stories must be shared! So we have started a new blog series entitled Seven Minutes in Stroke'.

Our first 'Seven Minutes in Stroke' series kicks off with the inspiring Valeria Caso, President elect of the European Stroke Organisation.

Seven minutes in stroke

1. What inspired you towards neuroscience?

My interest for neuroscience was sparked by a conference on Childhood Neuropsychiatry that I attended during my last year of high school; listening to the speaker, showing the developmental phases of the brain and its pathologies, I knew that this was my calling.

2. Why stroke?

During my 2nd year of Neurological specialization my Director sent me to Germany,  my home country, to learn how to set up what would be the future Perugia Stroke Unit. During those 6 months, my passion for stroke care began.

3. What have been the highs so far?

Well, the Perugia Stroke Unit was established in 1998, so over the last 17 years the satisfying moments have been many. We adopted the stroke pathways that resulted in one of the lowest mortality rates in Italy. We have seen great advances in treatment which have saved, undoubtedly, hundreds of lives, as well as reducing significantly disability.

4. What have been the lows?

Still, people have not gotten the message that when they have symptoms of stroke they need to get to the hospital. In fact, because of this we see unnecessary victims of stroke.

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

I am very lucky because my family members are very supportive, especially my well-chosen husband.

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

The first and most important is my friend and colleague Maurizio Paciaroni who was the first person I met at Clinica Neurologica. Over the last twenty years, we have been working side by side building up the Stroke Unit and carrying out research. Our dedication has produced many accomplishments in the field of stroke. The remaining three mentors have been Didier Leys, Werner Hacke and Michael Brainin who have provided me with professional opportunities that were important steps in my career. I am grateful for their genuine support and their trust.  

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

Currently, my most important collaborations include those with healthcare professionals interested in nurturing the field of Women’s Medicine. This is because, we share the understanding  that there are inherent  differences between the sexes regarding responses to treatment, time of disease and outcome.  Building these collaborations has been possible through mutual integrity and passion for the patients.