Developing, implementing, and evaluating the first national Memory and Cognition Clinic Guidelines in Australia.

Introduction: A lack of national consensus on the roles and responsibilities of Australian memory and cognition clinics contributes to the large variability seen across services. The introduction of guidelines and a quality assessment framework could facilitate greater harmonization and quality improvements.

Methods: We used a modified Delphi process to develop the guidelines.

Barriers and enablers of dementia training in healthcare workers in rural and remote Australia: A scoping review to inform future approaches to training.

Introduction: Dementia is now responsible for the greatest burden of disease of any chronic illness in older Australians. Rural and remote communities bear the impacts of this disproportionately. Additional training and education for healthcare staff to support people living with dementia is needed.

Characterising Australian memory clinics: current practice and service needs informing national service guidelines.

Background: Memory clinics (MCs) play a key role in accurate and timely diagnoses and treatment of dementia and mild cognitive impairment. However, within Australia, there are little data available on current practices in MCs, which hinder international comparisons for best practice, harmonisation efforts and national coordination. Here, we aimed to characterise current service profiles of Australian MCs.

Randomised placebo-controlled cross-over study examining the role of anamorelin in mesothelioma (The ANTHEM study): rationale and protocol.

Introduction: Cachexia is common in malignant mesothelioma (MM); half of patients have malnutrition and low skeletal muscle mass. Malnourished patients have worse quality of life (QoL). Weight loss is strongly associated with poor survival.

Comparison of the longitudinal effects of persistent periodic breathing and apnoea on cerebral oxygenation in term- and preterm-born infants.

Key Points: Periodic breathing and apnoea were more common in preterm compared to age-matched term-born infants across the first 6 months after term-corrected age. Periodic breathing decreased with age in both term and preterm infants. Apnoea duration was not different between groups; however, the decline in apnoea index with postnatal age observed in the term infants was not seen in the preterm infants.

The Longitudinal Effects of Persistent Apnea on Cerebral Oxygenation in Infants Born Preterm.

Objective: To assess the incidence and impact of persistent apnea on heart rate (HR), oxygen saturation (SpO), and brain tissue oxygenation index (TOI) over the first 6 months after term equivalent age in ex-preterm infants.

Study Design: Twenty-four preterm infants born between 27 and 36 weeks of gestational age were studied with daytime polysomnography at 2-4 weeks, 2-3 months, and 5-6 months post-term corrected age. Apneas lasting ≥3 seconds were included and maximal percentage changes (nadir) in HR, SpO and tissue oxygenation index (TOI, NIRO-200 Hamamatsu) from baseline were analyzed.

Discrimination of sleep states using continuous cerebral bedside monitoring (amplitude-integrated electroencephalography) compared to polysomnography in infants.

Aim: Limited two-channel electroencephalography (EEG) and amplitude-integrated EEG (aEEG) monitorings are being increasingly used; however, these measurements have not been compared with polysomnographic monitoring, the gold standard for determining infant sleep states. We aimed to determine the accuracy of two-channel EEG and aEEG recordings in defining sleep states and wakefulness in term infants compared to polysomnographic monitoring.

Methods: Sleep was assessed in eight healthy term born infants (mean: 34 ± 3 days), using simultaneous polysomnography (Compumedics S-Series) and a two-channel EEG monitor (Brainz BRM2).

Dummy/pacifier use in preterm infants increases blood pressure and improves heart rate control.

Background: Preterm infants are at increased risk of sudden infant death syndrome (SIDS). Use of a dummy/pacifier is thought to be protective against SIDS; accordingly, we assessed the effects of dummy/pacifier use on blood pressure, cerebral oxygenation, and heart rate control over the first 6 mo of life after term corrected age (CA) when SIDS risk is greatest.

Methods: Thirty-five preterm infants were studied longitudinally at 2-4 wk, 2-3 mo, and 5-6 mo CA.

The longitudinal effects of persistent periodic breathing on cerebral oxygenation in preterm infants.

Objectives: Periodic breathing is common in preterm infants, but is thought to be benign. The aim of our study was to assess the incidence and impact of periodic breathing on heart rate (HR), oxygen saturation (SpO2), and brain tissue oxygenation index (TOI) over the first six months after term-equivalent age.

Study Design: Twenty-four preterm infants (27-36 weeks gestational age) were studied with daytime polysomnography in quiet sleep (QS) and active sleep (AS) and in both the prone and supine positions at 2-4 weeks, 2-3 months, and 5-6 months post-term corrected age.

The Effect of Gestational Age at Birth on Post-Term Maturation of Heart Rate Variability.

Study Objective: Preterm birth delays maturation of autonomic cardiovascular control, reflected in reduced heart rate variability (HRV) in preterm compared to term infants at term-equivalent age. It has been suggested that immature cardiovascular control contributes to the increased risk for the sudden infant death syndrome (SIDS) in preterm infants. However, the effects of prone sleeping, the major SIDS risk factor, and of gestational age (GA) at birth on HRV have not been assessed in preterm infants beyond term-equivalent age.

Preterm Infants Exhibit Greater Variability in Cerebrovascular Control than Term Infants.

Study Objectives: Sudden infant death syndrome (SIDS) remains an important cause of infant death, particularly among infants born preterm. Prone sleeping is the major risk factor for SIDS and this has recently been shown to alter cerebrovascular control in term infants. As preterm infants are at greater risk for SIDS than those born at term, we hypothesized that their cerebrovascular control in the prone position would be reduced compared to term infants.

Understanding and improving communication processes in an increasingly multicultural aged care workforce.

This study explored how culture shapes relationships in aged care and the extent to which the residential aged care sector supports a cohesive multicultural workforce. An exploratory methodology utilising semi-structured questionnaires collected data from 58 participants comprising: staff who provide direct care to residents; managers; and family members from six residential care facilities in Perth, Western Australia. Communication issues emerged as an over-arching theme, and included interpersonal communication, the effect of cultural norms on communication and the impact of informal and formal workplace policies relating to spoken and written language.

Gestational age at birth affects maturation of baroreflex control.

Objectives: To assess the effect of prone sleeping, the major risk factor for sudden infant death syndrome, in the control of blood pressure (BP) in preterm infants born across a range of gestational ages.

Study Design: Daytime polysomnography was performed at 2-4 weeks, 2-3 months, and 5-6 months postterm age. The participants were 21 very preterm (mean gestation 29.

Cerebral oxygenation in preterm infants.

Background And Objective: Prone sleeping is a major risk factor for sudden infant death syndrome (SIDS) and preterm infants are at significantly increased risk. In term infants, prone sleeping is associated with reduced mean arterial pressure (MAP) and cerebral tissue oxygenation index (TOI). However, little is known about the effects of sleeping position on TOI and MAP in preterm infants.

The development of cardiovascular and cerebral vascular control in preterm infants.

Over the past three decades there has been a steady increase in the incidence of preterm birth. The worldwide rate of preterm birth is estimated to be 9.6% of all births, a total of almost 13 million births annually.

Proactive primary care of carers of people with cognitive impairment: a feasibility study.

Background: Over 250 000 Australians live with dementia, and it is estimated that this number will more than double by 2030. Many people with dementia or cognitive impairment are cared for at home by family carers who may themselves be frail older adults or who may suffer from chronic conditions. There is evidence that caring has adverse impacts on carers; however, many do not seek or delay seeking appropriate health care.

Storage induced changes to high protein powders: influence on surface properties and solubility.

Background: MPC 80 is a high-protein (80%) milk powder commonly used in the food industry as a functional ingredient and valued for its nutritional quality. However, its rehydration properties decline during storage, causing more time to be required for rehydration of the powder by the end user. It is thought that changes at the surface of the powder particles contribute to this reduced solubility during storage.

Simulation of impact test for determining "health" of percutaneous bone anchored implants.

There is an ongoing requirement for a clinically relevant, noninvasive technique to monitor the integrity of percutaneous implants used for dental restorations, bone-anchored hearing aids, and to retain extra-oral prostheses (ear, eye, nose, etc). Because of the limitations of conventional diagnostic techniques (CT, MRI), mechanical techniques that measure the dynamic response of the implant-abutment system are being developed. This paper documents a finite element analysis that simulates a transient response to mechanical impact testing using contact elements.

Masticatory muscle reaction in simulated low-velocity rear-end impacts.

Aims: To evaluate the electromyographic (EMG) activity of masseter and temporalis muscles in relation to impact awareness, gender, impact magnitude, and kinematics of head movement in simulated low-velocity rear-end impacts.

Methods: Twenty-nine individuals (17 men and 12 women) were subjected in random order to 3 rear-end impacts: 2 unexpected impacts (chair accelerations of 4.5 m/s2 and 10.

Mandibular kinematics associated with simulated low-velocity rear-end impacts.

Rear-end-impact motor vehicle accidents may result in cervical and temporomandibular-related pain complaints. Head kimematics in simulated low-impact rear-end impacts have been investigated but mandibular kinematics have not been described. Thirty healthy adult subjects underwent three impacts (4.

Kinematics of head movement in simulated low velocity rear-end impacts.

Objectives: To evaluate kinematics of head movement related to impact velocity, gender and awareness in simulated low velocity rear-end impacts.

Methods: Thirty individuals were subjected in random order to three rear-end impacts: two unexpected impacts causing chair acceleration of 4.5m/s2 (slow) and 10.

The role of sternocleidomastoid muscle in simulated low velocity rear-end impacts.

The objectives of this study were to evaluate behavior of sternocleidomastoid muscle (SCM) electromyogram (EMG) related to impact velocity, gender, awareness and kinematics of head movement in simulated low velocity rear-end impacts. Twenty-nine healthy adults (17 male) were subjected in random order to three rear-end impacts: Two unexpected impacts causing chair accelerations of 4.5 m/s(2) (slow) and 10.

Computer modelling of hooks for use as intra-operative force sensors.

There are a number of forces applied during scoliosis surgery, the magnitude and direction of which remains unknown. There is little literature concerning the in vivo distribution of forces along the spine. Computer modelling (ANSYS) was used to investigate the possibility of using an instrumented hook to intra-operatively measure the antero-posterior and distraction/compression forces applied by the surgeon during corrective scoliosis surgery.

Intra-operative measurement of vertebral bone strength.

A significant complication of surgical correction of the deformed spine is pull out of the vertebral hooks or screws. This complication can be partly attributed to poor bone stock. Currently, there are few methods available for surgeons to assess the mechanical strength and stiffness of the vertebra, and even fewer methods that provide in-vivo measurements.