ANNA Celebrating Fifty Years

Reflections

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<p>Huntington’s Disease (HD) is a complex neurodegenerative disorder, with a life expectancy 10-20 years after symptom onset which is usually in middle age. Symptoms of HD include physical deterioration, cognitive impairment and a high incidence of suicide and suicidal ideation, which may cause intolerable suffering. While the strong association between depression and other psychiatric manifestations with suicide is discussed, this paper explores whether suicide can ever be deemed rational. By the time a person with HD reaches an advanced and terminal stage, their decisionmaking capacity will be so impaired as to make them ineligible for Voluntary Assisted Dying (VAD) under all current and proposed legislation in Australia and New Zealand. Given that Advance Care Planning (ACP) can provide an opportunity to refuse all medical treatment, except palliative treatment, could this provide an acceptable alternative to suicide and VAD? Nurses need to consider these ethical dilemmas and remain informed on the debates. They may experience moral conflict when a person wishes to discuss their view on rational suicide or seek to implement refusal of treatment in an advanced care directive. They must be aware and consider how their professional obligations and personal opinions interact with this complex topic.</p>
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The Intersection between Voluntary Assisted Dying, Suicide and Advance Care Planning in Huntington’s Disease

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<h3>Introduction</h3>
<p>Changes in intravenous thrombolysis treatment rates for acute ischaemic stroke during the COVID-19 pandemic have been reported. We examined the differences in the provision of intravenous thrombolysis in patients with acute ischaemic stroke, two years prior to and two years into the COVID-19 pandemic.</p>
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<h3>Methods</h3>
<p>Data were compared between March 1, 2018 to February 28, 2020 (Pre-COVID-19) and March 1, 2020 to February 28, 2022 (COVID-19). Data collected included patients’ demographics, intravenous thrombolysis rates, and patient outcomes.</p>
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<h3>Results</h3>
<p>There was an increase in ischaemic stroke patient admissions during the COVID-19 period (Pre-COVID-19 n=1041, vs COVID-19 n=1087). Yet, fewer stroke patients received intravenous thrombolysis (19.2% vs 13.9%, p&lt;0.001), and there were more stroke mimics thrombolysed (8.3% vs 15.6%, p=0.021) during this period. During the COVID-19 period, there was a significant delay in hospital presentation for patients who were thrombolysed (Pre-COVID-19 = 86 minutes vs COVID-19 = 107 minutes, p = 0.004); and delay in giving thrombolysis (median door to needle time: Pre-COVID-19 = 59 minutes vs COVID-19 = 65 minutes, p = 0.002). Fewer patients had severe stroke symptoms (National Institute of Health Stroke Scale score = >15) (12.2% vs 4.8%, p=0.009) during the COVID-19 period. There was no significant difference in patients’ post-thrombolysis outcome (median National Institute of Health Stroke Scale score = 1, p=0.136; discharge modified Rankin Scale score = 1, p=0.647; and mortality p=0.655).</p>
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<h3>Conclusion</h3>
<p>This study showed that during the first 2 years of the COVID-19 pandemic, there was a significant decline in the thrombolysis rates and delay in the administration of the intravenous thrombolysis treatment.</p>
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Intravenous Thrombolysis in Acute Ischaemic Stroke Two Years into the COVID-19 Pandemic: A Retrospective Study

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<p>Superficial temporal artery (STA) to middle cerebral artery (MCA) bypass, also referred to as STA-MCA bypass, is a direct revascularisation treatment for moyamoya disease. Moyamoya disease is a rare cerebrovascular condition characterised by progressive narrowing of the distal segments of the internal carotid arteries. Untreated, this may cause varied and progressive symptoms for patients, with a significantly increased risk of stroke annually. STA-MCA bypass is performed several times a year at Royal North Shore Hospital by specialist cerebrovascular neurosurgeons. This is a quaternary service with patient referrals received from throughout Australia.</p>
<p>This paper will provide an overview of moyamoya, the surgical treatment and nursing care. The pre- and post-procedure nursing care for these patients is paramount, including perioperative blood pressure management, neurological assessment and wound care. The paper will also explore a case study of a patient who underwent a STA-MCA bypass, highlighting the value of specialised neuroscience nursing care, and additional considerations when managing patients living at a distance from the local health district.</p>
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Puff of Smoke: Moyamoya and the nursing role following STA-MCA bypass

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<p>Apomorphine therapy was first discovered in the 19th century and became clinically available for use in 1980’s. Apomorphine therapy has been described as an underutilised therapy for Parkinson’s disease (The aim of this study was to determine the incidence of Impulse Control Disorders (ICD) using a clinician administered rating scale the ‘Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease Rating Scale’ (QUIP-RS). The results of this study were consistent with the current literature that was reviewed. We found that apomorphine therapy were unlikely to worsen ICD and the use of apomorphine infusion may even improve ICD. In addition, concomitant use of dopamine agonists was not likely to worsen ICD.</p>
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The incidence of worsening impulse control disorders in the initiation of apomorphine therapy

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<p>Drug induced parkinsonism (DIP) is one of the most frequently occurring side effects of dopamine-receptor blocking agents such as antipsychotic (neuroleptic) and antiemetic drugs. It typically presents with extrapyramidal signs, such as slowed movements, reduced facial expression and muscle stiffness. In contrast to Parkinson’s disease, which is caused by a progressive degeneration of pre-synaptic dopaminergic neurons that project from the substantia nigra in the brainstem, DIP is thought to usually occur due to the post-synaptic antagonism of dopamine receptors in the striatum. However, the two conditions can sometimes be clinically indistinguishable, and may even occur together, and thus it can be challenging to make an accurate diagnosis of DIP. It is important to consider DIP in the differential diagnosis of any person with extrapyramidal signs within the context of recent medication changes as the condition is reversible when the offending drug is withdrawn and, without early identification, there is substantial risk of increased morbidity, complications such as falls, and poor quality of life. Recent advancements in cerebral imaging have improved diagnostic accuracy but this technology is costly and not widely available.</p>
<p>There is a dearth of literature pertaining to the role of neuroscience nurses and DIP. This is concerning as the potential for DIP presentations to occur within the neuroscience setting is high. Neuroscience nurses, particularly those working within the movement disorder speciality areas, need the skills to advocate and pursue further investigation for patients who present with extrapyramidal signs, especially if these begin in the context of the prescription of dopamine-blocking drugs. This review is written primarily for neurosciences nurses but will be applicable to a wide range of healthcare workers; it aims to outline potential causative drugs, risk factors and the key clinical characteristics of DIP. It also highlights useful features that help distinguish DIP from Parkinson’s disease, summarises investigations and discusses management and care.</p>
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Identifying and Managing Drug Induced Parkinsonism: The Role of Neuroscience Nurses

Brainstem

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<p>Most of us know Roald Dahl’s Childrens works but few of us are familiar with his fascination with medicine and in particular neuroscience. During Dahl’s adult life his family suffered some terrible medical tragedies, and it was the medical interactions during these times that influenced some of his most famous writing from explosive potions in George’s Marvellous Medicine to Gobblefunk, the language created by Dahl for the BFG.</p>
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Book Review: Roald Dahl’s Marvellous Medicine

AHEAD OF PRINT

Volume 34 (2024): Issue 1 (May 2024)

Volume 33 (2023): Issue 2 (October 2023)

Volume 33 (2023): Issue 1 (May 2023)

Volume 32 (2022): Issue 2 (October 2022)

Volume 32 (2022): Issue 1 (May 2022)

Volume 31 (2021): Issue 2 (October 2021)

Volume 31 (2021): Issue 1 (May 2021)

Volume 30 (2020): Issue 2 (October 2020)

Volume 30 (2020): Issue 1 (May 2020)

Volume 29 (2019): Issue 2 (May 2019)

Volume 29 (2019): Issue 1 (May 2019)

Volume 28 (2018): Issue 2 (November 2018)

Volume 28 (2018): Issue 1 (June 2018)

Volume 27 (2017): Issue 2 (November 2017)

Volume 27 (2017): Issue 1 (November 2017)

Volume 26 (2016): Issue 2 (May 2016)

Volume 26 (2016): Issue 1 (May 2016)

Volume 25 (2015): Issue 2 (October 2015)

Volume 25 (2015): Issue 1 (May 2015)

Australasian Journal of Neuroscience

Australasian Journal of Neuroscience (AJoN) Journal Scope and Aims  Published bi-annually (May and October), the Australasian Journal of Neuroscience (AJoN), the official journal of the Australasian Neuroscience Nurses Association (ANNA), has published original peer reviewed articles since 1988 making it one of the longest standing neuroscience nursing journals.  The AJoN is an international peer reviewed open access journal that aims to promote the development and exchange of knowledge that reflects the broad and emerging interests of neuroscience nursing and the neuroscience nursing profession. The AJoN is at the forefront of disseminating and communicating knowledge and through the promotion of clinically related scholarship, the AJoN supports and advances the practice and discipline of neuroscience nursing.  The mission of the AJoN is to further the neuroscience nursing profession through representation and the provision of works that best represent neuroscience nursing expertise and experience. Through this provision evidence is translated into neuroscience nursing practice to improve health outcomes for individuals, families, and populations.  Fields of nursing represented in the AJoN include, but are not limited to, neurology, movement disorders, neurosurgical, neuro-intensive, neuro-rehabilitative, neuropsychiatry, neuro-gerontology, neuro-paediatric, neuro-emergency and neuro-trauma. Contributions are also welcome from other healthcare fields on issues and developments that have a direct impact on neuroscience nursing practice.  The AJoN welcomes manuscripts from both new and experienced authors wishing to contribute neuroscience knowledge to nursing practice and research. Both National and International submissions are welcome, with the AJoN supporting the exchange of ideas and experience that represents different practices and cultures.  Submitted original articles should make a novel contribution to neuroscience nursing with examples including advances in neurosurgical and neurological nursing, patient care, complex care interventions, research, policy, professional issues, and theory. Submissions must be of a high quality and the journal accepts various article types including (but not limited to) review articles, systematic reports, case series, case studies, quantitative, qualitative, and mixed methods research articles, practice updates, guest editorials, clinical trials, quality improvement articles, letters to the editor, commentaries, and the development of new guidelines that provide a unique insight into the field of neuroscience nursing. The journal’s purpose is to advance the field of neuroscience nursing by presenting published works with an emphasis on knowledge that will influence the way neuroscience nursing is practiced, taught, researched, and administrated. This information is applicable to nurses working in clinical, administrative, educational,  leadership and research settings. Each issues contains a variety of papers, commentaries and published works resulting from the National ANNA conference. The target audience of the AJoN includes nurses, student nurses, nurse practitioners, managers, executives, administrators, educators, and higher research degree students as well as allied health professionals.  Topics relevant to the AJoN include the development of clinical research and knowledge, evidenced based practice, leadership, and scientific enquiry. Works that explore the patient and family experience, illness, and recovery within the neuroscience field. Organisational factors including governance, patient safety, role development and models of service delivery. As well as cultural comparisons and evaluations of neuroscience nursing practice across different healthcare sectors, social and geographical settings.  The AJoN offers authors the benefits of a highly respected journal in the field of neuroscience nursing, indexed in a wide range of databases including (EBSCO, Elsevier, MIAR, MtScienceWork, ReadCube, SCILIT and Semantic Scholar). The journal has a truly global readership, rapid manuscript screening and efficient editorial processes. The journal also offers a highly visual format, with full colour figures, images, and tables.  The AJoN Editor is advised and supported by a Board of Reviewers that represent all facets of neuroscience nursing. Submitted papers are reviewed by Reviewers who meet a high standard of academic and clinical expertise. The AJoN will ensure that practice and policy development is evidenced based, research is informed at an advanced level and that readers are challenged to engage in critical debate and critically reflect on the interface between practice, policy, and research. The AJoN team believes that every neuroscience nurse should have the opportunity to grow and develop their practice and career through quality education and professional development. The AJoN is essential reading for anyone with an interest in neuroscience nursing.   Archiving  Sciendo archives the contents of this journal in Portico - digital long-term preservation service of scholarly books, journals and collections.  Plagiarism Policy  The editorial board is participating in a growing community of Similarity Check System's users in order to ensure that the content published is original and trustworthy. Similarity Check is a medium that allows for comprehensive manuscripts screening, aimed to eliminate plagiarism and provide a high standard and quality peer-review process. 

Australasian Journal of Neuroscience

Volume 34 (2024): Issue 1 (May 2024)

ANNA Celebrating Fifty Years

Reflections

The Intersection between Voluntary Assisted Dying, Suicide and Advance Care Planning in Huntington’s Disease

Intravenous Thrombolysis in Acute Ischaemic Stroke Two Years into the COVID-19 Pandemic: A Retrospective Study

Puff of Smoke: Moyamoya and the nursing role following STA-MCA bypass

The incidence of worsening impulse control disorders in the initiation of apomorphine therapy

Identifying and Managing Drug Induced Parkinsonism: The Role of Neuroscience Nurses

Brainstem

Book Review: Roald Dahl’s Marvellous Medicine

Reflections

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