ORCID Profile
0000-0003-2261-169X
Current Organisations
Royal Brisbane and Women's Hospital
,
QIMR Berghofer Medical Research Institute
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Publisher: Elsevier BV
Date: 09-2021
Publisher: American Society of Hematology
Date: 2020
Publisher: SAGE Publications
Date: 16-02-2021
Abstract: While employment rates have increased in people with multiple sclerosis (PwMS), little is known about the longitudinal trends of work productivity. To describe the longitudinal patterns of work productivity and examine the factors associated with annual change of work productivity of PwMS. Study participants were employed participants of the Australian MS Longitudinal Study (AMSLS) followed from 2015 to 2019 with at least two repeated measures ( n = 2121). We used linear mixed models to examine if the within-in idual variations in MS symptoms are associated with changes in work productivity. The mean annual change in work productivity between 2015 and 2019 was −0.23% ( SD = 18.68%). Not the actual severity of symptoms but rather the changes in severity of symptoms that are associated with change in work productivity in the same year. In a multivariable model, every unit increase in mean annual change in ‘pain and sensory symptoms’, ‘feelings of anxiety and depression’, and ‘fatigue and cognitive symptoms’ were independently associated with 2.43%, 1.55% and 1.01% annual reductions in work productivity, respectively. In idual changes in work productivity are largely driven by the changes in symptom severity rather than the absolute severity. Stabilising/improving MS symptoms might improve work productivity.
Publisher: SAGE Publications
Date: 17-06-2021
Abstract: Multiple sclerosis (MS)-related knowledge is an important evaluation metric for health education interventions. However, few MS knowledge assessment tools are currently available for use. This study aims to develop a reliable and valid Multiple Sclerosis Knowledge Assessment Scale (MSKAS) for use in the MS community and the general public. The MSKAS was developed using a Delphi study methodology and was administered to participants in the first open enrolment of the Understanding Multiple Sclerosis (UMS) online course. Rasch analysis was used to examine its psychometric properties and develop the final scale. Experts from across the MS community participated in the development of the MSKAS, resulting in an initial scale of 42 items. Five hundred and forty-three UMS participants completed the MSKAS 89% were female and 30% were people with MS. The final unidimensional 22-item scale has a person separation index of 2.16, a person reliability index of 0.82, an item separation index of 11.19, and a Cronbach’s alpha (kr-20) test reliability of 0.87. The MSKAS is a unidimensional scale with good construct validity and internal consistency. The MSKAS has the potential to be useful for the assessment of MS knowledge in research and clinical practice.
Publisher: Wiley
Date: 23-03-2023
DOI: 10.1002/HPJA.716
Abstract: Evaluated the impact of the Understanding Multiple Sclerosis (MS) massive open online course, which was intended to increase understanding and awareness about MS, on self‐reported health behaviour change 6 months after course completion. Observational cohort study evaluating precourse(baseline) and postcourse (immediately postcourse and six‐month follow‐up) survey data. The main study outcomes were self‐reported health behaviour change change type and measurable improvement. We also collected participant characteristic data (eg, age, physical activity). We compared participants who reported health behaviour change at follow‐up to those who did not and compared those who improved to those who did not using χ 2 and t tests. Participant characteristics, change types and change improvement were described descriptively. Consistency between changes reported immediately postcourse and at the 6‐month follow‐up was assessed using χ 2 tests and textual analysis. N = 303 course completers were included in this study. The study cohort included MS community members (eg, people with MS, healthcare providers) and nonmembers. N = 127 (41.9%) reported behaviour change in ≥1 area at follow‐up. Of these, 90 (70.9%) reported a measured change, and of these, 57 (63.3%) showed improvement. The most reported change types were knowledge, exercise hysical activity and diet. N = 81 (63.8% of those reporting a change) reported a change in both immediately and 6 months after course completion, with 72.0% of those that described both changes giving similar responses each time. Understanding MS encourages health behaviour change among course completers up to 6 months after course completion. An online education intervention can effectively encourage health behaviour change over a 6‐month follow‐up period, suggesting a transition from acute change to maintenance. The primary mechanisms underpinning this effect are information provision, including both scientific evidence and lived experience, and goal‐setting activities and discussions.
Publisher: BMJ
Date: 10-2022
DOI: 10.1136/BMJOPEN-2022-062703
Abstract: Generic multiattribute utility instruments (MAUIs) are efficient tools for determining and enumerating health-related quality of life. MAUIs accomplish this by generating health state utilities (HSUs) via algorithms. Minimal important differences (MIDs) assist with the interpretation of HSUs by estimating minimum changes that are clinically significant. The overall goal of the proposed systematic review and meta-analysis is the development of comprehensive guidelines for MID estimation. This protocol defines a systematic review and meta-analysis of MIDs for generic MAUIs. The proposed research will involve a comprehensive investigation of 10 databases (EconLit, IDEAs database, INAHTA database, Medline, PsycINFO, Embase, Emcare, JBIEBP and CINAHL) from 1 June 2022 to 7 June 2022, and will be performed and reported in accordance with several validated guidelines, principally the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of papers, considered for inclusion in the review, will be appraised using the COnsensus-based Standards for the selection of health Measurement INstruments, inter alia. Narrative analysis will involve identifying the characteristics of MIDs including methods of calculation, sources of heterogeneity, and validation. Meta-analysis will also be conducted. The descriptive element of meta-analysis will involve the generation of I 2 statistics and Galbraith plots of MID heterogeneity. Together with narrative analysis, this will allow sources of MID heterogeniety to be identified. A multilevel mixed model, estimated via restricted maximum likelihood estimation, will be constructed for the purposes of meta-regression. Meta-regression will attempt to enumerate the effects of sources of heterogeneity on MID estimates. Meta-analysis will be concluded with pooling of MIDs via a linear random-effects model. Ethics approval is not required for this review, as it will aggregate data from published literature. Methods of dissemination will include publication in a peer-reviewed journal, as well as presentation at conferences and seminars. CRD42021261821.
Publisher: American Society of Hematology
Date: 05-05-2021
Abstract: Immunopathology and intestinal stem cell (ISC) loss in the gastrointestinal (GI) tract is the prima facie manifestation of graft-versus-host disease (GVHD) and is responsible for significant mortality after allogeneic bone marrow transplantation (BMT). Approaches to prevent GVHD to date focus on immune suppression. Here, we identify interferon-λ (IFN-λ interleukin-28 [IL-28]/IL-29) as a key protector of GI GVHD immunopathology, notably within the ISC compartment. Ifnlr1−/− mice displayed exaggerated GI GVHD and mortality independent of Paneth cells and alterations to the microbiome. Ifnlr1−/− intestinal organoid growth was significantly impaired, and targeted Ifnlr1 deficiency exhibited effects intrinsic to recipient Lgr5+ ISCs and natural killer cells. PEGylated recombinant IL-29 (PEG-rIL-29) treatment of naive mice enhanced Lgr5+ ISC numbers and organoid growth independent of both IL-22 and type I IFN and modulated proliferative and apoptosis gene sets in Lgr5+ ISCs. PEG-rIL-29 treatment improved survival, reduced GVHD severity, and enhanced epithelial proliferation and ISC-derived organoid growth after BMT. The preservation of ISC numbers in response to PEG-rIL-29 after BMT occurred both in the presence and absence of IFN-λ–signaling in recipient natural killer cells. IFN-λ is therefore an attractive and rapidly testable approach to prevent ISC loss and immunopathology during GVHD.
Publisher: American Society of Hematology
Date: 04-10-2019
DOI: 10.1182/BLOODADVANCES.2019000053
Abstract: GM-CSF is derived from both Th17/Tc17-positive and Th17/Tc17-negative donor lineages after bone marrow transplantation. GM-CSF promotes the accumulation of alloantigen-presenting, migratory donor DCs in the gastrointestinal tract during GVHD.
Publisher: Springer Science and Business Media LLC
Date: 03-08-2023
DOI: 10.1038/S41409-023-02038-9
Abstract: Acute gastrointestinal graft versus host disease (GI-GVHD) is a common complication following allogeneic haematopoietic cell transplantation (HCT), and is characterised by severe morbidity, frequent treatment-refractoriness, and high mortality. Early, accurate identification of GI-GVHD could allow for therapeutic interventions to ameliorate its severity, improve response rates and survival however, standard endoscopic biopsy is inadequately informative in terms of diagnostic sensitivity or outcome prediction. In an era where rapid technological and laboratory advances have dramatically expanded our understanding of GI-GVHD biology and potential therapeutic targets, there is substantial scope for novel investigations that can precisely guide GI-GVHD management. In particular, the combination of tissue-based biomarker assessment (plasma cytokines, faecal microbiome) and molecular imaging by positron emission tomography (PET) offers the potential for non-invasive, real-time in vivo assessment of donor:recipient immune activity within the GI tract for GI-GVHD prediction or diagnosis. In this article, we review the evidence regarding GI-GVHD diagnosis, and examine the potential roles and translational opportunities posed by these novel diagnostic tools, with a focus on the evolving role of PET.
Publisher: Wiley
Date: 13-12-2021
DOI: 10.1002/HPJA.559
Abstract: Evaluated the impact of Understanding Multiple Sclerosis (MS) massive open online course, which was intended to increase understanding and awareness about MS, on self‐reported health behaviour change. Observational cohort study evaluating pre‐ (baseline) and post‐course (8‐10‐week follow‐up) survey data. The main study outcomes were self‐reported health behaviour change, change type and measurable improvement. We also collected participant characteristic data (eg, age, physical activity). We compared participants who reported health behaviour change at follow‐up to those who did not and compared those who improved with those who did not using chi square and t tests. Participant characteristics, change types and change improvement were described descriptively. A total of N = 560 course completers were included in this study. The study cohort included MS community members (eg, people with MS, health care providers) and nonmembers. Two hundred and forty‐seven (44.1%) reported behaviour change in ≥1 area at follow‐up, 160 (64.8%) reported a measurable change and, of these, 109 (68.1%) showed improvement. Participants who reported a change and those who improved had significantly lower precourse health behaviours and characteristics (eg, quality of life, diet quality). The most reported change types were knowledge, exercise hysical activity, diet and care practice. Understanding MS encourages health behaviour change among course completers, primarily through the provision of information and goal‐setting activities and discussions. An online education intervention can effectively encourage health behaviour change over an 8‐10‐week follow‐up period. Information provision, including both scientific evidence and lived experience, and goal‐setting activities and discussions are the primary mechanisms underpinning that change.
Publisher: American Society of Hematology
Date: 05-12-2019
Abstract: DCs are the principal source of IL-6 dysregulation after alloSCT. IL-6–dependent GVHD is driven by classical signaling of IL-6R on donor T cells but is regulated by trans signaling.
Publisher: Wiley
Date: 24-04-2009
Publisher: SAGE Publications
Date: 02-06-2022
DOI: 10.1177/13524585221097573
Abstract: A comprehensive understanding of factors associated with multiple sclerosis (MS)-related work productivity loss will inform targeted interventions. We have previously shown the strong impact of symptom severity on MS-related work productivity loss. However, the effect of work difficulties, work self-efficacy and work psychological safety is yet to be well evaluated in this context. This study evaluates the association between work difficulties, work self-efficacy and work psychological safety, and MS-related presenteeism, absenteeism and total work productivity loss. We analysed data from employed participants of the Australian MS Longitudinal Study (AMSLS) who took part in both the 2015 Medication and Disease Course survey, and 2015 Employment survey ( n = 744). Data were analysed using Cragg Hurdle regression models. We found that low workplace self-esteem, interpersonal difficulties at work and work self-efficacy were associated with total work productivity loss. In a multivariable model, a 10-unit decrease in workplace self-esteem, increase in interpersonal difficulties at work and 5-unit increase in work self-efficacy were independently associated with a 3.75% increase, 2.89% increase and 3.36% reduction in total work productivity loss, respectively. When separating total work productivity loss in presenteeism and absenteeism, stronger effects were seen for presenteeism than absenteeism. Surprisingly, work psychological safety was not associated with MS-related work productivity loss. Work psychosocial well-being such as self-confidence at work, work self-efficacy and interpersonal difficulties at work are crucial factors governing work productivity in people with MS (PwMS). Multidisciplinary support team assistance of PwMS in symptom self-care, skills around effective communication about MS in the workplace, the psychological impact of work and the modification of work demands may positively influence the employment outcomes.
Publisher: Wiley
Date: 27-01-2009
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.MSARD.2022.104092
Abstract: Massive open online courses (MOOCs) have grown rapidly in popularity since becoming available worldwide in 2012. There are currently > 30,000 MOOCs available from > 900 universities. However, despite their global reach, MOOCs typically have low completion rates. To evaluate reasons for non-completion among enrolees in the Understanding Multiple Sclerosis (MS) MOOC. This was a mixed methods study evaluating quantitative and qualitative data collected in an online questionnaire administered to Understanding MS enrolees who did not complete the course. The quantitative data was evaluated using frequencies, percentages, means, and standard deviations. The qualitative data was assessed using textual analysis. We recruited 397 participants (4.5% of non-completers). Both the qualitative and quantitative data suggests that the primary reasons for non-completion were time constraints and/or limitations. Some of these were exacerbated by the COVID-19 pandemic. People with MS also cited MS-related symptoms as a reason for non-completion. Suggested changes to the course reflected these results and included extending the course open period and making it self-paced. Although it was impossible to determine if study participants were representative of all non-completers due to selection bias, the results provide useful information for developing future MS educational resources. Accessibility, particularly addressing potential challenges related to MS symptoms and time constraints, should be a primary consideration when developing an educational resource for the MS community.
Publisher: Elsevier BV
Date: 11-2019
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.MSARD.2022.104085
Abstract: Participation in the Understanding Multiple Sclerosis (MS) massive open online course (MOOC) significantly increases MS knowledge in both people living with MS (pwMS) and not living with MS at course completion. We also observed modest increases in health literacy, self-efficacy, and quality of life. To examine long-term participant knowledge retention over a six-month follow-up period following completion of the Understanding MS MOOC, a freely available six-week online health education intervention. We conducted pre-post analysis using paired t-tests to determine the effect of the course on MS knowledge (primary outcome), health literacy, resilience, self-efficacy, quality of life, and MS symptom severity among pwMS and not living with MS. We assessed the effect of participant characteristics on the change in MS knowledge using linear regression. Both pwMS (N=139) and not living with MS (N=164) significantly increased MS knowledge over the follow-up period. PwMS also showed increases in health literacy and self-efficacy. These increases were largely maintained from the post-course assessment. There was no effect on resilience or quality of life. The Understanding MS MOOC significantly increased MS knowledge and this knowledge was maintained six months after course completion. Our results reinforce the importance and potential impact of health education in the MS community.
Publisher: American Society of Hematology
Date: 18-10-2019
DOI: 10.1182/BLOODADVANCES.2019000453
Abstract: Peg-IFNα is tolerated and induces disease response in patients who relapse after allogeneic SCT. Increased pretreatment MAIT and pDC proportions were associated with better progression-free and overall survival after peg-IFNα treatment.
Publisher: Springer Science and Business Media LLC
Date: 15-08-2022
Publisher: Springer Science and Business Media LLC
Date: 27-10-2023
Publisher: American Society of Hematology
Date: 30-12-2021
Abstract: Donor and recipient cytomegalovirus (CMV) serostatus correlate with transplant-related mortality that is associated with reduced survival following allogeneic stem cell transplant (SCT). Prior epidemiologic studies have suggested that CMV seronegative recipients (R–) receiving a CMV-seropositive graft (D+) experience inferior outcomes compared with other serostatus combinations, an observation that appears independent of viral reactivation. We therefore investigated the hypothesis that prior donor CMV exposure irreversibly modifies immunologic function after SCT. We identified a CD4+/CD57+/CD27– T-cell subset that was differentially expressed between D+ and D– transplants and validated results with 120 patient s les. This T-cell subset represents an average of 2.9% (D–/R–), 18% (D–/R+), 12% (D+/R–), and 19.6% (D+/R+) (P & .0001) of the total CD4+ T-cell compartment and stably persists for at least several years post-SCT. Even in the absence of CMV reactivation post-SCT, D+/R– transplants displayed a significant enrichment of these cells compared with D–/R– transplants (P = .0078). These are effector memory cells (CCR7–/CD45RA+/−) that express T-bet, Eomesodermin, granzyme B, secrete Th1 cytokines, and are enriched in CMV-specific T cells. These cells are associated with decreased T-cell receptor ersity (P & .0001) and reduced proportions of major histocompatibility class (MHC) II expressing classical monocytes (P & .0001), myeloid (P = .024), and plasmacytoid dendritic cells (P = .0014). These data describe a highly expanded CD4+ T-cell population and putative mechanisms by which prior donor or recipient CMV exposure may create a lasting immunologic imprint following SCT, providing a rationale for using D– grafts for R– transplant recipients.
Publisher: Informa UK Limited
Date: 15-11-2013
Publisher: Elsevier BV
Date: 03-2022
Publisher: American Society of Hematology
Date: 08-04-2021
Abstract: We determined the efficacy of tocilizumab (TCZ) in preventing grade 2-4 acute graft-versus-host disease (aGVHD) in patients with acute leukemia or myelodysplasia undergoing matched sibling donor (MSD) or volunteer unrelated donor (VUD) allogeneic stem cell transplantation after myeloablative or reduced-intensity conditioning across 5 Australian centers. A total of 145 patients (50 MSD, 95 VUD) were randomly assigned to placebo or TCZ on day −1. All patients received T-cell–replete peripheral blood stem cell grafts and graft-versus-host disease (GVHD) prophylaxis with cyclosporin/methotrexate. A planned substudy analyzed the VUD cohort. With a median follow-up of 746 days, the incidence of grade 2-4 aGVHD at day 100 for the entire cohort was 36% for placebo vs 27% for TCZ (hazard ratio [HR], 0.69 95% confidence interval [CI], 0.38-1.26 P = .23) and 45% vs 32% (HR, 0.61 95% CI, 0.31-1.22 P = .16) for the VUD subgroup. The incidence of grade 2-4 aGVHD at day 180 for the entire cohort was 40% for placebo vs 29% for TCZ (HR, 0.68 95% CI, 0.38-1.22 P = .19) and 48% vs 32% (HR, 0.59 95% CI, 0.30-1.16 P = .13) for the VUD subgroup. Reductions in aGVHD were predominantly in grade 2 disease. For the entire cohort, transplant-related mortality occurred in 8% vs 11% of placebo-treated vs TCZ-treated patients, respectively (P = .56), and overall survival was 79% vs 71% (P = .27). Median day to neutrophil and platelet engraftment was delayed by 2 to 3 days in TCZ-treated patients, whereas liver toxicity and infectious complications were similar between groups. In this phase 3 randomized double-blind trial, TCZ showed nonsignificant trends toward reduced incidence of grade 2-4 aGVHD in recipients from HLA-matched VUDs but no improvements in long term-survival.
No related grants have been discovered for Andrea Henden.