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Wantirna, Australia

Gururajan A.,Monash Institute of Pharmaceutical Sciences | Taylor D.A.,Eastern Health | Malone D.T.,Monash Institute of Pharmaceutical Sciences
Journal of Psychopharmacology

Recently, a novel paradigm has been designed to assess social investigative behaviour in pairs of Sprague-Dawley rats, which involves physical separation whilst ensuring they are able to maintain contact through other social cues. We have modified this set-up in order to assess not just social behaviour but also locomotor activity of the rats. Results showed that the MK-801- (0.3 mg/kg) treated rats displayed reduced social investigative behaviour, hyperactivity as well as reduced attention span. Pretreatment with the phytocannabinoid cannabidiol (3 mg/kg) not only normalised social investigative behaviour but increased it beyond control levels. Pretreatment with clozapine (1, 3 mg/kg) also normalised social investigative behaviour. Both cannabidiol and clozapine inhibited MK-801-induced hyperactivity. However, there were no effects of pretreatment on impairments to attention span. Our findings reinforce several aspects of the validity of the MK-801-induced model of social withdrawal and hyperactivity and also support the use of this novel set-up for further investigations to assess the antipsychotic potential of novel compounds. © The Author(s) 2012. Source

Yao W.,Eastern Health
Journal of applied clinical medical physics / American College of Medical Physics

We propose an approach to determining optimal beam weights in breast/chest wall IMRT treatment plans. The goal is to decrease breathing effect and to maximize skin dose if the skin is included in the target or, otherwise, to minimize the skin dose. Two points in the target are utilized to calculate the optimal weights. The optimal plan (i.e., the plan with optimal beam weights) consists of high energy unblocked beams, low energy unblocked beams, and IMRT beams. Six breast and five chest wall cases were retrospectively planned with this scheme in Eclipse, including one breast case where CTV was contoured by the physician. Compared with 3D CRT plans composed of unblocked and field-in-field beams, the optimal plans demonstrated comparable or better dose uniformity, homogeneity, and conformity to the target, especially at beam junction when supraclavicular nodes are involved. Compared with nonoptimal plans (i.e., plans with nonoptimized weights), the optimal plans had better dose distributions at shallow depths close to the skin, especially in cases where breathing effect was taken into account. This was verified with experiments using a MapCHECK device attached to a motion simulation table (to mimic motion caused by breathing). Source

Cognitive impairment presents unique clinical challenges in the management of older adults with cancer. With an ageing population, the recognition and management of cognitive impairment is likely to become more important in oncology practice. Currently, screening for cognitive impairment is not routinely performed in oncology. However, screening has been shown to detect cognitive deficits in a significant proportion of older adults with cancer. This can have a significant impact on treatment decisions, including determining suitability for cancer therapy and capacity to provide informed consent. In addition, cognitive impairment can enhance the risk of complications from cancer and its treatment. Early identification can facilitate appropriate decision-making and interventions to minimise its consequences. Further research is needed on recognition and management of cognitive impairment in older adults with cancer. This article provides an overview of cognitive impairment in older adults with cancer, with the aim of informing clinicians on the importance of assessing cognition. Source

Wallis J.A.,Eastern Health | Taylor N.F.,Allied Health Clinical Research Office | Taylor N.F.,La Trobe University
Osteoarthritis and Cartilage

Objective: To determine if pre-operative interventions for hip and knee osteoarthritis provide benefit before and after joint replacement. Method: Systematic review with meta-analysis of randomised controlled trials (RCTs) of pre-operative interventions for people with hip or knee osteoarthritis awaiting joint replacement surgery. Standardised mean differences (SMD) were calculated for pain, musculoskeletal impairment, activity limitation, quality of life, and health service utilisation (length of stay and discharge destination). The GRADE approach was used to determine the quality of the evidence. Results: Twenty-three RCTs involving 1461 participants awaiting hip or knee replacement surgery were identified. Meta-analysis provided moderate quality evidence that pre-operative exercise interventions for knee osteoarthritis reduced pain prior to knee replacement surgery (SMD (95% CI) = 0.43 [0.13, 0.73]). None of the other meta-analyses investigating pre-operative interventions for knee osteoarthritis demonstrated any effect. Meta-analyses provided low to moderate quality evidence that exercise interventions for hip osteoarthritis reduced pain (SMD (95% CI) = 0.52 [0.04, 1.01]) and improved activity (SMD (95% CI) = 0.47 [0.11, 0.83]) prior to hip replacement surgery. Meta-analyses provided low quality evidence that exercise with education programs improved activity after hip replacement with reduced time to reach functional milestones during hospital stay (e.g., SMD (95% CI) = 0.50 [0.10, 0.90] for first day walking). Conclusion: Low to moderate evidence from mostly small RCTs demonstrated that pre-operative interventions, particularly exercise, reduce pain for patients with hip and knee osteoarthritis prior to joint replacement, and exercise with education programs may improve activity after hip replacement. © 2011 Osteoarthritis Research Society International. Source

Zheng C.,Peter James Center | Lynch L.,Eastern Health | Taylor N.,La Trobe University

Background: Speech pathologists face the clinical obstacle of providing an intensive service for individuals with aphasia. Computer therapy potentially offers a solution to the dilemma of increasing therapy frequency while maintaining or reducing the load on therapists’ resources. Aims: This systematic review of the literature aimed to determine the effect of computer therapy both in comparison to no therapy and in comparison to clinician-delivered therapy in individuals with aphasia. Seventeen terms encompassing three main concepts (aphasia, technology, and rehabilitation) were used to search four electronic databases. Two reviewers independently screened titles and abstracts against inclusion/exclusion criteria. Data extraction for included studies was completed by one reviewer and confirmed by the second reviewer. Main Contribution: Seven studies were included, with six studies suitable for determining the effectiveness of computer therapy in comparison to no therapy, and three studies suitable for determining the effectiveness of computer therapy in comparison to clinician-delivered therapy. Two studies were suitable for answering both questions. The studies ranged in quality and were analysed descriptively. Meta-analysis was unable to be completed due to heterogeneity in methods, study types, computer programs, and outcome measures. All six studies investigating computer therapy in comparison to no therapy reported statistically significant improvements within the computer group. Five out of six studies reported statistically significant differences in language outcomes between the computer therapy and control group. All three studies comparing computer- and clinician-delivered therapy reported improvements in both the clinician and computer-delivered interventions with no statistically significant differences in language outcomes between the two treatment groups. One study reported no statistically significant differences in number of sessions needed to reach therapy criterion, whereas another reported an observed increase in the number of computer-delivered sessions over clinician-delivered sessions required to reach the therapy criterion for several treatment levels. Conclusions: This review provides evidence that computer therapy is effective when compared to no therapy and provides preliminary evidence that computer-delivered therapy may be as effective as clinician-delivered therapy for a specific population of individuals with aphasia. However, the quality of the evidence is low due to the small number of studies included. This review highlights the need for further research investigating the effectiveness of computer therapy in comparison to clinician-delivered therapy in a larger sample to enable the exploration of factors such as the type of aphasia and severity and the role of feedback and cueing hierarchies on treatment success. © 2014 Taylor & Francis. Source

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