Support for people with dementia experiencing severe responsive behaviours: Unpacking the disconnect between policy and practice.

Objective: The Severe Behaviour Response Team (SBRT) program, which was established in 2015 to support aged care residents with dementia experiencing very severe and extreme responsive behaviours received far fewer referrals than projected during its first year. This article describes the outcomes of a brief survey to identify potential barriers to referrals and identify opportunities to improve the uptake of the service.

Methods: A pragmatic, quasi-experimental study was conducted involving clinical leads working in a representative sample of care homes that had not used the SBRT.

Implementation of a Pilot SMS-Based Crisis Support Service in Australia.

Australia's first short message service (SMS) crisis support service was launched by Lifeline Australia in July 2018. The pilot program was independently evaluated over a 240-day period. We aimed to examine the experiences of key staff employed in the Lifeline Text pilot and identify the skills and types of support required to deliver a high-quality SMS-based crisis support service.

Evaluation of Outcomes for Help Seekers Accessing a Pilot SMS-Based Crisis Intervention Service in Australia.

In July 2018, Lifeline Australia launched Australia's first short message service (SMS) crisis support service. Lifeline Text aims to reduce psychological distress and increase coping and social connectedness among help seekers, particularly those who prefer text-based communication. We aimed to independently evaluate the pilot SMS service over a 240-day period.

Rapid response teams to support dementia care in Australian aged care homes: Review of the evidence.

Objectives: To identify attributes of rapid response services designed to support people with very severe and extreme responsive behaviours, otherwise known as behavioural and psychological symptoms of dementia, in aged care homes.

Methods: A rapid evidence assessment was conducted to inform the evaluation of the Severe Behaviour Response Team (SBRT) service, including a targeted search of peer-reviewed academic literature and an Internet-based search of government, service provider, peak body and university websites.

Results: A number of localised rapid response services targeting people with similar clinical profiles were identified, but none operated on the scale of the SBRT.

'Don't fix what ain't broke': evaluating the effectiveness of a Men's Shed in inner-regional Australia.

Men's Sheds and similar community programmes are known to encourage help-seeking behaviour and thus improve the health and well-being outcomes for the men who attend. This paper investigates this issue through a community needs assessment of a Men's Shed programme in inner-regional Australia. The immediate purpose of this research was to help direct future funding initiatives, and provide recommendations for potential changes and improvements to the programme.

Evolution of a multilevel framework for health program evaluation.

A well-conceived evaluation framework increases understanding of a program's goals and objectives, facilitates the identification of outcomes and can be used as a planning tool during program development. Herein we describe the origins and development of an evaluation framework that recognises that implementation is influenced by the setting in which it takes place, the individuals involved and the processes by which implementation is accomplished. The framework includes an evaluation hierarchy that focuses on outcomes for consumers, providers and the care delivery system, and is structured according to six domains: program delivery, impact, sustainability, capacity building, generalisability and dissemination.

Is it feasible and desirable to collect voluntarily quality and outcome data nationally in palliative oncology care?

Hospice/palliative care is a critical component of cancer care. In Australia, more than 85% of people referred to specialized hospice/palliative care services (SHPCS) have a primary diagnosis of cancer, and 60% of people who die from cancer will be referred to SHPCS. The Palliative Care Outcomes Collaboration (PCOC) is an Australian initiative that allows SHPCS to collect nationally agreed-upon measures to better understand quality, safety, and outcomes of care.

Genetic and metabolic predictors of chemosensitivity in oligodendroglial neoplasms.

The -1p/-19q genotype predicts chemosensitivity in oligodendroglial neoplasms, but some with intact 1p/19q also respond and not all with 1p/19q loss derive durable benefit from chemotherapy. We have evaluated the predictive and prognostic significance of pretherapy (201)Tl and (18)F-FDG SPECT and genotype in 38 primary and 10 recurrent oligodendroglial neoplasms following PCV chemotherapy. 1p/19q loss was seen in 8/15 OII, 6/15 OAII, 7/7 OIII, 3/11 OAIII and was associated with response (Fisher-Exact: P=0.

Cerebral blood volume, genotype and chemosensitivity in oligodendroglial tumours.

Introduction: The biological factors responsible for differential chemoresponsiveness in oligodendroglial tumours with or without the -1p/-19q genotype are unknown, but tumour vascularity may contribute. We aimed to determine whether dynamic susceptibility contrast (DSC) magnetic resonance imaging (MRI) could distinguish molecular subtypes of oligodendroglial tumour, and examined the relationship between relative cerebral blood volume (rCBV) and outcome following procarbazine, lomustine and vincristine (PCV) chemotherapy.

Methods: Pretherapy rCBV was calculated and inter- and intraobserver variability assessed.

Clinical use of genotype to predict chemosensitivity in oligodendroglial tumors.

Background: The -1p/-19q genotype has been associated with prolonged survival and chemosensitivity in oligodendroglial neoplasms, but the predictive and prognostic significance of genotype in the routine clinic is not established.

Methods: The authors investigated allelic imbalance in 1p36, 19q13, 17p13, 10p12-15, and 10q22-26 and p53 mutation in a cohort representative of clinical practice at their center (50 primary, 26 recurrent cases) given PCV chemotherapy between 2000 and 2003 and compared with response and outcome following PCV.

Results: 1p/19q loss was found in 12/19 OII, 10/23 OAII, 11/13 OIII, and 6/21 OAIII.

MRS of oligodendroglial tumors: correlation with histopathology and genetic subtypes.

Background: Oligodendroglial neoplasms with combined loss of chromosomes 1p and 19q may have a good prognosis and respond to procarbazine-lomustine (CCNU)-vincristine (PCV) chemotherapy.

Objective: To determine whether single voxel magnetic resonance spectroscopy (SV-MRS) obtained through routine clinical practice distinguishes between histopathologic and genetic subtypes of oligodendroglial tumors.

Methods: Forty-eight patients with oligodendroglial tumors (19 oligodendrogliomas and 29 oligoastrocytomas) underwent molecular genetic analysis to determine allelic imbalance in chromosomes 1p36 and 19q13.

Molecular pathology and clinical characteristics of oligodendroglial neoplasms.

To evaluate the role of molecular genetics in the routine clinic, we investigated allelic imbalance at 1p36, 19q13, 17p13, 10p12-15, and 10q22-26 and p53 mutation in 100 oligodendroglial neoplasms diagnosed at a single treatment center between 2000 and 2003. The -1p/-19q genotype, seen in 64, 34, 77, and 30% of OII, OAII, OIII, and OAIII respectively, was inversely related to p53 mutation and 17p13 loss. Genotype was unrelated to tumor location and could not distinguish high-grade tumors that presented de novo from those that progressed from a previous lower grade malignancy.

Correlation of molecular genetics with molecular and morphological imaging in gliomas with an oligodendroglial component.

Purpose: Since the recognition that oligodendrogliomas may be chemosensitive, their diagnosis and clinical management has become highly controversial. Histopathology diagnosis remains challenging and new tools such as molecular genetics or molecular imaging require evaluation.

Experimental Design: In a single-center, population-based prospective study, allelic imbalance in chromosomes 1p36, 19q13, 17p13, 10p12-15, and 10q22-26 has been investigated in 19 oligodendroglioma WHO grade 2 (OII), 20 oligoastrocytoma WHO grade 2 (OAII), 8 oligodendroglioma WHO grade 3 (OIII), and 12 oligoastrocytoma WHO grade 3 (OAIII), and compared with pretherapy histopathology, computed tomography and/or magnetic resonance (CT and/or MR), [fluorine-18]fluoro-2-deoxyglucose (18F-FDG), and thallium-201 single-photon emission computed tomography (201Tl SPECT).