Publications

Tolin, DF, Worden, BL, Wootton, BM & Gilliam, CM 2017, CBT for Hoarding Disorder, Wiley.
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Tolin, DF, Worden, BL, Wootton, BM & Gilliam, CM 2017, CBT for Hoarding Disorder A Group Therapy Program Therapist's Guide, John Wiley & Sons.
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Easy to implement without home visits, this is a cutting-edge treatment program for professionals and group leaders of all educational backgrounds treating problematic hoarding behavior across a wide variety of treatment settings and ...

Armstrong, E, Bryant, LE, Ferguson, A & Simmons-Mackie, N 2017, 'Approaches to Assessment and Treatment of Everyday Talk in Aphasia' in Papathanasiou, I & Coppens, P (eds), Aphasia and Related Neurogenic Communication Disorders, Jones & Bartlett Publishers.
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Aphasia and Related Neurogenic Communication Disorders, Second Edition Includes Navigate 2 Advantage Access

Jones, MK, Menzies, RG, Vaccaro, LD & St Clare, T 2017, 'Danger Ideation Reduction Therapy ☆' in Reference Module in Neuroscience and Biobehavioral Psychology, Elsevier, pp. 615-619.
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© 2016 Elsevier Inc. All rights reserved. This article presents a brief description of the expectancy model that underpins Danger Ideation Reduction Therapy and outlines the empirical findings related to this account. It also provides a description of the treatment components of the two Danger Ideation Reduction Therapy (DIRT) packages that have been developed; DIRT for Obsessive Compulsive Washing (OC-W) and the more recently developed DIRT package for people with Obsessive Compulsive Checking (OC-C). The therapeutic effectiveness of DIRT for OC-W and DIRT for OC-C will be discussed by reviewing the treatment trials that have been conducted to date.

Menzies, R 2017, 'Mental health measurement and management with stuttering' in Onslow, M & Jelčić Jakšić, S (eds), Applications of stuttering treatment research: Proceedings of the third Croatian symposium, pp. 96-103.

Norton, A 2017, 'Novel treatment approaches for anxiety disorders' in Neurobiology of Mental Illness.

O'Brian, S 2017, 'Speech treatments for adults' in Onslow, M, Lowe, R & Jelčić Jakšić, S (eds), Applications of stuttering treatment research: Proceedings of the third Croatian symposium, pp. 72-83.

Onslow, M & Andrews, C 2017, 'Treatment of school age children who stutte' in Onslow, M, Lowe, R & Jelčić Jakšić, S (eds), Applications of stuttering treatment research: Proceedings of the third Croatian symposium, pp. 41-49.

Wootton, B & Diefenbach, GJ 2017, 'Computerized Cognitive Behavioral Therapy' in The SAGE Encyclopedia of Abnormal and Clinical Psychology, SAGE Publications, Inc..
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Key features include: 1,400 signed articles contained in 7 volumes and available in choice of print and/or electronic formats although organized A-to-Z, front matter includes a Reader’s Guide grouping related entries thematically back ...

Abdel Shaheed, C, Maher, CG, Williams, KA & McLachlan, AJ 2017, 'Efficacy and tolerability of muscle relaxants for low back pain: Systematic review and meta‐analysis', European Journal of Pain, vol. 21, no. 2, pp. 228-237.
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AbstractMuscle relaxants are commonly prescribed for low back pain (LBP); however, there is limited evidence of their clinical efficacy and tolerability. This review evaluated the efficacy and tolerability of muscle relaxants in people with LBP. We searched online databases including Medline, EMBASE, CENTRAL and PsycINFO (inception to end October 2015) and performed citation tracking for eligible randomized controlled trials (RCTs). Two authors independently extracted data and assessed risk of bias of randomized controlled trials of muscle relaxants. Pain outcomes were converted to a common 0–100 scale. Data were pooled using a random effects model with strength of evidence assessed using GRADE. Fifteen trials (3362 participants) were evaluated in this review. A total of five trials (496 participants) provide high quality evidence that muscle relaxants provide clinically significant pain relief in the short term for acute LBP; MD −21.3, [−29.0, −13.5]. There was no information on long‐term outcomes. The median adverse event rate in clinical trials for muscle relaxants was similar to placebo 14.1% IQR (7.0–28.7%) and 16.0% (4.1–31.2%); p = 0.5, respectively. There is no evidence for the efficacy of benzodiazepines in LBP

Alhawassi, TM, Krass, I & Pont, LG 2017, 'Prevalence, management and control of hypertension in older adults on admission to hospital', Saudi Pharmaceutical Journal, vol. 25, no. 8, pp. 1201-1207.
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© 2017 The Authors Introduction The aim of this study was to explore the prevalence and management of hypertension among older adults on admission to hospital and to assess the choice of antihypertensive pharmacotherapy in light of relevant comorbid conditions using the national treatment guideline. Materials and methods A retrospective cross sectional study of 503 patients aged 65 years or older admitted to a large metropolitan teaching hospital in Sydney Australia was conducted. The main outcome measures were prevalence of hypertension, blood pressure (BP) control, antihypertensive medication use and the appropriateness of antihypertensive medications. Results Sixty-nine percent (n = 347) of the study population had a documented diagnosis of hypertension and of these, approximately one third were at target BP levels on admission to hospital. Some concerns regarding choice of antihypertensive noted with 51% of those with comorbid diabetes and 30% of those with comorbid heart failure receiving a potentially inappropriate antihypertensive agent. Conclusions Despite the use of antihypertensive pharmacotherapy, many older adults do not have optimal BP control and are not reaching target BP levels. New strategies to improve blood pressure control in older populations especially targeting women, those with a past history of myocardial infarction and those on multiple antihypertensive medications are needed.

Almeida, MO, Saragiotto, BT, Maher, CG & Pena Costa, LO 2017, 'Influence of allocation concealment and intention-to-treat analysis on treatment effects of physical therapy interventions in low back pain randomised controlled trials: a protocol of a meta-epidemiological study', BMJ Open, vol. 7, no. 9, pp. e017301-e017301.
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IntroductionMeta-epidemiological studies examining the influence of methodological characteristics, such as allocation concealment and intention-to-treat analysis have been performed in a large number of healthcare areas. However, there are no studies investigating these characteristics in physical therapy interventions for patients with low back pain. The aim of this study is to investigate the influence of allocation concealment and the use of intention-to-treat analysis on estimates of treatment effects of physical therapy interventions in low back pain clinical trials.Methods and analysisSearches on PubMed, Embase, Cochrane Database of Systematic Reviews, Physiotherapy Evidence Database (PEDro) and CINAHL databases will be performed. We will search for systematic reviews that include a meta-analysis of randomised controlled trials that compared physical therapy interventions in patients with low back pain with placebo or no intervention, and have pain intensity or disability as the primary outcomes. Information about selection (allocation concealment) and attrition bias (intention-to-treat analysis) will be extracted from the PEDro database for each included trial. Information about bibliographic data, study characteristics, participants’ characteristics and study results will be extracted. A random-effects model will be used to provide separate estimates of treatment effects for trials with and without allocation concealment and with and without intention-to-treat analysis (eg, four estimates). A meta-regression will be performed to measure the association between methodological features and treatment effects from each trial. The dependent variable will be the treatment effect (the mean between-group differences) for the primary outcomes (pain or disability), while the independent variables will be the methodological features of interest (alloc...

Anderson, CS, Arima, H, Lavados, P, Billot, L, Hackett, ML, Olavarría, VV, Muñoz Venturelli, P, Brunser, A, Peng, B, Cui, L, Song, L, Rogers, K, Middleton, S, Lim, JY, Forshaw, D, Lightbody, CE, Woodward, M, Pontes-Neto, O, De Silva, HA, Lin, R-T, Lee, T-H, Pandian, JD, Mead, GE, Robinson, T & Watkins, C 2017, 'Cluster-Randomized, Crossover Trial of Head Positioning in Acute Stroke', New England Journal of Medicine, vol. 376, no. 25, pp. 2437-2447.
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© 2017 Massachusetts Medical Society. BACKGROUND The role of supine positioning after acute stroke in improving cerebral blood flow and the countervailing risk of aspiration pneumonia have led to variation in head positioning in clinical practice. We wanted to determine whether outcomes in patients with acute ischemic stroke could be improved by positioning the patient to be lying flat (i.e., fully supine with the back horizontal and the face upwards) during treatment to increase cerebral perfusion. METHODS In a pragmatic, cluster-randomized, crossover trial conducted in nine countries, we assigned 11,093 patients with acute stroke (85% of the strokes were ischemic) to receive care in either a lying-flat position or a sitting-up position with the head elevated to at least 30 degrees, according to the randomization assignment of the hospital to which they were admitted; the designated position was initiated soon after hospital admission and was maintained for 24 hours. The primary outcome was degree of disability at 90 days, as assessed with the use of the modified Rankin scale (scores range from 0 to 6, with higher scores indicating greater disability and a score of 6 indicating death). RESULTS The median interval between the onset of stroke symptoms and the initiation of the assigned position was 14 hours (interquartile range, 5 to 35). Patients in the lying-flat group were less likely than patients in the sitting-up group to maintain the position for 24 hours (87% vs. 95%, P<0.001). In a proportional-odds model, there was no significant shift in the distribution of 90-day disability outcomes on the global modified Rankin scale between patients in the lying-flat group and patients in the sitting-up group (unadjusted odds ratio for a difference in the distribution of scores on the modified Rankin scale in the lying-flat group, 1.01; 95% confidence interval, 0.92 to 1.10; P = 0.84). Mortality within 90 days was 7.3% among the patients in the lying-flat group and 7...

Árnadóttir, S, Verhagen, A & Bindels, P 2017, 'Cervixcarcinoom komt ook bij jonge vrouwen voor', Huisarts en wetenschap, vol. 60, no. 10, pp. 520-522.
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Avramović, P, Kenny, B, Power, E, McDonald, S, Tate, R, Hunt, L, MacDonald, S, Heard, R & Togher, L 2017, 'Exploring the relationship between cognition and functional verbal reasoning in adults with severe traumatic brain injury at six months post injury', Brain Injury, vol. 31, no. 4, pp. 502-516.
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© 2017 Taylor & Francis Group, LLC. Objective(s): This study aims to determine the association between cognitive impairment and functional verbal reasoning in adults with severe traumatic brain injury (TBI), at six months post-injury. Method(s): 38 participants with severe TBI were assessed using the four tasks on the Functional Assessment of Verbal Reasoning and Executive Strategies (FAVRES) [1] and a battery of neuropsychological tests at 6 months post injury in a cross-sectional observational study. Results: Overall performance on the FAVRES [1] was strongly associated with overall performance on the neuropsychological battery (rho = 0.60). FAVRES Task 2 and FAVRES Task 4 had the most significant positive associations with the cognitive indices of Attention and speed of processing, Memory and Executive functions. There was one weak significant association between the Task 1 Accuracy score and the Total Cognitive index (rho = 0.46). Conclusions: Performance on the FAVRES [1] is positively associated with cognitive processes. Participants with stronger verbal reasoning skills which may be required for activities in work, home and social contexts also had higher scores on tests of cognitive functioning. These findings may inform clinical practices for speech pathologists and other health professionals, in the assessment and treatment of cognitive communication disorders during early stages of recovery in people with severe TBI.

Awasthi, R, Kulkarni, GT, Ramana, MV, de Jesus Andreoli Pinto, T, Kikuchi, IS, Molim Ghisleni, DD, de Souza Braga, M, De Bank, P & Dua, K 2017, 'Dual crosslinked pectin–alginate network as sustained release hydrophilic matrix for repaglinide', International Journal of Biological Macromolecules, vol. 97, pp. 721-732.
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© 2017 Elsevier B.V. Repaglinide, an oral antidiabetic agent, has a rapid onset of action and short half–life of approximately 1 h. Developing a controlled and prolonged release delivery system is required to maintain its therapeutic plasma concentration and to eliminate its adverse effects particularly hypoglycemia. The present study aimed to develop controlled release repaglinide loaded beads using sodium alginate and pectin with dual cross–linking for effective control of drug release. The prepared beads were characterized for size, percentage drug entrapment efficiency, in vitro drug release and the morphological examination using scanning electron microscope. For the comparative study, the release profile of a marketed conventional tablet of repaglinide (Prandin® tablets 2 mg, Novo Nordisk) was determined by the same procedure as followed for beads. The particle size of beads was in the range of 698 ± 2.34–769 ± 1.43 μm. The drug entrapment efficiency varied between 55.24 ± 4.61 to 82.29 ± 3.42%. The FTIR results suggest that there was no interaction between repaglinide and excipients. The XRD and DSC results suggest partial molecular dispersion and amorphization of the drug throughout the system. These results suggest that repaglinide did not dissolve completely in the polymer composition and seems not to be involved in the cross–linking reaction. The percent drug release was decreased with higher polymer concentrations. In conclusion, the developed beads could enhance drug entrapment efficiency, prolong the drug release and enhance bioavailability for better control of diabetes.

Berle, D 2017, '‘Just think positive’: We can all work to address the publication bias issue', Australian & New Zealand Journal of Psychiatry, vol. 51, no. 5, pp. 536-536.
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Berle, D, Steel, Z, Essue, BM, Keay, L, Jan, S, Tan Phuc, H & Hackett, ML 2017, 'Multisite prospective investigation of psychological outcomes following cataract surgery in Vietnam', BMJ Global Health, vol. 2, no. 1, pp. e000162-e000162.
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Beuscart, J, Pont, LG, Thevelin, S, Boland, B, Dalleur, O, Rutjes, AWS, Westbrook, JI & Spinewine, A 2017, 'A systematic review of the outcomes reported in trials of medication review in older patients: the need for a core outcome set', British Journal of Clinical Pharmacology, vol. 83, no. 5, pp. 942-952.
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AimMedication review has been advocated as one of the measures to tackle the challenge of polypharmacy in older patients, yet there is no consensus on how best to evaluate its efficacy. This study aimed to assess outcome reporting in trials of medication review in older patients.MethodsRandomized controlled trials (RCTs), prospective studies and RCT protocols involving medication review performed in patients aged 65 years or older in any setting of care were identified from: (1) a recent systematic review; (2) RCT registries of ongoing studies; (3) the Cochrane library. The type, definition, and frequency of all outcomes reported were extracted independently by two researchers.ResultsForty‐seven RCTs or prospective published studies and 32 RCT protocols were identified. A total of 327 distinct outcomes were identified in the 47 published studies. Only one fifth (21%) of the studies evaluated the impact of medication reviews on adverse events such as drug reactions or drug‐related hospital admissions. Most of the outcomes were related to medication use (n = 114, 35%) and healthcare use (n = 74, 23%). Very few outcomes were patient‐related (n = 24, 7%). A total of 248 distinct outcomes were identified in the 32 RCT protocols. Overall, the number of outcomes and the number and type of health domains covered by the outcomes varied largely.ConclusionOutcome reporting from RCTs concerning medication review in older patients is heterogeneous. This review highlights the need for a standardized core outcome set for medication review in older patients, to improve outcome reporting and evidence synthesis.

Bier, JD, Kamper, SJ, Verhagen, AP, Maher, CG & Williams, CM 2017, 'Patient Nonadherence to Guideline-Recommended Care in Acute Low Back Pain', Archives of Physical Medicine and Rehabilitation, vol. 98, no. 12, pp. 2416-2421.
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To describe the magnitude of patient-reported nonadherence with guideline-recommended care for acute low back pain.Secondary analysis of data from participants enrolled in the Paracetamol for Acute Low Back Pain study trial, a randomized controlled trial evaluating the effectiveness of paracetamol for acute low back pain.Primary care, general practitioner.Data from participants with acute low back pain (N=1643).Guideline-recommended care, including reassurance, simple analgesia, and the advice to stay active and avoid bed rest. Also, advice against additional treatments and referral for imaging.Proportion of nonadherence with guideline-recommended care. Nonadherence was defined as (1) failure to consume the advised paracetamol dose, or (2) receipt of additional health care, tests, or medication during the trial treatment period (4wk). Multivariable logistic regression analysis was performed to determine the factors associated with nonadherence.In the first week of treatment, 39.7% of participants were classified as nonadherent. Over the 4-week treatment period, 70.0% were nonadherent, and 57.5% did not complete the advised paracetamol regimen. Higher perceived risk of persistent pain, lower level of disability, and not claiming workers' compensation were associated with nonadherence, with odds ratios ranging from .46 to 1.05.Adherence to guideline-recommended care for acute low back pain was poor. Most participants do not complete the advised paracetamol regimen. Higher perceived risk of persistence of complaints, lower baseline disability, and participants not claiming workers' compensation were independently associated with nonadherence.

Bier, JD, Ostelo, RWJG, Koes, BW & Verhagen, AP 2017, 'Validity and reproducibility of the modified STarT Back Tool (Dutch version) for patients with neck pain in primary care', Musculoskeletal Science and Practice, vol. 31, pp. 22-29.
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© 2017 Elsevier Ltd Objective To evaluate the reliability and validity of the Dutch version of the STarT Back screening Tool (SBT), for patients with neck pain. Methods We modified the SBT to fit patients with neck pain. General practitioners and physiotherapists included patients who completed both a baseline and a follow-up questionnaire at 3 days and 3 months, respectively. The construct validity was assessed using Pearson's correlation between the SBT and the reference questionnaires. The reproducibility was assessed in the first week using the quadratic weighted kappa and the specific agreement. Predictive validity was assessed using a relative-risk ratio (RR) for, amongst others, persisting disability at 3 months. Content validity was analysed using both floor and ceiling effects. Results In total, 100 patients were included; 58% were categorised as being at “low risk” for persisting disability, 37% at “medium risk” and 5% at “high risk”. As expected for the construct validity, we found a moderate to high correlation for all questions except for activity question 3. The reproducibility had a quadratic-weighted kappa of 0.58, and a specific agreement of 90.9% for “low-risk” and 66.7% for “medium-risk” patients. The RRs for persisting disability for “medium-risk” against “low-risk” patients were 1.5 (95% C.I. 0.9–2.4) and 1.5 (95% C.I. 0.5–4.1) for pain. The sample size for high-risk patients was low. Conclusion The original SBT is modified to fit patients with neck pain in Dutch primary care. The psychometric analysis indicates sufficiently reliable outcomes, although the predictive validity showed statistically insignificant results.

Bier, JD, Ostelo, RWJG, van Hooff, ML, Koes, BW & Verhagen, AP 2017, 'Validity and Reproducibility of the STarT Back Tool (Dutch Version) in Patients With Low Back Pain in Primary Care Settings', Physical Therapy, vol. 97, no. 5, pp. 561-570.
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Abstract Objective. The purpose of this study was to translate and to investigate the reliability and validity of the STarT Back screening tool (SBT) in the primary care setting among patients with nonspecific low back pain (LBP). Design. The SBT was formally translated into Dutch following a multistep approach for forward and backward translation. General practitioners and physical therapists included patients with LBP. Methods. Patients completed a baseline questionnaire and a follow-up at 3 days and 3 months. The construct validity was calculated with Pearson's correlation coefficient. The reproducibility was assessed using the quadratic weighted kappa and the specific agreement. Predictive validity was assessed using relative risk ratios for persisting disability at 3 months. Content validity was analyzed using floor and ceiling effects. Results. In total, 184 patients were included; 52.2% were categorized in the “low-risk” subgroup, 38.0% “medium-risk,” and 9.8% “high-risk.” For the construct validity we found, as expected, a moderate to high Pearson's correlation for questions 3 to 9 and a low correlation for questions 1 and 2 with their respective reference questionnaires. The reproducibility had a quadratic weighted kappa of 0.65 and the specific agreement of 82.4% for “low-risk,” 53.3% for “medium-risk,” and 33.3% for “high-risk.” For the predictive validity for persisting disability we found a relative risk ratio for “medium-risk” of 1.8 (95% confidence interval [CI]: 1.0–3.1) and 2.7 (95% CI: 1.4–4.9) for “high-risk” compared with “low-risk.” For the content validity, we found that no floor and ceiling effects were present. Limitations. There was a relatively small sample size for the retest reliability study. Patients were not compared between physical therapist and GP...

Botermann, L, Wachter, A, Monzel, K, Krueger, K, Ewen, S, Mahfoud, F, Griese-Mammen, N, Schulz, M & Laufs, U 2017, 'Do patients with diabetes type 2 or chronic heart failure understand a medication plan?', Pharmazie, vol. 72, no. 12, pp. 764-768.
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A standardized medication plan (MP) was recently enacted into German law (§ 31a SGB V). The purpose of our study was to assess if patients with chronic diseases requiring polymedication understand the standardized MP and can transfer the given information into practice. 100 patients who took at least five medicines regularly were prospectively included in a cross-sectional study: 50 patients with the primary diagnosis chronic heart failure (CHF), and 50 with diabetes mellitus type 2 (DMT2). We performed a structured test-scenario studying the handling of a provided MP then evaluated the execution of the information on the MP by filling pill boxes and requested patients' opinion. An established weighted scoring system, the 'Evaluation Tool to test the handling of the Medication Plan' (ET-MP) was applied to quantitate the ability of the patients to handle the MP. In addition, signs of depression, cognitive function and self-care behavior in chronic heart failure were characterized using the PHQ-9, Mini-Cog, and G9-EHFScB-9 questionnaires, respectively. The understanding of the MP was poor and irrespective of the underlying primary diagnosis. Only 32% of all patients were able to handle the MP without difficulties (ET-MP score >90%), the median ET-MP score was 83 [(IQR) 50-98]. Comprehension of the MP was better in patients aged <70 years compared to ≥70 years (p<0.01). Patients ≥10 years of education achieved higher ET-MP results than patients with <10 years of education (p<0.01). Patients with signs of cognitive impairment exhibited significantly lower ET-MP scores than patients without cognitive impairment (p<0.001). There were no significant correlations of the ET-MP score with number of daily medications, living situation, sex, the Charlson Comorbidity Index, the PHQ-9 score, and use of a dosing aid or possession of a medication list.

Brown, J, Coxon, K, Fong, C, Clarke, E, Rogers, K & Keay, L 2017, 'Seat belt repositioning and use of vehicle seat cushions is increased among older drivers aged 75 years and older with morbidities', Australasian Journal on Ageing, vol. 36, no. 1, pp. 26-31.
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ObjectiveGood seat belt fit and positioning is important for crash protection. Older drivers experience problems in achieving good seat belt fit and often reposition seat belts and/or use seat cushions. Comfort influences these behaviours. This work examines the impact of functional morbidities on belt positioning and accessory use and whether comfort mediates this relationshipMethodsMediation analysis was used to examine the relationship between morbidities affecting physical function, comfort, belt repositions and seat cushion use among 380 drivers aged 75 years and older.ResultsMusculoskeletal morbidities increase the likelihood of seat belt repositioning (OR 1.37, 95% CI 1.12–1.67) and comfort partially mediates this relationship (P = 0.03). Morbidities of any type also increase the likelihood of seat cushion use (OR 1.15 95% CI 1.04–1.27), but comfort plays no role in this relationship (P = 0.87).ConclusionGreater awareness among older drivers is needed, to ensure behavioural modifications do not impair their crash protection.

Brown, L, Halaki, M, Packman, A, Onslow, M, Wilson, L & Menzies, R 2017, 'Response to Letter to the Editor', Journal of Fluency Disorders, vol. 53, pp. 55-57.
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Brunner, M, Hemsley, B, Togher, L & Palmer, S 2017, 'Technology and its role in rehabilitation for people with cognitive-communication disability following a traumatic brain injury (TBI)', Brain Injury, vol. 31, no. 8, pp. 1028-1043.
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© 2017 Taylor & Francis Group, LLC. Purpose: To review the literature on communication technologies in rehabilitation for people with a traumatic brain injury (TBI), and: (a) determine its application to cognitive-communicative rehabilitation, and b) develop a model to guide communication technology use with people after TBI. Method: This integrative literature review of communication technology in TBI rehabilitation and cognitive-communication involved searching nine scientific databases and included 95 studies. Results: Three major types of communication technologies (assistive technology, augmentative and alternative communication technology, and information communication technology) and multiple factors relating to use of technology by or with people after TBI were categorized according to: (i) individual needs, motivations and goals; (ii) individual impairments, activities, participation and environmental factors; and (iii) technologies. While there is substantial research relating to communication technologies and cognitive rehabilitation after TBI, little relates specifically to cognitive-communication rehabilitation. Conclusions: Further investigation is needed into the experiences and views of people with TBI who use communication technologies, to provide the ‘user’ perspective and influence user-centred design. Research is necessary to investigate the training interventions that address factors fundamental for success, and any impact on communication. The proposed model provides an evidence-based framework for incorporating technology into speech pathology clinical practice and research.

Bryant, L, Spencer, E & Ferguson, A 2017, 'Clinical use of linguistic discourse analysis for the assessment of language in aphasia', Aphasiology, vol. 31, no. 10, pp. 1105-1126.
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Buchbinder, R, Page, MJ, Huang, H, Verhagen, AP, Beaton, D, Kopkow, C, Lenza, M, Jain, NB, Richards, B, Richards, P, Voshaar, M, van der Windt, D & Gagnier, JJ 2017, 'A Preliminary Core Domain Set for Clinical Trials of Shoulder Disorders: A Report from the OMERACT 2016 Shoulder Core Outcome Set Special Interest Group', The Journal of Rheumatology, vol. 44, no. 12, pp. 1880-1883.
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Objective.The Outcome Measures in Rheumatology (OMERACT) Shoulder Core Outcome Set Special Interest Group (SIG) was established to develop a core outcome set (COS) for clinical trials of shoulder disorders.Methods.In preparation for OMERACT 2016, we systematically examined all outcome domains and measurement instruments reported in 409 randomized trials of interventions for shoulder disorders published between 1954 and 2015. Informed by these data, we conducted an international Delphi consensus study including shoulder trial experts, clinicians, and patients to identify key domains that should be included in a shoulder disorder COS. Findings were discussed at a stakeholder premeeting of OMERACT. At OMERACT 2016, we sought consensus on a preliminary core domain set and input into next steps.Results.There were 13 and 15 participants at the premeeting and the OMERACT 2016 SIG meeting, respectively (9 attended both meetings). Consensus was reached on a preliminary core domain set consisting of an inner core of 4 domains: pain, physical function/activity, global perceived effect, and adverse events including death. A middle core consisted of 3 domains: emotional well-being, sleep, and participation (recreation and work). An outer core of research required to inform the final COS was also formulated.Conclusion.Our next steps are to (1) analyze whether participation (recreation and work) should be in the inner core, (2) conduct a third Delphi round to finalize definitions and wording of domains and reach final endorsement for the domains, and (3) determine which instruments fulfill the OMERACT criteria for measuring each domain.

Burton, AL & Abbott, MJ 2017, 'Conceptualising Binge Eating: A Review of the Theoretical and Empirical Literature', Behaviour Change, vol. 34, no. 3, pp. 168-198.
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Binge eating is a distressing symptom common to bulimia nervosa (BN), anorexia nervosa binge/purge subtype (AN-BP) and binge-eating disorder (BED). Over the last 40 years, many attempts have been made to conceptualise this symptom in terms of its antecedents, function, triggers, consequences, and maintaining factors. Cognitive theories of binge eating have evolved as new evidence has emerged. This literature review summarises the main and most influential cognitive models of binge eating across different eating disorder presentations. Many theories have examined binge eating in the context of restriction or compensatory behaviours, as is often observed in cases of BN. Few theories have examined binge eating as it occurs in BED specifically. The long-term efficacy of cognitive behavioural therapy (CBT) treatment based on these models leaves much to be desired, and indicates that there may be maintaining factors of binge eating not addressed in the typical CBT treatment for eating disorders. More recent cognitive models of binge eating propose possible maintaining beliefs, but further study is required to validate these models. Suggestions for future research are presented.

Burton, AL, Hay, P, Kleitman, S, Smith, E, Raman, J, Swinbourne, J, Touyz, SW & Abbott, MJ 2017, 'Confirmatory factor analysis and examination of the psychometric properties of the eating beliefs questionnaire', BMC Psychiatry, vol. 17, no. 1, p. 237.
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BACKGROUND: The Eating Beliefs Questionnaire (EBQ) is a 27-item self-report measure that assesses positive and negative beliefs about binge eating. It has been validated and its factor structure explored in a non-clinical sample. This study tested the psychometric properties of the EBQ in a clinical and a non-clinical sample. METHOD: A sample of 769 participants (573 participants recruited from the university and general community, 76 seeking treatment for an eating disorder and 120 participating in obesity research) completed a battery of questionnaires. A subset of clinical participants with a diagnosis of Bulimia Nervosa or Binge Eating Disorder completed the test-battery before and after receiving a psychological treatment (n = 27) or after allocation to a wait-list period (n = 28), and a subset of 35 community participants completed the test battery again after an interval of two-weeks. Confirmatory Factor Analysis (CFA) was performed. RESULTS: CFA found a two-factor structure that provided a good fit to the data, supporting the solution presented in the development paper. Items with poor psychometric properties were removed, resulting in a 16 item measure. EBQ scores were found to correlate with binge eating episode frequency, increases in body mass index (BMI), and measures of eating disorder behaviours and related psychopathology. The EBQ was found to have excellent internal consistency (α = .94), good test-retest reliability (r = .91) and sensitivity to treatment. CONCLUSION: These findings indicate that the EBQ is a psychometrically sound and clinically useful measure.

Chan, EKW, Shen, Q, Cordato, D, Kneebone, I, Xu, Y-H & Chan, DKY 2017, 'Delirium post-stroke: short- to long-term effect on anxiety and depression compared to effect on cognition', Topics in Stroke Rehabilitation, vol. 24, no. 8, pp. 597-600.
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© 2017 Informa UK Limited, trading as Taylor & Francis Group. Background: Delirium is common after stroke and has significant negative impact on mortality, morbidity, cognitive function, and institutionalization. Despite these known effects, any impact of delirium on the emotional well-being of stroke survivors is unclear. Methods: A post hoc analysis was performed on our prospective cohort study of 156 stroke patients. Hospital Anxiety and Depression (HAD) scale scores were compared between patients with delirium and patients without delirium at 1-month, 6-month, and 12-month post-stroke. Results: Contrary to the negative impact of delirium on cognition and functional status, we did not discern any influence on HAD scale scores in the short to long term. The median scores of the HAD anxiety scale were 4 (interquartile range IQR 3) at 1 month, 5.5 (IQR 8.75) at 6 months, and 6 (IQR 5) at 12 months in the delirium group compared to 5 (IQR 7) at 1 month (p = 0.6), 4 (IQR 7) at 6 months (p = 0.4), and 6 (IQR 5.75) at 12 months (p = 0.9) in the non-delirium group, respectively. Similarly, the median scores of the HAD depression scale were 5 (IQR 4) at 1 month, 4 (IQR 6.5) at 6 months, and 3 (IQR 6) at 12 months in the delirium group compared to 6 (IQR 5.75) at 1 month (p = 0.9), 5 (IQR 7) at 6 months (p = 0.9), and 6 (IQR 5) at 12 months (p = 0.5) in the non-delirium group. Conclusion: Delirium may not have a significant effect on the development of anxiety or depression after stroke which differs in its effect on cognitive function and functional status.

Chevalier, A, Coxon, K, Chevalier, AJ, Clarke, E, Rogers, K, Brown, J, Boufous, S, Ivers, R & Keay, L 2017, 'Predictors of older drivers’ involvement in rapid deceleration events', Accident Analysis & Prevention, vol. 98, pp. 312-319.
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© 2016 Elsevier Ltd Rapid deceleration occurs when substantial force slows the speed of a vehicle. Rapid deceleration events (RDEs) have been proposed as a surrogate safety measure. As there is concern about crash involvement of older drivers and the effect of age-related declining visual and cognitive function on driving performance, we examined the relationship between RDEs and older driver's vision, cognitive function and driving confidence, using naturalistic driving measures. Participants aged 75 to 94 years had their vehicle instrumented for 12 months. To minimise the chance of identifying false positives, accelerometer data was processed to identify RDEs with a substantial deceleration of >750 milli-g (7.35 m/s2). We examined the incidence of RDEs amongst older drivers, and how this behaviour is affected by differences in age; sex; visual function, cognitive function; driving confidence; and declines over the 12 months. Almost two-thirds (64%) of participants were involved in at least one RDE, and 22% of these participants experienced a meaningful decline in contrast sensitivity during the 12 months. We conducted regression modelling to examine associations between RDEs and predictive measures adjusted for (i) duration of monitoring and (ii) distance driven. We found the rate of RDEs per distance increased with age; although, this did not remain in the multivariate model. In the multivariate model, we found older drivers who experienced a decline in contrast sensitivity over the 12 months and those with lower baseline driving confidence were at increased risk of involvement in RDEs adjusted for distance driven. In other studies, contrast sensitivity has been associated with increased crash involvement for older drivers. These findings lend support for the use of RDEs as a surrogate safety measure, and demonstrate an association between a surrogate safety measure and a decline in contrast sensitivity of older drivers.

Chevalier, A, Coxon, K, Rogers, K, Chevalier, AJ, Wall, J, Brown, J, Clarke, E, Ivers, R & Keay, L 2017, 'Predictors of older drivers' involvement in high-range speeding behavior', Traffic Injury Prevention, vol. 18, no. 2, pp. 124-131.
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OBJECTIVE: Even small increases in vehicle speed raise crash risk and resulting injury severity. Older drivers are at increased risk of involvement in casualty crashes and injury compared to younger drivers. However, there is little objective evidence about older drivers' speeding. This study investigates the nature and predictors of high-range speeding among drivers aged 75-94 years. METHODS: Speed per second was estimated using Global Positioning System devices installed in participants' vehicles. High-range speeding events were defined as traveling an average 10+km/h above the speed limit over 30 seconds. Descriptive analysis examined speeding events by participant characteristics and mileage driven. Regression analyses were used to examine the association between involvement in high-range speeding events and possible predictive factors. RESULTS: Most (96%, 182/190) participants agreed to have their vehicle instrumented, and speeding events were accurately recorded for 97% (177/182) of participants. While 77% (136/177) of participants were involved in one or more high-range events, 42% (75/177) were involved in greater than five events during 12-months of data collection. Participants involved in high-range events drove approximately twice as many kilometres as those not involved. High-range events tended to be infrequent (median = 6 per 10,000 km; IQR = 2-18). The rate of high-range speeding was associated with better cognitive function and attention to the driving environment. CONCLUSION: This suggests those older drivers with poorer cognition and visual attention may drive more cautiously, thereby reducing their high-range speeding behavior.

Chow, CK, Thakkar, J, Bennett, A, Hillis, G, Burke, M, Usherwood, T, Vo, K, Rogers, K, Atkins, E, Webster, R, Chou, M, Dehbi, H-M, Salam, A, Patel, A, Neal, B, Peiris, D, Krum, H, Chalmers, J, Nelson, M, Reid, CM, Woodward, M, Hilmer, S, Thom, S & Rodgers, A 2017, 'Quarter-dose quadruple combination therapy for initial treatment of hypertension: placebo-controlled, crossover, randomised trial and systematic review', The Lancet, vol. 389, no. 10073, pp. 1035-1042.
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Cibulka, MT, Saragiotto, BT, Maher, CG, Hancock, MJ & Koes, BW 2017, 'April 2017 Letter to the Editor-in-Chief', Journal of Orthopaedic & Sports Physical Therapy, vol. 47, no. 4, pp. 295-295.
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Cohen, R, Newton-John, T & Slater, A 2017, 'The relationship between Facebook and Instagram appearance-focused activities and body image concerns in young women', Body Image, vol. 23, pp. 183-187.
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© 2017 The present study aimed to identify the specific social networking sites (SNS) features that relate to body image concerns in young women. A total of 259 women aged 18–29 years completed questionnaire measures of SNS use (Facebook and Instagram) and body image concerns. It was found that appearance-focused SNS use, rather than overall SNS use, was related to body image concerns in young women. Specifically, greater engagement in photo activities on Facebook, but not general Facebook use, was associated with greater thin-ideal internalisation and body surveillance. Similarly, following appearance-focused accounts on Instagram was associated with thin-ideal internalisation, body surveillance, and drive for thinness, whereas following appearance-neutral accounts was not associated with any body image outcomes. Implications for future SNS research, as well as for body image and disordered eating interventions for young women, are discussed.

Craike, MJ, Mosely, K, Browne, JL, Pouwer, F & Speight, J 2017, 'Associations Between Physical Activity and Depressive Symptoms by Weight Status Among Adults With Type 2 Diabetes: Results From Diabetes MILES–Australia', Journal of Physical Activity and Health, vol. 14, no. 3, pp. 195-202.
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Background:To examine associations between physical activity (PA) and depressive symptoms among adults with type 2 diabetes mellitus (Type 2 DM), and whether associations varied according to weight status.Methods:Diabetes MILES–Australia is a national survey of adults with diabetes, focused on behavioral and psychosocial issues. Data from 705 respondents with Type 2 DM were analyzed, including: demographic and clinical characteristics, PA (IPAQ-SF), depressive symptoms (PHQ-9), and BMI (self-reported height and weight). Data analysis was performed using ANCOVA.Results:Respondents were aged 59 ± 8 years; 50% women. PA was negatively associated with depressive symptoms for the overall sample (ηp2= 0.04,P < .001) and all weight categories separately: healthy (ηp2 0.11 P = .041,), overweight (ηp2= 0.04, P = .025) and obese (ηp2 = 0.03, P = .007). For people who were healthy (BMI 18.5 to 24.9) or overweight (BMI 25 to 29.9), high amounts of PA were significantly associated with fewer depressive symptoms; for adults who were obese (BMI ≥ 30) however, both moderate and high amounts were associated with fewer depressive symptoms.Conclusions:PA is associated with fewer depressive symptoms among adults with Type 2DM, however the amount of PA associated with fewer depressive symptoms varies according to weight status. Lower amounts of PA might be required for people who are obese t...

Crespo-Gonzalez, C, Garcia-Cardenas, V & Benrimoj, SI 2017, 'The next phase in professional services research: From implementation to sustainability', Research in Social and Administrative Pharmacy, vol. 13, no. 5, pp. 896-901.
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© 2017 Elsevier Inc. The provision of professional pharmacy services has been heralded as the professional and the economic future of pharmacy. There are different phases involved in a service creation including service design, impact evaluation, implementation and sustainability. The two first phases have been subject to extensive research. In the last years the principles of Implementation science have been applied in pharmacy to study the initial uptake and integration of evidence-based services into routine practice. However, little attention has been paid to the sustainability of those services, during which there is a continued use of the service previously implemented to achieve and sustain long-term outcomes. The objective of this commentary is to describe the differences and common characteristics between the implementation and the sustainability phase and to propose a definition for pharmacy. A literature search was performed. Four critical elements were identified: 1. The aim of the implementation phase is to incorporate new services into practice, the sustainability phase's aim is to make the services routine to achieve and sustain long-term benefits 2. At the implementation phase planned activities are used as a process to integrate the new service, at the sustainability phase there is a continuous improvement of the service 3. The implementation phase occurs during the period of time between the adoption of a service and its integration. Some authors suggest the sustainability phase is a concomitant phase with the implementation phase and others suggest it is independent 4. There is a lack of consensus regarding the duration of each phase. The following definition of sustainability for pharmacy services is proposed: “Sustainability is a phase in the process of a professional pharmacy service, in which the service previously integrated into practice during the implementation phase is routinized and institutionalized over time to achieve and...

Crook, A, Williams, K, Adams, L, Blair, I & Rowe, DB 2017, 'Predictive genetic testing for amyotrophic lateral sclerosis and frontotemporal dementia: genetic counselling considerations', Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, vol. 18, no. 7-8, pp. 475-485.
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Once a gene mutation that is causal of amyotrophic lateral sclerosis (ALS) and/or frontotemporal dementia (FTD) is identified in a family, relatives may decide to undergo predictive genetic testing to determine whether they are at risk of developing disease. Recent advances in gene discovery have led to a pressing need to better understand the implications of predictive genetic testing. Here we review the uptake of genetic counselling, predictive and reproductive testing, and the factors that impact the decision to undergo testing, for consideration in clinical practice. The literature suggests that the factors impacting the decision to undergo testing are complex due to the nature of these diseases, absence of available preventative medical treatment and variable age of onset in mutation carriers. Gaining further insight into the decision-making process and the impact of testing is critical as we seek to develop best-practice guidelines for predictive testing for familial ALS and FTD.

Day, MA, Lang, CP, Newton‐John, TRO, Ehde, DM & Jensen, MP 2017, 'A content review of cognitive process measures used in pain research within adult populations', European Journal of Pain, vol. 21, no. 1, pp. 45-60.
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AbstractBackground and objectivePrevious research suggests that measures of cognitive process may be confounded by the inclusion of items that also assess cognitive content. The primary aims of this content review were to: (1) identify the domains of cognitive processes assessed by measures used in pain research; and (2) determine if pain‐specific cognitive process measures with adequate psychometric properties exist.Databases and data treatmentPsychInfo, CINAHL, PsycArticles, MEDLINE, and Academic Search Complete databases were searched to identify the measures of cognitive process used in pain research. Identified measures were double coded and the measure's items were rated as: (1) cognitive content; (2) cognitive process; (3) behavioural/social; and/or (4) emotional coping/responses to pain.ResultsA total of 319 scales were identified; of these, 29 were coded as providing an un‐confounded assessment of cognitive process, and 12 were pain‐specific. The cognitive process domains assessed in these measures are Absorption, Dissociation, Reappraisal, Distraction/Suppression, Acceptance, Rumination, Non‐Judgment, and Enhancement. Pain‐specific, un‐confounded measures were identified for: Dissociation, Reappraisal, Distraction/Suppression, and Acceptance. Psychometric properties of all 319 scales are reported in supplementary material.ConclusionsTo understand the importance of cognitive processes in influencing pain outcomes as well as explaining the efficacy of pain treatments, valid and pain‐specific cognitive process measures that are not confounded with non‐process domains (e.g....

de Goffau, MJ, Klaver, ARE, Willemsen, MG, Bindels, PJE & Verhagen, AP 2017, 'The Effectiveness of Treatments for Patients With Medication Overuse Headache: A Systematic Review and Meta-Analysis', The Journal of Pain, vol. 18, no. 6, pp. 615-627.
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© 2016 American Pain Society Worldwide, approximately 1 to 2% of the adult population suffers from chronic headache due to overuse of pain medication. Guidelines recommend acute withdrawal of medication, but the optimal treatment remains unknown. We aimed to evaluate the benefit of treatments for patients with medication overuse headache (MOH). We performed an extensive literature search until November 2015, selecting randomized controlled trials that evaluated interventions for adults with MOH. Two authors assessed the eligible trials and extracted data. We calculated effect estimates and used the random effects model for the pooled analysis. Our primary outcome measures were ‘headache days’ and ‘days with medication.’ Outcome data were categorized as short-term (up to 12 weeks) or long-term (≥12 weeks) outcomes. This review consists of 16 trials including 1,105 patients. Four trials evaluated the use of prednisone with placebo or celecoxib after medication withdrawal; 7 trials evaluated various methods of withdrawal versus other methods of withdrawal, and 5 trials evaluated prophylactic medication compared with placebo or ibuprofen. We found no significant differences in headache days between prednisone versus placebo or between outpatient versus inpatient treatment, but we found a significant difference in days with medication. Overall, we found no benefit of prophylactic medication versus placebo. We found low to very low quality of evidence of no benefit of prednisone, prophylaxis, and various withdrawal interventions. Because the burden of MOH for patients is enormous, larger and high-quality intervention trials are needed. Perspective This article presents a critical look at studies of patients with MOHs. It appears that the withdrawal strategy remains the best treatment option, although there is scant evidence on the efficacy of any treatment options.

Dean, S, Foureur, M, Zaslawski, C, Newton-John, T, Yu, N & Pappas, E 2017, 'The effects of a structured mindfulness program on the development of empathy in healthcare students', NursingPlus Open, vol. 3, pp. 1-5.
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Dean, S, Peng, W, Zaslawski, C, Elliott, D, Newton-John, T, Campo, M & Pappas, E 2017, 'Mindfulness in Physical and Occupational Therapy Education and Practice: A scoping review', Physical Therapy Reviews, vol. 22, no. 5-6, pp. 221-228.
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© 2017 Informa UK Limited, trading as Taylor & Francis Group. Background: Mindfulness practices provide numerous benefits for individuals with a variety of health issues. Recent research has highlighted the benefits of mindfulness for health professionals. The potential benefits for physical and occupational therapists or students however, are currently unclear. Objectives: To perform a scoping review on the effects of mindfulness practices among physical (PT) and occupational therapists (OT) and students of those disciplines. Methods: Eligible published articles in English were identified through a literature search of MEDLINE, PsycINFO, Cochrane Library, and AMED from the inception of databases to November 2015. Titles, abstracts, and full-text articles were screened for the selection of relevant papers. Articles identified as editorials, correspondences, commentaries, case reports, abstracts alone, and review papers were excluded. Results: Six studies (two qualitative studies, one quantitative study, one mixed-method study, and two experimental studies) met the inclusion criteria. Three studies focused on PT/OT students, two on clinicians and one on current clinicians who had previously failed a course. These studies highlighted the potential benefits of mindfulness for physical and occupational therapists. They should be interpreted with caution however, due to the small number of relevant studies, high heterogeneity in mindfulness interventions and methodological limitations. Conclusions: There is a paucity of research on the effects of mindfulness among physical and occupational therapists and students of those disciplines. The lack of relevant studies makes a systematic review challenging but the findings of the current studies suggest potentially promising effects.

Dear, BF, Gandy, M, Karin, E, Ricciardi, T, Fogliati, VJ, McDonald, S, Staples, LG, Perry, KN, Sharpe, L, Nicholas, MK & Titov, N 2017, 'The pain course: a randomised controlled trial comparing a remote-delivered chronic pain management program when provided in online and workbook formats', Pain, vol. 158, no. 7, pp. 1289-1301.
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Abstract This study compared a remote-delivered pain management program, the Pain Course, when delivered in online and workbook formats. Participants (n = 178) were randomised into 2 groups: (1) an Internet Group (n = 84) who were provided with secure accounts to the program in an online format; or (2) a Workbook Group (n = 94) who were mailed workbook versions of the program. The content of both programs was identical and comprised 5 core lessons, which participants were encouraged to work through over an 8-week period, according to a prescribed timetable. All participants were provided with weekly contact with a clinical psychologist through email and telephone throughout the program. The overall findings suggest that the workbook format was no less effective or acceptable than the validated online format. Significant improvements (avg. improvement; Internet Group vs Workbook Group) in levels of disability (PDI: 16% vs 24%; RMDQ: 12% vs 15%), anxiety (GAD-7: 36% vs 26%), and depression (PHQ-9: 36% vs 36%) were observed in both groups immediately posttreatment. Further improvements were observed in disability levels to 3-month follow-up, and improvements across the other primary outcomes were maintained until 12-month follow-up. High treatment completion rates and levels of satisfaction were reported in both groups, and both groups required a similarly small amount of clinician contact per participant (M = 74.85 minutes; SD = 41.03). These results highlight the public health potential of remote-delivered pain management programs, delivered in either workbook or online formats, as methods of increasing access to pain management.

Deveza, RC, Elkins, M & Saragiotto, BT 2017, 'PEDro systematic review update: exercise for coronary heart disease', British Journal of Sports Medicine, vol. 51, no. 9, pp. 755-756.
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Dhar Shukla, S, Hansbro, P & Walters, E 2017, 'Blocking rhinoviral adhesion molecule (ICAM-1): potential to prevent COPD exacerbations', International Journal of Chronic Obstructive Pulmonary Disease, vol. Volume 12, pp. 1413-1414.
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Dive, L 2017, 'Autonomy, Information, and Paternalism in Clinical Communication', The American Journal of Bioethics, vol. 17, no. 11, pp. 50-52.
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Dive, L, Mason, P, Light, E, Kerridge, I & Lipworth, W 2017, 'Globalisation and the Ethics of Transnational Biobank Networks', Asian Bioethics Review, vol. 9, no. 4, pp. 301-310.
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Dorstyn, D, Black, R, Mpofu, E & Kneebone, I 2017, 'Utilizing the ICF to understand depressive symptomology in multiple sclerosis: An exploratory systematic review.', Rehabilitation Psychology, vol. 62, no. 2, pp. 143-164.
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© 2017 American Psychological Association. Purpose: Acceptance of the International Classification of Functioning, Disability and Health (ICF) in research and clinical practice has been delayed, despite its multiperspective approach to health measurement. This review utilized the ICF to examine evidence on the associations between depressive symptoms and psychosocial functioning in a patient cohort: multiple sclerosis (MS). Research Method: Forty-nine studies, involving 7,548 adults with relapsing or progressive forms of MS, were quantitatively evaluated. Data were categorized according to ICF domains: activities of individuals along with their participation in life areas and influential environmental and personal factors. Effect size estimates, in the form of Pearson's r, 95% confidence intervals and Fail-safe Ns were calculated. Results: Depression severity was linked to reduced social activities and participation levels (29%, n = 14 studies). Limited quality and/or frequency of informal support from family and friends was also identified as an environmental barrier to participation (29%, n = 14 studies). Intrapersonal markers of depressive symptomatology (e.g., low self-efficacy, anxiety, poor coping, illness attitudes and beliefs) were routinely reported (53%, n = 29 studies). Conclusions: The ICF can help guide the selection of clinical measures to assess psychosocial functioning in adults with MS and highlight areas necessitating further research and/or intervention. For those reporting depressed mood, this might include interventions premised on supporting activity and participation in addition to reinforcing interpersonal strengths. To enhance the utility of the ICF in MS care, further research is needed to operationalize its domains and to map this framework onto existing measurement tools.

Dorstyn, D, Roberts, R, Murphy, G, Kneebone, I, Migliorini, C, Craig, A, Hutchinson, C & Field, D 2017, 'Piloting an email-based resource package for job seekers with multiple sclerosis', Disability and Rehabilitation, vol. 39, no. 9, pp. 867-873.
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© 2016 Informa UK Limited, trading as Taylor & Francis Group. Purpose: Media-based rehabilitation provides a powerful opportunity to examine vocational behaviors in the disability sector. However, this research is preliminary at best. This paper reports pilot data. Method: Eighteen adults with multiple sclerosis (MS) accessed an email-delivered, resource-based package, Work and MS. Pre- and post-access vocational self-efficacy and identity (Job-Procurement Self Efficacy Scale, My Vocational Situation Scale- primary outcomes), life orientation and depressed mood (Life Orientation Test–revised and Patient Health Questionnaire-9–secondary outcomes) were assessed. Pre- and post-change scores were examined with Wilcoxon signed ranks tests and Hedges g effect sizes with associated 95% confidence intervals. Reliable change analyses were additionally calculated to determine the clinical significance of individual change scores. Results: Significant and positive effects were reported for vocational self-efficacy, identity, and optimism. Reliable change scores in one or more of these key outcomes were reported by 30% of the sample. Satisfaction with the content and delivery of the email-based intervention was also noted. Conclusions: Preliminary evidence suggests that Work and MS can help to promote vocational goals, interests and strengths among job seekers with a disability by providing a set of tools, information and linkages relating to vocational pursuits and career development. Replication with a randomized control design is indicated. Implications for Rehabilitation Research indicates a high unemployment rate among working-age adults with MS. A combination of disease-specific, psychological, programmatic and societal variables contribute to employment instability in this group. This pilot study demonstrates that an e-mail-based resource package, Work and MS, provides an innovative and feasible option for promoting consumer engagement with vocational servic...

Dua, K, Hansbro, NG, Foster, PS & Hansbro, PM 2017, 'MicroRNAs as therapeutics for future drug delivery systems in treatment of lung diseases', Drug Delivery and Translational Research, vol. 7, no. 1, pp. 168-178.
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© 2016, Controlled Release Society. The rapid advancement in the area of microRNAs (miRNAs) from discovery to their translation into therapeutic moieties reflects their significance as important regulators in the management of disease pathology. The miRNAs can potentially be a new class of drugs in the near future for the treatment of various lung diseases, but it lacks the current knowledge how these identified therapeutic moieties can be designed into an effective, patient complaint and targeted drug delivery system. miRNAs have characteristic features like small size and low molecular weight which makes them easily translated into an effective drug delivery system. In this review, we have summarised the concept of miRNAs and different approaches which can be employed to deliver miRNAs effectively and safely to the target cells including the challenges associated with their development in particular emphasis on pulmonary diseases. Such approaches will be of interest for both the biological and formulation scientists to understand and explore the new vistas in the area of miRNA delivery for pulmonary inflammatory diseases.

Dua, K, Shukla, SD, Andreoli Pinto, TDJ & Hansbro, PM 2017, 'Nanotechnology: Advancing the translational respiratory research', INTERVENTIONAL MEDICINE AND APPLIED SCIENCE, vol. 9, no. 1, pp. 39-41.
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Dua, K, Shukla, SD, de Jesus Andreoli Pinto, T & Hansbro, PM 2017, 'Nanotechnology: Advancing the translational respiratory research', Interventional Medicine and Applied Science, vol. 9, no. 1, pp. 39-41.
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Considering the various limitations associated with the conventional dosage forms, nanotechnology is gaining increased attention in drug delivery particularly in respiratory medicine and research because of its advantages like targeting effects, improved pharmacotherapy, and patient compliance. This paper provides a quick snapshot about the recent trends and applications of nanotechnology to various translational and formulation scientists working on various respiratory diseases, which can help paving a new path in developing effective drug delivery system.

Dua, K, Shukla, SD, Tekade, RK & Hansbro, PM 2017, 'Whether a novel drug delivery system can overcome the problem of biofilms in respiratory diseases?', Drug Delivery and Translational Research, vol. 7, no. 1, pp. 179-187.
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© 2016, Controlled Release Society. Biofilm comprises a community of microorganisms which form on medical devices and can lead to various threatening infections. It is a major concern in various respiratory diseases like cystic fibrosis, chronic obstructive pulmonary disease, etc. The treatment strategies for such infections are difficult due to the resistance of the microflora existing in the biofilms against various antimicrobial agents, thus posing threats to the patient population. The present era witnesses the beginning of research to understand the biofilm physiology and the associated microfloral diversity by applying -omics approaches. There is very limited information about how the deposition of biofilm on the respiratory devices and lung itself affects the drug delivered, the delivery system, and other implications. The present mini review summarizes the basic introduction to the biofilms and its avoidance using various drug delivery systems with special emphasis on the respiratory diseases. Understanding the approaches, principles, and modes of drug delivery involved in preventing biofilm deposition will be of interest to both biological and formulation scientists, thereby opening avenues to explore the new vistas in biofilm research for identifying better treatments for pulmonary infectious diseases.

Eccles, A, Morris, R & Kneebone, I 2017, 'Psychometric properties of the Behavioural Outcomes of Anxiety questionnaire in stroke patients with aphasia', Clinical Rehabilitation, vol. 31, no. 3, pp. 369-378.
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Objective: To evaluate the psychometric properties of an observational, carer-completed anxiety screen for aphasic stroke patients. Design: Phase 1: A cross-sectional questionnaire design to establish psychometric properties. Phase 2: A randomized longitudinal design with treatment and control to evaluate sensitivity to change and repeatability/reliability. Subjects: Phase 1: 111 patient-carer dyads were recruited through stroke charities: patient mean age 69.7(10. 7), 6.2(5. 2) years since stroke, 76 male; carer mean age 64.7(12. 2), 27 male. Phase 2. A subsample of 50 dyads (29 completed). Measures: All patients completed the Tension Rating Circles and the Frenchay Aphasia Screening Test. Carers completed the Behavioural Outcomes of Anxiety questionnaire, observational versions of the Hospital Anxiety and Depression Scale (HADS-A) and the Generalised Anxiety Disorder-7, and a feedback questionnaire. Intervention: Phase 2: 25 dyads were offered relaxation training and 25 acted as controls. Results: The Behavioural Outcomes of Anxiety questionnaire correlated .77 with the HADS-A and Cronbach’s Alpha was .82 demonstrating validity and internal consistency. Using HADS-A cut-off > 7 as criterion the area under the curve was 0.90 and at cut-off of > 16 sensitivity (0.85) and specificity (0.85) were both good. Scores declined significantly more in a group given anxiety training ( n = 12) than in a control group ( n = 17), demonstrating sensitivity to change and construct validity. Two-week repeatability/reliability was .92. Feedback suggested the scale was acceptable.

Elbourn, E, Togher, L, Kenny, B & Power, E 2017, 'Strengthening the quality of longitudinal research into cognitive-communication recovery after traumatic brain injury: A systematic review', International Journal of Speech-Language Pathology, vol. 19, no. 1, pp. 1-16.
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© 2016 The Speech Pathology Association of Australia Limited Published by Informa UK Limited, trading as Taylor & Francis Group. Purpose: (i) To systematically review longitudinal and prognostic studies relating to the trajectory of cognitive-communication recovery after TBI and (ii) to provide recommendations to strengthen future research. Method: Thirteen health literature databases were accessed up until July 2014. Main measures: Articles were screened systematically against pre-determined inclusion and exclusion criteria. Quality reviews were performed on the selected articles using a modified Downs & Black Rating Scale. Two independent reviewers performed the reviews. Result: Sixteen longitudinal and prognostic articles met the inclusion criteria. There was evidence of either maintenance or improvement of cognitive-communication skills during the first 3 years post-injury. However, the studies did not provide detailed recovery trajectories, by failing to evaluate numerous data points over time. No studies evaluated recovery beyond 3 years post-injury. Injury severity, lesion location, brain volume loss and conversation skills may predict specific cognitive-communication outcomes. There was high variability in study characteristics and measures. Conclusion: There is currently scarce evidence regarding cognitive-communication recovery and prognosis. People with TBI may recover or maintain pre-morbid cognitive-communication skills during the early rehabilitation stage. Further research detailing the recovery trajectory with a view to evaluating predictive factors is strongly indicated. Guidelines for future research are provided.

Epping, R, Verhagen, AP, Hoebink, EA, Rooker, S & Scholten-Peeters, GGM 2017, 'The diagnostic accuracy and test-retest reliability of the Dutch PainDETECT and the DN4 screening tools for neuropathic pain in patients with suspected cervical or lumbar radiculopathy', Musculoskeletal Science and Practice, vol. 30, pp. 72-79.
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© 2017 Elsevier Ltd Background It is important to identify neuropathic pain early to guide treatment decisions and prevent chronicity. There is lack of evidence whether the Dutch painDETECT questionnaire and Douleure Neuropathique en 4 questions (DN4) can adequately assess neuropathic pain. Methods Patients suspected of cervical or lumbar radiculopathy were eligible for inclusion. The Dutch painDETECT and DN4 were considered as the index tests and were compared to the reference test consisting of the consensus expert diagnosis by using the grading system for neuropathic pain. The index tests and neuropathic pain diagnosis were blindly performed. Diagnostic accuracy was determined by calculating sensitivity, specificity, predictive values and likely hood ratios. Test-retest reliability for the index tests was assessed using Intraclass Correlation Coefficients (ICC). Results A total of 180 patients were included, of which 110 for the reliability analysis. Fifty-nine patients (33%) had neuropathic pain according to the reference test. Both the painDETECT and DN4 had moderate sensitivity of respectively 75% (95% CI: 61.6–85.0) and 76% (95% CI: 63.4–86.4) and poor specificity of respectively 51% (95% CI: 42.0–60.4) and 42% (95% CI: 33.2–51.5). Combining negative test results for both screening tools increased the sensitivity up to 83% (95% CI: 71.0–91.6). The ICC for the painDETECT was 0.91 (95% CI: 0.86–0.94) and for the DN4 0.86 (95% CI: 0.80–0.91). Conclusions The use of the Dutch painDETECT and the DN4 in patients with suspected radiculopathy should not be recommended yet. A combination of both screening tools seems most suitable to rule out neuropathic pain in patients suspected of radiculopathy. Level of evidence Diagnosis, Level 1B.

Fong, J, Buckley, T, Cashin, A & Pont, L 2017, 'Nurse practitioner prescribing in Australia: A comprehensive literature review', Australian Critical Care, vol. 30, no. 5, pp. 252-259.
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In Australia, the nurse practitioner (NP) obtained prescriptive authority in some jurisdictions in 2001. One of the key aspects in which the scope of NPs differs from Registered Nurses (RNs) relates to the legal privilege to prescribe medications. Although NPs have had prescriptive authority in Australia since 2001, with access to the Commonwealth subsidy scheme (PBS) since 2010, little is known about NPs prescriptive patterns or outcomes of prescriptive practice.The aim of this scoping review was to examine the extent, range and nature of research conducted in relation to NP prescribing in the Australian health context as well as identify gaps in the existing literature. Whilst considerable research has been undertaken on medical prescribing, to date there is no published review of studies regarding NP prescribing in the Australian context.A structured search of the literature was undertaken using permutations of the following key words ’nurse practitioner prescribing Australia’, ’nurse practitioner and prescribing’, ’advanced practice nurse and prescribing’, ’nurse practitioner and Australia’. Databases where searched from January 2000 to January 2016. Databases searched include PsycInfo, Pubmed, CINAHL and Medline.There are a number of distinguishing features of NP prescribing practices in the Australian context. Little is known about the prescribing behaviours of critical care NPs in both the international and Australian context. Key themes identified were: barriers to prescribing, attitudes to NP prescribing, frequency of prescribing, types of medications prescribed, prescribing practice behaviours and confidence in prescribing.The impact of legislative changes on Australian NPs clinical practice and service delivery is still evolving. This review should create impetus for further research to determine the outcomes of NP prescribing on both patient and health service outcomes in the Australian healthcare context including critical care settings.

Freed, GL, Turbitt, E & Allen, A 2017, 'Public or private care: where do specialists spend their time?', Australian Health Review, vol. 41, no. 5, pp. 541-541.
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ObjectivesThe aim of the present study was to provide data to help clarify the public–private division of clinical care provision by doctors in Australia.MethodsA secondary analysis was performed of data from the workforce survey administered by the Australian Health Practitioner Regulation Agency. The questionnaire included demographic and employment questions. Analysis included frequency distributions of demographic variables and mean and median calculations of employment data. Data were analysed from those currently employed in eight adult specialities chosen to provide a mix of surgical and medical fields. The specialties were orthopaedic surgery, otolaryngology, ophthalmology, cardiology, neurology, nephrology, gastroenterology and rheumatology.ResultsFor the specialities analysed in the present study, a large majority of the time spent in patient care was provided in the private sector. For the surgical specialties studied, on average less than 30% of clinical time was spent in the public sector. There was considerable variation among specialties in whether a greater proportion of time was spent in out-patient versus in-patient care and how that was divided between the public and private sectors.ConclusionsEnsuring Australians have a medical workforce that meets the needs of the population will require assessments of the public and private medical markets, the needs of each market and the adequacy with which current physician clinical time allocation meets those requirements. By appreciating this nuance, Australia can develop policies and strategies for the current and future speciality workforce to meet the nation’s needs.What is known about the topic?Australian medical specialists can split their clinical practice time between the public (e.g. public hospitals, public clinics) and private (e.g. private hospitals, private consulting rooms) sectors. For all medical specialists combined, working hours have been reported to b...

Freed, GL, Turbitt, E, Gafforini, S & Kunin, M 2017, 'Paediatrician perceptions of patient referral and discharge', Australian Health Review, vol. 41, no. 5, pp. 561-561.
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ObjectiveThe aim of the present study was to determine the factors involved in the decision of paediatric specialists to discharge patients back to their primary care provider following referral. Return of patients to primary care, when medically appropriate, is essential to provide efficient care to children given the limited workforce of paediatric subspecialists in Australia.MethodsData were compiled from a self-completed mail survey of all paediatricians in five specialties at two children’s hospitals in Melbourne (n = 81). Analysis involved frequency distributions and descriptive analyses, followed by bivariate analyses to determine the differences, if any, among respondents based on the demographic variables collected.ResultsThe response rate was 91%. Most paediatricians (73%) believed that at least sometimes referrals were for a condition general practitioners (GPs) should be able to manage themselves. However, only 36% reported that they frequently or almost always provided the referring GP with information on how to care for the particular condition without a referral. Concerns regarding whether a patient would receive required care following discharge were felt to be important by most paediatricians. Further, many paediatricians reported that their discharge decision is affected by concerns it would be too complicated to arrange for a GP to take over the care of a patient.ConclusionsUnderstanding the factors involved in the referral process and the decision to discharge patients from speciality care clinics to primary care is essential to develop strategies to address long waiting times. Ensuring appropriate referral of children involves the participation of GPs, parents and specialists.What is known about the topic?Most paediatric subspecialists practice in paediatric hospitals, where there is a sufficient volume of patients requiring their services. There have been reports across Australia of increased referrals to ge...

Freed, GL, Turbitt, E, Kunin, M, Gafforini, S, Sanci, L & Spike, N 2017, 'Children referred for specialty care: Parental perspectives and preferences on referral, follow‐up and primary care', Journal of Paediatrics and Child Health, vol. 53, no. 1, pp. 18-25.
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AimOver the last decade, there has been a dramatic increase in the number of referrals for paediatric subspecialty care and in overall appointments (new and review) to these doctors. We sought to determine the perspective of parents regarding their role in the initiation of referrals, their preferences for follow‐up and the role of general practitioners (GPs) in care co‐ordination.MethodsSelf‐completed survey in outpatient paediatric clinics (general paediatrics and four subspecialties) at two children's hospitals in Victoria. Recruitment targets were 100 parents in each of the general paediatrics clinics and 50 parents in each subspecialty clinic, equally divided between new and review visits (total n = 600).ResultsA total of 606 parents provided responses, with a decline rate of 9%. Many (52%) new patients were referred by a GP with the remainder from a variety of other sources. With specific regard to providing general care to their child, only 45% were completely confident in a GP. Most (76%) agreed with the statement that a GP would give their child a referral to see a paediatrician whenever they ask. Approximately, a third of parents reported that a GP rarely or never co‐ordinates the care of their child with other doctors.ConclusionsParents play an important role in both the initiation of paediatric specialty referrals and the patterns of follow‐up care provided. Parent perspectives, pref...

Freedman, R, Mountain, H, Karina, D & Schofield, L 2017, 'A Retrospective Exploration of the Impact of the ‘Angelina Jolie Effect’ on the Single State‐Wide Familial Cancer Program in Perth, Western Australia', Journal of Genetic Counseling, vol. 26, no. 1, pp. 52-62.
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AbstractGlobal media has the power to influence the ways the public engage with health services. On May 14th 2013, Angelina Jolie published an article in the New York Times magazine, outlining her decision to undergo BRCA mutation testing due to a family history of cancer; then proceed with a mastectomy. The article evoked significant interest from the media and the public. During the months that followed, the Familial Cancer Program (FCP) at Genetic Services of Western Australia (GSWA) experienced a significant increase in referrals and enquiries. Resources were overstretched and it became clear we needed to adjust work practices to manage the escalating numbers. New strategies were devised to cope with the influx of enquiries, albeit without the benefit of additional resources. We conducted an audit of referrals to the FCP made between January 2012 and December 2014. This included a comparison of the months prior to and following the New York Times article. The aim of the audit was to quantify the impact of the “Angelina Jolie effect” on referrals to the FCP. Whilst the increased awareness of the role of genetic services in risk assessment and testing for familial breast and ovarian cancer was considered positive, pre‐referral risk assessment at the primary health level to evaluate the appropriateness of their patients for referral could have been helpful. Potentially, many inappropriate referrals to FCP may have been avoided with primary health evaluation thus lessening the burden on our service and preventing unnecessary worry in well women who possessed minimal family history or risk factors. It is important to understand the factors driving the uptake of risk reduction activities, particularly if engagement with a genetics service is considered part of that pathway. Continued education about cancer risk due to family history, individual features and awareness surrounding genetic testing criteria, costs and availabi...

Fuller, JM, Saini, B, Bosnic-Anticevich, S, Garcia Cardenas, V, Benrimoj, SI & Armour, C 2017, 'Testing evidence routine practice: Using an implementation framework to embed a clinically proven asthma service in Australian community pharmacy', Research in Social and Administrative Pharmacy, vol. 13, no. 5, pp. 989-996.
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© 2017 Elsevier Inc. Introduction Community pharmacists are well placed and evidence clearly demonstrates that they can be suitably trained to deliver professional services that improve the management of asthma patients in clinical, economic and humanistic terms. However the gap between this evidence and practice reality remains wide. In this study we measure the implementation process as well as the service benefits of an asthma service model. Methods Using an effectiveness-implementation hybrid design, a defined implementation process (progression from Exploration through Preparation and Testing to Operation stages) supporting an asthma service (promoting asthma control and inhaler technique) was tested in 17 community pharmacies across metropolitan Sydney. Results Seven pharmacies reached the Operation stage of implementation. Eight pharmacies reached the Testing stage of implementation and two pharmacies did not progress beyond the Preparation stage of implementation. A total of 128 patients were enrolled in the asthma service with 110 patients remaining enrolled at the close of the study. Asthma control showed a positive trend throughout the service with the overall proportion of patients with ‘poor’ asthma control at baseline decreasing from 72% to 57% at study close. There was a statistically significant increase in the proportion of patients with correct inhaler technique from 12% at Baseline (Visit 1) to 33% at Visit 2 and 57% at study close. Conclusion Implementation of the asthma service varied across pharmacies. Different strategies specific to practice sites at different stages of the implementation model may result in greater uptake of professional services. The asthma service led to improved patient outcomes overall with a positive trend in asthma control and significant change in inhaler technique.

Gagnier, JJ, Page, MJ, Huang, H, Verhagen, AP & Buchbinder, R 2017, 'Creation of a core outcome set for clinical trials of people with shoulder pain: a study protocol', Trials, vol. 18, no. 1, pp. 1-9.
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© 2017 The Author(s). Background: The selection of appropriate outcomes or domains is crucial when designing clinical trials, to appreciate the effects of different interventions, pool results, and make valid comparisons between trials. If the findings are to influence policy and practice, then the chosen outcomes need to be relevant and important to key stakeholders, including patients and the public, healthcare professionals and others making decisions about health care. There is a growing recognition that insufficient attention has been paid to the outcomes measured in clinical trials. Recent reviews of the measurement properties of patient-reported outcome measures for shoulder disorders revealed a large selection of diverse measures, many with questionable validity, reliability, and responsiveness. These issues could be addressed through the development and use of an agreed standardized collection of outcomes, known as a core outcome set (COS), which should be measured and reported in all trials of shoulder disorders. The purpose of the present project is to develop and disseminate a COS for clinical trials in shoulder disorders. Methods/Design: The methods for the COS development will include 3 phases: (1) a comprehensive review of the core domains used in shoulder disorder trials; (2) an international Delphi study involving relevant stakeholders (patients, clinicians, scientists) to define which domains should be core; and (3) an international focus group informed by the evidence identified in phases 1 and 2, to determine which measurement instruments best measure the core domains and identification of any evidence gaps that require further empiric evidence. Discussion: The aim of the current proposal is to convene several meetings of international experts and patients to develop a COS for clinical trials of shoulder disorders and to develop an implementation strategy to ensure rapid uptake of the core set of outcomes in clinical trials. There wo...

Garcia-Cardenas, V, Benrimoj, SI, Ocampo, CC, Goyenechea, E, Martinez–Martinez, F & Gastelurrutia, MA 2017, 'Evaluation of the implementation process and outcomes of a professional pharmacy service in a community pharmacy setting. A case report', Research in Social and Administrative Pharmacy, vol. 13, no. 3, pp. 614-627.
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© 2016 Elsevier Inc. Pharmacist-led medication review services are recognized as a key to medicines management. This case study describes the implementation process of a medication review with follow-up service in a community pharmacy setting and evaluates its initial outcomes. An implementation-effectiveness hybrid study was undertaken in a community pharmacy setting. The implementation process was divided into four different phases: Exploration and adoption, program installation, initial implementation, and full operation. A core set of implementation outcomes was measured, including penetration, implementation costs, feasibility, fidelity, acceptability, appropriateness and efficiency. The penetration rate of the service was nearly 62.5%, and the implementation costs were 57,359.67€. There was a high retention-participation rate of patients. For every month of service provision, there was a 1.27 increase in the number of patients requesting the service, compared to the number of patients being offered the service. The time spent on service provision was 171.7 min per patient. Average patient satisfaction with the service was 4.82 (SD: 0.39, scale 1–5), and the acceptance rate of care plans by patients and general medical practitioners were 96.99% and 96.46%, respectively. There were 408 negative outcomes associated with the use of medications were identified during the study (3.09 per patient), of which 96.3% were resolved. The average time per patient spent on service provision significantly decreased along the 18 months of service provision. This case report can assist individual pharmacists and professional organizations interested in implementing evidence-based services by offering an example on how to approach the implementation process in a systematic way.

Golzan, SM, Goozee, K, Georgevsky, D, Avolio, A, Chatterjee, P, Shen, K, Gupta, V, Chung, R, Savage, G, Orr, CF, Martins, RN & Graham, SL 2017, 'Retinal vascular and structural changes are associated with amyloid burden in the elderly: ophthalmic biomarkers of preclinical Alzheimer’s disease', Alzheimer's Research & Therapy, vol. 9, no. 1.
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Guo, YE, Togher, L, Power, E & Heard, R 2017, 'Validation of the assessment of living with aphasia in Singapore', Aphasiology, vol. 31, no. 9, pp. 981-998.
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© 2016 Informa UK Limited, trading as Taylor & Francis Group. Background: The Assessment of Living with Aphasia (ALA) is a pictographic, self-report measure of aphasia-related quality of life (QoL). It has yet to be used in the Singapore population or adapted to other languages. Aims: To examine the reliability and validity of the ALA and develop a Mandarin Chinese adaptation, the ALA-C, in the Singapore context. Methods & procedures: Linguistic validation of the ALA was conducted to derive the ALA-C. People with aphasia (PWA) who were at least 6 months post-onset underwent the ALA/ALA-C and a series of reference measures in their dominant language (English/Mandarin). Test–retest reliability was evaluated using intra-class correlations and internal consistency using Cronbach’s alpha. Eight reference measures were administered to assess construct validity. Outcomes & results: Sixty-six PWA were recruited to the study. Both the ALA and ALA-C showed excellent internal consistency (α = 0.97/0.96) and test–retest reliability (intraclass correlation = 0.97/0.98), and acceptable convergent (r = 0.63–0.83 and 0.70–0.83 respectively) and discriminant (r = 0.45–0.60 and 0.39–0.53, respectively) validity. Conclusions: Both ALA and ALA-C demonstrated excellent reliability and good validity. Further research is warranted to examine use by more practicing clinicians and with more participants of varying degrees of aphasia severity to enable additional investigation of its psychometric properties.

Guo, YE, Togher, L, Power, E, Heard, R, Luo, N, Yap, P & Koh, GCH 2017, 'Sensitivity to change and responsiveness of the Stroke and Aphasia Quality-of-Life Scale (SAQOL) in a Singapore stroke population', Aphasiology, vol. 31, no. 4, pp. 427-446.
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© 2016 Informa UK Limited, trading as Taylor & Francis Group. Background: The health-related quality of life (HRQoL) of people with aphasia (PWA) in Singapore is unknown. Aims: To compare outcomes between stroke survivors with and without aphasia in Singapore and examine the sensitivity and responsiveness to change of the Stroke and Aphasia QOL Scale (SAQOL-39g) and its Singapore (Mandarin) variant, SAQOL-CSg. Methods & Procedures: A longitudinal cohort study was conducted with stroke survivors with and without aphasia. Participants underwent a series of questionnaires at 3 and 12 months post-stroke including SAQOL-39g/SAQOL-CSg, Barthel Index, Modified Rankin Scale (MRS), Mini Mental State Examination, Frontal Assessment Battery, Center for Epidemiologic Studies Depression Scale and the EQ-5D. The following data analyses were conducted: comparison of stroke outcomes between participants with and without aphasia, computation of floor and ceiling effects, calculation of effect sizes (ESs) to determine sensitivity to change and estimation of minimally important differences (MIDs) for examining responsiveness. Outcomes & Results: A total of 78 participants (29.5% female, 29.5% PWA, mean age 64.1 years) completed all the assessments on both occasions. At 12 months post-stroke, PWA had higher levels of disability on the MRS (Mann–Whitney U = 294.5, p < 0.01) and reported significantly lower quality of life on the SAQOL-39g/SAQOL-CSg (U = 349, p < 0.01) and the EQ-5D index (U = 447, p < 0.05). In terms of sensitivity to change, the SAQOL-39g/SAQOL- 35CSg showed a small degree of improvement for the entire sample (ES, r = 0.22) but change was only significant for participants without aphasia. MID estimates for improvement were 0.21 on the SAQOL-39g/SAQOL-CSg and 0.17 on the EQ-5D index. Conclusions: PWA reported poorer HRQoL even when physical function was comparable. SAQOL-39g/SAQOL-CSg was found to have adequate sensitivity to change (i.e., reflect at least ...

Guo, YE, Togher, L, Power, E, Hutomo, E, Yang, Y-F, Tay, A, Yen, S-C & Koh, GC-H 2017, 'Assessment of Aphasia Across the International Classification of Functioning, Disability and Health Using an iPad-Based Application', Telemedicine and e-Health, vol. 23, no. 4, pp. 313-326.
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© 2017, Mary Ann Liebert, Inc. Background: Access2Aphasia™ is an iPad™-based aphasia assessment application that enables real-time audiovisual communication between people with aphasia (PWA) and speech-language pathologists (SLPs), and the use of supported conversation techniques. This study aimed to establish the reliability of aphasia assessment across the International Classification of Functioning, Disability and Health (ICF) using Access2Aphasia, and compare it with face-to-face (FTF) assessment. Consumer perspectives of Access2Aphasia were also examined. Materials and Methods: Thirty PWA were randomized into two conditions: online-led and FTF assessment. Participants in the online-led group were assessed remotely using Access2Aphasia™ in their own homes, while an FTF SLP scored silently simultaneously. Participants in the FTF group were assessed FTF using standard administration materials. Assessment included two subtests of the Psycholinguistic Assessment of Language Processing Activities (PALPA) and the Assessment of Living with Aphasia (ALA) to allow for outcomes to be captured across the ICF domains. Consumer perspectives on Access2Aphasia were obtained from both PWA and research SLPs in the online-led group. Results: Kappa statistics indicated moderate to almost perfect agreement between online and FTF SLPs (k = 0.71-1.00). Intrarater and interrater reliability was excellent (ICC = 0.99-1.00) and equivalent for the online-led and FTF conditions. Both PWA and research SLPs in the online-led group reported being satisfied with the experience overall, with suggestions provided by research SLPs to improve Access2Aphasia. Conclusion: This study supports the provision of iPad-based aphasia assessments across the ICF in the online environment, with comparable reliability to FTF assessments. Future research is warranted to support the development of iPad-based aphasia assessment and treatment as an alternative mode of service delivery to PWA.

Gupta, G, Chellappan, DK, Agarwal, M, Ashwathanarayana, M, Nammi, S, Pabreja, K & Dua, K 2017, 'Pharmacological Evaluation of the Recuperative Effect of Morusin Against Aluminium Trichloride (AlCl3)-Induced Memory Impairment in Rats', Central Nervous System Agents in Medicinal Chemistry, vol. 17, no. 3, pp. 196-200.
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BACKGROUND: Elevation in brain levels of aluminium can be neurotoxic and can cause learning and memory deficiencies. In Chinese medicine, Morus alba is used as a neuroprotective herb. The current study was intended to discover the recuperative effect of morusin against aluminium trichloride (AlCl3)-induced memory impairment in rats along with biochemical mechanism of its protective action. METHODS: Memory deficiency was produced by AlCl3 (100 mg/kg; p.o.) in experimental animals. Learning and memory activity was measured using Morris water maze (MWM) test model. Central cholinergic activity was evaluated through the measurement of brain acetylcholinesterase (AChE) activity. In addition to the above, oxidative stress was determined through assessment of brain thiobarbituric acid-reactive species (TBARS) and glutathione (GSH) levels. RESULTS: AlCl3 administration prompted significant deficiency of learning and memory in rats, as specified by a noticeable reduction in MWM presentation. AlCl3 administration also produced a significant deterioration in brain AChE action and brain oxidative stress (increase in TBARS and decrease in GSH) levels. Treatment with morusin (5.0 and 10.0 mg/kg, dose orally) significantly overturned AlCl3- induced learning and memory shortages along with diminution of AlCl3-induced rise in brain AChE activity and brain oxidative stress levels. CONCLUSION: It may be concluded that morusin exerts a memory-preservative outcome in mental discrepancies of rats feasibly through its various activities.

Hemsley, B & Balandin, S 2017, 'Evidence and innovation in AAC research: expanding borders and boundaries for a global audience', Augmentative and Alternative Communication, vol. 33, no. 1, pp. 1-2.
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The Research Symposium of ISAAC 2016 was held in association with the 17th Biennial International Conference of ISAAC in Toronto, Canada from August 12-13, 2016. The symposium featured four symposia themes, such as language and AAC in multicultural contexts, design and AAC, social media and AAC, and assessing children�s AAC symbol communication needs. The overall theme of the symposium was evidence and innovation, in recognition that the field of AAC research needed to expand its current borders and boundaries to consider innovative research in face-to-face arenas and online communication for people with complex communication needs and their families globally.

Hemsley, B, Balandin, S, Palmer, S & Dann, S 2017, 'A call for innovative social media research in the field of augmentative and alternative communication', Augmentative and Alternative Communication, vol. 33, no. 1, pp. 14-22.
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© 2017 International Society for Augmentative and Alternative Communication. Augmentative and alternative communication (AAC) social media research is relatively new, and is built on a foundation of research on use of the Internet and social media by people with communication disabilities. Although the field is expanding to include a range of people who use AAC, there are limitations and gaps in research that will need to be addressed in order to keep pace with the rapid evolution of social media connectivity in assistive communication technologies. In this paper, we consider the aims, scope, and methodologies of AAC social media research, with a focus on social network sites. Lack of detailed attention to specific social network sites and little use of social media data limits the extent to which findings can be confirmed. Increased use of social media data across a range of platforms, including Instagram and YouTube, would provide important insights into the lives of people who use AAC and the ways in which they and their supporters use social media. New directions for AAC social media research are presented in line with those discussed at the social media research symposium at the International Society for Augmentative and Alternative Communication in Toronto, Canada, on August 12, 2016.

Hines, M, Brunner, M, Poon, S, Lam, M, Tran, V, Yu, D, Togher, L, Shaw, T & Power, E 2017, 'Tribes and tribulations: interdisciplinary eHealth in providing services for people with a traumatic brain injury (TBI)', BMC Health Services Research, vol. 17, no. 1, pp. 1-13.
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© 2017 The Author(s). Background: eHealth has potential for supporting interdisciplinary care in contemporary traumatic brain injury (TBI) rehabilitation practice, yet little is known about whether this potential is being realised, or what needs to be done to further support its implementation. The purpose of this study was to explore health professionals' experiences of, and attitudes towards eHealth technologies to support interdisciplinary practice within rehabilitation for people after TBI. Methods: A qualitative study using narrative analysis was conducted. One individual interview and three focus groups were conducted with health professionals (n = 17) working in TBI rehabilitation in public and private healthcare settings across regional and metropolitan New South Wales, Australia. Results: Narrative analysis revealed that participants held largely favourable views about eHealth and its potential to support interdisciplinary practice in TBI rehabilitation. However, participants encountered various issues related to (a) the design of, and access to electronic medical records, (b) technology, (c) eHealth implementation, and (d) information and communication technology processes that disconnected them from the work they needed to accomplish. In response, health professionals attempted to make the most of unsatisfactory eHealth systems and processes, but were still mostly unsuccessful in optimising the quality, efficiency, and client-centredness of their work. Conclusions: Attention to sources of disconnection experienced by health professionals, specifically design of, and access to electronic health records, eHealth resourcing, and policies and procedures related to eHealth and interdisciplinary practice are required if the potential of eHealth for supporting interdisciplinary practice is to be realised.

Hing, N, Russell, AMT & Hronis, A 2017, 'What Behaviours and Cognitions Support Responsible Consumption of Gambling? Results from an Expert Survey', International Journal of Mental Health and Addiction, vol. 15, no. 6, pp. 1320-1341.
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© 2017, Springer Science+Business Media, LLC. This study analysed expert views on (1) the adequacy of the current promotion of responsible gambling, (2) the practicality and worth of developing an evidence-based set of responsible gambling consumption behaviours and cognitions and (3) the relative importance of behaviours and cognitions promoted as supporting responsible consumption of gambling. Experts (N = 107) rated the importance of 61 behaviours and cognitions, distilled from a systematic literature review and content analysis of 30 websites, and grouped into seven categories. Behaviours and cognitions considered most important for problem gamblers related to ensuring gambling is affordable, limiting persistence at gambling, and using help and support. Those for at-risk gamblers related to understanding gambling, ensuring gambling expenditure is affordable, and keeping gambling in balance. For non-problem gamblers, important behaviours and cognitions related to understanding gambling, keeping gambling in balance, and positive motivations for gambling. Current promotion of responsible gambling was considered inadequate. Efforts to develop, validate and promote evidence-based responsible gambling consumption behaviours and cognitions can build on those identified in this research.

Hodge, C, Sutton, G, Devasahayam, R, Georges, P, Treloggen, J, Cooper, S & Petsoglou, C 2017, 'The use of donor scleral patch in ophthalmic surgery', Cell and Tissue Banking, vol. 18, no. 1, pp. 119-128.
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© 2016, Springer Science+Business Media Dordrecht. Scleral tissue has been in use in ophthalmology for many years although indications for use have varied. We retrospectively reviewed scleral transplant tissue requests over a 12 month period at a local eye bank and confirmed a small but significant demand for the use of scleral tissue. Iatrogenic surgical complications are the primary indication for use. Our understanding of the indications and outcomes of scleral graft procedures is derived from case reports and small cohort series. We reviewed the current literature on existing indications for its use and discuss the relative outcomes. To our knowledge this represents the first review of scleral transplant indications and further summarises usage rates in the Lions NSW Eye Bank which may provide practical information for those surgeons who use scleral tissue and Eye Banks who supply it.

Hogden, A & Crook, A 2017, 'Patient-centered decision making in amyotrophic lateral sclerosis: where are we?', Neurodegenerative Disease Management, vol. 7, no. 6, pp. 377-386.
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Developments in amyotrophic lateral sclerosis research and care delivery have created new arenas, and new dilemmas, for patients’ decision making. This review explores three aspects of amyotrophic lateral sclerosis patient-centered care and decision making: patient-centered service delivery through the expanding multidisciplinary team; decision making for genetic testing and the implications of undergoing testing; and development of user-designed decision support tools to help patients and families make decisions as their choices become more complex. Until a cure is found, well-timed and effective decision making will rely on patient and family preferences to guide them through an increasingly complicated disease landscape.

Hough, M 2017, 'A short history of the Book Collectors Society of Australia, 1944-1981.', Biblionews and Australian Notes and Queries: journal for book collectors, no. no 395-396, pp. 91-98.

Hronis, A, Roberts, L & Kneebone, II 2017, 'A review of cognitive impairments in children with intellectual disabilities: Implications for cognitive behaviour therapy', British Journal of Clinical Psychology, vol. 56, no. 2, pp. 189-207.
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ObjectiveNearly half of children with intellectual disability (ID) have comorbid affective disorders. These problems are chronic if left untreated and can significantly impact upon future vocational, educational, and social opportunities. Despite this, there is a paucity of research into effective treatments for this population. Notably, one of the most supported of psychological therapies, cognitive behaviour therapy (CBT), remains largely uninvestigated in children with ID. The current review considers the neuropsychological profile of children and adolescents with mild to moderate ID, with a view to informing how CBT might best be adapted for children and adolescents with ID.MethodNarrative review of literature considering the neuropsychological profiles of children and adolescents with ID, with specific focus upon attention, memory, learning, executive functioning, and communication. Studies were identified through SCOPUS, PsycINFO, and PubMed databases, using combinations of the key words ‘intellectual disability’, ‘learning disability’, ‘neuropsychology’, ‘attention’, ‘learning’, ‘memory’, ‘executive function’, ‘language’, and ‘reading’.ResultsChildren with ID have significant deficits in attention, learning, memory, executive functions, and language. These deficits are likely to have a negative...

Iverach, L, Lowe, R, Jones, M, O’Brian, S, Menzies, RG, Packman, A & Onslow, M 2017, 'A speech and psychological profile of treatment-seeking adolescents who stutter', Journal of Fluency Disorders, vol. 51, pp. 24-38.
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The purpose of this study was to evaluate the relationship between stuttering severity, psychological functioning, and overall impact of stuttering, in a large sample of adolescents who stutter. Method Participants were 102 adolescents (11–17 years) seeking speech treatment for stuttering, including 86 boys and 16 girls, classified into younger (11–14 years, n = 57) and older (15–17 years, n = 45) adolescents. Linear regression models were used to evaluate the relationship between speech and psychological variables and overall impact of stuttering. Results The impact of stuttering during adolescence is influenced by a complex interplay of speech and psychological variables. Anxiety and depression scores fell within normal limits. However, higher self-reported stuttering severity predicted higher anxiety and internalizing problems. Boys reported externalizing problems—aggression, rule-breaking—in the clinical range, and girls reported total problems in the borderline-clinical range. Overall, higher scores on measures of anxiety, stuttering severity, and speech dissatisfaction predicted a more negative overall impact of stuttering. Conclusion To our knowledge, this is the largest cohort study of adolescents who stutter. Higher stuttering severity, speech dissatisfaction, and anxiety predicted a more negative overall impact of stuttering, indicating the importance of carefully managing the speech and psychological needs of adolescents who stutter. Further research is needed to understand the relationship between stuttering and externalizing problems for adolescent boys who stutter.

Iverach, L, Rapee, RM, Wong, QJJ & Lowe, R 2017, 'Maintenance of Social Anxiety in Stuttering: A Cognitive-Behavioral Model', American Journal of Speech-Language Pathology, vol. 26, no. 2, pp. 540-556.
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Purpose Stuttering is a speech disorder frequently accompanied by anxiety in social-evaluative situations. A growing body of research has confirmed a significant rate of social anxiety disorder among adults who stutter. Social anxiety disorder is a chronic and disabling anxiety disorder associated with substantial life impairment. Several influential models have described cognitive-behavioral factors that contribute to the maintenance of social anxiety in nonstuttering populations. The purpose of the present article is to apply these leading models to the experience of social anxiety for people who stutter. Method Components from existing models were applied to stuttering in order to determine cognitive-behavioral processes that occur before, during, and after social-evaluative situations, which may increase the likelihood of stuttering-related social fears persisting. Results Maintenance of social anxiety in stuttering may be influenced by a host of interrelated factors, including fear of negative evaluation, negative social-evaluative cognitions, attentional biases, self-focused attention, safety behaviors, and anticipatory and postevent processing. Conclusion Given the chronic nature of social anxiety disorder, identifying factors that contribute to the persistence of stuttering-related social fears has the potential to inform clinical practice and the development of psychological treatment programs to address the speech and psychological needs of people who stutter with social anxiety.

Jacobs, C, Pichert, G, Harris, J, Tucker, K & Michie, S 2017, 'Key messages for communicating information about BRCA1 and BRCA2 to women with breast or ovarian cancer: Consensus across health professionals and service users', Psycho-Oncology, vol. 26, no. 11, pp. 1818-1824.
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AbstractBackgroundGenetic testing of cancer predisposing genes will increasingly be needed in oncology clinics to target cancer treatment. This Delphi study aimed to identify areas of agreement and disagreement between genetics and oncology health professionals and service users about the key messages required by women with breast/ovarian cancer who undergo BRCA1/BRCA2 genetic testing and the optimal timing of communicating key messages.MethodsParticipants were 16 expert health professionals specialising in oncology/genetics and 16 service users with breast/ovarian cancer and a pathogenic BRCA1/BRCA2 variant. Online questionnaires containing 53 inductively developed information messages were circulated to the groups separately. Participants rated each message as key/not key on a Likert scale and suggested additional messages. Questionnaires were modified according to the feedback and up to 3 rounds were circulated. Consensus was reached when there was ≥75% agreement.ResultsThirty key messages were agreed by both groups with 7 of the key messages agreed by ≥95% of participants: dominant inheritance, the availability of predictive testing, the importance of pretest discussion, increased risk of breast and ovarian cancer, and the option of risk‐reducing mastectomy and bilateral salpingo‐oophorectomy. Both groups agreed that key messages should be communicated before genetic testing and once a pathogenic variant has been identified.ConclusionsThere was a high level of agreement within and between the groups about the information requirements of women with breast/ovarian cancer about BRCA1/BRCA2. These key messages will be hel...

Jodar-Sanchez, F, Malet-Larrea, A, Martin, JJ, Garcia-Mochon, L, Lopez del Amo, MP, Martinez-Martinez, F, Gastelurrutia-Garralda, MA, Garcia-Cardenas, V, Sabater-Hernandez, D, Saez-Benito, L & Benrimoj, SI 2017, 'Cost-Utility Analysis of a Medication Review with Follow-Up Service for Older Adults with Polypharmacy in Community Pharmacies in Spain: The conSIGUE Program', PHARMACEUTICAL CARE ESPANA, vol. 19, no. 3, pp. 158-159.

Johnson, C, Mohan, S, Rogers, K, Shivashankar, R, Thout, S, Gupta, P, He, F, MacGregor, G, Webster, J, Krishnan, A, Maulik, P, Reddy, K, Prabhakaran, D & Neal, B 2017, 'The Association of Knowledge and Behaviours Related to Salt with 24-h Urinary Salt Excretion in a Population from North and South India', Nutrients, vol. 9, no. 2, pp. 144-144.
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Consumer knowledge is understood to play a role in managing risk factors associated with cardiovascular disease and may be influenced by level of education. The association between population knowledge, behaviours and actual salt consumption was explored overall, and for more-educated compared to less-educated individuals. A cross-sectional survey was done in an age-and sex-stratified random sample of 1395 participants from urban and rural areas of North and South India. A single 24-h urine sample, participants' physical measurements and questionnaire data were collected. The mean age of participants was 40 years, 47% were women and mean 24-h urinary salt excretion was 9.27 (8.87-9.69) g/day. Many participants reported favourable knowledge and behaviours to minimise risks related to salt. Several of these behaviours were associated with reduced salt intake-less use of salt while cooking, avoidance of snacks, namkeens, and avoidance of pickles (all p < 0.003). Mean salt intake was comparable in more-educated (9.21, 8.55-9.87 g/day) versus less-educated (9.34, 8.57-10.12 g/day) individuals (p = 0.82). There was no substantively different pattern of knowledge and behaviours between more-versus less-educated groups and no clear evidence that level of education influenced salt intake. Several consumer behaviours related to use of salt during food preparation and consumption of salty products were related to actual salt consumption and therefore appear to offer an opportunity for intervention. These would be a reasonable focus for a government-led education campaign targeting salt.

Johnson, C, Mohan, S, Rogers, K, Shivashankar, R, Thout, SR, Gupta, P, He, FJ, MacGregor, GA, Webster, J, Krishnan, A, Maulik, PK, Reddy, KS, Prabhakaran, D & Neal, B 2017, 'Mean Dietary Salt Intake in Urban and Rural Areas in India: A Population Survey of 1395 Persons', Journal of the American Heart Association, vol. 6, no. 1, pp. 1-17.
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Background The scientific evidence base in support of population‐wide salt reduction is strong, but current high‐quality data about salt intake levels in India are mostly absent. This project sought to estimate daily salt consumption levels in selected communities of Delhi and Haryana in north India and Andhra Pradesh in south India. Methods and Results In this study, 24‐hour urine samples were collected using an age‐ and sex‐stratified sampling strategy in rural, urban, and slum areas. Salt intake estimates were made for the overall population of each region and for major subgroups by weighting the survey data for the populations of Delhi and Haryana, and Andhra Pradesh. Complete 24‐hour urine samples were available for 637 participants from Delhi and Haryana and 758 from Andhra Pradesh (65% and 68% response rates, respectively). Weighted mean population 24‐hour urine excretion of salt was 8.59 g/day (95% CI 7.68–9.51) in Delhi and Haryana and 9.46 g/day (95% CI 9.06–9.85) in Andhra Pradesh ( P =0.097). Estimates inflated to account for the minimum likely nonurinary losses of sodium provided corresponding estimates of daily salt intake of 9.45 g/day (95% CI 8.45–10.46) and 10.41 g/day (95% CI 9.97–10.84), respectively. ...

Juch, JNS, Maas, ET, Ostelo, RWJG, Groeneweg, JG, Kallewaard, J-W, Koes, BW, Verhagen, AP, van Dongen, JM, Huygen, FJPM & van Tulder, MW 2017, 'Effect of Radiofrequency Denervation on Pain Intensity Among Patients With Chronic Low Back Pain', JAMA, vol. 318, no. 1, pp. 68-68.
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© 2017 American Medical Association. All rights reserved. IMPORTANCE Radiofrequency denervation is a commonly used treatment for chronic low back pain, but high-quality evidence for its effectiveness is lacking. OBJECTIVE To evaluate the effectiveness of radiofrequency denervation added to a standardized exercise program for patients with chronic low back pain. DESIGN, SETTING, AND PARTICIPANTS Three pragmatic multicenter, nonblinded randomized clinical trials on the effectiveness of minimal interventional treatments for participants with chronic low back pain (Mint study) were conducted in 16 multidisciplinary pain clinics in the Netherlands. Eligible participants were included between January 1, 2013, and October 24, 2014, and had chronic low back pain, a positive diagnostic block at the facet joints (facet joint trial, 251 participants), sacroiliac joints (sacroiliac joint trial, 228 participants), or a combination of facet joints, sacroiliac joints, or intervertebral disks (combination trial, 202 participants) and were unresponsive to conservative care. INTERVENTIONS All participants received a 3-month standardized exercise program and psychological support if needed. Participants in the intervention group received radiofrequency denervation as well. This is usually a 1-Time procedure, but the maximum number of treatments in the trial was 3. MAIN OUTCOMES AND MEASURES The primary outcomewas pain intensity (numeric rating scale, 0-10; whereby 0 indicated no pain and 10 indicated worst pain imaginable) measured 3 months after the intervention. The prespecified minimal clinically important difference was defined as 2 points or more. Final follow-up was at 12 months, ending October 2015. RESULTS Among 681 participants who were randomized (mean age, 52.2 years; 421 women [61.8%], mean baseline pain intensity, 7.1), 599 (88%) completed the 3-month follow-up, and 521 (77%) completed the 12-month follow-up. The mean difference in pain intensity between the ...

Karel, YHJM, Scholten-Peeters, GGM, Thoomes-de Graaf, M, Duijn, E, van Broekhoven, JB, Koes, BW & Verhagen, AP 2017, 'Physiotherapy for patients with shoulder pain in primary care: a descriptive study of diagnostic- and therapeutic management', Physiotherapy, vol. 103, no. 4, pp. 369-378.
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© 2016 Chartered Society of Physiotherapy Background Shoulder pain is one of the three main musculoskeletal complaints and more than 50% of the patients have symptoms longer than 6 months. Until now, limited data exist about the content of physiotherapy for patients with shoulder pain in primary care. Objective Describe current physiotherapeutic diagnostic- and therapeutic management, including the use of diagnostic ultrasound, in patients with shoulder pain in primary care. Design and setting A prospective cohort study in primary care physiotherapy with a 12 week follow-up. Methods Descriptive data from physiotherapists was collected, such as: the diagnostic hypotheses after patient history and physical examination, the use of specific tests and diagnostic ultrasound, the interventions used and possible changes in treatment plan. Results Subacromial impingement syndrome was the most common hypothesis after patient history (48%) as well as physical examination (39%). Diagnostic ultrasound was used in 31% and of these patients the clinical diagnosis changed in 29%. Various interventions were used in all clinical diagnoses. After 12 weeks 41% of patients still received physiotherapy treatment. Conclusions Patients with shoulder pain in physiotherapy practice frequently show signs of subacromial impingement syndrome. The interventions used by the physiotherapists were generally in line with the guideline for subacromial impingement syndrome however a small proportion of physiotherapists used massage and tape/bracing techniques. A large proportion of patients were still receiving treatment after 12 weeks when no improvement was observed. If treatment for patients with subacromial impingement shows no benefit patients should be referred back to the general practitioner or orthopedic surgeon. Conclusions from this study might be slightly biased because of the selection of physiotherapists.

Karel, YHJM, Verhagen, AP, Thoomes-de Graaf, M, Duijn, E, van den Borne, MPJ, Beumer, A, Ottenheijm, RPG, Dinant, G-JJ, Koes, BW & Scholten-Peeters, GGM 2017, 'Development of a Prognostic Model for Patients With Shoulder Complaints in Physical Therapist Practice', Physical Therapy, vol. 97, no. 1, pp. 72-80.
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Abstract Background Health care providers need prognostic factors to distinguish between patients who are likely to recover and those who are not likely to recover. Objective The aim of this study was to: (1) describe the clinical course of recovery and (2) identify prognostic factors of recovery in patients with shoulder pain at the 26-week follow-up. Design A prospective cohort study was carried out in the Netherlands and included 389 patients who consulted a physical therapist for a new episode of shoulder pain. Method Participants were followed for 26 weeks. Potential predictors of recovery were selected from the literature and, with the addition of 2 new variables (ie, use of diagnostic ultrasound and working alliance), evaluated in the multivariable regression analysis. Multiple imputation was used to handle missing data, and bootstrap methods were used for internal validation. Results The recovery rate was 60% for the total population and 65% for the working population after 26 weeks. Short duration of complaints, lower disability scores, having a paid job, better working alliance, and no feelings of anxiety or depression were associated with recovery. In the working population, only duration of complaints and disability remained in the final model. The area under the receiver operating characteristic curve (AUC) f...

Kefalianos, E, Onslow, M, Packman, A, Vogel, A, Pezic, A, Mensah, F, Conway, L, Bavin, E, Block, S & Reilly, S 2017, 'The History of Stuttering by 7 Years of Age: Follow-Up of a Prospective Community Cohort', Journal of Speech, Language, and Hearing Research, vol. 60, no. 10, pp. 2828-2839.
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Purpose For a community cohort of children confirmed to have stuttered by the age of 4 years, we report (a) the recovery rate from stuttering, (b) predictors of recovery, and (c) comorbidities at the age of 7 years. Method This study was nested in the Early Language in Victoria Study. Predictors of stuttering recovery included child, family, and environmental measures and first-degree relative history of stuttering. Comorbidities examined at 7 years included temperament, language, nonverbal cognition, and health-related quality of life. Results The recovery rate by the age of 7 years was 65%. Girls with stronger communication skills at the age of 2 years had higher odds of recovery (adjusted OR = 7.1, 95% CI [1.3, 37.9], p = .02), but similar effects were not evident for boys (adjusted OR = 0.5, 95% CI [0.3, 1.1], p = .10). At the age of 7 years, children who had recovered from stuttering were more likely to have stronger language skills than children whose stuttering persisted ( p = .05). No evident differences were identified on other outcomes including nonverbal cognition, temperament, and parent-reported quality of life. Conclusion Overall, findings suggested that there may be associations between language ability and recovery from stuttering. Subsequent research i...

Kefalianos, E, Onslow, M, Ukoumunne, OC, Block, S & Reilly, S 2017, 'Temperament and Early Stuttering Development: Cross-Sectional Findings From a Community Cohort', Journal of Speech, Language, and Hearing Research, vol. 60, no. 4, pp. 772-784.
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Purpose The purpose of this study was to ascertain if there is an association between stuttering severity and behaviors and the expression of temperament characteristics, including precursors of anxiety. Method We studied temperament characteristics of a prospectively recruited community cohort of children who stutter ( N = 173) at ages 3, 4, and 6 years using the Short Temperament Scale STS (Prior, Sanson, Smart & Oberklaid, 2000). Results Six of 131 statistical tests of association between stuttering severity and behaviors and temperament traits were statistically significant at the 5% level, which was no more than expected by chance alone. Conclusions On the basis of parent responses to the STS, preschoolers who exhibited different levels of stuttering severity and behaviors did not generally express temperament traits differently from one another. Stuttering severity and stuttering behaviors were not associated with the precursors of anxiety. Overall, taking multiple tests into consideration, results show little evidence of association between stuttering severity and temperament up to 4 years of age or between stuttering behaviors and temperament up to 6 years of age.

Kikuchi, IS, Cardoso Galante, RS, Dua, K, Malipeddi, VR, Awasthi, R, Ghisleni, DDM & de Jesus Andreoli Pinto, T 2017, 'Hydrogel Based Drug Delivery Systems: A Review with Special Emphasis on Challenges Associated with Decontamination of Hydrogels and Biomaterials', Current Drug Delivery, vol. 14, no. 7, pp. 917-925.
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© 2017 Bentham Science Publishers. Background: Many researches involving the development of new techniques and biomaterials to formulate a suitable drug delivery system and tissue engineering have been conducted. The majority of published literature from these researches emphasizes the production and materials characterization. The safety aspect of hydrogels and biomaterials is a major constraint in their biological applications. Objective: The present review article aimed to summarize various literatures that encompass the difficulties encountered with decontamination and sterilization methods in the preparations of biomaterials and especially hydrogels for biological applications. Method: We searched for original and review articles from various indexed journals reporting applications of hydrogels and biomaterials in drug delivery systems and the importance of decontamination process for hydrogel containing preparations based on various patents evidences. Results: Despite the vast literature available, limited information regarding the decontamination and sterilization processes related to hydrogels and biomaterials is reported. Sterilization processes to hydrogels are not yet fully explored. Researchers working on hydrogel based systems can consider decontamination of such biomaterial as an important tool to allow for commercialization within the chemical, herbal or pharmaceutical industries. Conclusion: Unfortunately, till date, limited papers are available which reported the challenges associated with decontamination methods to prepare hydrogels and biomaterials for biological applications. In conclusion, each case of biomaterial requires individual consideration to decontamination and/or sterilization. This must be submitted to a specific method, but more than one technique can be involved. Physicochemical and biological alterations must be avoided and evaluated by the appropriate assays method. Furthermore, it is also important to consider that e...

Kohler, JN, Turbitt, E & Biesecker, BB 2017, 'Personal utility in genomic testing: a systematic literature review', European Journal of Human Genetics, vol. 25, no. 6, pp. 662-668.
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Researchers and clinicians refer to outcomes of genomic testing that extend beyond clinical utility as 'personal utility'. No systematic delineation of personal utility exists, making it challenging to appreciate its scope. Identifying empirical elements of personal utility reported in the literature offers an inventory that can be subsequently ranked for its relative value by those who have undergone genomic testing. A systematic review was conducted of the peer-reviewed literature reporting non-health-related outcomes of genomic testing from 1 January 2003 to 5 August 2016. Inclusion criteria specified English language, date of publication, and presence of empirical evidence. Identified outcomes were iteratively coded into unique domains. The search returned 551 abstracts from which 31 studies met the inclusion criteria. Study populations and type of genomic testing varied. Coding resulted in 15 distinct elements of personal utility, organized into three domains related to personal outcomes: affective, cognitive, and behavioral; and one domain related to social outcomes. The domains of personal utility may inform pre-test counseling by helping patients anticipate potential value of test results beyond clinical utility. Identified elements may also inform investigations into the prevalence and importance of personal utility to future test users.

Kohler, JN, Turbitt, E, Lewis, KL, Wilfond, BS, Jamal, L, Peay, HL, Biesecker, LG & Biesecker, BB 2017, 'Defining personal utility in genomics: A Delphi study', Clinical Genetics, vol. 92, no. 3, pp. 290-297.
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BackgroundIndividual genome sequencing results are valued by patients in ways distinct from clinical utility. Such outcomes have been described as components of “personal utility,” a concept that broadly encompasses patient‐endorsed benefits, that is operationally defined as non‐clinical outcomes. No empirical delineation of these outcomes has been reported.AimTo address this gap, we administered a Delphi survey to adult participants in a National Institute of Health (NIH) clinical exome study to extract the most highly endorsed outcomes constituting personal utility.Materials and MethodsForty research participants responded to a Delphi survey to rate 35 items identified by a systematic literature review of personal utility.ResultsTwo rounds of ranking resulted in 24 items that represented 14 distinct elements of personal utility. Elements most highly endorsed by participants were: increased self‐knowledge, knowledge of “the condition,” altruism, and anticipated coping.DiscussionOur findings represent the first systematic effort to delineate elements of personal utility that may be used to anticipate participant expectation and inform genetic counseling prior to sequencing. The 24 items reported need to be studied further in additional clinical genome sequencing studies to assess generalizability in other populations. Further research will help to understand motivations and to predict the meaning and use of results.

Kota, A, Deshpande, DA, Haghi, M, Oliver, B & Sharma, P 2017, 'Autophagy and airway fibrosis: Is there a link?', F1000Research, vol. 6, no. 409, pp. 409-409.
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In the past decade, an emerging process named “autophagy” has generated intense interest in many chronic lung diseases. Tissue remodeling and fibrosis is a common feature of many airway diseases, and current therapies do not prevent or reverse these structural changes. Autophagy has evolved as a conserved process for bulk degradation and recycling of cytoplasmic components to maintain basal cellular homeostasis and healthy organelle populations in the cell. Furthermore, autophagy serves as a cell survival mechanism and can also be induced by chemical and physical stress to the cell. Accumulating evidence demonstrates that autophagy plays an essential role in vital cellular processes, including tissue remodeling. This review will discuss some of the recent advancements made in understanding the role of this fundamental process in airway fibrosis with emphasis on airway remodeling, and how autophagy can be exploited as a target for airway remodeling in asthma and chronic obstructive pulmonary disease.

Kothari, M, Stubbs, PW, Figlewski, K, Pedersen, AR, Jensen, J, Baad‐Hansen, L, Svensson, P & Nielsen, JF 2017, 'Effect of transcranial direct current stimulation on neuroplasticity in corticomotor pathways of the tongue muscles', Journal of Oral Rehabilitation, vol. 44, no. 9, pp. 691-701.
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SummaryThe aim of this study is to investigate effects of transcranial direct current stimulation (tDCS) on neuroplasticity in corticomotor pathways related to tongue muscles evoked by a training task using the tongue drive system (TDS). Using a crossover design, 13 healthy participants completed two sessions of tDCS while performing 30 min of TDS training. Sessions were spaced at least 2 weeks apart and participants randomly received anodal and sham tDCS stimulation in the first session and the other condition in the second session. Single and paired pulse transcranial magnetic stimulation was used to elicit motor evoked potentials (MEPs) of the tongue at three time‐points: before, immediately after and 30 min after training. Participant‐based reports of fun, pain, fatigue and motivation, level of difficulty and effort were evaluated on numerical rating scales. There was no consistent significant effect of anodal and sham stimulation on single or paired pulse stimulation MEP amplitude immediately or 30 min after TDS training. Irrespective of tDCS type, training with TDS induced cortical plasticity in terms of increased MEP amplitudes for higher stimulus intensities after 30 min compared with before and immediately after training. Participant‐based rep...

Kothari, M, Stubbs, PW, Pedersen, AR, Jensen, J & Nielsen, JF 2017, 'Reliability of surface electromyography measurements from the suprahyoid muscle complex', Journal of Oral Rehabilitation, vol. 44, no. 9, pp. 683-690.
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SummaryAssessment of swallowing musculature using motor evoked potentials (MEPs) can be used to evaluate neural pathways. However, recording of the swallowing musculature is often invasive, uncomfortable and unrealistic in normal clinical practice. To investigate the possibility of using the suprahyoid muscle complex (SMC) using surface electromyography (sEMG) to assess changes to neural pathways by determining the reliability of measurements in healthy participants over days. Seventeen healthy participants were recruited. Measurements were performed twice with one week between sessions. Single‐pulse (at 120% and 140% of the resting motor threshold (rMT)) and paired‐pulse (2 ms and 15 ms paired pulse) transcranial magnetic stimulation (TMS) were used to elicit MEPs in the SMC which were recorded using sEMG. ≈50% of participants (range: 42–58%; depending on stimulus type/intensity) had significantly different MEP values between day 1 and day 2 for single‐pulse and paired‐pulse TMS. A large stimulus artefact resulted in MEP responses that could not be assessed in four participants. The assessment of the SMC using sEMG following

Kouzani, AZ, Adams, S, J. Whyte, D, Oliver, R, Hemsley, B, Palmer, S & Balandin, S 2017, '3D Printing of Food for People with Swallowing Difficulties', KnE Engineering, vol. 2, no. 2, pp. 23-23.
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Dysphagia affects many people worldwide. Modifying foods to standard consistencies, and manual design and assembly of foods for the daily requirements of people with dysphagia is challenging. People with dysphagia may develop a dislike for pureed foods due to the unattractiveness of the appearance of the foods, the lack of variety in daily meals, and the diluted taste of meals. Three-dimensional (3D) food printing is emerging as a method for making foods for people with special mealtime needs. Very few efforts have been made to apply 3D food printing to improving the lives of people with special mealtime needs such as those with dysphagia. This paper presents the design and 3D printing of visually appetizing pureed foods for people with dysphagia with high consistency and repeatability. A tuna fish involving pureed tuna (protein), pureed pumpkin (fruit), and pureed beetroot (vegetable) is designed and then 3D printed. The steps involved in the design of tuna fish, preparation of purees, and printing of tuna fish are described. The obtained results are presented, and the findings of this research work are discussed.

Kunin, M, Turbitt, E, Gafforini, SA, Sanci, LA, Spike, NA & Freed, GL 2017, 'Parental preferences for paediatric specialty follow-up care', Australian Health Review, vol. 41, no. 4, pp. 401-401.
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Objective The aim of the present study was to examine factors associated with: (1) parental preference to receive follow-up care for their child from a general practitioner (GP); and (2) a decision to seek treatment when there is a slight worsening of their child’s condition. Methods Parents presenting with their child at any one of five paediatric out-patient clinics at two public hospitals in Melbourne (Vic., Australia) were surveyed. We performed frequency distributions, bivariate analyses and multivariate logistic regression to evaluate associations with the preference for a GP for follow-up care and treatment in case of a slight worsening. Results In all, 606 parents were recruited to the study, 283 being new presentations and 323 presenting for review. GPs were selected as the preference for follow-up care by 23% (n = 142) of respondents, and 26% (n = 160) reported they would seek treatment from a GP if the condition of their child were to worsen slightly. There was an increased likelihood to prefer a GP for follow-up care for new patients (odds ratio (OR) 3.10; 95% confidence interval (CI) 1.99–4.83), those attending general paediatrics clinic (OR 1.73; 95% CI 1.11–2.70), and parents with a lower level of education (OR 1.74; 95% CI 1.09–2.78). For review patients, if during the previous visit a paediatrician suggested follow-up with a GP, parents were more likely to prefer a GP as a follow-up provider (OR 6.70; 95% CI 3.42–13.10) and to seek treatment from a GP in case of a slight worsening (OR 1.86; 95% CI 1.03–3.37). Conclusion Most parents attending paediatric out-patient appointments prefer to return for follow-up care; however, a paediatrician’s advice may have an important role in return of paediatric patients to primary care. What is known about the topic? In Australia, there has been a growing concern regarding long waiting times for specialist consultations in out-patient clinics and difficulties with access for new patients. Thi...

Langdon, R, Seymour, K, Williams, T & Ward, PB 2017, 'Automatic attentional orienting to other people's gaze in schizophrenia', Quarterly Journal of Experimental Psychology, vol. 70, no. 8, pp. 1549-1558.
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Explicit tests of social cognition have revealed pervasive deficits in schizophrenia. Less is known of automatic social cognition in schizophrenia. We used a spatial orienting task to investigate automatic shifts of attention cued by another person's eye gaze in 29 patients and 28 controls. Central photographic images of a face with eyes shifted left or right, or looking straight ahead, preceded targets that appeared left or right of the cue. To examine automatic effects, cue direction was non-predictive of target location. Cue–target intervals were 100, 300, and 800 ms. In non-social control trials, arrows replaced eye-gaze cues. Both groups showed automatic attentional orienting indexed by faster reaction times (RTs) when arrows were congruent with target location across all cue–target intervals. Similar congruency effects were seen for eye-shift cues at 300 and 800 ms intervals, but patients showed significantly larger congruency effects at 800 ms, which were driven by delayed responses to incongruent target locations. At short 100-ms cue–target intervals, neither group showed faster RTs for congruent than for incongruent eye-shift cues, but patients were significantly slower to detect targets after direct-gaze cues. These findings conflict with previous studies using schematic line drawings of eye-shifts that have found automatic attentional orienting to be reduced in schizophrenia. Instead, our data indicate that patients display abnormalities in responding to gaze direction at various stages of gaze processing—reflected by a stronger preferential capture of attention by another person's direct eye contact at initial stages of gaze processing and difficulties disengaging from a gazed-at location once shared attention is established.

Law, T, Packman, A, Onslow, M, To, CK-S, Tong, MC-F & Lee, KY-S 2017, 'The Topography of Stuttering in Cantonese', Folia Phoniatrica et Logopaedica, vol. 69, no. 3, pp. 110-117.
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<b><i>Objective:</i></b> This is the first study to investigate the behavioral nature (topography) of stuttering in Cantonese. Cantonese, a Sino-Tibetan language, is both tonal and syllable-timed. Previous studies of stuttering topography have mainly been in Western languages, which are mainly stress-timed. <b><i>Methods:</i></b> Conversational speech samples were collected from 24 native Cantonese-speaking adults who stuttered. Six consecutive stuttering moments from each participant were analyzed using the Lidcombe behavioral data language (LBDL). A complexity analysis based on the LBDL was developed to indicate the proportion of multiple-behavior stuttering moments for each participant. <b><i>Results:</i></b> There was no significant difference in the frequency of the 7 LBDL behaviors. Almost half the stuttering moments across participants were reported as complex, containing more than 1 stuttering behavior, and stuttering complexity correlated significantly with stuttering severity. <b><i>Conclusions:</i></b> These preliminary findings require replication because of their important theoretical and clinical implications. Differences in topography across languages have the potential to contribute to our understanding of the nature of stuttering. Clinically, the recognition of such differences may assist practitioners in identifying stuttering, for example when screening for early stuttering. The LBDL complexity score developed in this study has the potential to be used in other languages.

Lawless, M, Hodge, C, Reich, J, Levitz, L, Bhatt, UK, McAlinden, C, Roberts, K & Roberts, TV 2017, 'Visual and refractive outcomes following implantation of a new trifocal intraocular lens', Eye and Vision, vol. 4, no. 1, p. 10.
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Independence from all optical aids, and freedom from unwanted symptoms, following cataract and lens surgery remains the ultimate goal of both patient and surgeon. The development of trifocal IOL technology provides an ever-increasing range of options. The purpose of our study is to understand the predictability, safety and efficacy of a new trifocal intraocular lens (IOL) following cataract or refractive lens exchange (RLE) surgery.This was a retrospective consecutive case series of patients undergoing cataract extraction or RLE followed by implantation of the Alcon IQ Panoptix IOL. Pre and postoperative refractive and visual parameters were recorded and evaluated. As the cohort followed a normal distribution, standard parametric tests were used. Paired t-test was used to compare the difference between target and postoperative refractive errors. The incidence of intraoperative and postoperative complications was also reported.The IOL was implanted in 66 eyes of 33 patients. Mean postoperative spherical equivalent (SE) refraction was -0.08 ± 0.25 dioptres (D). This was not significantly different from the target refraction (p = 0.841). Sixty-five percent of patients were within ± 0.25 D of the target SE refraction with 100% within ± 0.50 D of intended correction. Mean postoperative uncorrected distance visual acuity (UDVA) was 0.01 ± 0.10 LogMAR. All patients achieved an unaided distance acuity of 20/40 or better postoperatively. Binocularly, 100% saw 0.20 LogMAR or better at near without correction and 88.9% achieved this level for uncorrected intermediate visual acuity. No intraoperative complications were noted. Five patients complained of moderate haloes in the early postoperative period.The AcrySof IQ Panoptix IOL provides functional uncorrected visual acuity at distance, intermediate and near positions. Our results remain equivalent with existing trifocal IOL outcomes and provide surgeons with a further IOL alternative for the patient motivated to obtain tru...

Lawless, M, Levitz, L & Hodge, C 2017, 'Reviewing the visual benefits of femtosecond laser-assisted cataract surgery: Can we improve our outcomes?', Indian Journal of Ophthalmology, vol. 65, no. 12, pp. 1314-1314.
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© 2017 Indian Journal of Ophthalmology. Femtosecond laser-Assisted cataract surgery (FLACS) was introduced in 2009 and has increasingly been incorporated into surgical practice. The automation of three key aspects of cataract surgery was expected to deliver a significant improvement in both refractive and safety outcomes. The published literature has not yet shown consistent refractive improvement above conventional techniques. The purpose of this paper is to review current FLACS refractive outcomes and explore factors that may have contributed to the current findings and whether future improvements are possible.

Lenander, C, Midlöv, P, Viberg, N, Chalmers, J, Rogers, K & Bondesson, Å 2017, 'Use of Antipsychotic Drugs by Elderly Primary Care Patients and the Effects of Medication Reviews: A Cross-Sectional Study in Sweden', Drugs - Real World Outcomes, vol. 4, no. 3, pp. 159-165.
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BACKGROUND: Antipsychotics form a class of drugs that should be used with caution among elderly people because of a high risk of adverse events. Despite the risks and modest effects, their use is estimated to be high, especially in nursing homes. OBJECTIVE: The aim was to explore the effects of medication reviews on antipsychotic drug use for elderly primary care patients and describe the extent of, and reasons for, the prescription of antipsychotics. METHODS: In this cross-sectional study in primary care in Skåne, Sweden, patients aged ≥75 years living in nursing homes or in their own homes with home care were included. The effects of medication reviews were documented, as were the use of antipsychotics and the differences in characteristics between patients receiving or not receiving antipsychotics. RESULTS: A total of 1683 patients aged 87.6 (±5.7) years were included in the analysis. Medication reviews reduced the use of antipsychotics by 23% (p < 0.001) in this study. Of the 206 patients using antipsychotics, 43% (n = 93) had an approved indication, while for 15% (n = 32) the indication was not given. Antipsychotic drug use was more common with increasing number of drugs (p = 0.001), and in nursing home residents (p < 0.01). It was also more frequent in patients with cognitive impairment, depressive symptoms or sleeping problems. CONCLUSION: The use of antipsychotic drugs is high in elderly patients in nursing homes. They are often given for indications that are not officially approved or are poorly documented. Medication reviews appear to offer one useful strategy for reducing excessive use of these drugs.

Lowe, R, Helgadottir, F, Menzies, R, Heard, R, O'Brian, S, Packman, A & Onslow, M 2017, 'Safety Behaviors and Stuttering', Journal of Speech, Language, and Hearing Research, vol. 60, no. 5, pp. 1246-1253.
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Purpose Those who are socially anxious may use safety behaviors during feared social interactions to prevent negative outcomes. Safety behaviors are associated with anxiety maintenance and poorer treatment outcomes because they prevent fear extinction. Social anxiety disorder is often comorbid with stuttering. Speech pathologists reported in a recent publication (Helgadottir, Menzies, Onslow, Packman, & O'Brian, 2014a) that they often recommended procedures for clients that could be safety behaviors. This study investigated the self-reported use of safety behaviors by adults who stutter. Method Participants were 133 adults who stutter enrolled in an online cognitive-behavior therapy program. Participants completed a questionnaire about their use of potential safety behaviors when anxious during social encounters. Correlations were computed between safety behaviors and pretreatment scores on measures of fear of negative evaluation and negative cognitions. Results Of 133 participants, 132 reported that they used safety behaviors. Many of the safety behaviors correlated with higher scores for fear of negative evaluation and negative cognitions. Conclusions Adults who stutter report using safety behaviors, and their use is associated with pretreatment fear of negative evaluation and unhelpful thoughts about stuttering. These results suggest that the negative effects of safety behaviors may extend to those who stutter, and further research is needed.

Ludemann, A, Power, E & Hoffmann, TC 2017, 'Investigating the Adequacy of Intervention Descriptions in Recent Speech-Language Pathology Literature: Is Evidence From Randomized Trials Useable?', American Journal of Speech-Language Pathology, vol. 26, no. 2, pp. 443-455.
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Purpose To evaluate the completeness of intervention descriptions in recent randomized controlled trials of speech-language pathology treatments. Method A consecutive sample of entries on the speechBITE database yielded 129 articles and 162 interventions. Interventions were rated using the Template for Intervention Description and Replication (TIDieR) checklist. Rating occurred at 3 stages: interventions as published in the primary article, secondary locations referred to by the article (e.g., protocol papers, websites), and contact with corresponding authors. Results No interventions were completely described in primary publications or after analyzing information from secondary locations. After information was added from correspondence with authors, a total of 28% of interventions was rated as complete. The intervention elements with the most information missing in the primary publications were tailoring and modification of interventions (in 25% and 13% of articles, respectively) and intervention materials and where they could be accessed (18%). Elements that were adequately described in most articles were intervention names (in 100% of articles); rationale (96%); and details of the frequency, session duration, and length of interventions (69%). Conclusions Clinicians and researchers are restricted in the usability of evidence from speech-language pathology randomized trials because of poor reporting of elements essential to the replication of interventions.

Lyell, D, Magrabi, F, Raban, MZ, Pont, LG, Baysari, MT, Day, RO & Coiera, E 2017, 'Automation bias in electronic prescribing', BMC Medical Informatics and Decision Making, vol. 17, no. 1, pp. 1-10.
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© 2017 The Author(s). Background: Clinical decision support (CDS) in e-prescribing can improve safety by alerting potential errors, but introduces new sources of risk. Automation bias (AB) occurs when users over-rely on CDS, reducing vigilance in information seeking and processing. Evidence of AB has been found in other clinical tasks, but has not yet been tested with e-prescribing. This study tests for the presence of AB in e-prescribing and the impact of task complexity and interruptions on AB. Methods: One hundred and twenty students in the final two years of a medical degree prescribed medicines for nine clinical scenarios using a simulated e-prescribing system. Quality of CDS (correct, incorrect and no CDS) and task complexity (low, low + interruption and high) were varied between conditions. Omission errors (failure to detect prescribing errors) and commission errors (acceptance of false positive alerts) were measured. Results: Compared to scenarios with no CDS, correct CDS reduced omission errors by 38.3% (p < .0001, n = 120), 46.6% (p < .0001, n = 70), and 39.2% (p < .0001, n = 120) for low, low + interrupt and high complexity scenarios respectively. Incorrect CDS increased omission errors by 33.3% (p < .0001, n = 120), 24.5% (p < .009, n = 82), and 26.7% (p < .0001, n = 120). Participants made commission errors, 65.8% (p < .0001, n = 120), 53.5% (p < .0001, n = 82), and 51.7% (p < .0001, n = 120). Task complexity and interruptions had no impact on AB. Conclusions: This study found evidence of AB omission and commission errors in e-prescribing. Verification of CDS alerts is key to avoiding AB errors. However, interventions focused on this have had limited success to date. Clinicians should remain vigilant to the risks of CDS failures and verify CDS.

Maas, ET, Juch, JNS, Ostelo, RWJG, Groeneweg, JG, Kallewaard, JW, Koes, BW, Verhagen, AP, Huygen, FJPM & van Tulder, MW 2017, 'Systematic review of patient history and physical examination to diagnose chronic low back pain originating from the facet joints', European Journal of Pain, vol. 21, no. 3, pp. 403-414.
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AbstractPatient history and physical examination are frequently used procedures to diagnose chronic low back pain (CLBP) originating from the facet joints, although the diagnostic accuracy is controversial. The aim of this systematic review is to determine the diagnostic accuracy of patient history and/or physical examination to identify CLBP originating from the facet joints using diagnostic blocks as reference standard. We searched MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane Collaboration database from inception until June 2016. Two review authors independently selected studies for inclusion, extracted data and assessed the risk of bias. We calculated sensitivity and specificity values, with 95% confidence intervals (95% CI). Twelve studies were included, in which 129 combinations of index tests and reference standards were presented. Most of these index tests have only been evaluated in single studies with a high risk of bias. Four studies evaluated the diagnostic accuracy of the Revel's criteria combination. Because of the clinical heterogeneity, results were not pooled. The published sensitivities ranged from 0.11 (95% CI 0.02–0.29) to 1.00 (95% CI 0.75–1.00), and the specificities ranged from 0.66 (95% CI 0.46–0.82) to 0.91 (95% CI 0.83–0.96). Due to clinical heterogenei...

Malet-Larrea, A, Goyenechea, E, Gastelurrutia, MA, Calvo, B, García-Cárdenas, V, Cabases, JM, Noain, A, Martínez-Martínez, F, Sabater-Hernández, D & Benrimoj, SI 2017, 'Cost analysis and cost-benefit analysis of a medication review with follow-up service in aged polypharmacy patients', The European Journal of Health Economics, vol. 18, no. 9, pp. 1069-1078.
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BACKGROUND: Drug related problems have a significant clinical and economic burden on patients and the healthcare system. Medication review with follow-up (MRF) is a professional pharmacy service aimed at improving patient's health outcomes through an optimization of the medication. OBJECTIVE: To ascertain the economic impact of the MRF service provided in community pharmacies to aged polypharmacy patients comparing MRF with usual care, by undertaking a cost analysis and a cost-benefit analysis. METHODS: The economic evaluation was based on a cluster randomized controlled trial. Patients in the intervention group (IG) received the MRF service and the comparison group (CG) received usual care. The analysis was conducted from the national health system (NHS) perspective over 6 months. Direct medical costs were included and expressed in euros at 2014 prices. Health benefits were estimated by assigning a monetary value to the quality-adjusted life years. One-way deterministic sensitivity analysis was undertaken in order to analyse the uncertainty. RESULTS: The analysis included 1403 patients (IG: n = 688 vs CG: n = 715). The cost analysis showed that the MRF saved 97 € per patient in 6 months. Extrapolating data to 1 year and assuming a fee for service of 22 € per patient-month, the estimated savings were 273 € per patient-year. The cost-benefit ratio revealed that for every 1 € invested in MRF, a benefit of 3.3 € to 6.2 € was obtained. CONCLUSION: The MRF provided health benefits to patients and substantial cost savings to the NHS. Investment in this service would represent an efficient use of healthcare resources.

Malipeddi, VR, Awasthi, R, Ghisleni, DDM, de Souza Braga, M, Kikuchi, IS, de Jesus Andreoli Pinto, T & Dua, K 2017, 'Preparation and characterization of metoprolol tartrate containing matrix type transdermal drug delivery system', Drug Delivery and Translational Research, vol. 7, no. 1, pp. 66-76.
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© 2016, Controlled Release Society. The present study aimed to develop matrix-type transdermal drug delivery system (TDDS) of metoprolol tartrate using polyvinyl pyrrolidone (PVP) and polyvinyl alcohol (PVA). The transdermal films were evaluated for physical parameters, Fourier transform infrared spectroscopy analysis (FTIR), differential scanning calorimetry (DSC), in vitro drug release, in vitro skin permeability, skin irritation test and stability studies. The films were found to be tough, non-sticky, easily moldable and possess good tensile strength. As the concentration of PVA was increased, the tensile strength of the films was also increased. Results of FTIR spectroscopy and DSC revealed the absence of any drug-polymer interactions. In vitro release of metoprolol followed zero-order kinetics and the mechanism of release was found to be diffusion rate controlled. In vitro release studies of metoprolol using Keshary-Chein (vertical diffusion cell) indicated 65.5 % drug was released in 24 h. In vitro skin permeation of metoprolol transdermal films showed 58.13 % of the drug was released after 24 h. In vitro skin permeation of metoprolol followed zero-order kinetics in selected formulations. The mechanism of release was found to be diffusion rate controlled. In a 22-day skin irritation test, tested formulation of transdermal films did not exhibit any allergic reactions, inflammation, or contact dermatitis. The transdermal films showed good stability in the 180-day stability study. It can be concluded that the TDDS of MPT can help in bypassing the first-pass effect and will provide patient improved compliance, without sacrificing the therapeutic advantages of the drugs.

Martin, AI, Devasahayam, R, Hodge, C, Cooper, S & Sutton, GL 2017, 'Analysis of the learning curve for pre‐cut corneal specimens in preparation for lamellar transplantation: a prospective, single‐centre, consecutive case series prepared at the Lions New South Wales Eye Bank', Clinical & Experimental Ophthalmology, vol. 45, no. 7, pp. 689-694.
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AbstractImportanceThis study is the first paper to establish a learning curve by a single technician.BackgroundPreparation of pre‐cut corneal endothelial grafts commenced at Lions New South Wales Eye Bank in December 2014. The primary objective of this study was to review the safety and reliability of the preparation method during the first year of production.DesignThis is a hospital‐based, prospective case series.ParticipantsThere were 234 consecutive donor corneal lenticules.MethodsDonor lenticules were prepared by a single operator using a linear cutting microkeratome. Immediately prior to cutting, central corneal thickness values were recorded. Measurements of the corneal bed were taken immediately following lenticule preparation. Outcomes were separated by blade sizes, and intended thickness was compared to actual thickness for each setting. Early specimens were compared to later ones to assess for a learning curve within the technique.Main Outcome MeasureThe main parameter measured is the mean difference from intended lamellar cut thickness.ResultsThe mean final cut thickness was 122.36 ± 20.35 μm, and the mean difference from intended cut was 30.17 ± 37.45 μm. No significant difference was found between results achieved with early specimens versus those achieved with later specimens (P = 0.425).Conclusions and RelevanceThin, reproducible endothelial grafts can routinely be produced by trained t...

Matsos, A, Loomes, M, Zhou, I, Macmillan, E, Sabel, I, Rotziokos, E, Beckwith, W & Johnston, IN 2017, 'Chemotherapy-induced cognitive impairments: White matter pathologies', Cancer Treatment Reviews, vol. 61, pp. 6-14.
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McCarthy, S, Meredith, J, Bryant, L & Hemsley, B 2017, 'Legal and Ethical Issues Surrounding Advance Care Directives in Australia: Implications for the Advance Care Planning Document in the Australian My Health Record.', J Law Med, vol. 25, no. 1, pp. 136-149.
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This article reviews legal and scientific literature relating to Advance Care Planning (ACP) and Advance Care Directives (ACDs) in Australia, for information about (a) opportunities or benefits of ACP and ACDs and (b) risks, barriers or difficulties in relation to ACP and ACDs. These are discussed in relation to

Meyer, SE, Yamato, TP & Saragiotto, BT 2017, 'Knee injury and ACL tear prevention programmes (PEDro synthesis)', British Journal of Sports Medicine, vol. 51, no. 15, pp. 1161-1162.
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Morgan, C, Mason, E, Newby, JM, Mahoney, AEJ, Hobbs, MJ, McAloon, J & Andrews, G 2017, 'The effectiveness of unguided internet cognitive behavioural therapy for mixed anxiety and depression', Internet Interventions, vol. 10, pp. 47-53.
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© 2017 The Authors Clinician-guided internet-delivered cognitive behavioral therapy (iCBT) is an effective treatment for depression and anxiety disorders. However, few studies have examined the effectiveness of completely unguided iCBT. The current research investigated adherence to, and the effects of two brief unguided iCBT programs on depression and anxiety symptom severity, and psychological distress. Study 1 evaluated a four-lesson transdiagnostic iCBT program for anxiety and depression (N = 927). Study 2 then evaluated a three-lesson version of the same program (N = 5107) in order to determine whether reducing the duration of treatment would influence adherence and treatment effects. Cross-tabulations and independent t-tests were used to examine the extent to which users adhered and remitted with treatment. Linear mixed models were used to evaluate the effects of treatment in the entire sample, and stratified by gender and completer-type (e.g., users who completed some but not all lessons vs. those who completed all lessons of treatment). Among those who began treatment, 13.83% completed all four lessons in Study 1. Shortening the course to three lessons did not improve adherence (e.g., 13.11% in Study 2). In both studies, users, on average, experienced moderate to large effect size reductions in anxiety and depressive symptom severity, as well as psychological distress. This pattern of results was robust across gender and for those who did and did not complete treatment. Approximately two-thirds of those who completed treatment experienced remission. These data show that unguided iCBT programs, which have the capacity to attract large numbers of individuals with clinically significant symptoms of depression and anxiety, and psychological distress, can produce significant improvements in wellbeing.

Morris, R, Eccles, A, Ryan, B & Kneebone, II 2017, 'Prevalence of anxiety in people with aphasia after stroke', Aphasiology, vol. 31, no. 12, pp. 1410-1415.
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© 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Background: Anxiety is common after stroke and is associated with poorer recovery. People with aphasia after stroke are typically excluded from studies of anxiety prevalence and so the number of those affected is unclear. Aims: To make a preliminary estimate of the prevalence of significant anxiety in people with aphasia after stroke. Methods & Procedures: Carers to community-dwelling people with aphasia after stroke, N = 111, completed the Behavioural Outcomes of Anxiety scale (BOA), a modified Hospital Anxiety and Depression Scale–Anxiety sub-scale (HADS-A), and a modified Generalised Anxiety Disorder-7 item (GAD-7) scale to determine the presence of significant anxiety in the person for whom they cared. Associates of anxiety in people with aphasia after stroke were also investigated. Outcomes & Results: The BOA identified 49 people (44%) as having significant anxiety. Findings for the HADS-A = 46 (41%) were similar; however, for the GAD-7, the rate was substantially lower = 18 (16%). Anxiety after stroke had a modest but significant association with younger age (all measures) and with the Frenchay Aphasia Severity Test scores (BOA and HADS-A only). Conclusions: The prevalence of anxiety in people with aphasia after stroke is high and likely higher than in those with stroke with no aphasia when measured using a validated tool for this population. Risk factors for anxiety appear to be severity of aphasia and younger age. This finding should be tempered by the fact that this is a preliminary study in a relatively small sample consisting of those attending stroke groups and the use of caregiver assessments may overestimate the prevalence of mood disorder.

Næss-Schmidt, ET, Blicher, JU, Eskildsen, SF, Tietze, A, Hansen, B, Stubbs, PW, Jespersen, S, Østergaard, L & Nielsen, JF 2017, 'Microstructural changes in the thalamus after mild traumatic brain injury: A longitudinal diffusion and mean kurtosis tensor MRI study', Brain Injury, vol. 31, no. 2, pp. 230-236.
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© 2017 Taylor & Francis Group, LLC. Primary objective: The primary aim of this study was to assess microstructural changes in the thalamus, hippocampus and corpus callosum with a fast mean kurtosis tensor (MKT) technique, in the acute and sub-acute phase after mTBI. It was hypothesized that MKT would differ between baseline and follow-up in patients. The secondary aim was to relate diffusion measures to symptoms of mTBI. Research design: A longitudinal case-control study. Methods and procedures: Twenty-seven patients with mTBI and 27 age- and gender-matched healthy controls were enrolled in the study. Patients were scanned within 2 weeks and 3 months after mTBI, while the controls were scanned once. Main outcomes and results: MKT decreased significantly (p = 0.02) from baseline to follow-up in the thalamus in patients. Compared to healthy subjects, thalamic MKT values were significantly larger in patients at baseline (p = 0.048). Secondary analysis revealed a significant decrease (p = 0.01) in fractional anisotropy in the splenium of corpus callosum from baseline to follow-up. Conclusions: The current study indicates microstructural changes in the thalamus and corpus callosum from within 14 days to 3 months after mTBI and suggests MKT as a potential biomarker after mTBI.

Næss-Schmidt, ET, Morthorst, M, Pedersen, AR, Nielsen, JF & Stubbs, PW 2017, 'Corticospinal excitability changes following blood flow restriction training of the tibialis anterior: a preliminary study', Heliyon, vol. 3, no. 1, pp. e00217-e00217.
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To examine the neural excitability of projections to the tibialis anterior (TA) following blood flow restriction training (BFRT). This is the first study to examine the TA following BFRT.Ten subjects performed each experiment. Experiment one consisted of BFRT at 130 mmHg (BFRT-low). Experiment two consisted of BFRT at 200 mmHg (BFRT-high), training (TR-only) and blood flow restriction at 200 mmHg (BFR-only) performed on separate days. Blood flow restriction was applied to the thigh and training consisted of rapid dorsiflexion contractions against gravity every 10 s for 15-min. The motor evoked potential (MEP) peak-to-peak amplitudes were recorded pre-intervention and 1-, 10-, 20- and 30-min post-intervention and expressed relative to the maximal peak-to-peak M-wave at each time-point.Experiment one revealed no difference in MEP amplitudes for BFRT-low over time (P = 0.09). Experiment two revealed a significant effect of time (P < 0.001), with 1-min post-intervention MEP amplitudes significantly facilitated compared to pre-intervention, but no effect of intervention (P = 0.79) or intervention*time interaction (P = 0.25). Post-hoc power calculations were performed for the intervention*time interaction.Corticospinal excitability of projections to the TA did not change following BFRT-low and corticospinal excitability changes between BFRT-high, BFR-only and TR-only interventions were not different over time. In experiment two, there was a significant main effect of time 1-min post-intervention which was mainly due to the BFRT-high intervention. Post-hoc power calculations revealed that 15 subjects were required for a significant interaction effect 80% of the time however, as the changes in corticospinal excitability were not prolonged, a new dataset of ≥ 15 subjects was not acquired.

Najdawi, F, Crook, A, Maidens, J, McEvoy, C, Fellowes, A, Pickett, J, Ho, M, Nevell, D, McIlroy, K, Sheen, A, Sioson, L, Ahadi, M, Turchini, J, Clarkson, A, Hogg, R, Valmadre, S, Gard, G, Dooley, SJ, Scott, RJ, Fox, SB, Field, M & Gill, AJ 2017, 'Lessons learnt from implementation of a Lynch syndrome screening program for patients with gynaecological malignancy', Pathology, vol. 49, no. 5, pp. 457-464.
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Newton-John, TRO, Ventura, AD, Mosely, K, Browne, JL & Speight, J 2017, '‘Are you sure you’re going to have another one of those?’: A qualitative analysis of the social control and social support models in type 2 diabetes', Journal of Health Psychology, vol. 22, no. 14, pp. 1819-1829.
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While there is evidence that spouses can impact the self-management of adults with type 2 diabetes mellitus, less is known about the influence of the wider social network. This qualitative study explored the perceived impact of the family as well as friends and work colleagues on type 2 diabetes mellitus self-management. A total of 25 adults with type 2 diabetes mellitus participated in semi-structured interviews regarding their social experiences of living with diabetes. Deductive thematic analysis was applied to the data. Pre-existing themes of health-related social control and social support were identified in the wider social network, with additional themes of non-involvement and unintentional undermining also emerging.

Nicholson perry, K, Donovan, M, Knight, R & Shires, A 2017, 'Addressing Professional Competency Problems in Clinical Psychology Trainees', Australian Psychologist, vol. 52, no. 2, pp. 121-129.
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© 2017 The Australian Psychological Society Objective: Clinical psychology trainees with problems of professional competence (PPC) continue to be a challenge for courses. Despite the rapid development of competency-based training models, the impact of this shift to the identification and management of professional competency problems is unclear. This project aims to describe how clinical psychology trainees with PPC are identified and managed within the Australian and New Zealand context. Method: An online survey was distributed through Australian and New Zealand universities offering clinical psychology training programmes. Questions addressed approaches to monitoring progress on placements, identification and management of trainees determined to be underperforming on placements, and the perceived usefulness of a range of strategies such as the use of standardised-rating tools. Results: Thirty one responses were received, representing 40 clinical psychology training courses in 22 institutions across Australia and New Zealand. In all cases, at least one trainee with a PPC had been detected in the previous 5 years, most commonly attributed to psychological, behavioural, and developmental issues. Respondents reported the use of a range of preventive and remedial strategies, including the use of psychometrically validated competency evaluation rating forms to assist in the grading of placements. Conclusion: Trainees with PPC occur on a fairly regular basis in clinical psychology training courses in Australian and New Zealand. While some processes involved in the identification and management of these students have been refined and systematised, some opportunities to facilitate early identification and remediation may yet need further enhancement.

Noain, A, Garcia-Cardenas, V, Gastelurrutia, MA, Malet-Larrea, A, Martinez-Martinez, F, Sabater-Hernandez, D & Benrimoj, SI 2017, 'Cost analysis for the implementation of a medication review with follow-up service in Spain', International Journal of Clinical Pharmacy, vol. 39, no. 4, pp. 750-758.
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Odgaard, L, Johnsen, SP, Stubbs, PW, Pedersen, AR & Nielsen, JF 2017, 'Alternative measures reveal different but low estimates of labour market attachment after severe traumatic brain injury: A nationwide cohort study', Brain Injury, vol. 31, no. 10, pp. 1298-1306.
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To explore if the definition of labour market attachment (LMA) changes LMA proportions after severe traumatic brain injury (TBI).Cohort study with 5-year follow-up.Patients aged 18-64 years with severe TBI from 2004 to 2012 (n = 637) and matched controls (n = 2497).LMA was defined in three ways. All definitions included patients working with no government benefits. Definition 2 included patients receiving unemployment benefits (LMA-unemployment benefits). Definition 3 included patients receiving supplemental benefits/services such as patients involved in work-activation schemes (LMA supplementary benefits). First week of return to work (RTW), stable LMA first year after RTW and weekly LMA prevalence were calculated. Patients and controls were compared using multivariable conditional logistic regression.LMA unemployment benefits had similar proportions to LMA with no benefits. These estimates were lower than LMA supplemental benefits where 52% attempted to RTW and 31% achieved stable LMA within 2 years. The maximal LMA prevalence (LMA supplementary benefits) decreased from 33 to 30% from years 2 to 5. Adjusted odds ratios were 0.05 and 0.06 for years 1 and 2, and 0.07 for stable LMA in patients compared to controls.LMA proportions differed depending on the definition. Regardless of definition, LMA proportions following severe TBI were low in Denmark.

Palagyi, A, Keay, L & Rogers, K 2017, 'Depressive symptoms in older adults awaiting cataract surgery: methodological and statistical issues – response', Clinical & Experimental Ophthalmology, vol. 45, no. 8, pp. 841-842.
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Palagyi, A, Morlet, N, McCluskey, P, White, A, Meuleners, L, Ng, JQ, Lamoureux, E, Pesudovs, K, Stapleton, F, Ivers, RQ, Rogers, K & Keay, L 2017, 'Visual and refractive associations with falls after first-eye cataract surgery', Journal of Cataract and Refractive Surgery, vol. 43, no. 10, pp. 1313-1321.
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Purpose To clarify the effect of first-eye cataract surgery on the incidence of falls and identify components of visual function associated with fall risk. Setting Eight public hospital eye clinics in Sydney, Melbourne, and Perth, Australia. Design Prospective cohort study. Methods The study recruited patients who had bilateral cataract, were aged 65 years or older, and were on public hospital cataract surgery waiting lists. Comprehensive assessments of vision, physical function, and exercise activity were performed before and after first-eye cataract surgery. Falls were reported prospectively for up to 2 years and associations with falls were assessed using generalized linear mixed models. Results Of the 329 patients recruited, 196 (66.6%) completed first-eye surgery within the study period. First-eye cataract surgery reduced incident falls by 33% (adjusted incidence rate ratio 0.67; 95% confidence interval [CI], 0.49-0.92; P =.01). Poorer dominant-eye visual acuity was associated with falls during the study timeline (incidence rate ratio, 2.20; 95% CI, 1.02-4.74; P =.04). Patients with larger than a spherical equivalent of ±0.75 diopter change in the spectacle lens (operated eye) had a 2-fold greater incidence of falls in the period after first-eye cataract surgery than those with less or no change in lens power (incidence rate ratio, 2.17; 95% CI, 1.23-3.85; P =.008). Conclusions First-eye cataract surgery significantly reduced incident falls. Major changes in the dioptric power of spectacle correction of the operated eye after surgery increased the fall risk. Cautious postoperative refractive management is important to maximize the benefit of cataract surgery as a fall-prevention measure.

Palagyi, A, Ng, JQ, Rogers, K, Meuleners, L, McCluskey, P, White, A, Morlet, N & Keay, L 2017, 'Fear of falling and physical function in older adults with cataract: Exploring the role of vision as a moderator', Geriatrics & Gerontology International, vol. 17, no. 10, pp. 1551-1558.
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AimTo examine fear of falling and associated factors in a cohort of older adults with cataract, and investigate the interplay of vision and physical function with respect to fear of falling.MethodsWe analyzed baseline data from a longitudinal study of adults aged ≥65 years referred for cataract surgery. Fear of falling was assessed by the Short Falls Efficacy Scale‐International. Physical function was determined by the Short Physical Performance Battery. Participants underwent assessment of visual acuity, contrast sensitivity, visual disability, quality of life, depressive symptoms, exercise frequency, comorbidity and falls history. Factors associated with fear of falling were assessed using linear regression. Planned stepwise regression investigated vision as a potential moderator of the relationship between physical function and fear of falling.ResultsAmong 322 participants, 32.9 % (n = 106) showed high fear of falling. Poorer physical function, more comorbidities and greater visual disability were independently associated with a higher fear of falling (all P < 0.001). Visual disability moderated the relationship between physical function and fear of falling (β = −0.10, P = 0.04). The impact of physical function on fear of falling was strongest in participants with higher (+1 standard deviation above the mean) visual disability (b = −0.21, P < 0.001).ConclusionsFear of falling in older adults with cataract is greatest in those with poorer physical function and higher levels of visual disability. Perceived visual ability has a moderating role in the relationship between physical function and fear of falling; phys...

Panken, G, Verhagen, AP, Terwee, CB & Heymans, MW 2017, 'Clinical Prediction Models for Patients With Nontraumatic Knee Pain in Primary Care: A Systematic Review and Internal Validation Study', Journal of Orthopaedic & Sports Physical Therapy, vol. 47, no. 8, pp. 518-529.
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Study Design Systematic review and validation study. Background Many prognostic models of knee pain outcomes have been developed for use in primary care. Variability among published studies with regard to patient population, outcome measures, and relevant prognostic factors hampers the generalizability and implementation of these models. Objectives To summarize existing prognostic models in patients with knee pain in a primary care setting and to develop and internally validate new summary prognostic models. Methods After a sensitive search strategy, 2 reviewers independently selected prognostic models for patients with nontraumatic knee pain and assessed the methodological quality of the included studies. All predictors of the included studies were evaluated, summarized, and classified. The predictors assessed in multiple studies of sufficient quality are presented in this review. Using data from the Musculoskeletal System Study (BAS) cohort of patients with a new episode of knee pain, recruited consecutively by Dutch general medical practitioners (n = 372), we used predictors with a strong level of evidence to develop new prognostic models for each outcome measure and internally validated these models. Results Sixteen studies were eligible for inclusion. We considered 11 studies to be of sufficient quality. None of these studies validated their models. Five predictors with strong evidence were related to function and 6 to recovery, and were used to compose 2 prognostic models for patients with knee pain at 1 year. Running these new models in another data set showed explained variances (R2) of 0.36 (function) and 0.33 (recovery). The area under the curve of the recovery model was 0.79. After internal validation, the adjusted R2 values of the models were 0.30 (function) and 0.20 (recovery), and the area under the curve was 0.73. Conclusion We developed 2 valid prognostic models for function and recovery for patients with nontraumatic knee pain, based on predictor...

Panth, N, Manandhar, B & Paudel, KR 2017, 'Anticancer Activity ofPunica granatum(Pomegranate): A Review', Phytotherapy Research, vol. 31, no. 4, pp. 568-578.
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Copyright © 2017 John Wiley & Sons, Ltd. Cancer is a pathological condition where excessive and abnormal cell growth leads to widespread invasion within the body to affect various organ functions. It is known that chemotherapeutic agents are themselves possible candidate of cancer generation as they can kill normal cells. So, therapeutic approach for cancer treatment and prevention is weighed in terms of benefit to risk ratio. Nowadays, there is an immense interest for the search herbal formulation with cancer preventive effect because of the problems, generated with existing chemotherapeutic regimens. Research interest in fruits rich in polyphenols is increasing because of their anticancer potential. In this review, we highlight the potential health benefits of pomegranate (Punica granatum) fruit and the underlying mechanism of its inhibition of cancer progression. Pomegranate has demonstrated anti-proliferative, anti-metastatic and anti-invasive effects on various cancer cell line in vitro as well as in vivo animal model or human clinical trial. Although several clinical trials are in progress for identifying the pomegranate as a candidate for various cancer treatment. It is necessary to replicate and validate its therapeutic efficacy by multiple clinical studies in order to formulate pomegranate products as an integral part of the dietary and pharmacological intervention in anticancer therapy. Copyright © 2017 John Wiley & Sons, Ltd.

Patel, VK, Williams, H, Li, SCH, Fletcher, JP & Medbury, HJ 2017, 'Monocyte inflammatory profile is specific for individuals and associated with altered blood lipid levels', Atherosclerosis, vol. 263, pp. 15-23.
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Peng, Y, Du, X, Rogers, KD, Wu, Y, Gao, R & Patel, A 2017, 'Predicting In-Hospital Mortality in Patients With Acute Coronary Syndrome in China', The American Journal of Cardiology, vol. 120, no. 7, pp. 1077-1083.
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© 2017 Elsevier Inc. Currently available risk scores (RSs) were derived from populations with very few participants from China. We aimed to develop an RS based on data from patients with acute coronary syndrome in China and to compare its performance with the commonly promoted Global Registry of Acute Coronary Events (GRACE) RS. Clinical Pathways for Acute Coronary Syndromes—Phase 2 was a trial of a quality improvement intervention in China. Patients recruited from 75 hospitals from October 2007 to August 2010 were divided into training and validation sets based on immediate or delayed implementation. A Clinical Pathways for Acute Coronary Syndromes (CPACS) RS for in-hospital mortality was developed separately by gender, using the training set (6,790 patients). Discrimination and calibration of the CPACS RS and GRACE RS were compared on the validation set (3,801 patients). Although discrimination of the GRACE RS was acceptable, this was improved with the CPACS RS (c-statistic 0.82 vs 0.87, p = 0.012 for men; c-statistic 0.78 vs 0.85, p = 0.006 for women). The absolute bias was significantly lower with CPACS RS for both genders (7.6% vs 97.5% in men and 21.5% vs 77.2% in women), compared with the GRACE RS, which systematically overestimated risk. The CPACS RS underestimated risk in women, but only in those already above threshold levels currently used to define a clinical high-risk population. In conclusion, the GRACE RS substantially overestimates the risk of in-hospital death in patients presenting to the hospital with a suspected acute coronary syndrome in China. We have developed and independently validated a new RS utilizing data from Chinese patients.

Petersen, KS, Johnson, C, Mohan, S, Rogers, K, Shivashankar, R, Thout, SR, Gupta, P, He, FJ, MacGregor, GA, Webster, J, Santos, JA, Krishnan, A, Maulik, PK, Reddy, KS, Gupta, R, Prabhakaran, D & Neal, B 2017, 'Estimating population salt intake in India using spot urine samples', Journal of Hypertension, vol. 35, no. 11, pp. 2207-2213.
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Objective: To compare estimates of mean population salt intake in North and South India derived from spot urine samples versus 24-h urine collections. Methods: In a cross-sectional survey, participants were sampled from slum, urban and rural communities in North and in South India. Participants provided 24-h urine collections, and random morning spot urine samples. Salt intake was estimated from the spot urine samples using a series of established estimating equations. Salt intake data from the 24-h urine collections and spot urine equations were weighted to provide estimates of salt intake for Delhi and Haryana, and Andhra Pradesh. Results: A total of 957 individuals provided a complete 24-h urine collection and a spot urine sample. Weighted mean salt intake based on the 24-h urine collection, was 8.59 (95% confidence interval 7.73-9.45) and 9.46 g/day (8.95-9.96) in Delhi and Haryana, and Andhra Pradesh, respectively. Corresponding estimates based on the Tanaka equation [9.04 (8.63-9.45) and 9.79 g/day (9.62-9.96) for Delhi and Haryana, and Andhra Pradesh, respectively], the Mage equation [8.80 (7.67-9.94) and 10.19 g/day (95% CI 9.59-10.79)], the INTERSALT equation [7.99 (7.61-8.37) and 8.64 g/day (8.04-9.23)] and the INTERSALT equation with potassium [8.13 (7.74-8.52) and 8.81 g/day (8.16-9.46)] were all within 1 g/day of the estimate based upon 24-h collections. For the Toft equation, estimates were 1-2 g/day higher [9.94 (9.24-10.64) and 10.69 g/day (9.44-11.93)] and for the Kawasaki equation they were 3-4 g/day higher [12.14 (11.30-12.97) and 13.64 g/day (13.15-14.12)]. Conclusion: In urban and rural areas in North and South India, most spot urine-based equations provided reasonable estimates of mean population salt intake. Equations that did not provide good estimates may have failed because specimen collection was not aligned with the original method.

Phillips, J, Yu, D, Poon, SK, Lam, M, Hines, M, Brunner, M, Keep, M, Power, E, Shaw, T & Togher, L 2017, 'E-Health Readiness for Teams: A Comprehensive Conceptual Model.', Stud Health Technol Inform, vol. 239, pp. 119-125.
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The use of information technology in the delivery of healthcare services is pervasive but faces many barriers. We propose a four-factor comprehensive conceptual model to provide a measure of interdisciplinary healthcare readiness to provide healthcare services using e-health. We incorporate factors from a series of focus group studies and the wider literature and construct a conceptual model. We utilise the Delphi method to establish content validity and use a series of Q sorts for initial construct validity. This model will improve patient outcomes through healthcare teams identifying barriers to using e-health effectively and efficiently.

Pillay, A, Trieu, K, Santos, J, Sukhu, A, Schultz, J, Wate, J, Bell, C, Moodie, M, Snowdon, W, Ma, G, Rogers, K & Webster, J 2017, 'Assessment of a Salt Reduction Intervention on Adult Population Salt Intake in Fiji', Nutrients, vol. 9, no. 12, pp. 1350-1350.
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© 2017 by the authors. Licensee MDPI, Basel, Switzerland. Reducing population salt intake is a global public health priority due to the potential to save lives and reduce the burden on the healthcare system through decreased blood pressure. This implementation science research project set out to measure salt consumption patterns and to assess the impact of a complex, multi-faceted intervention to reduce population salt intake in Fiji between 2012 and 2016. The intervention combined initiatives to engage food businesses to reduce salt in foods and meals with targeted consumer behavior change programs. There were 169 participants at baseline (response rate 28.2%) and 272 at 20 months (response rate 22.4%). The mean salt intake from 24-h urine samples was estimated to be 11.7 grams per day (g/d) at baseline and 10.3 g/d after 20 months (difference: −1.4 g/day, 95% CI −3.1 to 0.3, p = 0.115). Sub-analysis showed a statistically significant reduction in female salt intake in the Central Division but no differential impact in relation to age or ethnicity. Whilst the low response rate means it is not possible to draw firm conclusions about these changes, the population salt intake in Fiji, at 10.3 g/day, is still twice the World Health Organization’s (WHO) recommended maximum intake. This project also assessed iodine intake levels in women of child-bearing age and found that they were within recommended guidelines. Existing policies and programs to reduce salt intake and prevent iodine deficiency need to be maintained or strengthened. Monitoring to assess changes in salt intake and to ensure that iodine levels remain adequate should be built into future surveys.

Pont, LG 2017, 'Playing ball with the Red Sox: the 31^st International Conference on Phamacoepidemiology and Therapeutic Risk Management, Boston, USA', Journal of Pharmacy Practice and Research, vol. 47, no. 5, pp. 402-402.
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As a 2015 recipient of the Pfizer Pharmacy Grant, I attended the 31st International Conference on Phamacoepidemiology and Therapeutic Risk Management in Boston from August 21–26, 2015. The International Conference on Pharmacoepidemiology (ICPE) is the annual meeting of the International Society of Pharmacoepidemiology (ISPE) and alternates annually between North America and Europe. Approximately 1500 researchers, clinicians, regulators, policy makers and academics from around the world attended the conference. Prior to the main meeting, ISPE runs 2 days of pre‐conference educational courses in a number of specialty areas. I was involved in the Introduction to Drug Utilisation Research session, which introduced participants to the basic principles, methodologies, resources and use of drug utilisation research, including a session presented by the World Health Organization on their ATC/DDD (Anatomic Therapeutic Classification/Defined Daily Dose) methodology.1 I was also involved with colleagues from France and USA in a workshop on designing and conducting non‐database research where participants worked through a series of case studies to better understand the challenges of doing epidemiological research without large databases. Each day the conference ran multiple concurrent sessions, each with a different therapeutic or methodological focus. With my research interest, drug utilisation research among older persons, I was able to attend relevant and interesting sessions each day in the drug utilisation stream, which showcased international research. It was interesting to see that many of the issues we are struggling with around medication use among older persons are international challenges. One of the highlights of the meeting was the plenary session on ‘The eye of the beholder’, where adverse drug reactions were discussed from different perspectives, including those of a physician, the pharmaceutical industry, a lawyer, regulators and a patient. The patient ha...

Pont, LG, Morgan, TK, Williamson, M, Haaijer, FM & van Driel, ML 2017, 'Validity of prescribing indicators for assessing quality of antibiotic use in Australian general practice', International Journal of Pharmacy Practice, vol. 25, no. 1, pp. 66-74.
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© 2016 Royal Pharmaceutical Society Objectives: The aim of this study was to assess the validity of a set of European quality indicators for assessing antimicrobial prescribing in Australian General Practice. Methods: A modified UCLA/RAND appropriateness method was used to assess the validity of 30 antimicrobial prescribing indicators. An expert panel of 12 general practitioners scored the validity of each indicator for measuring quality in Australian general practice. Four quality domains were considered: monitoring antibiotic resistance, benefit to individual patients, value for money and value to policymakers. Panel members were also asked to comment on the relevance to the Australian context and proposed benchmarks for each indicator. Key findings: All panel members were in agreement regarding the validity of each indicator in each of the specified domains with exception of the indicator assessing the use of systemic antibiotics for pneumonia. The majority of the indicators and their associated benchmarks were considered valid for assessing quality in Australian General Practice, however, there were differences regarding the quality domain that each indicator was considered valid for. Monitoring quality considering individual patient benefit was the most problematic domain with respect to validity. Conclusions: This study demonstrates the validity of 30 European indicators for assessing quality of antimicrobial prescribing in general practice in a non-European setting and provides guidance regarding acceptable benchmarks for the indicators. With international concerns regarding misuse of antibiotics and global interest in prescribing quality, valid evidence-based antimicrobial prescribing indicators and associated benchmarks are an essential tool for assessing prescribing quality.

Psarakis, M, Greene, D, Moresi, M, Baker, M, Stubbs, P, Brodie, M, Lord, S & Hoang, P 2017, 'Impaired heel to toe progression during gait is related to reduced ankle range of motion in people with Multiple Sclerosis', Clinical Biomechanics, vol. 49, pp. 96-100.
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Gait impairment in people with Multiple Sclerosis results from neurological impairment, muscle weakness and reduced range of motion. Restrictions in passive ankle range of motion can result in abnormal heel-to-toe progression (weight transfer) and inefficient gait patterns in people with Multiple Sclerosis. The purpose of this study was to determine the associations between gait impairment, heel-to-toe progression and ankle range of motion in people with Multiple Sclerosis.Twelve participants with Multiple Sclerosis and twelve healthy age-matched participants were assessed. Spatiotemporal parameters of gait and individual footprint data were used to investigate group differences. A pressure sensitive walkway was used to divide each footprint into three phases (contact, mid-stance, propulsive) and calculate the heel-to-toe progression during the stance phase of gait.Compared to healthy controls, people with Multiple Sclerosis spent relatively less time in contact phase (7.8% vs 25.1%) and more time in the mid stance phase of gait (57.3% vs 33.7%). Inter-limb differences were observed in people with Multiple Sclerosis between the affected and non-affected sides for contact (7.8% vs 15.3%) and mid stance (57.3% and 47.1%) phases. Differences in heel-to-toe progression remained significant after adjusting for walking speed and were correlated with walking distance and ankle range of motion.Impaired heel-to-toe progression was related to poor ankle range of motion in people with Multiple Sclerosis. Heel-to-toe progression provided a sensitive measure for assessing gait impairments that were not detectable using standard spatiotemporal gait parameters.

Quel de Oliveira, C, Refshauge, K, Middleton, J, de Jong, L & Davis, GM 2017, 'Effects of Activity-Based Therapy Interventions on Mobility, Independence, and Quality of Life for People with Spinal Cord Injuries: A Systematic Review and Meta-Analysis', Journal of Neurotrauma, vol. 34, no. 9, pp. 1726-1743.
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Rietdijk, R, Power, E, Brunner, M & Togher, L 2017, 'Reliability of Videoconferencing Administration of a Communication Questionnaire to People With Traumatic Brain Injury and Their Close Others', Journal of Head Trauma Rehabilitation, vol. 32, no. 6, pp. E38-E44.
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Objectives: To compare in-person with videoconferencing administration of a communication questionnaire for people with traumatic brain injury (TBI) and their close others. Design: Repeated-measures design with randomized order of administration. Participants: Twenty adults with severe TBI and their close others. Methods: Both participants with TBI and their close others completed the La Trobe Communication Questionnaire (LCQ) via interview with a clinician, once via Skype and once during a home visit. Measures: Total LCQ score and time taken for completion. Results: There were no significant differences between videoconferencing and in-person conditions in the total scores or time taken to complete the questionnaire. Conclusions: Videoconferencing-based administration of the LCQ is as reliable and efficient as in-person administration.

Rogers, JM, Ferrari, M, Mosely, K, Lang, CP & Brennan, L 2017, 'Mindfulness‐based interventions for adults who are overweight or obese: a meta‐analysis of physical and psychological health outcomes', Obesity Reviews, vol. 18, no. 1, pp. 51-67.
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SummaryObjectiveThe aim of this study was to evaluate the impact of mindfulness‐based interventions on psychological and physical health outcomes in adults who are overweight or obese.MethodsWe searched 14 electronic databases for randomized controlled trials and prospective cohort studies that met eligibility criteria. Comprehensive Meta‐analysis software was used to compute the effect size estimate Hedge's g.ResultsFifteen studies measuring post‐treatment outcomes of mindfulness‐based interventions in 560 individuals were identified. The average weight loss was 4.2 kg. Overall effects were large for improving eating behaviours (g = 1.08), medium for depression (g = 0.64), anxiety (g = 0.62) and eating attitudes (g = 0.57) and small for body mass index (BMI; g = 0.47) and metacognition (g = 0.38) outcomes. Therapeutic effects for BMI (g = 0.43), anxiety (g = 0.53), eating attitudes (g = 0.48) and eating behaviours (g = 0.53) remained significant when examining results from higher quality randomized control trials alone. There was no efficacy advantage for studies exceeding the median dose of 12 h of face‐to‐face intervention. Studies utilizing an Acceptance and Commitment Therapy approach provided the only significant effect for improving BMI (g = 0.66), while mindfulness approaches produced great variation from small to large (

Santo, K, Chow, CK, Thiagalingam, A, Rogers, K, Chalmers, J & Redfern, J 2017, 'MEDication reminder APPs to improve medication adherence in Coronary Heart Disease (MedApp-CHD) Study: a randomised controlled trial protocol', BMJ Open, vol. 7, no. 10, pp. e017540-e017540.
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IntroductionThe growing number of smartphone health applications available in the app stores makes these apps a promising tool to help reduce the global problem of non-adherence to long-term medications. However, to date, there is limited evidence that available medication reminder apps are effective. This study aims to determine the impact of medication reminder apps on adherence to cardiovascular medication when compared with usual care for people with coronary heart disease (CHD) and to determine whether an advanced app compared with a basic app is associated with higher adherence.Methods and analysisRandomised controlled trial with follow-up at 3 months to evaluate the feasibility and effectiveness of medication reminder apps on medication adherence compared with usual care. An estimated sample size of 156 patients with CHD will be randomised to one of three groups (usual care group, basic medication reminder app group and advanced medication reminder app group). The usual care group will receive standard care for CHD with no access to a medication reminder app. The basic medication reminder app group will have access to a medication reminder app with a basic feature of providing simple daily reminders with no interactivity. The advanced medication reminder app group will have access to a medication reminder app with additional interactive and customisable features. The primary outcome is medication adherence measured by the eight-item Morisky Medication Adherence Scale at 3 months. Secondary outcomes include clinical measurements of blood pressure and cholesterol levels, and medication knowledge. A process evaluation will also be performed to assess the feasibility of the intervention by evaluating the acceptability, utility and engagement with the apps.Ethics and disseminationEthic...

Saragiotto, BT, Maher, CG, Hancock, MJ & Koes, BW 2017, 'Subgrouping Patients With Nonspecific Low Back Pain: Hope or Hype?', Journal of Orthopaedic & Sports Physical Therapy, vol. 47, no. 2, pp. 44-48.
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Saragiotto, BT, Maher, CG, Traeger, AC, Li, Q & McAuley, JH 2017, 'Dispelling the myth that chronic pain is unresponsive to treatment', British Journal of Sports Medicine, vol. 51, no. 13, pp. 986-988.
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Seymour, K, Rhodes, G, McGuire, J, Williams, N, Jeffery, L & Langdon, R 2017, 'Assessing early processing of eye gaze in schizophrenia: measuring the cone of direct gaze and reflexive orienting of attention', Cognitive Neuropsychiatry, vol. 22, no. 2, pp. 122-136.
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Shariflou, S, Georgevsky, D, Mansour, H, Rezaeian, M, Hosseini, N, Gani, F, Gupta, V, Braidy, N & Golzan, SM 2017, 'Diagnostic and Prognostic Potential of Retinal Biomarkers in Early On-Set Alzheimer’s Disease', Current Alzheimer Research, vol. 14, no. 9, pp. 1000-1007.
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© 2017 Bentham Science Publishers. Objective: Accumulating evidence suggests that the eye can be used in the assessment of early on-set Alzheimer’s disease (AD). The eye offers a natural window to the brain through the retina. The retina and brain share common developmental origins and patho-physiological origins and mechanisms, having been sequestered from it during early development, but retaining its connections with the brain via the optic nerve. Therefore, it is well understood that neurological abnormalities have a direct profound impact on the retina. Recent studies suggest an array of physiological and pathological changes in the retina in dementia and specifically in AD. There are also reports on imaging the two hallmark proteins of the disease, extracellular amyloid beta peptides and intracellular hyper phosphorylated tau protein, as a proxy to neuroimaging. Results: In this review, we summarise retinal structural, functional and vascular changes reported to be associated with AD. We also review techniques employed to image these two major hall mark proteins of AD and their relevance for early detection of AD.

Sharma, S, Pathak, S, Gupta, G, Sharma, SK, Singh, L, Sharma, RK, Mishra, A & Dua, K 2017, 'Pharmacological evaluation of aqueous extract of syzigium cumini for its antihyperglycemic and antidyslipidemic properties in diabetic rats fed a high cholesterol diet—Role of PPARγ and PPARα', Biomedicine & Pharmacotherapy, vol. 89, pp. 447-453.
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© 2017 Elsevier Masson SAS In India syzygium cumini (Myrtaceae) is commonly used traditional medicine to treat diabetes. The present study was undertaken to assess an investigation of antihyperglycemic and antidyslipidemic properties of aqueous extract of Syzigium Cumini (SC) in diabetic rats fed a high cholesterol diet. The aqueous extract of SC was screened for antihyperglycemic and antidyslipidemic activity by streptozotocin induced diabetes in rats. Animals were treated with 100, 200 and 400 mg/kg body weight of aqueous extract of SC. Metformin were used as reference antihyperglycemic drugs for comparison. Administration of aqueous extract of SC or metformin for 21 days resulted in a significant (P < 0.05) reduction in serum glucose, insulin and Homeostasis model assessment of insulin resistance (HOMA-IR) compared with diabetic controls. Treatment with 100 mg/kg/day aqueous extract of SC did not result in a significant reduction in serum insulin levels, but 200 mg/kg/day and 400 mg/kg/day, aqueous extract of SC and metformin showed significant reductions 17.89%, 19.60% and 24.40%, respectively. Furthermore, administration of 100, 200 and 400 mg/kg/day, aqueous extract of SC and metformin resulted in significant decrease in insulin resistance of 19.20%, 41.59%, 51.55% and 68.68%, respectively. In high fat diet- streptozotocin (HFD – STZ) treated rats β-cells function (HOMA-B) were markedly reduced (5.8-fold), however observed a significant (P < 0.01) improvement of β-cell function with aqueous extract of SC (400 mg/kg/day) and metformin. The aqueous extract of SC seeds exhibits significant insulin-sensitizing, antidyslipidemic, antioxidant, anti-inflammatory and β-cell salvaging activity in HFD-STZ-induced type 2 diabetic rats via overexpression of PPARγ and PPARα activity, affirming its potential to be used in the prevention and treatment of type 2 diabetes mellitus (T2DM). Further isolation and characterization of active components in SC seed extra...

Sharpe, L, McDonald, S, Correia, H, Raue, PJ, Meade, T, Nicholas, M & Arean, P 2017, 'Pain severity predicts depressive symptoms over and above individual illnesses and multimorbidity in older adults', BMC Psychiatry, vol. 17, no. 1, p. 166.
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BACKGROUND: Multi-morbidity in older adults is commonly associated with depressed mood. Similarly, subjective reports of pain are also associated with both physical illness and increased depressive symptoms. However, whether pain independently contributes to the experience of depression in older people with multi-morbidity has not been studied. METHODS: In this study, participants were 1281 consecutive older adults presenting to one of 19 primary care services in Australia (recruitment rate = 75%). Participants were asked to indicate the presence of a number of common chronic illnesses, to rate their current pain severity and to complete the Geriatric Depression Scale. RESULTS: Results confirmed that the number of medical illnesses reported was strongly associated with depressive symptoms. Twenty-six percent of participants with multi-morbidity scored in the clinical range for depressive symptoms in comparison to 15% of participants with no illnesses or a single illness. In regression analyses, the presence of chronic pain (t = 5.969, p < 0.0005), diabetes (t = 4.309, p < 0.0005), respiratory (t = 3.720, p < 0.0005) or neurological illness (t = 2.701, p = 0.007) were all independent contributors to depressive symptoms. Even when controlling for each individual illness, and the overall number of illnesses (t = 2.207, p = 0.028), pain severity remained an independent predictor of depressed mood (F change = 28.866, p < 0.0005, t = 5.373, p < 0.0005). CONCLUSIONS: Physicians should consider screening for mood problems amongst those with multi-morbidity, particularly those who experience pain.

Sheedy, S, MacMillan, V, O'Brian, S & Onslow, M 2017, 'Lidcombe Program: Development and validation of reflective questions', Journal of Clinical Practice in Speech-Language Pathology, vol. 19, no. 3, pp. 151-156.
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The Lidcombe Program of early stuttering intervention is an evidence-based behavioural treatment originally developed for children younger than 6 years. Problem-solving is inherent during Lidcombe Program treatment. Therefore a number of reflective questions were devised to assist speech-language pathologists (SLPs) to detect clinical procedures that vary from those recommended in the Lidcombe Program Treatment Guide and to employ suitable strategies. A two-stage validation process of the reflective questions was conducted. First, questions were developed and then revised with input from the members of the international Lidcombe Program Trainers Consortium. Then feedback on their clinical usefulness was obtained from public health SLPs. The outcomes of each stage of validation are reported and implications for speech-language pathologists delivering the Lidcombe Program discussed.

Sheppard, JJ, Malandraki, GA, Pifer, P, Cuff, J, Troche, M, Hemsley, B, Balandin, S, Mishra, A & Hochman, R 2017, 'Validation of the Choking Risk Assessment and Pneumonia Risk Assessment for adults with Intellectual and Developmental Disability (IDD)', Research in Developmental Disabilities, vol. 69, pp. 61-76.
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© 2017 Elsevier Ltd Background Risk assessments are needed to identify adults with intellectual and developmental disability (IDD) at high risk of choking and pneumonia. Aim To describe the development and validation of the Choking Risk Assessment (CRA) and the Pneumonia Risk Assessment (PRA) for adults with IDD. Methods Test items were identified through literature review and focus groups. Five-year retrospective chart reviews identified a positive choking group (PCG), a negative choking group (NCG), a positive pneumonia group (PPG), and a negative pneumonia group (NPG). Participants were tested with the CRA and PRA by clinicians blind to these testing conditions. Results The CRA and PRA differentiated the PCG (n = 93) from the NCG (n = 526) and the PPG (n = 63) from the NPG (n = 209) with high specificity (0.91 and 0.92 respectively) and moderate to average sensitivity (0.53 and 0.62 respectively). Further analyses revealed associations between clinical diagnoses of dysphagia and choking (p = 0.043), and pneumonia (p < 0.001). Conclusions The CRA and PRA are reliable, valid risk indicators for choking and pneumonia in adults with IDD. Precautions for mitigating choking and pneumonia risks can be applied selectively thus avoiding undue impacts on quality of life and unnecessary interventions for low risk individuals.

Shires, A, Vrklevski, L, Hyde, J, Bliokas, V & Simmons, A 2017, 'Barriers to Provision of External Clinical Psychology Student Placements', Australian Psychologist, vol. 52, no. 2, pp. 140-148.
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© 2016 The Australian Psychological Society Objective: With increasing focus on the treatment of mental health problems the need for clinical psychologists is expanding, driving strong demand for postgraduate clinical psychology training programs. Although the number of training places in Australia has increased, the availability of external placements appears to have lagged behind, causing significant challenges to students. Using a survey of clinical psychologists in New South Wales, Australia, this study evaluated the capacity for placements and explored issues that may impact on field placement capacity. Method: A survey was developed in order to identify potential student placement capacity and factors that may prevent potential supervisors from offering placements to students. The survey was distributed electronically through clinical psychology networks targeting those employed in NSW. Results: One hundred and forty endorsed clinical psychologists completed the survey. Of these, 42% stated they felt unable to offer field placements to students within the next 12 months. The most commonly cited barriers to offering a placement included a lack of time (21%); not being a PsyBA supervisor (18%); being employed part-time (18%) and the concern that clinical supervision time did not attract funding under the current public health funding model (16%). Conclusion: The study provides an estimate of clinical field placement capacity in NSW. The results suggest that the capacity in the existing clinical psychology workforce could meet clinical field placement demand. The authors discuss reasons why anecdotally, this does not appear to reflect the reality of field placement coordinators and students. The authors provide possible strategies for addressing the issues raised.

Shrubsole, K, Worrall, L, Power, E & O’Connor, DA 2017, 'Recommendations for post-stroke aphasia rehabilitation: an updated systematic review and evaluation of clinical practice guidelines', Aphasiology, vol. 31, no. 1, pp. 1-24.
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© 2016 Informa UK Limited, trading as Taylor & Francis Group. Background: Clinical practice guidelines (CPGs) have been shown to improve patient care and outcomes. For speech pathologists working with people with post-stroke aphasia, there is currently no single high-quality guideline that summarises all of the available research knowledge into recommendations to guide decision-making. While multiple stroke and aphasia guidelines exist, some are of low methodological quality, are out of date, or do not provide recommendations that specifically guide aphasia management. As such, it may be difficult for clinicians to choose one particular guideline to follow. Aim: To identify, extract, and evaluate recommendations from high-quality CPGs to inform the management of post-stroke aphasia by speech pathologists. Methods & Procedures: An updated systematic review of stroke and speech pathology-specific clinical guidelines was conducted in January 2015. The search included multiple databases (MEDLINE, Embase, CINAHL), guideline and stroke websites, and other sources. The quality of included guidelines was assessed using the Appraisal of Guidelines and Research and Evaluation (AGREE) II tool. Guidelines that obtained a high AGREE II “Rigour of Development” score were retained and the aphasia-relevant recommendations from these guidelines were extracted for further analysis. Recommendations were evaluated according to their applicability to aphasia and the clarity of linkages between the recommendations and underlying evidence. Outcomes & Results: Five new guidelines were identified. Their AGREE II ratings ranged from 31.3 to 71.9, and one met the cut-off of 66.67 for further analysis. One hundred and eleven recommendations from four guidelines were extracted and evaluated. From these, 76 recommendations met the inclusion criteria, 25 of which were specifically targeted at aphasia management, the remainder being general rehabilitation principles that may apply to ...

Smith, KA, Iverach, L, O'Brian, S, Mensah, F, Kefalianos, E, Hearne, A & Reilly, S 2017, 'Anxiety in 11-Year-Old Children Who Stutter: Findings From a Prospective Longitudinal Community Sample', Journal of Speech, Language, and Hearing Research, vol. 60, no. 5, pp. 1211-1222.
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Purpose To examine if a community sample of 11-year-old children with persistent stuttering have higher anxiety than children who have recovered from stuttering and nonstuttering controls. Method Participants in a community cohort study were categorized into 3 groups: (a) those with persistent stuttering, (b) those with recovered stuttering, and (c) nonstuttering controls. Linear regression modeling compared outcomes on measures of child anxiety and emotional and behavioral functioning for the 3 groups. Results Without adjustment for covariates (unadjusted analyses), the group with persistent stuttering showed significantly increased anxiety compared with the recovered stuttering group and nonstuttering controls. The group with persistent stuttering had a higher number of children with autism spectrum disorder and/or learning difficulties. Once these variables were included as covariates in subsequent analysis, there was no difference in anxiety, emotional and behavioral functioning, or temperament among groups. Conclusion Although recognized to be associated with stuttering in clinical samples, anxiety was not higher in school-age children who stutter in a community cohort. It may be that anxiety develops later or is less marked in community cohorts compared with clinical samples. We did, however, observe higher anxiety scores in those children who stuttered and had autism spectrum disorder or learning difficulties. Implications and recommendations for research are discussed.

Sohal, SS, Hansbro, PM, Shukla, SD, Eapen, MS & Walters, EH 2017, 'Potential Mechanisms of Microbial Pathogens in Idiopathic Interstitial Lung Disease', Chest, vol. 152, no. 4, pp. 899-900.
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Stevens, B, Hyde, J, Knight, R, Shires, A & Alexander, R 2017, 'Competency‐based training and assessment in Australian postgraduate clinical psychology education', Clinical Psychologist, vol. 21, no. 3, pp. 174-185.
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© 2015 The Australian Psychological Society Background: Competency-based training and assessment is considered the best practice internationally in postgraduate clinical psychology education. In Australia, there are still some ways to go as programmes begin to integrate competency-based pedagogical models into clinical training and assessment. Further understanding of the strengths and challenges of these models will be useful to educators interested in developing a competency-based approach. Methods: A structured literature review was carried out using the databases PsychInfo, PubMed, and PsychArticles. Keywords were: competency, and “training” or “assessment” or “model” or “clinical” or “psychology” or “medicine” or “allied health.” Articles had to be written in the English language and published in peer-reviewed journals. Relevant book chapters and web references from professional accreditation bodies were also assessed for inclusion. A total of 54 references were utilised in the review. Results: The review supports the relevance of competency-based learning and teaching. It draws on seminal benchmarking work from the international literature and considers the strengths and limitations of competency-based approaches to clinical health training and assessment. The review provides support for the ongoing progression towards competency-based training models in Australian postgraduate clinical psychology. Conclusions: Competency-based training and assessment methods offer educators sophisticated mechanisms for ensuring that clinical psychology graduates are prepared to meet the demands of professional practice and public accountability. Further efforts at integrating competency-based training models into Australian postgraduate curriculum, and associated research into the outcomes, are necessary to ensure a pedagogical culture of best practice in this country.

Stubbs, PW, Pedersen, AR & Nielsen, JF 2017, 'Day-to-day features of soleus stretch reflexes in sub-acute stroke patients', Somatosensory & Motor Research, vol. 34, no. 2, pp. 123-128.
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The aim of the study was to assess the reliability and variability of stretch reflex magnitude (SRmag) in sub-acute stroke patients. For testing, rapid dorsiflexion stretches were induced 24 h apart in 22 patients and 34 controls. SRmag between sessions in patients and controls was not different and the SRmag on the more-affected side was significantly larger than the less-affected, dominant, and non-dominant sides. The SRmag was consistent between sessions. Therefore, patients were not as variable between sessions as we had hypothesized.

Taxis, K, Kochen, S, Wouters, H, Boersma, F, Jan Gerard, M, Mulder, H, Pavlovic, J, Stevens, G, Andrew, M & Pont, LG 2017, 'Cross-national comparison of medication use in Australian and Dutch nursing homes', Age and Ageing, vol. 47, no. 2, p. 319.
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The author would like to apologise for an error in the originally published paper. One of the authors' names appeared incorrectly in the originally published paper. 'McLachlan Andrew' has been corrected to 'Andrew McLachlan'.

Taxis, K, Kochen, S, Wouters, H, Boersma, F, Jan Gerard, M, Mulder, H, Pavlovic, J, Stevens, G, McLachlan, A & Pont, LG 2017, 'Cross-national comparison of medication use in Australian and Dutch nursing homes', Age and Ageing, vol. 46, no. 2, pp. 320-323.
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© The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. Background: cross-national comparisons can be used to explore therapeutic areas and identify potential medication issues. Methods: we used cross-sectional pharmacy supply data to explore medication use for nursing home residents in Australia (AU n = 26 homes, 1,560 residents) and the Netherlands (NL n = 6 homes, 2,037 residents). Binary logistic regression analysis was used to calculate the sex and aged adjusted odds ratios (OR) and associated 95% confidence intervals with a flexible Bonferroni-Holm procedure used to adjust for multiple hypothesis testing. Results: total use of antipsychotics (AU: 37.7%, NL: 40.3%; OR 0.91 (0.79-1.04, P = 0.16) and antibacterials (66.8% AU, 62.4% NL, OR 1.08 (0.93-1.24, P = 0.31) was similar, but choice of individual agents differed between the two countries. Differences were observed in the use of antithrombotics (46.7% AU, 64.7% NL, OR 0.48 (0.42-0.56, P > 0.01), ophthalmologicals (44.3% AU, 22.1% NL, OR 2.80 (2.42-3.24, P < 0.001), laxatives (77.1% AU, 65.8% NL, OR 1.65 (1.41-1.92, P < 0.001). Conclusion: while the general prevalence of medication use in nursing home residents was similar across the two countries, distinct differences existed in the choice of agent among therapeutic groups. Comparing use between countries identified a number of potential medication related problem areas that need further exploration.

Taylor-Rubin, C, Croot, K, Power, E, Savage, SA, Hodges, JR & Togher, L 2017, 'Communication behaviors associated with successful conversation in semantic variant primary progressive aphasia', International Psychogeriatrics, vol. 29, no. 10, pp. 1619-1632.
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ABSTRACTBackground:Primary progressive aphasia (PPA) affects a range of language and cognitive domains that impact on conversation. Little is known about conversation breakdown in the semantic variant of PPA (svPPA, also known as semantic dementia). This study investigates conversation of people with svPPA.Methods:Dyadic conversations about everyday activities between seven individuals with svPPA and their partners, and seven control pairs were video recorded and transcribed. Number of words, turns, and length of turns were measured. Trouble-indicating behaviors (TIBs) and repair behaviors were categorized and identified as successful or not for each participant in each dyad.Results:In general, individuals with svPPA were active participants in conversation, taking an equal proportion of turns, but indicating a great deal of more trouble in conversation, shown by the significantly higher number of TIBs than evidenced by partners or control participants. TIBs were interactive (asking for confirmation with a shorter repetition of the original utterance or a repetition which included a request for specific information) and non-interactive (such as failing to take up or continue the topic or a minimal response) and unlike those previously reported for people with other PPA variants and dementia of the Alzheimer type. Communication behaviors of the partner were critical to conversational success.Conclusions:Examination of trouble and repair in 10-min conversations of individuals with svPPA and their important communication partners has potential to inform speech pathology interventions to enhance successful conversation, in svPPA and should be an integral part of the comprehensive care plan.

Thom, JM, Diong, J, Stubbs, PW & Herbert, RD 2017, 'Passive elongation of muscle fascicles in human muscles with short and long tendons', Physiological Reports, vol. 5, no. 23, pp. 1-8.
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This study tested the hypothesis that the ratio of changes in muscle fascicle and tendon length that occurs with joint movement scales linearly with the ratio of the slack lengths of the muscle fascicles and tendons. We compared the contribution of muscle fascicles to passive muscle-tendon lengthening in muscles with relatively short and long fascicles. Fifteen healthy adults participated in the study. The medial gastrocnemius, tibialis anterior, and brachialis muscle-tendon units were passively lengthened by slowly rotating the ankle or elbow. Change in muscle fascicle length was measured with ultrasonography. Change in muscle-tendon length was calculated from estimated muscle moment arms. Change in tendon length was calculated by subtracting change in fascicle length from change in muscle-tendon length. The median (IQR) contribution of muscle fascicles to passive lengthening of the muscle-tendon unit, measured as the ratio of the change in fascicle length to the change in muscle-tendon unit length, was 0.39 (0.26-0.48) for the medial gastrocnemius, 0.51 (0.29-0.60) for tibialis anterior, and 0.65 (0.49-0.90) for brachialis. Brachialis muscle fascicles contributed to muscle-tendon unit lengthening significantly more than medial gastrocnemius muscle fascicles, but less than would be expected if the fascicle contribution scaled linearly with the ratio of muscle fascicle and tendon slack lengths.

Thoomes-de Graaf, M, Scholten-Peeters, W, Duijn, E, Karel, Y, de Vet, HCW, Koes, B & Verhagen, A 2017, 'The Responsiveness and Interpretability of the Shoulder Pain and Disability Index', Journal of Orthopaedic & Sports Physical Therapy, vol. 47, no. 4, pp. 278-286.
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Study Design Clinical measurement study, prospective cohort design. Background Shoulder pain is a common disorder, and treatment is most often focused on a reduction of pain and functional disabilities. Several reviews have encouraged the use of the Shoulder Pain and Disability Index (SPADI) to objectify functional disability. It is important to assess the responsiveness and interpretability of the SPADI in patients seeking physical therapy treatment for their shoulder pain in a primary care setting. Objective To assess the responsiveness and interpretability of the SPADI in patients with shoulder pain visiting a physical therapist in primary care. Methods The target population consisted of patients who consulted a physical therapist for their shoulder pain. The patients received physical therapy treatment and completed the Dutch-language version of the SPADI at baseline and at 26-week follow-up. The interpretability floor and ceiling effects and the minimal important change (MIC) were assessed using the receiver operating characteristic method, and a visual anchor-based MIC distribution method was used to assess several Global Perceived Effect scale (GPE)-based anchors. The measurement error was calculated using the smallest detectable change. For the responsiveness, the area under the receiver operating characteristic curve was used, and correlations with the GPE and the change score of the Shoulder Disability Questionnaire (as this questionnaire measures the same construct) were assessed. Results A total of 356 patients participated at baseline and 237 (67%) returned the SPADI after 26 weeks. The mean score on the SPADI at baseline was 46.7 points (on a 0-100 scale). The SPADI showed no signs of floor and ceiling effects. The smallest detectable change was 19.7 points. The MIC was 20 (43% of baseline value), and therefore a change of 43% or more in an individual patient was considered to be clinically relevant. The area under the receiver operating characteris...

Tong, JY, Golzan, M, Georgevsky, D, Williamson, JP, Graham, SL, Farah, CS & Fraser, CL 2017, 'Quantitative Retinal Vascular Changes in Obstructive Sleep Apnea', American Journal of Ophthalmology, vol. 182, pp. 72-80.
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Purpose To examine the relationship between both static and dynamic retinal vascular caliber and the severity of obstructive sleep apnea (OSA). Design Prospective cross-sectional study. Methods Adult patients undergoing diagnostic polysomnography studies at a private Australian university teaching hospital were recruited. OSA severity was defined by the apnea-hypopnea index (AHI): severe >30, moderate >15–30, mild 5–15, and controls <5. Of 115 patients recruited (73 male; mean age 58 ± 13 years), there were 41 severe, 35 moderate, and 25 mild OSA patients and 14 controls. Static retinal vascular caliber was measured as the average diameter of retinal arterioles (CRAE) and venules (CRVE), and summarized as the arteriovenous ratio (AVR). Dynamic retinal vascular caliber was evaluated as the average pulsation amplitude of retinal arterioles (SRAP) and venules (SRVP). Comparisons across groups were performed using multivariate linear regression analysis. All results were adjusted for age, body mass index, and mean arterial pressure. Results Increasing AHI was significantly associated with decreasing AVR (P = .008) and CRAE (P = .016). A significant relationship was demonstrated between increasing AHI and attenuated retinal vascular pulsation amplitude (arterioles P = .028; venules P < .0001). Conclusions Increasing OSA severity is independently associated with retinal arteriolar narrowing and attenuated vascular pulsation amplitude. The retinal vasculature is easily imaged, and may be a surrogate biomarker of cerebral and systemic vascular risk in patients with OSA requiring further comprehensive investigation.

Tong, JY, Viswanathan, D, Hodge, C, Sutton, G, Chan, C & Males, JJ 2017, 'Corneal Collagen Crosslinking for Post-LASIK Ectasia: An Australian Study', Asia-Pacific Journal of Ophthalmology, vol. 6, no. 3, pp. 228-232.
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PURPOSE: Post laser-assisted in situ keratomileusis (LASIK) ectasia is a rare and unpredictable complication after LASIK. Corneal collagen crosslinking (CXL) has emerged as a promising technique to address this complication. Our study evaluates the long-term efficacy of CXL for post-LASIK ectasia in an Australian setting. DESIGN: Retrospective review of post-LASIK ectasia patients referred to and treated at 3 corneal refractive surgery institutions in Sydney, Australia. METHODS: Eleven patients (14 eyes; mean age, 39.7 ± 12.6 years) underwent epithelium-off CXL with follow-up ranging from 12-78 months. Best spectacle-corrected visual acuity (BSCVA), simulated keratometry, corneal topography indices, and higher-order aberrations (HOAs) [mean ± standard error of the mean (SEM)] were measured with a rotating Scheimpflug camera (Pentacam, Oculus). Comparisons between baseline measurements and postoperative outcomes were performed using paired t test analysis. RESULTS: At last follow-up, BSCVA improved significantly by 0.2 ± 0.06 logMAR (P = 0.01), and 12 of 14 eyes showed no keratometric deterioration. Of the corneal topography indices, index of height asymmetry showed a trend toward a significant improvement (P = 0.05). There was no progression of corneal HOAs. Central corneal thickness was not significantly altered (P = 0.6). No major postoperative complications were observed. CONCLUSIONS: In the Australian setting, CXL has proven effective at stabilizing the progression of post-LASIK ectasia, inducing corneal regularity, and improving visual acuity.

Tran, V, Lam, MK, Amon, KL, Brunner, M, Hines, M, Penman, M, Lowe, R & Togher, L 2017, 'Interdisciplinary eHealth for the care of people living with traumatic brain injury: A systematic review', Brain Injury, vol. 31, no. 13-14, pp. 1701-1710.
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To identify literature which discusses the barriers and enablers of eHealth technology and which evaluates its role in facilitating interdisciplinary team work for the care of people with a traumatic brain injury (TBI).Systematic review.Studies were identified by searching CINAHL, Embase, Medline, PsycINFO, Scopus, and Web of Science.Studies included in the review were required to feature an eHealth intervention which assisted interdisciplinary care for people with TBI.Descriptive data for each study described the eHealth intervention, interdisciplinary team, outcomes, and barriers and facilitators in implementing eHealth interventions.The search resulted in 1389 publications, of which 35 were retrieved and scanned in full. Six studies met all the inclusion criteria for the review. Four different eHealth interventions were identified: (i) an electronic goals systems, (ii) telerehabilitation, (iii) videoconferencing, and (iv) a point-of-care team-based information system. Various barriers and facilitators were identified in the use of eHealth.eHealth interventions have been reported to support interdisciplinary teams for the care of TBI. However, there is a substantial gap in existing literature regarding the barriers and enablers which characterize a successful interdisciplinary eHealth model for people with TBI.

Turbitt, E, Kunin, M, Gafforini, S & Freed, GL 2017, 'Motivators and barriers for paediatricians discharging patients', Australian Journal of Primary Health, vol. 23, no. 3, pp. 284-284.
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The aim of this study was to identify motivators and barriers that paediatricians face when discharging patients from outpatient specialty care. A questionnaire was administered to outpatient care paediatricians in Victoria working in one of five speciality public hospital clinics. Questions focused on how important various motivators and barriers were in respondents’ decision to discharge a patient from their clinic. Nearly all (91%, n=74) paediatricians invited to participate provided responses. The factor influencing the greatest proportion of paediatricians in their decision to discharge patients back to primary care was the potential that patients may not receive the required care from a GP. The next most highly rated barrier was that it is too complicated to arrange discharge; rated as a very important influence by one-third of paediatricians (33%, n=24). Improvements to the discharge process may encourage more paediatricians to discharge patients back to their GP, therefore freeing up appointment slots. This in turn could reduce waiting times for paediatric outpatient clinics in Victoria. The concern from paediatricians that patients may not receive the required care from a GP warrants attention and should be further investigated.

Turbitt, E, Kunin, M, Gafforini, S, Sanci, L, Spike, N & Freed, GL 2017, 'Perspectives of Australian general practitioners on shared care for paediatric patients', Australian Journal of Primary Health, vol. 23, no. 2, pp. 147-147.
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Australian general practitioners (GPs) are seeing proportionally fewer paediatric patients. GPs may be increasingly relying on secondary or tertiary care physicians to provide care to children with complex, chronic conditions. Shared-care initiatives may provide a solution to the apparent increasing dependence of GPs on paediatric specialists, although, currently, evidence is lacking about both the prevalence and composition of shared care for children in Australia. We invited 377 GPs in Melbourne, Australia, who had referred at least two children to specialist paediatric outpatient clinics within the 2014 calendar year, to participate in a mailed survey study. Items analysed for the present report included those relating to shared-care arrangements between GPs and paediatric specialists. Responses were received from 254 GPs (response rate 67%). The majority (90%) of GPs in our study have been involved in shared-care arrangements with outpatient paediatricians. We found wide variation in the success of these arrangements, measured through the ability of GPs to establish clear roles with paediatricians. For a national discussion around shared care to be productive, clear definitions and classifications will be crucial. Future research could investigate the reasons for variability in shared care in Australia, and examine optimal shared-care arrangements for children.

van der Gaag, WH, van den Berg, R, Koes, BW, Bohnen, AM, Hazen, LMG, Peul, WC, Voogt, L, Verhagen, AP, Bierma-Zeinstra, SMA & Luijsterburg, PAJ 2017, 'Discontinuation of a randomised controlled trial in general practice due to unsuccessful patient recruitment', BJGP Open, vol. 1, no. 3, pp. bjgpopen17X101085-bjgpopen17X101085.
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BackgroundA randomised controlled trial (RCT) in general practice, recruiting incident patients with (sub)acute sciatica, was discontinued because of insufficient recruitment.AimTo describe factors that influenced the recruitment process and ultimately led to discontinuation of this trial, and to enable others to learn from this experience.Design & settingA pragmatic RCT was designed to compare two pain medication prescription strategies for treatment of (sub)acute sciatica in general practice. After 1 year of patient recruitment, the trial was prematurely terminated.MethodTo analyse the underperforming recruitment, patient information systems of 20 general practices were screened twice a month to search for eligible patients and identify reasons for non-eligibility. Secondly, after study termination, an open question was distributed to the participating GPs for their views on the recruitment process.ResultsA total of 116 GPs from 37 general practices collaborated in the trial. Only eight of 234 patients were included after 12 months. The 22 GPs who offered their opinion on the main reasons for unsuccessful recruitment considered that these were the low incidence rate and strict eligibility criteria, a strong patient and/or GP preference, and time constraints.ConclusionFor this RCT, multiple factors were related to recruitment problems but it remains unknown which determinants prevailed. As the research question is unanswered but remains relevant, it is recommended that GPs’ daily practice is taken into account when designing an RCT, a pilot study should be performed for feasibility of recruitment,...

Van Eerdenbrugh, S, Packman, A, Onslow, M, O’brian, S & Menzies, R 2017, 'Development of an internet version of the Lidcombe Program of early stuttering intervention: A trial of Part 1', International Journal of Speech-Language Pathology, vol. 19, no. 6, pp. 637-637.
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Van Zanden, B, Marsh, HW, Seaton, M, Parker, PD, Guo, J & Duineveld, JJ 2017, 'How well do parents know their adolescent children? Parent inferences of student self-concepts reflect dimensional comparison processes', Learning and Instruction, vol. 47, pp. 25-32.
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The internal/external frame of reference (I/E) model posits paradoxical relations between achievement and self-concept in mathematics and verbal domains. There is strong support for the I/E model based on student self-ratings, however, reviews of self-concept research claim that the I/E model does not apply to ratings by parents and significant others. We aimed to test these claims using parent inferred self-concepts. In contrast to widely cited claims, we found support for I/E model for both students (N = 486; aged 11–17; 57.2% female) and their parents (80.5% female). Math and verbal achievement had positive effects on self-concepts in the matching domain (e.g., math achievement predicting math self-concept) but negative effects for self-concepts in the non-matching domain (e.g., math achievement predicting verbal self-concept). Integrating conflicting claims, we found support for dimensional comparison processes for inferred self-concept ratings by parents, but not for parent perceptions of student abilities similar to the measures used that were the basis of previous claims.

Veldre, A & Andrews, S 2017, 'Parafoveal preview benefit in sentence reading: Independent effects of plausibility and orthographic relatedness', Psychonomic Bulletin & Review, vol. 24, no. 2, pp. 519-528.
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Verhagen, A & Bohnen, A 2017, 'Onderbouwing diagnostisch proces NHG-Standaarden', Huisarts en wetenschap, vol. 60, no. 8, pp. 387-392.
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Verhagen, AP 2017, 'Taping is not recommended for shoulder pain', Nederlands Tijdschrift voor Geneeskunde, vol. 161, no. 28.

Verhagen, AP 2017, 'The art of systematic reviews', Musculoskeletal Science and Practice, vol. 31, pp. iv-vi.
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Verhagen, AP, Downie, A, Maher, CG & Koes, BW 2017, 'Most red flags for malignancy in low back pain guidelines lack empirical support: a systematic review', Pain, vol. 158, no. 10, pp. 1860-1868.
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Abstract Clinicians do not want to miss underlying serious pathology, but it is still unclear which red flags are relevant. We aimed to evaluate the origin and evidence on diagnostic accuracy of red flags for malignancy for management of low back pain (LBP) in primary care. We performed a comprehensive overview and searched the literature using snowballing techniques and reference checking for evidence on red flags endorsed in clinical guidelines for identifying patients with higher likelihood of malignancy. We selected studies including people with LBP without any restriction on study design. We extracted data on prevalence and diagnostic accuracy. Furthermore, we assessed the methodological quality of studies evaluating diagnostic accuracy. We identified 13 red flags endorsed in a total of 16 guidelines and 2 extra red flags not endorsed in any guideline. We included 33 publications varying from systematic reviews to case reports. The origin of many red flags was unclear or was sourced from case reports. The incidence of malignancy in patients presenting with LBP in primary care varied between 0% and 0.7%. Seven studies provided diagnostic accuracy data on red flags. We found 5 red flags with accuracy data from 2 or more studies, with 2 (“history of malignancy” and “strong clinical suspicion”) considered informative. In conclusion, the origin and diagnostic accuracy of many red flags endorsed in guidelines are unclear. A “history of malignancy” and “strong clinical suspicion” are the only red flags with empirical evidence of acceptably high diagnostic accuracy.

Vuik-Verheij, S, Bindels, P & Verhagen, A 2017, 'Is ouderenmishandeling onderdeel van uw differentiële diagnose?', Huisarts en wetenschap, vol. 60, no. 12, pp. 655-660.
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Wallace, SJ, Worrall, L, Rose, T & Le Dorze, G 2017, 'Which treatment outcomes are most important to aphasia clinicians and managers? An international e-Delphi consensus study', Aphasiology, vol. 31, no. 6, pp. 643-673.
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Wallace, SJ, Worrall, L, Rose, T, Le Dorze, G, Cruice, M, Isaksen, J, Kong, APH, Simmons-Mackie, N, Scarinci, N & Gauvreau, CA 2017, 'Which outcomes are most important to people with aphasia and their families? an international nominal group technique study framed within the ICF', Disability and Rehabilitation, vol. 39, no. 14, pp. 1364-1379.
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Walsh, L, Hemsley, B, Allan, M, Adams, N, Balandin, S, Georgiou, A, Higgins, I, McCarthy, S & Hill, S 2017, 'The E-health Literacy Demands of Australia's My Health Record: A Heuristic Evaluation of Usability.', Perspect Health Inf Manag, vol. 14, no. Fall, pp. 1f-28.
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BACKGROUND: My Health Record is Australia's electronic personal health record system, which was introduced in July 2012. As of August 2017, approximately 21 percent of Australia's total population was registered to use My Health Record. Internationally, usability issues have been shown to negatively influence the uptake and use of electronic health record systems, and this scenario may particularly affect people who have low e-health literacy. It is likely that usability issues are negatively affecting the uptake and use of My Health Record in Australia. OBJECTIVE: To identify potential e-health literacy-related usability issues within My Health Record through a heuristic evaluation method. METHODS: Between September 14 and October 12, 2016, three of the authors conducted a heuristic evaluation of the two consumer-facing components of My Health Record-the information website and the electronic health record itself. These two components were evaluated against two sets of heuristics-the Health Literacy Online checklist and the Monkman Heuristics. The Health Literacy Online checklist and Monkman Heuristics are evidence-based checklists of web design elements with a focus on design for audiences with low health literacy. During this heuristic evaluation, the investigators individually navigated through the consumer-facing components of My Health Record, recording instances where the My Health Record did not conform to the checklist criteria. After the individual evaluations were completed, the investigators conferred and aggregated their results. From this process, a list of usability violations was constructed. RESULTS: When evaluated against the Health Literacy Online Checklist, the information website demonstrated violations in 12 of 35 criteria, and the electronic health record demonstrated violations in 16 of 35 criteria. When evaluated against the Monkman Heuristics, the information website demonstrated violations in 7 of 11 criteria, and the electron...

Wardle, S, Seymour, K & Taubert, J 2017, 'Decoding face pareidolia in the human brain with fMRI', Journal of Vision, vol. 17, no. 10, pp. 294-294.
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Wardle, SG, Ritchie, JB, Seymour, K & Carlson, TA 2017, 'Edge-Related Activity Is Not Necessary to Explain Orientation Decoding in Human Visual Cortex', The Journal of Neuroscience, vol. 37, no. 5, pp. 1187-1196.
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Multivariate pattern analysis is a powerful technique; however, a significant theoretical limitation in neuroscience is the ambiguity in interpreting the source of decodable information used by classifiers. This is exemplified by the continued controversy over the source of orientation decoding from fMRI responses in human V1. Recently Carlson (2014) identified a potential source of decodable information by modeling voxel responses based on the Hubel and Wiesel (1972) ice-cube model of visual cortex. The model revealed that activity associated with the edges of gratings covaries with orientation and could potentially be used to discriminate orientation. Here we empirically evaluate whether “edge-related activity” underlies orientation decoding from patterns of BOLD response in human V1. First, we systematically mapped classifier performance as a function of stimulus location using population receptive field modeling to isolate each voxel's overlap with a large annular grating stimulus. Orientation was decodable across the stimulus; however, peak decoding performance occurred for voxels with receptive fields closer to the fovea and overlapping with the inner edge. Critically, we did not observe the expected second peak in decoding performance at the outer stimulus edge as predicted by the edge account. Second, we evaluated whether voxels that contribute most to classifier performance have receptive fields that cluster in cortical regions corresponding to the retinotopic location of the stimulus edge. Instead, we find the distribution of highly weighted voxels to be approximately random, with a modest bias toward more foveal voxels. Our results demonstrate that edge-related activity is likely not necessary for orientation decoding.SIGNIFICANCE STATEMENTA significant theoretical limitation of multivariate pattern analysis in neuroscience is the ambiguity in interpreting the source of decodable information use...

Werth, BL, Williams, KA & Pont, LG 2017, 'Laxative Use and Self-Reported Constipation in a Community-Dwelling Elderly Population', Gastroenterology Nursing, vol. 40, no. 2, pp. 134-141.
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The objectives of this study were to (1) determine the prevalence of laxative use and self-reported constipation and (2) identify risk factors associated with constipation in a community-dwelling elderly population. A retrospective cross-sectional survey using data from the Australian Longitudinal Study of Ageing was used to explore laxative use and constipation in a cohort of community-dwelling older persons. The prevalence of laxative use was 15% and the prevalence of self-reported constipation was 21%. Females were more likely to report constipation and use laxatives. Of those using laxatives, men were more likely to have their laxatives prescribed by a doctor whereas women were more likely to self-medicate. Poor self-rated health and a higher need for assistance with activities of daily living were identified as risk factors for constipation. Constipation is a common condition affecting the community-dwelling elderly. There is a need to optimize the management of constipation and use of laxatives in such populations.

White, D, Sutherland, CAM & Burton, AL 2017, 'Choosing face: The curse of self in profile image selection', Cognitive Research: Principles and Implications, vol. 2, no. 1, pp. 1-9.
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AbstractPeople draw automatic social inferences from photos of unfamiliar faces and these first impressions are associated with important real-world outcomes. Here we examine the effect of selecting online profile images on first impressions. We model the process of profile image selection by asking participants to indicate the likelihood that images of their own face (“self-selection”) and of an unfamiliar face (“other-selection”) would be used as profile images on key social networking sites. Across two large Internet-based studies (n = 610), in line with predictions, image selections accentuated favorable social impressions and these impressions were aligned to the social context of the networking sites. However, contrary to predictions based on people’s general expertise in self-presentation, other-selected images conferred more favorable impressions than self-selected images. We conclude that people make suboptimal choices when selecting their own profile pictures, such that self-perception places important limits on facial first impressions formed by others. These results underscore the dynamic nature of person perception in real-world contexts.

Worrall, LE, Hudson, K, Khan, A, Ryan, B & Simmons-Mackie, N 2017, 'Determinants of Living Well With Aphasia in the First Year Poststroke: A Prospective Cohort Study', Archives of Physical Medicine and Rehabilitation, vol. 98, no. 2, pp. 235-240.
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OBJECTIVE: To determine factors that contribute to living well with aphasia in the first 12 months poststroke. DESIGN: Prospective longitudinal cohort study. SETTING: Hospitalized care, ambulatory care, and general community. PARTICIPANTS: A referred sample of people (N=58) with a first incidence of aphasia after stroke was assessed at 3, 6, 9, and 12 months postonset. Participants were recruited through speech-language pathologists in 2 capital cities in Australia. Presence of aphasia was determined through the Western Aphasia Battery-Revised by an experienced speech-language pathologist. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The main outcomes were the 5 domains of the Assessment for Living with Aphasia at 3, 6, 9, and 12 months poststroke. The independent variables included demographics, physical functioning, social network, mood, aphasia severity, and a self-rating of successfully living with aphasia at the same time points. Mixed effects modeling was used to determine which factors contributed to the trajectory of each of the 5 domains of participation, impairment, environment, personal factors, and life with aphasia. RESULTS: Higher household income, larger social network size, being a woman, and having milder aphasia were positively associated with the participation domain. Graduate or postgraduate educational levels, low mood, and poor physical functioning were negatively associated with the participation domain. Factors positively associated with other domains included higher income, self-ratings of successfully living with aphasia, and aphasia severity. Low mood was consistently negatively associated with all of the domains. CONCLUSIONS: Psychosocial determinants were the most significant predictors of living well with aphasia in the first 12 months postonset. Aphasia rehabilitation needs to attend more to these factors to optimize outcomes.

Yamato, T, Maher, C, Saragiotto, B, Moseley, A, Hoffmann, T, Elkins, M & Hasson, S 2017, 'The TIDieR checklist will benefit the physiotherapy profession', Physiotherapy Theory and Practice, vol. 33, no. 4, pp. 267-268.
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Yamato, TP, Maher, CG, Saragiotto, BT, Catley, MJ & McAuley, JH 2017, 'The Roland–Morris Disability Questionnaire: one or more dimensions?', European Spine Journal, vol. 26, no. 2, pp. 301-308.
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Yamato, TP, Maher, CG, Saragiotto, BT, Shaheed, CA, Moseley, AM, Lin, CC, Koes, B & McLachlan, AJ 2017, 'Comparison of effect sizes between enriched and nonenriched trials of analgesics for chronic musculoskeletal pain: a systematic review', British Journal of Clinical Pharmacology, vol. 83, no. 11, pp. 2347-2355.
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AIMSTo investigate the use of an enriched study design on the estimates of treatment effect in analgesic trials for chronic musculoskeletal pain.MethodsDatabase searches were conducted from 2004 to 2014. We included randomized placebo‐controlled trials evaluating pain medications for chronic musculoskeletal pain. Methodological quality was assessed using the PEDro scale. The estimates of treatment effect on pain and adverse events were compared between enriched and nonenriched designs. Metaregression was used to assess the association between the effect size estimate and the study design controlling for analgesic dose and methodological quality.ResultsWe included 108 trials, of which 99 were included in the meta‐analysis (n = 44 171). There were no overall differences in effect sizes between enriched and nonenriched designs for pain intensity. There was a significant difference for a reduction in any adverse events favouring enriched designs for opioids, but not for other analgesics or the outcome serious adverse events. There was an association between effect size and methodological quality, with failure to blind the outcome assessor and failure to use intention‐to‐treat analysis being associated with larger effect sizes.ConclusionsThere is no evidence that the use of an enriched study design changes the treatment effect size estimate for pain. There is some evidence that clinical trials that employ enriched designs report a reduced risk of adverse events in trials for chronic musculoskeletal pain, but it is unclear whether enriched designs influence estimates of serious adverse events. Features of trial design and study quality were associated with treatment effect estimates.

Yu, D, Poon, SK, Tran, V, Lam, MK, Hines, M, Brunner, M, Power, E, Shaw, T & Togher, L 2017, 'Enabler for Interdisciplinary eHealthcare: A Qualitative Study.', Stud Health Technol Inform, vol. 239, pp. 160-166.
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The complex relations between Health Technologies and clinical practices have been the focus of intensive research in recent years. This research represents a shift towards a holistic view where evaluation of health technologies is linked to organisational practices. In this paper, we address the gaps in existing literature regarding the holistic evaluation of e-health in clinical practice. We report the results from a qualitative study conducted to gain insight into e-health in practice within an interdisciplinary healthcare domain. Findings from this qualitative study, provides the foundation for the creation of a generic measurement model that allows for the comparative analysis of health technologies and assist in the decision-making of its stakeholders.

Benson, H, Lucas, C, Benrimoj, S & Williams, KA 1970, 'Integrating Pharmacists in General Practice: Drug Related Problems in the Patient Centred Medical Home', Pharmaceutical Society of Australia National Conference (PSA17), Sydney.

Caughey, GE, Taxis, K, Pont, LG, Zongo, A & Wettermark, B 1970, 'Evidence Generation in Multimorbidity: A New Frontier in Drug Utilization', PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, WILEY, pp. 253-254.

Golzan, M, Georgevsky, D, Bowd, C, Weinreb, RN & Graham, SL 1970, 'Visual field sensitivity is decreased with reduced spontaneous venous pulsation in glaucoma eyes', INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, Annual Meeting of the Association-for-Research-in-Vision-and-Ophthalmology (ARVO) - Imaging in the Eye, ASSOC RESEARCH VISION OPHTHALMOLOGY INC, MD, Baltimore.

Gonsalvez, C, Deane, F & Shires, AG 1970, 'Key findings from a multisite project on competence assessment.', Clinical Psychology Course Directors Forum, Bisbane.

Gray, K, Stephen, R, Terrill, B, Wilson, B, Middleton, A, Tytherleigh, R, Turbitt, E, Gaff, C, Savard, J, Hickerton, C, Newson, A & Metcalfe, S 1970, 'Consumer Health Informatics Aspects of Direct-to-Consumer Personal Genomic Testing.', Stud Health Technol Inform, 16th World Congress on Medical and Health Informatics (MEDINFO), IOS PRESS, Netherlands, pp. 89-93.
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This paper uses consumer health informatics as a framework to explore whether and how direct-to-consumer personal genomic testing can be regarded as a form of information which assists consumers to manage their health. It presents findings from qualitative content analysis of web sites that offer testing services, and of transcripts from focus groups conducted as part a study of the Australian public's expectations of personal genomics. Content analysis showed that service offerings have some features of consumer health information but lack consistency. Focus group participants were mostly unfamiliar with the specifics of test reports and related information services. Some of their ideas about aids to knowledge were in line with the benefits described on provider web sites, but some expectations were inflated. People were ambivalent about whether these services would address consumers' health needs, interests and contexts and whether they would support consumers' health self-management decisions and outcomes. There is scope for consumer health informatics approaches to refine the usage and the utility of direct-to-consumer personal genomic testing. Further research may focus on how uptake is affected by consumers' health literacy or by services' engagement with consumers about what they really want.

Hemsley, B, Palmer, S, Goonan, W & Dann, S 1970, 'Motor Neurone Disease (MND) and Amyotrophic Lateral Sclerosis (ALS): Social Media Communication on Selected #MND and #ALS Tagged Tweets', Proceedings of the 50th Hawaii International Conference on System Sciences (2017), Hawaii International Conference on System Sciences, Hawaii International Conference on System Sciences, pp. 3764-3773.
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In March-April 2016, 3288 original tweets tagged with #MND #ALS and other minor related tags (e.g., #cureALS #cureMND) were analysed using mixed quantitative and qualitative methods on tweet data and content. In this paper we outline the technical methods used in gathering and selecting relevant tweets for analysis, and present the results including inductive coding of content themes. The findings will inform (a) future social media research in relation to MND/ALS, (b) improved supports for people with MND/ALS and their families to use Twitter for information exchange, advocacy, and as a non-verbal form of communication, and (c) knowledge for MND/ALS service providers and philanthropic organisations on ways to engage with adults with MND/ALS in Twitter.

Lundström, M, Dickman, M, Henry, Y, Manning, S, Rosen, P, Tassignon, M-J, Young, D & Stenevi, U 1970, 'Femtosecond laser–assisted cataract surgeries reported to the European Registry of Quality Outcomes for Cataract and Refractive Surgery: Baseline characteristics, surgical procedure, and outcomes', Journal of Cataract and Refractive Surgery, Ovid Technologies (Wolters Kluwer Health), pp. 1549-1556.
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© 2017 ASCRS and ESCRS Purpose To describe a large cohort of femtosecond laser–assisted cataract surgeries in terms of baseline characteristics and the related outcomes. Setting Eighteen cataract surgery clinics in 9 European countries and Australia. Design Prospective multicenter case series. Methods Data on consecutive eyes having femtosecond laser–assisted cataract surgery in the participating clinics were entered in the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO). A trained registry manager in each clinic was responsible for valid reporting to the EUREQUO. Demographics, preoperative corrected distance visual acuity (CDVA), risk factors, type of surgery, type of intraocular lens, visual outcomes, refractive outcomes, and complications were reported. Results Complete data were available for 3379 cases. The mean age was 64.4 years ± 10.9 (SD) and 57.8% (95% confidence interval [CI], 56.1-59.5) of the patients were women. A surgical complication was reported in 2.9% of all cases (95% CI, 2.4-3.5). The mean postoperative CDVA was 0.04 ± 0.15. logarithm of the minimum angle of resolution. A biometry prediction error (spherical equivalent) was within ±0.5 diopter in 71.8% (95% CI, 70.3-73.3) of all surgeries. Postoperative complications were reported in 3.3% (95% CI, 2.7-4.0). Patients with good preoperative CDVA had the best visual and refractive outcomes; patients with poor preoperative visual acuity had poorer outcomes. Conclusions The visual and refractive outcomes of femtosecond laser–assisted cataract surgery were favorable compared with manual phacoemulsification. The outcomes were highly influenced by the preoperative visual acuity, but all preoperative CDVA groups had acceptable outcomes.

Morgan, IG, French, A & Rose, KA 1970, 'SCHOOL SYSTEMS WITH A HIGH PREVALENCE OF MYOPIA DOMINATE INTERNATIONAL COMPARISONS IN MATHS AND SCIENCE', INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, Annual Meeting of the Association-for-Research-in-Vision-and-Ophthalmology (ARVO) - Imaging in the Eye, ASSOC RESEARCH VISION OPHTHALMOLOGY INC, Baltimore, MD.

Pont, LG, Raban, MZ, Siette, J, Mitchell, R, Georgiou, A & Westbrook, J 1970, 'Antipsychotics Are Forever? De-Prescribing of Antipsychotics in Residential Aged Care', PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, WILEY, pp. 329-330.

Ryan, B, Hudson, K, Worrall, L, Simmons-Mackie, N, Thomas, E, Finch, E, Clark, K & Lethlean, J 1970, 'The Aphasia Action, Success, and Knowledge Programme: Results from an Australian Phase I Trial of a Speech-Pathology-Led Intervention for People with Aphasia Early Post Stroke', Brain Impairment, CSIRO Publishing, pp. 284-298.
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Background: Speech pathologists work to optimise communication and reduce the emotional and social impact of communication disability in patients with aphasia but need evidence-based interventions to effectively do so.Objective: This phase 1 study aims to evaluate an Australian speech-pathology-led intervention called the Aphasia Action, Success, and Knowledge (Aphasia ASK) programme for patients with aphasia early post stroke.Methods: A convergent parallel mixed-methods design was utilised. The intervention included up to six individual face-to-face sessions with seven participants with aphasia and their nominated family member(s). Quantitative outcomes assessing mood, quality of life, and communication confidence were conducted for the participants with aphasia. Follow-up interviews were conducted with both participants with aphasia and family members to determine their perceptions of the programme.Results: Significant improvements were found in communication confidence and mood after treatment and the gains were maintained at 3-month follow-up. Participants with aphasia and their family members reported a good level of satisfaction with the programme.Conclusions: Findings suggest the Aphasia ASK programme is a suitable intervention with positive initial outcomes for people with aphasia. A larger scale evaluation with a greater variety of participants is now required. An Australian cluster randomised control trial is planned.

Shires, AG, •Gonsalvez, C, Blackman, R & knight, R 1970, 'Assessment of Practicum competencies in Clinical Psychology: Key findings and Future Directions', Australian and New Zealand Psychology Training Clinic Directors Conference, Sydney.

Shires, AG, Sharpe, L & Newton John, T 1970, 'Comparison of brief mindfulness task with a distraction task in the reduction of induced pain.', 38th National Conference of the Australian Association for cognitve and behavioural therapy, Sydney, Australia.

Tsuchiya, N, Davidson, M, Alais, D & van Boxtel, J 1970, 'Steady-State EEG Response Correlates of Cross-Modally Facilitated Transitions During Binocular Rivalry', I-PERCEPTION, SAGE PUBLICATIONS LTD, pp. 29-30.

Turbitt, E, Chrysostomou, P, Heidlebaugh, A & Biesecker, BB 1970, 'A RANDOMIZED CONTROLLED TRIAL COMPARING TWO CONSENT INTERVENTIONS FOR ENROLLMENT INTO A SEQUENCING STUDY', ANNALS OF BEHAVIORAL MEDICINE, OXFORD UNIV PRESS INC, pp. S1022-S1023.

Williams, H, Cassorla, G, Pertsoulis, N, Patel, V, Vicaretti, M, Marmash, N, Hitos, K, Fletcher, JP & Medbury, HJ 1970, 'Human classical monocytes display unbalanced M1/M2 phenotype with increased atherosclerotic risk and presence of disease', International Angiology, Edizioni Minerva Medica, pp. 145-155.
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BACKGROUND: Specific monocyte and macrophage subsets have been implicated in atherosclerosis, with intermediate monocytes proportionally elevated in cardiovascular disease and M1 macrophages abundant in unstable atherosclerotic plaques. While several studies have shown altered proportions of these subsets in atherosclerosis, studies examining functional and phenotypic subset alterations remain scarce. METHODS: We used whole blood flow cytometry to investigate the expression of M1 (CD86) and M2 (CD163) markers on monocyte subsets of atherosclerotic patients and controls. RESULTS: Atherosclerotic patients had a more inflammatory monocyte profile than controls, indicated by increased intermediate subset proportions, a higher classical monocyte CD86/CD163 ratio, and elevated serum M1-related chemokines. A more inflammatory profile appeared to correlate with atherosclerotic risk, as in controls classical monocyte CD86/CD163 ratio was negatively correlated with HDL and apolipoprotein A1, and positively correlated with interleukin-1?. CONCLUSIONS: We conclude that monocyte subsets show functional and phenotypic changes in cardiovascular disease and such changes are likely to contribute to atherosclerotic progression.

Aly, M, García-Cárdenas, V, Williams, K & Benrimoj, SI 2017, 'WITHDRAWN: A Review Of International Pharmacy- Based Minor Ailment Services And Proposed Service Design Model', Elsevier BV.
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Onslow, M, Lowe, R & Jelčić Jakšić, S 2017, 'Applications of stuttering treatment research: Proceedings of the third Croatian symposium'.

Shires, A 2017, 'APN CLINICAL FOCUS SEMINARIntroduction to Mindfulness-integrated Cognitive Behaviour Therapy (MiCBT)'.
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APN CLINICAL FOCUS SEMINAR Introduction to Mindfulness-integrated Cognitive Behaviour Therapy (MiCBT)

Shires, AG 2017, 'How can I make the most out of clinical supervision?'.
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Presentation on Clinical Supervision to University of Sydney Gambling journal group.

Shires, AG 2017, 'University based Psychology Clinic models'.
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Presentation to the AAPTC.

Wardle, SG, Seymour, K & Taubert, J 2017, 'Characterizing the response to face pareidolia in human category-selective visual cortex', Cold Spring Harbor Laboratory.
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