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One of the earliest identifiable features of autism spectrum disorder (ASD) is altered attention. Mice expressing the ASD-associated R451C mutation in synaptic adhesion protein neuroligin-3 (NL3) exhibit impaired reciprocal social interactions and repetitive and restrictive behaviours. The role of this mutation in attentional abnormalities has not been established. We assessed attention in male NL3R451C mice using two well-established tasks in touchscreen chambers. In the 5-choice serial reaction task, rodents were trained to attend to light stimuli that appear in any one of five locations. While no differences between NL3R451C and WT mice were seen in accuracy or omissions, slower response times and quicker reward collection latencies were seen across all training and probe trials. In the rodent continuous-performance test, animals were required to discriminate, and identify a visual target pattern over multiple distractor stimuli. NL3R451C mice displayed enhanced ability to attend to stimuli when task-load was low during training and baseline but lost this advantage when difficulty was increased by altering task parameters in probe trials. NL3R451C mice made less responses to the distractor stimuli, exhibiting lower false alarm rates during all training stages and in probe trials. Slower response times and quicker reward latencies were consistently seen in NL3R451C mice in the rCPT. Slower response times are a major cognitive phenotype reported in ASD patients and are indicative of slower processing speed. Enhanced attention has been shown in a subset of ASD patients and we have demonstrated this phenotype also exists in the NL3R451C mouse model.

BACKGROUND: Cardiovascular disease is the most common cause of death and disability in indigenous communities but limited prospective data exist about stroke. AIMS: To estimate the difference in stroke recognition, risk factors, treatment rates and outcomes between indigenous and non-indigenous peoples admitted to the Wagga Wagga Rural Referral Hospital (WWRRH) over a 5-year period with a suspected acute stroke. METHODS: All suspected strokes presenting to the 33 peripheral hospitals within the Murrumbidgee Local Health District (MLHD) were transferred to the WWRRH and prospectively assessed over a 5-year period from 1 January 2012 to 31 December 2017. Actions at stroke onset, risks factors, stroke type, treatment and outcomes were analysed. RESULTS: A total of 1843 patients were included. Of these, 45 (2.5%) patients were indigenous. Only 26.6% of indigenous and 34% of non-indigenous patients knew of the face, arm, speech, time (FAST) acronym. Indigenous patients were younger (mean age 62.0 years vs 74.4 years) and more likely to have diabetes (risk difference (RD) 22.3% (95% CI: 3%, 41.7%)), dyslipidaemia (RD 19.4% (95% CI: 21.%, 36.7%)), and be ever smokers (RD 24.9% (95% CI: 9.5%, 40.3%)). Stroke types were similar except lacunar infarcts were more common (19.2% vs 8.4%). Treatment rates and outcomes were similar between the two groups. CONCLUSIONS: Indigenous Australians with stroke are a decade younger and have a higher prevalence of important, modifiable stroke-risk factors. Delayed presentation to hospital is more common, due in part to stroke symptoms being underrecognised. When admitted to a specialised stroke unit, treatment rates and outcomes are comparable.

Background: Use of environmental enrichment significantly improves sensorimotor recovery in experimental stroke. The AREISSA trial, a multi-site (N=4), cluster, cross-over trial, determined whether a patient-driven model of environmental enrichment reduced stroke survivor inactivity and was safe in the clinical setting. Aim(s): This qualitative sub-study within AREISSA sought to describe stroke survivor perceived barriers and enablers to engaging in activity during rehabilitation in a site that had implemented a patientdriven model of environmental enrichment. Method(s): The environmental enrichment under investigation in AREISSA included access to communal and individual physical, cognitive and social stimulation. Face to face semi-structured interviews were conducted (by a speech pathologist) with stroke survivors (n=31) following discharge from rehabilitation. Descriptive content qualitative methods using thematic analysis were used. Result(s): Seven main themes arose: (i) poor communication between staff and patients regarding activity options limits awareness and subsequent engagement, (ii) family provides lots of support and facilitates engagement, (iii) stroke related disability limits capacity for activity, (iv) personal preferences, beliefs and personality types influence activity choice, (v) socialisation (involving patients, visitors and staff) promotes activity, (vi) hospital rules, real or perceived can limit activity, and (vii) wayfinding and hospital layout has an effect on engagement. Conclusion(s): Stroke survivor heterogeneity (stroke & personality related factors), hospital culture and the built environment were perceived to impede activity in an enriched rehabilitation environment. Future iterations of this model of environmental enrichment must address these barriers and build in greater involvement of family and opportunities for socialisation.

Background: Use of environmental enrichment significantly improves sensorimotor recovery in experimental stroke. The AREISSA trial, a multi-site (N=4), cluster, cross-over trial, determined whether a patient-driven model of environmental enrichment reduced inactivity and was safe in the clinical setting. Aim(s): This qualitative sub-study within AREISSA sought to describe the staff experience of implementing a patient-driven model of environmental enrichment for stroke survivors in a mixed rehabilitation unit. Method(s): The environmental enrichment implemented by the multi-disciplinary teams at sites participating in AREISSA included access to communal and individual physical, cognitive and social stimulation. Purposive sampling of these teams was employed to ensure most disciplines were represented. Participants (n=22) completed telephone based semi-structured interviews. Descriptive content qualitative methods using thematic analysis were used. Result(s): Five main themes arose: (i) staff attitudes, awareness and engagement with the model of environmental enrichment influenced implementation, (ii) the built environment made implementation difficult, (iii) activity limitations restricted stroke survivor engagement with environmental enrichment, (iv) stroke survivor preference for how to spend non-therapy time differed, and (v) stroke survivor mood was variable and affected engagement in activity. Conclusion(s): Implementation and stroke survivor use of a patient-driven model of environmental enrichment was perceived by staff to be influenced predominantly by stroke survivor-specific variables. Staff behaviour and knowledge, and the built environment were also perceived to affect successful implementation. These results highlight the complexities of clinical translation of environmental enrichment and can inform future attempts to improve activity by stroke survivors.