"It Doesn't Make Sense for Us Not to Have One" - Understanding reasons why community sports organizations chose to participate in a funded automated external defibrillator program
- Authors: Fortington, Lauren , Bekker, Sheree , Morgan, Damian , Finch, Caroline
- Date: 2019
- Type: Text , Journal article
- Relation: Clinical Journal of Sport Medicine Vol. 29, no. 4 (2019), p. 324-328
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- Description: Objective: Implementation of automated external defibrillators (AEDs) in community sports settings is an important component of emergency medical planning. This study aimed to understand motivations for why sports organizations participated in a government-funded program that provided AEDs and associated first-aid training. Design: Face-to-face interviews. Setting: Community sports organizations in Victoria, Australia. Participants: Representatives from 14 organizations who participated in a government-funded AED program. Main Outcome Measures: Motivations to participate in the AED program were explored using a qualitative descriptive approach. Results: Two overarching themes emerged: awareness of the program and decision to apply. Awareness was gained indirectly through grant advertising in newsletters/emails/web sites and directly through their sporting associations. For most organizations, there was no decision process per se, rather, the opportunity to apply was the key determinant for participating in the program. A duty of care also emerged as a key driving factor, with recognition of AEDs as a valuable asset to communities broadly, not just the participants' immediate sports setting. Reflecting on participation in the program, these participants identified that it was important to increase awareness about AED ownership and use. The program benefits were clearly summed up as being best prepared for a worst-case scenario. Discussion: This study provides new understanding of why community sports organizations apply for an AED and training. The strongest reason was simply the opportunity to acquire this at no cost. Therefore, for wider implementation of AEDs, additional funding opportunities, targeted awareness of these opportunities, and continued promotion of AED importance are recommended.
121 Telomere attrition is attenuated in ultra-marathon runners
- Authors: Denham, Joshua , Nankervis, Scott , Debiec, Radek , Harvey, Jack , Pascoe, Deborah , Marques, Francine , O’Brien, Brendan , Zukowska-Szczechowska, Ewa , Tomaszewski, Maciej , Charchar, Fadi
- Date: 2012
- Type: Text , Journal article
- Relation: Journal of Hypertension Vol. 30, no. e-Supplement (September 2012), p. e37
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- Description: Background: Leukocyte telomere length is a marker of biological ageing and its shortening is associated with cardiovascular disease. Engagement in regular moderate-intensity physical activity is a recognised method of cardiovascular disease prevention. However, it is not clear whether repeated exposure to ultra-strenuous physical exercise is beneficial long-term and whether it may attenuate biological ageing. Methods: We compared leukocyte telomere length in context of inflammation and endothelial dysfunction between 67 male ultra-marathon runners and 67 age-, sex- and BMI-matched apparently healthy controls. Genomic DNA was extracted from peripheral blood and leukocyte telomere length was measured by quantitative polymerase chain reaction assays. Adhesion molecules (sICAM-1, sE-selectin) and inflammatory markers (IL-6, C-reactive protein) concentrations were measured in 67 ultra-marathon runners by quantitative sandwich enzyme immunoassay technique, high-sensitive immunoassay and ultra-sensitive double antibody sandwich ELISA, respectively. Results: Adjusted (for age, BMI, blood pressure and lipids) leukocyte telomere length was approximately 13.8% greater in the ultra-marathon runners than in the controls (P<0.001). This translates into approximately 32.9 years difference in age-related telomere length attrition. There was a strong negative linear correlation between sICAM-1 and leukocyte telomere length in the ultra-marathon runners (r=-0.33; P=0.007) and this association retained its statistical significance after adjustment for age, BMI, blood pressure and lipids in multiple regression (P=0.026). Conclusion: Prolonged, intense physical exercise may attenuate cellular ageing possibly through a protective effect on endothelial function.
- Description: C1
2020 International Society of Hypertension global hypertension practice guidelines
- Authors: Unger, Thomas , Borghi, Claudio , Charchar, Fadi , Khan, Nadia , Poulter, Neil , Prabhakaran, Dorairaj , Ramirez, Agustin , Schlaich, Markus , Stergiou, George , Tomaszewski, Maciej , Wainford, Richard , Williams, Bryan , Schutte, Aletta
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of hypertension Vol. 38, no. 6 (2020), p. 982-1004
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- Description: DOCUMENT REVIEWERS: Hind Beheiry (Sudan), Irina Chazova (Russia), Albertino Damasceno (Mozambique), Anna Dominiczak (UK), Anastase Dzudie (Cameroon), Stephen Harrap (Australia), Hiroshi Itoh (Japan), Tazeen Jafar (Singapore), Marc Jaffe (USA), Patricio Jaramillo-Lopez (Colombia), Kazuomi Kario (Japan), Giuseppe Mancia (Italy), Ana Mocumbi (Mozambique), Sanjeevi N.Narasingan (India), Elijah Ogola (Kenya), Srinath Reddy (India), Ernesto Schiffrin (Canada), Ann Soenarta (Indonesia), Rhian Touyz (UK), Yudah Turana (Indonesia), Michael Weber (USA), Paul Whelton (USA), Xin Hua Zhang, (Australia), Yuqing Zhang (China).
2020 International Society of Hypertension global hypertension practice guidelines
- Authors: Unger, Thomas , Borghi, Claudio , Charchar, Fadi , Khan, Nadia , Poulter, Neil , Prabhakaran, Dorairaj , Ramirez, Agustin , Schlaich, Markus , Stergiou, George , Wainford, Richard , Williams, Bryan , Schutte, Aletta
- Date: 2020
- Type: Text , Journal article
- Relation: Hypertension Vol. 75, no. 6 (2020), p. 1334-1357
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A 12-month prospective cohort study of symptoms of common mental disorders among European professional footballers
- Authors: Gouttebarge, Vincent , Aoki, Haruhito , Verhagen, Evert , Kerkhoffs, Gino
- Date: 2017
- Type: Text , Journal article
- Relation: Clinical Journal of Sport Medicine Vol. 27, no. 5 (2017), p. 487-492
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- Description: Objective: To determine the 12-month incidence and comorbidity of symptoms of common mental disorders (CMD) among European professional footballers and to explore the association of potential stressors with the health conditions under study among those European professional footballers. Design: Observational prospective cohort study with a follow-up period of 12 months. Participants: Male professional footballers from 5 European countries (n = 384 at baseline). Assessment of Risk Factors: Adverse life events, conflicts with trainer/coach, and career dissatisfaction were explored by using validated questionnaires. Main Outcome Measures: Symptoms of distress, anxiety/depression, sleep disturbance, and adverse alcohol use were assessed using validated questionnaires. Results: A total of 384 players (mean age of 27 years old; mean career duration of 8 years) were enrolled, of which 262 completed the follow-up period. The incidence of symptoms of CMD were 12% for distress, 37% for anxiety/depression, 19% for sleep disturbance, and 14% for adverse alcohol use. Over the follow-up period of 12 months, approximately 13% of the participants reported 2 symptoms, 5% three symptoms, and 3% four symptoms. Professional footballers reporting recent adverse life events, a conflict with trainer/coach, or career dissatisfaction were more likely to report symptoms of CMD, but statistically significant associations were not found. Conclusions: The 12-month incidence of symptoms of CMD among European professional footballers ranged from 12% for symptoms of distress to 37% for symptoms of anxiety/depression. A professional football team typically drawn from a squad of 25 players can expect symptoms of CMD to occur among at least 3 players in one season.
A mixed methods case study exploring the impact of membership of a multi-activity, multicentre community group on social wellbeing of older adults
- Authors: Lindsay-Smith, Gabrielle , O'Sullivan, Grant , Eime, Rochelle , Harvey, Jack , van Uffelen, Jannique
- Date: 2018
- Type: Text , Journal article
- Relation: BMC Geriatrics Vol. 18, no. 1 (2018), p. 1-14
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- Description: Background: Social wellbeing factors such as loneliness and social support have a major impact on the health of older adults and can contribute to physical and mental wellbeing. However, with increasing age, social contacts and social support typically decrease and levels of loneliness increase. Group social engagement appears to have additional benefits for the health of older adults compared to socialising individually with friends and family, but further research is required to confirm whether group activities can be beneficial for the social wellbeing of older adults. Methods: This one-year longitudinal mixed methods study investigated the effect of joining a community group, offering a range of social and physical activities, on social wellbeing of adults with a mean age of 70. The study combined a quantitative survey assessing loneliness and social support (n = 28; three time-points, analysed using linear mixed models) and a qualitative focus group study (n = 11, analysed using thematic analysis) of members from Life Activities Clubs Victoria, Australia. Results: There was a significant reduction in loneliness (p = 0.023) and a trend toward an increase in social support (p = 0.056) in the first year after joining. The focus group confirmed these observations and suggested that social support may take longer than 1 year to develop. Focus groups also identified that group membership provided important opportunities for developing new and diverse social connections through shared interest and experience. These connections were key in improving the social wellbeing of members, especially in their sense of feeling supported or connected and less lonely. Participants agreed that increasing connections was especially beneficial following significant life events such as retirement, moving to a new house or partners becoming unwell. Conclusions: Becoming a member of a community group offering social and physical activities may improve social wellbeing in older adults, especially following significant life events such as retirement or moving-house, where social network changes. These results indicate that ageing policy and strategies would benefit from encouraging long-term participation in social groups to assist in adapting to changes that occur in later life and optimise healthy ageing.
A mixed-methods case study exploring the impact of participation in community activity groups for older adults on physical activity, health and wellbeing
- Authors: Lindsay-Smith, Gabrielle , Eime, Rochelle , O'Sullivan, Grant , Harvey, Jack , van Uffelen, Jannique
- Date: 2019
- Type: Text , Journal article
- Relation: Bmc Geriatrics Vol. 19, no. 1 (2019), p. 1-15
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- Description: Background Regular physical activity (PA) has many health benefits but declines with age. Community multi-activity groups offering volunteer-led socially-oriented activity programs could provide an opportunity for older people to maintain or increase PA levels and promote their health. The aim of this study was to examine the potential effect of becoming a member of an existing community activity group on PA levels, physical and mental health-related quality of life (HR QoL), comparing any impacts associated with participation in physical activity or social activity programs. Methods This mixed-methods case study, combining a longitudinal quantitative-survey with qualitative focus groups to contextualise the survey results, focused on an Australian community organisation called Life Activities Clubs (LACs). LACs provide various physical activities (e.g. walking, cycling, dancing) and social activities (e.g. book groups, dine-outs, craft). Data were collected using a self-report survey administered at baseline, six and twelve-months after joining and group differences between participants of PA programs (PA group) and social programs (social group) were analysed using linear mixed-models. Two focus groups with LAC members were held, one representing each activity type and analysed using content and thematic analysis. Results 35 people (mean age 67) completed the surveys and 11 people participated in the focus groups. PA levels and physical health-related QoL were maintained over 1 year in the PA group, and declined between baseline and 12-months in the social group. Focus groups suggested social aspects of PA programs increased motivation to maintain regular attendance and do more PA than participants would on their own and that physical activities provided health benefits. Mental HR QoL did not change in either group, focus groups suggested this was because the social aspects of both types of program provide benefits relating to mental health including stress relief, enjoyment and adapting to major life events, to prevent a decline in QoL. Conclusions Community PA programs appear to maintain PA levels and physical HR QoL in older adults, and both social and PA programs may maintain mental HR QoL. Incorporating both types of program into one organisation may also encourage less physically active members to try physical activities.
A multi-omics glimpse into the biology of arterial stiffness
- Authors: Eales, James , Romaine, Simon , Charchar, Fadi , Tomaszewski, Maciej
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Hypertension Vol. 34, no. 1 (2015), p. 32-35
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- Description: It has long been recognized that the structure of arteries throughout the vascular tree is not uniform. Notably, the media of large proximal (central) vessels contains relatively much greater amounts of elastin and elastic lamellae than smaller, more distal (peripheral) arteries; the converse is true of vascular smooth muscle cells. Under physiological conditions, the greater elasticity of central arteries compared with more muscular peripheral arteries allows conversion of the pulsatile nature of ventricular ejection into a relatively steady flow of blood at the distal end of the arterial system, conferring protection from pulsatile energy [1,2]. Furthermore, these differences in impedance can generate partial wave reflections, which arrive in the aorta during diastole, boosting diastolic blood pressure and augmenting coronary perfusion pressure [3].
A new way of categorising recurrent, repeat and multiple sports injuries for injury incidence studies - the subsequent injury categorisation (SIC) model
- Authors: Finch, Caroline , Cook, Jill , Gabbe, Belinda , Orchard, John
- Date: 2015
- Type: Text , Journal article
- Relation: Australasian Epidemiologist Vol. 22, no. 1 (2015), p. 22-25
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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- Description: Injuries are a major contributor to healthcare costs and individuals' health and disability status. In response to the overall public health burden, injuries were one of the first medical conditions identified as an Australian National Health Priority Area. Our previous epidemiological research has shown that sports injuries, especially those sustained through formal and highly competitive sport, are often associated with considerable pain and dysfunction. They have significant ongoing impact on quality of life and need for medical treatment, including in the hospital setting.They are also a major barrier towards both the uptake and continuance of health-generating physical activity guidance.
A novel interaction between sympathetic overactivity and aberrant regulation of renin by miR-181a in BPH/2J genetically hypertensive mice
- Authors: Jackson, Kristy , Marques, Francine , Watson, Anna , Palma-Rigo, Keisia , Nguyen-Huu, Thu-Phuc , Morris, Brian , Charchar, Fadi , Davern, Pamela , Head, Geoffrey
- Date: 2013
- Type: Text , Journal article
- Relation: Hypertension Vol. 62 , no. 4 (2013), p. 775-781
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- Description: Genetically hypertensive mice (BPH/2J) are hypertensive because of an exaggerated contribution of the sympathetic nervous system to blood pressure. We hypothesize that an additional contribution to elevated blood pressure is via sympathetically mediated activation of the intrarenal renin-angiotensin system. Our aim was to determine the contribution of the renin-angiotensin system and sympathetic nervous system to hypertension in BPH/2J mice. BPH/2J and normotensive BPN/3J mice were preimplanted with radiotelemetry devices to measure blood pressure. Depressor responses to ganglion blocker pentolinium (5 mg/kg i.p.) in mice pretreated with the angiotensin-converting enzyme inhibitor enalaprilat (1.5 mg/kg i.p.) revealed a 2-fold greater sympathetic contribution to blood pressure in BPH/2J mice during the active and inactive period. However, the depressor response to enalaprilat was 4-fold greater in BPH/2J compared with BPN/3J mice, but only during the active period (P=0.01). This was associated with 1.6-fold higher renal renin messenger RNA (mRNA; P=0.02) and 0.8-fold lower abundance of micro-RNA-181a (P=0.03), identified previously as regulating human renin mRNA. Renin mRNA levels correlated positively with depressor responses to pentolinium (r=0.99; P=0.001), and BPH/2J mice had greater renal sympathetic innervation density as identified by tyrosine hydroxylase staining of cortical tubules. Although there is a major sympathetic contribution to hypertension in BPH/2J mice, the renin-angiotensin system also contributes, doing so to a greater extent during the active period and less during the inactive period. This is the opposite of the normal renin-angiotensin system circadian pattern. We suggest that renal hyperinnervation and enhanced sympathetically induced renin synthesis mediated by lower micro-RNA-181a contributes to hypertension in BPH/2J mice.
A peptide antagonist of thrombospondin-1 promotes abdominal aortic aneurysm progression in the angiotensin II-infused apolipoprotein-E-deficient mouse
- Authors: Krishna, Smriti , Seto, Sai-Wang , Jose, Roby , Biros, Erik , Moran, Corey , Wang, Yutang , Clancy, Paula , Golledge, Jonathan
- Date: 2016
- Type: Text , Journal article
- Relation: Arteriosclerosis, Thrombosis, and Vascular Biology Vol. 35, no. 2 (2016), p. 389-398
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- Description: OBJECTIVE - : Interaction of the activating sequence in thrombospondin-1 (TSP-1) with the conserved sequence (leucine-serine-lysine-leucine [LSKL]) in the latency-associated peptide region of latent transforming growth factor (TGF)-β complex is important in regulating TGF-β1 activity. We aimed to assess the effect of blocking peptide LSKL on the progression of pre-established abdominal aortic aneurysm in angiotensin II-infused apolipoprotein E-deficient (ApoE) mice. APPROACH AND RESULTS - : Abdominal aortic aneurysm was established in 3-month-old male ApoE mice with subcutaneous infusion of angiotensin II for 28 days. After this, mice received LSKL peptide or control SLLK (serine-leucine-leucine-lysine) peptide (4 mg/kg) via daily intraperitoneal injection for an additional 2 weeks. Administration of LSKL peptide promoted larger suprarenal aortic diameter, as determined by ultrasound and morphometric analysis, and stimulated more severe atherosclerosis within the aortic arch. In addition, mice receiving LSKL peptide exhibited elevated circulating proinflammatory cytokine levels and greater inflammatory cells within the suprarenal aorta compared with controls. Mice receiving LSKL peptide showed low plasma TGF-β1 activity and low levels of aortic tissue phosphorylated to total Smad2/3. Aortic gene expression of TGF-β receptor 1 (TGFBRI) and receptor 2 (TGFBRII), but not TGF-β1 and thrombospondin-1, were lower in mice receiving LSKL peptide than controls. LSKL peptide administration was associated with greater aortic elastin fragmentation and lower expression and activity of the TGF-β1-target gene lysyl oxidase like 1 (LOXL1). CONCLUSIONS - : Attenuation of thrombospondin-1-directed activation of TGF-β1 promotes abdominal aortic aneurysm and atherosclerosis progression in the angiotensin II-infused ApoE mouse model. © 2014 American Heart Association, Inc.
A phase II trial for the efficacy of physiotherapy intervention for early-onset hip osteoarthritis: Study protocol for a randomised controlled trial
- Authors: Kemp, Joanne , Moore, Kate , Fransen, Marlene , Russell, Trevor , Crossley, Kay
- Date: 2015
- Type: Text , Journal article
- Relation: Trials Vol. 16, no. 1 (2015), p. 1-8
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- Description: Background: Early-onset hip osteoarthritis is commonly seen in people undergoing hip arthroscopy and is associated with increased pain, reduced ability to participate in physical activity, reduced quality of life and reduced range of motion and muscle strength. Despite this, the efficacy of non-surgical interventions such as exercise therapies remains unknown. The primary aim is to establish the feasibility of a phase III randomised controlled trial investigating a targeted physiotherapy intervention for people with early-onset hip osteoarthritis. The secondary aims are to determine the size of treatment effects of a physiotherapy intervention, targeted to improve hip joint range and hip-related symptoms in early-onset hip osteoarthritis following hip arthroscopy, compared to a health-education control. Methods: This protocol describes a randomised, assessor- and participant-blind, controlled clinical trial. We will include 20 participants who are (i) aged between 18 and 50 years; (ii) have undergone hip arthroscopy during the past six to 12 months; (iii) have early-onset hip osteoarthritis (defined as chondrolabral pathology) at the time of hip arthroscopy; and (iv) experience hip-related pain during activities. Primary outcome will be the feasibility of a phase III clinical trial. Secondary outcomes will be (i) perceived global change score; (ii) hip-related symptoms (measured using the Hip disability and Osteoarthritis Outcome Score (HOOS) pain subscale, activity subscale, and sport and recreation subscale); (iii) hip quality of life (measured using the HOOS quality of life subscale and International Hip Outcome tool; (iv) hip muscle strength and (v) hip range of motion. The physiotherapy intervention is semi-standardised, including joint and soft tissue mobilisation and stretching, hip and trunk muscle retraining and functional and activity-specific retraining and education. The control intervention encompasses individualised health education, with the same frequency and duration as the intervention. The trial primary end-point is the conclusion of the 12-week intervention, and follow-up measures will be collected at the 12-week post-baseline assessment. Discussion: The findings of this study will provide guidance regarding the feasibility of a full-scale phase III randomised controlled trial, prior to its undertaking. Trial registration: The trial protocol was registered with the Australian Clinical Trials Registry (number: 12614000426684) on 17 April 2014. © Kemp et al.
A population-based survey of knowledge of first aid for burns in New South Wales
- Authors: Harvey, Lara , Barr, Margo , Poulos, Roslyn , Finch, Caroline , Sherker, Shauna , Harvey, Jack
- Date: 2011
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 195, no. 8 (2011), p. 465-468
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- Description: Objective: To determine the current level of knowledge of first aid for a burn injury and sources of this knowledge among the general population of New South Wales. Design, setting and participants: People aged 16 years or older were interviewed as part of the 2007 NSW Population Health Survey, a continuous telephone survey of NSW residents. Main outcome measure: Weighted proportion of the population with optimal first aid knowledge for burns. Results: In total, 7320 respondents were asked questions related to burn injuries and first aid. Of the surveyed population, 82% reported that they would cool a burn with water, and 9% reported that they would cool the burn for the recommended 20 minutes. Few respondents reported that they would remove the patient’s clothing and keep the injured person warm. The most common sources of first aid information were a first aid book (42%) and the internet (33%). Speaking a language other than English at home, and being over 65 years of age were associated with a lack of first aid knowledge. Conclusions: A minority of people living in NSW know the optimal time for cooling a burn injury and other appropriate first aid steps for burns. This study demonstrates a gap in the public’s knowledge, especially among non-English speaking people and older people, and highlights the need for a clear, consistent first aid message.
A randomized controlled trial of MoodSwings 2.0 : An internet-based self-management program for bipolar disorder
- Authors: Gliddon, Emma , Cosgrove, Victoria , Berk, Lesley , Lauder, Sue , Mohebbi, Mohammadreza , Grimm, David , Dodd, Seetal , Coulson, Carolyn , Raju, Karishma , Suppes, Trisha , Berk, Michael
- Date: 2019
- Type: Text , Journal article
- Relation: Bipolar Disorders Vol. 21, no. 1 (2019), p. 28-39
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- Description: Objectives MoodSwings 2.0 is an online self-guided intervention for bipolar disorder that includes educational modules, interactive tools, and discussion forums. The primary aim of the study was to determine if participation in MoodSwings 2.0 would result in decreased symptoms of depression and mania compared to the control condition. Secondary aims were to identify improvements in core depression symptoms, quality of life, medication adherence, functioning, and time to relapse. Methods This was a three-arm randomized controlled trial that compared two intervention arms against a peer support control group (forum). A total of 304 adults aged 21 to 65 years with a diagnosis of bipolar disorder were assigned to a forum-only control group (Group 1; n = 102), a forum plus modules treatment group (Group 2; n = 102), or a forum, modules, and tools treatment group (Group 3; n = 100), in addition to usual care. Results There was a significant intervention impact showing improvement on the primary outcome of depression for Group 2 compared to Group 1 (P = .05) with effect sizes (Cohen's d) ranging from 0.17 to 0.43. There was also a significant intervention impact showing improvement on the secondary outcome of core depression for Group 2 (P = .02) and Group 3 (P = .05), but worse physical functioning for Group 3 (P = .01), compared to Group 1. Conclusions This study provides evidence of the efficacy of internet-based psychoeducation interventions for bipolar disorder in reducing depressive symptoms. Further investigation is needed to assess effectiveness in a public program.
A reassessment of the relationship between depression and all-cause mortality in 3,604,005 participants from 293 studies
- Authors: Miloyan, Beyon , Fried, Eiko
- Date: 2017
- Type: Text , Journal article
- Relation: World psychiatry : Official Journal of the World Psychiatric Association (WPA) Vol. 16, no. 2 (2017), p. 219-220
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A review of mathematical models used to determine sperm donor limits for infertility treatment
- Authors: Sawyer, Neroli , McDonald, John
- Date: 2008
- Type: Text , Journal article
- Relation: Fertility and Sterility Vol. 90, no. 2 (2008), p. 265-271
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- Description: Objective: To review mathematical models used to determine sperm donor limits for infertility treatment and to consider the need to develop a new, internationally recognized and applicable model for calculating limits. Design: Literature review. Setting: Models for determining sperm donor limits were identified through bibliographic databases. Patient(s): Published models. Intervention(s): Variables used in the models were defined, evaluated, and assessed for relevancy and applicability. Main Outcome Measure(s): Relevance and applicability of model variables used to predict the number of consanguineous matings, probability of unwitting sibling mating and contribution to F (coefficient of inbreeding). Result(s): Models found to be outdated and inadequate for the present-day. Conclusion(s): Many countries have introduced limits to the number of offspring each anonymous sperm donor can father but these limits vary considerably. Published models for calculating sperm donor limits are in need of improvement and it is recommended that an enhanced, internationally applicable formula be developed for calculating acceptable limits. Moreover, it is recommended that further research be undertaken into the social and familial consequences of the revocation of sperm donor anonymity and the implications for the setting of sperm donor limits. © 2008 American Society for Reproductive Medicine.
- Description: C1
A therapist-assisted cognitive behavior therapy internet intervention for posttraumatic stress disorder: Pre-, post- and 3-month follow-up results from an open trial
- Authors: Klein, Britt , Mitchell, Joanna , Abbott, Jo-Anne , Shandley, Kerrie , Austin, David , Gilson, Kathryn , Kiropoulos, Litza , Cannard, Gwenda , Redman, Tomi
- Date: 2010
- Type: Text , Journal article
- Relation: Journal of Anxiety Disorders Vol. 24, no. 6 (2010), p. 635-644
- Full Text: false
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- Description: This study was an open trial evaluation of a 10-week therapist-assisted cognitive behavior therapy (CBT) internet intervention (PTSD Online) undertaken with people with a primary clinical diagnosis of posttraumatic stress disorder (PTSD) (n= 22) at pre-assessment. Participants were re-assessed at post-assessment and 3-month follow-up. Significant improvements on PTSD severity ratings and related PTSD symptomatology were observed at post-assessment and maintained at 3-month follow-up. At post-assessment, 69.2% of the sample showed clinically significant improvement and 77% of the sample at follow-up assessment. Non-significant, yet improved, change was observed on all other general psychological measures. Overall, treatment satisfaction was good (69%), participant therapeutic alliance ratings were high (87.5%), and the average total therapist time required was 194.5. min. PTSD Online appears to be an efficacious treatment option for people with PTSD that can be provided entirely remotely, with far less therapist time than traditional face-to-face treatment, and without compromising therapeutic alliance. © 2010 Elsevier Ltd.
Access to stroke care units in Australian public hospitals : Facts and temporal progress
- Authors: Cadilhac, Dominique , Lalor, Erin , Pearce, Dora , Levi, Christopher , Donnan, Geoffrey
- Date: 2006
- Type: Text , Journal article
- Relation: Internal Medicine Journal Vol. 36, no. 11 (2006), p. 700-704
- Full Text: false
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- Description: Background: There is level I evidence that management of stroke patients in stroke units (SU) improves outcomes (death and institutionalization) by approximately 20%. In Australia, there is uncertainty as to the proportion of incident cases that have access to SU. Recent national and State-based policy initiatives to increase access to SU have been taken. However, objective evidence related to SU implementation progress is lacking. The aims of the study were (i) to determine the number of SU in Australian acute public hospitals in 2004, (ii) to describe hospitals according to national SU policy criteria and (iii) to compare results to the 1999 survey to track progress. Methods: The method used in the study was a cross-sectional, postal survey technique. The participants were clinical representatives considered appropriate to describe stroke care within survey hospitals. Results: The outcome of the study was presence of a SU according to an accepted definition. Response rate was 261/301 (87%). Sixty-one sites (23%) had either a SU and/or a dedicated stroke team. Fifty sites claimed to have a SU (19%). New South Wales with 23 had the most number of SU. Based on policy criteria, up to 64 sites could have a SU. In 1999, there were 35 public hospitals with a SU. Conclusion: Access to SU in Australian public hospitals remains low compared with other countries (Sweden, 70%). Implementation strategies supported by appropriate health policy to improve access are needed. © 2006 Royal Australasian College of Physicians.
Acupuncture : a promising approach for Comorbid depression and insomnia in perimenopause
- Authors: Zhao, Fei , Fu, Qiang-Aiang , Spencer, Sarah , Kennedy, Gerard , Conduit, Russell , Zhang, Wen-Jing , Zheng, Zhen
- Date: 2021
- Type: Text , Journal article
- Relation: Nature and Science of Sleep Vol. 13, no. (2021), p. 1823-1863
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- Description: Comorbid depression and insomnia are ubiquitous mental complaints among women going through the perimenopausal stage of life and can result in major decline in quality of life. Antidepressive agents combined with/without hypnotics, and/or hormone therapy are currently the most common treatment for perimenopausal depression (PMD) and insomnia (PMI). Balancing the benefits of these pharmacotherapies against the risk of adverse events (AEs) is a difficult task for both clinicians and women. There has been a growing body of research regarding the utilization of acupuncture for treatment of PMD or PMI, whereas no studies of acupuncture for comorbid PMD and PMI have appeared. In this review, we summarize the clinical and preclinical evidence of acupuncture as a treatment for PMD or PMI, and then discuss the potential mechanisms involved and the role of acupuncture in helping women during this transition. Most clinical trials indicate that acupuncture ameliorates not only PMD/PMI but also climacteric symptoms with minimal AEs. It also regulates serum hormone levels. The reliability of trials is however limited due to methodological flaws in most studies. Rodent studies suggest that acupuncture prolongs total sleep time and reduces depression-like behavior in PMI and PMD models, respectively. These effects are possibly mediated through multiple mechanisms of action, including modulating sex hormones, neurotransmitters, hypothalamic-pituitary-adrenal axis/hypothalamic-pituitary-ovary axis, oxidative stress, signaling pathways, and other cellular events. In conclusion, acupuncture is a promising therapeutic strategy for comorbid depression and insomnia during perimenopause. Neuroendocrine modulation is likely to play a major role in mediating those effects. High-quality trials are required to further validate acupuncture’s effectiveness. © 2021 Zhao et al.
Acupuncture as an independent or adjuvant management to standard care for perimenopausal depression : a systematic review and meta-analysis
- Authors: Zhao, Fei , Fu, Qiang-Qiang , Kennedy, Gerard , Conduit, Russell , Zhang, Wen-Jing , Zheng, Zhen
- Date: 2021
- Type: Text , Journal article , Review
- Relation: Frontiers in Psychiatry Vol. 12, no. (2021), p.
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- Description: Background: Many women with perimenopausal depression (PMD) have sought alternative therapies such as acupuncture because of concerns about risks associated with antidepressant and hormone replacement therapy (HRT). This systematic review aimed to clarify if acupuncture is effective for PMD compared with waitlist control or placebo/sham acupuncture, and if acupuncture alone or combined with standard care (antidepressant and/or HRT) is more effective in ameliorating PMD in comparison with standard care alone. Methods: Randomized controlled trials (RCTs) of PMD treatment via acupuncture vs. waitlist control or placebo/sham acupuncture, and RCTs of PMD treatment via acupuncture alone or combined with Western pharmacotherapy vs. Western pharmacotherapy were searched for from seven databases from inception to December 2020. Cochrane criteria were followed. Results: Twenty-five studies involving 2,213 women were analyzed. Meta-analyses indicated that acupuncture significantly reduced the global scores of Hamilton Depression Scale (HAMD) [standardized mean difference (SMD) = −0.54, 95% CI (−0.91, −0.16), p < 0.01], compared with standard care. The therapeutic effect of acupuncture maintained at 2-, 4-, and 12-week follow-ups. Acupuncture combined with standard care was more effective than standard care alone in decreasing HAMD scores [SMD = −0.82, 95% CI (−1.07, −0.58), p < 0.01]. Too few RCTs were available to assess the clinical efficacy differences between acupuncture and placebo/sham acupuncture or HRT alone. Acupuncture also showed better effects in decreasing Kupperman index (KI) scores, whether compared with antidepressant alone [MD = −4.55, 95% CI (−8.46, −0.65), p = 0.02] or antidepressant combined with HRT [MD = −0.89, 95% CI (−1.34, −0.43), p < 0.01]. Conclusions: In comparison with standard care, acupuncture alone or combined with standard care was associated with significant improvements in PMD and reductions of other menopausal symptoms. This finding suggests that acupuncture may be a useful addition to treatment for PMD. © Copyright © 2021 Zhao, Fu, Kennedy, Conduit, Zhang and Zheng.