November stroke current awareness by Musgrove Park Hospital Library

Library Services Musgrove Park and Somerset Partnership

Current Awareness Stroke This monthly Current Awareness Bulletin is produced by the Library, Musgrove Park Academy to provide staff with a range of stroke-related resources to support practice. It includes recently published guidelines and research articles, news and policy items.

This guide provides a selection of resources relevant to the subject area and is not intended to be a comprehensive list. All websites have been evaluated and details are correct at the time of publications. Details correct at time of going to print. Please note that resources are continuously updated. For further help or guidance, please contact a member of library staff.

This guide has been compiled by: Jess Pawley Senior Library Assistant Musgrove Park Hospital Library Service jessica.pawley@tst.nhs.uk

Issue 4 November 2015

Contents Click on a section title to navigate contents Page Recent journal articles

Books

10 UpToDate & DynaMed

Reports, publications and resources

Twitter

Training & Networking Opportunities, Conferences, Events

Literature search service

Library contact details: Library Musgrove Park Academy Musgrove Park Hospital Taunton Somerset TA1 5DA Tel: 01823 34 (2433) Fax: 01823 34 (2434) Email: library@tst.nhs.uk Blog: http://librarymph.wordpress.com @musgrovesompar

RECENT JOURNAL ARTICLES BACK TO TOP This is a list of journal articles on the topic of stroke. Some articles are available in the library or online via an OpenAthens password by following the full-text link. If you would like an article which is not available as full-text then please contact library staff. Please note that abstracts are not always available for all articles.

MUSGROVE STAFF ONLY Click on the image to access full-text-available from 1970 to current using your OpenAthens password

ARTICLES FROM OTHER JOURNALS

Title: Nocturnal blood pressure dipping in acute ischemic stroke. Citation: Acta neurologica Scandinavica, Nov 2015, vol. 132, no. 5, p. 323-328 (November 2015) Author(s): Sargento-Freitas, J, Laranjinha, I, Galego, O, Rebelo-Ferreira, A, Moura, B, Correia, M, Silva, F, Machado, C, Cordeiro, G, Cunha, L Abstract: We aim to assess the impact of early nocturnal blood pressure (BP) variation in the functional outcome of patients after an acute ischemic stroke. We included consecutive stroke patients treated with intravenous thrombolysis (IVrtPA) in a tertiary stroke center. BP measurements were performed at regular intervals throughout day and night during the first 48 h after stroke onset, and subjects were divided into four dipping categories (extreme dippers, dippers, non-dippers, and reverse dippers). Recanalization was assessed by transcranial color-coded Doppler and/or angiographic CT. Hemorrhagic transformation was evaluated at 24 h follow-up CT scan. Functional outcome was evaluated at 3 months after stroke using the modified Rankin Scale. A total of 304 patients were included, mean age 72.80 Âą 11.10 years. After 24 h of systolic BP monitoring, 30.59% were classified as reverse dippers, 39.14% as non-dippers, 19.10% as dippers, and 11.18% as extreme dippers. Multivariate analysis did not show an independent association of any dipping class with 3-month functional outcome. Hemorrhagic transformation was not uniform between dipping classes: 25.81% for reverse dippers, 14.29% for non-dippers, 15.52% for dippers, and 5.88% for extreme dippers, P = 0.033. Nocturnal BP dipping pattern is not associated with functional outcome at 3 months in acute stroke patients treated with IVrtPA. Hemorrhagic transformation was more frequent in reverse dippers. ÂŠ 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. ________________________________________________________________________________ Title: Prognostic factors for long-term poor outcomes after acute ischemic stroke in very old age (>80 years) patients: Total cholesterol level might differently influence long-term outcomes after acute ischemic stroke at ages above 80 years. Citation: Geriatrics & gerontology international, Nov 2015, vol. 15, no. 11, p. 1227-1233 (November

2015) Author(s): Cha, Jae-Kwan, Lim, Jun-Ho, Kim, Dae-Hyun, Nah, Hyun-Wook, Park, Hyun-Seok, Choi, Jae-Hyung, Suh, Hyun-Kyung, Huh, Jae-Taeck Abstract: We investigated the differences in determinant factors for functional outcomes between patients aged >80 years and those aged <80 years after acute ischemic stroke (AIS). In particular, we would like to know the differential impacts of initial total cholesterol (TC) levels between the two groups. We defined a poor outcome as 3-6 modified Rankin Scale 90 days after AIS. In the present study, 2772 participants were enrolled. Among them, 374 patients (13.5%) were aged >80 years, and 1061 patients had a poor outcome 90 days after AIS. The proportion was significantly higher in patients aged >80 years than in those aged <80 years after AIS. Regarding factors relating to poor outcomes, previous history of stroke, stroke severity and stroke subtypes of ischemic stroke were independent factors in patients aged <80 years, and the stroke severity and initial TC level independently influenced the outcome for patients aged >80 years. In particular, risk of poor outcome adjusted for age, stroke severity and subtypes of ischemic stroke for patients (OR [95% CI]) in the first quartile range (≤157 mg%) were 2.21 (1.06-4.62), in the third quartile range (184-210 mg%) 2.76 (1.27-6.01) and in the fourth quartile range (≥211 mg%) 2.75 (1.21-6.24) compared with those in the second quartile range (158-183 mg%) in patients aged >80 years. There were also some differences in related factors regarding occurrences of poor outcome between the two groups. In particular, the initial TC level might play a crucial role for the outcome after AIS in the very old population. Geriatr Gerontol Int 2015; 15: 1227-1233. © 2014 Japan Geriatrics Society. ________________________________________________________________________________ Title: Post-stroke depression and post-stroke anxiety: prevalence and predictors. Citation: International psychogeriatrics / IPA, Nov 2015, vol. 27, no. 11, p. 1805-1812 (November 2015) Author(s): Schöttke, Henning, Giabbiconi, Claire-Marie Abstract: Epidemiological research on post-stroke affective disorders has been mainly focusing on post-stroke depression (PSD). In contrast, research on post-stroke anxiety (PSA) is in its early stages. The present study proposes a broad picture on post-stroke affective disorders, including PSD and PSA in German stroke in-patients during rehabilitation. In addition, we investigated whether lifetime affective disorders predict the emergence of PSD and PSA. 289 stroke patients were assessed in the early weeks following stroke for a range of mood and anxiety disorders by means of the Structured Clinical Interview relying on the Diagnostic and Statistical Manual of Mental Disorders IV. This assessment was conducted for two periods: for post-stroke and retroactively for the period preceding stroke (lifetime). The covariation between PSD and PSA was investigated using Spearman-ρ correlation. Predictors of PSD and PSA prevalence based on the respective lifetime prevalence were investigated using logistic regression analyses. PSD prevalence was 31.1%, PSA prevalence was 20.4%. We also found significant correlations between depression and anxiety at post-stroke and for the lifetime period. Interestingly, lifetime depression could not predict the emergence of PSD. In contrast, lifetime anxiety was a good predictor of PSA. We were able to highlight the complexity of post-stroke affective disorders by strengthening the comorbidity of depression and anxiety. In addition, we contrasted the predictability of PSA based on its lifetime history compared to PSD which was not predictable based on lifetime depression. ________________________________________________________________________________ Title: Factors facilitating or hampering nurses identification of stroke in emergency calls. Citation: Journal of advanced nursing, Nov 2015, vol. 71, no. 11, p. 2609-2621 (November 2015) Author(s): Berglund, Annika, Heikkilä, Kristiina, Bohm, Katarina, Schenck-Gustafsson, Karin, von Euler, Mia

Abstract: To explore the factors that facilitate or hamper identification of stroke in emergency calls concerning patients with stroke who have fallen or been in a lying position. Early identification of stroke in emergency calls is vital but can be complicated as the patients may be unable to express themselves and the callers generally are bystanders. In a previous study, we found presentation of fall or the patient being in a lying position to be the major problem in 66% of emergency calls concerning, but not dispatched as acute stroke. A qualitative study using interpretive phenomenology. Analysis of transcribed emergency calls concerning 29 patients with stroke diagnoses at hospital discharge, in 2011 and presented with fall/lying position. Patients' ability to express themselves, callers' knowledge of the patient and of stroke, first call-takers' and nurses' authority, nurses' coaching and nurses' expertise skills facilitated or hindered the identification of stroke. Certain aspects are adjustable, but some are determined by the situation or on callers' and patients' abilities and thus difficult to change. Nurses' expertise skills were the only theme found to have a decisive effect of the identification of stroke on its own. To increase identification of stroke in emergency calls concerning stroke, the first call-takers' and nurses' action, competence and awareness of obstacles are crucial and if strengthened would likely increase the identification of stroke in emergency calls. In complicated cases, nurses' expertise skills seem essential for identification of stroke. ÂŠ 2015 John Wiley & Sons Ltd. ________________________________________________________________________________ Title: Stroke Risk Perception in Atrial Fibrillation Patients is not Associated with Clinical Stroke Risk. Citation: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, Nov 2015, vol. 24, no. 11, p. 2527-2532 (November 2015) Author(s): Fournaise, Anders, Skov, Jane, Bladbjerg, Else-Marie, Leppin, Anja Abstract: Clinical risk stratification models, such as the CHA2DS2-VASc, are used to assess stroke risk in atrial fibrillation (AF) patients. No study has yet investigated whether and to which extent these patients have a realistic perception of their personal stroke risk. The purpose of this study was to investigate and describe the association between AF patients' stroke risk perception and clinical stroke risk. In an observational cross-sectional study design, we surveyed 178 AF patients with a mean age of 70.6 years (SD 8.3) in stable anticoagulant treatment (65% treatment duration >12 months). Clinical stroke risk was scored through the CHA2DS2-VASc, and patients rated their perceived personal stroke risk on a 7-point Likert scale. There was no significant association between clinical stroke risk assessment and patients' stroke risk perception (rho = .025; P = .741). Approximately 60% of the high-risk patients had an unrealistic perception of their own stroke risk, and there was no significant increase in risk perception from those with a lower compared with a higher risk factor load (Ď&#x2021;(2) = .010; P = .522). Considering possible negative implications in terms of lack of motivation for lifestyle behavior change and adequate adherence to the treatment and monitoring of vitamin K antagonist, the apparent underestimation of risk by large subgroups warrants attention and needs further investigation with regard to possible behavioral consequences. Copyright ÂŠ 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved. ________________________________________________________________________________ Title: Brain health and shared risk factors for dementia and stroke. Citation: Nature reviews. Neurology, Nov 2015, vol. 11, no. 11, p. 651-657 (November 2015) Author(s): Gardener, Hannah, Wright, Clinton B, Rundek, Tatjana, Sacco, Ralph L Abstract: Impaired brain health encompasses a range of clinical outcomes, including stroke, dementia, vascular cognitive impairment, cognitive ageing, and vascular functional impairment. Conditions associated with poor brain health represent leading causes of global morbidity and

mortality, with projected increases in public health burden as the population ages. Many vascular risk factors are shared predictors for poor brain health. Moreover, subclinical brain MRI markers of vascular damage are risk factors shared between stroke and dementia, and can be used for risk stratification and early intervention. The broad concept of brain health has resulted in a conceptual shift from vascular risk factors to determinants of brain health. Global campaigns to reduce cardiovascular diseases by targeting modifiable risk factors are necessary and will have a broad impact on brain health. Research is needed on the distinct and overlapping aetiologies of brain health conditions, and to define MRI markers to help clinicians identify patients who will benefit from aggressive prevention measures. Full text: Available Nature Publishing Group at Nature Reviews Neurology ________________________________________________________________________________ Title: Differences in Common Genetic Predisposition to Ischemic Stroke by Age and Sex. Citation: Stroke; a journal of cerebral circulation, Nov 2015, vol. 46, no. 11, p. 3042-3047 (November 2015) Author(s): Traylor, Matthew, Rutten-Jacobs, Loes C A, Holliday, Elizabeth G, Malik, Rainer, Sudlow, Cathie, Rothwell, Peter M, Maguire, Jane M, Koblar, Simon A, Bevan, Steve, Boncoraglio, Giorgio, Dichgans, Martin, Levi, Chris, Lewis, Cathryn M, Markus, Hugh S Abstract: Evidence from epidemiological studies points to differences in factors predisposing to stroke by age and sex. Whether these arise because of different genetic influences remained untested. Here, we use data from 4 genome-wide association data sets to study the relationship between genetic influence on stroke with both age and sex. Using genomic-relatedness-matrix restricted maximum likelihood methods, we performed 4 analyses: (1) we calculated the genetic correlation between groups divided by age and (2) by sex, (3) we calculated the heritability of age-atstroke-onset, and (4) we evaluated the evidence that heritability of stroke is greater in women than in men. We found that genetic factors influence age at stroke onset (h(2) [SE]=18.0 [6.8]; P=0.0038), with a trend toward a stronger influence in women (women: h(2) [SE]=21.6 [3.5]; Men: h(2) [SE]=13.9 [2.8]). Although a moderate proportion of genetic factors was shared between sexes (rG [SE]=0.68 [0.16]) and between younger and older cases (rG [SE]=0.70 [0.17]), there was evidence to suggest that there are genetic susceptibility factors that are specific to sex (P=0.037) and to younger or older groups (P=0.056), particularly for women (P=0.0068). Finally, we found a trend toward higher heritability of stroke in women although this was not significantly greater than in men (P=0.084). Our results indicate that there are genetic factors that are either unique to or have a different effect between younger and older age groups and between women and men. Performing large, wellpowered genome-wide association study analyses in these groups is likely to uncover further associations. ÂŠ 2015 The Authors. ________________________________________________________________________________ Title: Copeptin and Long-Term Risk of Recurrent Vascular Events After Transient Ischemic Attack and Ischemic Stroke: Population-Based Study. Citation: Stroke; a journal of cerebral circulation, Nov 2015, vol. 46, no. 11, p. 3117-3123 (November 2015) Author(s): Greisenegger, Stefan, Segal, Helen C, Burgess, Annette I, Poole, Debbie L, Mehta, Ziyah, Rothwell, Peter M Abstract: Copeptin, the c-terminal portion of provasopressin, is a useful prognostic marker in patients after myocardial infarction and heart failure. More recently, high levels of copeptin have also been associated with worse functional outcome and increased mortality within the first year after ischemic stroke and transient ischemic attack (TIA). However, to date, there are no published data on whether copeptin predicts long-term risk of vascular events after TIA and stroke. We measured copeptin levels

in consecutive patients with TIA or ischemic stroke in a population-based study (Oxford Vascular Study) recruited from 2002 to 2007 and followed up to 2014. Associations with risk of recurrent vascular events were determined by Cox-regression. During ≈6000 patient-years in 1076 patients, there were 357 recurrent vascular events, including 174 ischemic strokes. After adjustment for age, sex, and risk factors, copeptin was predictive of recurrent vascular events (adjusted hazard ratio per SD, 1.47; 95% confidence interval, 1.31-1.64; P=0.0001), vascular death (1.85; 1.60-2.14; P<0.0001), all-cause death (1.75; 1.58-1.93; P<0.0001), and recurrent ischemic stroke (1.22; 1.04-1.44; P=0.017); and improved model-discrimination significantly: net reclassification improvement for recurrent vascular events (32%; P<0.0001), vascular death (55%; P<0.0001), death (66%; P<0.0001), and recurrent stroke (16%; P=0.044). The predictive value of copeptin was largest in patients with cardioembolic index events (adjusted hazard ratio, 1.84; 95% confidence interval, 1.53-2.20 versus 1.31, 1.14-1.50 in noncardioembolic stroke; P=0.0025). In patients with cardioembolic stroke, high copeptin levels were associated with a 4-fold increased risk of vascular events within the first year of follow-up (adjusted hazard ratio, 4.02; 95% confidence interval, 2.13-7.70). In patients with TIA and ischemic stroke, copeptin predicted recurrent vascular events and death, particularly after cardioembolic TIA/stroke. Further validation is required, in particular, in studies using more extensive cardiac evaluation. © 2015 American Heart Association, Inc. ________________________________________________________________________________ Title: Intravenous Thrombolysis for Stroke Recurring Within 3 Months From the Previous Event. Citation: Stroke; a journal of cerebral circulation, Nov 2015, vol. 46, no. 11, p. 3184-3189 (November 2015) Author(s): Karlinski, Michal, Kobayashi, Adam, Czlonkowska, Anna, Mikulik, Robert, Vaclavik, Daniel, Brozman, Miroslav, Gdovinova, Zuzana, Švigelj, Viktor, Csiba, Laszlo, Fekete, Klara, Kõrv, Janika, Demarin, Vida, Bašic-Kes, Vanja, Vilionskis, Aleksandras, Jatuzis, Dalius, Krespi, Yakup, Shamalov, Nikolay, Andonova, Silva, Ahmed, Niaz, Wahlgren, Nils, Safe Implementation of Treatments in Stroke–East Registry (SITS-EAST) Investigators Abstract: According to the European license, alteplase can be given no sooner than 3 months after previous stroke. However, it is not known whether past history of stroke influences the effect of treatment. Our aim was to evaluate safety and functional outcome after intravenous thrombolysis administered in everyday practice to patients with previous stroke ≤3 months compared with those with first-ever stroke. We analyzed consecutive cases treated with alteplase between October 2003 and July 2014 contributed to the Safe Implementation of Thrombolysis for Stroke-Eastern Europe registry from 12 countries. Odds ratios were calculated using unadjusted and adjusted logistic regression. Of 13 007 patients, 11 221 (86%) had no history of stroke and 249 (2%) experienced previous stroke ≤3 months before admission. Patients with previous stroke ≤3 months had a higher proportion of hypertension and hyperlipidemia. There were no significant differences in outcome, including symptomatic intracerebral hemorrhage according to European Cooperative Acute Stroke Study (unadjusted odds ratio 1.27, 95% confidence interval: 0.74-2.15), and being alive and independent at 3 months (odds ratio 0.81, 95% confidence interval: 0.61-1.09). Patients currently treated with alteplase, despite a history of previous stroke ≤3 months, do not seem to achieve worse outcome than those with first-ever stroke. Although careful patient selection was probably of major importance, our findings provide reassurance that this group of patients may safely benefit from thrombolysis and should not be arbitrarily excluded as a whole. Further studies are needed to identify the shortest safe time lapse from the previous event to treatment with alteplase. © 2015 American Heart Association, Inc.

________________________________________________________________________________ Title: Differences Between US and UK Adults in Stroke Preparedness: Evidence From Parallel Population-Based Community Surveys. Citation: Stroke; a journal of cerebral circulation, Nov 2015, vol. 46, no. 11, p. 3220-3225 (November 2015) Author(s): Dombrowski, Stephan U, Ford, Gary A, Morgenstern, Lewis B, White, Martin, Sniehotta, Falko F, Mackintosh, Joan E, Gellert, Paul, Skolarus, Lesli E Abstract: Although time-dependent treatment is available, most people delay contacting emergency medical services for stroke. Given differences in the healthcare system and public health campaigns, exploring between-country differences in stroke preparedness may identify novel ways to increase acute stroke treatment. A survey was mailed to population-based samples in Ingham County, Michigan, US (n=2500), and Newcastle upon Tyne, UK (n=2500). Surveys included stroke perceptions and stroke/nonstroke scenarios to assess recognition and response to stroke. Betweencountry differences and associations with stroke preparedness were examined using t tests and linear mixed models. Overall response rate was 27.4%. The mean age of participants was 55 years, and 58% were female. US participants were better in recognizing stroke (70% versus 63%, d=0.27) and were more likely to call emergency medical services (55% versus 52%, d=0.11). After controlling for demographics and comorbidities, US participants remained more likely to recognize stroke but were not more likely to respond appropriately. A greater belief that medical treatment can help with stroke and understanding of stroke was associated with improved stroke recognition and response. Overall, stroke recognition and response were moderate. US participants were modestly better at recognizing stroke, although there was little difference in response to stroke. Future stroke awareness interventions could focus more on stroke outcome expectations and developing a greater understanding of stroke among the public. ÂŠ 2015 The Authors. Source: Medline ________________________________________________________________________________

BOOKS BACK TO TOP If you are unable to find a book, or require a book that is not on this list, please ask library staff who will be able to locate the book for you using interlibrary loan. Books available to borrow The Stroke Book Torbey et al nd 2013, 2 edition

Stroke Recovery and Rehabilitation Joel Stein et al nd 2015, 2 edition

From the back of the book: The Stroke Book is a concise and practical reference for anyone involved in managing critically ill cerebrovascular patients. â&#x20AC;˘ Covers a wide range of common conditions such as ischemic and hemorrhagic strokes, subarachnoid hemorrhages and intracranial aneurysms â&#x20AC;˘ Provides focused protocols for assessing and treating stroke patients in the emergency room, intensive care unit or general hospital setting Written by experienced contributors from leading stroke centers, this is an essential companion for navigating stroke-related clinical situations successfully and making informed decisions about treatment.

From the back of the book:

The definitive core text in its field, "Stroke Recovery and Rehabilitation" is a comprehensive reference covering all aspects of stroke rehabilitation - from neurophysiology of stroke through the latest treatments and interventions for functional recovery and restoration of mobility. This second edition is completely updated to reflect recent advances in scientific understanding of neural recovery and growing evidence for new clinical therapies.

Taunton and SomPar NHS staff - Have you visited the EBL eBook catalogue? Follow the links below and login via OpenAthens to read online books free for 5-10 minutes each day, send requests for eBook loans or purchase suggestions Taunton & Somerset eBook catalogue

Somerset Partnership eBook catalogue

About OpenAthens

COCHRANE SYSTEMATIC REVIEWS BACK TO TOP Full-text evidence-based systematic reviews prepared by the Cochrane collection Reviews from October/November 2015 Pharmacological interventions for unilateral spatial neglect after stroke Peroxisome proliferator-activated receptor gamma agonists for preventing recurrent stroke and other vascular events in patients with stroke or transient ischaemic attack Fibrates for secondary prevention of cardiovascular disease and stroke

Protocols from October/November 2015 Massage therapy for improving functional activity after stroke

GUIDELINES

National Clinical Guideline for Stroke, 4 edition 2012 NICE Guidelines Secondary prevention after a myocardial infarction- NICE quality standard [QS99] Published date: September 2015 Cardiovascular risk assessment and lipid modification- NICE quality standard [QS100] Published date: September 2015 Edoxaban for preventing stroke and systemic embolism in people with non-valvular atrial fibrillationNICE technology appraisal guidance [TA355] Published date: September 2015

UPTODATE & DYNAMED BACK TO TOP What’s new from our clinical decision-making tools on the topic of stroke. UpToDate –Access for Musgrove staff onlyDynaMed Please contact library staff for details on how to access these resources; you will need an Athens password if accessing from home.

REPORTS, PUBLICATIONS AND RESOURCES

NICE Pathway on Stroke UK Stroke Forum- hosted by Stroke Association Stroke Association website- contains information about support groups, conferences, fundraising, research and professional advice including toolkits and posters.

TOPIC ALERTS AND UPDATES

ABSTRACTS AVAILABLE VIA LINKS BELOW - FOR FULL-TEXT PLEASE ASK LIBRARY STAFF Right hemisphere grey matter structure and language outcomes in chronic left hemisphere stroke Brain, First published online: 31 October 2015

Elsevier Practice Updates Safety and Efficacy of AbobotulinumtoxinA for Hemiparesis After Stroke or Traumatic Brain Injury Lancet Neurology, Volume 14, No. 10, p992–1001, October 2015

Post-stroke fatigue and its association with poor functional outcome after stroke in young adults J Neurol Neurosurg Psychiatry, 2015;86:1120-1126 FREE FULL TEXT WITH ATHENS LOGIN Time to endovascular reperfusion and degree of disability in acute stroke Annals of Neurology, Volume 78, Issue 4, pages 584–593, October 2015 FREE FULL TEXT Differential Vascular Pathophysiologic Types of Intracranial Atherosclerotic Stroke- A High-Resolution Wall Magnetic Resonance Imaging Study Stroke, 2015; 46: 2815-2821 FREE FULL TEXT WITH ATHENS LOGIN- MUSGROVE STAFF ONLY Rates and Determinants of 5-Year Outcomes After Atrial Fibrillation–Related Stroke- A Population Study Stroke, Published online before print October 15, 2015 Effect of Hyperacute Administration (Within 6 Hours) of Transdermal Glyceryl Trinitrate, a Nitric Oxide Donor, on Outcome After Stroke- Subgroup Analysis of the Efficacy of Nitric Oxide in Stroke (ENOS) Trial Stroke, 2015; 46: 3194-3201 Medscape Topic Alerts Association between job strain and risk of incident stroke Neurology, Published online before print October 14, 2015 Differences Between US and UK Adults in Stroke Preparedness- Evidence From Parallel PopulationBased Community Surveys STROKE, Published online before print September 29, 2015 FREE FULL TEXT Treatment and Outcome of Thrombolysis-Related Hemorrhage: A Multicenter Retrospective Study JAMA Neurol. Published online October 26, 2015.

TRIP Database Quality of life in patients with TIA and minor ischemic stroke. Neurology, published ahead of print November 4, 2015

Low ADAMTS13 activity is associated with an increased risk of ischemic stroke. Blood. 2015 Oct 28 Diagnosing Paroxysmal Atrial Fibrillation in Patients With Ischemic Strokes and Transient Ischemic Attacks Using Echocardiographic Measurements of Left Atrium Function. Am J Cardiol. 2015 Oct 19 Nurse-Led, Telephone-Based, Secondary Preventive Follow-Up after Stroke or Transient Ischemic Attack Improves Blood Pressure and LDL Cholesterol: Results from the First 12 Months of the Randomized, Controlled NAILED Stroke Risk Factor Trial.

PLoS One. 2015 Oct 16;10(10):e0139997 FREE FULL TEXT

Methodological Factors in Determining Risk of Dementia After Transient Ischemic Attack and Stroke: (III) Applicability of Cognitive Tests Stroke, 2015; 46: 3067-3073 FREE FULL TEXT WITH ATHENS LOGIN- MUSGROVE STAFF ONLY Diffusion-weighted imaging in transient neurological attacks. Ann Neurol. 2015 Oct 8 Copeptin and Long-Term Risk of Recurrent Vascular Events After Transient Ischemic Attack and Ischemic Stroke: Population-Based Study Stroke. 2015 Nov;46(11):3117-23. FREE FULL TEXT WITH ATHENS LOGIN- MUSGROVE STAFF ONLY

TWITTER BACK TO TOP The latest from popular Twitter pages dedicated to stroke: Stroke Association @TheStrokeAssoc World Stroke Campaign @WStrokeCampaign Sign Against Stroke in Atrial Fibrillation @signagnststroke Different Strokes- Support for Younger Stroke Survivors @diffstrokes

TRAINING & NETWORKING OPPORTUNITIES, CONFERENCES, EVENTS BACK TO TOP

18 -19 March 2016, Birmingham

BMJ Masterclass- Stroke- 11 December 2015, London

LITERATURE SEARCH SERVICE BACK TO TOP Looking for the latest evidence-based research but havenâ&#x20AC;&#x2122;t got time to trawl the databases? Do you need a literature search carried out? Do you need to find evidence to support an improvement? Do you want to know how something has been done elsewhere and whether it worked?

Library staff provide a literature search service for busy clinicians who are pressed for time.

To request a search please complete and return the appropriate form, providing as much information as possible. Alternatively if you would like an assisted search training session, where we will sit down with you and go through the steps of a literature search, then please contact the library. Musgrove staff click here to access literature search form Somerset Partnership staff click here to access literature search form

TRAINING AND ATHENS BACK TO TOP Most electronic resources are available via an Athens password. You can register for this via the Library intranet page, or from home at www.swice.nhs.uk and following the link for Athens selfregistration. Please note that registering from home will take longer as it will need to be verified that you are NHS staff/student on placement. The library offers training on how to access and use Athens resources, as well as an introductory course on critical appraisal. You can book a course through the Learning and Development intranet page, or by contacting the library directly.