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Estimating the longitudinal association between pain characteristics and clinical outcomes in young people with mental ill-health
No full textBackground. Mental ill-health has a major impact on young people, with pain often co-occurring. We estimated the prevalence and impact of pain in young people with mental ill-health. Methods. Longitudinal data (baseline and three-month follow-up) of 1,107 Australian young people (aged 12–25 years) attending one of five youth mental health services. Multi-level linear mixed models estimated associations between pain characteristics (frequency, intensity, and limitations) and outcomes with false discovery rate (FDR) adjustment. Pain characteristics were baseline-centered to estimate if the baseline score (between-participant effect) and/or change from baseline (within-participant effect) was associated with outcomes. Results. At baseline, 16% reported serious pain more than 3 days, 51% reported at least moderate pain, and 25% reported pain-related activity limitations in the last week. Between participants, higher serious pain frequency was associated with greater anxiety symptoms (β[95%CI]: 0.90 [0.45, 1.35], FDR-p=0.001), higher pain intensity was associated with greater symptoms of depression (1.50 [0.71, 2.28], FDR-p=0.001), anxiety (1.22 [0.56, 1.89], FDR-p=0.002), and suicidal ideation (3.47 [0.98, 5.96], FDR-p=0.020), and higher pain limitations were associated with greater depressive symptoms (1.13 [0.63, 1.63], FDR-p<0.001). Within participants, increases in pain intensity were associated with increases in tobacco use risk (1.09 [0.48, 1.70], FDR-p=0.002), and increases in pain limitations were associated with increases in depressive symptoms (0.99 [0.54, 1.43], FDR-p<0.001) and decreases in social and occupational functioning (1.08 [1.78, 0.38], FDR-p=0.009). Conclusions. One-in-two young people seeking support for mental ill-health report pain. Youth mental health services should consider integrating pain management.</p
A mixed methods evaluation of an alcohol and other drug psychoeducation program for clients with complex support needs
No full textBackgroundClients with co-occurring and complex needs represent an important segment of the alcohol and other drug (AOD) treatment population. Retaining and engaging individuals in AOD treatment is challenging, and this pursuit is further impeded when clients present with complex support needs. This study sought to establish the feasibility and acceptability of a newly developed psychoeducation program for this clientele, attending a non-residential treatment service in New South Wales.MethodsThe study employed a mixed methods approach. The team analysed aggregated non identifiable routinely collected data, including alcohol and other drug use, psychological distress and quality of life metrics pre and post intervention. Qualitative semi-structured interviews were also conducted with consenting clients and clinicians to complement quantitative data.ResultsTwenty-five eligible clients consented to have their data used for this study and nine consented to participate in an interview. Results show a significant decrease in psychological distress among clients at exit compared to baseline, however no significant change in quality-of-life scores or substance use was quantitatively observed. Some clients self-reported a reduction in substance use and most appreciated the flexibility of the one-on-one service offering.ConclusionsOur findings show that the psychoeducational program delivered to clients with complex support needs at Rendu House is feasible and acceptable to both clients and clinicians, and that the use of routinely collected data to measure treatment outcomes is viable within this setting. Our findings also demonstrate the value of qualitative inquiry in situating narratives of recovery among clients with complex needs where improvements may be incremental
Exploring Physical Activity Levels, Barriers, and Education Sources in People with Cancer Undergoing Chemotherapy
No full textPurpose: Physical activity (PA) during chemotherapy can lessen side effects, support treatment adherence, and improve overall outcomes, yet the barriers to PA in this population remain underexplored. This study assessed self-reported PA levels, barriers, and sources of PA education among adults with cancer undergoing chemotherapy. Methods: A cross-sectional survey was conducted among adult outpatients receiving chemotherapy in the ACT, Australia. The survey collected demographic information, PA levels using the modified Godin–Shephard Leisure Time Questionnaire, barriers to PA, and sources of PA education. Both quantitative and qualitative analyses were performed. Results: Of 111 participants (mean age 59.2), only 11.7% met ‘active’ PA status and 9.9% met resistance exercise guidelines. Barriers included fatigue, strength, pain, motivation, nausea, and lack of time. Notably, almost one-third received no PA education during chemotherapy, and nearly half wanted more. Education by accredited exercise physiologists increased resistance exercise participation. Conclusions: Few participants met PA recommendations during chemotherapy, with many reporting insufficient PA education and significant barriers. These findings highlight critical gaps in patient care and education. Addressing these through integrated, evidence-based PA programs and policy changes could enhance patient health, improve outcomes, and reduce disparities in supportive cancer care.</p
C4d Immunoreactivity in Autoimmune and HBV-Induced Hepatitis:Implications for Complement-Mediated Hepatocellular Injury
No full textBackground: Although immune complex formation is widely acknowledged as the etiological agent for the development of systemic lupus erythematosus, polyarteritis nodosa, reactive arthritis, etc., its roles in chronic hepatitis are less understood. This study aims to compare the immunohistochemistry profile of immune complex deposition in patients with chronic hepatitis B (CHB) and autoimmune hepatitis (AIH). Methods: Immunohistochemistry of C4d, a widely used marker for complement deposition was employed on liver biopsies from 72 and 15 patients with CHB and AIH, respectively. Statistical analysis was performed to analyze its prevalence and its association with a range of clinical and histological parameters. Results: Among the 15 AIH biopsies examined, C4d deposition was observed in 11 cases (73.3%), the majority of which showed a periportal staining pattern (10/11). In CHB, 61 (84.7%) of 72 cases tested positive for C4d, which did not differ significantly with that of AIH. While the periportal pattern was predominantly observed in CHB cases, positive staining in central veins, sinusoids, and hepatic parenchyma were also documented. In particular, C4d deposition is significantly associated with elevated serum ALT and liver inflammation in CHB. Of note, in specimens with a patchy parenchymal C4d staining pattern, a spatially correlated HBsAg IHC signal was observed in adjacent sections from the same tissue. Conclusions: These data suggest an involvement of immune complex-mediated immunopathy in autoimmune hepatitis and HBV-induced hepatitis. The positive intrahepatic C4d signal was associated with heightened liver inflammation. The colocalization of the C4d signal on hepatocytes with HBsAg strongly suggests a causal relationship between viral activity and complement deposition. These observations align with our recent evidence implicating the contribution of capsid–antibody complexes in the pathogenesis of CHB.</p
Association of physical activity and sitting time trajectories with mortality risk in 9430 Australian adults with coronary heart disease
No full textObjectives: To examine the dose–response relationship between moderate-to-vigorous physical activity (MVPA) and sitting time trajectories with cardiac and all-cause mortality in a cohort of middle-aged and older-adults after a diagnosis of coronary heart disease (CHD). Design: This prospective cohort study comprised Australian participants aged ≥ 45-years with CHD (2006–2020) who had self-reported MVPA (min/wk) and sitting time (hr/day) data from at least two survey waves. Methods: MVPA and sitting time trajectories were categorised as remaining high, decreasing, increasing, and remaining low. Cardiac and all-cause mortality were the main outcomes. Associations were explored using Cox regression models. Results: The cohort included 9430 participants (mean (SD) age, 70 (10) years; 3557 females (38 %)). During a median follow-up of 4.4 (IQR, 6.1) years, 540 cardiac and 2843 all-cause deaths were recorded. Compared with individuals that remained inactive, remaining active was associated with a 36 % and 49 % lower risk of cardiac and all-cause death, respectively. Decreasing or increasing MVPA over time was associated with a 20–33 % lower risk of all-cause death. Compared with high sitting time, individuals that maintained low sitting time or decreased their sitting time over time reduced the associated risk of cardiac and all-cause death by 33–38 %. Conclusions: Regardless of pre-CHD diagnosis movement behaviours, individuals' post-CHD diagnosis can reduce their risk of cardiac and all-cause mortality by achieving the physical activity thresholds at any time and reducing their sitting time over-time. Further research is needed to confirm the physical activity and sitting time thresholds to receive these benefits.</p
You, me, the lakes and the storm water drain
No full textThis exposition charts a creative collaboration between two humans, two lakes and a stormwater drain. By thinking with water as archive and unknowability, making art with the water-bodies of significance to them, and drawing upon the thoughts of key scholars and Indigenous artists, the authors explore questions of ancestry, memory, belonging, and ecological recuperation. Throughout this process, they reflect upon and dialogue about the pedagogical implications of their creative collaboration, undertaken at the intersection of new-materialist arts and common worlds environmental education
Body image flexibility in adolescents and emerging adults: conceptualisation, measurement, and protective functions
No full textPoroelastic size dependent dynamics of viscoelastic microbeams connected via a viscoelastic layer
No full textThis article aims to investigate the dynamics of clamped-clamped porous viscoelastic double microbeams interconnected via a viscoelastic layer within the framework of the modified couple stress theory (MCST). Different types of porosity distributions are considered to examine the material imperfection effects on the dynamics of the double microbeam. A closed-cell porosity model is employed to model the variation of the material properties in the thickness plane. The coupled longitudinal and lateral equations of motion are derived using Hamilton’s principle. The governing equations of motion are solved using the modal decomposition method. The equations of motion are verified against the literature for simplified cases (i.e., a non-porous single viscoelastic microbeam and a porous single microbeam resting on a viscoelastic foundation). The numerical results are validated for simpler versions of the system using the finite element method and against the existing literature for a simplified case of a uniformly distributed porous double macrobeam connected via an elastic layer. Influences of viscoelasticity in the double microbeam, viscoelastic layer, porosity, and small-scale influences on the dynamics of the viscoelastic double microbeams are studied. It was found that increasing the material length-scale factor causes the complex fundamental lateral vibrational frequencies to increase for all the porosity patterns
Second Skin:Exploring bioclimate wrapping for climate-resilient housing in Australia
No full textSecond Skin (aka. FlaxWing) is a research project that focuses on the possibilities of a more climate responsive architectural approach. Via concepts of adaptation, we consider the social and technical reuse of existing building stock; the transformation of prevailing construction practices via the uptake of bio-based and low-carbon building materials; and the very adaptation of buildings themselves in response to environmental and occupant influences enacted via cyber-physical systems. Our research is situated by designs, visualisations, and prototypes of a second skin, which transforms an existing residential building in Canberra, albeit with a view to expand its deployment to other new and old buildings both here and in other parts of Australia. It is, however, not intended to be read as an architectural project, rather, it employs an architectural scenario as a way of positioning questions that span material research, computational design and fabrication, and machine control. Second Skin is a collocation of multiple research trajectories within a speculative retrofit scenario, and while each trajectory may be nascent, collectively, they highlight the many ways that architecture can contribute to a decarbonised built environment.<br/
Can classroom-based Peer Patient simulation predict real-life clinical performance in physiotherapy students?
Get PDFIntroductionAuthentic classroom-based assessments that determine healthcare students' readiness-for-work are essential to maintain the safety of patients. Simulation-based assessments show potential, but can be costly, and rigorous investigation of their ability to predict future performance is lacking. This study explored the ability of a peer-simulation practical examination to predict physiotherapy students’ performance on work-integrated learning. Therefore, the research question was: can classroom-based Peer Patient practical examinations predict work-integrated learning performance?MethodA single-centre, prospective study was conducted in a cohort of Australian physiotherapy students. Senior students were trained to play the role of the patient in an end-of-unit examination for junior students. The predictor variable was the junior students' results on the practical examination. The outcome variables were the junior students’ final scores on their rehabilitation work-integrated learning placement.ResultsThis study shows that a peer simulation practical examination and final work-integrated learning scores have a moderate positive correlation, r = .45, p = 0.01. Seventy-seven junior students consented to participate (91 %) with 67 meeting the requirements to complete their placement (87 %). The students who failed their practical examination were 10.1 times more likely to fail their placement.ConclusionsPeer-simulation practical examinations are moderately predictive of physiotherapy student performance on work-integrated learning. Healthcare academics could consider the potential value of using peer-simulation examinations to identify students’ requiring more support before commencing placements.<br/