Findings suggest the Aboriginal Community Antenatal Program and partner agencies areincreasing provision of community based pre-conception and antenatal health services and enhancingcollaboration between a range of health provider agencies, with partnerships between Aboriginal andnon-Aboriginal program staff contributing to an emerging model of community antenatal care.

Patients requiring inter-hospital air transport across large geographical spaces areat significant risk of adverse outcomes. The aims of this study were to examine the charac-teristics of clinical handover conducted by telephone and subsequently transcribed in medicalrecords during the inter-hospital transfer of rural patients, and to identify any deficits of thistelephone clinical handover. A retrospective audit was conducted of transcribed telephone han-dovers (‘patient expect’ calls) occurring with inter-hospital transfers from two rural hospitalsto a metropolitan tertiary hospital of all rural patients (n = 127) between January and June2012.

An Australian hospital-based student training ward delivering safe, client-centred care while developing students' interprofessional practice capabilities.

Royal Perth Hospital, in partnership with Curtin University, established the first interprofessional student training ward in Australia, based on best practice from Europe. Evaluation of the student and client experience was undertaken. Feedback from all stakeholders was obtained regularly as a key element of the quality improvement process.

A 22-year-old Australian woman with atypical subacute sclerosing panencephalitis diagnosed at postmortem.

Measles remains a significant global health problem. Despite the decline in measles prevalence in Australia following the implementation of a national vaccination program, challenges surrounding this disease remain. This report describes a 22-year-old woman who presented with coordination loss, tremor, choreiform movements and marked visual blurring, and her condition rapidly deteriorated to coma and death.

iSoBAR--a concept and handover checklist: the National Clinical Handover Initiative.

Effective communication at clinical handover is important for improving patient safety and reducing adverse outcomes. In consultation with doctors, nurses and allied health staff in the Western Australian Country Health Service, we developed a clinical handover checklist, adapted from an existing tool for standardising communication. The acronym "iSoBAR" (identify-situation-observations-background-agreed plan-read back) summarises the components of the checklist.

Results of a multicentre, randomised controlled trial of intra-arterial urokinase in the treatment of acute posterior circulation ischaemic stroke.

Background: Patients with ischaemic stroke due to occlusion of the basilar or vertebral arteries may develop a rapid deterioration in neurological status leading to coma and often to death. While intra-arterial thrombolysis may be used in this context, no randomised controlled data exist to support its safety or efficacy.

Methods: Randomised controlled trial of intra-arterial urokinase within 24 h of symptom onset in patients with stroke and angiographic evidence of posterior circulation vascular occlusion.

Carotid arterial stent placement: results and follow-up in 53 patients.

Purpose: To describe the results, complications, and follow-up data after stent placement for occlusive internal carotid arterial disease and to compare the results with those in the literature.

Materials And Methods: Carotid arterial stent placement was attempted in 57 arteries in 53 patients. Thirty-six (68%) of 53 patients were symptomatic.

Five-year survival after first-ever stroke and related prognostic factors in the Perth Community Stroke Study.

Background And Purpose: Few community-based studies have examined the long-term survival and prognostic factors for death within 5 years after an acute first-ever stroke. This study aimed to determine the absolute and relative survival and the independent baseline prognostic factors for death over the next 5 years among all individuals and among 30-day survivors after a first-ever stroke in a population of Perth, Western Australia.

Methods: Between February 1989 and August 1990, all individuals with a suspected acute stroke or transient ischemic attack of the brain who were resident in a geographically defined region of Perth, Western Australia, with a population of 138 708 people, were registered prospectively and assessed according to standardized diagnostic criteria.

Long-term risk of first recurrent stroke in the Perth Community Stroke Study.

Background And Purpose: Few community-based studies have examined the long-term risk of recurrent stroke after an acute first-ever stroke. This study aimed to determine the absolute and relative risks of a first recurrent stroke over the first 5 years after a first-ever stroke and the predictors of such recurrence in a population-based series of people with first-ever stroke in Perth, Western Australia.

Methods: Between February 1989 and August 1990, all people with a suspected acute stroke or transient ischemic attack of the brain who were resident in a geographically defined region of Perth, Western Australia, with a population of 138 708 people, were registered prospectively and assessed according to standardized diagnostic criteria.

Risk factors for post-stroke depression.

Objective: To examine possible risk factors in post-stroke depression (PSD) other than site of lesion in the brain

Data Sources: 191 first-ever stroke patients were examined physically shortly after their stroke and examined psychiatrically and physically 4 months post-stroke.

Setting: A geographically defined segment of the metropolitan area of Perth, Western Australia, from which all strokes over a course of 18 months were examined (the Perth Community Stroke Study).

Measures: Psychiatric Assessment Schedule, Mini Mental State Examination, Barthel Index, Frenchay Activities Index, physical illness and sociodemographic data were collected.

Streptokinase for acute ischemic stroke with relationship to time of administration: Australian Streptokinase (ASK) Trial Study Group.

Objectives: To determine whether the administration of 1.5 million units of streptokinase intravenously within 4 hours of the onset of acute ischemic stroke would reduce morbidity and mortality at 3 months and whether outcomes may be better for those receiving therapy within 3 hours of stroke onset compared with those receiving it after 3 hours.

Design: Randomized, double-blind, placebo-controlled trial with 3-month follow-up.

A population-based assessment of the impact and burden of caregiving for long-term stroke survivors.

Background And Purpose: Little attention has been focused on the demands on caregivers in stroke outcome research. A major aim of this study was to identify factors in patients associated with emotional distress in caregivers 1 year after stroke.

Methods: One-year stroke survivors with residual handicap (defined by the Oxford Handicap Scale) and their chief caregivers were interviewed as part of the follow-up activities for patients (n = 492) registered with the Perth Community Stroke Study.

Screening instruments for depression and anxiety following stroke: experience in the Perth community stroke study.

Evaluation of the relative efficacy of three screening instruments for depression and anxiety in a group of stroke patients was undertaken as part of the Perth community stroke study. Data are presented on the sensitivity and specificity of the Hospital Anxiety and Depression Scale (HAPS), the Geriatric Depression Scale and the General Health Questionnaire (GHQ) (28-item version) in screening patients 4 months after stroke for depressive and anxiety disorders diagnosed according to DSM-III criteria. The GHQ-28 and GDS but not the HADS depression, were shown to be satisfactory screening instruments for depression, with the GHQ-28 having an overall superiority.

Anxiety disorders after stroke: results from the Perth Community Stroke Study.

Background: The prevalence of anxiety disorders in 294 patients who survived to four months in the Perth Community Stroke Study (Perth, Australia), and a follow-up of these patients at 12 months, are presented.

Method: Diagnoses are described both in the usual DSM hierarchic format and by a non-hierarchic approach. Adoption of the hierarchic approach alone greatly underestimates the prevalence of anxiety disorders.

Prevalence of depression after stroke: the Perth Community Stroke Study.

Background: The Perth Community Stroke Study (PCSS) was a population-based study of the incidence, cause, and outcome of acute stroke.

Method: Subjects from the study were assessed initially, by examination and interview, and at four- and 12-month follow-ups to determine differences in prevalence of depression between the sexes and between patients with first-ever and recurrent strokes.

Results: The prevalence of depressive illness four months after stroke in 294 patients from the PCSS was 23% (18-28%), 15% (11-19%) major depression and 8% (5-11%) minor depression.

Predicting survival for 1 year among different subtypes of stroke. Results from the Perth Community Stroke Study.

Background And Purpose: Few studies have evaluated the factors influencing or predicting long-term survival after stroke in an unselected series of patients in whom the underlying cerebrovascular pathology is clearly defined. Moreover, the relative importance of risk factors for stroke, including sociodemographic and premorbid variables, has not been described in detail.

Methods: The study cohort consisted of 492 patients with stroke who were registered with a population-based study of acute cerebrovascular disease undertaken in Perth, Western Australia, during an 18-month period in 1989 and 1990.

Validation of a clinical classification for subtypes of acute cerebral infarction.

The validity of a clinical classification system was assessed for subtypes of cerebral infarction for use in clinical trials of putative stroke therapies and clinical decision making in a population based stroke register (n = 536) compiled in Perth, Western Australia in 1989-90. The Perth Community Stroke Project (PCSS) used definitions and methodology similar to the Oxfordshire Community Stroke Project (OCSP) where the classification system was developed. In the PCSS, 421 cases of cerebral infarction and primary intracerebral haemorrhage (PICH), confirmed by brain imaging or necropsy, were classified into the subtypes total anterior circulation syndrome (TACS), partial anterior circulation syndrome (PACS), lacunar syndrome (LACS), and posterior circulation syndrome (POCS).

Spectrum of primary intracerebral haemorrhage in Perth, Western Australia, 1989-90: incidence and outcome.

In a population based register of stroke (n = 536) compiled in Perth, Western Australia during an 18 month period in 1989-90, 60 cases (11%) of primary intracerebral haemorrhage were identified among 56 persons (52% men). The mean age of these patients was 68 (range 23-93) and 46 (77%) events were first ever strokes. The crude annual incidence was 35 per 100,000, with a peak in the eighth decade, and a male predominance.

Mechanism of stroke complicating cardiopulmonary bypass surgery.

Background: Stroke is a devastating complication of cardiopulmonary bypass (CPB) surgery which occurs in 1 to 5% of cases. Strategies to reduce its incidence require a knowledge of the underlying pathology and aetiology.

Aims: To determine the incidence, pathology and aetiology of stroke complicating CPB.

Stroke incidence and case fatality in Australasia. A comparison of the Auckland and Perth population-based stroke registers.

Background And Purpose: Population-based studies are crucial for identifying explanations for the decline in mortality from stroke and for generating strategies for public health policy. However, the present particular methodological difficulties, and comparability between them is generally poor. In this article we compare the incidence and case fatality of stroke as assessed by two independent well-designed incidence studies.

The role of lifestyle factors in the etiology of stroke. A population-based case-control study in Perth, Western Australia.

Background And Purpose: We sought to examine risk factors for all strokes and for ischemic stroke and primary intracerebral hemorrhage separately.

Methods: This was a population-based case-control study. Each case subject meeting World Health Organization criteria for stroke (n = 536) from a population-based register of acute cerebrovascular events compiled in Perth, Western Australia, in 1989 to 1990 was matched for age and sex with up to five control subjects drawn from the same geographical area.