Publications

This systematic review aims to synthesize the evidence from randomized controlled trials to evaluate the analgesic effect of electroencephalographic neurofeedback. In addition, we will synthesize the findings of nonrandomized studies in a narrative review.

We will apply the search strategy in 5 electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PsycInfo, and CINAHL) for published studies and in clinical trial registries for completed unpublished studies. We will include studies that used electroencephalographic neurofeedback as an intervention for people with chronic pain. Risk-of-bias tools will be used to assess methodological quality of the included studies. We will include randomized controlled trials if they have compared electroencephalographic neurofeedback with any other intervention or placebo control. The data from randomized controlled trials will be aggregated to perform a meta-analysis for quantitative synthesis. The primary outcome measure is pain intensity assessed by self-report scales. Secondary o...

Hesam-Shariati, N, Newton-John, T, Singh, AK, Tirado Cortes, CA, Do, T-TN, Craig, A, Middleton, JW, Jensen, MP, Trost, Z, Lin, C-T & Gustin, SM 2020, 'Evaluation of the Effectiveness of a Novel Brain-Computer Interface Neuromodulative Intervention to Relieve Neuropathic Pain Following Spinal Cord Injury: Protocol for a Single-Case Experimental Design With Multiple Baselines', JMIR Research Protocols, vol. 9, no. 9, pp. e20979-e20979.
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Background Neuropathic pain is a debilitating secondary condition for many individuals with spinal cord injury. Spinal cord injury neuropathic pain often is poorly responsive to existing pharmacological and nonpharmacological treatments. A growing body of evidence supports the potential for brain-computer interface systems to reduce spinal cord injury neuropathic pain via electroencephalographic neurofeedback. However, further studies are needed to provide more definitive evidence regarding the effectiveness of this intervention. Objective The primary objective of this study is to evaluate the effectiveness of a multiday course of a brain-computer interface neuromodulative intervention in a gaming environment to provide pain relief for individuals with neuropathic pain following spinal cord injury. Methods We have developed a novel brain-computer interface-based neuromodulative intervention for spinal cord injury neuropathic pain. Our brain-computer interface neuromodulative treatment includes an interactive gaming interface, and a neuromodulation protocol targeted to suppress theta (4-8 Hz) and high beta (20-30 Hz) frequency powers, and enhance alpha (9-12 Hz) power. We will use a single-case experimental design with multiple baselines to examine the effectiveness of our self-developed brain-computer interface neuromodulative intervention for the treatment of spinal cord injury neuropathic pain. We will recruit 3 participants with spinal cord injury neuropathic pain. Each participant will be randomly allocated to a different baseline phase (ie, 7, 10, or 14 days), which will then be followed by 20 sessions of a 30-minute brain-computer interface neuromodulative interventi...

Hofmann, GA, Gradl, G, Schulz, M, Haidinger, G, Tanew, A & Weber, B 2020, 'The frequency of photosensitizing drug dispensings in Austria and Germany: a correlation with their photosensitizing potential based on published literature', Journal of the European Academy of Dermatology and Venereology, vol. 34, no. 3, pp. 589-600.
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AbstractBackgroundDrug‐induced photosensitivity refers to the development of cutaneous adverse events due to interaction between a pharmaceutical compound and sunlight. Although photosensitivity is a very commonly listed side‐effect of systemic drugs, reliable data on its actual incidence are lacking so far.ObjectivesA possible approach to evaluate the real‐life extent of drug‐induced photosensitivity would be an analysis of the frequency of exposure to a given photosensitizing drug combined with an indicator of its photosensitizing potential. This could serve as a basis for developing a pharmaceutical ‘heatmap’ of photosensitivity.MethodsThe present study investigated the number of reimbursed dispensed packages of potentially photosensitizing drugs in Germany (DE) and Austria (AT) between 2010 and 2017 based on nationwide health insurance‐based databases. In addition, an indicator for the photosensitizing potential was established for each drug based on the number of reports on photosensitivity in the literature.ResultsThis analysis includes means of 632 826 944 (+/−14 894 918) drug dispensings per year in DE and 113 270 754 (+/−1 964 690) in AT. Out of these, the mean percentage of drugs that enlist photosensitivity as a potential side‐effect was 49.5% (±0.7) in DE and 48.2% (±1.2) in AT. When plotting the number of reimbursed dispens...

Hronis, A, Roberts, R, Roberts, L & Kneebone, I 2020, 'Potential for children with intellectual disability to engage in cognitive behaviour therapy: the parent perspective', Journal of Intellectual Disability Research, vol. 64, no. 1, pp. 62-67.
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AbstractBackgroundThis study aimed to obtain the opinions of parents and carers of children with intellectual disability (ID) as to whether cognitive behaviour therapy (CBT) could be useful for their children.MethodsA mixed qualitative and quantitative method was employed. Twenty‐one carers of children aged 10 to 17 having borderline to moderate intellectual functioning responded to an online questionnaire. Participants were provided with information about CBT and asked to respond to open‐ended questions. Quantitative data pertained to questions about their child's ability to identify and describe thoughts, feelings and behaviours. Thematic analysis of responses was conducted using an inductive method of identifying themes from the qualitative data collected.ResultsFive themes emerged from the qualitative analysis: Emotional Attunement (i.e. parent's understanding and recognition of their child's emotions), Role of the Therapist (i.e. ways therapists could facilitate the intervention), Role of the Parent (i.e. ways parents could engage in the therapy process), Anticipated Obstacles (i.e. what may get in the way of the therapy) and Suggested Adaptations for Therapy (i.e. how CBT can be adapted to suit the needs of children with ID). Seventy‐six per cent agreed that their child would be able to engage in CBT with assistance.ConclusionsThe majority of parents believed that CBT is an intervention that children with ID could engage in, provided the therapy is adapted, and the therapist accommodates their needs.

Hutchings, E, Loomes, M, Butow, P & Boyle, FM 2020, 'A systematic literature review of health consumer attitudes towards secondary use and sharing of health administrative and clinical trial data: a focus on privacy, trust, and transparency', Systematic Reviews, vol. 9, no. 1.
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AbstractWe aimed to synthesise data on issues related to stakeholder perceptions of privacy, trust, and transparency in use of secondary data. A systematic literature review of healthcare consumer attitudes towards the secondary use and sharing of health administrative and clinical trial data was conducted. EMBASE/MEDLINE, Cochrane Library, PubMed, CINAHL, Informit Health Collection, PROSPERO Database of Systematic Reviews, PsycINFO, and ProQuest databases were searched. Eligible articles included those reporting qualitative or quantitative original research and published in English. No restrictions were placed on publication dates, study design or disease setting. One author screened articles for eligibility, and two authors were involved in the full text review process. Data was extracted using a pre-piloted data extraction template by one author and checked by another. Conflicts were resolved by consensus. Quality and bias were assessed using the QualSyst criteria for qualitative and quantitative studies. This paper focuses on a subset of 35 articles identified from the wider search which focus on issues of privacy, trust, and transparency. Studies included a total of 56,365 respondents. Results of this systematic literature review indicate that while respondents identified advantages in sharing health data, concerns relating to trust, transparency, and privacy remain. Organisations collecting health data and those who seek to share data or undertake secondary data analysis should continue to develop trust, transparency, and privacy with healthcare consumers through open dialogue and education. Consideration should be given to these issues at all stages of data collection including the conception, design, and implementation phases. While individuals understand the benefits of health data sharing for research purposes, ensuring a balance between public benefit and individual privacy is essential. Researchers and those ...

Hutchings, E, Loomes, M, Butow, P & Boyle, FM 2020, 'A systematic literature review of researchers’ and healthcare professionals’ attitudes towards the secondary use and sharing of health administrative and clinical trial data', Systematic Reviews, vol. 9, no. 1.
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Abstract A systematic literature review of researchers and healthcare professionals’ attitudes towards the secondary use and sharing of health administrative and clinical trial data was conducted using electronic data searching. Eligible articles included those reporting qualitative or quantitative original research and published in English. No restrictions were placed on publication dates, study design, or disease setting. Two authors were involved in all stages of the review process; conflicts were resolved by consensus. Data was extracted independently using a pre-piloted data extraction template. Quality and bias were assessed using the QualSyst criteria for qualitative studies. Eighteen eligible articles were identified, and articles were categorised into four key themes: barriers, facilitators, access, and ownership; 14 subthemes were identified. While respondents were generally supportive of data sharing, concerns were expressed about access to data, data storage infrastructure, and consent. Perceptions of data ownership and acknowledgement, trust, and policy frameworks influenced sharing practice, as did age, discipline, professional focus, and world region. Young researchers were less willing to share data; they were willing to share in circumstances where they were acknowledged. While there is a general consensus that increased data sharing in health is beneficial to the wider scientific community, substantial barriers remain. Systematic review registration PROSPERO CRD42018110559

Ioannidis, AS, Töteberg-Harms, M, Hamann, T & Hodge, C 2020, '<p>Refractive Outcomes After Trabecular Micro-Bypass Stents (iStent <em>Inject</em>) with Cataract Extraction in Open-Angle Glaucoma</p>', Clinical Ophthalmology, vol. Volume 14, pp. 517-524.
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Purpose:Simultaneous cataract and glaucoma surgery has traditionally been challenging for the anterior segment surgeon. The introduction of minimally invasive glaucoma surgery (MIGS) in conjunction with cataract surgery appears safe and effective in lowering intraocular pressure. Although a significant visual impact leading from the combined procedure is unexpected, we aim to describe the refractive outcomes in a cohort of patients undergoing simultaneous cataract removal and iStent inject and discuss the potential implications of combined surgery in patients with co-existent glaucoma. Patients and Methods:This is a retrospective consecutive case series inclusive of patients undergoing combined femtosecond laser-assisted cataract surgery and the insertion of two trabecular micro-bypass stents (iStent inject). Visual acuity, refraction and astigmatic vector analysis were collated and analysed from the preoperative and 4 weeks postoperative visits. Results:One hundred and six eyes of 89 patients from 2 surgeons were included in the original cohort. The mean absolute difference from target refraction was 0.36 ± 0.25D. 73.9% of eyes were within ± 0.5D of the refractive target and 98.9% of eyes were within ± 1.00D. 73.8% of eyes had 0.5D or less residual refractive astigmatism following the procedure. Conclusion:We present a novel cohort of glaucoma patients undergoing combined trabecular micro-bypass stents (iStent inject) and cataract surgery achieving excellent refractive outcomes. The results of this study indicate that this second-generation device is refractively neutral.

Ivers, R, Coombes, J, Sherrington, C, Mackean, T, Tiedemann, A, Hill, A-M, Keay, L, Clemson, L, Simpson, J, Ryder, C, Macniven, R & Clapham, K 2020, 'Healthy ageing among older Aboriginal people: the Ironbark study protocol for a cluster randomised controlled trial', Injury Prevention, vol. 26, no. 6, pp. 581-587.
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IntroductionOlder Aboriginal people have a strong leadership role in their community including passing on knowledge and teachings around culture and connections to Country. Falls significantly affect older people and are a growing concern for older Aboriginal people and their families. Regular participation in balance and strength exercise has been shown to be efficacious in reducing falls. A pilot study developed in partnership with Aboriginal communities, the Ironbark: Standing Strong and Tall programme, demonstrated high community acceptability and feasibility, and gains in balance and strength in Aboriginal participants. This cluster randomised controlled trial will assess the effectiveness of the programme in reducing the rate of falls in older Aboriginal people.MethodsWe will examine the effectiveness and cost-effectiveness of the Ironbark group-based fall prevention programme compared with a group-based social programme, with Aboriginal people aged 45 years and older in three Australian states. The primary outcome is fall rates over 12 months, measured using weekly self-reported data. Secondary outcomes measured at baseline and after 12 months include quality of life, psychological distress, activities of daily living, physical activity, functional mobility and central obesity. Differences between study groups in the primary and secondary outcomes at 12 months will be estimated.ConclusionThis is the first trial to investigate the effectiveness and cost-effectiveness of a fall prevention programme for Aboriginal peoples aged ≥45 years. The study has strong cultural and community governance, including Aboriginal investigators and staff, and is guided by a steering committee that includes representatives of Aboriginal community-controlled services.

Jefferson, FA, Shires, A & McAloon, J 2020, 'Parenting Self-compassion: a Systematic Review and Meta-analysis', Mindfulness, vol. 11, no. 9, pp. 2067-2088.
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Jha, NK, Sharma, A, Jha, SK, Ojha, S, Chellappan, DK, Gupta, G, Kesari, KK, Bhardwaj, S, Shukla, SD, Tambuwala, MM, Ruokolainen, J, Dua, K & Singh, SK 2020, 'Alzheimer's disease-like perturbations in HIV-mediated neuronal dysfunctions: understanding mechanisms and developing therapeutic strategies', Open Biology, vol. 10, no. 12, pp. 200286-200286.
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Excessive exposure to toxic substances or chemicals in the environment and various pathogens, including viruses and bacteria, is associated with the onset of numerous brain abnormalities. Among them, pathogens, specifically viruses, elicit persistent inflammation that plays a major role in Alzheimer's disease (AD) as well as dementia. AD is the most common brain disorder that affects thought, speech, memory and ability to execute daily routines. It is also manifested by progressive synaptic impairment and neurodegeneration, which eventually leads to dementia following the accumulation of Aβ and hyperphosphorylated Tau. Numerous factors contribute to the pathogenesis of AD, including neuroinflammation associated with pathogens, and specifically viruses. The human immunodeficiency virus (HIV) is often linked with HIV-associated neurocognitive disorders (HAND) following permeation through the blood–brain barrier (BBB) and induction of persistent neuroinflammation. Further, HIV infections also exhibited the ability to modulate numerous AD-associated factors such as BBB regulators, members of stress-related pathways as well as the amyloid and Tau pathways that lead to the formation of amyloid plaques or neurofibrillary tangles accumulation. Studies regarding the role of HIV in HAND and AD are still in infancy, and potential link or mechanism between both is not yet established. Thus, in the present article, we attempt to discuss various molecular mechanisms that contribute to the basic understanding of the role of HIV-associated neuroinflammation in AD and HAND. Further, using numerous growth factors and drugs, we also present possible therapeutic strategies to curb the neuroinflammatory changes and its associated sequels.

Jiang, JY, Hodge, C & Lawless, M 2020, 'Understanding chord mu through a large population‐based study', Clinical & Experimental Ophthalmology, vol. 48, no. 7, pp. 998-1001.
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Jin-Ying Wong, Yin Ng, Z, Mehta, M, Shukla, SD, Panneerselvam, J, Madheswaran, T, Gupta, G, Negi, P, Kumar, P, Pillay, V, Hsu, A, Hansbro, NG, Wark, P, Bebawy, M, Hansbro, PM, Dua, K & Chellappan, DK 2020, 'Curcumin-loaded niosomes downregulate mRNA expression of pro-inflammatory markers involved in asthma: an in vitro study', Nanomedicine, vol. 15, no. 30, pp. 2955-2970.
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Aim: In this study, curcumin was encapsulated in niosomes (Nio-Curc) to increase its effectiveness for the treatment of asthma. Materials & methods: The formulation underwent various physicochemical characterization experiments, an in vitro release study, molecular simulations and was evaluated for in vitro anti-inflammatory activity. Results: Results showed that Nio-Curc had a mean particle size of 284.93 ± 14.27 nm, zeta potential of -46.93 and encapsulation efficacy of 99.62%, which demonstrates optimized physicochemical characteristics. Curcumin release in vitro could be sustained for up to 24 h. Additionally, Nio-Curc effectively reduced mRNA transcript expression of pro-inflammatory markers; IL-6, IL-8, IL-1β and TNF-α in immortalized human airway basal cell line (BCi-NS1.1). Conclusion: In this study, we have demonstrated that Nio-Curc mitigated the mRNA expression of pro-inflammatory markers in an in vitro study, which could be applied to treatment of asthma with further studies.

Kaliuzhna, M, Stein, T, Sterzer, P & Seymour, KJ 2020, 'Examining motion speed processing in schizophrenia using the flash lag illusion', Schizophrenia Research: Cognition, vol. 19, pp. 100165-100165.
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Kaluarachchi, T, McDonald, F, Patterson, P & Newton-John, TRO 2020, 'Being a teenager and cancer patient: What do adolescents and young adults with cancer find valuable and challenging with their friends and cancer peers?', Journal of Psychosocial Oncology, vol. 38, no. 2, pp. 195-209.
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© 2019, © 2019 Taylor & Francis Group, LLC. Purpose: This study examined Adolescent and Young Adult (AYA) cancer patients’ experiences with friends and cancer friends (peers) throughout their cancer journey. Research approach: Qualitative, thematic analysis. Participants: Twelve AYA diagnosed with cancer, treated within the past five years. Methodological approach: Individual semi-structured interviews, focusing on friend and peer experiences pre-/post-diagnosis, during and after treatment. Findings: Overarching themes of ‘valued’ vs. ‘challenging’ aspects with friends and peers. Interpretation: Friend and peer relationships were both valuable, but in different ways. Friends provided general support and helped AYA feel like a normal teenager, while peers provided targeted support and helped AYA feel like a normal teenager with cancer. Peers had an intimate understanding of cancer, whereas poor understanding by friends led to further challenges such as avoidance and being dismissive. Peer relations were notably challenged by a premature confrontation with mortality. Friendships evolved and changed throughout the cancer journey.

Kelman, JC, Hodge, C, Stanwell, P, Mustafic, N & Fraser, CL 2020, 'Retinal nerve fibre changes in sports‐related repetitive traumatic brain injury', Clinical & Experimental Ophthalmology, vol. 48, no. 2, pp. 204-211.
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AbstractImportanceThere is limited literature on the use of optical coherence tomography in the assessment of retinal nerve fibre layer (RNFL) thickness in sports‐related repetitive mild traumatic brain injury.BackgroundTo evaluate RNFL thickness in professional rugby league players. RNFL thinning may serve as a proxy for wider white matter degeneration.DesignCross‐sectional observational study.ParticipantsThirteen retired Australian professional rugby league players were recruited.MethodsParticipants underwent binocular optical coherence tomography to measure RNFL thickness. Each participant underwent a complete ophthalmic assessment to exclude concurrent disease.Main Outcome MeasuresRNFL thickness of each eye were compared with a normative database.ResultsParticipants had played professional Rugby League for 18 years on average and reported sustaining 15 sports‐related concussions throughout their career. The RNFL in participants was four micrometres thinner than that of matched normative data. Cohort average RNFL thickness was reduced in 12 out of 14 optical coherence testing parameters. These findings were statistically significant in the left inferonasal [P = .013] and left nasal [P = .006] sectors. There was no statistically significant relationship between RNFL thickness and other visual measures.Conclusions and RelevanceThis study is the first to demonstrate RNFL thinning in a cohort of retire...

Kemmis-Riggs, J & McAloon, J 2020, 'A Narrative Review of the Needs of Children in Foster and Kinship Care: Informing a Research Agenda', Behaviour Change, vol. 37, no. 4, pp. 171-180.
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AbstractAs a result of maltreatment, children in care can present with a range of complex needs and challenges. In addition to direct clinical care commonly provided by paediatricians, psychiatrists, and clinical psychologists, the provision of knowledge and skills to foster and kinship carers have become modes of support common in responding to these needs and challenges. A narrative review of key systematic reviews and empirical research was conducted to assess the effectiveness of existing foster carer interventions. Results indicated a range of methodological characteristics that limit our ability to develop a sound, research-driven, evidence base. As a result, we remain limited in our knowledge about which treatments are effective, for which symptoms they are effective, and for which population subgroups they are most likely to be effective. This review provides a summary of identified needs and challenges in the delivery of foster carer interventions. It provides an account of current treatment components and offers a platform for the development and progression of a programme of research in an effort to advance knowledge in the area.

Kemmis-Riggs, J, Grove, R, McAloon, J & Berle, D 2020, 'Early Parenting Characteristics Associated with Internalizing Symptoms Across Seven Waves of the Longitudinal Study of Australian Children', Journal of Abnormal Child Psychology, vol. 48, no. 12, pp. 1603-1615.
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The aim of this study was to identify whether parenting style during a child's toddler years predicts the course of the child's internalising symptoms throughout early to middle childhood. The current study uses data from waves 1 to 7 (acquired biennially) of the infant cohort (N = 4494) of Growing up in Australia: the Longitudinal Study of Australian Children (LSAC), a population-based longitudinal study. Latent class growth analysis identified four distinct longitudinal trajectories of internalizing symptoms: Low stable (66% of the children), High increasing (7%), Low increasing (17%) and High decreasing (10%). Multinomial logistic regression indicated that low self-efficacy and socioeconomic disadvantage during the toddler years were significant predictors of unfavourable (i.e., increasing) trajectories of internalizing symptoms across later childhood. Parenting hostility was a significant predictor of the low increasing trajectory. Additionally, male children were more likely than females to follow unfavourable trajectories. However, low parenting warmth was not predictive of increasing symptoms across time. Our findings highlight the importance of parenting factors in a child's early years, particularly the potentially detrimental outcomes associated with parental hostility and low self-efficacy.

Khatak, S, Mehta, M, Awasthi, R, Paudel, KR, Singh, SK, Gulati, M, Hansbro, NG, Hansbro, PM, Dua, K & Dureja, H 2020, 'Solid lipid nanoparticles containing anti-tubercular drugs attenuate the Mycobacterium marinum infection', Tuberculosis, vol. 125, pp. 102008-102008.
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The present study aimed to formulate anti-tubercular drugs (Rifampicin, Isoniazid and Pyrazinamide) loaded solid lipid nanoparticles (ATDs-SLNs) using microemulsion technique for oral administration. Central composite designed (CCD) was applied to study the effect of stearic acid (X1), Compritol® 888 ATO (X2) and equal ratio of poloxamer 188: sodium taurocholate (% w/w) (X3) on particle size, zeta potential and entrapment efficiency. The optimised formulation (SLN8) was found to be spherical in shape with mean particle size 187.9 ± 10.73 nm and zeta potential -47.4 mV. The maximum percentage entrapment of RIF, INH and PYZ in the optimised formulation was found to be 86.40 ± 0.274, 83.84 ± 0.269 and 81.43 ± 0.576, respectively. The in-vitro drug release study demonstrated that the release of drug from SLNs was slow in comparison to marketed formulation and pure ATDs. Cytotoxicity of the ATDs-SLNs was studied on murine macrophage cell line (RAW 264.7) using modified MTT assay demonstrated two folds growth inhibition of M. marinum as compared to standard antitubercular drugs. Overall, the developed SLNs may be considered as a promising anti-mycobacterial nano-drug, providing a new direction to the tuberculosis clinics.

Kneebone, II, Fife-Schaw, C, Lam, LT & das Nair, R 2020, 'The factor structure of the Center for Epidemiological Study - Depression Scale in people with multiple sclerosis', F1000Research, vol. 9, pp. 1038-1038.
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Background: Depression is common in multiple sclerosis (MS); however, its assessment is complicated by biological processes. In this context it is important to consider the performance of depression screening measures including that their factor structure is consistent with expectation.  This study sought to identify the factor structure of the Center for Epidemiological Study - Depression Scale (CES-D) in people with MS (PwMS). Methods: Participants (N = 493) were those who had consented to take part in a large three-phase longitudinal study of depression in PwMS. CES-D questionnaires completed at phase 1 of the study were utilised. An error in the questionnaire meant it was most appropriate to consider data for 19 of the 20 CES-D questionnaire items. The data was split into two samples by a random selection process to create an exploratory, model development sample and a validation sample. The first sample was subject to confirmatory factor analysis. Following examination of model fit and specification errors, the original model was modified. The revised model was tested in the confirmation sample to assess reproducibility. Results: The analysis results supported the original four factor solution for the CES-D, that is: Depressed Affect, Positive Affect, Somatic Complaints/Activity Inhibition, and Interpersonal Difficulties. Conclusions: The CES-D appears to have a coherent structure with which to examine depression in PwMS.

Koenig-Robert, R & Pearson, J 2020, 'Decoding Nonconscious Thought Representations during Successful Thought Suppression', Journal of Cognitive Neuroscience, vol. 32, no. 12, pp. 2272-2284.
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Abstract Controlling our thoughts is central to mental well-being, and its failure is at the crux of a number of mental disorders. Paradoxically, behavioral evidence shows that thought suppression often fails. Despite the broad importance of understanding the mechanisms of thought control, little is known about the fate of neural representations of suppressed thoughts. Using fMRI, we investigated the brain areas involved in controlling visual thoughts and tracked suppressed thought representations using multivoxel pattern analysis. Participants were asked to either visualize a vegetable/fruit or suppress any visual thoughts about those objects. Surprisingly, the content (object identity) of successfully suppressed thoughts was still decodable in visual areas with algorithms trained on imagery. This suggests that visual representations of suppressed thoughts are still present despite reports that they are not. Thought generation was associated with the left hemisphere, and thought suppression was associated with right hemisphere engagement. Furthermore, general linear model analyses showed that subjective success in thought suppression was correlated with engagement of executive areas, whereas thought-suppression failure was associated with engagement of visual and memory-related areas. These results suggest that the content of suppressed thoughts exists hidden from awareness, seemingly without an individual's knowledge, providing a compelling reason why thought suppression is so ineffective. These data inform models of unconscious thought production and could be used to develop new treatment approaches to disorders involving maladaptive thoughts.

Komalla, V, Allam, VSRR, Kwok, PCL, Sheikholeslami, B, Owen, L, Jaffe, A, Waters, SA, Mohammad, S, Oliver, BG, Chen, H & Haghi, M 2020, 'A phospholipid-based formulation for the treatment of airway inflammation in chronic respiratory diseases', European Journal of Pharmaceutics and Biopharmaceutics, vol. 157, pp. 47-58.
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Komalla, V, Sheikholeslami, B, Li, G, Bokshi, B, Chan, YL, Ung, A, Gregory Oliver, B, Chen, H & Haghi, M 2020, 'Impact of A Cargo-Less Liposomal Formulation on Dietary Obesity-Related Metabolic Disorders in Mice', International Journal of Molecular Sciences, vol. 21, no. 20, pp. 7640-7640.
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Current therapeutic options for obesity often require pharmacological intervention with dietary restrictions. Obesity is associated with underlying inflammation due to increased tissue macrophage infiltration, and recent evidence shows that inflammation can drive obesity, creating a feed forward mechanism. Therefore, targeting obesity-induced macrophage infiltration may be an effective way of treating obesity. Here, we developed cargo-less liposomes (UTS-001) using 1,2-dioleoyl-sn-glycero-3-phosphocholine, DOPC (synthetic phosphatidylcholine) as a single-agent to manage weight gain and related glucose disorders due to high fat diet (HFD) consumption in mice. UTS-001 displayed potent immunomodulatory properties, including reducing resident macrophage number in both fat and liver, downregulating liver markers involved in gluconeogenesis, and increasing marker involved in thermogenesis. As a result, UTS-001 significantly enhanced systemic glucose tolerance in vivo and insulin-stimulated cellular glucose uptake in vitro, as well as reducing fat accumulation upon ad libitum HFD consumption in mice. UTS-001 targets tissue residence macrophages to suppress tissue inflammation during HFD-induced obesity, resulting in improved weight control and glucose metabolism. Thus, UTS-001 represents a promising therapeutic strategy for body weight management and glycaemic control.

Kramer, I, Hooning, MJ, Mavaddat, N, Hauptmann, M, Keeman, R, Steyerberg, EW, Giardiello, D, Antoniou, AC, Pharoah, PDP, Canisius, S, Abu-Ful, Z, Andrulis, IL, Anton-Culver, H, Aronson, KJ, Augustinsson, A, Becher, H, Beckmann, MW, Behrens, S, Benitez, J, Bermisheva, M, Bogdanova, NV, Bojesen, SE, Bolla, MK, Bonanni, B, Brauch, H, Bremer, M, Brucker, SY, Burwinkel, B, Castelao, JE, Chan, TL, Chang-Claude, J, Chanock, SJ, Chenevix-Trench, G, Choi, J-Y, Clarke, CL, Collée, JM, Couch, FJ, Cox, A, Cross, SS, Czene, K, Daly, MB, Devilee, P, Dörk, T, dos-Santos-Silva, I, Dunning, AM, Dwek, M, Eccles, DM, Evans, DG, Fasching, PA, Flyger, H, Gago-Dominguez, M, García-Closas, M, García-Sáenz, JA, Giles, GG, Goldgar, DE, González-Neira, A, Haiman, CA, Håkansson, N, Hamann, U, Hartman, M, Heemskerk-Gerritsen, BAM, Hollestelle, A, Hopper, JL, Hou, M-F, Howell, A, Ito, H, Jakimovska, M, Jakubowska, A, Janni, W, John, EM, Jung, A, Kang, D, Kets, CM, Khusnutdinova, E, Ko, Y-D, Kristensen, VN, Kurian, AW, Kwong, A, Lambrechts, D, Le Marchand, L, Li, J, Lindblom, A, Lubiński, J, Mannermaa, A, Manoochehri, M, Margolin, S, Matsuo, K, Mavroudis, D, Meindl, A, Milne, RL, Mulligan, AM, Muranen, TA, Neuhausen, SL, Nevanlinna, H, Newman, WG, Olshan, AF, Olson, JE, Olsson, H, Park-Simon, T-W, Peto, J, Petridis, C, Plaseska-Karanfilska, D, Presneau, N, Pylkäs, K, Radice, P, Rennert, G, Romero, A, Roylance, R, Saloustros, E, Sawyer, EJ, Schmutzler, RK, Schwentner, L, Scott, C, See, M-H, Shah, M, Shen, C-Y, Shu, X-O, Siesling, S, Slager, S, Sohn, C, Southey, MC, Spinelli, JJ, Stone, J, Tapper, WJ, Tengström, M, Teo, SH, Terry, MB, Tollenaar, RAEM, Tomlinson, I, Troester, MA, Vachon, CM, van Ongeval, C, van Veen, EM, Winqvist, R, Wolk, A, Zheng, W, Ziogas, A, Easton, DF, Hall, P, Schmidt, MK, Børresen-Dale, A-L, Sahlberg, K, Ottestad, L, Kåresen, R, Schlichting, E, Holmen, MM, Sauer, T, Haakensen, V, Engebråten, O, Naume, B, Fosså, A, Kiserud, C, Reinertsen, K, Helland, Å, Riis, M, Geisler, J, Alnæs, GG, Clarke, C, Marsh, D, Scott, R, Baxter, R, Yip, D, Carpenter, J, Davis, A, Pathmanathan, N, Simpson, P, Graham, JD, Sachchithananthan, M, Amor, D, Andrews, L, Antill, Y, Balleine, R, Beesley, J, Bennett, I, Bogwitz, M, Botes, L, Brennan, M, Brown, M, Buckley, M, Burke, J, Butow, P, Caldon, L, Campbell, I, Chauhan, D, Chauhan, M, Chenevix-Trench, G & et al. 2020, 'Breast Cancer Polygenic Risk Score and Contralateral Breast Cancer Risk', The American Journal of Human Genetics, vol. 107, no. 5, pp. 837-848.
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Previous research has shown that polygenic risk scores (PRSs) can be used to stratify women according to their risk of developing primary invasive breast cancer. This study aimed to evaluate the association between a recently validated PRS of 313 germline variants (PRS313) and contralateral breast cancer (CBC) risk. We included 56,068 women of European ancestry diagnosed with first invasive breast cancer from 1990 onward with follow-up from the Breast Cancer Association Consortium. Metachronous CBC risk (N = 1,027) according to the distribution of PRS313 was quantified using Cox regression analyses. We assessed PRS313 interaction with age at first diagnosis, family history, morphology, ER status, PR status, and HER2 status, and (neo)adjuvant therapy. In studies of Asian women, with limited follow-up, CBC risk associated with PRS313 was assessed using logistic regression for 340 women with CBC compared with 12,133 women with unilateral breast cancer. Higher PRS313 was associated with increased CBC risk: hazard ratio per standard deviation (SD) = 1.25 (95%CI = 1.18-1.33) for Europeans, and an OR per SD = 1.15 (95%CI = 1.02-1.29) for Asians. The absolute lifetime risks of CBC, accounting for death as competing risk, were 12.4% for European women at the 10th percentile and 20.5% at the 90th percentile of PRS313. We found no evidence of confounding by or interaction with individual characteristics, characteristics of the primary tumor, or treatment. The C-index for the PRS313 alone was 0.563 (95%CI = 0.547-0.586). In conclusion, PRS313 is an independent factor associated with CBC risk and can be incorporated into CBC risk prediction models to help improve stratification and optimize surveillance and treatment strategies.

Lawless, M, Jiang, JY, Hodge, C, Sutton, G, Roberts, TV & Barrett, G 2020, 'Total keratometry in intraocular lens power calculations in eyes with previous laser refractive surgery', Clinical & Experimental Ophthalmology, vol. 48, no. 6, pp. 749-756.
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AbstractImportanceIntraocular lens (IOL) calculations in post‐refractive cases remain a concern. Our study identifies improved options for surgeons.BackgroundTo evaluate and compare the prediction accuracy of IOL power calculation methods after previous laser refractive surgery using standard keratometry (SK), measured posterior corneal astigmatism (PCA) and total keratometry (TK).DesignRetrospective consecutive cohort.ParticipantsA total of 50 consecutive patients (72 eyes) at a private institution who underwent cataract surgery with prior laser refractive procedures.MethodsMethods using SK included ASCRS mean, Barrett True‐K no history, Haigis‐L and Shammas IOL formulae. Barrett True‐K using posterior values (True K TK), Haigis and Holladay 1 Double‐K methods using TK were also assessed. Post‐surgery refraction was undertaken at minimum 3 weeks following surgery.Main Outcome MeasuresArithmetic and absolute IOL refractive prediction errors, variances in mean arithmetic IOL prediction error, and percentage of eyes within ±0.25D, ±0.50D, ±0.75D and ±1.00D of refractive prediction errors were compared.ResultsThe Barrett True‐K (TK) provided the lowest mean refractive prediction error (RPE) and variance for both prior myopes and hyperopes undergoing cataract surgery. The Barrett True‐K (TK) exhibited the highest percentages of eyes within ±0.50D, ±0.75D and ±1.00D of the RPE compared to other formulae for prior myopic patients.Conclusions and RelevanceAccur...

Levitz, LM, Hodge, C, Grzybowski, A & Kim, SJ 2020, 'Dual therapy for cystoid macular edema treatment after phacoemulsification surgery', Journal of Cataract and Refractive Surgery, vol. 46, no. 12, pp. 1691-1691.
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Lucas, C, Power, T, Kennedy, DS, Forrest, G, Hemsley, B, Freeman-Sanderson, A, Courtney-Harris, M, Ferguson, C & Hayes, C 2020, 'Conceptualisation and development of the RIPE-N model (reflective interprofessional education-network model) to enhance interprofessional collaboration across multiple health professions', Reflective Practice, vol. 21, no. 5, pp. 712-730.
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© 2020, © 2020 Informa UK Limited, trading as Taylor & Francis Group. This paper describes a novel model of learning, designed to enhance interprofessional education (IPE) and interprofessional collaboration (IPC). Lessons learned, plans for sustainability and future directions for policy, practice, implementation, and curriculum training are also discussed. The RIPE-N model (Reflective Interprofessional Education–Network model) was developed for an interprofessional simulation environment involving five health professions–pharmacy, nursing, orthoptics, physiotherapy, and speech pathology with the potential to increase the number of health professions involved. The RIPE-N model was adapted from the original RIPE Model (Reflective Interprofessional Education Model), utilising unfolding multidisciplinary case from admission through to discharge. Key adaptations of RIPE to include a greater focus on professional practice and the opportunity for collaboration by all disciplines. Reflection is critical to the RIPE-N model to develop the reflective practitioner, hence the inclusion of collaborative reflective (‘pause and reflect’) stations aimed at improving collaborative clinical decision-making skills among diverse healthcare professionals.

Luckett, T, Newton-John, T, Phillips, J, Holliday, S, Giannitrapani, K, Powell-Davies, G, Lovell, M, Liauw, W, Rowett, D, Pearson, S-A, Raymond, B, Heneka, N & Lorenz, K 2020, 'Risk of opioid misuse in people with cancer and pain and related clinical considerations: a qualitative study of the perspectives of Australian general practitioners', BMJ Open, vol. 10, no. 2, pp. e034363-e034363.
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ObjectiveTo explore the perspectives of general practitioners (GPs) concerning the risk of opioid misuse in people with cancer and pain and related clinical considerations.DesignA qualitative approach using semistructured telephone interviews. Analysis used an integrative approach.SettingPrimary care.ParticipantsAustralian GPs with experience of prescribing opioids for people with cancer and pain.ResultsTwenty-two GPs participated, and three themes emerged. Theme 1 (Misuse is not the main problem) contextualised misuse as a relatively minor concern compared with pain control and toxicity, and highlighted underlying systemic factors, including limitations in continuity of care and doctor expertise. Theme 2 (‘A different mindset’ for cancer pain) captured participants’ relative comfort in prescribing opioids for pain in cancer versus non-cancer contexts, and acknowledgement that compassion and greater perceived community acceptance were driving factors, in addition to scientific support for mechanisms and clinical efficacy. Participant attitudes towards prescribing for people with cancer versus non-cancer pain differed most when cancer was in the palliative phase, when they were unconcerned by misuse. Participants were equivocal about the risk–benefit ratio of long-term opioid therapy in the chronic phase of cancer, and were reluctant to prescribe for disease-free survivors. Theme 3 (‘The question is always, ‘how lazy have you been?’) captured participants’ acknowledgement that they sometimes prescribed opioids for cancer pain as a default, easier option compared with more holistic pain...

Maas, ET, Juch, JNS, Ostelo, RWJG, Groeneweg, JG, Kallewaard, J-W, Koes, BW, Verhagen, AP, van Dongen, JM, van Tulder, MW & Huygen, FJPM 2020, 'Cost-Effectiveness of Radiofrequency Denervation for Patients With Chronic Low Back Pain: The MINT Randomized Clinical Trials', Value in Health, vol. 23, no. 5, pp. 585-594.
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OBJECTIVES:To evaluate the cost-effectiveness of radiofrequency denervation when added to a standardized exercise program for patients with chronic low back pain. METHODS:An economic evaluation was conducted alongside 3 pragmatic multicenter, nonblinded randomized clinical trials (RCTs) in The Netherlands with a follow up of 52 weeks. 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 (n = 251), sacroiliac (SI) joints (n = 228), or a combination of facet joints, SI joints, and intervertebral discs (n = 202); and were unresponsive to initial conservative care. Quality-adjusted life-years (QALYs) and societal costs were measured using self-reported questionnaires. Missing data were imputed using multiple imputation. Bootstrapping was used to estimate statistical uncertainty. RESULTS:After 52 weeks, no difference in costs between groups was found in the facet joint or combination RCT. The total costs were significantly higher for the intervention group in the SI joint RCT. The maximum probability of radiofrequency denervation being cost-effective when added to a standardized exercise program ranged from 0.10 in the facet joint RCT to 0.17 in the SI joint RCT irrespective of the ceiling ratio, and 0.65 at a ceiling ratio of €30 000 per QALY in the combination RCT. CONCLUSIONS:Although equivocal among patients with symptoms in a combination of the facet joints, SI joints, and intervertebral discs, evidence suggests that radiofrequency denervation combined with a standardized exercise program cannot be considered cost-effective from a societal perspective for patients with chronic low back pain originating from either facet or SI joints in a Dutch healthcare setting.

Macfarlane, F, Luo, A, Moses, K, Russell, A, Cheyne, J, Bolger, ADP & Wootton, BM 2020, 'Psychometric properties of the body dysmorphic disorder‐dimensional scale', Clinical Psychologist, vol. 24, no. 2, pp. 114-122.
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Makeham, M, Pont, L, Verdult, C, Hardie, R-A, Raban, MZ, Mitchell, R, Purdy, H, Teichert, M, Ingersoll, A & Westbrook, JI 2020, 'The General Practice and Residential Aged Care Facility Concordance of Medication (GRACEMED) study', International Journal of Medical Informatics, vol. 143, pp. 104264-104264.
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BACKGROUND: The lack of interoperable IT systems between residential aged care facilities (RACF) and general practitioners (GP) in primary care settings in Australia introduces the potential for medication discrepancies and other medication errors. The aim of the GRACEMED study is to determine the extent and potential severity of medication discrepancies between general practice and RACFs, and identify factors associated with medication discrepancies. METHODS: A cross sectional study of medication discrepancies between RACF medication orders and GP medication lists was conducted in the Sydney North Health Network, Australia. A random sample of RACF residents was included from practice lists provided by the general practices. RACF medication orders and GP medication lists for the included residents were compared, and medication discrepancies between the two sources were identified and characterised in terms of discrepancy type, potential for harm and associated factors. RESULTS: 31 GPs and 203 residents were included in the study. A total of 1777 discrepancies were identified giving an overall discrepancy rate of 72.6 discrepancies for every 100 medications. Omissions were the most common discrepancy type (35.2%,) followed by dose discrepancies (34.4%) and additions (30.4%). 48.5% of residents had a discrepancy with the potential to result in moderate harm and 9.8% had a discrepancy with the potential for severe harm. Number of medications prescribed was the only factor associated with medication discrepancies. CONCLUSION: Increased use of systems that allow information sharing and improved interoperability of clinical information is urgently needed to address medication safety issues experienced by RACF residents.

Malyla, V, Paudel, KR, Shukla, SD, Donovan, C, Wadhwa, R, Pickles, S, Chimankar, V, Sahu, P, Bielefeldt-Ohmann, H, Bebawy, M, Hansbro, PM & Dua, K 2020, 'Recent advances in experimental animal models of lung cancer', Future Medicinal Chemistry, vol. 12, no. 7, pp. 567-581.
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Manandhar, B, Cochran, BJ & Rye, K 2020, 'Role of High‐Density Lipoproteins in Cholesterol Homeostasis and Glycemic Control', Journal of the American Heart Association, vol. 9, no. 1.
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Manandhar, B, Kim, HJ & Rhyu, DY 2020, 'Caulerpa okamurae extract attenuates inflammatory interaction, regulates glucose metabolism and increases insulin sensitivity in 3T3-L1 adipocytes and RAW 264.7 macrophages', Journal of Integrative Medicine, vol. 18, no. 3, pp. 253-264.
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Manchanda, R, Burnell, M, Gaba, F, Desai, R, Wardle, J, Gessler, S, Side, L, Sanderson, S, Loggenberg, K, Brady, AF, Dorkins, H, Wallis, Y, Chapman, C, Jacobs, C, Legood, R, Beller, U, Tomlinson, I, Menon, U & Jacobs, I 2020, 'Randomised trial of population‐based BRCA testing in Ashkenazi Jews: long‐term outcomes', BJOG: An International Journal of Obstetrics & Gynaecology, vol. 127, no. 3, pp. 364-375.
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ObjectiveUnselected population‐based BRCA testing provides the opportunity to apply genomics on a population‐scale to maximise primary prevention for breast‐and‐ovarian cancer. We compare long‐term outcomes of population‐based and family‐history (FH)/clinical‐criteria‐based BRCA testing on psychological health and quality of life.DesignRandomised controlled trial (RCT) (ISRCTN73338115) GCaPPS, with two‐arms: (i) population‐screening (PS); (ii) FH/clinical‐criteria‐based testing.SettingNorth London Ashkenazi‐Jewish (AJ) population.Population/SampleAJ women/men.MethodsPopulation‐based RCT (1:1). Participants were recruited through self‐referral, following pre‐test genetic counselling from the North London AJ population.Inclusion criteria: A...

McAlinden, KD, Kota, A, Haghi, M, Ghavami, S & Sharma, P 2020, 'Pharmacologic Inhibition of Vacuolar H⁺ATPase Attenuates Features of Severe Asthma in Mice', American Journal of Respiratory Cell and Molecular Biology, vol. 62, no. 1, pp. 117-120.
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Asthma can be defined as “an abnormal state of the airways which causes the airways to narrow too much and too quickly in response to a wide variety of provoking stimuli” (1), and is associated with numerous genetic and environmental interactions. Because of the complexity and heterogeneity of asthma, some patients may experience spontaneous bronchoconstriction, and especially those with severe asthma are less likely to achieve complete reversibility of airflow obstruction (2). Many patients with asthma also have comorbidities such as obesity and metabolic dysfunction, further complicating the disease phenotype and making treatment more difficult (3). The factors that determine these associations are not well understood. Current therapies that target airway narrowing and inflammation are not entirely comprehensive or universally effective, and many patients remain symptomatic. Despite advances in biological therapies, the decision criteria that clinicians use when selecting a biologic for each patient remain uncertain. Therefore, alternative novel therapies are needed to provide new avenues in the pursuit of severe asthma control. In this study, we tested the therapeutic efficacy of bafilomycin A1 (Baf) compared with fluticasone propionate (FP) in a steroid-insensitive mouse model of severe asthma. Baf, a macrolide produced by Streptomyces griseus ssp. sulphurus, is a highly selective inhibitor of vacuolar-type H+-ATPase (V-ATPase) (4, 5). One function of V-ATPases is to acidify the intracellular environment of lysosomes. In binding to V-ATPases, Baf inhibits autophagy flux by interfering with the fusion of the autophagosome with the lysosome (5, 6). Autophagy is a homeostatic process that is dependent on lysosome fusion to degrade and recycle cellular components, and dysregulation of autophagy is known to be associated with severe asthma pathogenesis (7). We further verified our findings in primary human smooth muscle cells in vitro, where we looked at overcomin...

McCaig, D, Elliott, MT, Prnjak, K, Walasek, L & Meyer, C 2020, 'Engagement with MyFitnessPal in eating disorders: Qualitative insights from online forums', International Journal of Eating Disorders, vol. 53, no. 3, pp. 404-411.
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AbstractObjectiveUsing calorie‐counting and fitness‐tracking technologies is concerning in relation to eating disorders. While studies in this area typically assess one aspect of use (e.g., frequency), engagement with a device or application is more complex. Consequently, important relationships between the use of these technologies and the eating disorder symptomatology might remain undetected. The current study therefore used comments from online eating disorder‐related forums to generate comprehensive qualitative insights into engagement with a popular calorie‐counting and fitness‐tracking application, MyFitnessPal.MethodFirst, we extracted every comment mentioning MyFitnessPal made on three eating disorder‐related forums between May 2015 and January 2018 (1,695 comments from 920 commenters). Then, we conducted an inductive thematic analysis using these comments to identify important aspects of engagement with MyFitnessPal.ResultsThe analyses resulted in three themes: Preventing misuse, describing ways in which MyFitnessPal attempts to prevent pathological use and actions taken by users to circumvent its interventions; Accuracy, outlining distrust of MyFitnessPal's accuracy and ways in which perceived inaccuracy is reduced or compensated for; and Psychosocial factors, comprising cognitive, behavioral, and social factors that influence, or are influenced by, engagement with MyFitnessPal.DiscussionThe qualitative insights provide a detailed overview of how peopl...

Mehta, M, Dhanjal, DS, Paudel, KR, Singh, B, Gupta, G, Rajeshkumar, S, Thangavelu, L, Tambuwala, MM, Bakshi, HA, Chellappan, DK, Pandey, P, Dureja, H, Charbe, NB, Singh, SK, Shukla, SD, Nammi, S, Aljabali, AA, Wich, PR, Hansbro, PM, Satija, S & Dua, K 2020, 'Cellular signalling pathways mediating the pathogenesis of chronic inflammatory respiratory diseases: an update', Inflammopharmacology, vol. 28, no. 4, pp. 795-817.
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Respiratory disorders, especially non-communicable, chronic inflammatory diseases, are amongst the leading causes of mortality and morbidity worldwide. Respiratory diseases involve multiple pulmonary components, including airways and lungs that lead to their abnormal physiological functioning. Several signaling pathways have been reported to play an important role in the pathophysiology of respiratory diseases. These pathways, in addition, become the compounding factors contributing to the clinical outcomes in respiratory diseases. A range of signaling components such as Notch, Hedgehog, Wingless/Wnt, bone morphogenetic proteins, epidermal growth factor and fibroblast growth factor is primarily employed by these pathways in the eventual cascade of events. The different aberrations in such cell-signaling processes trigger the onset of respiratory diseases making the conventional therapeutic modalities ineffective. These challenges have prompted us to explore novel and effective approaches for the prevention and/or treatment of respiratory diseases. In this review, we have attempted to deliberate on the current literature describing the role of major cell signaling pathways in the pathogenesis of pulmonary diseases and discuss promising advances in the field of therapeutics that could lead to novel clinical therapies capable of preventing or reversing pulmonary vascular pathology in such patients.

Mehta, M, Dhanjal, DS, Satija, S, Wadhwa, R, Paudel, KR, Chellappan, DK, Mohammad, S, Haghi, M, Hansbro, PM & Dua, K 2020, 'Advancing of Cellular Signaling Pathways in Respiratory Diseases Using Nanocarrier Based Drug Delivery Systems', Current Pharmaceutical Design, vol. 26, no. 42, pp. 5380-5392.
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Cell Signaling pathways form an integral part of our existence that allows the cells to comprehend astimulus and respond back. Such reactions to external cues from the environment are required and are essential toregulate the normal functioning of our body. Abnormalities in the system arise when there are errors developed inthese signals, resulting in a complication or a disease. Presently, respiratory diseases contribute to being the thirdleading cause of morbidity worldwide. According to the current statistics, over 339 million people are asthmatic,65 million are suffering from COPD, 2.3 million are lung cancer patients and 10 million are tuberculosis patients.This toll of statistics with chronic respiratory diseases leaves a heavy burden on society and the nation&#039;s annualhealth expenditure. Hence, a better understanding of the processes governing these cellular pathways will enableus to treat and manage these deadly respiratory diseases effectively. Moreover, it is important to comprehend thesynergy and interplay of the cellular signaling pathways in respiratory diseases, which will enable us to exploreand develop suitable strategies for targeted drug delivery. This review, in particular, focuses on the major respiratorydiseases and further provides an in-depth discussion on the various cell signaling pathways that are involvedin the pathophysiology of respiratory diseases. Moreover, the review also analyses the defining concepts aboutadvanced nano-drug delivery systems involving various nanocarriers and propose newer prospects to minimizethe current challenges faced by researchers and formulation scientists.

Mehta, M, Paudel, KR, Shukla, SD, Shastri, MD, Singh, SK, Gulati, M, Dureja, H, Gupta, G, Satija, S, Hansbro, PM, Chellappan, DK & Dua, K 2020, 'Interferon therapy for preventing COPD exacerbations.', EXCLI J, vol. 19, pp. 1477-1480.
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Menzies, RE & Menzies, RG 2020, 'Death anxiety in the time of COVID-19: theoretical explanations and clinical implications', The Cognitive Behaviour Therapist, vol. 13, p. e19.
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Abstract The recent COVID-19 pandemic has triggered a surge in anxiety across the globe. Much of the public’s behavioural and emotional response to the virus can be understood through the framework of terror management theory, which proposes that fear of death drives much of human behaviour. In the context of the current pandemic, death anxiety, a recently proposed transdiagnostic construct, appears especially relevant. Fear of death has recently been shown to predict not only anxiety related to COVID-19, but also to play a causal role in various mental health conditions. Given this, it is argued that treatment programmes in mental health may need to broaden their focus to directly target the dread of death. Notably, cognitive behavioural therapy (CBT) has been shown to produce significant reductions in death anxiety. As such, it is possible that complementing current treatments with specific CBT techniques addressing fears of death may ensure enhanced long-term symptom reduction. Further research is essential in order to examine whether treating death anxiety will indeed improve long-term outcomes, and prevent the emergence of future disorders in vulnerable populations. Key learning aims (1) To understand terror management theory and its theoretical explanation of death anxiety in the context of COVID-19. (2) To understand the transdiagnostic role of death anxiety in mental health disorders. (3) To understand current treatment approaches for directly targeting death anxiety, and the importance of doing so to improve long-term treatment o...

Menzies, RE, Neimeyer, RA & Menzies, RG 2020, 'Death Anxiety, Loss, and Grief in the Time of COVID-19', Behaviour Change, vol. 37, no. 3, pp. 111-115.
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Molinero, A, Carbajal de Lara, JA, Cantalapiedra Fernández, F, Eguilleor Villena, A, Gutiérrez Ríos, P & Amador-Fernández, N 2020, 'Demanda de antibióticos sin prescripción en la farmacia comunitaria. Descripción de la intervención del farmacéutico', Medicina de Familia. SEMERGEN, vol. 46, no. 8, pp. 545-552.
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Möller, H, Senserrick, T, Rogers, K, Sakashita, C, de Rome, L, Boufous, S, Davey, C, Cullen, P & Ivers, R 2020, 'Crash risk factors for novice motorcycle riders', Journal of Safety Research, vol. 73, pp. 93-101.
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BACKGROUND:Motorcycle riders have the highest injury and fatality rates among all road users. This research sought in-depth understanding of crash risk factors to help in developing targeted measures to reduce motorcycle crash injuries and fatalities. METHODS:We used interview data from a study of 2,399 novice motorcycle riders in Victoria, Australia from 2010 to 2012 linked with their police-recorded crash and offence data. The outcome measure was self and/or police reported crash. The association between potential risk factors and crashes was explored in multivariable logistic regression models. RESULTS:In the multivariable analysis, riders who reported being involved in three or more near crashes had 1.74 times (95% CI 1.11-2.74) higher odds of crashing compared to riders who reported no near-crash events, and riders who participated in a pre-learner course had 1.41 times higher odds of crashing (95% CI 1.07-1.87) compared with riders who did not attend a pre-learner course. Riders who had been involved in a crash before the study had 1.58 times (95% CI 1.14-2.19) higher odds of crashing during the study period compared with riders who were not involved in a crash. Each additional month of having held a license and learner permit decreased the odds of crashing by 2%, and each additional 1,000 km of riding before the study increased the odds of crashing by 2%. CONCLUSION:Measures of pre-learner training and riding experience were the strongest predictors of crashing in this cohort of novice motorcycle riders. At the time of the study there was no compulsory rider training to obtain a learner permit in Victoria and no on-road courses were available. It may be plausible that riders who voluntarily participated in an unregulated pre-learner course became or remained at high risk of crash after obtaining a rider license. We suggest systematically reviewing the safety benefits of voluntary versus mandatory pre-learner and learner courses and the potential need to in...

Moorkens, E, Barcina Lacosta, T, Vulto, AG, Schulz, M, Gradl, G, Enners, S, Selke, G, Huys, I & Simoens, S 2020, 'Learnings from Regional Market Dynamics of Originator and Biosimilar Infliximab and Etanercept in Germany', Pharmaceuticals, vol. 13, no. 10, pp. 324-324.
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Drug budget and prescription control measures are implemented regionally in Germany, meaning that the uptake of pharmaceuticals, including biosimilars, can vary by region. We examine regional market dynamics of tumor necrosis factor alpha (TNFα) inhibitor originators and biosimilars in Germany and studied the influence of biosimilar policies on these dynamics. This study is based on: (1) a literature review in which German biosimilar policies are identified, (2) the analysis of dispensing data (2010–2018) for the class of TNFα inhibitors, and (3) ten semi-structured interviews investigating prescribers’ and insurers’ views on factors potentially influencing biosimilar uptake. The analysis of biosimilar market shares of infliximab and etanercept revealed wide variations across the 17 German Regional Associations of Statutory Health Insurance Accredited Physicians (PA regions). Quantitative analyses indicated that biosimilar market shares for infliximab and etanercept were significantly lower in former East Germany when compared to former West Germany regions. Through qualitative interview analyses, this study showed that the use of infliximab and etanercept biosimilars across Germany is primarily influenced by (1) the regional-level implementation of biosimilar quotas and the presence of monitoring/sanctioning mechanisms to ensure adherence to these quotas, (2) the different insurer-manufacturer discount contracts, and (3) gainsharing arrangements established at the insurer-prescriber level.

Moses, K, Gayed, M, Chuah, S & Wootton, BM 2020, 'The Use of Evidence-Based Assessment for Anxiety Disorders in an Australian Sample', Journal of Anxiety Disorders, vol. 75, pp. 102279-102279.
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Anxiety disorders are common and cause considerable functional impairment. Fortunately, evidence-based treatments are available, however, treatment effectiveness is often reliant on the provision of an accurate diagnosis. Accurate diagnosis requires a multi-method evidence-based assessment (EBA). Assessment techniques available to clinicians include a clinical interview, semi-structured diagnostic interview, self-report/clinician-administered rating scales and direct observation. Research demonstrates that only a small number of therapists utilize EBA, and to date this has not been investigated in an Australian sample. One hundred and two registered Australian psychologists (Mage = 40.98; SD = 12.67; 83.6% female) participated in an online study investigating assessment practices. Participants were asked to indicate EBA frequency of use and the obstacles they face to using EBA. The majority of participants (69% working with adult patients and 51% working with pediatric patients) reported partial use of EBA. Few psychologists (21% working with adult patients and 11% working with child patients) indicated complete use of EBA. Thirty-six percent of participants indicated negative beliefs about the usefulness or helpfulness of EBA. Multiple obstacles to the use of EBA were reported including concerns with the time required to complete assessment (27%), and a lack of access to assessment tools (10%). Implications for training and clinical practice are discussed.

Munday, I, Newton‐John, T & Kneebone, I 2020, '‘Barbed wire wrapped around my feet’: Metaphor use in chronic pain', British Journal of Health Psychology, vol. 25, no. 3, pp. 814-830.
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ObjectivesAs there is no objective test for pain, sufferers rely on language to communicate their pain experience. Pain description frequently takes the form of metaphor; however, there has been limited research in this area. This study thus sought to extend previous findings on metaphor use in specific pain subgroups to a larger, heterogeneous chronic pain sample, utilizing a systematic method of metaphor analysis.DesignConceptual metaphor theory was utilized to explore the metaphors used by those with chronic pain via qualitative methodology.MethodsAn anonymous online survey was conducted which asked for the descriptions and metaphors people use to describe their pain. Systematic metaphor analysis was used to classify and analyse the metaphors used into specific metaphor source domains.ResultsParticipants who reported chronic pain completed the survey (N = 247, age 19–78, M = 43.69). Seven overarching metaphor source domains were found. These were coded as Causes of Physical Damage, Common Pain Experiences, Electricity, Insects, Rigidity, Bodily Misperception, and Death and Mortality.ConclusionsParticipants utilized a wide variety of metaphors to describe their pain. The most common descriptions couched chronic pain in terms of physical damage. A better understanding of pain metaphors may have implications for improved health care communication and provide targets for clinical interventions.

Mutsaers, BJ, Janssen, FJF, Koes, BW, Pool-Goudswaard, A & Verhagen, AP 2020, 'Differences in Patient Characteristics, Number of Treatments, and Recovery Rates Between Referred and Self-referred Patients With Nonspecific Neck Pain in Manual Therapy: A Secondary Analysis', Journal of Manipulative and Physiological Therapeutics, vol. 43, no. 6, pp. 559-565.
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Objective

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Conclusion

Mutsaers, J-HAM, Pool-Goudzwaard, AL, Peters, R, Koes, BW & Verhagen, AP 2020, 'Recovery expectations of neck pain patients do not predict treatments outcome in manual therapy', Scientific Reports, vol. 10, no. 1.
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AbstractPatient recovery expectations can predict treatment outcome. Little is known about the association of patient recovery expectations on treatment outcome in patients with neck pain consulting a manual therapist. This study evaluates the predictive value of recovery expectations in neck pain patients consulting manual therapists in the Netherlands. The primary outcome measure ‘recovery’ is defined as ‘reduction in pain and perceived improvement’. A prospective cohort study a total of 1195 neck pain patients. Patients completed the Patient Expectancies List (PEL) at baseline (3 item questionnaire, score range from 3 to 12), functional status (NDI), the Global Perceived Effect (GPE) for recovery (7-points Likert scale) post treatment and pain scores (NRS) at baseline and post treatment. The relationship between recovery expectancy and recovery (dichotomized GPE scores) was assessed by logistic regression analysis. Patients generally reported high recovery expectations on all three questions of the PEL (mean sumscores ranging from 11.3 to 11.6). When adjusted for covariates the PEL sum-score did not predict recovery (explained variance was 0.10 for the total PEL). Separately, the first question of the PEL showed predictive potential (OR 3.7; 95%CI 0.19–73.74) for recovery, but failed to reach statistical significance. In this study patient recovery expectations did not predict treatment outcome. Variables predicting recovery were recurrence and duration of pain. The precise relationship between patient recovery expectations and outcome is complex and still inconclusive. Research on patient expectancy would benefit from more consistent use of theoretical expectancy and outcome models.

Næss-Schmidt, E, Andersen, N-BDV, Christiansen, DH, Nielsen, JF & Stubbs, PW 2020, 'Cohort profile: Design and implementation of the Danish Physiotherapy Research Database for patients receiving primary care with chronic disease', BMJ Open, vol. 10, no. 11, pp. e040207-e040207.
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PurposeFree of charge physiotherapy (FCP) is free physiotherapy provided by the Danish government for patients with a range of chronic diseases. To date, the population has not been described in depth making evaluation and decision making difficult. The purpose of this study was to (1) describe the development and the content of a novel clinical physiotherapy database for FCP (PhysDB-FCP) and (2) present the cohort profile based on the data collected.ParticipantsNinety-nine clinics (17 460 FCP patients) were invited to participate in the development process from 2018 to 2019. Eleven clinics consented (2780 FCP patients) and 534 patients performed the physiotherapy assessment using the PhysDB-FCP tool, with 393/534 completing the patient survey.Findings to dateThe content of the PhysDB-FCP was developed through an iterative process involving consensus between clinical and research workgroups. Prior to using the tool all consenting sites received training to use/administer the tool. All data were collected/stored using the PhysDB-FCP. Items finally chosen for the PhysDB-FCP included demographic information, questions about health status and daily functioning, functional tests, treatment plan and validated questionnaires. The initial patient cohort composed of 63.4% women with main diagnoses of multiple sclerosis (22.7%) and Parkinson’s disease (17.0%). The ability to perform personal/instrumental activities of daily living and functional ability varied widely. Other non-physiotherapy related issues were identified in numerous patients (ie, 34.9% of patients were at risk of depression) and multidisciplinary interventional approaches could be considered.Future plansThe current study has provided a comprehensive description of pat...

O'Brian, S, Heard, R, Onslow, M, Packman, A, Lowe, R & Menzies, RG 2020, 'Clinical Trials of Adult Stuttering Treatment: Comparison of Percentage Syllables Stuttered With Self-Reported Stuttering Severity as Primary Outcomes', Journal of Speech, Language, and Hearing Research, vol. 63, no. 5, pp. 1387-1394.
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Purpose In a companion paper, we found no statistical reason to favor percentage syllables stuttered (%SS) over parent-reported stuttering severity as a primary outcome measure for clinical trials of early stuttering. Hence, considering the logistical advantages of the latter measure, we recommended parent-reported stuttering severity for use as an outcome measure. The present report extends the prior analysis to a comparison of %SS with self-reported stuttering severity (SRSS) for use as an outcome measure in clinical trials of stuttering treatments for adults. Method We analyzed data from four randomized clinical trials for adults that incorporated %SS and SRSS data at prerandomization and at 6 months post randomization. We analyzed the distributions associated with the two measures, their agreement, and their estimates of effect sizes. Results The positively skewed distribution of %SS warrants much reservation about its value as a clinical trial outcome measure. This skew causes inherent instability because of spurious data associated with low scores, which occur commonly at the low end of such a distribution. This inherent instability is compounded by inherent problems with absolute reliability of %SS measures. These problems are reduced with the much more normal distribution of SRSS. Conclusions The logistical arguments in favor of SRSS apply similarly to adults as they do when parents report the stuttering severity of their children. However, there are statistical reasons to favor SRSS over %SS measures as a primary outcome of clinical trials with adult partic...

Osborn, R, Roberts, L & Kneebone, I 2020, 'Barriers to accessing mental health treatment for parents of children with intellectual disabilities: a preliminary study', Disability and Rehabilitation, vol. 42, no. 16, pp. 2311-2317.
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PURPOSE:Parents of children with intellectual disability often experience heightened levels of psychological distress compared to parents of typically developing children due to increased parenting demands. Given these demands, parents may also have difficulty accessing mental health treatment for themselves. This research investigated whether parents of children with intellectual disability experience barriers in accessing mental health treatment for themselves related to the increased parenting demands of having a child with an intellectual disability. MATERIALS AND METHODS:80 parents of children with intellectual disability were surveyed about barriers to accessing mental health treatment for themselves and interest in an e-treatment. RESULTS:Parents who experienced mental health difficulties were more likely to experience barriers in accessing treatment. For parents who had experienced mental health difficulties, cost, arranging childcare, and availability of providers were significant barriers to accessing treatment. Older participants were less likely to report cost as a barrier. Participants with higher incomes were less likely to report work scheduling as a barrier. Participants reported interest in an e-treatment, with younger participants more likely to express interest. CONCLUSIONS:These preliminary findings suggest that parents of children with intellectual disability experience barriers to accessing treatment. Research directions include developing e-treatments for these carers. Implications for rehabilitation Having a child with an intellectual disability is associated with increased parenting demands, and significant stress for parents The results of this survey suggest that for parents who are experiencing mental health difficulties, cost, arranging childcare and availability of providers may act as barriers to accessing treatment for their own mental health concerns Rehabilitation professionals can assist parents in addressing these bar...

Ouyang, M, Boaden, E, Arima, H, Lavados, PM, Billot, L, Hackett, ML, Olavarría, VV, Muñoz-Venturelli, P, Song, L, Rogers, K, Middleton, S, Pontes-Neto, OM, Lee, T-H, Watkins, C, Robinson, T & Anderson, CS 2020, 'Dysphagia screening and risks of pneumonia and adverse outcomes after acute stroke: An international multicenter study', International Journal of Stroke, vol. 15, no. 2, pp. 206-215.
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Background Dysphagia is associated with aspiration pneumonia after stroke. Data are limited on the influences of dysphagia screen and assessment in clinical practice. Aims To determine associations between a “brief” screen and “detailed” assessment of dysphagia on clinical outcomes in acute stroke patients. Methods A prospective cohort study analyzed retrospectively using data from a multicenter, cluster cross-over, randomized controlled trial (Head Positioning in Acute Stroke Trial [HeadPoST]) from 114 hospitals in nine countries. HeadPoST included 11,093 acute stroke patients randomized to lying-flat or sitting-up head positioning. Herein, we report predefined secondary analyses of the association of dysphagia screening and assessment and clinical outcomes of pneumonia and death or disability (modified Rankin scale 3–6) at 90 days. Results Overall, 8784 (79.2%) and 3917 (35.3%) patients were screened and assessed for dysphagia, respectively, but the frequency and timing for each varied widely across regions. Neither use of a screen nor an assessment for dysphagia was associated with the outcomes, but their results were compared to “screen-pass” patients, those who failed had higher risks of pneumonia (adjusted odds ratio [aOR] = 3.00, 95% confidence interval [CI] = 2.18–4.10) and death or disability (aOR = 1.66, 95% CI = 1.41–1.95). Similar results were evidence for the results of an assessment for dysphagia. Subsequent feeding restrictions were related to higher risk of pneumonia in patients failed dysphagia screen or assessment (aOR = 4.06, 95% CI = 1.72–9.54). Conclusions Failing a dysphagia screen is associated with increased risks of pneumonia and poor clin...

Parker, PD, Van Zanden, B, Marsh, HW, Owen, K, Duineveld, JJ & Noetel, M 2020, 'The Intersection of Gender, Social Class, and Cultural Context: a Meta-Analysis', Educational Psychology Review, vol. 32, no. 1, pp. 197-228.
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© 2019, Springer Science+Business Media, LLC, part of Springer Nature. Expectancy value theory is often evoked by educational psychologists to explain gender differences in Science, Technology, Engineering, and Mathematics (STEM) variables. Yet gender does not operate in isolation. Nor are gender effects likely to be context free. In the current meta-analysis, we explore gender differences in STEM-related expectancy for success, and the task values of intrinsic, utility, attainment, and cost. We find that gender differences were generally small in size. Invoking the concept of intersectionality, we find that heterogeneity in gender effect sizes are large and gender differences are moderated, primarily, by socioeconomic status, ethnic diversity, and somewhat by national gender equality.

Pate, JW, Hancock, MJ, Hush, JM, Gray, K, Pounder, M & Pacey, V 2020, 'Prognostic factors for pain and functional disability in children and adolescents with persisting pain: A systematic review and meta‐analysis', European Journal of Pain, vol. 24, no. 4, pp. 722-741.
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AbstractBackground and objectiveThe aim of this study was to investigate prognostic factors for pain and functional disability in children and/or adolescents with persisting pain.Databases and data treatmentTo be included, studies had to be published, peer‐reviewed prospective cohort studies of children and/or adolescents with persisting pain at baseline, that reported at least one baseline prognostic factor and its relationship with pain or functional disability at least 1 month after baseline. Two reviewers independently assessed study eligibility, completed data extraction and undertook quality assessment. Meta‐analyses were performed when a prognostic factor was reported in two or more studies.ResultsOf 10,992 studies identified from electronic database searches, 18 were included, investigating 62 potential prognostic factors. In clinical settings, insufficient data were available for meta‐analysis. Some positive associations with pain and/or disability were reported by single studies for older age, baseline pain intensity and baseline functional disability across multiple combinations of follow‐up times and outcomes. In community settings, meta‐analyses of two studies found that prognostic factors for the ongoing presence of pain at medium‐term (1‐year) follow‐up were older age (OR 1.25; 95% CI = 1.05–1.47), weekly day tiredness (OR 1.69; 95% CI = 1.14–2.51), weekly abdominal pain (OR 1.44; 95% CI = 1.03–2.02) and waking during the night (OR 1.49; 95% CI = 1.05–2.13). No studies in community settings reported on prognostic factors for functional disability.ConclusionsPrognostic factors having significant associations with future pain and disability were identified; however, as few were investigat...

Pate, JW, Heathcote, LC, Simons, LE, Leake, H & Moseley, GL 2020, 'Creating online animated videos to reach and engage youth: Lessons learned from pain science education and a call to action', Paediatric and Neonatal Pain, vol. 2, no. 4, pp. 131-138.
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AbstractEngaging youth in evidence‐based health education has the capacity to positively impact their experiences of health and illness across the lifespan. In particular, pain science education is now an established part of the treatment arsenal for persistent pain conditions in adults, and there are calls to build educational resources for youth with pain. In this paper, we argue that high‐quality online animated videos are a potentially excellent medium to engage youth at a mass level in pain science education. We present and compare two collaborations between clinician‐scientists and industry to create and disseminate online animated videos for pain science education (“Mysterious Science of Pain” and “Tame the Beast”). We discuss the advantages, disadvantages, and methods of evaluation for each approach, as well as summarizing overall lessons learned. We provide this information as a guiding framework for clinician‐scientists to collaborate with industry in building engaging and impactful health education resources for young people.

Pate, JW, Simons, LE, Hancock, MJ, Hush, JM, Noblet, T, Pounder, M & Pacey, V 2020, 'The Concept of Pain Inventory (COPI)', The Clinical Journal of Pain, vol. 36, no. 12, pp. 940-949.
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Objectives: Clinical guidelines recommend that health care providers assist children to understand their experience of persistent pain, with pain science education a key component of clinical management in pediatric pain clinics. Currently, no tool exists to assess a child’s concept of pain. The aim of this study was to develop such a tool and to evaluate its psychometric properties. Methods: After a rigorous process to generate items, assess content validity, evaluate readability and understandability, and pretest items, a cohort of 124 children (aged 8 to 12 y) independently completed the measure on 2 occasions, along with additional measures of pain, function, and pain-related distress. Results: The resulting unidimensional 14-item Concept of Pain Inventory (COPI) had acceptable internal consistency (α= 0.78) and moderate test-retest reliability (intraclass correlation coefficient (3,1) = 0.55; 95% CI, 0.37-0.68). Higher COPI scores reflect greater alignment with contemporary pain science. COPI scores were inversely correlated with pain intensity and functional disability, but unrelated to pain catastrophizing and pain-related fear. At 1 to 2 months’ follow-up, baseline COPI scores were inversely correlated with clinical variables of functional disability and pain intensity. Discussion: These results support the COPI as a brief, psychometrically sound tool to assess a child’s concept of pain. Clinically, this tool may facilitate individualized pain science education to target identified conceptual “gaps” or misconceptions and to evaluate the effectiveness of pain...

Paudel, KR, Dharwal, V, Patel, VK, Galvao, I, Wadhwa, R, Malyla, V, Shen, SS, Budden, KF, Hansbro, NG, Vaughan, A, Yang, IA, Kohonen-Corish, MRJ, Bebawy, M, Dua, K & Hansbro, PM 2020, 'Role of Lung Microbiome in Innate Immune Response Associated With Chronic Lung Diseases', Frontiers in Medicine, vol. 7, p. 554.
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Respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD), lung fibrosis, and lung cancer, pose a huge socio-economic burden on society and are one of the leading causes of death worldwide. In the past, culture-dependent techniques could not detect bacteria in the lungs, therefore the lungs were considered a sterile environment. However, the development of culture-independent techniques, particularly 16S rRNA sequencing, allowed for the detection of commensal microbes in the lung and with further investigation, their roles in disease have since emerged. In healthy individuals, the predominant commensal microbes are of phylum Firmicutes and Bacteroidetes, including those of the genera Veillonella and Prevotella. In contrast, pathogenic microbes (Haemophilus, Streptococcus, Klebsiella, Pseudomonas) are often associated with lung diseases. There is growing evidence that microbial metabolites, structural components, and toxins from pathogenic and opportunistic bacteria have the capacity to stimulate both innate and adaptive immune responses, and therefore can contribute to the pathogenesis of lung diseases. Here we review the multiple mechanisms that are altered by pathogenic microbiomes in asthma, COPD, lung cancer, and lung fibrosis. Furthermore, we focus on the recent exciting advancements in therapies that can be used to restore altered microbiomes in the lungs.

Payne, EA & Berle, D 2020, 'Posttraumatic stress disorder symptoms among offspring of Holocaust survivors: A systematic review and meta-analysis.', Traumatology, vol. 27, no. 3, pp. 254-264.
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Payne, JM, Walsh, KS, Pride, NA, Haebich, KM, Maier, A, Chisholm, A, Glad, DM, Casnar, CL, Rouel, M, Lorenzo, J, Del Castillo, A, North, KN & Klein‐Tasman, B 2020, 'Social skills and autism spectrum disorder symptoms in children with neurofibromatosis type 1: evidence for clinical trial outcomes', Developmental Medicine & Child Neurology, vol. 62, no. 7, pp. 813-819.
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AimWe examined key features of two outcome measures for social dysfunction and autism spectrum disorder traits, the Social Responsiveness Scale, Second Edition (SRS‐2) and the Social Skills Improvement System – Rating Scales (SSIS‐RS), in children with neurofibromatosis type 1 (NF1). The aim of the study was to provide objective evidence as to which behavioural endpoint should be used in clinical trials.MethodCross‐sectional behavioural and demographic data were pooled from four paediatric NF1 tertiary referral centres in Australia and the United States (N=122; 65 males, 57 females; mean age [SD] 9y 2mo [3y], range 3–15y).ResultsDistributions of SRS‐2 and SSIS‐RS scores were unimodal and both yielded deficits, with a higher proportion of severely impaired scores on the SRS‐2 (16.4%) compared to the SSIS‐RS (8.2%). Pearson’s product‐moment correlations revealed that both questionnaires were highly related to each other (r=−0.72, p<0.001) and to measures of adaptive social functioning (both p<0.001). Both questionnaires were significantly related to attention‐deficit/hyperactivity disorder symptoms, but only very weakly associated with intelligence.InterpretationThe SRS‐2 and SSIS‐RS capture social dysfunction associated with NF1, suggesting both may be suitable choices for assessing social outcomes in this population in a clinical trial. However, careful thought needs to be given to the nature of the intervention when selecting either as a primary endpoint.What this paper addsThe Social Responsive...

Peters, R, Schmitt, MA, Verhagen, AP, Pool-Goudzwaard, AL, Mutsaers, J-HAM & Koes, BW 2020, 'Comparing the range of musculoskeletal therapies applied by physical therapists with postgraduate qualifications in manual therapy in patients with non-specific neck pain with international guidelines and recommendations: An observational study', Musculoskeletal Science and Practice, vol. 46, pp. 102069-102069.
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The aim of this study is to compare Dutch usual care musculoskeletal therapy in patients with non-specific neck pain with recommendations from international clinical practice guidelines. Physical therapy is diverse, as it may consist of exercise, massage, advice, and other modalities. Physical therapists with post graduate qualifications in manual therapy (MT) may additionally apply spinal thrust manipulation or non-thrust mobilization techniques to treat neck pain. It is important that, in the absence of a Dutch clinical guideline for the treatment of patients with neck pain, musculoskeletal therapists use the available recommendations from international clinical practice guidelines when treating patients with neck pain. One updated clinical practice guideline was identified (Blanpied, 2017), a report from the Task Force on Neck Pain (Guzman et al., 2008) and the IFOMPT International Framework for Examination of the Cervical Region for potential of Cervical Arterial Dysfunction prior to Orthopaedic Manual Therapy Intervention (Rushton et al., 2014). At baseline 1193 patients are included and data with regard to pain, disability, fear avoidance, expectations and applied treatment modalities are gathered. Outcome is measured using the Global Perceived Effect questionnaire. Results show that patients with acute neck pain are treated significantly more often with manipulation compared to patients with sub-acute or chronic neck pain (p < .000) and younger patients are treated with manipulation more often than older patients (p < .000). In the presence of comorbidity, the preference of spinal manipulation seems to diminish, in favour of mobilization and exercise. Almost every patient receives multimodal therapy (94.3%) and spinal manipulation and mobilization are rarely used as a stand-alone treatment (4.5% and 0.8%). Dutch musculoskeletal therapists choose treatment strategies that correspond with recommendations from international guidelines.

Phillips, JR, Matar, E, Martens, KAE, Halliday, GM, Moustafa, AA & Lewis, SJG 2020, 'Evaluating the Sustained Attention Response Task to Quantify Cognitive Fluctuations in Dementia With Lewy Bodies', Journal of Geriatric Psychiatry and Neurology, vol. 33, no. 6, pp. 333-339.
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Cognitive fluctuations (CFs) are a core diagnostic feature of dementia with Lewy bodies (DLB). Detection of CF is still mostly based on subjective reports from the patient or informant; more quantitative measures are likely to improve the accuracy for the diagnosis of DLB. The purpose of the current study is to test whether performance on the Sustained Attention Response Task (SART) could distinguish those patients with DLB with and without CF. Twenty-four patients with DLB were tested on the SART and performance was related to scores on the Clinical Assessment of Fluctuations (CAFs) and One Day Fluctuation Assessment Scale (ODFAS). The number of “misses” made was a significant predictor of their fluctuation severity, attentional performance, disorganized thinking, and language production ratings on the ODFAS. However, measures on the SART did not correlate with measures on the CAF scale. In conclusion, these findings suggest that SART is a feasible measure of sustained attention in this population and has clinical and diagnostic relevance to the measurement of CF, particularly those aspects measured by the ODFAS.

Phillips, K, Brockman, R, Bailey, PE & Kneebone, II 2020, 'Schema in older adults: does the schema mode model apply?', Behavioural and Cognitive Psychotherapy, vol. 48, no. 3, pp. 341-349.
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AbstractBackground:The relevance of schema theory to psychopathology, in particular personality disorder, in younger adults is established. Investigations into the relevance of schema theory to older adults, however, is highly limited.Aims:To consider the relationship of schema modes to psychopathology in older adults and establish whether maladaptive schema modes are associated with unmet needs and that this relationship is mediated by the healthy adult mode of responding in this population.Method:One hundred and four older adults were recruited from an established database. Participants completed questionnaires assessing psychopathology, schema modes (YAMI: Young-Atkinson Mode Inventory) and basic psychological needs (BPNS: Basic Psychological Needs Scale – autonomy, competence and relatedness). Ninety-four responses were included after applying exclusion criteria.Results:The healthy adult schema mode was found to be associated with reduced psychopathology, and maladaptive child modes (angry and vulnerable child) to increased psychopathology. The healthy adult schema mode mediated the relationship between maladaptive child modes and needs satisfaction.Conclusions:As predicted by schema theory, the presence of one of the maladaptive child modes makes it difficult for an older individual to have their needs met, but the presence of healthy adult mode works to support this process.

Power, E, Bryant, L & Shrubsole, K 2020, 'Making aphasia implementation stick: ensuring the sustainability of implementation', Speech, Language and Hearing, vol. 23, no. 1, pp. 25-29.
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© 2020, © 2020 Informa UK Limited, trading as Taylor & Francis Group. Background: Evidence-practice gaps exist in aphasia rehabilitation across the continuum of care. The principles of implementation science have been utilised in recent research to reduce evidence-practice gaps and demonstrate improvements in clinical practice. However, the sustainability of these changes are unknown. Sustained outcomes are critical to establishing whether practice improvements have been maintained with clear ongoing health impacts for clients. Without sustained outcomes there is potential waste of time and resources in an already burdened health system. Aims: In this tutorial paper, we provide a brief introduction to clinical sustainability models and outline evidence for sustainability of outcomes in aphasia implementation research to date. Methods: We utilised a recent review of aphasia implementation studies to critically evaluate the sustainability of implementation research. Each included article was analysed with reference to (i) sustainability processes and measures, and (ii) important stages in designing, monitoring, and revising behaviour change. Two examples of aphasia implementation research are then presented to illustrate potential methods to enhance intermediate and long term sustainability. Results: None of the six reviewed studies contained a specific sustainability plan, and none included outcome measurement beyond 6 months post-intervention. While behaviour change approaches were utilised, no study implemented an iterative behaviour change strategy beyond one implementation cycle to address to ongoing or new implementation barriers. Discussion and Conclusions: Aphasia implementation research has not targeted implementation sustainability beyond a single ‘revolution’ of the implementation cycle. Future implementation efforts in aphasia require focus on a more continuous, iterative implementation process with reference to models of implementation that promote s...

Prasher, P, Sharma, M, Singh, L, Kumar Chellappan, D, Shukla, S, Pont, LG, Williams, KA & Dua, K 2020, 'Letter to the Editor: Integrating the Roles of Pharmacy Practice and Drug Delivery in Mitigating COVID-19.', Altern Ther Health Med, vol. 26, no. S2, pp. 90-91.
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No Abstract Available.

Prnjak, K, Mitchison, D, Griffiths, S, Mond, J, Gideon, N, Serpell, L & Hay, P 2020, 'Further development of the 12-item EDE-QS: identifying a cut-off for screening purposes', BMC Psychiatry, vol. 20, no. 1.
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AbstractBackgroundThe Eating Disorder Examination – Questionnaire Short (EDE-QS) was developed as a 12-item version of the Eating Disorder Examination Questionnaire (EDE-Q) with a 4-point response scale that assesses eating disorder (ED) symptoms over the preceding 7 days. It has demonstrated good psychometric properties at initial testing. The purpose of this brief report is to determine a threshold score that could be used in screening for probable ED cases in community settings.MethodsData collected from Gideon et al. (2016) were re-analyzed. In their study, 559 participants (80.86% female; 9.66% self-reported ED diagnosis) completed the EDE-Q, EDE-QS, SCOFF, and Clinical Impairment Assessment (CIA). Discriminatory power was compared between ED instruments using receiver operating characteristic (ROC) curve analyses.ResultsA score of 15 emerged as the threshold that ensured the best trade-off between sensitivity (.83) and specificity (.85), and good positive predictive value (.37) for the EDE-QS, with discriminatory power comparable to other ED instruments.ConclusionThe EDE-QS appears to be an instrument with good discriminatory power that could be used for ED screening purposes.

Prnjak, K, Pemberton, S, Helms, E & Phillips, JG 2020, 'Reactions to ideal body shapes', The Journal of General Psychology, vol. 147, no. 4, pp. 361-380.
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Rajeev Krishnan, S, De Rubis, G, Suen, H, Joshua, D, Lam Kwan, Y & Bebawy, M 2020, 'A liquid biopsy to detect multidrug resistance and disease burden in multiple myeloma', Blood Cancer Journal, vol. 10, no. 3.
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AbstractMultiple myeloma is an incurable cancer of bone marrow plasma cells, with a 5-year survival rate of 43%. Its incidence has increased by 126% since 1990. Treatment typically involves high-dose combination chemotherapy, but therapeutic response and patient survival are unpredictable and highly variable—attributed largely to the development of multidrug resistance (MDR). MDR is the simultaneous cross-resistance to a range of unrelated chemotherapeutic agents and is associated with poor prognosis and survival. Currently, no clinical procedures allow for a direct, continuous monitoring of MDR. We identified circulating large extracellular vesicles (specifically microparticles (MPs)) that can be used to monitor disease burden, disease progression and development of MDR in myeloma. These MPs differ phenotypically in the expression of four protein biomarkers: a plasma-cell marker (CD138), the MDR protein, P-glycoprotein (P-gp), the stem-cell marker (CD34); and phosphatidylserine (PS), an MP marker and mediator of cancer spread. Elevated levels of P-gp+and PS+MPs correlate with disease progression and treatment unresponsiveness. Furthermore, P-gp, PS and CD34 are predominantly expressed in CD138−MPs in advanced disease. In particular, a dual-positive (CD138−P-gp+CD34+) population is elevated in aggressive/unresponsive disease. Our test provides a personalised liquid biopsy with potential to address the unmet clinical need of monitoring MDR and treatment failure in myeloma.

Read, J, Sharpe, L, Burton, AL, Arean, PA, Raue, PJ, McDonald, S, Titov, N, Gandy, M & Dear, BF 2020, 'A randomized controlled trial of internet-delivered cognitive behaviour therapy to prevent the development of depressive disorders in older adults with multimorbidity', Journal of Affective Disorders, vol. 264, pp. 464-473.
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BACKGROUND:Multimorbidity, which commonly impacts older adults is associated with higher rates of depression. We aimed to investigate whether internet delivered cognitive-behaviour therapy (iCBT) could prevent depressive disorders in older adults with multimorbidity who were not currently depressed. METHOD:302 primary care and community participants aged 65 years and over, who had multimorbidity but did not meet criteria for a depressive disorder were randomised to an intervention group who received an eight-week, five session iCBT (n = 150) or to a control group (n = 152) who received treatment as usual. Diagnostic interviews were conducted at baseline, and three and six months after the intervention period, where indicated, and the presence of depressive disorder was the primary outcome. RESULTS:The intention to treat, chi-square analyses indicated there were significantly fewer cases of depressive disorder in the treatment group compared to the control group by six-month follow-up (χ²(1,302) = 5.21, p = .02). LIMITATIONS:The main limitations of this RCT are a short follow up period and low proportion of participants who developed depressive disorders. Participants were relatively well educated, with a majority having English as their first language. CONCLUSIONS:These results indicate that depressive disorder was prevented in the first six months following iCBT with three times the number of cases of depressive disorder in the control group compared to the treatment group. Further research is required to determine whether iCBT can be effective for preventing depressive disorder in this population over a longer time period.

Rezaeian, M, Georgevsky, D, Golzan, SM, Graham, S, Avolio, A & Butlin, M 2020, 'Pressure Dependency of Retinal Arterial Pulse Wave Velocity in the Rat', Artery Research, vol. 26, no. 1, pp. 27-33.
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Abstract Purpose The retinal vasculature provides unique in vivo access to the microcirculation and presents the possibility of measuring small artery (retinal) stiffness using pulse wave velocity (PWV). This study investigates whether retinal artery PWV (rPWV) has a blood pressure (BP) dependency. Methods Fundus videos from eight Sprague-Dawley rats aged 12 weeks were captured (Zeiss fundus microscope with high-speed camera, 125 fps, Optronis, Germany) simultaneously with aortic BP. Retinal artery diameter waveforms at proximal and distal sites were extracted and transit time calculated from the phase delay between frequency components (4–6 Hz, typical heart rate of rats) of the waveforms. rPWV was measured across a physiological range of mean arterial pressure (MAP): baseline (90–110 mmHg); 130 mmHg to baseline following systemic phenylephrine (PE) infusion (30 µg/kg/min); 130 mmHg to baseline during PE infusion with simultaneous inferior vena cava occlusion (VO); 70 mmHg to baseline following systemic sodium nitroprusside infusion; and 70 mmHg to baseline following VO. The correlation between retinal artery rPWV and BP was quantified. Results There was a significant positive correlation between retinal artery rPWV and MAP as expected (0.19 mm/s/mmHg, R2 = 0.59, p < 0.001). There was a positive correlation between retinal and aortic PWV (R2 = 0.09, p = 0.03). Conclusion ...

Rezaeian, M, Golzan, SM, Avolio, AP, Graham, S & Butlin, M 2020, 'The Association between Retinal and Central Pulse Wave Velocity in the Elderly', Artery Research, vol. 26, no. 3, pp. 148-153.
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Abstract Purpose The retina provides a non-invasive window to monitor microvascular circulation. Carotid-femoral Pulse Wave Velocity (cfPWV) is an indicator of large artery stiffness and is associated with systemic cardiovascular diseases. This study investigates whether Retinal artery PWV (rPWV) reflects cfPWV changes in an elderly cohort. Methods A total of 37 elderly participants (28 female, age 79 ± 5 years) were studied. Participants with a history of diabetes, glaucoma, and any neurological or eye-related disorders were excluded. Twenty four subjects were taking antihypertensive medication. A 60-s recording of retinal arterial diameter changes were captured (25 Hz frame rate, Dynamic Vessel Analyzer). Systolic blood pressure, Diastolic Blood Pressure (DBP), cfPWV and Intraocular Pressure (IOP) were measured. A custom-written algorithm was used to extract pulse amplitudes from retinal arterial diameters within one- and three-disc diameters from the optic disc. rPWV was designated as the ratio of the distance between two sites along the artery to the time delay between pulses. Predictors of rPWV were assessed by linear regression and parameter selection techniques. Results There was a positive correlation between rPWV and cfPWV (Pearson’s correlation coefficient 0.82, p < 0.001). In parameter selection models, cfPWV, transmural pressure (DBP–IOP), male sex, and IOP were isolated as predictors of rPWV. Conclusion This study found a positive correlation between rPWV and cfPWV in an elderly cohort. Th...

Robertson, L, Paparo, J & Wootton, BM 2020, 'Understanding barriers to treatment and treatment delivery preferences for individuals with symptoms of hoarding disorder: A preliminary study', Journal of Obsessive-Compulsive and Related Disorders, vol. 26, pp. 100560-100560.
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© 2020 Elsevier Inc. Hoarding Disorder (HD) is a common and debilitating mental health condition that is characterized by low treatment uptake and high drop-out rates. The aim of the present study was to 1) provide a preliminary evaluation of the barriers to psychological help-seeking and 2) understand psychological treatment preferences of individuals with clinically significant symptoms of HD. Fifty participants (82% female; M age = 47.82, SD = 12.92) completed the study. The most frequently cited barriers to treatment were related to cost (66%), self-reliance (58%), and lack of knowledge about treatment options (42%). Likelihood of seeking treatment for HD symptoms was low and past-treatment predicted treatment-seeking intention, while symptom severity, depression, and internalized stigma were non-significant predictors (F(4, 44) = 9.40, p <.001; R2 = 0.49). Participants indicated a preference for individually-administered treatment (41.3%) or remote low intensity treatments (30.4%), over accelerated or group therapy approaches. The study highlights that individuals with HD experience significant barriers to accessing psychological treatment for HD and providing a variety of low cost, evidence-based treatment approaches may enhance treatment uptake for this population.

Røe, Y, Buchbinder, R, Grotle, M, Whittle, S, Ramiro, S, Huang, H, Gagnier, J, Verhagen, A & Østensjø, S 2020, 'What Do the OMERACT Shoulder Core Set Candidate Instruments Measure? An Analysis Using the Refined International Classification of Functioning, Disability, and Health Linking Rules', The Journal of Rheumatology, vol. 47, no. 10, pp. 1557-1564.
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Objective.The objective of this paper is to assess the content and measurement constructs of the candidate instruments for the domains of “pain” and “physical function/activity” in the Outcome Measures in Rheumatology (OMERACT) shoulder core set. The results of this International Classification of Functioning, Disability, and Health (ICF)–based analysis may inform further decisions on which instruments should ultimately be included in the core set.Methods.The materials for the analysis were the 13 candidate measurement instruments within pain and physical function/activity in the shoulder core domain set, which either passed or received amber ratings (meaning there were some issues with the instrument) in the OMERACT filtering process. The content of the candidate instruments was extracted and linked to the ICF using the refined linking rules. The linking rules enhance the comparability of instruments by providing a comprehensive overview of the content of the instruments, the context in which the measurements take place, the perspectives adopted, and the types of response options.Results.The ICF content analysis showed a large variation in content and measurement constructs in the candidate instruments for the shoulder core outcome measurement set.Conclusion.Two of 6 pain instruments include constructs other than pain. Within the physical function/activity domain, 2 candidate instruments matched the domain, 3 included additional content, and 2 included meaningful concepts in the response options, suggesting that they should be omitted as candidate instruments. The analyses show that the content in most existing instruments of shoulder pain and functioning extends across core set domains.

Rose, T, Waterson, J & Caird, E 2020, 'The Communication Research Registry: facilitating access to research experiences for people with a communication disability', Speech, Language and Hearing, vol. 23, no. 4, pp. 208-220.
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Russell, A, Pozo de bolger, A, Moses, K, Luo, A & Wootton, BM 2020, 'Psychometric properties of the excoriation (skin‐picking disorder) dimensional scale', Clinical Psychologist, vol. 24, no. 3, pp. 246-253.
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Ryder, C, Mackean, T, Hunter, K, Towers, K, Rogers, K, Holland, AJA & Ivers, R 2020, 'Factors contributing to longer length of stay in Aboriginal and Torres Strait Islander children hospitalised for burn injury', Injury Epidemiology, vol. 7, no. 1.
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AbstractBackgroundAboriginal and Torres Strait Islander children have higher incidence, severity and hospital length of stay for their acute burn injuries than other Australian children. We examined factors contributing to longer length of stay for Aboriginal and Torres Strait Islander children with an acute burn injury.MethodsBurns Registry of Australia and New Zealand admissions of children < 16 years of age between October 2009 and July 2018 were analysed. Descriptive statistics explored patient and injury characteristics; Cox-regression models estimated characteristics associated with longer length of stay. Knowledge Interface methodology and Indigenous research methods were used throughout.ResultsA total of 723 children were identified as Aboriginal and Torres Strait Islander and 6257 as other Australian. The median hospital length of stay for Aboriginal and Torres Strait Islander children (5 days [CI 5–6]) was 4 days longer than other Australian children (1 day [CI 1–2]). Remoteness, flame burns, high percentage total body surface area (%TBSA) and full thickness burns were factors associated with longer length of stay for Aboriginal and Torres Strait Islander children. Similar prognostic factors were identified for other Australian children along with Streptococcus sp. and Staphylococcus sp. infection.ConclusionRemoteness, flame burns, %TBSA, and full thickness burns are prognostic factors contributing to extended hospital length of stay for all Australian children. These factors are more prevalent in Aboriginal and Torres Strait Islander children, impacting length of stay. Treatment programs, clinical guidelines, and burns policies should engage with the unique circumstances of Ab...

Saragiotto, BT, Fioratti, I, Tiedemann, A, Hancock, MJ, Yamato, TP, Wang, SSY, Chau, JY & Lin, C-WC 2020, 'The Effectiveness of Strategies to Promote Walking in People With Musculoskeletal Disorders: A Systematic Review With Meta-analysis', Journal of Orthopaedic & Sports Physical Therapy, vol. 50, no. 11, pp. 597-606.
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Satija, S, Mehta, M, Sharma, M, Prasher, P, Gupta, G, Chellappan, DK & Dua, K 2020, 'Vesicular drug delivery systems as theranostics in COVID-19', Future Medicinal Chemistry, vol. 12, no. 18, pp. 1607-1609.
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Schulz, M, Griese‐Mammen, N, Böhm, M & Laufs, U 2020, 'Letter on ‘Pharmacy‐based interdisciplinary intervention for patients with chronic heart failure: results of the PHARM‐CHF randomized controlled trial’: reply', European Journal of Heart Failure, vol. 22, no. 3, pp. 565-566.
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Schulz, M, Griese‐Mammen, N, Schumacher, PM, Anker, SD, Koehler, F, Ruckes, C, Rettig‐Ewen, V, Wachter, R, Trenk, D, Böhm, M & Laufs, U 2020, 'The impact of pharmacist/physician care on quality of life in elderly heart failure patients: results of the PHARM‐CHF randomized controlled trial', ESC Heart Failure, vol. 7, no. 6, pp. 3310-3319.
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AbstractAimsPatients with heart failure (HF) have impaired quality of life (QoL). The randomized controlled trial PHARM‐CHF investigated whether an interdisciplinary intervention consisting of regular contacts with the community pharmacy and weekly dosing aids improves medication adherence in patients with HF. It is unknown how an intervention involving frequent structured pharmacy visits affects QoL. Our aim was to explore adherence to the intervention and effects on QoL.Methods and resultsAmong 237 patients, n = 110 were randomized to pharmacy care and n = 127 to usual care. The pharmacy care group received a medication review followed by (bi‐)weekly dose dispensing and counselling. The median follow‐up was 2.0 years [inter‐quartile range (IQR) 1.2–2.7]. Median interval between pharmacy visits was 8.4 days (IQR 8.0–10.3) and the visits lasted in median 14 min (IQR 10–15). Median adherence to the intervention was 96% (IQR 84–100). QoL at 365 days was predefined as a main secondary and at 730 days as another secondary endpoint in PHARM‐CHF. QoL was measured by the Minnesota Living with Heart Failure Questionnaire; and for 111 patients (n = 47 in the pharmacy care group and n = 64 in the usual care group), data were available at baseline, and after 365 and 730 days (mean age 74 years; 41% female). Improvement in QoL was numerically higher in the pharmacy care group after 365 days and was significantly better after 730 days (difference in total scores −7.7 points [−14.5 to −1.0]; P = 0.026) compared to the usual care group. In all subgroups examined, this treatment effect was preserved. Improvements in the physical and emotional dimensions were numerically higher in the pharmacy care group afte...

Schulz, M, Griese‐Mammen, N, Schumacher, PM, Strauch, D, Freudewald, L, Said, A, Tsuyuki, RT, Laufs, U, Kintscher, U, Böhm, M & Mahfoud, F 2020, 'Development and implementation of blood pressure screening and referral guidelines for German community pharmacists', The Journal of Clinical Hypertension, vol. 22, no. 10, pp. 1807-1816.
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AbstractInvolvement of community pharmacists in the detection and control of hypertension improves patient care. However, current European or North‐American guidelines do not provide specific guidance how to implement collaboration between pharmacists and physicians, especially when and how to refer patients with undetected or uncontrolled hypertension to a physician. The German Society of Cardiology and the ABDA – Federal Union of German Associations of Pharmacists developed and tested referral recommendations for community pharmacists, embedded in two guideline worksheets. The project included a guideline‐directed blood pressure (BP) measurement and recommendations when patients should be referred to their physician. A “red flag” referral within 4 weeks was recommended when SBP was >140 mm Hg or DBP >90 mm Hg (for subjects <80 years), and >160 mm Hg or >90 mm Hg (≥80 years) in undetected individuals, or >130 mm Hg or >80 mm Hg (<65 years) and >140 mm Hg or >80 mm Hg (≥65 years) in treated patients. BP was measured in 187 individuals (86 with known hypertension, mean [±SD] age 62 ± 15 years, 64% female, and 101 without known hypertension, 47 ± 16 years, 75% female) from 17 community pharmacies. In patients with hypertension, poorly controlled BP was detected in 55% (n = 47) and were referred. A total of 16/101 subjects without a history of hypertension were referred to their physician because of uncontrolled BP. Structured BP testing in pharmacies identified a significant number of subjects with undetected/undiagnosed hypertension and patients with poorly controlled BP. Community pharmacists could play a significant role in collaboration with physicians to improve the management of hypertension.

Schulz, M, Schmoldt, A, Andresen-Streichert, H & Iwersen-Bergmann, S 2020, 'Revisited: Therapeutic and toxic blood concentrations of more than 1100 drugs and other xenobiotics', Critical Care, vol. 24, no. 1.
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AbstractIn order to assess the significance of drug/substance levels measured in intensive care medicine and clinical and forensic toxicology as well as for therapeutic drug monitoring, it is essential that a comprehensive collection of data is readily available. We revisited and expanded our 2012 compilation of therapeutic and toxic plasma concentration ranges as well as half-lives of now more than 1100 drugs and other xenobiotics.Data have been abstracted from original papers, text books, and previous compilations and have been completed with data collected in our own forensic and clinical toxicology laboratories. We compiled the data presented in the table and the corresponding annotations over the past 30+ years. A previous compilation was completely double-checked, revised, and updated, if necessary. In addition, more than 200 substances, especially drugs who have been introduced since 2012 to the market as well as illegal drugs and other xenobiotics which became known to cause intoxications were added. We carefully referenced all data. Moreover, the annotations providing details were updated and revised, when necessary.For more than 1100 drugs and other xenobiotics, therapeutic (“normal”) and, if data was available, toxic, and comatose-fatal plasma/blood concentrations as well as elimination half-lives were compiled in a table.In case of intoxications, the blood concentration of the substance and/or metabolite better predicts the clinical severity of the case when compared to the assumed amount and time of ingestion. Comparing and contrasting the clinical case against the data provided, including the half-life, may support the decision for or against further intensive care. In addition, the data provided are useful for the therapeutic monitoring of pharmacotherapies, to facilitate the diagnostic assessment and monitoring of acute and chronic intoxications as well a...

Scott, AJ, Sharpe, L, Loomes, M & Gandy, M 2020, 'Systematic Review and Meta-Analysis of Anxiety and Depression in Youth With Epilepsy', Journal of Pediatric Psychology, vol. 45, no. 2, pp. 133-144.
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Abstract Objective The aim of this systematic review and meta-analysis was to provide an estimate of the prevalence of anxiety and depressive disorders in youth with epilepsy (YWE). It also aimed to calculate the overall magnitude of observed differences in anxiety and depressive symptoms reported by YWE compared with healthy controls and investigate whether any factors moderated anxiety and depression outcomes in YWE. Methods Following prospective registration, electronic databases were searched up until October 2018. Studies were included if they reported on the rate of anxiety or depression in samples of YWE, and/or if they used valid measures of anxious or depressive symptomatology in YWE compared with a healthy control sample. Results Twenty-three studies met inclusion criteria. The overall pooled prevalence of anxiety disorders in YWE was 18.9% (95% confidence interval [CI] 12.0%–28.5%), and for depression the pooled prevalence was 13.5% (95% CI 8.8%–20.2%). In samples of YWE compared with healthy controls, significantly higher anxiety (d = 0.57, 95% CI 0.32–0.83, p &lt; .000) and depressive (d = 0.42, 95% CI 0.16–0.68, p &lt; .000) symptomatology was reported. Conclusions YWE report anxiety and depressive disorders and symptoms to a significantly higher degree than youth without epilepsy. There is also evidence that certain anxiety disorders (e.g. generalized anxiety disorder, separation anxiety disorder) are particularly elevated, per...

Shakespeare-Finch, J, Bowen-Salter, H, Cashin, M, Badawi, A, Wells, R, Rosenbaum, S & Steel, Z 2020, 'COVID-19: An Australian Perspective', Journal of Loss and Trauma, vol. 25, no. 8, pp. 662-672.
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Australia looks to be one of those lucky countries that adopted an early public health response limiting community transmission of COVID-19 and avoiding the levels of acute hospitalization and fatality seen in other settings. Yet the pandemic came on the back of the largest bushfire season the country had seen which itself followed a sequence of climatic disasters involving drought, cyclones and floods. The social and economic impact of the COVID-19 response has been substantial with widespread loss of employment, social dislocation and health fears sparked across the nation. Findings from risk modeling and population surveillance provide preliminary evidence of increased burden of psychological distress, morbidity and risk of suicide resulting from the current crisis. We also highlight the mental health risk that may arise from increased sedentary behavior with the introduction of lockdown and physical distancing measures. We also outline the potently valuable role of drawing on salutogenic models including resilience and posttraumatic growth research for individual and broader community level need.

Shanthosh, J, Rogers, K, Lung, T, Brown, J, Ivers, R, Wilson, A & Jan, S 2020, 'Effectiveness of child restraint legislation to reduce motor vehicle related serious injuries and fatalities: A national interrupted time series analysis', Accident Analysis & Prevention, vol. 142, pp. 105553-105553.
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Children that are unrestrained while travelling in a motor vehicle are more vulnerable to serious injury and death. The greatest levels of crash protection are achieved when children use the most age or size appropriate form of restraint. In this study, we aimed to examine the effectiveness of the introduction of age-appropriate child restraint legislation on serious and fatal injury in five Australian states and territories. For this interrupted time series analysis, we used a segmented regression method to assess the association between the implementation of child-restraint legislation and motor-vehicle related serious injuries and fatalities using data obtained from transport authorities in each jurisdiction. We estimated the change in annual rates after the implementation of legislation with the number of motor-vehicle accidents resulting in fatalities or serious injuries as the outcome, and the total number of injuries (minor, serious and fatal) as an offset in the model. We identified 10882 motor-vehicle related crashes resulting in fatalities (n = 188), serious injuries (n = 1730) and minor injuries (n = 8964). In NSW and VIC, the rate ratio was statistically significant and positive, indicating an increase in the rate of serious injuries and fatalities in the period post-legislation compared to the period prior to legislation. In all other states and territories, we did not find a statistically significant effect of legislation Road safety programs incorporating interventions targeted at increasing awareness of optimal restraint practices, strengthened enforcement and measures to improve the affordability of restraints are needed to support legislation.

Shariflou, S, Agar, A, Rose, K, Bowd, C & Golzan, SM 2020, 'Objective Quantification of Spontaneous Retinal Venous Pulsations Using a Novel Tablet-Based Ophthalmoscope', Translational Vision Science & Technology, vol. 9, no. 4, pp. 19-19.
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Purpose:Dynamic assessment of retinal vascular characteristics can aid in identifying glaucoma-specific biomarkers. More specifically, a loss of spontaneous retinal venous pulsations (SVPs) has been reported in glaucoma, but a lack of readily available tools has limited the ability to explore the full potential of SVP analysis in glaucoma assessment. Advancements in smart technology have paved the way for the development of portable, noninvasive, and inexpensive imaging modalities. By combining off-the-shelf optical elements and smart devices, the current study aims to determine whether SVPs can be detected and quantified using a novel tablet-based ophthalmoscope in glaucoma and glaucoma suspects. Methods:Thirty patients, including 21 with confirmed glaucoma (9 men; average age 75 ± 8 years) and 9 glaucoma suspects (5 men; average age 64 ± 9 years), were studied. All patients had intraocular pressure measurements, Humphrey visual field assessment, optical coherence tomography, and a 10-second videoscopy of the retinal circulation. The retinal vasculature recordings (46° field of view at 30 frames per second) were analyzed to extract SVP amplitudes. Results:SVPs were detected and quantified in 100% of patients with glaucoma and those with suspected glaucoma using the novel device. The average SVP amplitudes in glaucoma and glaucoma suspects were 42.6% ± 10.7% and 34% ± 6.7%, respectively. Conclusions:Our results suggest that a novel tablet-based ophthalmoscope can aid in documenting and objectively quantifying SVPs in all patients. Translational Relevance:Outcomes of this study provide an innovative, portable, noninvasive, and inexpensive solution for objective assessment of SVPs, which may have clinical relevance in glaucoma screening.

Shires, A, Sharpe, L, Davies, JN & Newton John, T 2020, 'The efficacy of mindfulness based interventions in acute pain: a systematic review and meta-analysis.', Pain, vol. 161, no. 8, pp. 1698-1707.
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Recent meta-analyses have shown MBIs to be effective for chronic pain, but no pooled estimates of the effect of MBIs on acute pain are available. This meta-analysis was conducted to fill that gap. A literature search was conducted in four databases. Articles were eligible if they reported on randomized controlled trials of MBIs for people with acute pain and included one of the following outcomes: pain severity, pain threshold, pain tolerance or pain-related distress. Two authors independently extracted the data, assessed risk of bias and provided GRADE ratings. Twenty-two studies were included. There was no evidence of an effect of MBIs on the primary outcome of pain severity in clinical (Hedge's g=0.52; [95%CI -0.241, 1.280]) or experimental settings (Hedge's g= 0.043; 95%CI [-0.161, 0.247]). There was a beneficial effect of MBIs on pain tolerance (Hedge's g=0.68; 95%CI [0.157, 1.282]) and pain threshold (Hedge's g=0.72; 95%CI [0.210, 1.154]) in experimental studies. There was no evidence of an effect of MBIs compared to control for pain-related distress in clinical (Hedge's g=0.159; 95%CI [-0.018, 0.419]) or experimental settings (Hedge's g=0.439; 95%CI [-0.164, 0.419]). GRADE assessment indicated that except for pain tolerance, the data were of low or very low quality. There is moderate evidence that MBIs are efficacious in increasing pain tolerance and weak evidence for pain threshold. However, there is an absence of good quality evidence for the efficacy of MBIs for reducing the pain severity or pain-related distress in either clinical or experimental settings.

Simmons-Mackie, N, Worrall, L, Shiggins, C, Isaksen, J, McMenamin, R, Rose, T, Guo, YE & Wallace, SJ 2020, 'Beyond the statistics: a research agenda in aphasia awareness', Aphasiology, vol. 34, no. 4, pp. 458-471.
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Singh, Y, Gupta, G, Satija, S, Pabreja, K, Chellappan, DK & Dua, K 2020, 'COVID‐19 transmission through host cell directed network of GPCR', Drug Development Research, vol. 81, no. 6, pp. 647-649.
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Smith, E, Treffiletti, A, Bailey, PE & Moustafa, AA 2020, 'The effect of attentional bias modification training on food intake in overweight and obese women', Journal of Health Psychology, vol. 25, no. 10-11, pp. 1511-1521.
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This study modified food attentional biases via computerized attentional bias modification training and examined the effects on food intake. Overweight women were randomly allocated to (1) direct attention away from food (“attentional-training”), (2) direct attention at random to food or neutral (“placebo”), or (3) no training (“control”). Individuals then completed a taste test. Those in the attentional-training consumed on average 600 kJ less of total food compared to the placebo. Those in the attentional-training had a reduction in food attentional bias compared to the placebo group, when controlling for executive function. Attentional-training seems to reduce high-calorie intake in overweight women.

Smyth, B, Zuo, L, Gray, NA, Chan, CT, de Zoysa, JR, Hong, D, Rogers, K, Wang, J, Cass, A, Gallagher, M, Perkovic, V & Jardine, M 2020, 'No evidence of a legacy effect on survival following randomization to extended hours dialysis in the ACTIVE Dialysis trial', Nephrology, vol. 25, no. 10, pp. 792-800.
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AbstractAimExtended hours haemodialysis is associated with superior survival to standard hours. However, residual confounding limits the interpretation of this observation. We aimed to determine the effect of a period of extended hours dialysis on long‐term survival among participants in the ACTIVE Dialysis trial.MethodsTwo‐hundred maintenance haemodialysis recipients were randomized to extended hours dialysis (median 24 h/wk) or standard hours dialysis (median 12 h/wk) for 12 months. Further pre‐specified observational follow up occurred at 24, 36 and 60 months. Vital status and modality of renal replacement therapy were ascertained.ResultsOver the 5 years, 38 participants died, 30 received a renal transplant, and 6 were lost to follow up. Total weekly dialysis hours did not differ between standard and extended groups during the follow‐up period (14.1 hours [95%CI 13.4‐14.8] vs 14.8 hours [95%CI 14.1‐15.6]; P = .16). There was no difference in all‐cause mortality (hazard ratio for extended hours 0.91 [95%CI 0.48‐1.72]; P = .77). Similar results were obtained after censoring participants at transplantation, and after adjusting for potential confounding variables. Subgroup analysis did not reveal differences in treatment effect by region, dialysis setting or vintage (P‐interaction .51, .54, .12, respectively).ConclusionTwelve months of extended hours dialysis did not improve long‐term survival nor affect dialysis hours after the intervention period. An urgent need remains to further define the optimal dialysis intensity across the broad range of dialysis recipients.

Sorbello, S, Quang Do, V, Palagyi, A & Keay, L 2020, 'Poorer Visual Acuity is Independently Associated With Impaired Balance and Step Length But Not Overall Physical Performance in Older Adults', Journal of Aging and Physical Activity, vol. 28, no. 5, pp. 756-764.
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This study examined the association between varying levels of visual acuity (VA) and physical performance (Short Physical Performance Battery) in older adults. A cross-sectional analysis of participants aged ≥50 years with a clinical diagnosis of vision loss across two studies was undertaken. Of 434 (96%) participants with available VA data, 74% (320/434) had nil, 7% (32/434) had mild, 8% (33/434) had moderate, and 11% (49/434) had severe visual impairment. Poorer VA of both better and worse eye was found to be significantly associated with poorer standing balance (p = .006 and p = .004, respectively); worse VA of the better eye was significantly associated with increased number of steps per meter (p = .005). Mean total Short Physical Performance Battery score of this study population was lower than published normative data for this age group. Physical activity programs for older people with reduced VA should be targeted at improving balance and gait skills to reduce falls risk.

Spencer, E, Bryant, L & Colyvas, K 2020, 'Minimizing Variability in Language Sampling Analysis', Topics in Language Disorders, vol. 40, no. 2, pp. 166-181.
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Variability is common in language sample analysis (LSA), arising from personal factors such as age or level of education, or from factors within the text such as its length and purpose. Variability can affect interpretation of results in clinical practice and research studies, as well as the ability to detect change in individuals over time. This article focuses on sample length and time-based variability in the LSA literature and how it has been addressed through a scoping review. We then propose a method for estimating the effect of this common source of variability to allow determination of reliable change in individuals over time. Although some sources of variability are acknowledged in the research literature and clinical evidence-based practice, there has been no consistent method to account for these. The proposed method we present offers a means to address text length and time-based variability and materials and examples to facilitate its implementation in future studies and practice.

Starcevic, V, Berle, D & Arnáez, S 2020, 'Recent Insights Into Cyberchondria', Current Psychiatry Reports, vol. 22, no. 11.
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PURPOSE OF REVIEW:The construct of cyberchondria was introduced relatively recently. This article aims to review the conceptualization, theoretical basis and correlates of cyberchondria, as well as its prevention and management. RECENT FINDINGS:Although there is no consensus, most definitions of cyberchondria emphasize online health research associated with heightened distress or anxiety. The two theoretical models of cyberchondria involve reassurance seeking and specific metacognitive beliefs. Cyberchondria has relationships with health anxiety, problematic Internet use and symptoms of obsessive-compulsive disorder, with public health implications pertaining to functional impairment and altered healthcare utilization. Suggestions about prevention and management of cyberchondria have been put forward, but not tested yet. Research interest in cyberchondria has steadily increased. It is uncertain whether cyberchondria can be considered a distinct entity. Future research should aim to clarify the conceptual status of cyberchondria, quantify its impact and develop evidence-based approaches for a better control of cyberchondria.

Starcevic, V, Berle, D, Arnáez, S, Vismara, M & Fineberg, NA 2020, 'The Assessment of Cyberchondria: Instruments for Assessing Problematic Online Health-Related Research', Current Addiction Reports, vol. 7, no. 2, pp. 149-165.
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© 2020, Springer Nature Switzerland AG. Purpose of Review: Cyberchondria is a problematic, i.e. distressing or anxiety-increasing pattern of online health information seeking. The development of psychometrically sound instruments for the assessment of cyberchondria is imperative for better understanding of this construct. The aim of the present article is to provide a systematic literature review of cyberchondria instruments. Recent Findings: Although several measures of cyberchondria have been developed, the Cyberchondria Severity Scale (CSS) has been used most often. The CSS is based on a solid theoretical framework, with very good to excellent reliability and validity. It has been translated into several languages. Modifications of the original version of the CSS have been introduced to refine its conceptual foundation and improve its utility by making it shorter. Summary: Further improvement of the CSS may boost the quality of cyberchondria research. There remains a need to test the theoretical underpinnings of the CSS and consider alternative models of cyberchondria.

Starcevic, V, Eslick, GD, Viswasam, K & Berle, D 2020, 'Symptoms of Obsessive-Compulsive Disorder during Pregnancy and the Postpartum Period: a Systematic Review and Meta-Analysis', Psychiatric Quarterly, vol. 91, no. 4, pp. 965-981.
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The main aim of this systematic review and meta-analysis was to calculate and compare the frequencies of obsessions and compulsions in women with obsessive-compulsive disorder (OCD) during pregnancy (OCD-P), the postpartum period (OCD-PP) and when they are neither pregnant nor postpartum (OCD-NPP). Fourteen studies were selected after applying the inclusion and exclusion criteria. The meta-analysis showed that aggressive obsessions were much more common in OCD-PP than in OCD-P and OCD-NPP and that washing/cleaning compulsions were less frequent in OCD-PP than in OCD-P and OCD-NPP. These differences were significant, whereas the frequencies of various obsessions and compulsions did not distinguish between OCD-P and OCD-NPP. Obsessions about accidental harm to the infant and other infant-focused obsessions, checking compulsions, self-reassurance and seeking reassurance from others were also relatively common in OCD-PP. Clinical manifestations of OCD-PP are relatively specific and differ from those of OCD-P and OCD-NPP, whereas OCD-P does not seem to have distinct clinical features. Although these findings do not necessarily suggest that OCD-PP is a distinct subtype of OCD, they have important conceptual and clinical implications.

Stavropoulos, A & Berle, D 2020, 'The influence of ruminative processing mode on the trajectory of intrusive memories following a negative mood induction', Journal of Behavior Therapy and Experimental Psychiatry, vol. 68, pp. 101528-101528.
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Stevens, MC, Levy, HC, Hallion, LS, Wootton, BM & Tolin, DF 2020, 'Functional Neuroimaging Test of an Emerging Neurobiological Model of Hoarding Disorder', Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, vol. 5, no. 1, pp. 68-75.
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BACKGROUND:Over the past decade, functional neuroimaging studies have found abnormal brain function in several cortical systems when patients with compulsive hoarding behaviors make decisions about personal possessions. The purpose of this study was to use functional magnetic resonance imaging to test a neurobiological model of hoarding disorder (HD) that has begun to emerge from these small studies by confirming HD-related brain dysfunction in previously implicated brain regions in the largest sample of HD patients examined to date. METHODS:We compared 79 adults diagnosed with DSM-5 HD with 44 non-HD control participants using a functional magnetic resonance imaging task of decision making to acquire or discard material possessions and on a control task involving semantic processing. RESULTS:HD brain activation profiles prominently featured insular and anterior cingulate cortex overengagement during possession-related choices that were not seen in non-HD brain activation profiles and also correlated with hoarders' clutter and difficulty discarding. Although HD patients overengaged the insula when deciding to discard, relative to when performing the non-decision making task contrast, the HD insula also was generally blunted. CONCLUSIONS:This study links the defining behavioral symptoms of HD to localized brain dysfunction within cingulo-opercular brain systems and firmly establishes the context-dependent importance of this network dysfunction in HD. The relevance of dysfunction in these brain regions is highlighted by a failure to replicate HD-related abnormalities in other brain regions implicated in prior HD functional magnetic resonance imaging studies. This study also raises the novel possibility that HD may involve abnormality in the inferior frontal cortex engaged for executive control over semantic processing.

Stewart, C, Power, E, McCluskey, A & Kuys, S 2020, 'Development of a participatory, tailored behaviour change intervention to increase active practice during inpatient stroke rehabilitation', Disability and Rehabilitation, vol. 42, no. 24, pp. 3516-3524.
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Stewart, C, Power, E, McCluskey, A, Kuys, S & Lovarini, M 2020, 'Evaluation of a staff behaviour change intervention to increase the use of ward-based practice books and active practice during inpatient stroke rehabilitation: a phase-1 pre–post observational study', Clinical Rehabilitation, vol. 34, no. 5, pp. 607-616.
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Objective: The aim of this study was to evaluate a staff behaviour change intervention to increase the use of ward-based practice books and active practice by stroke inpatients. Design: This is a pre–post observational study. Setting: This study was conducted in a inpatient rehabilitation unit in Australia. Subjects: Stroke inpatients participated in the study. Intervention: A staff behaviour change intervention was designed to support staff to implement practice books. The intervention included staff training on motivation and coaching, and weekly audit and feedback for six months. The environment was restructured to bring staff together weekly at the bedside to review audit data and share skills. Main measures: Medical record audit and behavioural mapping were used to compare the number of stroke participants with/using a practice book pre- and post-intervention. Pre- and post-intervention, the percentage of observations where a stroke participant was actively practising, repetitions of practice recorded and type of supervision were compared. Results: A total of 24 participants were observed ( n = 12 pre, n = 12 post). Post-intervention, the number of participants with practice books increased from one to six (OR = 11, 95% CI = (0.9, 550.7)), but this change was not statistically significant ( P = 0.069). Five participants recorded repetitions in their practice books post-intervention, three were observed using practice books. There was no change in median repetitions recorded ( rpbs = 0.00, 95% CI = (−0.4, 0.4), P = ...

Stubbs, PW & Mortensen, J 2020, 'Clinimetrics: The Scandinavian Stroke Scale', Journal of Physiotherapy, vol. 66, no. 2, pp. 132-132.
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The Scandinavian Stroke Scale (SSS) is a clinical measure of functional impairment and activity limitations in patients with acute stroke. It was first presented by the Copenhagen Stroke Study Group in 1985.1 The SSS consists of nine items measuring consciousness, eye movement, arm motor power, hand motor power, leg motor power, orientation, speech, facial palsy and gait.1 Each item is scored on an ordinal scale with two to five categories, with item scores ranging from 2 to 12. In the original scale, unconscious patients could not be scored, as the lowest category in this item read: reacts to verbal command, but is not fully conscious (score 2).1 However, a scale revision added the category unconscious (score 0).2 Thus, sum scores range from 0 to 58 in the edited version, with 0 indicating severe neurological deficits and 58 indicating no neurological deficits. The SSS includes items that are of functional significance to the patients and are easy to assess.1 Therefore, items such as dysarthria, visual field, sensation, and reflexes were omitted during scale development.1 The SSS can be administered in < 5 minutes by non-specialists (ie, physiotherapists and nurses).3 It is used worldwide and is available in multiple languages, including English,1 Danish4 and Portuguese.5

Stubbs, PW & Verhagen, AP 2020, 'Estimating Prevalence of Serious Spinal Pathology in Patients Presenting to the Emergency Department With Low Back Pain: Misrepresentation of Prospective Studies', The American Journal of Medicine, vol. 133, no. 10, pp. e613-e613.
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Sukkar, L, Kang, A, Hockham, C, Young, T, Jun, M, Foote, C, Pecoits-Filho, R, Neuen, B, Rogers, K, Pollock, C, Cass, A, Sullivan, D, Wong, G, Knight, J, Peiris, D, Gallagher, M & Jardine, M 2020, 'Incidence and Associations of Chronic Kidney Disease in Community Participants With Diabetes: A 5-Year Prospective Analysis of the EXTEND45 Study', Diabetes Care, vol. 43, no. 5, pp. 982-990.
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OBJECTIVE To determine the incidence of and factors associated with an estimated glomerular filtration rate (eGFR) &lt;60 mL/min/1.73 m2 in people with diabetes. RESEARCH DESIGN AND METHODS We identified people with diabetes in the EXamining ouTcomEs in chroNic Disease in the 45 and Up Study (EXTEND45), a population-based cohort study (2006–2014) that linked the Sax Institute’s 45 and Up Study cohort to community laboratory and administrative data in New South Wales, Australia. The study outcome was the first eGFR measurement &lt;60 mL/min/1.73 m2 recorded during the follow-up period. Participants with eGFR &lt; 60 mL/min/1.73 m2 at baseline were excluded. We used Poisson regression to estimate the incidence of eGFR &lt;60 mL/min/1.73 m2 and multivariable Cox regression to examine factors associated with the study outcome. RESULTS Of 9,313 participants with diabetes, 2,106 (22.6%) developed incident eGFR &lt;60 mL/min/1.73 m2 over a median follow-up time of 5.7 years (interquartile range, 3.0–5.9 years). The eGFR &lt;60 mL/min/1.73 m2 incidence rate per 100 person-years was 6.0 (95% CI 5.7–6.3) overall, 1.5 (1.3–1.9) in participants aged 45–54 years, 3.7 (3.4–4.0) for 55–64 year olds, 7.6 (7.1–8.1) for 65–74 year olds, 15.0 (13.0–16.0) for 75–84 year olds, and 26.0 (22.0–32.0) for those aged 85 years and over. In a fully adjusted multivariable model incidence was independently associated with age (hazard ratio 1.23 per 5-year increase; 95% CI 1.19–1.26), geography (outer regional and remote versus major city: 1.36; 1.17–1.58), obesity (obese class III versus normal: 1.44; 1.16–1.80), and the pr...

Sullivan, R, Harding, K, Skinner, I & Hemsley, B 2020, 'Falls in hospital patients with acquired communication disability secondary to stroke: A systematic review and meta‐analysis', International Journal of Language & Communication Disorders, vol. 55, no. 6, pp. 837-851.
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AbstractBackgroundFalls are a common safety incident in people with stroke. Studies report that between 14% and 65% of people with stroke fall at least once during their hospital admission. Risk factors for falls in people with stroke have been reported to include neglect, balance and dependence for activities of daily living. Communication disability has been identified as a risk factor for patient safety incidents in hospital that has not been closely examined as a potential risk factor for falls in people with stroke.AimTo determine the association between communication disability secondary to stroke and falls in people with stroke in hospital.Methods & ProceduresSystematic searches of five electronic databases were conducted in June 2019 using the key concepts of ‘falls’ and ‘stroke’ (PROSPERO CRD 42019137199). Included studies provided comparative data of falls in patients with stroke with and without communication disability. The methodological quality of the studies was examined using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD). Both a narrative synthesis and a meta‐analysis were completed.Main ContributionA total of 15 studies met the criteria for inclusion and 11 were included in a meta‐analysis. Three studies found people with communication disability had an increased rate of falls in hospital. However, a meta‐analysis showed no significant association between a non‐specific classification of communication disability and an increased risk of falls. There was some indication from individual studies that higher risk of falls may be associated with severe communication disability, but there were insufficient data reported on the severity of the communication disabi...

Sutton, G, Treloggen, J, Petsoglou, C & Hodge, C 2020, 'Twenty‐year review of donor characteristics in a single eye bank', Clinical & Experimental Ophthalmology, vol. 48, no. 5, pp. 706-708.
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Tang, SM, Kam, KW, French, AN, Yu, M, Chen, LJ, Young, AL, Rose, KA, Tham, CC, Pang, CP & Yam, JC 2020, 'Independent Influence of Parental Myopia on Childhood Myopia in a Dose-Related Manner in 2,055 Trios: The Hong Kong Children Eye Study', American Journal of Ophthalmology, vol. 218, pp. 199-207.
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PURPOSE:To determine the effects on childhood myopia of parental myopia, parental education, children's outdoor time and children's near wok. DESIGN:Population-based cross-sectional study METHODS: A total of 6,155 subjects in 2,055 family trios. Cycloplegic auto-refraction was measured for children and non-cycloplegic auto-refraction for parents. Parental education, children's outdoor time and near work were collected by questionnaires. Children were categorized into ten groups based on parental myopia levels. Associations of the above factors with myopia were evaluated by regression analyses. The areas under the receiver operating characteristic curve (AUROC) for myopia were evaluated. RESULTS:Mild parental myopia did not increase childhood myopia's risk, but the risk was 11.22-folds when both parents were highly myopic. Higher parental education (Father: OR=1.08, P=0.046; Mother: OR=1.11, P=0.001) and more reading time of children were risk factors (OR=1.21, P=0.044). Reduced odds of myopia were associated with more time spent on outdoor activities (OR=0.78, P=0.017) and on electronic devices (OR=0.80, P=0.005). Notably, all these factors became insignificant after adjustment, except for parental myopia. Children with more severe parental myopia spent more time on reading, but less on electronic devices. Parental myopic status alone accounted for 11.82% of myopia variation in children. With age and parental myopia, the AUROC for myopia was 0.731. CONCLUSIONS:Among parental and environmental factors, parental myopia confers, in a dose-related manner, the strongest independent effect on childhood myopia. Therefore children with high risk of myopia can be identified for early prevention, based on parental myopia data.

Tanna, V, Heathcote, LC, Heirich, MS, Rush, G, Neville, A, Noel, M, Pate, JW & Simons, LE 2020, 'Something Else Going On? Diagnostic Uncertainty in Children with Chronic Pain and Their Parents', Children, vol. 7, no. 10, pp. 165-165.
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Diagnostic uncertainty, the perceived lack of an accurate explanation of the patient’s health problem, remains relatively unstudied in children. This study examined the prevalence, familial concordance, and correlates of diagnostic uncertainty in children and their parents presenting to a multidisciplinary pain clinic in the United States. One hundred and twenty-six parents and 91 of their children (Mage = 13.93 years, range = 8–18 years) completed a brief three-item measure of diagnostic uncertainty, as well as measures of pain-related distress and functioning. Forty-eight percent of children and 37% of parents believed something else was going on with the child’s pain that doctors had not found out about yet. Across the three items, 66%–77% of children and their parents agreed in their endorsement of diagnostic uncertainty. Parents who believed that something else was going on with their child’s pain had children with higher avoidance of pain-related activities (F = 5.601, p = 0.020) and lower pain willingness (F = 4.782, p = 0.032). Neither parent nor child diagnostic uncertainty was significantly related to the child’s pain-related functioning. Diagnostic uncertainty, particularly in parents, is relevant in the experience of pediatric chronic pain and warrants further investigation as both a risk factor and therapeutic target.

Teirlinck, CH, Verhagen, AP, Reijneveld, EAE, Runhaar, J, van Middelkoop, M, van Ravesteyn, LM, Hermsen, L, de Groot, IB & Bierma-Zeinstra, SMA 2020, 'Responders to Exercise Therapy in Patients with Osteoarthritis of the Hip: A Systematic Review and Meta-Analysis', International Journal of Environmental Research and Public Health, vol. 17, no. 20, pp. 7380-7380.
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The Outcome Measures in Rheumatology workgroup (OMERACT), together with the Osteoarthritis Research Society International (OARSI) developed the OMERACT-OARSI responder criteria. These criteria are used to determine if a patient with osteoarthritis (OA) ‘responds’ to therapy, meaning experiences a clinically relevant effect of therapy. Recently, more clinical OA trials report on this outcome and most OA trials have data to calculate the number of responders according to these criteria. A systematic review and meta-analysis were performed on the response to exercise therapy, compared to no or minimal intervention in patients with hip OA using the OMERACT-OARSI responder criteria. The literature was searched for relevant randomized trials. If a trial fit the inclusion criteria, but number of responders was not reported, the first author was contacted. This way the numbers of responders of 14 trials were collected and a meta-analysis on short term (directly after treatment, 12 trials n = 1178) and long term (6–8 months after treatment, six trials n = 519) outcomes was performed. At short term, the risk difference (RD) was 0.14 (95% confidence interval (CI) 0.06–0.22) and number needed to treat (NNT) 7.1 (95% CI 4.5–17); at long term RD was 0.14 (95% CI 0.07–0.20) and NNT 7.1 (95% CI 5.0–14.3). Quality of evidence was moderate for the short term and high for the long term. In conclusion, 14% more hip OA patients responded to exercise therapy than to no therapy.

Thoomes-de Graaf, M, Wiersma, RE, Karel, Y, Duijn, E, Spek, B, Rizopoulos, D, Scholten-Peeters, GGM & Verhagen, AP 2020, 'The Effect of a Personalized Newsletter to Physical Therapists on Patient Recruitment: A Cluster Randomized Trial in Primary Physiotherapy Care', Journal of Manipulative and Physiological Therapeutics, vol. 43, no. 5, pp. 476-482.
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Objective

Methods

Results

Conclusions

Titov, N, Dear, BF, Nielssen, O, Wootton, B, Kayrouz, R, Karin, E, Genest, B, Bennett-Levy, J, Purtell, C, Bezuidenhout, G, Tan, R, Minissale, C, Thadhani, P, Webb, N, Willcock, S, Andersson, G, Hadjistavropoulos, HD, Mohr, DC, Kavanagh, DJ, Cross, S & Staples, LG 2020, 'User characteristics and outcomes from a national digital mental health service: an observational study of registrants of the Australian MindSpot Clinic', The Lancet Digital Health, vol. 2, no. 11, pp. e582-e593.
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Background:Interest is growing in digital and telehealth delivery of mental health services, but data are scarce on outcomes in routine care. The federally funded Australian MindSpot Clinic provides online and telephone psychological assessment and treatment services to Australian adults. We aimed to summarise demographic characteristics and treatment outcomes of patients registered with MindSpot over the first 7 years of clinic operation. Methods:We used an observational design to review all patients who registered for assessment with the MindSpot Clinic between Jan 1, 2013, and Dec 31, 2019. We descriptively analysed the demographics, service preferences, and baseline symptoms of patients. Among patients enrolled in a digital treatment course, we evaluated scales of depression (Patient Health Questionnaire-9 [PHQ-9]) and anxiety (Generalized Anxiety Disorder 7-Item Scale [GAD-7]), as primary measures of treatment outcome, from the screening assessment to post-treatment and a 3 month follow-up. The Kessler Psychological Distress 10-Item Plus Scale was also used to assess changes in general distress and disability, and course satisfaction was measured post-treatment. Outcomes:A total of 121 652 screening assessments were started, of which 96 018 (78·9%) were completed. The mean age of patients was 35·7 years (SD 13·8) and 88 702 (72·9%) were women. Based on available assessment data, 36 866 (34·5%) of 106 811 participants had never previously spoken to a health professional about their symptoms, and most people self-reported symptoms of anxiety (88 879 [81·9%] of 108 494) or depression (78 803 [72·6%] of 108 494), either alone or in combination, at baseline. 21 745 patients started treatment in a therapist-guided online course, of whom 14 503 (66·7%) completed treatment (≥four of five lessons). Key trends in service use included an increase in the proportion of people using MindSpot primarily for assessment and information, from 52·6% in 2013 to 66·7% i...

Treloggen, J, McKeon, H, Hodge, C & Petsoglou, C 2020, 'Ophthalmic use of amniotic membrane tissue in Australia: Introduction and initial use of a service', Clinical & Experimental Ophthalmology, vol. 48, no. 2, pp. 253-254.
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Turbitt, E & Biesecker, BB 2020, 'A primer in genomics for social and behavioral investigators', Translational Behavioral Medicine, vol. 10, no. 2, pp. 451-456.
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Abstract Genomics is being increasingly utilized in medical research and health care. Countless opportunities exist for social and behavioral scientists to answer novel and important research questions. Evidence that will be produced from such enquiries can help ensure appropriate use of genomic information and realize the potential of genomics to improve patient care and medical outcomes. Here, we provide an accessible overview of different types of genetic and genomic tests and the resulting information produced. There are important nuances that distinguish genetic from genomic tests and different information that each yield. We outline key examples where social and behavioral scientists have made an impact in this field, and opportunities for future research. The intention of this primer is to introduce or clarify genomics concepts to social and behavioral scientists, summarize prior research and outline future research directions. The time is ripe for social and behavioral scientists to engage in genomics and make important contributions to improve clinical and community translation of genomic discoveries.

Turnbull, H, Dark, L, Skinner, I & Hemsley, B 2020, 'The Readers, the Writers and the Documents', Journal of Clinical Practice in Speech-Language Pathology, vol. 22, no. 2, pp. 85-94.
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Umstead, KL, Han, PKJ, Lewis, KL, Miller, IM, Hepler, CL, Thompson, LJ, Wolfsberg, TG, Nguyen, A-D, Fredriksen, MT, Gibney, G, Turbitt, E, Biesecker, LG & Biesecker, BB 2020, 'Perceptions of uncertainties about carrier results identified by exome sequencing in a randomized controlled trial', Translational Behavioral Medicine, vol. 10, no. 2, pp. 441-450.
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Abstract How individuals perceive uncertainties in sequencing results may affect their clinical utility. The purpose of this study was to explore perceptions of uncertainties in carrier results and how they relate to psychological well-being and health behavior. Post-reproductive adults (N = 462) were randomized to receive carrier results from sequencing through either a web platform or a genetic counselor. On average, participants received two results. Group differences in affective, evaluative, and clinical uncertainties were assessed from baseline to 1 and 6 months; associations with test-specific distress and communication of results were assessed at 6 months. Reductions in affective uncertainty (∆x̅ = 0.78, 95% CI: 0.53, 1.02) and evaluative uncertainty (∆x̅ = 0.69, 95% CI: 0.51, 0.87) followed receipt of results regardless of randomization arm at 1 month. Participants in the web platform arm reported greater clinical uncertainty than those in the genetic counselor arm at 1 and 6 months; this was corroborated by the 1,230 questions asked of the genetic counselor and residual questions reported by those randomized to the web platform. Evaluative uncertainty was associated with a lower likelihood of communicating results to health care providers. Clinical uncertainty was associated with a lower likelihood of communicating results to children. Learning one’s carrier results may reduce perceptions of uncertainties, though web-based return may lead to less reduction in clinical uncertainty in the short term. These findings warrant reinforcement of clinical implications to minimize residual questions and promote appropriate health behavior (communicating results to at-risk relatives in the case of carrier results), especially when testing alternative delivery models.

Varas-Doval, R, Gastelurrutia, MA, Benrimoj, SI, García-Cárdenas, V, Sáez-Benito, L & Martinez-Martínez, F 2020, 'Clinical impact of a pharmacist-led medication review with follow up for aged polypharmacy patients: A cluster randomized controlled trial', Pharmacy Practice, vol. 18, no. 4, pp. 2133-2133.
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Background: Medication review with follow-up (MRF) is a service where community pharmacists undertake a medication review with monthly follow-up to provide continuing care. The ConSIGUE Program assessed the impact and implementation of MRF for aged polypharmacy patients in Spanish Community Pharmacies. The present paper reports on the clinical impact evaluation phase of ConSIGUE. Objective: The main objective of the study was to measure the effect of MRF on the primary outcome of the number of uncontrolled health problems. Secondary objectives were to analyze the drug-related problems (DRPs) identified as potential causes of ineffective or unsafe medications and the pharmacists’ interventions implemented during MRF provision. Methods: An open-label multi-centered cluster randomized study with comparison group (CG) was carried out in community pharmacies from 4 provinces in Spain during 6 months. The main inclusion criteria were patients over 64 years old, using 5 or more medicines. The intervention group (IG) received the MRF service (advanced medication review-type 3 MR) whereas patients in the CG received usual care. Results: 178 pharmacies recruited 1403 patients (IG= 688 patients; CG= 715 patients). During the 6 months of the study 72 patients were lost to follow up. The adjusted multi-level random effects models showed a significant reduction in the number of uncontrolled health problems over the periods in the IG (-0.72, 95% CI: -0.80, -0.65) and no change in the CG (-0.03, 95%CI: -0.10, 0.04). Main DRPs identified as potential causes of failures of uncontrolled health problems’ treatment were undertreated condition (559 DRPs; 35.81%), lack of treatment adherence (261 DRP; 16.67%) and risk of adverse effects (207 DRPs; 13.53%). Interventions performed by pharmacist to solve DRP mainly included the addition (246 interventions; 14.67%) and change (330 interventions; 19.68%) of a medicine and educational interventions on med...

Varas-Doval, R, Gastelurrutia, MA, Benrimoj, SI, Zarzuelo, MJ, Garcia-Cardenas, V, Perez-Escamilla, B & Martínez-Martínez, F 2020, 'Evaluating an implementation programme for medication review with follow-up in community pharmacy using a hybrid effectiveness study design: translating evidence into practice', BMJ Open, vol. 10, no. 9, pp. e036669-e036669.
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ObjectivesTo evaluate an implementation programme of a community pharmacy medication review with follow-up (MRF) service using a hybrid effectiveness-implementation study design, and to compare the clinical and humanistic outcomes with those in a previously conducted cluster randomised controlled trial (cRCT).SettingCommunity pharmacies in Spain.Participants135 community pharmacies and 222 pharmacists providing MRF to polymedicated patients aged 65 or over.InterventionThe intervention was an implementation programme for the MRF service. A national level group was established, mirrored with a provincial level group. A series of interventions were defined (1) to engage pharmacy owners with the implementation model and (2) to provide training to pharmacists consisting of clinical case studies, process of MRF, communication skills and data collection methods and (3) practice change facilitators.Primary and secondary outcome measuresThe primary outcomes for the implementation programme were progress, reach, fidelity and integration. The secondary outcomes were number of medications, non-controlled health problems, emergency visits, hospitalisations and health-related quality of life, which were compared with a previous 6-month cluster RCT.Results55% of pharmacies reached the implementation phase and 35.6% remained in the testing phase at 12 months. A reach of 89.3% (n=844) was achieved. Fidelity average score was 8.45 (min: 6.2, max: 9.3) out of 10. The integration mean score was 3.39 (SD: 0.72) out of 5. MRF service outcomes were similar to the cluster RCT study; however, the magnitude of the outcomes was ...

Veldre, A, Reichle, ED, Wong, R & Andrews, S 2020, 'The effect of contextual plausibility on word skipping during reading', Cognition, vol. 197, pp. 104184-104184.
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Viswasam, K, Berle, D & Starcevic, V 2020, 'Trajectories and predictors of anxiety symptoms during pregnancy in an Australian sample', Australian & New Zealand Journal of Psychiatry, vol. 54, no. 12, pp. 1173-1181.
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Background: There is a growing realisation that anxiety symptoms and disorders during pregnancy are associated with various negative outcomes. The aims of this study were to identify latent classes of anxiety symptom trajectories during pregnancy, compare anxiety levels between pregnancy trimesters and ascertain the predictors of anxiety symptom trajectories. Methods: Two hundred pregnant women in their first trimester who attended obstetric clinics at the local hospital were recruited. Three self-report questionnaires assessing anxiety levels were administered at three time points during pregnancy. Latent class growth analysis was used to identify anxiety symptom trajectories, and logistic regression analysis was performed to ascertain the predictors of latent class membership. Results: Data for analyses were available for 188 women. Two anxiety symptom trajectories were identified: a ‘high-anxiety’ trajectory (13.3% of participating women) and ‘low-anxiety’ trajectory (86.7%). This finding was consistent across all the anxiety measures used in the study. Overall, anxiety levels gradually decreased during pregnancy, with a significant decrease between the first and second trimesters on some measures. Past mental disorders and significant stressors in the preceding 6 months predicted membership in the ‘high-anxiety’ trajectory group. Conclusions: These findings support an early assessment of anxiety in pregnant women. If untreated, a high level of anxiety in the first trimester is likely to persist throughout pregnancy, although it may decrease somewhat. An early recognition of pathological anxiety during pregnancy allows its timely treatment and prevention of unfavourable outcomes.

Wadhwa, R, Paudel, KR, Mehta, M, Shukla, SD, Sunkara, K, Prasher, P, Panth, N, Goyal, R, Chellappan, DK, Gupta, G, Hansbro, PM, Aljabali, AAA, Tambuwala, MM & Dua, K 2020, 'Beyond the Obvious: Smoking and Respiratory Infection Implications on Alzheimer's Disease', CNS & Neurological Disorders - Drug Targets, vol. 19, no. 9, pp. 698-708.
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Tobacco smoke is not only a leading cause for chronic obstructive pulmonary disease, cardiovascular disorders, and lung and oral cancers, but also causes neurological disorders such as Alzheimer ’s disease. Tobacco smoke consists of more than 4500 toxic chemicals, which form free radicals and can cross blood-brain barrier resulting in oxidative stress, an extracellular amyloid plaque from the aggregation of amyloid β (Aβ) peptide deposition in the brain. Further, respiratory infections such as Chlamydia pneumoniae, respiratory syncytial virus have also been involved in the induction and development of the disease. The necessary information collated on this review has been gathered from various literature published from 1995 to 2019. The review article sheds light on the role of smoking and respiratory infections in causing oxidative stress and neuroinflammation, resulting in Alzheimer&#039;s disease (AD). This review will be of interest to scientists and researchers from biological and medical science disciplines, including microbiology, pharmaceutical sciences and the translational researchers, etc. The increasing understanding of the relationship between chronic lung disease and neurological disease is two-fold. First, this would help to identify the risk factors and possible therapeutic interventions to reduce the development and progression of both diseases. Second, this would help to reduce the probable risk of development of AD in the population prone to chronic lung diseases.

Watson, P, Pearson, D & Le Pelley, ME 2020, 'Reduced attentional capture by reward following an acute dose of alcohol', Psychopharmacology, vol. 237, no. 12, pp. 3625-3639.
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Watson, P, Pearson, D, Theeuwes, J, Most, SB & Le Pelley, ME 2020, 'Delayed disengagement of attention from distractors signalling reward', Cognition, vol. 195, pp. 104125-104125.
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Werth, BL, Fisher, MJ, Williams, KA & Pont, LG 2020, 'Chronic Constipation in the Community', Journal of Wound, Ostomy & Continence Nursing, vol. 47, no. 3, pp. 259-264.
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PURPOSE: The aim of this study was to determine the prevalence of chronic constipation and identify factors associated with chronic constipation in community-dwelling adults. DESIGN: Cross-sectional study. METHODS: The target population was community-dwelling Australian adults; 1978 participants completed an online questionnaire exploring symptoms, management, and factors potentially associated with constipation. Chronic constipation was identified using Rome III criteria. Multivariate logistic regression model was used to identify factors associated with chronic constipation. RESULTS: The prevalence of chronic constipation was 23.9%. Factors significantly associated with chronic constipation in the multivariate model were female gender (odds ratio [OR] = 1.42, 95% confidence interval [CI], 1.12-1.81), current employment (OR = 1.45, 95% CI, 1.11-1.88), regular smoking (OR = 1.60, 95% CI, 1.19-2.14), poor self-rated health (OR = 2.57, 95% CI, 1.28-5.19), thyroid disease (OR = 1.77, 95% CI, 1.21-2.79), depression (OR = 1.49, 95% CI, 1.08-2.06), hemorrhoids (OR = 2.98, 95% CI, 1.84-4.83), irritable bowel syndrome (OR = 2.45, 95% CI, 1.73-3.46), and use of anti-inflammatory/antirheumatic medications (OR = 2.06, 95% CI, 1.15-3.68). In contrast to these factors, use of medications acting on the renin-angiotensin system was associated with a reduced likelihood of chronic constipation (OR = 0.47, 95% CI, 0.24-0.91). CONCLUSIONS: Chronic constipation is prevalent amon...

Werth, BL, Williams, KA, Fisher, MJ & Pont, LG 2020, 'Use of over-the-counter laxatives by community-dwelling adults to treat and prevent constipation: a national cross-sectional study', European Journal of Clinical Pharmacology, vol. 76, no. 7, pp. 1003-1010.
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© 2020, Springer-Verlag GmbH Germany, part of Springer Nature. Purpose: Constipation is commonly self-managed with over-the-counter laxatives. The study aim was to explore laxative choice, healthcare professional recommendations in laxative selection, and laxative effectiveness when laxatives are used for treatment and for prevention of constipation by community-dwelling adults. Methods: A nationally representative sample of community-dwelling adults in Australia was surveyed. Participants completed an online questionnaire. Z tests for differences in proportions were used to compare the proportion of laxatives by class when used either for treatment or for prevention of constipation by choice of laxative, healthcare professional recommendation, and perceived effectiveness. Results: The questionnaire was completed by 2024 participants. Laxatives were used by 37% (n = 747) of participants with 31.3% using laxatives for treatment, 19.3% for prevention, and 49.7% using laxatives for both purposes. The most common laxatives used for treatment and prevention were contact laxatives (39.8% and 31.1% respectively) and bulk-forming laxatives (34.3% and 44.6% respectively). Of all laxatives used, 56.4% of laxatives were chosen with healthcare professional recommendation, and 53.5% of laxatives were found effective. Conclusion: Laxatives were used both for treatment and for prevention of constipation. However, laxatives are often perceived to be ineffective and healthcare professionals are not always involved in laxative choice. Modified guidelines which address the use of laxatives for both treatment and prevention, and increased healthcare professional involvement in appropriate choice and use of laxatives, may be required to improve constipation management in the community.

White, S, Jacobs, C & Phillips, J 2020, 'Mainstreaming genetics and genomics: a systematic review of the barriers and facilitators for nurses and physicians in secondary and tertiary care', Genetics in Medicine, vol. 22, no. 7, pp. 1149-1155.
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PURPOSE:Genetic and genomic health information increasingly informs routine clinical care and treatment. This systematic review aimed to identify the barriers and facilitators to integrating genetics and genomics into nurses' and physicians' usual practice (mainstreaming). METHODS:A search of MEDLINE, EMBASE, CINAHL, and PsycINFO generated 7873 articles, of which 48 were included. Using narrative synthesis, barriers and facilitators were mapped to the Theoretical Domains Framework (TDF). RESULTS:Barriers were limitations to genetics knowledge and skill, low confidence initiating genetics discussions, lack of resources and guidelines, and concerns about discrimination and psychological harm. Facilitators were positive attitudes toward genetics, willingness to participate in discussions upon patient initiation, and intention to engage in genetics education. CONCLUSION:Nurses and physicians are largely underprepared to integrate genetic and genomic health information into routine clinical care. Ethical, legal, and psychological concerns surrounding genetic information can lead to avoidance of genetics discussions. The knowledge-practice gap could limit patients' and families' access to vital genetic information. Building the capacity of the current and next generation of nurses and physicians to integrate genetics and genomics into usual clinical practice is essential if opportunities afforded by precision medicine are to be fully realized.

Wiecek, E, Torres-Robles, A, Cutler, RL, Benrimoj, SI & Garcia-Cardenas, V 2020, 'Impact of a Multicomponent Digital Therapeutic Mobile App on Medication Adherence in Patients with Chronic Conditions: Retrospective Analysis', Journal of Medical Internet Research, vol. 22, no. 8, pp. e17834-e17834.
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Background Strategies to improve medication adherence are widespread in the literature; however, their impact is limited in real practice. Few patients persistently engage long-term to improve health outcomes, even when they are aware of the consequences of poor adherence. Despite the potential of mobile phone apps as a tool to manage medication adherence, there is still limited evidence of the impact of these innovative interventions. Real-world evidence can assist in minimizing this evidence gap. Objective The objective of this study was to analyze the impact over time of a previously implemented digital therapeutic mobile app on medication adherence rates in adults with any chronic condition. Methods A retrospective observational study was performed to assess the adherence rates of patients with any chronic condition using Perx Health, a digital therapeutic that uses multiple components within a mobile health app to improve medication adherence. These components include gamification, dosage reminders, incentives, educational components, and social community components. Adherence was measured through mobile direct observation of therapy (MDOT) over 3-month and 6-month time periods. Implementation adherence, defined as the percentage of doses in which the correct dose of a medication was taken, was assessed across the study periods, in addition to timing adherence or percentage of doses taken at the appropriate time (±1 hour). The Friedman test was used to compare differences in adherence rates over time. Results We analyzed 243 and 130 patients who used the app fo...

Wiecek, E, Torres-Robles, A, Cutler, RL, Benrimoj, SI & Garcia-Cardenas, V 2020, 'Impact of a Multicomponent Digital Therapeutic Mobile App on Medication Adherence in Patients with Chronic Conditions: Retrospective Analysis (Preprint)'.
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Strategies to improve medication adherence are widespread in the literature; however, their impact is limited in real practice. Few patients persistently engage long-term to improve health outcomes, even when they are aware of the consequences of poor adherence. Despite the potential of mobile phone apps as a tool to manage medication adherence, there is still limited evidence of the impact of these innovative interventions. Real-world evidence can assist in minimizing this evidence gap.

The objective of this study was to analyze the impact over time of a previously implemented digital therapeutic mobile app on medication adherence rates in adults with any chronic condition.

A retrospective observational study was performed to assess the adherence rates of patients with any chronic condition using Perx Health, a digital therapeutic that uses multiple components within a mobile health app to improve medication adherence. These components include gamification, dosage reminders, incentives, educational components, and social community components. Adherence was measured through mobile direct observation of therapy (MDOT) over 3-month and 6-month time periods. Implementation adherence, defined as the percentage of doses in which the correct dose of a medication was taken, was assessed across the study periods, in addition to timing adherence or percentage of doses taken at the appropriate time (±1 hour). The Friedman test was used to compare differences in adherence rates over time.

Wilson, EJ, Stapinski, L, Dueber, DM, Rapee, RM, Burton, AL & Abbott, MJ 2020, 'Psychometric properties of the Intolerance of Uncertainty Scale-12 in generalized anxiety disorder: Assessment of factor structure, measurement properties and clinical utility', Journal of Anxiety Disorders, vol. 76, pp. 102309-102309.
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Intolerance of uncertainty is a psychological vulnerability implicated in the development and maintenance of generalized anxiety disorder (GAD). The Intolerance of Uncertainty Scale-12 (IUS-12) is a widely used measure, however no studies have thoroughly tested the psychometric properties in a clinically diagnosed GAD sample. This study aimed to evaluate the factor structure, measurement properties and clinical utility of the IUS-12 in clinical and non-clinical samples. Participants were screened using the Anxiety Disorders Interview Schedule for DSM-IV to ascertain clinical (n = 136: principal diagnosis of GAD) or non-clinical status (n = 76). Confirmatory factor analysis determined that the bifactor type (two-factor testlet) model demonstrated significantly better fit in comparison to the unidimensional model for the clinical sample. The IUS-12 exhibited limited multidimensionality indicating that only the total score provides meaningful interpretation. The IUS-12 demonstrated good construct validity (with DASS-21, MCQ-30, and PSWQ), good internal consistency, as well as good test-retest reliability over 12-weeks. The IUS-12 demonstrated responsivity to treatment following cognitive behavioral therapy and mindfulness based psychological interventions. Receiver operating characteristic curve analysis indicated an optimal cut-off score of 28 for distinguishing individuals with GAD from non-clinical cases. Overall, the IUS-12 is a valid, reliable and clinically useful instrument for individuals with GAD.

Wootton, BM, Davis, E, Moses, K, Moody, A & Maguire, P 2020, 'The development and initial validation of the Tokophobia Severity Scale', Clinical Psychologist, vol. 24, no. 3, pp. 267-275.
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Xie, Y, Baker, J, Young, T, Jun, M, Sukkar, L, Campain, A, Kang, A, Cass, A, Hu, J, Peiris, D, Pollock, C, Wong, G, Zoungas, S, Rogers, K, Jardine, M, Hockham, C, Jardine, M, Hockham, C, Jun, M, Rogers, K, Cass, A, Pollock, C, Chow, CK, Comino, E, Foote, C, Gallagher, M, Knight, J, McNamara, M, Liu, B, Lung, T, Peiris, D, Sullivan, D, Wilson, R, Wong, G & Zoungas, S 2020, 'Therapy Escalation Following an Elevated HbA1c in Adults Aged 45 Years and Older Living With Diabetes in Australia: A Real-World Observational Analysis', Diabetes Care, vol. 43, no. 11, pp. e185-e187.
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Xu, Y, Wong, R, He, S, Veldre, A & Andrews, S 2020, 'Is it smart to read on your phone? The impact of reading format and culture on the continued influence of misinformation', Memory & Cognition, vol. 48, no. 7, pp. 1112-1127.
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Yeates, L, McEwen, A & Ingles, J 2020, 'What do we do and how do we do it? Assessing genetic counselling in the modern era', European Journal of Human Genetics, vol. 28, no. 9, pp. 1137-1138.
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Yong, FR, Garcia-Cardenas, V, Williams, KA & (Charlie) Benrimoj, SI 2020, 'Factors affecting community pharmacist work: A scoping review and thematic synthesis using role theory', Research in Social and Administrative Pharmacy, vol. 16, no. 2, pp. 123-141.
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© 2019 Elsevier Inc. Many community pharmacists ideologically support recent changes to their roles in primary healthcare. However, their antithetical resistance towards practice change could have systemic causes (i.e. role stresses), which may account for increased job dissatisfaction, burnout, and job turnover in the profession. Deeper comprehension was sought using a role theory framework. Objective: To identify factors leading to role stresses and strain responses for community pharmacists, and to create a framework for community pharmacist role management. Method: PubMed, Scopus and Web of Science databases were searched for qualitative studies identifying community pharmacist role stress and strain using scoping review methodology from 1990 to 2019. Content and thematic analysis using the framework method was performed, and themes were reported using thematic synthesis. Results: Screening of 10,880 records resulted in 33 studies identified, with 41 factors categorised into four domains: Interpersonal Interactions, Social Setting, Individual Attributes, and Extra-Role. All role stresses were present. Reported role strains suggest role system imbalance. Conclusion: Community pharmacists are in a multifactorial transitional environment. Reported role stresses may be a function of past pharmacist roles and increased role expectations, amplified by many requisite interactions and individual pharmacist characteristics. Social science theories were found to be applicable to the community pharmacy setting.

You, J, Hodge, C, Hoque, M, Petsoglou, C & Sutton, G 2020, '<p>Human Platelets and Derived Products in Treating Ocular Surface Diseases – A Systematic Review</p>', Clinical Ophthalmology, vol. Volume 14, pp. 3195-3210.
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Human platelet products have emerged as an alternative treatment for a range of ocular surface diseases such as dry eye and corneal ulceration. With significant therapeutic potential and increasing popularity, this study aimed to conduct a systematic review to detail the various production methods involved in generating platelet-derived products, compare and analyze clinical findings across available studies, and disseminate the relative advantages, limitations, and challenges of using platelet products to treat ocular surface disease. Thirty-eight clinical studies were identified, excluding studies conducted in animals and non-English language. Studies reported clinical outcomes, which included ocular surface disease index, best-corrected visual acuity, and corneal fluorescein staining. Most clinical studies reported improved patient signs and symptoms with an increasing variety of human platelet products including platelet rich plasma eye drops, human platelet lysate and platelet gels. However, due to variations in production methods, and study designs as well as confusing terminology, it was suggested that characterization of platelet products is needed for proper evaluation across studies.

Zhang, H, Rogers, K, Sukkar, L, Jun, M, Kang, A, Young, T, Campain, A, Cass, A, Chow, CK, Comino, E, Foote, C, Gallagher, M, Knight, J, Liu, B, Lung, T, McNamara, M, Peiris, D, Pollock, C, Sullivan, D, Wong, G, Zoungas, S, Jardine, M & Hockham, C 2020, 'Prevalence, incidence and risk factors of diabetes in Australian adults aged ≥45 years: A cohort study using linked routinely-collected data', Journal of Clinical & Translational Endocrinology, vol. 22, pp. 100240-100240.
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