Management of eating disorders for people with higher weight: clinical practice guideline.

Introduction: The prevalence of eating disorders is high in people with higher weight. However, despite this, eating disorders experienced by people with higher weight have been consistently under-recognised and under-treated, and there is little to guide clinicians in the management of eating disorders in this population.

Aim: The aim of this guideline is to synthesise the current best practice approaches to the management of eating disorders in people with higher weight and make evidence-based clinical practice recommendations.

Novel methodology to quantify dehydration in head and neck cancer radiotherapy using DIXON MRI.

Introduction: Head and neck cancer (HNC) patients are at risk of weight change, due to inadequate nutrition intake or dehydration, when receiving radiotherapy (RT). This study aimed to develop methodology to measure water content changes on magnetic resonance imaging (MRI) scans of the head and neck region over the course of RT.

Methods: Retrospective datasets of 54 patients were analysed.

A pilot clinical study to Evaluate Liraglutide-mediated Anti-platelet activity in patients with type-2 Diabetes (ELAID study).

Background: Liraglutide is an effective treatment for the management of type 2 diabetes mellitus (T2DM). In addition to glycemic control and potential cardioprotective effects, recent studies suggest a possible role for liraglutide in the inhibition of platelet reactivity, further attenuating atherothrombotic risk in patients with T2DM. We evaluated the in-vivo antiplatelet effect of liraglutide in T2DM patients without macrovascular disease or concurrent anti-platelet therapy.

The first-in-human implementation of adaptive 4D cone beam CT for lung cancer radiotherapy: 4DCBCT in less time with less dose.

Background And Purpose: We present the first implementation of Adaptive 4D cone beam CT (4DCBCT) that adapts the image hardware (gantry rotation speed and kV projections) in response to the patient's real-time respiratory signal. Adaptive 4DCBCT was applied on lung cancer patients to reduce the scan time and imaging dose in the ADaptive CT Acquisition for Personalised Thoracic imaging (ADAPT) trial.

Materials And Methods: The ADAPT technology measures the patient's real-time respiratory signal and uses mathematical optimisation and external circuitry attached to the linear accelerator to modulate the gantry rotation speed and kV projection rate to reduce scan times and imaging dose.

Reducing 4DCBCT scan time and dose through motion compensated acquisition and reconstruction.

Conventional 4DCBCT captures 1320 projections across 4 min. Adaptive 4DCBCT has been developed to reduce imaging dose and scan time. This study investigated reconstruction algorithms that best complement adaptive 4DCBCT acquisition for reducing imaging dose and scan time whilst maintaining or improving image quality compared to conventional 4DCBCT acquisition using real patient data from the first 10 adaptive 4DCBCT patients.

ANZAED eating disorder treatment principles and general clinical practice and training standards.

Introduction: Eating disorders are complex to manage, and there is limited guidance around the depth and breadth of knowledge, skills and experience required by treatment providers. The Australia & New Zealand Academy for Eating Disorders (ANZAED) convened an expert group of eating disorder researchers and clinicians to define the clinical practice and training standards recommended for mental health professionals and dietitians providing treatment for individuals with an eating disorder. General principles and clinical practice standards were first developed, after which separate mental health professional and dietitian standards were drafted and collated by the appropriate members of the expert group.

ANZAED practice and training standards for mental health professionals providing eating disorder treatment.

Introduction: The Australia & New Zealand Academy for Eating Disorders (ANZAED) recently developed general principles and clinical practice standards recommended for mental health clinicians and dietitians providing treatment for people with eating disorders. Separate mental health practice and training standards were then devised as a foundation for strengthening the workforce and providing guidance to professional training programs and service providers on the minimal standards required for practice in the eating disorder field.

Recommendations: The present recommendations for mental health professionals providing eating disorder treatment describe the following practice and training standards: eating disorder treatment foundations (including co-ordination of services, establishing a positive therapeutic alliance, professional responsibility and knowledge of levels of care), assessment, diagnosis, intervention (including evidence-based intervention, managing psychiatric risk and managing co-morbid mental health problems), and monitoring and evaluation.

Cautiously optimistic: A survey of radiation oncology professionals' perceptions of automation in radiotherapy planning.

Introduction: While there is evidence to show the positive effects of automation, the impact on radiation oncology professionals has been poorly considered. This study examined radiation oncology professionals' perceptions of automation in radiotherapy planning.

Method: An online survey link was sent to the chief radiation therapists (RT) of all Australian radiotherapy centres to be forwarded to RTs, medical physicists (MP) and radiation oncologists (RO) within their institution.

Factors related to length of stay, referral on discharge and hospital readmission for children and adolescents with anorexia nervosa.

Objective: This study examined factors related to hospital length of stay (LOS), reported referral on discharge, and hospital readmission, for children and adolescents (C&A) admitted to public hospitals for anorexia nervosa (AN), in a large health jurisdiction in Australia.

Method: Sociodemographic, illness, treatment, and hospital factors associated with LOS, reported referral to post-hospital treatment, and readmission within 28 days were analyzed for C&A with AN admitted to all New South Wales public hospitals in 2017, using median, multinomial logit and logit models. The sample comprised 289 admissions by 200 C&A aged 9-18 years with a primary or secondary diagnosis of AN.

Prevalence of software alerts in radiotherapy.

Radiotherapy software messages (sometimes called alerts, pop-up windows, alarms, or error messages) to the user appear continuously on computer screens. These software messages sometimes require decisions to be made as to the next appropriate action. However, mainly these messages are for information only.

Quality management in radiation therapy: A 15 year review of incident reporting in two integrated cancer centres.

Fifteen years of reported incidents were reviewed to provide insight into the effectiveness of an Incident Learning System (ISL). The actual error rate over the 15 years was 1.3 reported errors per 1000 treatment attendances.

Adolescent development in family-based treatment for anorexia nervosa: Patients' and parents' narratives.

Maudsley Family-Based Treatment (FBT) is currently the best supported treatment for adolescents with anorexia nervosa (AN); however, little is known about whether it achieves its stated aim in the final phases of promoting the patient's return to an expected developmental trajectory. This study aimed to explore the perspectives of young people and their parents regarding the developmental impact of AN, and the role of FBT in addressing developmental challenges. Young people ( N = 12) who ceased FBT a minimum 1 year prior, and their parents ( N = 12), completed face-to-face semi-structured interviews, and data were analysed using a narrative inquiry method.

Does continuing family-based treatment for adolescent anorexia nervosa improve outcomes in those not remitted after 20 sessions?

Objective: Our aim was to investigate the benefit of ongoing family-based treatment (FBT) sessions for adolescent anorexia nervosa if remission criteria were not met at session 20.

Method: Participants were 69 medically unstable adolescents with Diagnostic and Statistical Manual of Mental Disorders (4th ed; DSM-IV) anorexia nervosa from a randomized controlled trial investigating length of hospital admission prior to outpatient FBT. Participants were divided post hoc into those meeting remission criteria at session 20 ( n = 16), those that had not remitted but continued with FBT ( n = 39) and those who ceased FBT undertaking alternative treatments ( n = 14).

How does family functioning effect the outcome of family based treatment for adolescents with severe anorexia nervosa?

Background: The aim of this research was to investigate the relationship between family functioning, adolescent-parent attachment and remission, as well as changes in these variables over time for adolescents with severe anorexia nervosa treated with family based treatment (FBT). Understanding how families respond to treatment is important because the family will be the ongoing context for psychosocial development in the longer term. The relationship between family functioning and outcome is also an important variable because it is potentially modifiable during treatment and this may improve outcome.

Exploring the effects of a family admissions program for adolescents with anorexia nervosa.

Background: This study investigated patient experience in a Family Admissions Program (FAP) - a pilot treatment program for adolescents with Anorexia Nervosa at the Children's Hospital, Westmead. Based on Maudsley Family Based Treatment (FBT), the FAP involves an adolescent and his/her family undergoing a two-week family-based hospital admission at the outset of treatment. The program aims to increase intensity and support to a level needed by some families struggling to engage with or access FBT.

Family Functioning and Relationship Quality for Adolescents in Family-based Treatment with Severe Anorexia Nervosa Compared with Non-clinical Adolescents.

This longitudinal study explored family functioning and relationship quality for adolescents with severe anorexia nervosa (AN). An important outcome given healthy family functioning supports effective adolescent development. Fifty-four female adolescents and their parents, treated with family-based treatment after inpatient admission, and 49 non-clinical age-matched adolescents and their parents were compared at assessment and 6 months after session 20.

Relational containment: exploring the effect of family-based treatment for anorexia on familial relationships.

Background: The aim of this research was to investigate the process of familial relationship change for adolescents with anorexia nervosa and their parents, who participated in Family-Based Treatment (FBT).

Method: A Constructionist grounded theory design was employed with purposive sampling. Sixteen young people between 12 and 18 years with a good outcome in FBT and twenty-eight of their parents participated.

Parental strategies used in the family meal session of family-based treatment for adolescent anorexia nervosa: Links with treatment outcomes.

Objective: Examine relationships between parental mealtime strategies used in the family meal session of family-based treatment (FBT) and adolescent outcomes at EOT (session 20).

Method: Eighteen families with an adolescent receiving FBT-AN participated. Parental strategies during videoed family meals were assessed using a family mealtime coding system.

The effectiveness of family-based treatment for full and partial adolescent anorexia nervosa in an independent private practice setting: Clinical outcomes.

Objective: Anorexia nervosa (AN) is a severe psychiatric illness with little evidence supporting treatment in adults. Among adolescents with AN, family-based treatment (FBT) is considered first-line outpatient approach, with a growing evidence base. However, research on FBT has stemmed from specialist services in research/public health settings.

Early weight gain in family-based treatment predicts greater weight gain and remission at the end of treatment and remission at 12-month follow-up in adolescent anorexia nervosa.

Objective: To Identify whether early weight gain in family-based treatment (FBT) predicted greater weight and remission at end of FBT and 12-month follow-up.

Method: Eighty-two adolescents, with anorexia nervosa, participated in a randomized control trial comparing brief hospitalization for medical stabilization and hospitalization for weight restoration to 90% expected body weight (EBW) (1:1), followed by 20 sessions of FBT. Sixty-nine completed trial protocol.

Just one more bite: a qualitative analysis of the family meal in family-based treatment for anorexia nervosa.

Objective: The family meal is an integral component of Maudsley family-based treatment for anorexia nervosa. The aim of this study was to determine whether there are different types of family meal, as suggested in the treatment manual, and whether within session processes differ according to meal type.

Method: Thirty video-recorded family meal sessions from a randomised controlled trial were transcribed and analysed using thematic analysis.

How do parents of adolescent patients with anorexia nervosa interact with their child at mealtimes? A study of parental strategies used in the family meal session of family-based treatment.

Objective: To examine the range and frequency of parental mealtime strategies used during the family meal session of Family-Based Treatment (FBT) for adolescent anorexia nervosa, and to explore the relationships between parental mealtime strategies, mealtime emotional tone and parental 'success' at encouraging adolescent food consumption.

Method: Participants were 21 families with a child aged between 12 and 18 years receiving FBT for adolescent anorexia nervosa. Video recordings of the family meal session (FBT session two) were coded using the Family Mealtime Coding System adapted in this study for use with adolescents (FMCS-A) to identify frequency of parental strategies, emotional tone of the meal (measured by adolescent positive and negative vocalisations) and frequency of prompted mouthfuls consumed by the adolescent (measured by the number of mouthfuls consumed by the adolescent immediately following parental interactions).

Haematogenous Spread of Staphylococcus aureus from an Iliacus Abscess to an ACL Reconstructed Knee.

We describe a case of a 19-year-old male who presented to the South West Health Service with a septic knee, secondary to haematogenous spread from an iliacus abscess. Thus far, there have been no reported cases of haematogenous spread of infection from an iliacus abscess to an ACL reconstructed knee, let alone in a healthy young person with no risk factors. The patient has had several washouts of the knee along with the drainage of the abscess.