ORCID Profile
0000-0002-9902-0858
Current Organisations
UNISA Graduate School of Business Leadership
,
Swinburne University of Technology
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Urban And Regional Planning | Demography | Correctional Theory, Offender Treatment and Rehabilitation | Courts and Sentencing | Psychology | Policy and Administration | Public Administration | Communications and Media Policy | Urban Policy | Population Trends And Policies | Forensic Psychology | Urban And Regional Studies |
ANZSRC Socio-Economic Objective (SEO)
Housing | Urban Planning | Environmental education and awareness | Consumption patterns, population issues and the environment | Public Services Policy Advice and Analysis | Communication not elsewhere classified | Law Enforcement | Mental Health Services | Rehabilitation and Correctional Services
Related Links
Publications
The Impact of a Short-Term Mental Health Intervention Delivered in an Australian Prison: A Multi-Cultural Comparison
Publisher: Informa UK Limited
Date: 11-05-2022
Trauma involving violation of trust and mental health help seeking among homeless adults
Publisher: Informa UK Limited
Date: 10-04-2022
Therapist-Assisted Internet-Based Cognitive-Behavioral Therapy Versus Progressive Relaxation in Obsessive-Compulsive Disorder: Randomized Controlled Trial (Preprint)
Publisher: JMIR Publications Inc.
Date: 04-12-2017
Abstract: bsessive-compulsive disorder (OCD) is a highly disabling psychological disorder with a chronic course if left untreated. Cognitive-behavioral therapy (CBT) has been shown to be an effective treatment, but access to face-to-face CBT is not always possible. Internet-based CBT (iCBT) has become an increasingly viable option. However, no study has compared iCBT to an analogous control condition using a randomized controlled trial (RCT). 2-armed RCT was used to compare a therapist-assisted 12-module iCBT to an analogous active attention control condition (therapist-assisted internet-based standard progressive relaxation training, iPRT) in adult OCD. This paper reports pre-post findings for OCD symptom severity. n total, 179 participants (117 females, 65.7%) were randomized (stratified by gender) into iCBT or iPRT. The iCBT intervention included psychoeducation, mood and behavioral management, exposure and response prevention (ERP), cognitive therapy, and relapse prevention the iPRT intervention included psychoeducation and relaxation techniques as a way of managing OCD-related anxiety but did not incorporate ERP or other CBT elements. Both treatments included audiovisual content, case stories, demonstrations of techniques, downloadable audio content and worksheets, and expert commentary. All participants received 1 weekly email, with a maximum 15-minute preparation time per client from a remote therapist trained in e-therapy. Emails aimed to monitor progress, provide support and encouragement, and assist in in idualizing the treatment. Participants were assessed for baseline and posttreatment OCD severity with the telephone-administered clinician-rated Yale-Brown Obsessive-Compulsive Scale (YBOCS) and other measures by assessors who were blinded to treatment allocation. o pretreatment differences were found between the 2 conditions. Intention-to-treat analysis revealed significant pre-post improvements in OCD symptom severity for both conditions (P .001). However, relative to iPRT, iCBT showed significantly greater symptom severity improvement (P=.001) Cohen d for iCBT was 1.05 (95% CI 0.72 to 1.37), whereas for iPRT it was 0.48 (95% CI 0.22 to 0.73). The iCBT condition was superior in regard to reliable improvement (25/51, 49% vs 16/55, 29% P=.04) and clinically significant pre-post-treatment changes (17/51, 33% vs 6/55, 11% P=.005). Those undertaking iCBT post completion of iPRT showed further significant symptom amelioration (P .001), although the sequential treatment was no more efficacious than iCBT alone (P=.63). his study is the first to compare a therapist-assisted iCBT program for OCD to an analogous active attention control condition using iPRT. Our findings demonstrate the large magnitude effect of iCBT for OCD interestingly, iPRT was also moderately efficacious, albeit significantly less so than the iCBT intervention. The findings are compared to previous internet-based and face-to-face CBT treatment programs for OCD. Future directions for technology-enhanced programs for the treatment of OCD are outlined. ustralian New Zealand Clinical Trials Registry ACTRN12611000321943 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=336704 (Archived by WebCite at 0ovUiOmd)
Cluster analysis reveals subclinical subgroups with shared autistic and schizotypal traits
Publisher: Elsevier BV
Date: 07-2018
DOI: 10.1016/J.PSYCHRES.2018.04.037
Abstract: Autism and schizophrenia spectrum research is typically based on coarse diagnostic classification, which overlooks in idual variation within clinical groups. This method limits the identification of underlying cognitive, genetic and neural correlates of specific symptom dimensions. This study, therefore, aimed to identify homogenous subclinical subgroups of specific autistic and schizotypal traits dimensions, that may be utilised to establish more effective diagnostic and treatment practices. Latent profile analysis of subscale scores derived from an autism-schizotypy questionnaire, completed by 1678 subclinical adults aged 18-40 years (1250 females), identified a local optimum of eight population clusters: High, Moderate and Low Psychosocial Difficulties High, Moderate and Low Autism-Schizotypy High Psychosis-Proneness and Moderate Schizotypy. These subgroups represent the convergent and discriminant dimensions of autism and schizotypy in the subclinical population, and highlight the importance of examining subgroups of specific symptom characteristics across these spectra in order to identify the underlying genetic and neural correlates that can be utilised to advance diagnostic and treatment practices.
GASP - An integrated approach to managing asthma patients
Publisher: Wiley
Date: 06-2020
DOI: 10.1111/RESP.13777
A systematic review of statistical models and outcomes of predicting fatal and serious injury crashes from driver crash and offense history data
Publisher: Springer Science and Business Media LLC
Date: 28-09-2020
DOI: 10.1186/S13643-020-01475-7
Abstract: Expenditure on driver-related behavioral interventions and road use policy is often justified by their impact on the frequency of fatal and serious injury crashes. Given the rarity of fatal and serious injury crashes, offense history, and crash history of drivers are sometimes used as an alternative measure of the impact of interventions and changes to policy. The primary purpose of this systematic review was to assess the rigor of statistical modeling used to predict fatal and serious crashes from offense history and crash history using a purpose-made quality assessment tool. A secondary purpose was to explore study outcomes. Only studies that used observational data and presented a statistical model of crash prediction from offense history or crash history were included. A quality assessment tool was developed for the systematic evaluation of statistical quality indicators across studies. The search was conducted in June 2019. One thousand one hundred and five unique records were identified, 252 full texts were screened for inclusion, resulting in 20 studies being included in the review. The results indicate substantial and important limitations in the modeling methods used. Most studies demonstrated poor statistical rigor ranging from low to middle quality. There was a lack of confidence in published findings due to poor variable selection, poor adherence to statistical assumptions relating to multicollinearity, and lack of validation using new data. It was concluded that future research should consider machine learning to overcome correlations in the data, use rigorous vetting procedures to identify predictor variables, and validate statistical models using new data to improve utility and generalizability of models. PROSPERO CRD42019137081
Self-reported diet quality differentiates nutrient intake, blood nutrient status, mood, and cognition: Implications for identifying nutritional neurocognitive risk factors in middle age
Publisher: MDPI AG
Date: 28-09-2020
DOI: 10.3390/NU12102964
Abstract: Evidence for diet quality representing a modifiable risk factor for age-related cognitive decline and mood disturbances has typically come from retrospective, cross-sectional analyses. Here a diet screening tool (DST) was used to categorize healthy middle-aged volunteers (n = 141, 40–65 years) into “optimal” or “sub-optimal” diet groups to investigate cross-sectional associations between diet quality, cognitive function, and mood. The DST distinguished levels of nutrient intake as assessed by Automated Self-Administered 24-h dietary recall and nutrient status, as assessed by blood biomarker measures. Compared with the “sub-optimal” group, the “optimal” diet group showed significantly higher intake of vitamin E (p = 0.007), magnesium (p = 0.001), zinc (p = 0.043) and fiber (p = 0.015), higher circulating levels of vitamin B6 (p = 0.030) and red blood cell folate (p = 0.026) and lower saturated fatty acids (p = 0.012). Regarding psychological outcomes, the “optimal” diet group had significantly better Stroop processing than those with a “sub-optimal” diet (p = 0.013). Regression analysis revealed that higher DST scores were associated with fewer mood disturbances (p = 0.002) and lower perceived stress (p = 0.031), although these differences were not significant when comparing “optimal” versus “sub-optimal” as discrete groups. This study demonstrates the potential of a 20-item diet screen to identify both nutritional and psychological status in an Australian setting.
The neural, cognitive and psychosocial effects of hearing aid use in older adults with post-lingual sensorineural hearing loss: A protocol for a prospective cohort study
Publisher: JMIR Publications Inc.
Date: 12-02-2018
Conversations about preventers in pharmacy
Publisher: Wiley
Date: 06-2020
DOI: 10.1111/RESP.13778
Using Blended Learning in Postgraduate Applied Statistics Programs
Publisher: Turkish Online Journal of Distance Education
Date: 04-2019
Abstract: Blended learning refers to a method of teaching and learning in which some form of online learning is used in addition to the traditional on-c us/face-to-face learning experience in an integrated manner. Postgraduate Applied Statistics programs at Swinburne University of Technology, Australia adopted the blended learning paradigm almost a decade ago to accommodate an increasingly erse student population. This paradigm allows for flexibility in design approaches, and accommodates the range of blended learning capabilities and experience of teachers and learners. The blended learning design adopted in these programs has involved the thoughtful integration of learning and teaching approaches in both on-c us, face-to-face and online/virtual learning environments by utilising the benefits of each of these environments. These programs focus on designing learning interactions across formal teaching spaces, informal learning spaces and online learning and teaching spaces. This flexible approach has been well accepted among both online and on-c us students. This paper describes the medium impact blended learning model adopted in these courses and the feedback received from students during recent study periods. The authors make the case that implementation of a successful blended learning model can enhance students’ learning experience for a mixed cohort of participants.
Videoconferencing Psychotherapy in the Public Sector: Synthesis and Model for Implementation
Publisher: JMIR Publications Inc.
Date: 21-01-2020
DOI: 10.2196/14996
Abstract: Videoconferencing psychotherapy (VCP) is a growing practice among mental health professionals. Early adopters have predominantly been in private practice settings, and more recent adoption has occurred in larger organizations, such as the military. The implementation of VCP into larger health service providers in the public sector is an important step in reaching and helping vulnerable and at-risk in iduals however, several additional implementation challenges exist for public sector organizations. The aim of this study was to offer an implementation model for effectively introducing VCP into public sector organizations. This model will also provide practical guidelines for planning and executing an embedded service trial to assess the effectiveness of the VCP modality once implemented. An iterative search strategy was employed, drawing on multiple fields of research across mental health, information technology, and organizational psychology. Previous VCP implementation papers were considered in detail to provide a synthesis of the barriers, facilitators, and lessons learned from the implementation attempts in the military and other public sector settings. A model was formulated, which draws on change management for technology integration and considers the specific needs for VCP integration in larger organizations. A total of 6 phases were formulated and were further broken down into practical and measurable steps. The model explicitly considers the barriers often encountered in large organizational settings and suggests steps to increase facilitating factors. Although the model proposed is time and resource intensive, it draws on a comprehensive understanding of larger organizational needs and the unique challenge that the introduction of VCP presents to such organizations.
Modelling the relationship of driver license and offense history with fatal and serious injury (FSI) crash involvement
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.JSR.2021.08.008
Abstract: Previous research has indicated that increases in traffic offenses are linked to increased crash involvement rates, making reductions in offending an appropriate measure for evaluating road safety interventions in the short-term. However, the extent to which traffic offending predicts fatal and serious injury (FSI) crash involvement risk is not well established, prompting this new Victorian (Australia) study. A preliminary cluster analysis was performed to describe the offense data and assess FSI crash involvement risk for each cluster. While controlling demographic and licensing variables, the key traffic offenses that predict future FSI crash involvement were then identified. The large s le size allowed the use of machine learning methods such as random forests, gradient boosting, and Least Absolute Shrinkage and Selection Operator (LASSO) regression. This was done for the 'all driver' s le and five sometimes overlapping groups of drivers the young, the elderly, and those with a motorcycle license, a heavy vehicle license endorsement and/or a history of license bans. With the exception of the group of drivers who had a history of bans, offense history significantly improved the accuracy of models predicting future FSI crash involvement using demographic and licensing data, suggesting that traffic offenses may be an important factor to consider when analyzing FSI crash involvement risk and the effects of road safety countermeasures. The results are helpful for identifying driver groups to target with further road safety countermeasures, and for showing that machine learning methods have an important role to play in research of this nature. Practical Application: This research indicates with whom road safety interventions should particularly be applied. Changes to driver demerit policies to better target offenses related to FSI crash involvement and repeat traffic offenders, who are at greater risk of FSI crash involvement, are recommended.
Facilitating engagement with school in students with chronic illness through positive education: A mixed-methods comparison study.
Publisher: American Psychological Association (APA)
Date: 11-2019
DOI: 10.1037/SPQ0000315
Abstract: Students with chronic illness may disengage from school, adversely affecting their school outcomes. Positive education targets students' social-emotional well-being (school well-being), which can increase engagement with school. We compared the relationship among positive educational practices, school well-being, and engagement with school as reported by parents of students with and without chronic illness. We used a convergent mixed-methods cross-sectional design. We collected data from 215 parents of school-age children with chronic illness and 212 parents of children without chronic illness. Data assessed positive educational practices, school well-being, and engagement with school, which we analyzed using regression and structural equation models. Forty-nine parents of students with chronic illness completed a telephone interview about their child's school experiences, which we analyzed using content analysis. School well-being was significantly lower among students with chronic illness, compared with students without chronic illness (p = .05). Higher student well-being (p ≤ .001) and higher levels of positive educational practices (p = .002) were associated with higher engagement with school. School well-being mediated the relationship between positive educational practices and engagement with school for students with chronic illness but not students without chronic illness. Parents of children with chronic illness described how positive educational practices and their child's school well-being promoted their child's engagement with school. Parents also reported the negative consequences of low school well-being. Positive educational practices alone may not be sufficient to increase engagement with school in students with low school well-being. Combined preventative and early intervention psychosocial support may best promote engagement with school in students with chronic illness. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Appropriate management of acute gastroenteritis in Australian children
Publisher: Public Library of Science (PLoS)
Date: 07-11-2019
Socio-cognitive processes associated with bladder and bowel incontinence anxiety: A proposed bivalent model
Publisher: Springer Science and Business Media LLC
Date: 07-11-2019
The Effect of Azithromycin on Structural Lung Disease in Infants with Cystic Fibrosis (COMBAT CF): A Phase 3, Randomised, Double-Blind, Placebo-Controlled Clinical Trial
Publisher: Elsevier BV
Date: 2021
DOI: 10.2139/SSRN.3990938
A systematic review and meta‐analysis of the relationship between obsessive‐compulsive symptoms and symptoms of proposed orthorexia nervosa: The contribution of assessments
Publisher: Wiley
Date: 15-10-2023
DOI: 10.1002/ERV.3041
WS02.4 Evaluating the role of short chain fatty acids in cystic fibrosis
Publisher: Elsevier BV
Date: 2021
Assessing the appropriateness of the management of otitis media in Australia
Publisher: Wiley
Date: 17-07-2020
DOI: 10.1111/JPC.14560
Abstract: Acute otitis media (AOM) is the most common infectious disease for which antibiotics are prescribed its management is costly and has the potential to increase the antimicrobial resistance of this infection. This study measured the levels of adherence to the clinical practice guidelines (CPGs) of AOM and otitis media with effusion (OME) management in Australian children. We searched for national and international CPGs relating to AOM and OME in children and created 37 indicators for assessment. We reviewed medical records for adherence to these indicators in 120 locations, across one inpatient and three ambulatory health-care settings. Our review s le was obtained from three Australian states that contain 60% of the nation's children. We reviewed the records of 1063 children with one or more assessments of CPG adherence for otitis media. Of 22 indicators with sufficient data, estimated adherence ranged from 7.4 to 99.1%. Overuse of treatment, particularly overprescribing of antibiotics, was more common than underuse. A frequent lack of adherence with recommended care was observed for children aged between 1 and 2 years with AOM. Adherence varied by health-care setting, with emergency departments and inpatient settings more adherent to CPGs than general practices. Our assessment of a number of indicators in the common settings in which otitis media is treated found that guideline adherence varied widely between in idual indicators. Internationally agreed standards for diagnosis and treatment, coupled with clinician education on the existence and content of CPGs and clinical decision support, are needed to improve the management of children presenting with AOM and OME.
Influenza vaccine uptake and its effectiveness in preventing hospitalisations among Australian children with chronic lung diseases
Publisher: Elsevier BV
Date: 12-2020
The quality of preventive care for pre-school aged children in Australian general practice
Publisher: Springer Science and Business Media LLC
Date: 12-2019
Investigating the Impact of Hearing Aid Use and Auditory Training on Cognition, Depressive Symptoms, and Social Interaction in Adults With Hearing Loss: Protocol for a Crossover Trial
Publisher: JMIR Publications Inc.
Date: 23-03-2018
DOI: 10.2196/RESPROT.8936
Hearing Aid Use in Older Adults With Postlingual Sensorineural Hearing Loss: Protocol for a Prospective Cohort Study
Publisher: JMIR Publications Inc.
Date: 26-10-2018
DOI: 10.2196/RESPROT.9916
Prevention and management of respiratory disease in young people with cerebral palsy: consensus statement
Publisher: Wiley
Date: 09-08-2020
DOI: 10.1111/DMCN.14640
Assessing the impact of the 13 valent pneumococcal vaccine on childhood empyema in Australia
Publisher: BMJ
Date: 27-01-2021
DOI: 10.1136/THORAXJNL-2020-216032
Abstract: Empyema is a serious complication of pneumonia frequently caused by Streptococcus pneumoniae (SP). We assessed the impact of the 13-valent pneumococcal conjugate vaccine (13vPCV) on childhood pneumonia and empyema after inclusion in the Australian National Immunisation Program. For bacterial pneumonia and empyema hospitalisations, we ascertained incidence rates (IRs) using the National Hospital Morbidity Database International Statistical Classification of Disease discharge codes and relevant population denominators, and calculated incidence rate ratios (IRR) comparing the 13vPCV period (June 2012–May 2017) with the 7vPCV period (June 2007–May 2011). Blood and pleural fluid (PF) cultures and PF PCR of 401 children with empyema from 11 Australian hospitals during the 13vPCV period were compared with our previous study in the 7vPCV period. Across 7vPCV and 13vPCV periods, IRs per million children (95% CIs) were 1605 (1588 to 1621) and 1272 (1259 to 1285) for bacterial pneumonia, and 14.23 (12.67 to 15.79) and 17.89 (16.37 to 19.42) for empyema hospitalisations. IRRs were 0.79 (0.78 to 0.80) for bacterial pneumonia and 1.25 (1.09 to 1.44) for empyema. Of 161 empyema cases with SP serotypes, 147 (91.3%) were vaccine types. ST3 accounted for 76.4% of identified serotypes in the 13vPCV period, more than double than the 7vPCV period (p .001) ST19A decreased from 36.4% to 12.4%. No cases of ST1 empyema were identified in the 13vPCV period versus 14.5% in the 7vPCV period. 13vPCV resulted in a significant reduction in all-cause hospitalisations for bacterial pneumonia but empyema hospitalisations significantly increased, with emergence of pneumococcal ST3 as the dominant serotype in empyema. Australian and New Zealand Clinical Trial Registry ACTRN 12614000354684.
Using Voice Biomarkers to Classify Psychological Distress in Adult Helpline Callers: A Retrospective Observational Study (Preprint)
Publisher: JMIR Publications Inc.
Date: 28-08-2022
Abstract: levated psychological distress has demonstrated impacts on in iduals’ health. Reliable and efficient ways to detect distress are key to early intervention. Artificial Intelligence has the potential to detect states of emotional distress in an accurate, efficient and timely manner. o automatically classify short segments of speech obtained from callers to national suicide prevention helpline services, according to low versus high psychological distress, using a range of voice biomarkers in combination with machine learning approaches. ne hundred and twenty telephone call recordings were initially converted to 16-bit Pulse Code Modulation format. Short variable length segments of each call were rated on psychological distress using the Distress Thermometer by the responding counsellor and a second team of psychologists blinded to the initial ratings (n=6). Nineteen voice biomarkers were derived from 40ms speech frames within each segment. Candidate biomarkers were reduced using Lasso regression, validated by generalised additive mixed effects regression, accounting for non-linearity, autocorrelation and moderation by sex. Speech frames were then grouped using k-means clustering based on the selected biomarkers. Finally, component-wise gradient boosting was used to classify each speech frame according to low versus high psychological distress. Classification accuracy was confirmed via leave one out cross validation ensuring that speech segments from single callers were not used in both the training and test data. sing twelve voice biomarkers, 686 of 747 speech segments were successfully classified, AUCROC = 93.8% (95% CI = 91.47, 94.6) and AUCPR = 94.8 (95% CI = 93.0, 96.5). When experiencing elevations in psychological distress, male speakers spoke with increasing loudness, higher frequencies in the 75th percentile of frequencies, but with poorer clarity of speech. In contrast, when experiencing psychological distress, the frequencies with which female callers spoke decreased in the highest quartile of frequencies, but exhibited increased clarity of speech. he high level of accuracy achieved suggests possibilities for real-time detection of psychological distress in helpline settings and has potential uses in pre-emptive triage. NZCTR, ACTRN12622000486729, www.anzctr.org.au/ACTRN12622000486729.aspx
Surviving the COVID-19 pandemic: An examination of adaptive coping strategies
Publisher: Elsevier BV
Date: 05-2022
Promoting Psychological Well-Being at Work by Reducing Stress and Improving Sleep: Mixed-Methods Analysis (Preprint)
Publisher: JMIR Publications Inc.
Date: 26-09-2017
Abstract: orkplace programs designed to improve the health and psychological well-being of employees are becoming increasingly popular. However, there are mixed reports regarding the effectiveness of such programs and little analysis of what helps people to engage with such programs. his evaluation of a particularly broad, team-based, digital health and well-being program uses mixed methods to identify the elements of the program that reduce work stress and promote psychological well-being, sleep quality, and productivity of employees. articipation in the Virgin Pulse Global Challenge program during May to September 2016 was studied. Self-reported stress, sleep quality, productivity, and psychological well-being data were collected both pre- and postprogram. Participant experience data were collected through a third final survey. However, the response rates for the last 2 surveys were only 48% and 10%, respectively. A random forest was used to estimate the probability of the completion of the last 2 surveys based on the preprogram assessment data and the demographic data for the entire s le (N=178,350). The inverse of these estimated probabilities were used as weights in hierarchical linear models in an attempt to address any estimation bias caused by the low response rates. These linear models described changes in psychological well-being, stress, sleep, and productivity over the duration of the program in relation to gender and age, engagement with each of the modules, each of the program features, and participant descriptions of the Virgin Pulse Global Challenge. A 0.1% significance level was used due to the large s le size for the final survey (N=18,653). he final analysis suggested that the program is more beneficial for older people, with 2.9% greater psychological well-being improvements observed on average in the case of women than men (P .001). With one exception, all the program modules contributed significantly to the outcome measures with the following average improvements observed: psychological well-being, 4.1%-6.0% quality of sleep, 3.2%-6.9% work-related stress, 1.7%-6.8% and productivity, 1.9%-4.2%. However, only 4 of the program features were found to have significant associations with the outcome measures with the following average improvements observed: psychological well-being, 3.7%-5.6% quality of sleep, 3.4%-6.5% work-related stress, 4.1%-6.4% and productivity, 1.6%-3.2%. Finally, descriptions of the Virgin Pulse Global Challenge produced 5 text topics that were related to the outcome measures. Healthy lifestyle descriptions showed a positive association with outcomes, whereas physical activity and step count tracking descriptions showed a negative association with outcomes. he complementary use of qualitative and quantitative survey data in a mixed-methods analysis provided rich information that will inform the development of this and other programs designed to improve employee health. However, the low response rates and the lack of a control group are limitations, despite the attempts to address these problems in the analysis.
Using Voice Biomarkers to Classify Suicide Risk in Adult Telehealth Callers: Retrospective Observational Study.
Publisher: JMIR Publications Inc.
Date: 15-08-2022
DOI: 10.2196/39807
Abstract: Artificial intelligence has the potential to innovate current practices used to detect the imminent risk of suicide and to address shortcomings in traditional assessment methods. In this paper, we sought to automatically classify short segments (40 milliseconds) of speech according to low versus imminent risk of suicide in a large number (n=281) of telephone calls made to 2 telehealth counselling services in Australia. A total of 281 help line telephone call recordings sourced from On The Line, Australia (n=266, 94.7%) and 000 Emergency services, Canberra (n=15, 5.3%) were included in this study. Imminent risk of suicide was coded for when callers affirmed intent, plan, and the availability of means level of risk was assessed by the responding counsellor and reassessed by a team of clinical researchers using the Columbia Suicide Severity Rating Scale (=5/6). Low risk of suicide was coded for in an absence of intent, plan, and means and via Columbia suicide Severity Scale Ratings (=1/2). Preprocessing involved normalization and pre-emphasis of voice signals, while voice biometrics were extracted using the statistical language r. Candidate predictors were identified using Lasso regression. Each voice biomarker was assessed as a predictor of suicide risk using a generalized additive mixed effects model with splines to account for nonlinearity. Finally, a component-wise gradient boosting model was used to classify each call recording based on precoded suicide risk ratings. A total of 77 imminent-risk calls were compared with 204 low-risk calls. Moreover, 36 voice biomarkers were extracted from each speech frame. Caller sex was a significant moderating factor (β=-.84, 95% CI -0.85, -0.84 t=6.59, P<.001). Candidate biomarkers were reduced to 11 primary markers, with distinct models developed for men and women. Using leave-one-out cross-validation, ensuring that the speech frames of no single caller featured in both training and test data sets simultaneously, an area under the precision or recall curve of 0.985 was achieved (95% CI 0.97, 1.0). The gamboost classification model correctly classified 469,332/470,032 (99.85%) speech frames. This study demonstrates an objective, efficient, and economical assessment of imminent suicide risk in an ecologically valid setting with potential applications to real-time assessment and response. Australian New Zealand Clinical Trials Registry ACTRN12622000486729 www.anzctr.org.au/ACTRN12622000486729.aspx.
Pneumococcal serotypes causing pneumonia in the 13 valent pneumococcal conjugate vaccine era in Australian children
Publisher: Elsevier BV
Date: 12-2020
Rehabilitation for atraumatic shoulder instability in circus arts performers: delivery via telehealth
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1016/J.JSE.2021.10.033
Abstract: The Watson Instability Program (WIP1) is current best evidence for conservative management of atraumatic shoulder instability, but it is unknown if this program can be effectively delivered via tele-consultation. The purpose of this longitudinal pre-post intervention study was to determine the effects of the WIP1 on patient-reported outcome measures, scapular position, shoulder strength, and handstand stability in student circus performers with atraumatic shoulder instability when delivered via tele-consultation. Student circus performers aged between 15 and 35 years from the National Institute of Circus Arts were recruited. A 12-week shoulder exercise program was delivered via tele-consultation during the Melbourne, Australia COVID-19 (coronavirus disease 2019) lockdown. The primary outcome measures were the Western Ontario Shoulder Instability Index score and the Melbourne Instability Shoulder Scale score. Secondary outcomes measures included the Orebro Musculoskeletal Pain Questionnaire, the T a Scale for Kinesiophobia, and physical assessment measures including strength via handheld dynamometry, scapular position using an inclinometer, and handstand stability via center-of-pressure fluctuation. Patient-reported outcomes were collected at baseline and 6-week, 12-week, 6-month, and 9-month time points, and physical outcomes were measured at baseline and 9-month time points. A repeated-measures mixed model (with effect sizes [ESs] and 95% confidence intervals [CIs]) was used to analyze patient-reported outcomes, handstand data, strength, and scapular measures. Significance was set at P < .05. Twenty-three student circus arts performers completed the study. Significant improvements were found in both Western Ontario Shoulder Instability Index scores (effect size [ES], 0.79 [95% CI, 0.31-1.33] at 6 weeks ES, 1.08 [95% CI, 0.55-1.6] at 12 weeks ES, 1.17 [95% CI, 0.62-1.78] at 6 months and ES, 1.31 [95% CI, 0.74-1.95] at 9 months P < .001) and Melbourne Instability Shoulder Scale scores (ES, 0.70 [95% CI, 0.22-1.22] at 6 weeks ES, 0.83 [95% CI, 0.34-1.37] at 3 months ES, 0.98 [95% CI, 0.46-1.54] at 6 months and ES, 0.98 [95% CI, 0.43-1.50] at 9 months P < .001), as well as Orebro Musculoskeletal Pain Questionnaire scores at all follow-up time points. The T a Scale for Kinesiophobia scores reached significance at 6 weeks and 12 weeks. Following rehabilitation, we found statistically significant increases in shoulder strength in all positions tested and increased scapular upward rotation measured at end-of-range abduction, as well as during loaded external rotation. The affected arm showed greater instability than the unaffected arm with a significant intervention effect on the affected arm showing a greater consistent anterior-posterior movement pattern. In a group of circus performers with atraumatic shoulder instability, treatment with the WIP1 via telehealth resulted in clinically and statistically significant improvements in shoulder symptoms and function.
Probabilistic approaches do not invalidate descriptive studies but answer fundamentally different questions: Reply to Loh and Ren (2023).
Publisher: American Psychological Association (APA)
Date: 09-2023
DOI: 10.1037/AMP0001212
The intestinal virome in children with cystic fibrosis differs from healthy controls
Publisher: Public Library of Science (PLoS)
Date: 22-05-2020
When trauma violates trust: PTSD symptoms among chronically homeless adults in Australia
Publisher: Informa UK Limited
Date: 13-09-2022
Assessing the quality of health care in the management of bronchiolitis in Australian children: A population-based sample survey
Publisher: BMJ
Date: 02-04-2019
DOI: 10.1136/BMJQS-2018-009028
Abstract: Bronchiolitis is the most common cause of respiratory hospitalisation in children aged years. Clinical practice guidelines (CPGs) suggest only supportive management of bronchiolitis. However, the availability of CPGs do not guarantee that they are used appropriately and marked variation in the clinical management exists. We conducted an assessment of guideline adherence in the management of bronchiolitis in children at a subnationally representative level including inpatient and ambulatory services in Australia. We searched for national and international CPGs relating to management of bronchiolitis in children and identified 16 recommendations which were formatted into 40 medical record audit indicator questions. A retrospective medical record review assessing compliance with the CPGs was conducted across three types of healthcare setting: hospital inpatient admissions, emergency department (ED) presentations and general practice (GP) consultations in three Australian states for children aged years receiving care in 2012 and 2013. Purpose-trained surveyors conducted 13 979 eligible indicator assessments across 796 visits for bronchiolitis at 119 sites. Guideline adherence for management of bronchiolitis was 77.3% (95% CI 72.6 to 81.5) for children attending EDs, 81.6% (95% CI 78.0 to 84.9) for inpatients and 52.3% (95% CI 44.8 to 59.7) for children attending GP consultations. While adherence to some in idual indicators was high, overall adherence to documentation of 10 indicators relating to history taking and examination was poorest and estimated at 2.7% (95% CI 1.5 to 4.4). The study is the first to assess guideline-adherence in both hospital (ED and inpatient) and GP settings. Our study demonstrated that while the quality of care for bronchiolitis was generally adherent to CPG indicators, specific aspects of management were deficient, especially documentation of history taking.
Gut Microbiota in Children With Cystic Fibrosis: A Taxonomic and Functional Dysbiosis
Publisher: Springer Science and Business Media LLC
Date: 09-12-2019
DOI: 10.1038/S41598-019-55028-7
Abstract: Intestinal dysbiosis has been observed in children with cystic fibrosis (CF), yet the functional consequences are poorly understood. We investigated the functional capacity of intestinal microbiota and inflammation in children with CF. Stool s les were collected from 27 children with CF and 27 age and gender matched healthy controls (HC) (aged 0.8–18 years). Microbial communities were investigated by iTag sequencing of 16S rRNA genes and functional profiles predicted using Tax4Fun. Inflammation was measured by faecal calprotectin and M2-pyruvate kinase. Paediatric CF gastrointestinal microbiota demonstrated lower richness and ersity compared to HC. CF s les exhibited a marked taxonomic and inferred functional dysbiosis when compared to HC. In children with CF, we predicted an enrichment of genes involved in short-chain fatty acid (SCFA), antioxidant and nutrient metabolism (relevant for growth and nutrition) in CF. The notion of pro-inflammatory GI microbiota in children with CF is supported by positive correlations between intestinal inflammatory markers and both genera and functional pathways. We also observed an association between intestinal genera and both growth z-scores and FEV1%. These taxonomic and functional changes provide insights into gastrointestinal disease in children with CF and future gastrointestinal therapeutics for CF should explore the aforementioned pathways and microbial changes.
WS03.6 Does the cystic fibrosis diet contribute to intestinal dysbiosis?
Publisher: Elsevier BV
Date: 06-2020
Avatar acceptability: views from the Australian Cystic Fibrosis community on the use of personalised organoid technology to guide treatment decisions
Publisher: European Respiratory Society (ERS)
Date: 10-2021
DOI: 10.1183/23120541.00448-2020
Abstract: Patient-oriented research approaches that reflect the needs and priorities of those most affected by health research outcomes improves translation of research findings into practice. Targeted therapies for cystic fibrosis (CF) are now a viable treatment option for some eligible in iduals despite the heterogeneous patient-specific therapeutic response. This has necessitated development of a clinical tool that predicts treatment response for in idual patients. Patient-derived mini-organs (organoids) have been at the forefront of this development. However, little is known about their acceptability in CF patients and members of the public. We used a cross-sectional observational design to conduct an online survey in people with CF, their carers and community comparisons. Acceptability was examined in five domains: 1) willingness to use organoids, 2) perceived advantages and disadvantages of organoids, 3) acceptable out-of-pocket costs, 4) turnaround time and 5) source of tissue. In total, 188 participants completed the questionnaire, including adults with CF and parents of children with CF (90 (48%)), and adults without CF and parents of children without CF (98 (52%)). Use of organoids to guide treatment decisions in CF was acceptable to 86 (95%) CF participants and 98 (100%) community participants. The most important advantage was that organoids may improve treatment selection, improving the patient's quality of life and life expectancy. The most important disadvantage was that the organoid recommended treatment might be unavailable or too expensive. These findings indicate acceptance of patient-derived organoids as a tool to predict treatment response by the majority of people surveyed. This may indicate successful future implementation into healthcare systems.
Supporting Self-management and Quality of Life in Bipolar Disorder With the PolarUs App (Alpha): Protocol for a Mixed Methods Study
Publisher: JMIR Publications Inc.
Date: 04-08-2022
DOI: 10.2196/36213
Abstract: Quality of life (QoL) is increasingly being recognized as a key outcome of interventions for bipolar disorder (BD). Mobile phone apps can increase access to evidence-based self-management strategies and provide real-time support. However, although in iduals with lived experiences desire support with monitoring and improving broader health domains, existing BD apps largely target mood symptoms only. Further, evidence from the broader mobile health (mHealth) literature has shown that the desires and goals of end users are not adequately considered during app development, and as a result, engagement with mental health apps is suboptimal. To capitalize on the potential of apps to optimize wellness in BD, there is a need for interventions developed in consultation with real-world users designed to support QoL self-monitoring and self-management. This mixed methods pilot study was designed to evaluate the alpha version of the newly developed PolarUs app, developed to support QoL self-monitoring and self-management in people with BD. Co-designed using a community-based participatory research framework, the PolarUs app builds on the web-based adaptation of a BD-specific QoL self-assessment measure and integrates material from a web-based portal providing information on evidence-informed self-management strategies in BD. The primary objectives of this project were to evaluate PolarUs app feasibility (via behavioral use metrics), the impact of PolarUs (via the Brief Quality of Life in Bipolar Disorder scale, our primary outcome measure), and explore engagement with the PolarUs app (via quantitative and qualitative methods). Participants will be residents of North America (N=150), aged years, with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision diagnosis of BD type 1, BD type 2, or BD not otherwise specified as assessed by structured diagnostic interview. An embedded mixed methods research design will be adopted qualitative interviews with a purposefully selected subs le (approximately, n=30) of participants will be conducted to explore in more depth feasibility, impact, and engagement with the PolarUs app over the 12-week study period. At the time of publication of this protocol, the development of the alpha version of the PolarUs app was complete. Participant enrollment has begun in June 2022. Data collection is expected to be completed by December 2022. Beyond contributing knowledge on the feasibility and impact of a novel app to support QoL and self-management in BD, this study will also provide new insights related to engagement with mHealth apps. Furthermore, it will function as a case study of successful co-design between people with BD, health care providers, and BD researchers, providing a template for the future use of community-based participatory research frameworks in mHealth intervention development. The results will be used to further refine the PolarUs app and inform the design of a larger clinical trial. PRR1-10.2196/36213
Ageing impairs the airway epithelium defence response to SARS-CoV-2
Publisher: Cold Spring Harbor Laboratory
Date: 06-04-2021
DOI: 10.1101/2021.04.05.437453
Abstract: Age-dependent differences in the clinical response to SARS-CoV-2 infection is well-documented 1–3 however the underlying molecular mechanisms involved are poorly understood. We infected fully differentiated human nasal epithelium cultures derived from healthy children (1-12 years old), young adults (26-34 years old) and older adults (56-62 years old) with SARS-COV-2 to identify age-related cell-intrinsic differences that may influence viral entry, replication and host defence response. We integrated imaging, transcriptomics, proteomics and biochemical assays revealing age-related changes in transcriptional regulation that impact viral replication, effectiveness of host responses and therapeutic drug targets. Viral load was lowest in infected older adult cultures despite the highest expression of SARS-CoV-2 entry and detection factors. We showed this was likely due to lower expression of hijacked host machinery essential for viral replication. Unlike the nasal epithelium of young adults and children, global host response and induction of the interferon signalling was profoundly impaired in older adults, which preferentially expressed proinflammatory cytokines mirroring the “cytokine storm” seen in severe COVID-19 4,5 . In silico screening of our virus-host-drug network identified drug classes with higher efficacy in older adults. Collectively, our data suggests that cellular alterations that occur during ageing impact the ability for the host nasal epithelium to respond to SARS-CoV-2 infection which could guide future therapeutic strategies.
Epidemiology of COVID-19 infection in young children under five years: A systematic review and meta-analysis
Publisher: Elsevier BV
Date: 2021
Comparing the impact of high versus low lockdown severity on the mental health of young people in Australia during the COVID-19 pandemic
Publisher: Elsevier BV
Date: 04-2023
Mental health status of healthcare versus other essential workers in Australia amidst the COVID-19 pandemic: Initial results from the collate project
Publisher: Elsevier BV
Date: 04-2021
Consumer Directed Care and Resident Quality of Life: How Leadership and Organizational Factors Impact on Success
Publisher: Informa UK Limited
Date: 12-01-2022
DOI: 10.1080/01634372.2021.2025185
Abstract: Previous studies have demonstrated inconsistency in the effectiveness of staff training programs in consumer directed care (CDC) as a means of enhancing the quality of life (QoL) of residents. The aim of this study was to investigate why this might be the case. We analyzed disaggregated cluster-by-cluster resident QoL outcomes after nursing home staff completed a CDC training program. In total, 33 nursing homes (11 clusters) participated in the study. As with previous studies, the outcomes across nursing homes were inconsistent - QoL improved at some sites but at many it remained stable or declined. Analysis of facilitator notes from the most and least successful clusters indicated that a lack of organizational support, for both the training and subsequent practice of CDC, was potentially the key barrier to effective implementation of training and so improvement in resident QoL. These findings demonstrate that all levels of aged care organizations - on the floor staff, managers and senior staff - need to fully support a CDC model of care to optimize outcomes for residents. Staff require training in CDC as well as long-term culture change within the nursing home so that training can be translated into practice.
Probiotics for people with cystic fibrosis
Publisher: Wiley
Date: 22-01-2020
Development and Validation of the Bladder and Bowel Incontinence Phobia Severity Scale
Publisher: Springer Publishing Company
Date: 30-09-2019
DOI: 10.1891/0889-8391.33.4.271
Abstract: The current research investigates the development and validation of the Bladder and Bowel Incontinence Phobia Severity Scale (BBIPSS). Over two studies, two independent s les consisting of university students and respondents from the general public were used to validate the scale (study 1 n = 226 study 2 n = 377). A 15-item, two-factor model was confirmed in study 2 where strong construct (convergent and ergent) validity was demonstrated. The BBIPSS did not display significant correlations with openness and gender ( ergent validity) and displayed significant correlations with depression, anxiety, and stress scores (DASS), alongside paruresis and parcopresis scores (Shy Bladder and Bowel Scale [SBBS] convergent validity) and the Bowel and Bladder-Control Anxiety Scale [BoBCAtS]. The BBIPSS also demonstrated strong test–retest reliability (bladder r = 0.89 bowel r = 0.86) in a small s le of adults ( n = 13). Overall, this scale provides researchers and clinicians with a reliable and psychometrically valid assessment tool to measure bladder and bowel incontinence phobia severity.
Using Vocal Characteristics To Classify Psychological Distress in Adult Helpline Callers: Retrospective Observational Study
Publisher: JMIR Publications Inc.
Date: 19-12-2022
DOI: 10.2196/42249
Abstract: Elevated psychological distress has demonstrated impacts on in iduals’ health. Reliable and efficient ways to detect distress are key to early intervention. Artificial intelligence has the potential to detect states of emotional distress in an accurate, efficient, and timely manner. The aim of this study was to automatically classify short segments of speech obtained from callers to national suicide prevention helpline services according to high versus low psychological distress and using a range of vocal characteristics in combination with machine learning approaches. A total of 120 telephone call recordings were initially converted to 16-bit pulse code modulation format. Short variable-length segments of each call were rated on psychological distress using the distress thermometer by the responding counselor and a second team of psychologists (n=6) blinded to the initial ratings. Following this, 24 vocal characteristics were initially extracted from 40-ms speech frames nested within segments within calls. After highly correlated variables were eliminated, 19 remained. Of 19 vocal characteristics, 7 were identified and validated as predictors of psychological distress using a penalized generalized additive mixed effects regression model, accounting for nonlinearity, autocorrelation, and moderation by sex. Speech frames were then grouped using k-means clustering based on the selected vocal characteristics. Finally, component-wise gradient boosting incorporating these clusters was used to classify each speech frame according to high versus low psychological distress. Classification accuracy was confirmed via leave-one-caller-out cross-validation, ensuring that speech segments from in idual callers were not used in both the training and test data. The s le comprised 87 female and 33 male callers. From an initial pool of 19 characteristics, 7 vocal characteristics were identified. After grouping speech frames into 2 separate clusters (correlation with sex of caller, Cramer’s V =0.02), the component-wise gradient boosting algorithm successfully classified psychological distress to a high level of accuracy, with an area under the receiver operating characteristic curve of 97.39% (95% CI 96.20-98.45) and an area under the precision-recall curve of 97.52 (95% CI 95.71-99.12). Thus, 39,282 of 41,883 (93.39%) speech frames nested within 728 of 754 segments (96.6%) were classified as exhibiting low psychological distress, and 71455 of 75503 (94.64%) speech frames nested within 382 of 423 (90.3%) segments were classified as exhibiting high psychological distress. As the probability of high psychological distress increases, male callers spoke louder, with greater vowel articulation but with greater roughness (subharmonic depth). In contrast, female callers exhibited decreased vocal clarity (entropy), greater proportion of signal noise, higher frequencies, increased breathiness (spectral slope), and increased roughness of speech with increasing psychological distress. In idual caller random effects contributed 68% to risk reduction in the classification algorithm, followed by cluster configuration (23.4%), spectral slope (4.4%), and the 50th percentile frequency (4.2%). The high level of accuracy achieved suggests possibilities for real-time detection of psychological distress in helpline settings and has potential uses in pre-emptive triage and evaluations of counseling outcomes. ANZCTR ACTRN12622000486729 www.anzctr.org.au/ACTRN12622000486729.aspx
Supporting Self-Management and Quality of Life in Bipolar Disorder with the Beta PolarUs App: Protocol for a Mixed-Methods Study (Preprint)
Publisher: JMIR Publications Inc.
Date: 05-01-2022
Abstract: uality of life (QoL) is increasingly recognised as a key outcome of self-management interventions for bipolar disorder (BD). Mobile phone applications (apps) can increase access to evidence-based self-management strategies and provide real-time support. However, while in iduals with lived experience desire support with monitoring and improving broader health domains, existing BD apps largely target mood symptoms only. Further, evidence from the broader mHealth literature has shown that the desires and goals of end-users are not adequately taken into account during app development, and as a result engagement with mental health apps is suboptimal. To capitalise on the potential of apps to optimise wellness in BD, there is a need for interventions developed in consultation with real-world users that are designed to support QoL self-monitoring and self-management. Objective: This mixed methods pilot study is designed to evaluate the beta version of the newly developed PolarUs app, which aims to support QoL self-monitoring and self-management in people with BD. Developed using a community-based participatory research framework, the PolarUs app builds on the web-based adaptation of a BD-specific QoL self-assessment measure, and integrates material from a web-based portal providing information on evidence-informed self-management strategies in BD. he primary objectives of this project are to: (1) evaluate PolarUs app feasibility (via behavioral usage metrics) (2) evaluate PolarUs impact (via the Brief Quality of Life in Bipolar Disorders, QoL.BD scale, our primary outcomes measure) and (3) explore engagement with the PolarUs app (via both quantitative and qualitative methods). tudy participants will be North American residents (N=150) aged 18-65 years with a DSM-5 diagnosis of BD-I, BD-II or BD not otherwise specified (NOS) as assessed by a structured diagnostic interview. An embedded mixed-methods research design will be adopted qualitative interviews with a purposefully selected sub-s le (~n=30) of participants will be conducted to explore in more depth feasibility, impact and engagement with the PolarUs app over the 12-week study period. t the time of publication of this protocol, the development of the beta version of the PolarUs app is complete. Participant enrollment is expected to begin in February 2022. Data collection is expected to be completed by December 2022. eyond contributing knowledge on the feasibility and impacts of a novel app to support QoL and self-management in BD, this study is also expected to provide new knowledge on engagement with mHealth apps. Furthermore, it is expected to function as a case study of successful co-design between in iduals living with BD, clinicians who specialise in the treatment of BD, and BD researchers, providing a template for future use of community-based participatory research frameworks in mHealth intervention development. Results will be used to further refine the PolarUs app and inform the design of a larger clinical trial.
Rare diseases research and policy in Australia
Publisher: Wiley
Date: 16-04-2021
DOI: 10.1111/JPC.15507
Abstract: Almost exactly 10 years after the publication of ‘Call for a national plan for rare diseases’ in this journal, the Federal Government launched the National Strategic Action Plan for Rare Diseases (the Action Plan) on the 26th of February 2020, in the lead up to Rare Disease Day on the 29th of February – a rare day for rare diseases. The Action Plan is the culmination of effective advocacy by Rare Voices Australia (RVA) and other stakeholders in the rare disease (RD) sector. RVA is the peak body for Australians living with a RD. The organisation works collaboratively with RD organisations, researchers and clinicians. Since the initial call for a RD plan, a number of health‐care initiatives and policy changes have gathered apace including expanded antenatal and newborn screening, the increasing application of next generation sequencing and advances in gene and cell therapeutics. The development of new models of care, diagnostic and treatment pathways, and communities of practice have started to ease the considerable burden and inequitable access to care experienced by RD patients and their families. However, much work remains to be done. The Action Plan outlines the actions to bring about the best possible health and well‐being outcomes for Australians living with RD. It is centred around three pillars – awareness and education, care and support, research and data – and will be delivered against the principles of person centredness, equity, and sustainable systems and workforce.
Nasopharyngeal density of respiratory viruses in childhood pneumonia in a highly vaccinated setting
Publisher: BMJ
Date: 07-2020
DOI: 10.1136/BMJRESP-2020-000593
Abstract: Detection of pneumonia-causing respiratory viruses in the nasopharynx of asymptomatic children has made their actual contribution to pneumonia unclear. We compared nasopharyngeal viral density between children with and without pneumonia to understand if viral density could be used to diagnose pneumonia. Nasopharyngeal swabs (NPS) were collected from hospitalised pneumonia cases at Princess Margaret Hospital (PMH) and contemporaneous age-matched controls at PMH outpatient clinics and a local immunisation clinic in Perth, Australia. The density (copies/mL) of respiratory syncytial virus (RSV), influenza A virus (InfA), human metapneumovirus (HMPV) and rhinovirus in NPS was determined using quantitative PCR. Linear regression analysis was done to assess the trend between viral density and age in months. The association between viral density and disease status was examined using logistic regression. Area under receiver operating characteristic (AUROC) curves were assessed to determine optimal discriminatory viral density cut-offs. Through May 2015 to October 2017, 230 pneumonia cases and 230 controls were enrolled. Median nasopharyngeal density for any respiratory virus was not substantially higher in cases than controls (p .05 for each). A decreasing density trend with increasing age was observed—the trend was statistically significant for RSV (regression coefficient −0.04, p=0.004) but not for other viruses. After adjusting for demographics and other viral densities, for every log 10 copies/mL density increase, the odds of being a case increased by six times for RSV, three times for HMPV and two times for InfA. The AUROC curves were .70 for each virus, suggesting poor case–control discrimination based on viral density. The nasopharyngeal density of respiratory viruses was not significantly higher in children with pneumonia than those without however, the odds of being a case increased with increased density for some viruses. The utility of viral density, alone, in defining pneumonia was limited.
Eating and exercise behaviors in eating disorders and the general population during the COVID-19 pandemic in Australia: Initial results from the COLLATE project
Publisher: Wiley
Date: 06-2020
DOI: 10.1002/EAT.23317
Long‐term morbidity of respiratory viral infections during chemotherapy in children with leukaemia
Publisher: Wiley
Date: 08-08-2019
DOI: 10.1002/PPUL.24456
Promoting Psychological Well-Being at Work by Reducing Stress and Improving Sleep: Mixed-Methods Analysis
Publisher: JMIR Publications Inc.
Date: 19-10-2018
DOI: 10.2196/JMIR.9058
Investigating the Impact of Hearing Aid Use and Auditory Training on Cognition, Depressive Symptoms, and Social Interaction in Adults With Hearing Loss: Protocol for a Crossover Trial (Preprint)
Publisher: JMIR Publications Inc.
Date: 11-09-2017
Abstract: ensorineural hearing loss is the most common sensory deficit among older adults. Some of the psychosocial consequences of this condition include difficulty in understanding speech, depression, and social isolation. Studies have shown that older adults with hearing loss show some age-related cognitive decline. Hearing aids have been proven as successful interventions to alleviate sensorineural hearing loss. In addition to hearing aid use, the positive effects of auditory training—formal listening activities designed to optimize speech perception—are now being documented among adults with hearing loss who use hearing aids, especially new hearing aid users. Auditory training has also been shown to produce prolonged cognitive performance improvements. However, there is still little evidence to support the benefits of simultaneous hearing aid use and in idualized face-to-face auditory training on cognitive performance in adults with hearing loss. his study will investigate whether using hearing aids for the first time will improve the impact of in idualized face-to-face auditory training on cognition, depression, and social interaction for adults with sensorineural hearing loss. The rationale for this study is based on the hypothesis that, in adults with sensorineural hearing loss, using hearing aids for the first time in combination with in idualized face-to-face auditory training will be more effective for improving cognition, depressive symptoms, and social interaction rather than auditory training on its own. his is a crossover trial targeting 40 men and women between 50 and 90 years of age with either mild or moderate symmetric sensorineural hearing loss. Consented, willing participants will be recruited from either an independent living accommodation or via a community database to undergo a 6-month intensive face-to-face auditory training program (active control). Participants will be assigned in random order to receive hearing aid (intervention) for either the first 3 or last 3 months of the 6-month auditory training program. Each participant will be tested at baseline, 3, and 6 months using a neuropsychological battery of computer-based cognitive assessments, together with a depression symptom instrument and a social interaction measure. The primary outcome will be cognitive performance with regard to spatial working memory. Secondary outcome measures include other cognition performance measures, depressive symptoms, social interaction, and hearing satisfaction. ata analysis is currently under way and the first results are expected to be submitted for publication in June 2018. esults from the study will inform strategies for aural rehabilitation, hearing aid delivery, and future hearing loss intervention trials. linicalTrials.gov NCT03112850 t2/show/NCT03112850 (Archived by WebCite at xz12fD0B).
Raising Suicide in Medical Appointments—Barriers and Facilitators Experienced by Young Adults and GPs: A Mixed-Methods Systematic Review
Publisher: MDPI AG
Date: 2023
Abstract: The aim of this review was to understand the barriers and facilitators facing GPs and young adults in raising and addressing suicide in medical appointments. A mixed-methods systematic review was conducted of qualitative and quantitative studies. The focus was papers that explored barriers and facilitators experienced by young adults aged 18 to 26, and GPs working in primary care environments. Nine studies met the inclusion criteria. Four studies provided information on young adults’ views, four on GPs, and one considered both GP and young adults’ viewpoints. Nine barrier and seven facilitator themes were identified. Unique to this review was the recognition that young adults want GPs to initiate the conversation about suicide. They see this as a GP’s responsibility. This review further confirmed that GPs lack the confidence and skills to assess suicide risk in young adults. Both findings combined could explain previous results for reduced identification of suicide risk in this cohort. GP training needs considerable focus on addressing skill deficiencies and improving GP confidence to assess suicide risk. However, introducing suicide risk screening in primary care for young adults should be a priority as this will overcome the need for young adults to voluntarily disclose thoughts of suicide.
The Demographic Representativeness and Health Outcomes of Digital Health Station Users: Longitudinal Study
Publisher: JMIR Publications Inc.
Date: 26-06-2020
DOI: 10.2196/14977
Abstract: Digital health stations offer an affordable and accessible platform for people to monitor their health however, there is limited information regarding the demographic profile of users and the health benefits of this technology. This study aimed to assess the demographic representativeness of health station users, identify the factors associated with repeat utilization of stations, and determine if the health status of repeat users changed between baseline and final health check. Data from 180,442 health station users in Australia, including 8441 repeat users, were compared with 2014-2015 Australian National Health Survey (NHS) participants on key demographic and health characteristics. Binary logistic regression analyses were used to compare demographic and health characteristics of repeat and one-time users. Baseline and final health checks of repeat users were compared using McNemar tests and Wilcoxon signed rank tests. The relationship between the number of checks and final health scores was investigated using generalized linear models. The demographic profile of SiSU health station users differs from that of the general population. A larger proportion of SiSU users were female (100,814/180,442, 55.87% vs 7807/15,393, 50.72%), younger (86,387/180,442, 47.88% vs 5309/15,393, 34.49% aged less than 35 years), and socioeconomically advantaged (64,388/180,442, 35.68% vs 3117/15,393, 20.25%). Compared with NHS participants, a smaller proportion of SiSU health station users were overweight or obese, were smokers, had high blood pressure (BP), or had diabetes. When data were weighted for demographic differences, only rates of high BP were found to be lower for SiSU users compared with the NHS participants (odds ratio [OR] 1.26 P .001). Repeat users were more likely to be female (OR 1.37 P .001), younger (OR 0.99 P .001), and from high socioeconomic status areas—those residing in socioeconomic index for areas quintiles 4 and 5 were significantly more likely to be repeat users compared with those residing in quintile 1 (OR 1.243 P .001 and OR 1.151 P .001, respectively). Repeat users were more likely to have a higher BMI (OR 1.02 P .001), high BP (OR 1.15 P .001), and less likely to be smokers (OR 0.77 P .001). Significant improvements in health status were observed for repeat users. Mean BMI decreased by 0.97 kg/m2 from baseline to final check (z=−14.24 P .001), whereas the proportion of people with high BP decreased from 15.77% (1080/6848) to 12.90% (885/6860 χ21=38.2 P .001). The proportion of smokers decreased from 11.91% (1005/8438) to 10.13% (853/8421 χ21=48.4 P .001). Number of repeat health checks was significantly associated with smoking status (OR 0.96 P .048) but not with higher BP (P=.14) or BMI (P=.23). These findings provide valuable insight into the benefits of health stations for self-monitoring and partially support previous research regarding the effect of demographics and health status on self-management of health.
Detection and management of early glucose abnormalities in cystic fibrosis
Publisher: IntechOpen
Date: 09-06-2021
An overview of current mental health in the general population of Australia during the COVID-19 pandemic: Results from the COLLATE project
Publisher: Cold Spring Harbor Laboratory
Date: 18-07-2020
DOI: 10.1101/2020.07.16.20155887
Abstract: The novel coronavirus disease (COVID-19) poses significant mental health challenges globally however, to date, there is limited community level data. This study reports on the first wave of data from the COLLATE project (COvid-19 and you: mentaL heaLth in AusTralia now survEy), an ongoing study aimed at understanding the impact of the COVID-19 pandemic on the mental health and well-being of Australians. This paper addresses prevailing primary concerns related to the COVID-19 pandemic, current levels of negative emotions and risk factors predicting these negative emotions. On April 1st to 4th 2020, 5158 adult members of the Australian general public completed an online survey. Participants ranked their top ten current primary concerns about COVID-19, and completed standardized measures to ascertain levels of negative emotions (specifically, depression, anxiety and stress). Socio-demographic information was also collected and used in the assessment of risk factors. The top three primary concerns were all related to the health and well-being of family and loved ones. As expected, levels of negative emotion were exceptionally high. Modelling of predictors of negative emotions established several risk factors related to demographic variables, personal vulnerabilities, financial stresses, and social distancing experiences particularly being young, being female, or having a mental illness diagnosis. The data provides important characterization of the current mental health of Australians during the COVID-19 pandemic. Critically, it appears that specific groups in the Australian community may need special attention to ensure their mental health is protected during these difficult times. The data further suggests the need for immediate action to combat high levels of psychological distress, along with the exacerbation of mental health conditions, in relation to the COVID-19 pandemic in Australia. These results may provide some direction for international researchers hoping to characterize similar issues in other countries.
The effects of screen media content on young children’s executive functioning
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.JECP.2018.01.006
Abstract: Children's exposure to screen-based media has raised concerns for many reasons. One reason is that viewing particular television content has been shown to negatively affect children's executive functioning. Yet, it is unclear whether interacting with a touchscreen device affects executive functioning in the same way as the television research suggests. In the current study, 96 2- and 3-year-old children completed executive functioning measures of working memory and response inhibition and task switching before and after a brief screen intervention consisting of watching an educational television show, playing an educational app, or watching a cartoon. Children's ability to delay gratification was also assessed. Results indicate that the type of screen intervention had a significant effect on executive functioning performance. Children were more likely to delay gratification after playing an educational app than after viewing a cartoon. In particular instances, children's working memory improved after playing the educational app. These findings emphasize that, for young children's executive functioning, interactivity and content may be more important factors to consider than simply "screen time."
Management of fever in Australian children
Publisher: Springer Science and Business Media LLC
Date: 13-01-2020
DOI: 10.1186/S12887-020-1911-Y
Abstract: Fever in childhood is a common acute presentation requiring clinical triage to identify the few children who have serious underlying infection. Clinical practice guidelines (CPGs) have been developed to assist clinicians with this task. This study aimed to assess the proportion of care provided in accordance with CPG recommendations for the management of fever in Australian children. Clinical recommendations were extracted from five CPGs and formulated into 47 clinical indicators for use in auditing adherence. Indicators were categorised by phase of care: assessment, diagnosis and treatment. Patient records from children aged 0 to 15 years were s led from general practices (GP), emergency departments (ED) and hospital admissions in randomly-selected health districts in Queensland, New South Wales and South Australia during 2012 and 2013. Paediatric nurses, trained to assess eligibility for indicator assessment and adherence, reviewed eligible medical records. Adherence was estimated by in idual indicator, phase of care, age-group and setting. The field team conducted 14,879 eligible indicator assessments for 708 visits by 550 children with fever in 58 GP, 34 ED and 28 hospital inpatient settings. For the 33 indicators with sufficient data, adherence ranged from 14.7 to 98.1%. Estimated adherence with assessment-related indicators was 51.3% (95% CI: 48.1–54.6), 77.5% (95% CI: 65.3–87.1) for diagnostic-related indicators and 72.7% (95% CI: 65.3–79.3) for treatment-related indicators. Adherence for children 3 months of age was 73.4% (95% CI: 58.0–85.8) and 64.7% (95% CI: 57.0–71.9) for children 3–11 months of age, both significantly higher than for children aged 4–15 years (53.5% 95% CI: 50.0–56.9). The proportion of adherent care for children attending an ED was 77.5% (95% CI: 74.2–80.6) and 76.7% (95% CI: 71.7–81.3) for children admitted to hospital, both significantly higher than for children attending a GP (40.3% 95% CI: 34.6–46.1). This study reports a wide range of adherence by clinicians to 47 indicators of best practice for the management of febrile children, s led from urban and rural regions containing 60% of the Australian paediatric population. Documented adherence was lowest for indicators related to patient assessment, for care provided in GP settings, and for children aged 4–15 years.
Using voice biomarkers to classify suicide risk in telehealth callers (Preprint)
Publisher: JMIR Publications Inc.
Date: 24-05-2022
Abstract: rtificial Intelligence has the potential to innovate current practices used to detect imminent risk of suicide, and to address shortcomings in traditional assessment methods. e sought to automatically classify short segments (40ms) of speech according to low versus imminent risk of suicide in a large number (n = 281) of telephone calls made to two telehealth counselling services in Australia. his retrospective repeated measures cohort design included 281 helpline calls sourced from On The Line, Australia (n=266) and 000 Emergency services, Canberra (n=15). Imminent risk of suicide was coded for when callers affirmed intent, plan and the availability of means was assessed as such by the responding counsellor, and re-assessed by a team of clinical researchers using the Columbia Suicide Severity Rating scale (C-SSRS = 5/6). Low risk of suicide was coded for in an absence of intent, plan and means and via C-SSRS = 1/2. Pre-processing involved normalisation and pre-emphasis of voice signals, while voice biometrics were extracted using the statistical language r. Candidate predictors were identified using Lasso Regression. The relationship of each candidate biomarker was assessed as a predictor of suicide risk using a Generalized Additive Mixed effects regression Model (GAMM) using splines to account for non-linearity. Finally, a Component-Wise Gradient Boosting model was trained on 60% of the data, then validated and tested on the remaining data (20%/20%). eventy-seven imminent risk calls were compared with 204 low risk calls. 171,968 40ms frames featuring 36 voice biomarkers were extracted from these calls. Candidate biomarkers were reduced to 11 primary markers, with distinct models needed for men and women. Classification accuracies greater than 99.9% were obtained for imminent suicide risk for each of the data partitions using these primary markers. his study demonstrates an objective, efficient and economical assessment of imminent suicide risk in an ecologically valid setting with potential applications to real-time assessment and response. CTRN12622000486729
Three-tier SME internationalization process model: a Vietnam study on the relationship between managerial capacity, innovation strategies and technological and innovation leadership
Publisher: Informa UK Limited
Date: 03-04-2023
Rate of use and effectiveness of oseltamivir in the treatment of influenza illness in high-risk populations: A systematic review and meta-analysis
Publisher: Wiley
Date: 10-02-2021
DOI: 10.1002/HSR2.241
The Demographic Representativeness and Health Outcomes of Digital Health Station Users: Longitudinal Study (Preprint)
Publisher: JMIR Publications Inc.
Date: 09-06-2019
Abstract: igital health stations (health kiosks) offer an affordable and accessible platform for people to monitor their health however, there is limited information regarding the demographic profile of users and the health benefits of this technology. his study aimed to assess the demographic representativeness of health station users, identify the factors associated with repeat utilization of stations, and determine if the health status of repeat users changed between baseline and final health check. ata from 180,442 health station users in Australia, including 8441 repeat users, were compared with 2014-2015 Australian National Health Survey (NHS) participants on key demographic and health characteristics. Binary logistic regression analyses were used to compare demographic and health characteristics of repeat and one-time users. Baseline and final health checks of repeat users were compared using McNemar tests and Wilcoxon signed rank tests. The relationship between the number of checks and final health scores was investigated using generalized linear models. he demographic profile of SiSU health station users differs from that of the general population. A larger proportion of SiSU users were female (100,814/180,442, 55.87% vs 7807/15,393, 50.72%), younger (86,387/180,442, 47.88% vs 5309/15,393, 34.49% aged less than 35 years), and socioeconomically advantaged (64,388/180,442, 35.68% vs 3117/15,393, 20.25%). Compared with NHS participants, a smaller proportion of SiSU health station users were overweight or obese, were smokers, had high blood pressure (BP), or had diabetes. When data were weighted for demographic differences, only rates of high BP were found to be lower for SiSU users compared with the NHS participants (odds ratio [OR] 1.26 i P /i & .001). Repeat users were more likely to be female (OR 1.37 i P /i & .001), younger (OR 0.99 i P /i & .001), and from high socioeconomic status areas—those residing in socioeconomic index for areas quintiles 4 and 5 were significantly more likely to be repeat users compared with those residing in quintile 1 (OR 1.243 i P /i & .001 and OR 1.151 i P /i & .001, respectively). Repeat users were more likely to have a higher BMI (OR 1.02 i P /i & .001), high BP (OR 1.15 i P /i & .001), and less likely to be smokers (OR 0.77 i P /i & .001). Significant improvements in health status were observed for repeat users. Mean BMI decreased by 0.97 kg/m2 from baseline to final check (z=−14.24 i P /i & .001), whereas the proportion of people with high BP decreased from 15.77% (1080/6848) to 12.90% (885/6860 χ sup /sup sub /sub =38.2 i P /i & .001). The proportion of smokers decreased from 11.91% (1005/8438) to 10.13% (853/8421 χ sup /sup sub /sub =48.4 i P /i & .001). Number of repeat health checks was significantly associated with smoking status (OR 0.96 i P /i & .048) but not with higher BP ( i P /i =.14) or BMI ( i P /i =.23). hese findings provide valuable insight into the benefits of health stations for self-monitoring and partially support previous research regarding the effect of demographics and health status on self-management of health. >
Young children’s contingent interactions with a touchscreen influence their memory for spatial and narrative content
Publisher: Informa UK Limited
Date: 12-05-2020
Assessment of variation in care following hospital discharge for children with acute asthma
Publisher: Informa UK Limited
Date: 07-2021
DOI: 10.2147/JAA.S311721
Using Voice Biomarkers to Classify Psychological Distress in Adult Helpline Callers: A Retrospective Observational Study (Preprint)
Publisher: JMIR Publications Inc.
Date: 26-09-2022
Abstract: levated psychological distress has demonstrated impacts on in iduals’ health. Reliable and efficient ways to detect distress are key to early intervention. Artificial Intelligence has the potential to detect states of emotional distress in an accurate, efficient and timely manner. o automatically classify short segments of speech obtained from callers to national suicide prevention helpline services, according to low versus high psychological distress, using a range of voice biomarkers in combination with machine learning approaches. ne hundred and twenty telephone call recordings were initially converted to 16-bit Pulse Code Modulation format. Short variable length segments of each call were rated on psychological distress using the Distress Thermometer by the responding counselor and a second team of psychologists blinded to the initial ratings (n=6). Nineteen voice biomarkers were derived using 40ms speech frames derived from each annotated segment. Candidate biomarkers were reduced using Lasso regression, validated by generalised additive mixed effects regression, accounting for non-linearity, autocorrelation and moderation by sex. Speech frames were then grouped using k-means clustering based on the selected biomarkers. Finally, component-wise gradient boosting was used to classify each speech frame according to low versus high psychological distress. Classification accuracy was confirmed via leave one out cross validation ensuring that speech segments from single callers were not used in both the training and test data. sing twelve voice biomarkers, 686/747 speech segments were successfully classified, AUCROC = 93.8% (95% CI = 91.47, 94.6) and AUCPR = 94.8 (95% CI = 93.0, 96.5). When experiencing elevations in psychological distress, male speakers spoke with increasing loudness, higher frequencies in the 75th percentile of frequencies, but with poorer clarity of speech. In contrast, when experiencing psychological distress, the frequencies with which female callers spoke decreased in the highest quartile of frequencies, but exhibited increased clarity of speech. he high level of accuracy achieved suggests possibilities for real-time detection of psychological distress in helpline settings and has potential uses in pre-emptive triage. NZCTR, ACTRN12622000486729
A phospholipid-based formulation for the treatment of airway inflammation in chronic respiratory diseases
Publisher: Elsevier BV
Date: 12-2020
Detection of Suicide Risk Using Vocal Characteristics: Systematic Review
Publisher: JMIR Publications Inc.
Date: 22-12-2022
DOI: 10.2196/42386
Abstract: In an age when telehealth services are increasingly being used for forward triage, there is a need for accurate suicide risk detection. Vocal characteristics analyzed using artificial intelligence are now proving capable of detecting suicide risk with accuracies superior to traditional survey-based approaches, suggesting an efficient and economical approach to ensuring ongoing patient safety. This systematic review aimed to identify which vocal characteristics perform best at differentiating between patients with an elevated risk of suicide in comparison with other cohorts and identify the methodological specifications of the systems used to derive each feature and the accuracies of classification that result. A search of MEDLINE via Ovid, Scopus, Computers and Applied Science Complete, CADTH, Web of Science, ProQuest Dissertations and Theses A& I, Australian Policy Online, and Mednar was conducted between 1995 and 2020 and updated in 2021. The inclusion criteria were human participants with no language, age, or setting restrictions applied randomized controlled studies, observational cohort studies, and theses studies that used some measure of vocal quality and in iduals assessed as being at high risk of suicide compared with other in iduals at lower risk using a validated measure of suicide risk. Risk of bias was assessed using the Risk of Bias in Non-randomized Studies tool. A random-effects model meta-analysis was used wherever mean measures of vocal quality were reported. The search yielded 1074 unique citations, of which 30 (2.79%) were screened via full text. A total of 21 studies involving 1734 participants met all inclusion criteria. Most studies (15/21, 71%) sourced participants via either the Vanderbilt II database of recordings (8/21, 38%) or the Silverman and Silverman perceptual study recording database (7/21, 33%). Candidate vocal characteristics that performed best at differentiating between high risk of suicide and comparison cohorts included timing patterns of speech (median accuracy 95%), power spectral density sub-bands (median accuracy 90.3%), and mel-frequency cepstral coefficients (median accuracy 80%). A random-effects meta-analysis was used to compare 22 characteristics nested within 14% (3/21) of the studies, which demonstrated significant standardized mean differences for frequencies within the first and second formants (standardized mean difference ranged between −1.07 and −2.56) and jitter values (standardized mean difference=1.47). In 43% (9/21) of the studies, risk of bias was assessed as moderate, whereas in the remaining studies (12/21, 57%), the risk of bias was assessed as high. Although several key methodological issues prevailed among the studies reviewed, there is promise in the use of vocal characteristics to detect elevations in suicide risk, particularly in novel settings such as telehealth or conversational agents. PROSPERO International Prospective Register of Systematic Reviews CRD420200167413 www.crd.york.ac.uk rospero/display_record.php?ID=CRD42020167413
The cognitive and psychosocial effects of auditory training and hearing aids in adults with hearing loss
Publisher: Informa UK Limited
Date: 2019
DOI: 10.2147/CIA.S183905
Role of technology in improving knowledge and confidence in asthma management in school staff
Publisher: Informa UK Limited
Date: 05-02-2020
Therapist-assisted internet-based cognitive behavioral therapy versus progressive relaxation in obsessive-compulsive disorder: Randomized controlled trial
Publisher: JMIR Publications Inc.
Date: 08-08-2018
DOI: 10.2196/JMIR.9566
Use of technology by orientation and mobility professionals in Australia and Malaysia before COVID-19
Publisher: Informa UK Limited
Date: 09-07-2020
DOI: 10.1080/17483107.2020.1785565
Abstract: Orientation and Mobility (O&M) professionals teach people with low vision or blindness to use specialist assistive technologies to support confident travel, but many O&M clients now prefer a smartphone. This study aimed to investigate what technology O&M professionals in Australia and Malaysia have, use, like, and want to support their client work, to inform the development of O&M technologies and build capacity in the international O&M profession. A technology survey was completed by professionals ( Limited awareness of apps used by clients, unaffordability of devices, and inadequate technology training discouraged many O&M professionals from employing existing technologies in client programmes or for broader professional purposes. Professionals needed to learn smartphone accessibility features and travel-related apps, and ways to use technology during O&M client programmes, initial professional training, ongoing professional development and research. Smartphones are now integral to travel with low vision or blindness and early-adopter O&M clients are the travel tech-experts. O&M professionals need better initial training and then regular upskilling in mainstream O&M technologies to expand clients' travel choices. COVID-19 has created an imperative for technology laggards to upskill for O&M tele-practice. O&M technology could support comprehensive O&M specialist training and practice in Malaysia, to better serve O&M clients with complex needs.Implications for rehabilitationMost orientation and mobility (O&M) clients are travelling with a smartphone, so O&M specialists need to be abreast of mainstream technologies, accessibility features and apps used by clients for orientation, mobility, visual efficiency and social engagement.O&M specialists who are technology laggards need human-guided support to develop confidence in using travel technologies, and O&M clients are the experts. COVID-19 has created an imperative to learn skills for O&M tele-practice.Affordability is a significant barrier to O&M professionals and clients accessing specialist travel technologies in Malaysia, and to O&M professionals upgrading technology in Australia.Comprehensive training for O&M specialists is needed in Malaysia to meet the travel needs of clients with low vision or blindness who also have physical, cognitive, sensory or mental health complications.
Hearing Aid Use in Older Adults With Postlingual Sensorineural Hearing Loss: Protocol for a Prospective Cohort Study (Preprint)
Publisher: JMIR Publications Inc.
Date: 12-02-2018
Abstract: lder adults with postlingual sensorineural hearing loss (SNHL) exhibit a poor prognosis that not only includes impaired auditory function but also rapid cognitive decline, especially speech-related cognition, in addition to psychosocial dysfunction and an increased risk of dementia. Consistent with this prognosis, in iduals with SNHL exhibit global atrophic brain alteration as well as altered neural function and regional brain organization within the cortical substrates that underlie auditory and speech processing. Recent evidence suggests that the use of hearing aids might ameliorate this prognosis. he objective was to study the effects of a hearing aid use intervention on neurocognitive and psychosocial functioning in in iduals with SNHL aged ≥55 years. ll aspects of this study will be conducted at Swinburne University of Technology (Hawthorn, Victoria, Australia). We will recruit 2 groups (n=30 per group) of in iduals with mild to moderate SNHL from both the community and audiology health clinics (Alison Hennessy Audiology, Chelsea Hearing Pty Ltd). These groups will include in iduals who have worn a hearing aid for, at least, 12 months or never worn a hearing aid. All participants would be asked to complete, at 2 time points (t) including baseline (t=0) and follow-up (t=6 months), tests of hearing and psychosocial and cognitive function and attend a magnetic resonance imaging (MRI) session. The MRI session will include both structural and functional MRI (sMRI and fMRI) scans, the latter involving the performance of a novel speech processing task. his research is funded by the Barbara Dicker Brain Sciences Foundation Grants, the Australian Research Council, Alison Hennessy Audiology, and Chelsea Hearing Pty Ltd under the Industry Transformation Training Centre Scheme (ARC Project #IC140100023). We obtained the ethics approval on November 18, 2017 (Swinburne University Human Research Ethics Committee protocol number SHR Project 2017/266). The recruitment began in December 2017 and will be completed by December 2020. his is the first study to assess the effect hearing aid use has on neural, cognitive, and psychosocial factors in in iduals with SNHL who have never used hearing aids. Furthermore, this study is expected to clarify the relationships among altered brain structure and function, psychosocial factors, and cognition in response to the hearing aid use. ustralian New Zealand Clinical Trials Registry: ACTRN12617001616369 anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12617001616369 (Accessed by WebCite at 0yatZ9ze) R1-10.2196/9916
Guideline adherence in the management of head injury in Australian children: A population-based sample survey
Publisher: Public Library of Science (PLoS)
Date: 11-02-2020
Assessing the adherence to guidelines in the management of croup in Australian children
Publisher: Oxford University Press (OUP)
Date: 28-10-2019
Abstract: To determine the extent to which care received by Australian children presenting with croup is in agreement with Clinical Practice Guidelines (CPGs). Retrospective population-based s le survey. Croup clinical indicators were derived from CPGs. Medical records from three healthcare settings were s led for selected visits in 2012 and 2013 in three Australian states. Data were collected by nine experienced paediatric nurses, trained to assess eligibility for indicator assessment and adherence to CPGs. Surveyors undertook criterion-based medical record reviews using an electronic data collection tool. Documented guideline adherence was lower for general practitioners (65.9% 95% CI: 60.8–70.6) than emergency departments (91.1% 95% CI: 89.5–92.5) and inpatient admissions (91.3% 95% CI: 88.1–93.9). Overall adherence was very low for a bundle of 10 indicators related to assessment (4.5% 95% CI: 2.4–7.6) but higher for a bundle of four indicators relating to the avoidance of inappropriate therapy (83.1% 95% CI: 59.5–96.0). Most visits for croup were characterized by appropriate treatment in all healthcare settings. However, most children had limited documented clinical assessments, and some had unnecessary tests or inappropriate therapy, which has potential quality and cost implications. Universal CPG and clinical assessment tools may increase clinical consistency.
Impaired Lumbar Extensor Force Control Is Associated with Increased Lifting Knee Velocity in People with Chronic Low-Back Pain
Publisher: MDPI AG
Date: 31-10-2023
DOI: 10.3390/S23218855
Using a digital personal recovery resource in routine mental health practice: feasibility, acceptability and outcomes
Publisher: Informa UK Limited
Date: 07-09-2023
DOI: 10.1080/09638237.2022.2118688
Abstract: Digital technologies enable the dissemination of multimedia resources to support adults with serious mental illness in their self-management and personal recovery. However, delivery needs to accommodate engagement and accessibility challenges. We examined how a digital resource, designed for mental health workers and consumers to use together in session, would be used in routine practice. Thirty consumers and their workers participated. The web-based resource, Self-Management And Recovery Technology (SMART), was available to use within and between sessions, for a 6-month period. Workers initiated in-session use where relevant. Feasibility was explored via uptake and usage data and acceptability and impact via questionnaires. A pre-post design assessed recovery outcomes for consumers and relationship outcomes for consumers and workers. In participating mental health practitioner-consumer dyads, consumers gave strong acceptability ratings, and reported improved working relationships. However, the resource was typically used in one-third or fewer appointments, with consumers expressing a desire for greater in-session use. Improvements in self-rated personal recovery were not observed, possibly contributed to by low usage. In-session use was found helpful by consumers but may be constrained by other demands in mental health care delivery: collaborative use may require dedicated staff time or more formal implementation.
School students with chronic illness have unmet academic, social, and emotional school needs.
Publisher: American Psychological Association (APA)
Date: 11-2019
DOI: 10.1037/SPQ0000311
Abstract: Students with chronic illness generally have higher school needs than their healthy peers. The research to date examining school support for these needs has been limited to qualitative methods. We collected quantitative data to compare the school needs and supports received by 192 students with chronic illness and 208 students without chronic illness using parent-completed surveys. We assessed school experiences and receipt of school support across academic, social-emotional, and medical domains and school attendance. We analyzed the data using logistic regression. Students with chronic illness were 3.8 times more likely to have repeated a grade, 3.6 times more likely to have parent-reported academic challenges, and 4.9 times more likely to have recent illness-related school absenteeism than healthy students. Parents of students with chronic illness were 2.2 times more likely to report their child to have moderate-high emotional distress, and 4.6 times more likely to report that their child had low social confidence compared with parents of healthy students. Students with chronic illness did not receive more school-based tutoring, home-based tutoring, or support from a teacher's aide or school psychologist than healthy students. Students with chronic illness receive insufficient support to address their academic and social-emotional needs or high rates of school absenteeism. Evidence-based educational services must be developed and delivered to meet the needs of students with chronic illness at school and while recovering at home. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Cystic fibrosis-related diabetes and lung disease: An update
Publisher: European Respiratory Society (ERS)
Date: 16-02-2021
Using voice biometrics to classify emotional distress in helpline callers (Preprint)
Publisher: JMIR Publications Inc.
Date: 13-06-2022
Abstract: levated psychological distress has demonstrated impacts on in iduals’ health. Reliable and efficient ways to detect distress are key to early intervention. Artificial Intelligence has the potential to detect states of emotional distress in an accurate, efficient and timely manner. o automatically classify short segments of speech obtained from callers to national suicide prevention helpline services, according to low versus high psychological distress, using a range of voice biomarkers in combination with machine learning approaches. ne hundred and sixteen telephone call recordings were initially converted to 16-bit PCM format. Short variable length segments of each call were rated on psychological distress using the Distress Thermometer by the responding counsellor and a second team of psychologists blinded to the initial ratings (n=6). Nineteen voice biomarkers were derived from 40ms speech frames within each segment. Candidate biomarkers were reduced using Lasso regression, validated by generalised additive mixed effects regression, accounting for non-linearity and autocorrelation. Speech frames were then grouped using k-means clustering based on the selected biomarkers. Finally, component-wise gradient boosting was used to classify each speech frame according to low versus high psychological distress. en voice biomarkers were used to classify 40ms speech frames to a level of validation accuracy of 94.5% (Area under the receiver operating curve). Male speakers spoke with increasing loudness, roughness, breathiness and with lower dominant and third formant frequencies, when experiencing elevations in distress. Female callers experienced an upward shift in tonal pitch, and breathier speaking style with increasing distress. he high level of accuracy achieved suggests real-time detection of psychological distress in helpline settings and has potential uses in pre-emptive triage. one
Significant functional differences in differentiated Conditionally Reprogrammed (CRC)- and Feeder-free Dual SMAD inhibited-expanded human nasal epithelial cells
Publisher: Elsevier BV
Date: 03-2021
DOI: 10.1016/J.JCF.2020.12.019
Abstract: Patient-derived airway cells differentiated at Air Liquid Interface (ALI) are valuable models for Cystic fibrosis (CF) precision therapy. Different culture expansion methods have been established to extend expansion capacity of airway basal cells, while retaining functional airway epithelium physiology. Considerable variation in response to CFTR modulators is observed in cultures even within the same CFTR genotype and despite the use of similar ALI culture techniques. We aimed to address culture expansion method impact on differentiation. Nasal epithelial brushings from 14 in iduals (CF=9 non-CF=5) were collected, then equally ided and expanded under conditional reprogramming culture (CRC) and feeder-serum-free "dual-SMAD inhibition" (SMADi) methods. Expanded cells from each culture were differentiated with proprietary PneumaCult™-ALI media. Morphology (Immunofluorescence), global proteomics (LC-MS/MS) and function (barrier integrity, cilia motility, and ion transport) were compared in CRC No significant difference in the structural morphology or baseline global proteomics profile were observed. Barrier integrity and cilia motility were significantly different, despite no difference in cell junction morphology or cilia abundance. Epithelial Sodium Channels and Calcium-activated Chloride Channel activity did not differ but CFTR mediated chloride currents were significantly reduced in SMADi Alteration of cellular physiological function in vitro were more prominent than structural and differentiation potential in airway ALI. Since initial expansion culture conditions significantly influence CFTR activity, this could lead to false conclusions if data from different labs are compared against each other without specific reference ranges.
Pleural Effusion, Necrotizing Pneumonia and Long-Term Morbidity of Respiratory Infection in Childhood
Publisher: Elsevier
Date: 2021
Investigating predictors contributing to the expression of schizotypy during the COVID-19 pandemic
Publisher: Elsevier BV
Date: 06-2022
Novel Antioxidant Therapy with the Immediate Precursor to Glutathione, γ-Glutamylcysteine (GGC), Ameliorates LPS-Induced Cellular Stress in In Vitro 3D-Differentiated Airway Model from Primary Cystic Fibrosis Human Bronchial Cells
Publisher: MDPI AG
Date: 30-11-2020
Abstract: Systemic glutathione deficiency, inflammation, and oxidative stress are hallmarks of cystic fibrosis (CF), an inherited disease that causes persistent lung infections and severe damage to the respiratory system and many of the body organs. Improvements to current antioxidant therapeutic strategies are needed. The dietary supplement, γ-glutamylcysteine (GGC), which is the immediate precursor to glutathione, rapidly boosts cellular glutathione levels following a single dose in healthy in iduals. Efficacy of GGC against oxidative stress induced by Pseudomonas aeruginosa, which is a common and chronic pathogen infecting lungs of CF patients, remains unassessed. Primary mucocilliary differentiated airway (bronchial and/or nasal) epithelial cells were created from four in iduals with CF. Airway oxidative stress and inflammation was induced by P. aeruginosa lipopolysaccharide (LPS). Parameters including global proteomics alterations, cell redox state (glutathione, oxidative stress), pro-inflammatory mediators (IL-8, IDO-1), and cellular health (membrane integrity, stress granule formation, cell metabolic viability) were assayed under six experimental conditions: (1) Mock, (2) LPS-challenged (3) therapeutic, (4) prophylactic (5) therapeutic and prophylactic and (6) GGC alone. Proteomic analysis identified perturbation of several pathways related to cellular respiration and stress responses upon LPS challenge. Most of these were resolved when cells were treated with GGC. While GGC did not resolve LPS-induced IL-8 and IDO-1 activity, it effectively attenuated LPS-induced oxidative stress and stress granule formation, while significantly increasing total intracellular glutathione levels, metabolic viability and improving epithelial cell barrier integrity. Both therapeutic and prophylactic treatments were successful. Together, these findings indicate that GGC has therapeutic potential for treatment and prevention of oxidative stress-related damage to airways in cystic fibrosis.
Mesenchymal Stem Cell exosome delivered Zinc Finger Protein activation of cystic fibrosis transmembrane conductance regulator
Publisher: Wiley
Date: 2021
DOI: 10.1002/JEV2.12053
Managerial Perceptions of Leadership in Sri Lanka: Good Management and Leadership Excellence as Foundation for Sustainable Leadership Capacity Building in Post-Civil War Sri Lanka
Publisher: MDPI AG
Date: 11-02-2020
DOI: 10.3390/SU12041307
Abstract: In this paper, we examine cultural values that influence the leadership perceptions from a s le of 1140 managers in Sri Lankan organizations. Multivariate analysis such as regression, factor analysis and structural equation modeling was employed to explain leadership excellence. Trust and sustainability were found to be the most important ethical leadership characteristics with three distinct leadership perspectives—nurtured organization, good management and excellent leadership. Implications of this study suggest that trust, sustainability and loyalty should be emulated within a nurtured organization, and good management practice with less emphasis on morality should be emulated for developing HR capacity in Sri Lanka.
Dispensing Practices of Fixed Dose Combination Controller Therapy for Asthma in Australian Children and Adolescents
Publisher: MDPI AG
Date: 05-08-2020
Abstract: The Australian Asthma Handbook does not recommend use of fixed dose combination (FDC) controller medicines for asthma in children aged ≤5 years. FDCs are only recommended in children and adolescents (aged 6–18 years) not responding to initial inhaled corticosteroid (ICS) therapy. Using Pharmaceutical Benefits Scheme dispensing claims from 2013–2018, we examined the annual incident FDC dispensing and the incident FDC dispensing without prior ICS up to 365 days. We also determined cost of FDCs to government and patients. During 2013–2018, there were 35,635 FDC initiations and 31,368 (88%) did not have a preceding ICS dispensing. The annual incidence of FDC dispensing declined from 14.7 to 7.2/1000 children. Incidence of FDC dispensing/1000 children without a preceding ICS declined from 2.1 to 0.5 in children aged 1–2 years, 7.2 to 1.7 in 3–5 years, 14.8 to 5.1 in 6–11 years, and 18.6 to 11.9 in ≥12years. The cost of FDCs was 7.8 million Australian dollars (AUD) of which 4.4 million AUD was to government and 3.3 million AUD was to patient. Despite inappropriate dispensing of FDCs in children aged ≤5 years, incidence of FDC dispensing and more importantly incidence without a preceding ICS is declining in Australia.
Assessing the appropriateness of paediatric antibiotic overuse in Australian children
Publisher: Springer Science and Business Media LLC
Date: 24-04-2020
DOI: 10.1186/S12887-020-02052-6
Abstract: Infections caused by antibiotic resistant pathogens are increasing, with antibiotic overuse a key contributing factor. The CareTrack Kids (CTK) team assessed the care of children in Australia aged 0–15 years in 2012 and 2013 to determine the proportion of care in line with clinical practice guidelines (CPGs) for 17 common conditions. This study analyses indicators relating to paediatric antibiotic overuse to identify those which should be prioritised by antimicrobial stewardship and clinical improvement programs. A systematic search was undertaken for national and international CPGs relevant to 17 target conditions for Australian paediatric care in 2012–2013. Recommendations were screened and ratified by reviewers. The s ling frame comprised three states containing 60% of the Australian paediatric population (South Australia, New South Wales and Queensland). Multi-stage cluster s ling was used to select general practices, specialist paediatric practices, emergency departments and hospital inpatient services, and medical records within these. Medical records were reviewed by experienced paediatric nurses, trained to assess eligibility for indicator assessment and compliance with indicators. Adherence rates were estimated. Ten antibiotic overuse indicators were identified three for tonsillitis and one each for seven other conditions. A total of 2621 children were assessed. Estimated adherence for indicators ranged from 13.8 to 99.5% while the overall estimate of compliance was 61.9% (95% CI: 47.8–74.7). Conditions with high levels of appropriate avoidance of antibiotics were gastroenteritis and atopic eczema without signs of infection, bronchiolitis and croup. Indicators with less than 50% adherence were asthma exacerbation in children aged 2 years (47.1% 95% CI: 33.4–61.1), sore throat with no other signs of tonsillitis (40.9% 95% CI: 16.9, 68.6), acute otitis media in children aged 12 months who were mildly unwell (13.8% 95% CI: 5.1, 28.0), and sore throat and associated cough in children aged 4 years (14.3% 95% CI: 9.9, 19.7). The results of this study identify four candidate indicators (two for tonsillitis, one for otitis media and one for asthma) for monitoring by antibiotic stewardship and clinical improvement programs in ambulatory and hospital paediatric care, and intervention if needed.
Characterising the types of paediatric adverse events detected by the global trigger tool - CareTrack Kids
Publisher: SAGE Publications
Date: 11-2020
Abstract: A common method of learning about adverse events (AEs) is by reviewing medical records using the global trigger tool (GTT). However, these studies generally report rates of harm. The aim of this study is to characterise paediatric AEs detected by the GTT using descriptive and qualitative approaches. Medical records of children aged 0–15 were reviewed for presence of harm using the GTT. Records from 2012–2013 were s led from hospital inpatients, emergency departments, general practice and specialist paediatric practices in three Australian states. Nurses undertook a review of each record and if an AE was suspected a doctor performed a verification review of a summary created by the nurse. A qualitative content analysis was undertaken on the summary of verified AEs. A total of 232 AEs were detected from 6,689 records reviewed. Over four-fifths of the AEs (193/232, 83%) resulted in minor harm to the patient. Nearly half (112/232, 48%) related to medication/intravenous (IV) fluids. Of these, 83% (93/112) were adverse drug reactions. Problems with medical devices/equipment were the next most frequent with nearly two-thirds (32/51, 63%) of these related to intravenous devices. Problems associated with clinical processes rocedures comprise one in six AEs (38/232, 16%), of which diagnostic problems (12/38, 32%) and procedural complications (11/38, 29%) were the most frequent. Adverse drug reactions and issues with IVs are frequently identified AEs reflecting their common use in paediatrics. The qualitative approach taken in this study allowed AE types to be characterised, which is a prerequisite for developing and prioritising improvements in practice.
The Diagnostic Validity and Reliability of an Internet-Based Clinical Assessment Program for Mental Disorders
Publisher: JMIR Publications Inc.
Date: 21-09-2015
DOI: 10.2196/JMIR.4195
Investigating the Effects of a Multinutrient Supplement on Cognition, Mood and Biochemical Markers in Middle-Aged Adults with ‘Optimal’ and ‘Sub-Optimal’ Diets: A Randomized Double Blind Placebo Controlled Trial
Publisher: MDPI AG
Date: 29-11-2022
DOI: 10.3390/NU14235079
Abstract: Background: Previous randomized controlled trials examining cognitive and mood effects of combination multivitamin supplements in healthy, non-clinical adults have reported mixed results. One purported explanation for this is that the dietary status of participants at the start of supplement interventions may influence the magnitude of the effect of supplementation. Methods: In this study, we evaluated the effect of a multinutrient formula containing B group vitamins, Bacopa monniera and Ginkgo biloba on memory, attention, mood and biochemical markers of nutrient status in middle-aged adults (M = 52.84 years, n = 141) with ‘optimal’ and ‘sub-optimal’ diets over 12 weeks. We hypothesised that active supplementation would differentially improve memory and attention in those with a ‘sub-optimal’ diet. Results: Mixed model, repeated measures analysis revealed that, in comparison to placebo, active treatment was associated with significant increases in B vitamin status (B1, B6, B12). Regarding behavioural outcomes there was no significant benefit to memory (F(1, 113.51) = 0.53, p = 0.470) nor attention (F(1,113.77) = 1.89, p = 0.171) in the whole cohort. Contrary to our hypothesis, there was a significant beneficial effect of supplementation on attentional performance in in iduals with an ‘optimal’ diet prior to supplementation (F(1,57.25) = 4.94, p = 0.030). In the absence of a main effect of supplementation across the entire cohort, there were also a number of significant three-way interactions (treatment by time by diet group) detected in secondary outcomes including lower state anxiety and mental fatigue in those with an ‘optimal’ diet. Conclusion: These findings suggest that the cognitive benefit of B vitamin and herbal supplementation may be dependent on diet quality, supporting the concepts of ‘co-nutrient optimisation’ and interdependency of nutrients. This warrants further investigation. This study advocates characterising the diet of participants prior to supplementation as it may influence the effect of a nutraceutical intervention.
Antibiotic use for acute respiratory infections among under-5 children in Bangladesh: a population-based survey
Publisher: BMJ
Date: 04-2021
DOI: 10.1136/BMJGH-2020-004010
Abstract: Despite acute respiratory infections (ARIs) being the single largest reason for antibiotic use in under-5 children in Bangladesh, the prevalence of antibiotic use in the community for an ARI episode and factors associated with antibiotic use in this age group are unknown. We analysed nationally representative, population-based, household survey data from the Bangladesh Demographic and Health Survey 2014 to determine the prevalence of antibiotic use in the community for ARI in under-5 children. Using a causal graph and multivariable logistical regression, we then identified and determined the sociodemographic and antibiotic source factors significantly associated with the use of antibiotics for an episode of ARI. We analysed data for 2 144 children aged years with symptoms of ARI from 17 300 households. In our s le, 829 children (39%) received antibiotics for their ARI episode (95% CI 35.4% to 42.0%). Under-5 children from rural households were 60% (adjusted OR (aOR): 1.6 95% CI 1.2 to 2.1) more likely to receive antibiotics compared with those from urban households, largely driven by prescriptions from unqualified or traditional practitioners. Private health facilities were 50% (aOR: 0.5 95% CI 0.3 to 0.7) less likely to be sources of antibiotics compared with public health facilities and non-governmental organisations. Age of children, sex of children or household wealth had no impact on use of antibiotics. In this first nationally representative analysis of antibiotic use in under-5 children in Bangladesh, we found almost 40% of children received antibiotics for an ARI episode. The significant prevalence of antibiotic exposure in under-5 children supports the need for coordinated policy interventions and implementation of clinical practice guidelines at point of care to minimise the adverse effects attributed to antibiotic overuse.
Detection of suicide risk using voice signal characteristics: A systematic review (Preprint)
Publisher: JMIR Publications Inc.
Date: 09-2022
Abstract: n an age where telehealth services are increasingly being used for forward triage, the need for accurate suicide risk detection is increasing. Voice signals analysed using Artificial Intelligence is now proving capable of detecting suicide risk at accuracies superior to traditional interview based approaches, suggesting an efficient and economical approach to ensuring ongoing patient safety. his systematic review aimed to identify voice signal characteristics that discriminate between patients experiencing elevated risk of suicide and comparison cohorts and to identify the specific technical specifications of the systems used in classification. search of Medline via Ovid, Scopus, Computers and Applied Science Complete, CADTH, Web of Science, Proquest, Dissertations and Theses A& I, Australian Policy Online and Mednar was conducted between 1995 - 2021. A total of 1074 articles were assessed for relevance with 21 included in the final review. andidate voice signal characteristics discriminating between suicidal and comparison cohorts included speech timing patterns (median accuracy = 95%), power spectral density subbands (median accuracy = 90.3%) and mel-frequency cepstral coefficients (median accuracy = 80%). A random effects meta-analysis was used to compared 22 characteristics nested within three studies, which demonstrated significant standardised mean differences for frequencies within the first and second formants (standardised mean difference ranged between -1.07 and -2.56) and jitter values (standardised mean difference = 1.47). lthough a number of key methodological issues prevailed amongst the studies reviewed, there is significant promise in the use of voice signal characteristics to detect elevations in suicide risk. nternational Prospective Register of Systematic Reviews (PROSPERO) on 28th April 2020 (registration number CRD420200167413)
Treatment of Cystic Fibrosis: From Gene- to Cell-Based Therapies
Publisher: Frontiers Media SA
Date: 16-03-2021
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