australasian neuroscience nurses association

1
Issue 3, November 2005
Brainstem
www.anna.asn.au

• Inside this issue
• Presidents report
• Conference news
• WFNN News
• State news
• Membership
• 2005 AGM minutes
• Brainstem Evaluations
• Special features
• John Shead Biography
• Huntingtons Disease
• Onyx

I know that she is already busily planning next
years conference, which will see us heading up to
tropical Queensland in Cairns. Bring it
on! Cheryl will have more about the conference
in her report, but I can sum it up by saying it
was educational and fun (particularly the beach
theme dinner). If you want to see what ANNA
members got up to visit the ANNA website.   As
you will know we ran several competitions through
the year with the winners being announced at the
conference. Congratulations to the following
winners 33rd member to renew for 2005-2006
Rebecca Burke Most members recruited during the
week of ANND in May Royal North Shore Hospital,
Sydney. ANND celebration competition Sydney
West Area Health Service.  
Tracy taking the surf rider challenge
The end of the year and all of the festivities
that comes with it is fast approaching. This
will be our last BRAINSTEM for 2005 and on behalf
of the Executive team we wish you a safe and
merry Christmas and prosperous New Year. The
month of September saw 100 ANNA members come
together on the Gold Coast for our annual
scientific meeting (conference). It was great to
see so many members (both old and new)
participate in the sharing of neuroscience
knowledge and to network with fellow colleagues.
The diversity of the papers presented was
fantastic, with many areas relevant to
neuroscience nursing being addressed.
Congratulations to all of the presenters, in
particular our prize winners, Tim OMaley, Suzy
Goodman and Lucy Bailey. Cheryl (our friendly
conference convener) did a fantastic job
organising and coordinating the conference. The
great success of the conference, which was
evident from the evaluation responses, was
possible because of her dedication to every
detail in ensuring the conference met the needs
of ANNA members.
Our membership numbers have shown a steady rise
over the year, which is pleasing to see. It is
the members that strengthen our association and
we thank you for your support in continuing to
promote ANNA and recruit new members.   We
welcome to the Federal Executive Karen Tuqiri as
Treasurer. We look forward to Karen joining the
team and working together for the association.
australasian neuroscience nurses association
2
A Message from your Friendly Conference Convener
As I pack away the folder for conference 2005 and
label the 2006 folder I feel that you the members
deserve to read a somewhat bias report on the
33rd Annual Scientific Meeting. Legends Hotel,
Gold Coast QLD September 15th 17th 2005 was
the place to be according to _at_ 100 enthusiastic
ANNA members. On the Terrace with a drink in
one hand old friendships were reunited and new
ones started as delegates mingled amongst their
neuroscience colleagues. Tracy Desborough
welcomed all to our annual meeting and the
networking continued. 34 members submitted
abstracts for posters and oral presentations,
these submissions allowed the program to reflect
the diversity that Neuroscience Nursing
represents. Congratulations to our Prize winners,
all gave outstanding presentations representing
the work they do for Neuroscience patients
Tonnie Koenen Prize Tim OMaley
(QLD) Neurosurgical Society Australasia (NSA)
Prize Suzy Goodman (VIC) Poster Prize Kylie
Wright (NSW) First Time Presenter Lucy Bailey
(QLD) Congratulations to all presenters (oral
and poster) and moderators who expressed interest
in participating at a very successful conference,
I thank you and look forward to your support next
year.
3
I also look forward to the inundation of
abstract submissions we get when I post the call
for abstracts!! Remember the conference program
can only be as good as its content, which is up
to you the members. So if you want a longer
program or a more diverse program start thinking
about your abstract submission for next year now!
And tell your colleagues. As you know there is
more to a conference than just absorbing and
sharing knowledge, what about the social side or
in conference language networking
opportunities. The conference dinner is an
event that will be hard to beat, how many people
have now taken up surfing lessons or visited a
chiropractor??? How much fun was the mechanical
surf board and the dance floor both activities
proved that nurses are very talented people!! I
am sure there are storys being told around neuro
wards about who was the most talented on the surf
(Charmaine). Thank you all for a great night.
Thank you for attending and supporting our
conference it is always great to see our members
come together each year and share their
experiences. I look forward to seeing you all
next year. Bye for now Your Friendly
Conference Convener Cheryl Trudinger PS See you
in Cairns, September 14th 16th 2006
4
A tribute to John Shead- a biography

• There is a beautiful saying. Some people come
  into our lives and quickly go. Some stay awhile,
  leave footprints on our hearts. And we are never,
  ever the same.
• For those who had the privilege of having met and
  known John Shead, would agree that John has left
  footprints in our hearts. Johns recent sudden
  and tragic passing had a profound effect on all
  staff, across all disciplines throughout Westmead
  Hospital. It goes without saying that Johns
  prescience within the hospital was always obvious
  and highly valued, and now his absence has left
  an equally obvious void and sense of immeasurable
  loss for many, many people.
• John had been on the staff at Westmead for some
  twenty years and as such he had become an
  integral and much loved part of Westmead
  Hospital. John fulfilled many professional roles
  during his time, starting back in 1979 as a
  registered nurse. In 1981, John completed his
  midwifery training and stayed on staff
  thereafter. John subsequently ventured in to the
  world of Neural Sciences (some would say he took
  his job a bit too literally, as demonstrated by
  his shaved bald head!)
• After he successfully did the Neurological Course
  at Westmead, John went on to become the Nurse
  Unit Manager of the Neuro High Dependency Unit
  (D5b), before later becoming the Clinical Nurse
  Consultant in Neural Sciences.

• At one stage, John had completed more
  postgraduate courses at Westmead than any other
  nurse. In the last couple of years, John embraced
  the opportunity of a change in career direction
  and successfully fulfilled the role of Acting
  Facility Planner with the Maintenance and
  Facility department. This role assisted in
  raising the profile even higher and wider amongst
  the Westmead Hospital community and like his
  clinical career he took little time in proving
  what a highly valuable asset he was to the
  service.
• John dedicated almost half his lifetime to
  Westmead and he has left behind an indelible
  legacy. Many people were probably unaware of the
  extent of his great work and commitment, to both
  his clinical specialty and the nursing profession
  in general. John was a regular and popular
  lecturer on Neuro specialty on local, national
  and international level. John was the epitome of
  the quiet achiever, who got on with the job,
  always doing the best job possible. One of Johns
  greatest achievements was his outstanding ability
  as a teacher and mentor.

Thank you to Angela Lownie and Kate Murphy from
the Western Area Health Service, Sydney for
providing this contribution
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The 2005 World Congress on Huntingtons Disease
Impetus for change
Reported by Angela Lownie

• The 2005 World Congress on Huntington Disease was
  held at the Midland Hotel, Manchester from 10
  13th September 2005. The program and abstracts
  have been published as Supplement lV in the
  Journal of neurology, neurosurgery and psychiatry
  (Oct 2005, Vol 76).
• Along with 492 other participants, I spent the
  2.5 days absorbing what scientists, clinicians,
  and medical researchers from the fields of
  genetics, epidemiology, biochemistry, neurology,
  psychiatry, psychology, nursing, and general
  medicine, from every corner of the globe had to
  say about their work in understanding and
  overcoming, this baffling hereditary condition.
  Also there were care managers, administrators,
  and representatives of HD affected families
  through their local organizations, meeting
  together for an historic first time.
• The high- powered work for a cure or treatments
  to slow down the progress of the disease are
  truly astonishing and would take an article on
  their own to discuss. Suffice it to say that
  collaborative international research papers spoke
  (amongst many others) of efforts to regulate the
  toxicity of mutant Huntington (Rubinsztein et al
  of the role of dopamine in restoring cortical
  function in HD mice (Cummings et al) of evidence
  of the role of mRNA dysfunction in producing
  pathology (Hodges et al) preliminary results of
  clinical trials of human striatal tissue
  transplant (Dunnett Brain repair group)
  investigation of the effects of miraxion (motor
  features), memantine (cognitive impairment),
  coenzyme Q (functional decline) and investigation
  of any impact on disease course (minocycline) as
  well as Creatine, Phenylbutyrate, EthylEPA,
  Rosagiline, Citicoline, Lamotrigine, MPEP and
  Amantidine.

I was fortunate to have the opportunity to
attend, assisted by a much appreciated
Professional Development Scholarship from ANNA.
With my service director, neurologist Dr
Elizabeth McCusker, I presented a poster Ten
years of Huntington Disease outreach service in
New South Wales on the 2nd day with eleven
others under the heading of Clinical Care and
Management. In spite of the rather crowded
display space, I had several conversations with
other participants during the hour long poster
viewing session regarding the functioning of our
service. I particularly enjoyed discussions
regarding late stage residential care with team
members from the Netherlands working in a 70 bed
specialist residential unit Overduin, in
Katwijk. By comparison to my previous
experience a few years ago, it was pleasing to
find an increasing number of papers and posters
targeting care and management issues at this key
event. Posters from the Leicester Partnership
Trust (UK), Nottingham (UK), Russia, and the
Netherlands (as mentioned), presented work with
common threads to ours. Once again, we were happy
that our work in this area compares favorably
when viewed from the International
standpoint. However, it was the in-depth
conversations with nurses such as Dr Elizabeth
Almquist from Sweden regarding their work on
assessing nursing interventions and strategies
for aggressive behaviour, and Steve Smith from
the University of East Anglia who used the
conference to launch his book Huntingtons
Disease a Nursing Guide Applying the Roper,
Logan and Tierney Model of Nursing, that
provided the greatest benefit.
An excellent paper by administrator jim pollard
and psychologist R.M. Stein, accommodating the
cognitive phenotype a challenge to nursing
homes and considerations for care was the final
impetus to animated conversations which resulted
in plans to launch the first international
network of non medical professionals in
HD. Some last minute drafting late into the
night and we had a document, outlining the aims
and plans, to disseminate to the participants at
the last plenary session. It is hoped that this
network might be a force for change with regard
to the noticeable lack of research by allied
health therapists and nurses. The next congress
will be in dresden, Germany in 2007, and it would
be wonderful to be able to report on some
collaborative endeavors to that meeting.
Interested nurses and allied health staff can
join through contacting me (angela_lownie_at_wsahs.Ns
w.Gov.Au) or Steve smith (steve.Smith_at_uea.Ac.Uk)
or Jim pollard (jpollard_at_comcast.Net)
6
What is Huntington's Disease?

• Huntington's disease (HD) results from
  genetically programmed degeneration of brain
  cells, called neurons, in certain areas of the
  brain. This degeneration causes uncontrolled
  movements, loss of intellectual faculties, and
  emotional disturbance. HD is a familial disease,
  passed from parent to child through a mutation in
  the normal gene. Each child of an HD parent has a
  50-50 chance of inheriting the HD gene. If a
  child does not inherit the HD gene, he or she
  will not develop the disease and cannot pass it
  to subsequent generations. A person who inherits
  the HD gene will sooner or later develop the
  disease. Whether one child inherits the gene has
  no bearing on whether others will or will not
  inherit the gene. Some early symptoms of HD are
  mood swings, depression, irritability or trouble
  driving, learning new things, remembering a fact,
  or making a decision. As the disease progresses,
  concentration on intellectual tasks becomes
  increasingly difficult and the patient may have
  difficulty feeding himself or herself and
  swallowing. The rate of disease progression and
  the age of onset vary from person to person. A
  genetic test, coupled with a complete medical
  history and neurological and laboratory tests,
  help physician's diagnose HD. Presymptomic
  testing is available for individuals who are at
  risk for carrying the HD gene. In 1 to 3 percent
  of individuals with HD, no family history of HD
  can be found.
• How is HD Diagnosed?
• The great American folk singer and composer Woody
  Guthrie died on October 3, 1967, after suffering
  from HD for 13 years. He had been misdiagnosed,
  considered an alcoholic, and shuttled in and out
  of mental institutions and hospitals for years
  before being properly diagnosed. His case, sadly,
  is not extraordinary, although the diagnosis can
  be made easily by experienced neurologists.
• A neurologist will interview the individual
  intensively to obtain the medical history and
  rule out other conditions. A tool used by
  physicians to diagnose HD is to take the family
  history, sometimes called a pedigree or
  genealogy. It is extremely important for family
  members to be candid and truthful with a doctor
  who is taking a family history.
• The doctor will also ask about recent
  intellectual or emotional problems, which may be
  indications of HD, and will test the person's
  hearing, eye movements, strength, coordination,
  involuntary movements (chorea), sensation,
  reflexes, balance, movement, and mental status,
  and will probably order a number of laboratory
  tests as well.
• People with HD commonly have impairments in the
  way the eye follows or fixes on a moving target.
  Abnormalities of eye movements vary from person
  to person and differ, depending on the stage and
  duration of the illness.
• The discovery of the HD gene in 1993 resulted in
  a direct genetic test to make or confirm a
  diagnosis of HD in an individual who is
  exhibiting HD-like symptoms. Using a blood
  sample, the genetic test analyzes DNA for the HD
  mutation by counting the number of repeats in the
  HD gene region. Individuals who do not have HD
  usually have 28 or fewer CAG repeats. Individuals
  with HD usually have 40 or more repeats. A small
  percentage of individuals, however, have a number
  of repeats that fall within a borderline region

• Is there any treatment?
• Physicians prescribe a number of medications to
  help control emotional and movement problems
  associated with HD. Most drugs used to treat the
  symptoms of HD have side effects such as fatigue,
  restlessness, or hyperexcitability. It is
  extremely important for people with HD to
  maintain physical fitness as much as possible, as
  individuals who exercise and keep active tend to
  do better than those who do not.
• What is the prognosis?
• At this time, there is no way to stop or reverse
  the course of HD. Now that the HD gene has been
  located, investigators are continuing to study
  the HD gene with an eye toward understanding how
  it cause disease in the human body.
• What research is being done?
• Scientific investigations using electronic and
  other technologies enable scientists to see what
  the defective gene does to various structures in
  the brain and how it affects the body's chemistry
  and metabolism. Laboratory animals are being bred
  in the hope of duplicating the clinical features
  of HD so that researchers can learn more about
  the symptoms and progression of HD. Investigators
  are implanting fetal tissue in rodents and
  nonhuman primates with the hope of understanding,
  restoring, or replacing functions typically lost
  by neuronal degeneration in individuals with HD.
  Related areas of investigation include
  excitotoxicity (over stimulation of cells by
  natural chemicals found in the brain), defective
  energy metabolism (a defect in the mitochondria),
  oxidative stress (normal metabolic activity in
  the brain that produces toxic compounds called
  free radicals), tropic factors (natural chemical
  substances found in the human body that may
  protect against cell death).

7
state news
western Australia
This year has been a disappointing one for the WA
Branch, attendances at our sessions have been
variable and often poor a reflection of our
busy lives I guess. I also think there are a
number of other organizations that compete for
the neuroscience nurses including the MSNA,
Parkinsons special interest group,
Rehabilitation Nurses group etc. We all know
membership fees are costly and with family and
other commitments people make choices and I
believe this negatively impacts on our
membership. On the bright side we have held some
excellent educational sessions including sessions
on Cognition, MS, Stroke and the research done by
the Parkinsons Nurse Consultant on carers. Other
opportunities available to Members have been the
TCD workshop, the Trigeminal Neuralgia
presentation and the MS Awareness Week forums.
Increasingly we have seen the neurosurgical
nurses engage less with the Association hence the
focus on non surgical topics to encourage
attendance from the more active neurological
nurses. Our fundraising film night had great
potential but unfortunately with only 35 tickets
sold the potential wasnt realized but we did
make 122.50 profit. The biscuit sales were non
existent. No members expressed an interest in
attending the ANNA symposium but I understand
Catherine Bucholz and Jo McPhee (ex members non
financial) from SJOG attended with hospital
funding which is fantastic. The WCN is being held
in Sydney in November and I think this may have
distracted some members unable to attend
both. After 10 years as State Delegate for WA I
am not seeking nomination this year. Having
restarted the branch in 1995 and facilitating a
number of significant achievements including
several seminars which were videotaped, the
Professional Standards for Neuroscience Nurses
adopted nationally and the introduction of
National Neuroscience Nurses Day.
I believe it is time to hand over to new blood.
Since leaving the hospital system I have found it
increasingly difficult both time wise and with
networking as it is harder to access people
generally of site. Several key players have also
changed positions and / or left the system and
this has added to the difficulties faced in
generating interest and participation. I would
like to thank Lee for her work as secretary over
the last 12 months and Robyn for the great work
she did before that. I would also like to thank
that core of people who have attended the
meetings and helped with organising speakers and
events especially Harriet, Meg and Gill. I
would be happy to provide support to the new
position holders if necessary and hope that the
branch can be regenerated here in WA. Sue
Shapland State Delegate WA Branch ANNA September
2005
8
new south wales
queensland
Dear NSW members and Australasia members The NSW
branch held one of our most successful ever AGMs
prior to the annual conference. We were very
lucky to be supported by Medtronic and to have an
educational presentation on the management of
Hydrocephalus prior to the meeting. At the AGM we
welcomed Brianna Beattie to the NSW - Executive
as our weblinks assistant. Brianna is from Royal
North Shore Hospital and she will be working with
Anita Lloyd from Australasia to maintain the
links on our Webpage. In addition to this new
member we welcome Nicole Morley to the Executive.
At our next meeting we will be outlining Nicole's
new role - more of this in the next Brainstem
and Hemisphere News (the NSW newsletter
coordinated by Kylie Wright). Sadly I need to
advise members that the NSW - Secretary, Ms Heidi
Evans, will be retiring from her role after 5
years as our State Secretary. Never an easy task,
Heidi has helped us immeasurably with keeping our
meetings organised, minuted and allowing us to
use her own database for membership information -
in conjunction with that used by Australasia. I
would like to thank her for commitment to ANNA
and for all her efforts. A calendar will be going
out to NSW members shortly to advise of planned
events over the rest of the financial year but
before you get your Christmas events all planned
- Royal North Shore Hospital our hosting an ANNA
evening on the Wednesday 30th November 2005 from
5.30- 8.30pm. Refreshments are provided and the
meeting will take place in the Main Block, Level
13 Boardroom, Royal North Shore Hospital on the
Pacific Highway at St. Leonards. The contact
person for this event is Anne MacLeod on 9926
8074 or amacleod_at_nsccahs.health.nsw.gov.au. The
program for the evening is Onyx, Thrombolysis,
Research in Action and a Brain Bee Trivia Quiz.
Anne requests that members and non-members attend
and RSVP by 23rd November (especially to assist
with catering). Registration and payment may be
made on the night. Hope to see you there and for
those members who are not in the metropolitan
area who would like to be involved in an
education event - please contact me at
maureen.edgtton_at_swsahs.nsw.gov.au
I hope that all the members who attended the
conference enjoyed it. I have had some very
positive feedback from m colleagues here at the
Princess Alexandra Hospital. I was in the UK and
therefore unable to attend. In August, we were
guests of the Wesley Hospital, Brisbane for an
excellent informative presentation by Dr Peter
Silburn on Deep Brain Stimulation in the
treatment of Parkinson Disease. The next meeting,
which will be held on the 30th November is
sponsored by Novartis Pharmaceuticals and held in
Romeoss Italian Restaurant, Spring Hill. It will
feature Professor Mervyn Eadie presenting an
update on epilepsy. Contact me for further
information as space is limited. I am continuing
to send out journal articles by email, so any
Queensland member who does not receive them,
please let me know as this means I either dont
have your email address or I have the wrong
address. Any members who are unable to attend
meetings are encouraged to send in items for
discussion or requests for support. Sue Day Ph
07 3240 2137 Email sue_day_at_health.qld.gov.au
Maureen Edgtton-Winn Liverpool Hospital
Australian Nurse Practitioner Association
Supporting advanced nursing practice
2005 Report The Australian Nurse Practitioner
Association (ANPA) was officially formed in 2003.
The association aims to support and encourage
advanced nursing practice across specialties.
Members are committed to having a positive
influence over the clinical care and outcomes of
all patients and their families. Currently the
association has representatives from 5 states and
2 territories throughout Australia. Membership
has grown dramatically throughout the year. The
Inaugural Conference was held in October 2005 in
Canberra, ACT. Attendance exceeded expectations
with 170 delegates. Delegates included Nurse
Practitioners, aspiring Nurse Practitioners,
academics and other health professionals who
support advanced nursing practice. This exciting
and historic occasion provided opportunities for
all those involved to share knowledge, expertise
and commitment to clinical excellence Delegates
were also able to discuss future directions and
plans for advanced nursing practice. Keynote
speaker was Prof Donna Diers. Prof Diers
delivered a very inspiring address sharing
experiences and lessons learnt in the development
of advance nursing role development. More
information can be found at www.nursepractitioner
s.org.au Rochelle Firth Nurse Practitioner-
Neurosurgery Australian Nurse Practitioner
Association- Treasurer
9
Brainstem Questionnaire Collation
Earlier in the year we asked you for your
thoughts on your association newsletter. Here are
the results, and I hope that this issue starts to
reflect what you the members want ?And just as a
gentle reminder contributions from you the
members is greatly appreciated we would love to
know what is going on in the world of
neurosciences and hope that your good work is
shared amongst your professional peers
1. Could you please rate the following aspects of
brainstem currently
Excellent Very Good Satisfactory Poor
Quality of Publication 67 33
Frequency of Publication 8 42 25 25
Conference Information 17 58 17 8
Membership information 17 58 8 17
Clinical Content 8 26 33 33
Professional Issues 8 17 58 17
Association Information/Update 16 42 25 17
Educational Opportunities 50 33 17
Comments Much improved after the facelift The
format is good Very Informative Inclusion of
articles by community nurses and carer
organisations to keep us informed and updated An
article on research stats on beneficial outcomes
of early rehabilitation. Invitations to physios
and OTs to contribute articles to
Brainstem. Have a particular interest in brain
tumours A research article on common
co-morbidities in neurological. Pts would be of
interest.
10
3. Please indicate whether you would like to see
any of the following in future editions of
Brainstem?
Yes No Unsure
Member profiles 60 20 20
Unit profiles 70 10 30
General Professional Issues 100
Educational opportunities 100
A clinical theme eg Stroke, Neurosurg 80 20
State Delegate Updates 80 20
Clinical Issues 90 10
Conference Updates 80 10 10
Job advertisements 70 20 10
Product information 70 30
What other areas would you like to see covered
in Brainstem? WFNN Corner used to have in
journal few years ago Current trial (clinical
trials) Different types of neuro illness. I
would like clinical relevant data included-maybe
a topic an edition. All covered in
above Educational Opportunities Journal review
paragraph review Link page reviewed. Any other
comments/ suggestions? Many thanks for this
facelift of brainstem A job well done I like
brainstem to be in a newsletter format, with the
journal focus on clinical issues. More clinical
based information for current practicing nurses-
this will include people not able to attend
conferences. Appreciate all the work people put
in to get brainstem published. Issue 2 is a great
improvement from all previous issues.
11

• Following this years AGM, several decisions need
  to be highlighted to members
• membership rates shall be for a 12 month period
  i.e. if you applied in march, renewals will be
  expected in march the next year - pro rata rates
  will no longer apply. Each member will receive
  reminder renewals once the12 month period has
  passed
• ANNA Exec and state delegates will have the
  discretion to distribute all members with
  appropriate notices via email

noticeboard
RNSH ANNA Education Evening
This education evening will be focusing on
interventional neuroradiological techniques,
primarily the use of thrombolysis in stroke and
onyx for the treatment of aneurysms and
AVMs. Royal North Shore Hospital November 30th
630pm 830pm Further information Anne
Macleod Light refreshments and supper will be
provided
Q I have an issue with taking the size of the
pupil when doing GCS. I knew that I should take
the size of the pupil before shining light, but
often many people misunderstand as to take the
size of the pupil after shining light.
Colleagues on my ward all think that it should be
the "post" one rather than the "pre" one. Could
you guys tell me which is the correct one?? As
much as possible, can you also send me journal
articles to support the say, so that I can show
it to my colleague?? Articles that I have found
generally talk about the different types of
response of pupils towards light but they don't
describe how to take the size of the pupil
Let everyone know about your education evenings
and advertise in Brainstem! Send information at
least 2 months before the event, including event,
date, venue, contact details Send information to
Rochelle McKnight Email annaexecutive_at_bigpond.com
.au Fax [phone] Mail PO Box 6,
Artarmon, NSW 1570 Australia
A When we assess pupil size it is the resting
pupil size, that is before the light is shone in
the pupil. The references for this include
Joanne Hickey The Clinical Practice of
Neurological and Neurosurgical Nursing, 5th
edition and another useful journal article Shah,
S (1999). Neurological Assessment Nursing
Standard, 13 (22), 49-56
trivia
12
STROKE IT'S TIME! Call for Suggestions!
2nd Australasian Nursing Allied Health Stroke
Conference 6th 7th July 2006 Sydney, Australia

• The aims of this conference will be
• To highlight the timeframe for acute stroke care
• To discuss innovations in stroke management and
  research
• To promote new initiatives on stroke care
• To provide the latest information on best
  practice in stroke
• To provide a forum for stroke clinicians to share
  information
• To raise awareness of rehabilitation concepts in
  stroke
• To highlight rehabilitation practices by allied
  health
• To raise community awareness of stroke

• The Organising Committee request presentation
  ideas from prospective presenters participants
  to make this conference relevant and informative
  for all stroke clinicians.
• Just give us your ideas on what you would like to
  hear more of.
• This is a call for your suggestions!
• The call for abstracts will be sent out in the
  near future based on your responses of what YOU
  want to hear about. We have provided the
  organising committees aims of the conference to
  help guide you.
• Please send your ideas by the 31.10.05 to

Conference Secretariat Louise Pitney Conference
Action Pty Ltd, PO Box 576, Crows Nest, NSW
AUSTRALIA 1585 Tel [phone] Fax 02 9901
4586 Email louise_at_conferenceaction.com.au
13
ANNA is continuing to recruit new association
members! It is always encouraging to see so many
new memberships in the mail ? On behalf of ANNA,
the executive would like to welcome the following
new members.
Kerri Reeves The Canberra Hospital ACT
Justyne Anderson St Vincents Public Hospital - Sydney NSW
Penny Bisaro Prince of Wales Hospital NSW
Nghia Bui St Vincents Public Hospital - Sydney NSW
Renee Craig Royal North Shore Hospital NSW
Wendy Cutler Royal Prince Alfred Hospital NSW
Regina Edwards Prince of Wales Hospital NSW
Lauren Farmer St George Public Hospital NSW
Meredith Ford Royal North Shore Hospital NSW
Linda Maree Gesell John Hunter Hospital NSW
Alison Harris Wyong Hospital NSW
Philip Herbert Royal North Shore Hospital NSW
Jane Maree Hunter Central Coast Health NSW
Tracy Kelly Prince of Wales Hospital NSW
Steve Klekacroski St George Public Hospital NSW
Simon Latham Royal Prince Alfred Hospital NSW
Christina Mills North Shore Private Hospital NSW
Sandra Morgan   NSW
Colette Patteson North Shore Private Hospital NSW
Danni Phillips Nepean Hospital NSW
Daniel Troitsin Royal North Shore Hospital NSW
Dallas Tucker Nepean Hospital NSW
Christine Turner The Sutherland Hospital NSW
Kim Milners St George Hospital NSW
Meena Sharma Liverpool Health Service NSW
Kathryn Bergan Nepean Hospital NSW
Fiona Wade Westmead Children's Hospital NSW
membership news
A reminder to members to notify the Association
promptly of change of address, we have been
receiving increasing numbers of returns of
late. If you have Email addresses please let the
executive know - by emailing us and we will then
be in a position to electronically mail you all
relevant association documentation.
14
Marcia Greenaway Auckland City Hospital, Operating Rooms NZ-Nth
Anna Kreft Starship Children's Hospital Auckland NZ-Nth
Ben McIntyre Auckland City Hospital NZ-Nth
David Moxon Canterbury District Health Board NZ-Nth
Kathryn Robinson Starship Children's Hospital Auckland NZ-Nth
Mabeline Siaw Canterbury Health Board, New Zealand NZ-Nth
Nathan Hood Christchurch Hospital NZ-Sth
Melissa Burton Princess Alexandria Hospital QLD
Jacqueline Clare Cameron Royal Brisbane Hospital QLD
Sarah Day Royal Brisbane Hospital QLD
Sharmaine Denise Hoera Gold Coast Hospital QLD
Rosina McKeen Gold Coast Hospital QLD
Lorraine Barbara Retallick Gold Coast Hospital QLD
Jasmin Abdulhakeem Boxhill Hospital VIC
Suzanne De Lange Monash Medical Centre VIC
Natalie Derry St Vincent's Private Hospital - Melbourne VIC
Darren MacGregor Alfred Hospital VIC
Patricia O'Donoghue St Vincent's Mercy Private Hospital VIC
Joahnne Ramos Royal Children's Hospital, Melbourne VIC
Cheryl Schlosser Sir Charles Gairdner Hospital WA
membership news
Membership renewals are now overdue with names of
unfinancial members now removed from our active
membership lists and from future mail outs. If
you have colleagues who are concerned at their
current financial status please advise them to
contact the executive for clarification.
15
What the???
Onyx, a new embolization material
As a result of high blood flow and pressure
imbalances, Intracranial arterio-venous
malformations (AVM) are at risk of hemorrhage, or
rupture, which can lead to stroke, severe
disability and even death. They often represent a
complex clinical problem in regards to treatment,
the choice of treatment and the technical
difficulties related to treatment.
Treatment options for AVMs include catheter-based
therapies, surgery, radiation therapy, or a
combination of these treatments. Catheter-based
treatments involve the delivery of embolic
materials to occlude, or block, the abnormal
blood vessels comprising the AVM.
Onyx is a liquid embolic material that is
delivered by neurovascular specialists through
micro catheters directly into a vascular defect,
such as a brain aneurysm or AVM, in a very
controlled manner. After delivery of the embolic
material, it stays in liquid form until it comes
into contact with blood or other aqueous
solutions.
Once contact is made, Onyx begins to precipitate,
changing from liquid to a solid thereby sealing
off the vessels in the AVM from blood flow and
reducing the risk of rupture. Endovascular
embolization can reduce the size and vascularity
of the AVM, thereby facilitating safer and easier
surgical resection
Opaque can be seen radiologically Slow
injection for exact placement. Non-adhesive
easy injection with microcatheters
Disadvantages Vascular toxicity, vasospasm
necrosis. By-products of Onyx are released by
lungs producing an unpleasant smell. Cost
approx. 2000 per vial
Post insertion of onyx, the AVM no longer has a
blood supply
16
Annual General Meeting Minutes 17th September,
2005 Legends Hotel, Gold Coast, QLD

• Attendance Tracy Desborough, Sharon Eriksson,
  Cheryl Trudinger, Jennifer Blundell, Suzy
  Goodman, Carley Mills, Rochelle McKnight, Joanne
  McLoughlin, Terri Pinkis, Tania Heywood, Sue de
  Lange, Phillipa Balfour, Kellie McIntosh, Helen
  Houridis, Brianna Beattie, Allison ODea, Saskia
  Baaijens, Ros Nicholson, Karen OMalley, Tim
  OMalley, Barbara Lester, Lynette Wallace, Dallas
  Tucker, Sharryn Byers, Michael Sham, Anne
  MacLeod, Rochelle Firth, Vicki Evans, Jeanne
  Barr, Rosey Merheb, Mary Wyer, Penny Bayliss,
  Nerolie Lyle, Karen Tuqiri,
• Apologies Angela, Maureen Edgtton-Winn, Sue Day,
  Denise Le Lievre, Jane Henry, Joan Johnson, Sue
  Astegno, Brooke Lederman, Jill Stow, Naomi Moody,
  Eithnie Irving, Mary Lomas
• Proxies
• Chair Tracy Desborough
• 4.Confirmation of previous minutes Lynette
  Wallace Seconded Sharryn Byers

5. Tabling of Reports Content Action
5.1 President Report 5.2 NSW Report Since the change of executive, we have been meeting monthly to look at the processes Financial transactions, journal production, recruitment and retention strategies of members, benefits for members increasing the educational content of Brainstem, Strategies to improve the communication between the Executive and the State Delegates We plan to review again these strategies at the end of the year. Thank you to the Executive and State Delegates for their enthusiasm. Received and tabled
6. Business arising Content Action
6.1 Standards of Neuroscience Nursing 6.2 Affiliation with the College of Nursing 6.3 EBSCO Publishing Standards were mailed out early in the year. The Case studies were omitted accidentally, but will be printed and mailed out as an amendment within the month. With the change in Executive, this has not been followed up. This is essentially a branch initiative and will be forwarded to NSW to follow up ANNA has formalised the contract with EBSCO. Members will be informed in Brainstem further information RM to mail out case studies JB to submit a short contribution re EBSCO contract for Brainstem
7. Election of Office Bearers Content Action
7.1 Treasurer Position Nomination Karen Tuqiri Proposed Sharon Eriksson Seconded Tracy Desborough Accepted unanimously
17
8. New Business Content Actions
8.1 Affiliation with the NSA 8.2 Dual Membership 8.3 Email Correspondence 8.4 Receipting 8.5 AJON ANNA now consists of more than just neurosurgical nurses neurology, stroke, Parkinson's disease, ms, mnd The Exec raised the idea of not following the NSA and to look at becoming a stand alone independent conference. Concerns highlighted include sponsorship support there are still a few nurses that stay on from the ANNA conference for the NSA. There was a suggestion to encourage neurologists to present at future conferences There are competing bodies for professional organisations. The Exec would like to investigate the idea of having dual membership, targeting other organisations e.g. operating room nurses, spinal, rehab, ACCCN, Radiology Discussion around benefits which included Members receiving a discount from combined membership Advertising to affiliation members ANNA conference delegate rates Shared resources during conferences leading to a meeting that encompasses all areas within neurosciences The Exec proposed to the members the idea of ANNA business being emailed. Accepted unanimously Processes are being addressed in regards to the receipting of transactions and the timing. These will continue to be addressed with the change over of the role. JB reports that there have been difficulties in obtaining contributions, but the Journal is in print. Suggested journal article content case studies/ clinical updates Abstracts Themes JB is developing an article package which will include guidelines for article structure JB will also develop a guideline package for reviewers. Interested reviewers would look at 1- 2 papers per year TD/SE to follow up
9. Business without notice Content Actions
9.1 Membership pro rata rates Following discussion at the State delegate Meeting, the Exec would like to propose a standard 12 month membership. It was discussed that the pro rata rates were quite confusing to members. State delegates will be notified of unfinancial members regularly for follow up
Meeting closed 1550 Next meeting Cairns
September 2006
18
WORLD FEDERATION OF NEUROSCIENCE NURSES 2005
Update
Following a successful 9th Congress, Barcelona-
Spain, plans for the 10th Congress are under way.
The location of the next congress has yet to be
decided. To ensure the quality, efficiency and
support for congress preparations it was decided
that prospective host countries were to provide
submissions for consideration. Submissions are
due at the end of 2005 and congress location for
2009 will be announced at the beginning of 2006.
A Membership, Education, Research Committee
(MERC) has been formed. This is to ensure ongoing
development and opportunities for neuroscience
nurses. It is expected that the MERC will prove
to be extremely valuable in the growth of WFNN
and its members. There has been further
development in the Nurse Exchange Program with a
proposed sponsorship contract from Johnson and
Johnson. Details are still being finalised
however this program will create wonderful
opportunities for neuroscience nurses to exchange
practices and ideas. Ongoing information will be
updated on the web site www.wfnn.nu Rochelle
Firth Nurse Practitioner- Neurosurgery WFNN-
Secretary
Australasian Executive Contact Details
PO Box 6, Artarmon NSW 1570 AUSTRALIA annaexecutiv
e_at_bigpond.com.au phone [phone] fax 02 9439
9029