The mortality gap in people with severe mental illness is primarily driven by preventable cardiometabolic disease, strongly related to unhealthy diet, physical inactivity and metabolic effects of antipsychotic medication. The study is a 12-week RCT embedded in the Canberra Health Services, Specialist Youth Mental Health Outreach program. The trial will quantify whether metabolic and functional markers of physical health in young people, who have experienced early onset psychosis, can be improved by a combined practical dietary and physical activity intervention.

Affiliations
University of Canberra Research Institute for Sport and Exercise, Discipline of Sport and Exercise Science, School of Rehabilitation and Exercise Sciences, Faculty of Health, University of Canberra 

Lungs in Action (LIA) is a signature program of Lung Foundation Australia and is a community exercise program for people with chronic lung and heart disease. 

To determine the holistic health benefits of participation in LIA through a participant evaluation, concurrently with functional outcome measures over a three-month period. 

A convenience sample of LIA participants completed a health questionnaire (Qualtrics) that incorporated the EQ-5D-5L Health Questionnaire, demographics and structured health and wellbeing questions at baseline. A follow-up health questionnaire was undertaken three months post baseline. 

 

Concurrently, LIA Instructors conducted functional assessments of muscular strength (30sec Sit to Stand (30STS)), mobility, and balance (Timed Up and Go (TUG)) at baseline and 3 months post, to assess physiological adaptations in a participant’s ability to function independently. 

108 LIA participants (60±8 years; F=72) attending LIA consented to complete the baseline questionnaire with n=61 (60±7 years; F=41) completing 3-month post questionnaires. There were significant improvements in EQ-5D-5L anxiety domain (MD±SD; 0.18±0.22; p=0.04) and overall health rating (EQ-VAS) (MD±SD; 5.62±2.72; p=0.02).

74 participants (60±7 years; F=52) who attended an average of 11±6 classes over the three-month interval, completed functional testing at both timepoints. There was a significant decrease in time to complete the TUG (MD±SD; -0.81±1.41 sec; p<0.0001) and increase in repetitions for the 30sSTS (MD±SD; 1.68±2.76 reps; p<0.0001). 

Results indicate an increase in functional capacity, overall health, and a decrease in anxiety over the three-month period. These benefits may relate to improved independence and activities of daily living.

LIA provides a continuum of care, improving patient health outcomes.


Julie Cooke1, Kristal Grainger2, Emma Halloran2, Lissa Spencer3,4, Narelle Cox5,6, Julie Adsett7, Mary Roberts8, Andrew Williams9
 
 

1.     Research Institute for Sport and Exercise, University of Canberra, Australian Capital Territory, Australia 

2.     Pulmonary Exercise, Lung Foundation Australia, Queensland

3.     Department of Physiotherapy, Royal Prince Alfred Hospital Sydney, New South Wales, 

4.     School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, 

5.     Respiratory Research@Alfred, Monash University, Victoria, 

6.     Institute for Breathing and Sleep, Victoria, 

7.     Heart Failure Service, Royal Brisbane & Women’s Hospital, Queensland, 

8.     Department of Respiratory and Sleep Medicine, Westmead Hospital, New South Wales, Australia

9.     School of Health Sciences, University of Tasmania, Tasmania, Australia

Parkinson’s disease is a common, progressive neurological disease. Biofeedback can be added to physiotherapy, concurrent with activity, to provide people with knowledge of performance during intervention. However, the effectiveness of biofeedback in Parkinson’s disease is unclear. 

Is the addition of biofeedback to physiotherapy effective in improving activity limitations in people with Parkinson’s disease, compared with physiotherapy alone? 

A systematic review with meta-analysis of quasi-randomised or randomised trials was undertaken. Participants included people with idiopathic Parkinson’s disease. The intervention was biofeedback during activity training compared with the same amount of training without biofeedback. Outcome measures included measures of activity congruent with the activity trained. 

Nineteen studies comprising 578 participants were included in this review. The quality of included studies was good (average = 6 PEDro score). Given the diverse range of outcome measures reported across studies, results were presented as a pooled estimate of the standardised mean difference between groups (95% CI). Results showed a moderate, immediate effect of biofeedback in addition to physiotherapy compared with physiotherapy alone in all activities combined (SMD 0.35, 95% CI 0.07–0.63). There was a small, long-term effect of biofeedback in all activities (SMD 0.26, 95% CI 0.03–0.48). 

The addition of biofeedback to physiotherapy is more effective than physiotherapy alone, in improving activities in the short and long-term for people with Parkinson’s disease. 

Biofeedback in addition to physiotherapy should be implemented for people with Parkinson’s disease to maximise outcomes in improving activity limitations.

Globally, 34.6 million years of life are lost from suicide annually. Protective factors are thought to lower suicide risk or help a person defend against suicidal thoughts. However, it is currently unclear how protective factors for suicide interact with established risk factors to disrupt the developmental pathways from suicidal thoughts to behaviours. 

This study used Decision Tree (DT) analysis to identify the most relevant protective and risk factors in predicting suicidality in the general population. 

Online quota sampling was used to recruit 1,187 Australian adults (54.3% women; M age = 46.76 years, SD = 18.44) from market research panels to participate in an anonymous online survey. Sociodemographic information and a range of empirically and theoretically supported protective and risk factors for suicide were measured in relation to past month suicide ideation and attempt. A DT model with 41 protective and risk factors was built using the Chi-Square Automatic Interaction Detector algorithm. 

Two thirds (65.5%) of participants reported no suicidality, 16% ideation only (SI), and 18% both ideation and attempts (SI and SA). The DT model identified 18 different protective and risk profiles. Perceived burden (PB) was the strongest predictor of past month suicidality. 

Out of 41 protective and risk factors measured, low PB – comprising low feelings of self-hatred and liability to others – was found to be most protective against suicidality. Significance: The 18 different subgroups identified in the study highlight the complexity of interrelationships between suicide protective and risk factors and aid in the identification of risk profiles for suicidal behaviour.

People with heart disease have increased morbidity and mortality risk. Sedentary behaviour (SB) contributes to morbidity and behavioural smartphone apps may be feasible interventions however, it is unclear if they reduce SB and healthcare utilisation. 

 

Test a SB change smartphone app adjunct to cardiac rehabilitation on hospital admissions and emergency department (ED) presentations over 12-months.

 

A randomised controlled trial was conducted with 120 participants recruited from ACT cardiac rehabilitation programs. Participants were randomised 1:1 to cardiac rehabilitation plus the 6-month Vire app and online ToDo-CR program (intervention) or usual care (control). The primary outcome was non-elective hospital admissions and ED presentations over 12-months. Accelerometer-measured SB was recorded at baseline, 6- and 12-months. Logistic regression models and linear mixed-effects models were used in the analysis. Intervention and hospital admission costs were used to calculate incremental cost-effectiveness ratios (ICER). 

 

Intervention group participants were more likely to experience all-cause (OR1.54, 95%CI 0.58-4.10, p=0.39) and cardiac-related (OR3.26, 95%CI 0.84-12.55, p=0.09) hospital admissions and ED presentations (OR2.07, 95%CI 0.89-4.77, p=0.09) compared to the control. Despite this, 12-month cardiac-related hospital admission costs were lower in the intervention group ($252.40 vs $859.38, p=0.24). There were no significant between-group differences in SB minutes-per-day over 12-months, though the intervention group completed 22-minutes less than the control (95%CI -22.80-66.69, p=0.33, Cohen d=0.21). The intervention was more effective but also more costly in reducing SB (ICER $351.77).

 

The Vire app did not reduce hospital admissions and ED presentations. However, it appeared to reduce 12-month cardiac-related hospital admission costs and had a small effect on reducing SB.


Kacie Patterson1, Rachel Davey1, Richard Keegan2, Theo Niyonsenga1, Itismita Mohanty1, Sarah Bowen3, Elizabeth Regan4, Michelle Lander5, Sander van Berlo6, Nicole Freene1

 
 

1.     Health Research Institute, University of Canberra, Bruce, ACT 2617

2.     Research Institute for Sports and Exercise (UCRISE), Faculty of Health, University of Canberra, Bruce, ACT 2617

3.     National Capital Private Hospital, Garran, ACT 2605

4.     Calvary Public Hospital Bruce, Bruce, ACT 2617

5.     Canberra Health Services, Garran, ACT 2605,

6.     Onmi B.V., Torenallee 68-06, 5617BD, Eindhoven, The Netherlands

There is growing recognition specialist services are required to address presentations of fixation and lone-actor violence. Given the high prevalence of serious mental illness and psychosocial disadvantage, fixated threat assessment centres are jointly operated by policing and mental health services to reduce risk to community and improve outcomes for vulnerable people. Launched in 2020, the ACT FLAG is a collaboration between CHS and ACT Police and provides assessment and early intervention to people in the ACT.

 

This project evaluates the contribution of mental health to the joint model of the ACT FLAG including the frequency of clinician involvement in intervention, type of mental health intervention, and the change in level of concern over time for people referred to the ACT FLAG team.

 

Service use data from 2020 to 2023 (N=137), including the number and type of referrals, date of assessment, and intervention type were included for analysis. 

 

N=45 cases progressed to assessment, with 60% referred for fixation and 40% for lone-actor violence. A significant reduction in concern was found in 88% of cases. 28% of interventions were primarily mental health, and 53% were joint interventions with both police and mental health.

 

The findings indicate mental health intervention plays a significant role in the effective intervention within a multiagency risk management model used by the FLAG.

 

This multi-agency approach to healthcare and risk management is leading to a reduction in high-risk behaviours and promoting community safety while diverting vulnerable people from the justice system and into appropriate health care.