2014 Gold Coast Health and Medical Research Conference One Health: Enhancing Research, Practice and Outcomes

4th - 5th December Mercure Gold Coast Resort, CARRARA,Gold Coast, Queensland, Australia

2014 Gold Coast Health and Medical Research Conference One Health: Enhancing Health, Practice and Outcomes As Co-Chairs of the 10th Annual Gold Coast Health and Medical Research Conference we welcome you to what has become the premier forum for health and medical research in south east Queensland. Originally an initiative of the Griffith Health Institute, the Gold Coast Health and Medical Research Conference has now grown to encompass colleagues from the Gold Coast University Hospital, Bond University, Southern Cross University and the Gold Coast Medical Association. This event has been designed not only as an opportunity to showcase the outstanding research undertaken by our colleagues but also to foster collaborations to improve health research, practice, and outcomes. New this year were two pre-conference workshops hosted by our partners, Bond University and Gold Coast University Hospital. We are also pleased to have the Gold Coast Medical Association join us once again to host a Friday morning breakfast session. At the inaugural conference held in December 2005 at the Royal Pines Resort, Gold Coast, 17 research seminars presented and the meeting attracted over 70 registered participants. Since then, the conference has grown to attract over 350 participants. The conference theme this year is: ‘One Health: Enhancing Research, Practice and Outcomes’, which will explore the many aspects of health care and medical research by bringing together a unique breadth of researchers spanning biomedical science, genetics, immunology, cancer, clinical, mental and population health with clinical practitioners working in the area of health. In common with all of our previous conferences, participants are encouraged to provide a conference abstract for publication in the conference proceedings volume. The conference will offer opportunities for academic, postdoctoral and postgraduate students and our external research partners to identify research synergies that will benefit from collaboration. The program for 2014 includes plenary lectures, symposium sessions, interactive slide sessions, workshops, a mentoring session and a poster presentation. As ever, we hope you will find the experience both intellectually stimulating and socially rewarding and help us demonstrate the true vitality of our fast developing research community. Chairpersons Dr Richard Newsham-West Dr Dean Pountney Griffith Health Institute Griffith Health Institute Organising Committee Members Professor David Shum (Griffith Health Institute), Professor Roger Hughes (Bond University), A/Professor Susan Brandis (Gold Coast University Hospital), Professor Susan Nancarrow (Southern Cross University), Dr Philip Morris (Gold Coast Medical Association), Professor Andrea Marshall (Gold Coast University Hospital), A/Professor Joss Du Toit (Griffith Health Institute), Professor Suzanne Chambers (Griffith Health Institute), A/Professor Lynn Briggs (Griffith University) Learne Brown, Kelly Whittington, Vivienne Hughes, Carina de Vries (Griffith Health Institute)

CH

AIR

’S W

ELC

OM

E

1

VEN

UE

LAYO

UT

2

Celebrating its 10th anniversary and with more partners onboard than ever before, the Gold Coast Health and Medical Research Conference brings together medical experts, clinical and community health professionals, health educators and leaders, researchers and PhD students from across South East Queensland. Delegates will be inspired by the latest research, learn more about innovative treatments and technologies, have the opportunity to foster new collaborations and together will strengthen the Gold Coast Health and Knowledge Precinct.

CO

NFE

REN

CE

PAR

TNER

S

3

Wednesday 3 December Pre-Conference Workshops (included in conference registration)

9 – 12.00

Evidence Based Practice Location: Princeton Room, Bond University

1.30 – 4.30

Getting Published Location: Gold Coast University Hospital, Pathology and Education Building, small lecture theatre, ground floor, room E.G.002

Individuals are asked to upload their presentation (with the AV support contacts located in the rooms) during the break

before their presentation takes place. This will help us ensure sessions keep to time.

Thursday 4 December Mercure Resort, Gold Coast

7.45 – 8.50 Registrations [coffee and tea on arrival] Posters to be displayed in The Club Room

Masters Ballroom 9.00 – 9.07 Opening Address

Prof Ned Pankhurst, Senior Deputy Vice Chancellor Griffith University 9.10 – 10.00

Keynote Speaker: Prof Peter Hunter, Professor of Engineering Science Director, Auckland Bioengineering Institute University of Auckland Computational Physiology: Connecting molecular systems biology with clinical medicine Chair: Prof David Lloyd

10.00 – 10.25 Morning break – The Links Pre-function area and The Club Room 10:30 – 11:20

Keynote Speaker: Prof Paul Glasziou, Professor of Evidence-Based Medicine, Bond University Innovations and Diffusion in Health Research Chair: Prof David Shum

4

11.25 – 12.15 Panel discussion: The trans-disciplinary approach to the role of translating health research

from various disciplines into health outcomes Facilitator: Prof Roger Hughes, Pro Vice Chancellor (Research), Bond University Panel members: Prof Michele Sterling, Associate Director of the Centre of National Research On Disability and Rehabilitation Medicine (CONROD) • A/Prof Julia Crilly, Associate Professor, Emergency Care Griffith University and GCHHS Department of Emergency Medicine • Prof Peter Hunter, Professor of Engineering Science Director, Auckland Bioengineering Institute University of Auckland • Prof Nigel McMillan, Director of Molecular Basis of Disease, Griffith Health Institute • Prof Paul Glasziou, Professor of Evidence-Based Medicine Bond University

12.15 – 1.15 Lunch – The Links Pre-function area or Chellos Restaurant Pinehurst Room

12.30 – 1.20 Higher Degree Research Lunch session Beyond Academia: Marketing your professional and research skills to industry, private enterprise, and government Chair: Prof Rod Barrett Presenter: Eliza Howard Graduate Education Officer, Griffith Graduate Research School Overview: More than half of all Higher Degree Research graduates (PhD/Doctoral, and Research Masters) will embark on careers outside academia and the University sector. Despite this, industry, private enterprise, and government, do not always have a sound understanding of the broader skills and experience obtained by research graduates. It is essential that HDRs know how to articulate and market their generic skills and professional capabilities to a non-academic audience. This workshop will help attendees to build a portfolio their own skills and capabilities, and how to articulate these attributes to a non-specialist audience.

Stream 1 Augusta Room

Stream 2 Doral Room

Stream 3 Pinehurst

1.30 – 2.30 8 mins/2 min Q&A/2 min change

Session 1 – Free session

Chair: Assoc Prof Susan Brandis

Session 2 – Musculoskeletal health and disease Chair: Prof Mark Forwood

Session - 3 Optimising health outcomes Chair: Prof Claire Rickard

1.32 – 1.40 Exploring primary caregivers’ expectations about the benefits and risks of treatment for acute respiratory

The effect of a single Parathyroid Hormone (PTH) injection on the healing of stress fractures

The effect of third trimester micronutrient supplements on gestational length of well women at term

5

infections in children and involvement in management decisions Mr Peter Coxeter

Dr Mahmoud M Bakr

Miss Janelle McAlpine

1.44 – 1.52 Patient perceptions of the role of nutrition for pressure injury prevention in hospital Miss Shelley Roberts

Using Digital Image Correlation to Examine in-vivo localised Achilles tendon strain Dr Michael Ryan

Pre-operative self-efficacy education for patients undergoing joint replacement surgery (POEt): A pilot randomised controlled trial Dr Rachel Walker

1.56 – 2.04 Patients’ perceptions of participation in nursing care on medical wards Miss Georgia Tobiano

Prevalence and predictors of lateral epicondylalgia 3-5 years after non-surgical management Dr Leanne Bisset

Dressing and securement devices for central venous access devices: a Cochrane systematic review Ms Amanda Ullman

2.08 – 2.16 Five Year Analysis of a Tailored Community Based Exercise Program for Patients with Symptomatic Heart Failure Dr Jerome Goldstein

Immediate effect of eccentric exercise on Achilles and gastrocnemii tendon strain Mr Steven J Obst

A classification tool (GC-CODES) to identify the underlying clinical indication for general anaesthetic at caesarean section Dr Jennie Connell

2.20 – 2.28 How paid peer support is conceptualised in non-government mental health services Ms Victoria Stewart

Subject-specific knee kinematics model using MRI informed parallel mechanism Mr Simao Brito da Luz

Radioprotection of Bone Allograft using Tocopherol and Ascorbic Acid Miss Athena Brunt

Stream 1 Augusta Room

Stream 2 Doral Room

Stream 3 Pinehurst

2.40 – 3.40 8 mins/2 min Q&A/2 min change

Session 4 – Mental and psychological well being Chair: Prof Bonnie Barber

Session 5 – Cancer Chair: Assoc Prof Donna Sellers

Session 6 – Population health Chair: Prof Helen Chenery

2.42 – 2.50 Midwife psycho-education for reducing childbirth fear: a randomised controlled trial Dr Jocelyn Toohill

Gemcitabine enhances release of ATP from bladder urothelial cells but is selectively cytotoxic to bladder cancer cell lines Ms Stefanie Farr

The prevalence of Attention Deficit Hyperactivity Disorder, a systematic review and meta-analysis: Has it changed and why it matters Dr Rae Thomas

2.54 – 3.02 Factors affecting childbirth self-efficacy in pregnant women

Over-expression of the prion protein (PrP) in cell lines derived from common cancers

The Religious and Socio-cultural Determinants of Papanicolaou Test

6

Prof Debra Creedy

Mrs Caroline Atkinson Screening: An Application of the Health

Beliefs Model Dr Luqman Jubair

3.06 – 3.14 A formal plan for self-disclosure enhances supported employment outcomes among young people with severe mental illness Mr Philip Lee Williams

Use of Rosemary Leaves Aqueous Extract as Protection against Acute Doxorubicin-Induced Cardiotoxicity in Mice Mrs Afraa Mamoori Jawad

Prevalence of incidental prostate cancer: a systematic review of autopsy studies Prof Paul Glasziou

3.18 – 3.26 Evaluation of a newly developed measure of Theory of Mind: The Virtual Assessment of Social Cognition Ms Allana Canty

Gene profiling based on cell proliferation reveals intratumoral heterogeneity in an orthotopic glioblastoma model Mr Berwini Endaya

Associations between obesity, dietary intake and socio-economic factors in Australian children Mrs Erin Pitt

3.30 – 3.38 Health services utilization of women following a traumatic birth Dr Erika Turkstra

Translating distress screening into cancer care: Phase 1 of an implementation case study at Gold Coast University Hospital Mrs Beth Crowe

Exploration of parents’ knowledge, beliefs, and perceptions of the evidence in relation to the management of acute otitis media Dr Malene Plejdrup Hansen

3.40 – 4.05 Afternoon tea The Links Pre-function area and The Club Room

Stream 1 Augusta Room

Stream 2 Doral Room

Stream 3 Pinehurst

4.10 – 5.10 8 mins/2 min Q&A/2 min change

Session 7 – Free session #2 Chair: Prof Keith Grimwood

Session 8 – Free session #3 Chair: Prof John Headrick

Session 9 – Lifestyle health Chair: Dr Lauren Ball

4.12 – 4.20

Preliminary evaluation of the The Bond Diabetes Intervention: a patient-directed group-based lifestyle modification program for the management of type 2 diabetes Miss Kate Odgers-Jewell

Improving the therapeutic treatment of respiratory virus infection via intravenous liposomal delivery of siRNA to the lung Dr Daniel Clarke

The effect of mixer type on alcohol pharmacokinetics following low dose alcohol consumption in females; a randomised cross-over trial Mr Peter Herzig

4.24 – 4.32 The transmission of HIV and STIs among female sex workers in Ba Ria – Vung

What do healthcare professionals know about antibiotic resistance? A systematic

Passive interventions in primary health care waiting rooms are effective at

7

Tau, Vietnam Mr Tri Nguyen

review Dr Amanda McCullough

promoting healthy lifestyle behaviours: an integrative review Ms Sarah Cass

4.36 – 4.44 Arterial line versus venous line administration of Low Molecular Weight Heparin, Enoxaparin for prevention of thrombosis in the extracorporeal blood circuit of patients on Haemodialysis or Haemodiafiltration – A randomised crossover trial Dr Balaji Hiremagalur

Gilbert’s Syndrome: a condition associated with reduced indices of platelet activation under normal and induced oxidative stress conditions Mr Avinash R.

Chronic Inflammation: The Role of Diet, BMI and Genetic Factors Dr Natalie Colson

4.48 – 4.56 The influence of text-messaging, eating and drinking on simulated driving Dr Chris Irwin

Trenbolone treatment improves body composition and cardiac tolerance to ischemia-reperfusion more effectively than testosterone treatment in animal models of obesity and hypogonadism Mr Daniel Donner

Explicit and implicit motives toward reducing pre-drinking in young undergraduate students Mr Jacob Keech

5.00 – 5.08 Systematic literature review and network analysis of triple therapy for the treatment of patients with type 2 diabetes Dr Martin Downes

Cardiac dysfunction and ischaemic intolerance in murine type II diabetes mellitus is reversed by sustained ligand-activated preconditioning Ms Louise See Hoe

Maternal betel-nut chewing and its association with preterm delivery Miss Heddi Rowais

5.20 – 6.20

Canapés over Poster Viewing Session The Links Pre-function area and The Club Room

Masters Ballroom 7.00 – M/N Refreshments sponsored by

Conference Dinner & Principle Awards (Griffith, GCUH, Bond, SCU) 2 course plated/alternate drop and 3 ½ hour beverage package (thereafter cash-bar is available) DJ Entertainment

8

Gold Coast Medical Association Breakfast Symposium Clinical Approaches to Pain Management Friday, 5 December 7.30am – 9.20am Augusta Room

The problem of pain causes great suffering for patients and is an enormous challenge for physicians. Diagnosis and management of acute and chronic non-cancer and cancer-related pain is a complex area. It is essential for clinicians to know the appropriate investigations and management techniques to be of maximum help to patients and to avoid iatrogenic analgesic dependence problems. Our breakfast symposium will approach the problem of pain from three directions: an overview of pain assessment and the approach to management of acute pain; the management of chronic pain and; the problem of iatrogenic analgesic dependence and methods of avoiding this. Our three speakers are expert clinicians in the field of pain management. This breakfast symposium will be of critical importance to physicians and other health professionals caring for patients suffering significant pain and will be of interest to pain researchers and students in the field. Chaired by Prof Philip Morris, we have three outstanding speakers and topics: 7.30 – 7.45 Breakfast/welcome

7.45 – 8.15 Dr Anthony Espinet

Management of post surgical abdominal pain

8.15 – 8.45 Dr Leigh Dotchin Neuropathic pain and spinal cord neuromodulation

8.45 – 9.15 Dr Tim Grice Shoulder and Knee Pain – What can be done about them

9.15 – 9.20 Event concludes

GC

MA

BR

EAK

FAST

SYM

POSI

UM

9

Friday 5 December Mercure Resort, Gold Coast All posters to be removed, except those shortlisted for a prize [they will be listed at the Registration desk]

Individuals are asked to upload their presentation (with the AV support contacts located in the rooms) during the break before their presentation takes place. This will help us ensure sessions keep to time.

From 7am GCMA Registration Stream 1

Augusta Room Gold Coast Medical Association Symposium Clinical approaches to pain management Chair: Prof Philip Morris, GCMA 7.30 – 7.45 Breakfast/welcome 7.45 – 8.15 Dr Anthony Espinet - Management of post surgical abdominal pain 8.15 – 8.45 Dr Leigh Dotchin – Neuropathic pain and spinal cord neuromodulation 8.45 – 9.15 Dr Tim Grice – Shoulder and knee pain – What can be done about them 9.15 – 9.20 Event concludes

Stream 2 Doral Room

8.00 – 9.20 8 mins/2 min Q&A/2 min change

Brain Health and Disease Symposium Chair: Dr Jo Lewohl

8.02 – 8.10 Exclusion of Alpha-Synuclein aggregates from Calbindin-D28K cells in the unilateral rotenone-lesioned mouse model of

10

Parkinson’s disease Mr Alex Rcom-H’Cheo-Gauthier

8.14 – 8.22 Alpha-Synuclein as an Extracellular Trigger of Neuroinflammation Dr Dean Pountney

8.26 – 8.34 Mechanisms of gene regulation in alcoholism: role of α-synuclein in the pathophysiology of alcohol abuse Miss Paulina Janeczek

8.38 – 8.46 Psychological mechanisms for improving cognitive function in cancer survivors: A randomised controlled trial Dr Heather Green

8.50 – 8.58 Simvastatin and atorvastatin decrease in vitro release of neuroinflammatory mediators in microglial-like differentiated THP-1 monocytes Ms Amelia McFarland

9.02 – 9.10 Finding new molecular targets for Parkinson’s Disease through gene hunting in Queensland families with inherited Parkinsonism Assoc Prof George Mellick

Stream 1 Augusta Room

Stream 2 Doral Room

3 minute podium/2 min Q&A/1 min change 9.30 – 10.30 Digital poster – session 1

Chair: Prof Andrea Marshall Digital poster - session 2 Chair: Assoc Prof Joss Du Toit

9.35 A Five Year Follow-up Study of a Pregnancy Domestic Violence Program to Promote Routine Enquiry during Pregnancy Dr Kathleen Baird

Functional Capacity Evaluations in the 21st Century Assoc Prof Ev Innes

9.41 Food Accuracy and Adequacy in Hospitalised Patients Requiring Special Diets Miss Annabel Larby

In vitro and in vivo activity of Melaleuca alternifolia Concentrate against West Nile Virus infection Miss Adriana Pliego-Zamora

9.47 WRist Acupressure for Post-operative nausea and vomiting: A pilot study Prof Marie Cooke

Ischemic tolerance and mitochondrial respiration in hearts targeted with the pharmacological blockade, mdivi-1, of mitochondrial fission protein Dynamin-related-protein-1 (Drp-1) Ms Lauren Wendt

9.53 Improving Compliance with Venous Thromboembolism Prophylaxis Dr Sophie Conroy

Characterization of mesothelioma cancer stem cells and their metabolic signature Mrs Elham Alizadeh Pasdar

9.59 Australian Dental Students' Knowledge of Oral Nutrition care and personal trainers: a website analysis

11

Manifestations of Common Systemic Conditions Dr Ava Carter

Miss Katelyn Barnes

10.05 Why physical activity matters for older adults and what it means for them? Ms Urska Arnautovska

Evaluation of an NBN enabled pilot of remote monitoring for older people using telehealth Ms Annie Banbury

10.11 Validity and reliability of a novel back extensor muscle strength test Miss Amy Harding

Massive chromophobe renal cell carcinoma presenting with an acute small bowel obstruction Dr Vaite Tsing

10.17 Simulated Immersive Learning Clinical Scenarios (SILCS) for Pharmacy Practice Education Ms Lyndsee Baumann-Birkbeck

Influence of SUMOylation Inhibitors on a Parkinson’s disease Cell Model Miss Shamini Vijayakumaran

10.23 Can the energy drink ingredient taurine, be a killer as well as a protector? Assoc Prof Gillian Renshaw

Joint kinematic calculation based on 3D gait analysis data: Standard clinical practices versus contemporary musculoskeletal approaches Mr Hans Kainz

10.29 Acute effect of exercise on Achilles tendon strain: A systematic review Ms Leila Nuri

Stream 3 Pinehurst

9.30 – 10.30 8 mins/2 min Q&A/2 min change

Session – 10 Health education Chair: Dr Ben Weeks

9.32 – 9.40 Do Cochrane summaries help student midwives understand the findings of Cochrane reviews? The BRIEF randomised trial Assoc Prof Elaine Beller

9.44 – 9.52 The role of simulation-based education for developing intercultural communication skills in allied health and nursing students Ms Georgina Neville

9.56 – 10.04 Unifying professions: Identifying common values in seven health professions Assoc Prof Sandra Grace

10.08 – 10.16 Participation in an inter-professional undergraduate clinical simulation workshop highlights communication skill differences and emphasizes the value of combining the student, patient and facilitator perspectives. Assoc Prof Helen Massa

10.20 – 10.28 Simulated Telemedicine Environment Project for Students (STEPS) Dr Monique Waite

12

10.30 – 10.55 Morning break – The Links Pre-function area and The Club Room

Masters Ballroom 10.55 – 11.00 Introduction of Keynote Speaker

Chair: Dr Marianne Von Au 11.00 – 11.50 (40 mins + 10 min Q&A)

Keynote Speaker Prof Michele Sterling, Associate Director of the Centre of National Research On Disability and Rehabilitation Medicine (CONROD) Physiological and psychological factors underlying musculoskeletal injury and pain Chair: Dr Marianne Von Au

12.00 – 1.00 Best of the Best (Top 5 selected podiums) Chair: Prof Iain Graham

1.00 – 1.30 Conference awards and close (lunch follows) Mr Ian Langdon – Chairman, Gold Coast Hospital and Health Board Poster Awards • Best Applied Science Poster Award Sponsored by Gold Coast Hospital Foundation • Best Biomedical Poster Award Sponsored by Research and Data Analysis Centre • Best Clinical Poster Award Sponsored by HESTA • Best Digital Poster Award Sponsored by HESTA

Oral or Digital Poster Awards • First Presentation at a peer reviewed conference Sponsored by HESTA • PhD/Hons Student Podium Award Sponsored by HESTA • Best Clinician Podium Award Sponsored by Griffith Health Clinics

Oral only Award • Best of the Best Award (oral) Sponsored by Griffith Enterprise

All Categories • People’s Choice Award Sponsored by Gold Coast Medical Typing

1.30 – 2.30 Lunch Pre-function area and The Club Room

13

14

2014 Gold Coast Health and Medical Research Conference One Health: Enhancing Health, Practice and Outcomes A message to our sponsors … Many thanks to all of our sponsors for their commitment and support towards the 2014 Gold Coast Health and Medical Research Conference. Conference sponsors are an invaluable part of our success. The support and funding they provide allow us to create the best conference and experience possible. Our sincere thanks Conference Organising Committee

SPO

NSO

RS

15

Did you know that as a medical professional, you may be eligible for an industry specific loan package? Ask us today. At Aussie Robina, we have a wealth of experience to help find you the home loan that's suits your needs from the hundreds available on our panel of lenders. Why spend weeks running around to dozens of lenders to get the best deal, when we can search home loans from up to 19 of Australia's leading lenders in just minutes. Whether it’s getting into your new home, refinancing an existing home, or starting your investment portfolio, our goal is to make the process as simple as possible for you. Call us to book your free appointment.

It’s Smart To Ask. Website: www.aussie.com.au/robina

Phone Number: 07 5575 8688 Email robina@aussie.com.au Address: Shop 23B, East T Centre,

Corner Christine Avenue & Scottsdale Drive, Robina QLD 4226

SPO

NSO

RS

16

At Cook Medical our mission is simple; we are dedicated to bold leadership in pioneering innovative medical solutions to enhance patient care worldwide. This puts us at the forefront of research and development and manufacturing by continuing to prioritise patients by revolutionising healthcare treatments that improve people’s quality of life every day. By collaborating with physicians from around the world, we aim to solve complex problems in simple ways by working harder to improve our minimally invasive medical devices and the way they are delivered. That means we're always trying to find a better, simpler, more efficient way to treat patients. In Australia, Cook Medical has gained a reputation as centre of excellence for aortic intervention and reproductive health products thanks to ground breaking Research & Development and exclusive product manufacturing. By Merging traditional areas of expertise in device technology with cutting edge therapies Cook Medical will maintain its position as a leader in healthcare today and for years to come. Website: www.cookmedical.com

Phone Number: 07 3841 1188 Address: 95 Brandl Street

Brisbane Technology Park Eight Mile Plains, QLD 4113

SPO

NSO

RS

17

• Innovative Design • Precise Planning • Cost Clarity Elite is the health care industry design, build and fitout expert. With 30 years experience, the Elite team understand how to create dream practice environments that are aesthetically alluring and exceedingly functional. An intensive consultative process and precise planning translates your vision on schedule and on budget ever time. Our project scope covers town planning, design, fitout, refit, retrofit and complete build. Elite can even assist you to find and develop the perfect property. At Elite we pride ourselves on our award –winning 4-Step Process, which ensures that for every project we take our clients through the steps that will guarantee we transform their vision and budget into their dream practice environment. Website: http://www.elitefitout.com.au

Phone Number: 07 5413 5600 Address: PO Box312

Buddina QLD 4575

SPO

NSO

RS

18

Genesis CancerCare Queensland is the leading provider of high quality, advanced radiotherapy services in the State, operating out of the John Flynn Hospital at Tugun, Premion Place at Southport, Wesley Medical Centre at Auchenflower, Chermside Medical Complex and the Nambour Medical precinct at the Sunshine Coast. In every aspect of its design and offering, Genesis CancerCare Queensland (formerly Premion), is built around providing immediate outpatient access, regardless of health insurance status to specialist radiation oncologists and diagnostic tests. Genesis CancerCare Queensland is proud of its track record offering rapid access to affordable radiotherapy treatment for all patients, publicly or privately referred. Our Centres offer:

• No wait • Rapid access for patients • Affordable radiation treatment • Patient drop off at the door • Free parking • Free courtesy bus (Gold Coast & Sunshine Coast) • Highly experienced local team of doctors & support staff • State of the art technologies • Standard application of modern treatment techniques, • including RapidArc, IMRT, IGRT & Brachytherapy • Queensland’s first TrueBeam™ linear accelerator

Website: www.genesiscancercareqld.com.au

Phone Number: 07 5552 1400

SPO

NSO

RS

19

Genesis SleepCare is a part of the Genesis Care organisation. Genesis Care provides services to patients with cardiovascular disease, cancer and sleep disorders. As a leader in sleep service provision, Genesis SleepCare is committed to improving outcomes and access for patients with sleep problems. Symptoms may include: Snoring Obstructive Sleep

Apnoea (OSA) Restless Leg

Syndrome Insomnia Poor memory &

concentration Other sleep

disturbances

Untreated OSA may contribute to the following disorders: Obesity High blood pressure Heart arrhythmias Stroke Coronary heart

disease Type 2 Diabetes High cholesterol

Sleep services: Overnight in-hospital

sleep studies Home sleep studies Respiratory & Sleep

Specialist Consulting Out-patient CPAP

services for the education and

Provision of CPAP equipment

Locations: Brisbane I Bundaberg I Darwin I Gladstone I Gold Coast I Hervey Bay I Mackay I Maryborough I Sunshine Coast I Toowoomba Website: www.genesissleepcare.com.au

Phone Number: 1800 155 225

SPO

NSO

RS

20

Gold Coast Business Events (GCBE), a division of Gold Coast Tourism Corporation, is the peak business events marketing body for Australia’s premier resort city. We have decades of experience in providing complimentary professional services to meeting organisers, conference planners and event managers from around the world. We’ve got the right people, with the right attitude to make your next event a resounding success. We love our city and have networked up an extensive contact list over the years. We specialise in creating and presenting compelling conference bids and can assist with research, sourcing quotes and hosting site inspections. We’ll provide you with everything you need to make an informed decision including proposed venues, suppliers, attractions and key activities. We can also help you enlist the support of government leaders, strategic partners and local industry suppliers. If you’re aware of a congress, conference, meeting, exhibition or event that has the potential to be held on the Gold Coast, we can help you make it happen. Typically the events in question are those held by local, national and international Associations and are more than likely specific to your particular industry or field of expertise. Putting your hand up to bid for an event may at first seem a bit daunting but we can assist with navigating the process for your bid to ensure you have the best possible chance of bringing your conference to the Gold Coast. Website: www.visitgoldcoast.com/business-events

Phone Number: 07 5592 2699 Email: businessevents@gctourism.com.au Address: Suite N301 Oracle North

12 Charles Street Broadbeach QLD 4218

SPO

NSO

RS

21

Healthy Loans provides specialised mortgage and finance broking advice to the Healthcare sector and allied industries and is accredited to obtain loans from over 20 lenders (including all of the major banks. We provide quality advice to our clients helping them choose a suitable loan that meets their objectives, and we get it approved for you. We do all the legwork for you saving you time. There is no charge for our services. The business was established by Andrew Spanner who has over 25 years in the banking industry including establishing and leading the Healthcare team for one of the major banks on the Gold Coast & Northern NSW markets. Andrew and his team provide professional advice to navigate through the hundreds of different products across a variety of banks. Because we specialise in the Healthcare sector we are in a position to negotiate with the banks to obtain discounted interest rates and fees, and policy concessions that are not generally available. Refinancing loans is one of our popular specialties where clients are wanting to get a better deal. Healthy Loans is unique in that we are just as comfortable in arranging a Home Loan as we are in doing Car Loans, Equipment Finance, Commercial Property Loans or Self-Managed Superannuation Fund loans. If you have never used a broker before don’t be concerned. Over 40% of new Home Loans in Australia are now originated by Brokers. We are licensed by ASIC to give credit advice, and are qualified as a Credit Adviser with MFAA who are the leading Industry Body. So come to our exhibition booth at the conference and meet Andrew and his team. Website: www.healthyloans.com.au

Owner: Andrew Spanner Phone Number: 0421 577 961 Email: andrew@healthyloans.com.au

SPO

NSO

RS

22

For more than 25 years, HESTA has focused on helping those in the health and community services sector reach their retirement goals. We now have more than 785,000 members, 155,000 employers and more than $29 billion in assets. HESTA’s size means we can offer many benefits to members and employers. These include: low fees, a fully portable account, easy administration, access to low-cost income protection and death insurance, limited financial advice (at no extra cost), super education sessions and transition to retirement options. We also provide access to great value health insurance, banking and financial planning. Website: www.hesta.com.au

Issued by H.E.S.T. Australia Limited ABN 66 006 818 695 AFSL No. 235249,Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321. For more information about HESTA, call 1800 813 327 or visit hesta.com.au for a copy of a Product Disclosure Statement which should be considered when making a decision about HESTA products.

Phone Number: 1800 813 327

SPO

NSO

RS

23

Risk Key Business Insurance [Aust] Pty Ltd is a successful family based Company specialising in tailoring Risk Protection for Professional & Business Clients all over Australia. Collectively, Martin, Katrina & Paul have an outstanding record of over 55 years’ experience in the Financial Services Industry as Financial Planners specialising in Life Insurances. It is one of the leading Risk Protection Specialists in the Life Industry providing advice & strategies for:

Key Person Partnership Life Insurance Total & Permanent Disablement (Disability) Trauma (Critical Illnesses) Income Protection

We are there for you if you ever have to Claim on your Policies by helping with the correct paperwork & liaising with the Life Insurance Company to have your Claim paid promptly.

Phone Number: 07 5532 8876 Email: riskkeybusiness@bigpond.com Address Unit 4, 4 Wain Avenue

Ashmore, QLD 4214

SPO

NSO

RS

24

Peter J Hunter FRS, FRSNZ, MNZM Professor of Engineering Science Director, Auckland Bioengineering Institute, University of Auckland, New Zealand Biography Prof Hunter completed an engineering degree in 1971 in Theoretical and Applied Mechanics (now Engineering Science) at the University of Auckland, New Zealand, a Master of Engineering degree in 1972 (Auckland) on solving the equations of arterial blood flow and a DPhil (PhD) in Physiology at the University of Oxford in 1975 on finite element modeling of ventricular mechanics. His major research interests since then have been modelling many aspects of the human body using specially developed computational algorithms and an anatomically and biophysically based approach which incorporates detailed anatomical and microstructural measurements and material properties into the continuum models. The interrelated electrical, mechanical and biochemical functions of the heart, for example, have been modelled in the first ‘physiome’ model of an organ. As the recent co-Chair of the Physiome Committee of the International Union of Physiological Sciences (IUPS) he has been helping to lead the international Physiome Project which aims to develop model and data encoding standards (CellML, FieldML, BioSignalML) and to use computational methods for understanding the integrated physiological function of the body in terms of the structure and function of tissues, cells and proteins. He is currently a Professor of Engineering Science and Director of the Bioengineering Institute at the University of Auckland, co-Director of Computational Physiology at Oxford University and holds honorary or visiting Professorships at a number of Universities around the world. He is on the scientific advisory boards of a number of Research Institutes in Europe, the US and the Asia-Pacific region. He is an elected Fellow of the Royal Society (London and NZ), the World Council for Biomechanics, the American Institute for

Medical and Biological Engineering, and the International Academy of Medical & Biological Engineering (IAMBE). He has recently been President of the Physiological Society of New Zealand and is currently Secretary-General of the World Council for Biomechanics, Acting Vice-President of IUPS and Chair-Elect of IAMBE. Recent awards are the Rutherford medal and the KEA (Kiwi Expats Abroad) ‘World Class NZ’ Award in Research, Science, Technology & Academia category. Computational Physiology: Connecting molecular systems biology with clinical medicine Hunter, P. Auckland Bioengineering Institute, the University of Auckland, New Zealand Multi-scale models of organs and organ systems are being developed under the umbrella of the Physiome Project of the International Union of Physiological Sciences (IUPS) and the Virtual Physiological Human (VPH) project of the European Commission. These computational physiology models deal with multiple physical processes (coupled tissue mechanics, electrical activity, fluid flow, etc) and multiple spatial and temporal scales. They are intended both to help understand physiological function and to provide a basis for diagnosing and treating pathologies in a clinical setting. A long term goal of the project is to use computational modeling to analyze integrative biological function in terms of underlying structure and molecular mechanisms. It is also establishing web-accessible physiological databases dealing with model-related data at the cell, tissue, organ and organ system levels1. The talk will describe the current state of the standards, databases and software being developed to support robust and reproducible multi-scale models, and the progress being made towards their clinical application. These standards include CellML2 and FieldML3 for encoding models and BioSignalML for encoding time-varying signal data, together with model repositories and software tools for creating, visualizing and executing the models based on these standards. Recent work has focussed on the semantic annotation of physiological models in order to link parameters and variables in the models with bioinformatic databases5 and electronic health records.

25

References 1. Hunter PJ, Borg TK. Integration from proteins to

organs: The Physiome Project. Nature Reviews Molecular and Cell Biology. 4, 237-243, 2003.

2. Lloyd CM, Halstead MD, Nielsen PF. CellML: its future, present and past. Progress in Biophysics and Molecular Biology. 85(2-3):433-450, 2004.

3. Christie R et al. FieldML: concepts and implementation. Philosophical Transactions of the Royal Society (London), A367(1895):1869-1884, 2009.

4. de Bono B, Hunter PJ. Integrating knowledge representation and quantitative modelling in physiology. Biotechnology J. 7:958–972, 2012.

Professor Paul Glasziou PhD FRACGP Professor of Evidence-Based Medicine at Bond University and part-time General Practitioner Biography Professor Glasziou was the Director of the Centre for Evidence-Based Medicine in Oxford from 2003-2010. His key interests include identifying and removing the barriers to using high quality research in everyday clinical practice. Professor Glasziou has authored over 200 peer-reviewed journal articles – with a total of over 18,000 citations. His h-index is currently 57; 18 of these publications having been cited over 100 times. These research articles have appeared in key general medicine journals such as the BMJ (30), Lancet (8), JAMA (5), NEJM (3), Annals of Internal Medicine (3), PLOS Medicine (4) and the MJA (15), as well as a variety of specialist medical and methodological journals. He is the author of seven books related to evidence based practice: Systematic Reviews in Health Care, Decision Making in Health Care and Medicine: integrating evidence and values, An Evidence-Based Medicine Workbook, Clinical Thinking: Evidence, Communication and Decision-making,

Evidence-Based Medicine: How to Practice and Teach EBM, and Evidence-Based Medical Monitoring: Principles and Practice. He is the recipient of an NHRMC Australia Fellowship which he commenced at Bond University in July, 2010.

Innovations and Diffusion in Health Research Professor Paul Glasziou Centre for Research in Evidence-Based Practice, Bond University, Queensland The pace of change in medicine and medical services is accelerating. But not all change is improvement: much is passing fashion that wastes time and effort, and distracts from clinical care by competing for attention with the (rare) innovations that lead to real improvements. Hence differentiating fashion from true innovation is an essential skill in health care. While the growth of health care knowledge has great potential to improve patient care and health, finding the gold thread in the haystack is challenging. The volume of new information is vast, e.g., each day MEDLINE adds over 2,000 studies - including 3 new guidelines, 5 systematic reviews and 50 trials; and each week we describe at least 1 "new" disease. To better manage this wealth of information we need to: (i) identify which are the essential changes and which are fashions, and (ii) learn how to make that change happen, and stick. Numerous methods that have been tried to improve the diffusion of appropriate (and decrease the diffusion of inappropriate) innovations, but the pace of change seems to grow faster than our coping strategies adapt. While the “science” of both steps has improved over the past few decades, we still have no "magic bullets". This talk will illustrate some of the principles of innovation and improvement from health research and clinical practice in three areas: avoiding overdiagnosis and overtreatment, improving the clinical impact of services, and finally, reductions in waste in health research.

26

Professor Michele Sterling PhD,MPhty, BPhty, Grad Dip Manip Physio FACP Griffith Health Institute, Centre for National Research on Disability and Rehabilitation Medicine (CONROD) Biography Michele Sterling is Professor in the School of Allied Health, the Centre for Musculoskeletal Research and Associate Director of the Centre of National Research on Disability and Rehabilitation Medicine (CONROD), Griffith Health Institute, Griffith University. She holds a NHMRC Senior Research Fellowship, is a Musculoskeletal Physiotherapist and a Fellow of the Australian College of Physiotherapists. Michele leads the Rehabilitation (Medicine and Allied Health) program at CONROD. Her research focuses are 1) the biological and psychological factors underlying chronic pain development following minor injury; 2) the prediction of outcome following whiplash injury; 3) improving the timing and nature of interventions for musculoskeletal injury and pain and 4) translation of research findings to clinical practice. Michele has received over $13M in competitive research funding and has published over 100 papers and two books in the areas of whiplash injury and musculoskeletal pain. She is a member of the Editorial Board of PLos One and is Associate Editor of the European Journal of Physiotherapy. Michele is Chair of the Scientific Committee of the Australian Pain Society and is a past member of the Scientific Committee of the International Association for the Study of Pain. Physiological and psychological factors underlying musculoskeletal injury and pain Introduction /Aim: Musculoskeletal pain conditions are second only to cancer as a cause of disease burden in Australia. Non-hospitalized musculoskeletal injuries from road traffic crashes are associated with total costs of almost $1billion

per annum, which exceeds the combined costs of spinal cord and traumatic brain injury. Treatments usually demonstrate only modest effects and there is a high propensity for musculoskeletal injury to develop into a chronic pain condition. For this reason processes associated with non-recovery are of international interest such that more effective treatments may be developed. Methods: The results of several recent cohort studies and randomized controlled trials will be presented. Results: The results of these studies provide evidence that disturbed nociceptive processing (both sensitization and ineffective pain inhibition) are associated with poor recovery in a variety of injury models. Some data suggest that these factors may pre-exist in individuals prior to injury leaving them vulnerable to both initial and subsequent pain and disability. Psychological factors including pain castrophising, posttraumatic stress symptoms, fear of movement and recovery expectations are also predictive of poor health outcomes in musculoskeletal conditions. Some of these factors are also associated with non-responsiveness to current treatment approaches. Relationships between the physiological and psychological processes have been demonstrated. Conclusion: Health outcomes associated with musculoskeletal pain and injury are poor with treatments only modestly effective. Greater understanding of the processes underlying these conditions are essential if inroads into the associated burden are to be made.

27

A Over-expression of the prion protein (PrP) in cell lines derived from common cancers Atkinson, C.1, Munn, AL.1, Wiegmans, A.2, Khanna, KK2, Wei, MQ.1

1Griffith Health Institute and School of Medical Science, Griffith University, Gold Coast, Australia 2 QIMR Berghofer Medical Research Institute, Brisbane, Australia Introduction/Aim: The prion protein (PrP), is a cellular protein of unknown function. While the misfolded form of this protein, prion protein scrapie (PrPSc), is renowned for its role as the causative agent of a number of human and other animal neurodegenerative diseases, the potential role of PrP in cancer development and progression is becoming increasingly more significant. Previous research has demonstrated PrP over-expression in cancers such as gastric, pancreatic, breast and drug-resistant forms of breast and gastric cancer (whether in a misfolded or normal form is unknown). To further elucidate this role, this study aimed to determine the level of protein expression and the mRNA levels of the PrP gene in a number of human cell lines isolated from a broader range of common cancers and compared the expression with non-cancerous cell lines. Furthermore, we compared PrP expression in a breast cancer metastatic series ranging from non-metastatic to highly metastatic. Methods: Cancer cell lines used throughout this study include: A431 (skin); A549 (lung); HT29, SW620 and T84 (colorectal); DU145, PC3 and ALVA (prostate), MDA-MB-231 metastatic series (breast) and non-cancerous controls: MCF10a (breast), 293T (embryonic kidney). SDS-PAGE and western blot methods were employed to determine protein expression. Quantitative real-time polymerase chain reaction was used to determine mRNA levels of the PrP gene (PRNP). Results: PrP expression significantly increases in numerous cancer types including prostate, skin, colon and breast cancers, and appears to vary according to metastatic potential. Furthermore, we demonstrate here a significant difference in PrP expression among breast cancer cell lines with increasing metastatic potential. While PRNP mRNA levels increase with increasing metastatic potential, total PrP protein levels decrease suggesting degradation, export or loss of immunoreactivity (e.g. due to misfolding) of PrP. Conclusion: These results indicate a potential role of PrP in cancer development and metastasis that must be further examined to determine the exact mechanism of its involvement.

___

B The effect of a single Parathyroid Hormone (PTH) injection on the healing of stress fractures. Mahmoud M Bakr1,2, Wendy L Kelly1, Athena Brunt1,Gemma Diessel1, Ward L Massey2, Helen Massa1, Nigel A Morrison1 and Mark R Forwood1. 1 School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia. 2 School of Medical Sciences, Griffith University, Gold Coast, QLD, Australia. Introduction /Aim: Stress, or fatigue, fractures (Sfx), occur as a result of repetitive non-traumatic cyclic loading [1]. They are common in professional athletes, soldiers and dancers, and repair via a process of direct remodelling. Anti-inflammatory drugs (NSAIDs), commonly used in SFx patients, retard SFx healing, as do bisphosphonates (BPs)[1, 2]. Parathyroid hormone (PTH) has an anabolic effect that can accelerate bone remodelling and counteract effects of BP. Therefore, our aim was to investigate the short-term effect of a single PTH injection on the healing of SFx. Methods: Forty female wistar rats 300 g were allocated to PTH and vehicle (VEH) groups. 24 hours after Sfx, PTH group received a single dose of hPTH-(1-34) peptide (Sigma-Aldrich) (8 μg/100g) dissolved in 0.9% saline with 1% rat heat-inactivated serum. SFx was created in the right ulna of both groups using cyclic end-loading. We used the ulnar SFx model, allowing scrutiny of focal remodeling with a known time course and precise anatomical location. Both groups had an ulnar stress fracture induced in a single session (Figures 1 & 2). Ulnae of half of the groups were harvested two weeks after loading, the other half were harvested six weeks after loading. All ulnae were dissected, processed for histology and stained with Toluidine blue (Figure 3) and TRAP for osteoclasts count (Figure 4). Histomorphometry was conducted using OsteomeasureTM. Results: There were no differences between groups for cortical area, woven bone area or length of fracture. There was a trend for increased SFx porosity (resorption), erosion and area of new bone formation in PTH groups; but significantly increased osteoclast number when compared to the VEH group (P<0.01). Conclusion: These data provide evidence that a single PTH injection, 24 hours after SFx initiation, results in active changes in dynamics of bone remodelling that may accelerate healing. Additional data is now required to demonstrate the long-term effect on healing time, and potential for daily PTH injections on the healing of SFx.

___

28

Do Cochrane summaries help student midwives understand the findings of Cochrane reviews? The BRIEF randomised trial Alderdice F1, Lasserson T, McNeill J, Beller E4, Carroll M, Hundley V, Sunderland J, Devane D, Noyes J, Key S, Norris S, Wyn-Davies J, Clarke M 4 Centre for Research in Evidence-Based Practice, Bond University Introduction/Aim: Abstracts and plain language summaries (PLS) are often the only part of systematic review reports read. It is important to identify how they aid understanding, and the role of elements such as the authors’ conclusions. We assessed whether (a) the abstract or the PLS of a Cochrane Review is a better aid for midwifery students, and (b) whether inclusion of conclusions helps understanding of results. Methods: 813 midwifery students were recruited to this 2x2 factorial trial (abstract v PLS, conclusions v no conclusions). They were randomly allocated to one of four groups and asked to recall knowledge after reading summaries of two Cochrane Reviews, one with clear, and one with ambiguous findings. For both reviews they were given either the abstract with conclusions, the abstract without conclusions, the PLS with conclusions or the PLS without conclusions. The primary outcome was the proportion who gave the correct response concerning the main result of the review. Results: There was no statistically significant difference in correct response between Abstract and PLS groups in the clear findings review (abstract: 59.6%; PLS: 64.2%; risk difference 4.6%; CI -0.2 to 11.3) or the ambiguous findings review (42.7%; 39.3%; -3.4%; -10.1 to 3.4). There was no significant difference between conclusions and no conclusions groups in the review with clear findings (conclusions: 63.3%; no conclusions: 60.5%; 2.8%; -3.9 to 9.5) but a small, significant difference in the ambiguous findings case (44.7%; 37.3%; 7.3%; 0.6 to 14.1 p=0.03). There was no significant interaction between summary type (abstract or PLS) and whether conclusions were provided. Conclusion: Cochrane Review abstracts with and without conclusions generated similar results. PLS with conclusions gave similar results to abstracts with and without conclusions, but removing the conclusion from a PLS of a review with ambiguous findings led to more problems with interpretation. Student midwives had difficulty interpreting the results of systematic reviews, even those with clear findings.

___

Prevalence and predictors of lateral epicondylalgia 3-5 years after non-surgical management Coombes, B.1, Bisset, L.2, Vicenzino, B.1 1 School of Rehabilitation Sciences, University of Queensland, St Lucia, Australia 2 Griffith Health Institute, Griffith University, Gold Coast Campus, Australia Aim: To determine the prevalence and predictors of lateral epicondylalgia (LE) 3-5 years after enrolment in a placebo-blinded, randomised controlled trial. Methods: LE symptoms during the preceding 3 month census period were surveyed using an online questionnaire sent out to 163 participants with unilateral LE, 3-5 years after being randomised to one of four interventions: placebo injection, placebo injection plus manual therapy/exercise (physiotherapy); corticosteroid injection; or corticosteroid injection plus physiotherapy. Odds ratios and 95% CI predicting LE status were estimated using univariate and multivariate linear regression adjusted for treatment. Results: The survey response rate was 82% (134/163). The prevalence of LE in the studied elbow during the 3-month surveillance period was 20% (27/134). Participants with higher baseline pain and disability (OR1.1; 95% CI 1.0, 1.1) and those assigned to corticosteroid injection plus physiotherapy (OR 4.0; 1.0, 14.9) were significantly more likely to report LE. The mean Patient Rated Tennis Elbow Evaluation score in the LE prevalent subgroup was 15.5 (SD 16.6). Pain and disability was significantly higher than respective scores at one year (P=0.02). Most did not utilise additional healthcare. Five percent (7/134) reported bilateral LE, 3% (4/134) reported shoulder, elbow and hand pain, whereas none reported neck and arm pain. Conclusions: Patients with a minimum PRTEE score of 56 are at greater risk of persistent or recurrent LE. One in five individuals with LE experienced symptoms after a median of 3.9 years, far longer than is generally recognised. Late symptoms of LE may not be noticed by medical practitioners as frequently individuals self-manage their pain and do not return for further treatment.

___

29

Subject-specific knee kinematics model using MRI informed parallel mechanism

1Simao Brito da Luz, 1Luca Modenese, 1Peter Mills, 1Belinda Beck, 2Nicola Sancisi and 1David Lloyd

1Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, QLD 2DIEM, University of Bologna, Italy Introduction/Aims: Subject-specific neuromusculoskeletal (NMSK) computer simulation models can estimate muscle and joint articular forces, enabling the identification of factors causing joint disease or injury [1]. NMSK models include representations of joint kinematics. Musculoskeletal software, OpenSim [2], uses simplified 2D sagittal plane knee models scaled generically for each subject using motion analysis markers. NMSK models with scaled generic knee kinematics produce less accurate estimates of measured knee articular forces compared to those with subject-specific kinematic models [3]. Passive tibia-femoral, TF and patella-femoral, PF kinematics measured in cadavers can be well predicted using a 3D subject-specific TF and PF model [4, 5]. Using TF flexion angle as input, TF and PF models estimate tibia’s and patella’s remaining displacements relative to the femur. This study aimed to use MRI of in vivo knees to construct TF and PF models, based on [4, 5]. We compared the resulting kinematics with those from cadaveric studies. Methods: Fourteen participants were MRI scanned, with axial and sagittal slices collected. Bone coordinate frames and models inputs were created, fitting spheres to the femoral and tibial condyles. Two spheres were fitted to the femoral trochlea with their centers defining the PF hinge axis. Ligament attachment points were selected from attachment surfaces. From 0° to 90° flexion angles the kinematics of the unknown 11 DOF from both TF and PF models were determined by minimizing the length change of ligaments and the length change between spheres’ centers. Geometric optimization was performed to avoid singularities and best match the patterns of cadaveric results. Results: Both TF and PF well approximated the cadaveric data. TF correlation values were 0.87±0.07 abd-adduction, 0.88±0.01 int-ext rotation, 0.93±0.02 ant-posterior, 0.99±0.005 prox-distal and 0.67±0.33 med-lateral translations. PF correlation values were 0.99±0.0 flexion, 0.67±0.31 abd-adduction, -0.09±0.58 int-ext rotation, 0.99±0.006 ant-posterior, 0.99±0.004 prox-distal and 0±0.58 med-lateral translations. Conclusions: Differences in participants’ tissue geometry compared to cadavers may explain some of low correlations. Nevertheless, the overall good correlations indicate the models can

be used to reproduce subject-specific knee kinematics.

___

Radioprotection of Bone Allograft Using Tocopherol and Ascorbic Acid Brunt, A. R.1, Nguyen, H.1,2, Morgan, D. A. F.2,3, Forwood, M. R.1 1 School of Medical Science and the Griffith Health Institute, Griffith University, Gold Coast, Australia 2 The Queensland Bone and Skin Bank, Brisbane, Australia 3 The University of Queensland, Brisbane, Australia. Introduction/Aim: Despite advances in biomaterials, bone tissues remain necessary allograft materials in orthopaedics. In hip arthroplasty, allografts unite biologically, and achieve mechanical properties that provide good long-term clinical outcomes. Following total joint replacement, the strength of bone tissue used for structural allografts is a key factor in long-term success. Gamma irradiation is used to terminally sterilize bone allografts. Unfortunately, this negatively affects the mechanical properties of bone; and therefore the outcome of revision joint replacement surgery. Our aim was to determine if tocopherol (Vitamin E) and ascorbic acid (Vitamin C) can preserve mechanical properties of bone allograft during gamma irradiation. Methods: Ten femurs were collected from The Queensland Bone and Skin Bank (QBSB). Femurs were processed according to QBSB standard protocols. Each femur provided three cortical portions, which were each sectioned into 5 beams (40 x 4 x 2 mm) using a low speed saw. Cortical bone specimens were infused with a mixture of Vitamins E and C, and saline (controls), for 4 hours at room temperature. Processed and vitamin infused bone samples were equally grouped in five gamma irradiation doses: 0 kGy, 10 kGy, 15 kGy, 25 kGy, and 50 kGy, and irradiated under frozen conditions at Steritech, Narangba, Australia. Control specimens (0 kGy) remained in a freezer. Cortical bone specimens were mechanically tested for 3-point bending using an Instron 8722 servo-hydraulic material testing machine. Structural properties from load-displacement curves, were used to calculate material properties such as stress, strain, and toughness. Results: A dose-dependent reduction in toughness was observed in non-treated groups. We showed that cortical beams treated with antioxidants, Vitamins E and C, significantly improved toughness in comparison to non-treated groups. Cortical bone specimens treated with Vitamins E and C irradiated at lower gamma irradiation doses of 10 kGy and 15 kGy, had the same properties as fresh frozen bone allograft. Conclusion:

30

Our mechanical data provide evidence to support the use of antioxidants, Vitamins E and C, as a promising radioprotectant for bone allograft, to improve bone allograft mechanical performance. Improved quality of bone allograft will promote superior clinical outcomes for patients.

___

C Evaluation of a newly developed measure of Theory of Mind: The Virtual Assessment of Social Cognition Canty, A.1, Flemming, J.2, Neumann, D.1, & Shum, D. 1 1 Griffith Health Institute, Griffith University, Gold Coast, Australia 2 School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia Introduction /Aim: Recent research centered on the relationship between social cognition and social functioning has indicated that social cognition may be a valuable proximal treatment target for interventions aimed at improving functional outcomes in several clinical populations (e.g., schizophrenia, Horan et al., 2008; bipolar disorder, Kim et al., 2009). This is the first report on the validity and use of the multidimensional Virtual Assessment of Social Cognition (VASC) – to ecologically assess social cognitive abilities in healthy adult populations. Methods: The VASC consists of 12 video clips depicting a social drama imposed in an interactive virtual environment, with 42 multiple choice questions about the interactions. Participants also completed three existing measures of social cognition, the task emersion scale, a social functioning assessment and a battery of cognitive tests. Results: Responses from 62 community-dwelling participants indicated VASC scores were significantly correlated with other measures of social cognition. Significant correlations were also found between VASC scores and measures of interpersonal abilities. The VASC was also rated as significantly more immersive, reflective of everyday theory of mind processes, interesting and was afforded a higher recommendation than an existing computer-based theory of mind task (e.g., the Yoni Task). Further, the measure was found to have sound internal consistency and strong 4-week test-retest reliability. Conclusion: Results suggest that this measure has promise for use in clinical populations, but alternative versions may be needed before it can be used in pre-post or longitudinal designs.

___

Passive interventions in primary health care waiting rooms are effective at promoting healthy lifestyle behaviours: an integrative review Cass, S.1, 2, Ball, L.1, Leveritt, M.2 1 Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, Gold Coast, Australia 2 School of Human Movement Studies, University of Queensland, St Lucia, Australia Introduction/Aim: Facilitating healthy lifestyle behaviours is a global priority for health care systems. Approximately 90% of health care services provided in primary health care settings where waiting rooms have the potential to provide health promoting environments to support healthy lifestyle behaviours. The aim of this study was to undertake an integrative review to investigate the effectiveness of health related information provided in primary health care waiting rooms in promoting healthy lifestyle behaviours. Methods: The integrative review encompassed five phases: problem identification, literature search, data evaluation, data analysis and presentation of results. Quantitative, qualitative and mixed methods studies that explored the effectiveness of passive health related interventions in primary health care waiting rooms were included. Results: Of the 9,205 studies originally identified, 35 publications were included in the review. Findings from the 35 studies were grouped under four key themes: knowledge about a health condition or behaviour, attitudes and intentions towards a health condition or behaviour, health care use and interactions, and health-related behaviours. Overall, exposure to passive health related information provided in waiting rooms saw a positive effect on knowledge, attitudes and intentions, health care interactions and reported behaviours. However the quality assessment of these studies were variable. Conclusion: This study demonstrates that passive health related interventions in the primary health care setting are likely to be effective at promoting healthy lifestyle behaviours. Given the relative low cost involved in these passive interventions, implementation of similar initiatives in primary health care settings are warranted.

___

31

Improving the therapeutic treatment of respiratory virus infection via intravenous liposomal delivery of siRNA to the lung D. Clarke1, J. McCaskill2, K. Falconer3, K. Chappell4, P. Reading3, P. Young4, N. McMillan1 1 Griffith Health Institute, Griffith University, Southport, QLD, Australia 2 Diamantina Institute, University of Queensland, Buranda, QLD, Australia 3 Department of Microbiology and Immunology, The University of Melbourne, VIC, Australia 4 Australia Infectious Diseases Research Centre, University of Queensland, QLD, Australia Introduction/Aim: RNA interference is one of the fastest developing fields in biological science and has been demonstrated as a promising therapy for a wide range of viral infections. This highly specific suppression can be achieved by the introduction of short-interfering RNA (siRNA) into mammalian systems, resulting in the effective reduction of viral load. Unfortunately, this has been hindered by the lack of a good delivery system, which is especially the case in the treatment of respiratory diseases as increased fluid production and tissue remodeling during infection complicate the direct intranasal route of administration. Methods: We have developed a nanoparticle in vivo delivery system that should be highly efficient at delivering siRNA intravenously to both lung epithelial and endothelial cells, the target of most respiratory viral infections. Firstly, labeled nanoparticles were examined for their biodistribution and ability to deliver to the lung in mice after tail vein injection. Following this, nanoparticles containing siRNA targeting the P gene of respiratory syncytial virus (RSV) or the NP gene of influenza virus were administered intravenously to the mice and examined for therapeutic efficacy during respective virus infection. Results: Here we show that we were able to efficiently deliver siRNA to the cells of the lung by intravenous liposomal administration and that siRNA against RSV resulted in targeted knockdown with over an 80% reduction in RSV P gene expression in the lung. We also demonstrated similar findings during influenza virus infection with over a 90% decrease in viral titres seen in the lung following siRNA delivery by this method. Conclusion: Taken together, our approach overcomes the significant barriers seen with intranasal delivery of siRNA and classic antivirals during infection and is a significant advance in our ability to delivery siRNA overall. This work demonstrates an attractive alternate therapeutic delivery strategy for the treatment of acute respiratory viral diseases.

___

Chronic Inflammation: The Role of Diet, BMI and Genetic Factors Colson, NJ.1, Naug, HL.1, Schwarz L.1, Tucakovic, L1, Amiet B1, 1 Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: Chronic low-level inflammation has been associated with obesity, insulin resistance, cardiovascular disease, hypertension and abnormal lipid profiles. Both genetic and dietary factors appear to play a role with the standard western diet associated with the production of pro-inflammatory molecules, levels of which may also be influenced by genetic variation. The aim of the study was to examine if the inflammatory potential of the diet of healthy individuals interacted with genotypes of COMT Val158Met and MTHFR C677T to predict hs-CRP levels, a marker of inflammation. Methods: Fifty-three healthy volunteers were recruited for the study. Each volunteer completed a 3 day food diary, provided blood samples for biochemical and genetic analyses and underwent anthropometric testing to determine BMI. Participants were excluded if they took anti-inflammatory medication or were suffering from an infection. Dietary inflammation potential was calculated according to a published protocol. Results: Results showed that BMI was the strongest predictor of hs-CRP. As expected, obese individuals had higher hs-CRP levels, however surprisingly underweight individuals also had higher hs-CRP levels. Interestingly, we found that all individuals who were either underweight or obese had at least 1 copy of the COMT variant allele, and statistically significant higher dietary inflammatory potential and levels of hs-CRP compared to individuals within the normal or overweight BMI categories. In our regression model, we found that BMI, gender, inflammatory diet score and COMT variant genotype predicted 43% of hs-CRP levels. There was no influence of MTHFR genotypes. Conclusion: Inflammatory potential of the diet and COMT variant appears to influence hs-CRP levels in underweight and obese individuals.

___

32

A classification tool (GC-CODES) to identify the underlying clinical indication for general anaesthetic at caesarean section. Connell JE,1 Ellwood DA.2

1 Gold Coast University Hospital, Gold Coast, Queensland, Australia 2 Griffith University School of Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia Introduction/Aim: The Gold Coast University Hospital (GCUH) is undergoing rapid transition to a tertiary perinatal service. National benchmarking data has revealed a higher than expected rate of general anaesthetic (GA) use for caesarean section. Most healthcare outcomes favour a low overall GA caesarean rate. We aim to develop a classification tool to allow prospective identification of the underlying reason for the decision for GA. Methods: Local ethics approval was sought. Data were collected for the 3-year period from 1 August 2011 to 31 July 2014, for all women with a caesarean birth. A validation check to identify miscoded cases was performed using the paper birth register. Details of categorisation (1-4), time of birth and type(s) of anaesthetic were collected. For cases of GA caesarean, the patient medical record was reviewed. One of 4 classification codes was applied to each case: maternal request (GC-MREQ), anaesthetic indication due to medical or surgical risk (GC-ANAE), unsuccessful regional block (GC-UREG), and emergent fetal risk (GC-RISK). The observed to expected day-night frequency of the GC-RISK and CAT 1-3 GC-UREG caesareans was analysed for significance. Results: Within the study period there were 261 GA caesarean sections. A classification could be successfully assigned in 98%. Ambiguous or contradictory documentation precluded classification in 2%. In 5.3% of cases we identified more than one indication for GA. An antecedent principle was applied to assign a classification where this occurred. The overall rate of GA Caesarean has been >10% across the 3 years studied. No temporal association of significance was identified for any of the classified subgroups. Antenatal anaesthetic consultation occurred in only 50% of women who subsequently requested a GA. Conclusion: The GC-CODES tool performs well in classifying the underlying clinical rationale for choice of GA at caesarean. Prospective use of this tool is planned.

___

Improving Compliance with Venous Thromboembolism Prophylaxis Conroy, S.1 Mason, R.1 Sanmugarajah J.1 1. Medical Oncology Department, Gold Coast University Hospital, Queensland, Australia Introduction/Aim: Venous thromboembolism (VTE) is the largest preventable cause of death in hospitalised patients. Despite the fact that effective prophylactic measures have been readily available for decades, VTE continues to cause significant morbidity and mortality to the inpatient population. We aimed to assess compliance with VTE prophylactic measures on the oncology ward at the Gold Coast Hospital before and after re-education of staff. Methods: Medical records were reviewed for deep vein thrombosis (DVT) risk assessment, documentation of contraindication and prescription of prophylaxis for all patients admitted to the oncology ward in a two-month period prior to intervention (pre-intervention group). The findings of this audit were presented at multidisciplinary ward meetings and re-iteration of the importance of DVT prophylaxis was stressed. Further, nursing staff and pharmacists were encouraged to remind medical teams to perform DVT risk assessments. Following this, a similar audit was performed for a two-month period (post-intervention group). Results: Of the 259 patients in the pre-intervention group, less than half (42%) received a DVT risk assessment. A total of 71 patients (27%) received DVT prophylaxis during admission. 188 (73%) patients did not receive prophylaxis and of these 131 (70%) had active cancer, further increasing the DVT risk. Of patients who did not receive prophylaxis, 91 patients did not have a documented contraindication to prophylaxis. Of the 263 patients in the post-intervention group, 171 patients (65%) received DVT risk assessment. A total of 128 patients (49%) received prophylaxis, and after excluding patients with documented contraindications to prophylaxis this accounted for 74% of all patients. Conclusion: This audit has provided an opportunity for assessment of DVT prophylaxis on our ward, and the process of auditing in itself has increased compliance rates. Education at multidisciplinary meetings and working with nursing and allied health staff has improved DVT prophylaxis rates. This is an easy, less costly intervention to improve compliance, which can be practiced by most wards and hospitals.

___

33

Exploring primary caregivers’ expectations about the benefits and risks of treatment for acute respiratory infections in children and involvement in management decisions Coxeter, P.1, Hoffmann T.1, 2, Del Mar, C.1 1 Centre for Research in Evidence-Based Practice, Bond University, Gold Coast, Australia. 2 School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Australia. Introduction/Aim: Acute respiratory infections (ARIs) in children are common and the majority are prescribed and antibiotic. Overuse of antibiotics occurs despite strong evidence that antibiotics have limited benefit in common ARIs and that there are harms associated with their use, such as side-effects and the development of antibiotic resistance. One driver of inappropriate antibiotic prescription is patient/parental expectation of the need for antibiotics and the subsequent pressure felt by clinicians to meet this expectation. This study explores parents’ expectations of antibiotic benefits and harms for cough, sore throat or middle ear infection in children, and their preferred level of involvement in making shared decisions with their doctor. Methods: Computer-Assisted Telephone Interviews were conducted in an Australian representative sample of 401 primary caregivers of children 1 to ≤12 years of age, using a Random Digit Dialing of household landline telephones. Results: The majority of participants believed antibiotics can help for common ARIs, although many also believed that not using antibiotics, particularly for cough and sore throat, was an option. Most participants believed antibiotics can reduce the likelihood of illness-related complications. Participants consistently over-estimated the benefit of antibiotics on illness duration. Most (87%) believed there can be harms from antibiotic use in children with ARIs. Less than half (44%) of participants reported the final decision about whether to treat their child’s illness with antibiotics was made together with the doctor, and most (75%) reported wanting more involvement in future decisions about whether to use antibiotics for their child’s illness. Conclusion: Many parents believe antibiotics provide benefit for common ARIs in children and overestimate the benefits of antibiotic use on illness duration. Shared decision making, in which the evidence for antibiotic benefits and harms is communicated and enables parents to make an informed decision, should play a more prominent part in ARI consultations.

___

Factors affecting childbirth self-efficacy in pregnant women Creedy DK1,2, Schwartz L1, Toohill J1,2, Baird K1,2, Gamble J1,2 & Fenwick J1,2. 1 School of Nursing and Midwifery, Griffith University, Australia 2 Griffith Health Institute, Griffith University, Meadowbrook, Australia Introduction/Aim: Childbirth confidence is an indicator of women’s coping abilities during labour and birth. There are few Australian studies in this area. This paper presents socio-demographic, obstetric and psychological factors affecting self-efficacy in childbearing women and makes recommendations for practice. Methods: A secondary analyses of data collected for the BELIEF study (Birth Emotions – Looking to Improve Expectant Fear) was conducted. Women (n = 1410) were recruited during pregnancy (≤ 24 weeks gestation). Data included socio-demographic details; obstetric details including parity, birth preference, and pain; and standardised measures of CBSEI (Childbirth Self-efficacy Inventory), WDEQ-A (childbirth fear) and EPDS (depressive symptoms). Validity and reliability of CBSEI subscales were determined. Variables were tested against CBSEI first stage of labour sub-scales (outcome expectancy and self-efficacy expectancy) according to parity. Results: CBSEI total mean score was 443 (SD = 112.2) which is low compared to international studies. CBSEI, WDEQ, EPDS scores were highly correlated. Regardless of parity, women who reported low childbirth knowledge, preferred a caesarean section, and had high fear and depressive symptoms scores. There were no differences for nulliparous or multiparous women on outcome expectancy, but multiparous women had higher self-efficacy scores (p <.001). Multiparous women whose partner was unsupportive were more likely to report low self-efficacy expectancy (p <.05). Experiencing moderate pain in pregnancy was significantly associated with low self-efficacy expectancy in both parity groups, as well as low outcome expectancy in nulliparous women only. Conclusion: Few studies have investigated childbirth self-efficacy according to parity. Although multiparous women reported higher birth confidence than first time mothers, significant obstetric and psychological differences were found. Fear was the strongest predictor of low childbirth self-efficacy. Addressing women’s experiences of fear and pain through counselling and education may enhance self-efficacy for childbirth.

___

34

Translating distress screening into cancer care: Phase 1 of an implementation case study at Gold Coast University Hospital Sanmugarajah, J.1, Hyde, M. K. 2,3 , Crowe, B,1 Dunn, J., 2,3,4,5 Chambers, S. K.2,3,6,7 1 Gold Coast University Hospital, Medical Oncology, Gold Coast, Australia 2 Griffith Health Institute, Griffith University, Gold Coast, Australia 3 Cancer Council Queensland, Spring Hill, Australia 4 School of Public Health, Griffith University, Brisbane, Australia 5 School of Social Science, The University of Queensland, St Lucia, Australia 6 Health and Wellness Institute, Edith Cowan University, Perth, Australia 7 Centre for Clinical Research, University of Queensland, Herston, Australia Introduction/Aim: The diagnosis and treatment of cancer is accompanied by significant psychological distress. However, despite the existence of clinical practice guidelines for psychological care in oncology, this distress is often unrecognised and untreated. This presentation describes Phase 1 of a two-phase implementation case study to introduce routine screening for distress in cancer patients at Gold Coast University Hospital’s Medical Oncology unit using an internationally validated scale (Distress Thermometer) and referral to appropriate psychological care. Phase 1 obtained health professional’s perspectives on the proposed change; Phase 2 has yet to be conducted and will review pre- and post-implementation distress screening and referral rates. Methods: Medical Oncology staff (n = 4) were interviewed regarding their perspectives on current practice, benefits, barriers and facilitators of distress screening in the unit. A psychosocial care model for cancer patients was then developed and piloted in a small focus group with staff. Results: Thematic analysis of interview transcripts identified benefits (e.g., minimises risk), service gaps (e.g.,few cancer care co-ordinators), barriers (e.g., staff overwhelmed by referrals), and facilitators (e.g., integrate with current practice) of implementing distress screening. Results informed development of a psychosocial care model which integrated key staff roles; Distress Thermometer cut-off scores to prompt staff action; four critical decision rules to guide service use and referral; and core information and referral pathways for cancer patients identified as distressed in the unit. Additional Phase 1 outcomes included steps to enable direct referral to external supportive care services for cancer patients. The focus group identified aspects for further development including provision of distress

screening training for staff. Conclusion: Phase 1 identification of service gaps, barriers and facilitators and development of a psychosocial care model are critical steps to support implementation; pre-post review (Phase 2); and facilitate staff ownership and involvement in progressing this planned changed in practice.

___

D Trenbolone treatment improves body composition and cardiac tolerance to ischemia-reperfusion more effectively than testosterone treatment in animal models of obesity and hypogonadism Donner, D.G.1, Beck, B.1, Bulmer, A.B.1, Elliott, G.E.1, Du Toit, E.F. 1 Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: Correcting the hypogonadic phenotype with exogenous androgen treatment may prove to be preventative against obesity-related pathologies. However, testosterone replacement therapy is associated with additional metabolic perturbances due, in part, to its susceptibility to aromatization in the highly prevalent adipocytes of obese individuals. This study evaluated the effects of a novel selective androgen against classical testosterone replacement therapy in obese, hypogonadic rats. Methods: At 8 weeks of age, fifty male Wistar rats (300±30g) were fed either a standard rat chow (CTRL) or obesogenic diet (OGD). At 28 weeks of age, rats were randomly assorted into groups receiving either sham (OGD) or orchiectomy procedures. At 32 weeks, orchiectomised rats were implanted with an osmotic infusion pump delivering either vehicle (45% w/v 2β-hydroxypropyl cyclodextrin in water, ORX), or either 1mg/day testosterone (TEST) or trenbolone (TREN). Comprehensive physiological assessments were carried out to evaluate body composition, insulin sensitivity and cardiac tolerance to an ischemia-reperfusion event (45 min LAD coronary ligature, 120 min reperfusion). Results: The obesogenic diet increased visceral and subcutaneous adiposity and, absent of insulin resistance, reduced cardiac infarct size in OGD animals (19.64±1.16 vs. 25.91±1.65 % AAR in CTRL, p<0.05). Cardiac infarct size increased in response to orchiectomy (ORX: 41.23±1.38%, p<0.001). Both treatments effectively reduced infarct size (p<0.001) however TREN’s effect was greater (17.49±1.45 vs. 23.27±0.89 % in TEST, p<0.05). Although no differences in body weights were observed, fat mass percentage was greater in ORX animals (45.9±1.6,

35

p<0.05) but was not associated with insulin insensitivity (p>0.05). Although both treatments improved body composition, TREN was more effective at: 1) reducing adiposity; and 2) improving lean mass, compared to TEST. Conclusion: Trenbolone treatment improved body composition and cardiac tolerance to ischemia-reperfusion more significantly than testosterone treatment in obese, hypogonadic rats.

___

Systematic literature review and network analysis of triple therapy for the treatment of patients with type 2 diabetes Downes, MJ. 1, Bettington, E.1 Turkstra, E.1 1 Center for Applied Health Economics, Griffith Health Institute, Griffith University, Logan, Australia Introduction/Aim: Many type 2 diabetes patients require triple therapy in order to maintain glycaemic control (HbA1c) and balance adverse events as the disease progresses. The purpose of the systematic review was to evaluate the evidence available for triple therapy regimens. Methods: A systematic search of MEDLINE and Cochrane Library (2002- March 2014) was carried out. Randomized control trials were identified and relevant data were extracted. Network meta-analyses were conducted to compare efficacy at 6 months (HbA1c, body weight, hypoglycaemia) between the different treatments. Results: The literature search identified 20 trials with type 2 diabetes patients receiving triple therapy. The majority of trials were 24-26 weeks of duration. The following combinations were included in the analysis: Metformin (MET) + sulfonylureas (SU); MET+SU+ dipeptidyl peptidase 4 inhibitors (DPP-4-i); MET+SU+ thiazolidinediones (TZD); MET+SU+ Glucagon-like peptide-1 receptor agonists (GLP-1-RA); MET+SU+ insulins (INS); MET+SU+TZD; MET+TZD+DPP-4-i; and MET+SU+ sodium/glucose cotransporter 2 inhibitors (SGLT2-i). All triple therapies, which included MET+SU, were statistically superior to MET+SU in reducing HbA1c, with a reduction of 0.7-1.1%. MET+TZD+DPP-4-i was not statistically different at reducing HbA1c compared to MET+SU. Further, there were no clinical relevant differences between the included triple therapies. When used in combination with MET+SU, SGLT2-i and GLP-1-RA were superior to DPP-4-i, INS and TZDs in reducing body weight. INS was superior in reducing body weight compared to TZDs, and there were no differences between DPP-4-I, INS or TZDs. TZD and insulin in combination with MET+SU increased the odds of hypoglycaemia when compared to MET+SU. MET+SU+GLP-1-RA reduced the odds of

hypoglycaemia compared to MET+SU+INS. Conclusion: Overall, triple therapy results in improved short-term glycaemic control, compared to MET + SU dual therapy, with variable results on body weight and hypoglycaemia. Care is needed to select the correct regimen to ensure a balance between, HbA1c control, body weight regulation and limiting adverse events.

___

E Gene profiling based on cell proliferation reveals intratumoral heterogeneity in an orthotopic glioblastoma model Endaya, B.B.1, Lam, Y.P.2, Neuzil, J.1 1 School of Medical Science, Griffith Health Institute, Griffith University, Gold Coast, QLD, Australia 4222 2 Laboratory of Cancer Gene Therapy, Cellular and Molecular Research Division, Humprey Oei Institute of Cancer Research, National Cancer Centre of Singapore, Singapore Introduction/Aim: The leading causes of death from glioblastoma (GBM) is tumour invasion by the highly infiltrative, actively ‘proliferating’ tumour cells as well as post-treatment tumour recurrence arising from the chemoresistant/radioresistant tumour cells residing in the ‘non-proliferating’ tumour subfraction. Our aim is to establish a profiling method that will simultaneously characterise the gene expression of both tumour subfractions to determine differences that could help resolve intra-tumoral heterogeneity, a major obstacle in GBM therapy. Methods: In vitro GBM cells and tumour cells derived from an orthotopic model were bisected into ‘proliferating’ and ‘non-proliferating’ subfractions sorted based on the incorporation of the proliferation marker 5-ethynyl-2’-deoxyuridine into actively replicating cells. The tumour subfractions were subsequently analysed for a number of transcripts. Results: While we did not find any significant difference in the gene profiles between the two cellular subsets in vitro, we demonstrate ~2-6 fold increase in transcripts of cancer and neuronal stem cell markers and genes involved in tumour cell migration/invasion and ~2-fold decrease in transcripts of markers of hypoxia and their target genes in the proliferating tumor cells of the orthotopic GBM model when compared to their non-proliferating counterparts. Conclusion: This study establishes a novel profiling approach that allows for differential studies to dissect intra-tumoral heterogeneity based on proliferative capacity, providing a platform for elucidating the unique biology of individual tumours, with consequences for treatment design.

36

F Gemcitabine enhances release of ATP from bladder urothelial cells but is selectively cytotoxic to bladder cancer cell lines Farr, S1, McDermott, C1, Chess-William, R1. 1 Faculty of Health Science and Medicine, Bond University1, Gold Coast QLD Introduction/Aim: Intravesical chemotherapy for bladder cancer limits systemic absorption of cytotoxic drugs, but significant local urological side effects including dysuria and urgency still occur. No studies have investigated the potency of cytotoxic therapies on normal urothelial cells, which changes to may be responsible for the reported side effects. During bladder filling the normal urothelium releases mediators (ATP, acetylcholine, PGE2) which activate sensory nerves, but intravesical treatment with cytotoxic drugs may possibly disrupt this process. This study compared the toxicity of gemcitabine in cultured bladder urothelial cell lines (cancer versus non-cancer cells), and investigated drug induced changes in basal and stretch-induced release of urothelial mediators. Methods: The human urothelial bladder cancer cell lines RT4 and T24, and non-cancer UROtsa urothelial cells were treated with gemcitabine. Cell viability was measured 72 hours post-treatment using resazurin reduction assay. Basal and stretch-induced release (using hypotonic solution) of mediators was measured from urothelial cells post-gemcitabine treatment. Results: A concentration-dependent reduction in cell survival was seen 72 hours post-gemcitabine treatment. The potency of gemcitabine on cancer cells was approximately 100,000 fold greater than its potency on non-cancer urothelial cells (p<0.001). In urothelial cells treated with 4mg/mL gemcitabine, basal ATP release was significantly increased compared to control (16.4±2.5nM to 6.0±0.7nM, n=8-13, p<0.05). Levels of basal and stimulated acetylcholine and prostaglandin E2 release from urothelial cells were unchanged after incubation with gemcitabine. Conclusion: Gemcitabine was selectively toxic to malignant urothelial cells with comparison to the normal urothelial cells, although the mechanism of this currently unknown. The increased release of urothelial ATP after incubation with gemcitabine may contribute to the urinary urgency and pain experienced by patients after intravesical treatment with this cytotoxic drug.

___

G Prevalence of incidental prostate cancer: A systematic review of autopsy studies Bell K1, Del Mar C1, Wright G1, Dickinson J2, Glasziou P1. 1 Health Sciences & Medicine, Bond University, Robina, Australia 2 Department of Primary Care,University of Calgary, Canada. Introduction/Aim: Prostate cancer screening may detect non-progressive cancers, leading to over-diagnosis and over-treatment. The potential for over-diagnosis can be assessed from the reservoir of prostate cancer, for example, from autopsy studies that report incidental prostate cancer rates in men who died of other causes. We aimed to estimate the mean, and age-specific, cancer prevalence from all published autopsy studies. Methods: We identified eligible studies by: searches of Medline and Embase, forward and backward citation searches, and contacting authors. We screened the titles and abstracts of all articles; checked the full text articles for eligibility; and extracted clinical and pathology data using standardized forms. We extracted: mean cancer prevalence, decade specific cancer prevalence, and validity measures, then pooled data from all studies using logistic regression models. Results: The 29 studies included in the review dated from 1948 to 2013. Latent cancer was detected in all populations, with no obvious time trends in prevalence. Prostate cancer prevalence increased with each decade of age, OR =1.7 (1.6 – 1.8) and with use of Gleason score, OR=2.0 (1.1 – 3.7). No other factors were significantly predictive. The estimated mean cancer prevalence increased in a non-linear fashion from 5% (95% CI 3 – 8%) to 59% (95% CI 48 – 71%) by age >80 years. There was substantial variation between populations in estimated cancer prevalence. Conclusion: There is a substantial reservoir of latent prostate cancer which increases with age. The high risk of over-diagnosis may limit the usefulness of prostate cancer screening.

___

37

Five Year Analysis of a Tailored Community Based Exercise Program for Patients with Symptomatic Heart Failure Goldstein JM.1, Jayasinghe R.2, 3, Sabaratnam M.4 1 Cardiology Department, Gold Coast University Hospital, Queensland, Australia

2 Cardiology Department, Gold Coast University Hospital, Queensland, Australia 3 School of Medicine, Griffith University, Queensland, Australia 4 Chronic Disease and Post Acute Assessment Programs, Gold Coast Hospital & Health Service, Queensland, Australia Introduction /Aim: Exercise training in patients with symptomatic heart failure can help improve functional capacity. The benefits of exercise training in an older patient cohort are less clear. We hypothesised that the Gold Coast Community Heart Failure Exercise Program (GCC-HFEP) has led to improvements in the functional status of patients attending the program. Methods: 197 patients were recruited. Functional capacity was measured using the six minute walk test (6MWT), timed up and go test and grip strength before and after participation in the program. Quality of life was assessed with the Minnesota Living with Heart Failure (MLWHF) score. Results: From 2009 to 2014 197 patients participated in a mean 23 sessions (range 5 – 59 sessions). The cohort consisted predominantly of males (74%) with a mean age of 68 years (range 31 – 89 years). Sixty percent of patients had an ejection fraction of less than 40%. Upon completion of the program there was a 19% improvement in 6MWT (73 metres, 95% CI, 63 – 82 metres; p < .01) and a 23% improvement in performance of the timed up and go test (1.53 seconds, 95% CI, 1.30 – 1.74 seconds; p < .01). Grip strength improved in both hands (p < .01). Patients reported a statistically significant improvement in their quality of life as measured by the MLWHF score (mean difference 7.33, 95% CI 3.8 – 10.8, p < .01). Conclusion: Participation in the GCC-HFEP has led to clear benefits in patient functional status with an almost 20% increase in walking distance measured by the 6MWT. The demographic of this cohort represents patients within the broader community. Where possible all patients with symptoms of heart failure should have the opportunity to participate in a tailored exercise program.

___

Unifying professions: Identifying common values in seven health professions Grace, S.1, Innes, E.1, Joffe, B.1, East, L.2, Coutts, R.1, Nancarrow, S1. 1 Southern Cross University, Lismore, Australia 2 Deakin University, Geelong, Australia Introduction/Aim: This project arose from the need to develop an interprofessional assessment framework for undergraduate students completing shared clinical practice units. To achieve this, competencies that were common across a range of health professions were identified. This paper compares the competency frameworks of seven health professions (exercise physiology, nursing, occupational therapy, osteopathy, physiotherapy, podiatry and speech pathology) in order to identify common themes and values that could become the basis of a common assessment tool. Methods: We examined the most recent Australian professional competency frameworks for each of seven health professions. Team members used a constructivist grounded theory approach to identify key themes within each of the frameworks. The individual competencies for each profession were mapped against these themes, and then compared across professions. Finally, themes were examined until underlying values were identified and a higher order theoretical framework was developed. Results: We found that each profession reflected similar themes, however, the emphasis placed on each theme varied. Two overarching values emerged that encompassed these themes: 1) rights of the client (advocacy, safe, legal and ethical practice, person-centred care); and 2) capacity of the profession to serve the health care needs of clients (profession-specific expertise, effective communication, health promotion and illness prevention, primary health care, professionalism, reflective practice, evidence-based practice). Multidisciplinary practice represents the intersection of the rights of the client to receive the best available health care and the recognition of the individual contribution of each profession. Conclusion: In contrast to classical theories of professionalism that seek to differentiate the professions, our study demonstrates that the professions share a strong common framework. Indeed, rather than emphasising differences, the professions appear to embrace a common structure and understanding, based on common underpinning values. We propose that the recognition that all professions adhere to a common value base, and exploring professional similarities and differences from that value base, provides a unifying

38

framework for interprofessional cultures, as well as a professional code of conduct. This approach challenges the dominant paradigm in interdisciplinary thinking that distinguishes professions based on scope of practice.

___

Psychological mechanisms for improving cognitive function in cancer survivors: A randomised controlled trial Green, H.1, King, S. 1 1 Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: Several published studies of brief cognitive-behavioural interventions following non central nervous system malignancies have shown improvement in both subjective and objective cognitive functioning. This study aimed to (a) evaluate the previously successful ReCog intervention using a more rigorous research design and (b) further investigate potential psychological mechanisms of intervention effectiveness, namely cognitive self-efficacy and illness perceptions. Methods: Twenty-nine cancer survivors participated in a waitlist randomised controlled trial of ReCog. Assessments at pre-treatment, post-treatment and 3-month follow-up examined objective and subjective cognitive functioning, quality of life, distress, benefit finding, illness perceptions, and cognitive self-efficacy. A comparison group of 16 people without a history of cancer, matched to the intervention group for age, sex, and education, also participated. Results: Compared with waitlist and community groups, participating in the intervention was associated with significantly greater improvements in performance on visuospatial/constructional measures, delayed memory, and processing speed. The intervention group also showed significantly greater gains on subjective cognitive function, social quality of life, and cognitive self-efficacy as well as reduced distress. There was some evidence supporting illness perceptions as a mechanism of subjective changes associated with the intervention. Participants were highly satisfied with the intervention. Conclusion: Overall, these results provide support for the efficacy and feasibility of the ReCog group psychological intervention that targets cancer-related cognitive decline. The results also suggest that further attention to psychological mechanisms such as cognitive self-efficacy and illness perceptions could help in maximising effectiveness of psychological interventions with this population.

___

H Exploration of parents’ knowledge, beliefs, and perceptions of the evidence in relation to the management of acute otitis media Hansen, MP., Howlett, J., Del Mar, C., Hoffmann, T. Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, Robina, Australia Introduction/Aim: Up to 80% of children will have at least one episode of acute otitis media (AOM) by the time they are 3 years old. AOM is a common reason for antibiotic prescription, despite strong evidence that antibiotics provide minimal benefit, with most children recovering spontaneously within a few days. Several studies have demonstrated that patients (or parents’) expectations of antibiotics often influence general practitioners’ (GP) decision to prescribe antibiotics, but there has been little exploration about what parents understand about the evidence for antibiotic use for AOM. This study aimed to explore parents’ knowledge, beliefs and perceptions of the evidence about the management of AOM. Methods: Individual semi-structured interviews were conducted with 15 parents of children (aged ˂5 years old), who had presented to their GP with AOM in the last six months. Participants were recruited from 5 childcare centres and kindergartens. Interviews were audio-recorded, transcribed verbatim, and analysed thematically. Results: Most parents attended the GP primarily for the management of symptoms such as pain and fever. Others specifically wanted reassurance or were concerned about hearing loss. There was a general perception that antibiotics were the best and only way to treat an ear infection, although some participants mentioned pain relief medications or ‘no treatment’ as an option. A few participants were aware of the potential harms associated with antibiotic uses, however most reported wanting to use them anyway. Participants’ perceptions about the ‘best’ treatment were based on their experience and advice of the GP and others (such as their mother). Conclusion: There is discrepancy between parents’ understanding and expectations of AOM management and evidence-based recommendations. To help with making informed decisions, parents need to be provided with evidence-based information about the management options, including antibiotics benefits and harms.

___

39

The effect of mixer type on alcohol pharmacokinetics following low dose alcohol consumption in females; a randomised cross-over trial. Herzig, P.J. 1, Irwin C.1,2, Davey, A.K.3, Desbrow B.1,2. 1 School of Allied Health Sciences, Griffith University, Gold Coast, Australia. 2 Centre for Health Practice Innovation, Griffith University, Gold Coast, Australia 3 School of Pharmacy, Griffith University, Gold Coast, Australia Introduction/Aim: The risks associated with drink-driving have been well established. However, many individuals who consume low levels of alcohol subsequently choose to undertake complex tasks such as driving. Previous investigations suggest that alcoholic beverages containing a carbohydrate based mixer exhibit altered pharmacokinetics (PK) leading to lower blood concentrations than those containing an artificially sweetened mixer. The purpose of this study was to examine the PK of a small amount of alcohol combined with artificial sweetener or differing carbohydrate doses, compared to an unsweetened control beverage. Methods: Twelve healthy female participants completed a four-treatment randomised cross-over design investigation. Following an overnight fast, participants were provided an alcoholic drink (vodka and water) designed to raise breath alcohol concentration (BrAC) to ∼0.05% (324.1±22.6mL, 19.4±1.4g alcohol). Beverage treatments included a control beverage (CON), or the addition of either: aspartame (150mg), 15g white sugar (15gCHO) or 50g white sugar (50gCHO). Throughout the 3.5 h observation period duplicate BrACs and participants’ estimation of intoxication (BrACguess) were collected at regular intervals. Subjective ratings of feeling the effects of alcohol, willingness and ability to drive were also collected using visual analogue scales (VAS). Results: PK profiles (AUClast) of the CON, aspartame and 15gCHO treatments were significantly greater than the 50gCHO treatment (all p≤0.001). There was a significantly higher (p<0.001) peak BrAC (Cmax) during the CON (0.058±0.015%), aspartame (0.056±0.012%) and 15gCHO (0.052±0.009%) compared to the 50gCHO treatment (0.040±0.008%). No significant difference in Cmax was found between the aspartame and CON trials (p=0.457). Comparisons of the subjective measures of BrACguess and all VAS data were not different between treatments. Conclusion: A larger dose of simple carbohydrate appears to attenuate the PK exposure to a small amount of alcohol. Whilst PK differences exist, participants were

unable to discern these differences. Implications may include greater accident risk and law breaches if driving.

___

Arterial line versus venous line administration of Low Molecular Weight Heparin, Enoxaparin for prevention of thrombosis in the extracorporeal blood circuit of patients on Haemodialysis or Haemodiafiltration – A randomised crossover trial Jagadeesh Kurtkoti MBBS FRACP1, Bhadran Bose MBBS FRACP2, Balaji Hiremagalur MBBS FRACP1, Jing Sun PhD3, Tara Cochrane BMBS, FRACP, FRCPA1

1Gold Coast University Hospital, Southport, Queensland, Australia 2Nepean and Blue Mountains Hospital, Penrith, New South Wales, Australia 3Griffith Health Institute and School of Medicine, Griffith University, Queensland, Australia Address for Correspondence and Reprints Dr Jagadeesh Kurtkoti, Department of Renal medicine, Gold Coast University Hospital, Southport, QLD 4215, Tel: +61756874204, Fax: +61756874096. Email: Jagadeesh.Kurtkoti@health.qld.gov.au Introduction: The primary objective of this trial is to compare the Anti-factor Xa (AXa) level in the blood, a measure of Low molecular weight heparin (LMWH) effectiveness, after arterial administration (as per manufacturer’s recommendation) and venous line administration of equivalent doses for prevention of thrombosis in the extracorporeal blood circuit in patients on Haemodialysis or Haemodiafiltration using high-flux membrane. Methods: Eight patients on haemodialysis (HD) and eight on haemodiafiltration (HDF) were randomly assigned to receive arterial followed by venous line or venous followed by arterial line Enoxaparin. Patients underwent following sequence of treatments - Run in period (1 week), period 1 (Randomised to arterial or venous Enoxaparin for 2 weeks) and period 2 (Crossover of study arms for 2 weeks) and follow up for 2 weeks. The primary outcome measure was AXa blood level, 4 hours after enoxaparin administration, at the end of period 1 and period 2. The secondary outcome measures were manual compression time to stop bleeding from arteriovenous fistula, extracorporeal circuit clotting and systemic bleeding episodes. Results: The mean AXa blood level, 4 hour after venous circuit administration (0.57±0.20 (HD), 0.81±0.29 (HDF)) of Enoxaparin using chromogenic assay (Rotachrom®) was significantly greater than that after arterial administration of enoxaparin (0.38

40

±0.25 (HD), 0.39±0.14 (HDF) U/mL), (p < 0.001). No significant differences in bleeding or dialysis circuit thrombosis were noted between the two groups. Conclusion: In patients on hemodialysis or haemodiafiltration, venous line administration of Enoxaparin achieves greater 4 hour blood AXa level compared to arterial line administration of equivalent dose. There was no increase in major or minor bleeding episodes with venous line administration of Enoxaparin.

___

I The influence of text-messaging, eating and drinking on simulated driving Irwin, C.1, 2, Monement, S.2, Desbrow, B.1, 2 1 Griffith Health Institute, Griffith University, Gold Coast, Australia 2 School of Allied Health Sciences, Griffith University, Gold Coast, Australia Introduction/Aim: Driving is a complex task and distractions such as using a mobile phone are known to have a negative impact. Eating and drinking are other forms of distraction that have received less attention. The aim of this study was to determine the effects of a variety of distraction tasks (text-messaging, eating, drinking) on simulated driving. Methods: 28 healthy individuals (13 female) participated in a cross-over study involving 3 experimental trials. In each trial, participants completed a baseline drive (no distraction) before completing a second drive involving one of three different distraction tasks (drinking water, drinking water and eating a sandwich, drinking water and text-messaging). Outcome measures of driving consisted of standard deviation of lateral position (SDLP) and reaction time (RT) to critical events. Subjective ratings of difficulty in performing the drives were also collected. Results: Driving tasks involving texting and eating were associated with significant increases in SDLP compared to baseline (46.0±0.08 vs. 41.3±0.06cm and 44.8±0.10 vs. 41.6±0.07cm respectively), number of lane departures compared to baseline (10.9±7.8 vs. 7.6±7.1 and 9.4±7.5 vs. 7.1±7.0 respectively) and auditory RT compared to baseline (922±95 vs. 889±104ms and 933±101 vs. 901±103ms). No difference in SDLP (42.7±0.08 vs. 42.5±0.07cm), number of lane departures (7.6±7.7 vs. 7.0±6.8) or auditory RT (891±98 and 885±89ms) was observed in the drink only condition compared to baseline. No difference in RT to visual stimuli was observed between baseline and experimental drives for any of the conditions. Participants’ perceived the

drive involving texting to be most difficult despite similar magnitudes of impairment observed in the eating condition. Conclusion: Behaviours such as eating and texting whilst driving appear to negatively impact vehicle control and auditory RT. These findings may have direct implications for motorists who engage in these types of distracting behaviours behind the wheel and for the safety of other road users.

___

J Mechanisms of gene regulation in alcoholism: role of α-synuclein in the pathophysiology of alcohol abuse Janeczek, P.1, Dodd, P.R.2, Lewohl, J.M.1

1Griffith Health Institute, Griffith University, Gold Coast, Australia 2School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, Australia Introduction/Aim: Chronic alcohol abuse results in alterations in gene expression in brain regions susceptible to the neurotoxic effects of alcohol. α-Synuclein exists in a number of different splice-variants and its expression is influenced by genetic factors and microRNAs. Here we investigate the influence of ethanol on the expression of the variants in human alcoholic brain and an ethanol exposure cell-culture model. We also examine miRNA-mediated regulation of the variants and the influence of genetic variation on α-synuclein expression. Methods: Real-time PCR was used to measure α-synuclein splice-variant mRNA (SNCA-140, SNCA-112 and SNCA-115) levels. Comparisons were made between chronic and chronic-intermittent treatment with and without a withdrawal period to determine if the variants are differentially expressed in response to ethanol. Two transfection methods were used to investigate the miRNA-mediated regulation of α-synuclein. Several genetic variants were genotyped in a Caucasian population consisting of 125 controls and 115 alcoholics. Results: A significant decrease in expression levels of the SNCA-140 and SNCA-112 variants was observed in the prefrontal cortex of cirrhotic alcoholics compared with controls (P < 0.001, n = 12; P = 0.030, n = 12). An increase in expression of the SNCA-115 variant was seen in cirrhotic alcoholics compared to controls (P = 0.006, n = 12). Similarly, results show that the expression of SNCA-140 and SNCA-112 was down-regulated following chronic ethanol exposure in HEK293T cells with (P < 0.001, n = 16) and without withdrawal (P < 0.001, n = 8), whereas the expression of SNCA-115 was up-

41

regulated (P < 0.001, n = 16 and P < 0.001, n = 8). Conclusion: These findings suggest that ethanol may alter the expression of the α-synuclein variants differently. MiRNAs may regulate the expression of these variants and could be responsible for many of the gene expression changes that occur in the brain of chronic alcoholics.

___

The Religious and Socio-cultural Determinants of Papanicolaou Test Screening: An Application of the Health Beliefs Model Jubair, L.1, Sun, J. 2. 1 School of Medicine, Griffith University, Gold Coast, Australia 2 School of Medicine, Griffith University, Gold Coast, Australia Introduction/Aim: Cervical cancer is the third most common cancer affecting women worldwide. Human Papillomavirus infection (HPV) has been implicated in the etiology of the disease. Papanicolaou Test, which is performed by examining smears taken from the cervix, has proven effective in diagnosing HPV infection at an early stage. Unlike the developed countries, Pap screening attempts have largely failed in Iraq for unexplained reasons. The present study aimed to examine the association between the religious and socio-cultural barriers and Pap screening nonparticipation. The Health Beliefs Model (HBM) was utilized to examine the association between deficits in health beliefs and screening nonparticipation. Methods: A case-control study design was employed. Purposive sampling was performed to recruit 182 HPV infected women and 599 healthy women from three major hospitals in Baghdad, Iraq. The respondents were asked to fill a pretested and pre-piloted study questionnaire. Results: Descriptive analyses were conducted to describe study sample. As the study groups were not matched, chi-squared analysis was done to compare the difference between the two groups. Statistically different demographic variables were controlled as confounding factors in multivariate analysis. Logistic regression analysis revealed that the religious (OR: 0.82, 95% CI: 0.77, 0.88, p < 0.001) and socio-cultural barriers (OR: 0.93, 95% CI: 0.92, 0.95, p < 0.001) are associated with Pap screening nonparticipation. It also showed the deficits in health beliefs are associated with screening failure. MANCOVA results showed that the HPV infected women had higher perception of health beliefs and lower perception of the barriers as compared to healthy women. Conclusions: The present study provided an evidence that the religious and socio-cultural barriers

may be the reason behind Pap screening failure. The study reported poor knowledge about cervical cancer and Pap test among respondents. The deficits in health beliefs related to screening may be another reason for screening nonparticipation in Iraq.

___

K Explicit and implicit motives toward reducing pre-drinking in young undergraduate students Keech, J. J.1, Hamilton, K.1,2, Caudwell, K. M.2 & Hagger, M. S.2,1 1 School of Applied Psychology, Behavioural Basis of Health, Griffith Health Institute, Griffith University, Mount Gravatt, Australia 2 Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Australia Introduction/Aim: Alcohol is second only to tobacco as the leading cause of preventable drug-related death and hospitalisation in Australia. Alcohol consumption at risky levels is prevalent in young undergraduate students. In particular, pre-drinking (consuming alcohol prior to attending a subsequent event or licensed premises), due to its association with high-risk drinking, is a major social and public health issue. Interventions targeting excessive alcohol consumption have focused predominately on explicit motives, with mixed evidence regarding their efficacy. Decisions informing pre-drinking are most likely subject to a range of situational and motivational factors. We aimed to investigate explicit and implicit motives predicting students’ decisions to consume less alcohol during pre-drinking sessions based on a dual-systems model; the reflective/impulsive model (RIM). Methods: Undergraduate students (N = 359; 77.7% female; Mage = 20.19) completed online questionnaires comprising measures of explicit motives, behavioural intention, and past pre-drinking behaviour; followed by the Alcohol Identity Implicit Association Test. Four-weeks later, participants completed a follow-up measure of pre-drinking behaviour. Results: We found that higher levels of explicit autonomous motivation toward reducing alcohol consumption during pre-drinking sessions predicted significantly lower levels of alcohol consumption during pre-drinking sessions in the four-week follow-up period, mediated by intention to reduce consumption. Furthermore, Implicit Alcohol Identity predicted higher levels of alcohol consumption during pre-drinking sessions, independent of intention. All predictions remained significant, irrespective of past actions. Conclusion: Preliminary support for the

42

efficacy of the RIM in predicting reducing pre-drinking levels was found. It may be useful, then, for future research to consider both explicit and implicit systems in trying to understand better this risky drinking behaviour. Recent research suggests that autonomous motivation can be enhanced by fostering personal importance regarding a particular behaviour; and implicit associations appear malleable, with attempts to modify them proving successful. Practitioners developing interventions to curb pre-drinking may wish to consider such approaches.

___

Gilbert’s Syndrome: A condition associated with reduced indices of platelet activation under normal and induced oxidative stress conditions Avinash R. Kundur, Abishek B. Santhakumar, Andrew C. Bulmer and Indu Singh Heart Foundation Research Centre, Griffith Health Institute, Griffith University,Gold Coast, Queensland, Australia Introduction/Aim: Individuals with Gilbert’s syndrome (GS) expressing mild unconjugated hyperbilirubinemia (UCB), have a reduced risk of cardiovascular disease (CVD) due to increased antioxidant capacity. Oxidative stress induced platelet activation is central to the risk of developing thrombosis and CVD in conditions such as diabetes and obesity. Severe acute exercise in sedentary individuals induces significant oxidative stress, increasing platelet activation and aggregation, which is related to processes underpinning thrombosis and CVD. Here, we evaluate if elevated levels of UCB in GS can attenuate thrombotic risk factors in a model of normal and exercise induced oxidative stress. Methods: Blood samples, pre and post continuous aerobic exercise on a cycle ergometer (1 hour at 70% VO2Max (measure of individual’s maximal oxygen consumption)) were collected from matched GS and control. Platelet surface marker expression of PAC-1 (binds to GPIIb/IIIa surface receptor on activated platelets) and CD62P (binds to P-selectin released form activated platelets) was assessed using flow cytometry. Platelet aggregation using (ADP, collagen and arachidonic acid (AA)) and biochemistry profile were also evaluated. Results: A significant reduction in the expression of platelet surface marker P-selectin existed in GS versus control, pre and post exercise (P<0.001). Platelet aggregation induced by exogenous agonists AA and collagen were also significantly inhibited pre and post exercise in GS (P<0.01; P<0.04). Furthermore, significantly increased levels of UCB, HDL along with reduced levels of CRP and LDL pre exercise were found in GS when

compared with control. Conclusion: The results from this novel study indicate possible mechanisms whereby elevated bilirubin neutralizes platelet activation under normal and OS conditions in GS. Reduced P-selectin expression in addition to decreased AA and collagen induced platelet aggregation pre and post exercise signifies the potential of UCB related AOX capacity in inhibiting platelet activation, aggregation and granule release, thereby, reducing the risk of CVD under resting and OS conditions in GS.

___

M Use of Rosemary Leaves Aqueous Extract as Protection against Acute Doxorubicin-Induced Cardiotoxicity in Mice Afraa M. Jawad 1, Entisar Jawad Al Mukhtar2, Zena Hasan Sahib2, Hamid Naji 2, Vinod Gopalan1, Alfred KY Lam1. 1Cancer Molecular Pathology, Griffith Health Institute, Griffith University, Gold Coast. 2University of Babylon, College of Medicine, Iraq Introduction: Doxorubicin (DOX) is a potent anthracycline antibiotic widely used in the cancer chemotherapy to treat a wide variety of human malignancies. Cardiotoxicity has long been recognized as a complicating factor of DOX. There are several hypotheses to explain DOX cardiotoxicity, among these the free radical hypothesis which is the most thoroughly investigated. This study was designed to investigate the possible protective effect of aqueous extract of rosemary leaves against DOX-induced cardiotoxicity. Method: Twenty eight male Swiss Albino mice were randomly divided into four groups including group1 (negative control), treated with distill water (D.W), group 2 (positive control), treated with 15 mg/kg DOX as a single intraperitoneal (i.p) injection, groups 3 and 4 received 15mg/kg and 30mg/kg respectively of the aqueous extract of Rosmarinus officinalis leaves (ROE) orally (p.o), once daily for 2 weeks, then injected i.p with 15 mg/kg DOX. Two days after DOX or D.W (in control group) injection, animals in all groups were scarified and the levels of the cardiac biomarkers including serum creatine kinase (CK) and serum lactate dehydrogenase (LDH) were measured. Also the possible cardiac histopathological changes were investigated. Results: The administration of DOX (15 mg/kg i.p.) induced cardiomyopathy which manifested by significant elevation (p<0.001) in serum CK and LDH levels. In addition, cardiac histopathological sections showed moderate cytoplasm vacuolization

43

and inflammatory cells Infiltrate with vascular congestion. Oral administration of 30mg/kg ROE 2 weeks prior to DOX produced a significant protection which was evidenced by significant reduction (p<0.001) in CK and LDH levels. Moreover, histopathological sections showed only mild changes in comparison to DOX positive control group (p<0.01). Furthermore, Oral administration of 15mg/kg ROE 2 weeks prior to DOX showed no significant protection. Conclusion: Administration of 30mg/kg ROE protect against DOX-induced cardiotoxicity. This might serve as novel adjuvant therapy with DOX.

___

Participation in an inter-professional undergraduate clinical simulation workshop highlights communication skill differences and emphasizes the value of combining the student, patient and facilitator perspectives. Owen, S1., Massa, H1., Rose’Meyer, R1, Mitchell, C1., Shaw, J1. 1 Griffith Health Institute, Griffith University, Gold Coast, Australia Aim: To examine clinical reasoning and communication skills in undergraduate students encompassing four different health disciplines, including post-graduate Medicine and undergraduate Medical Science students preparing for Medicine. Methods: Health students (n=116) from Nursing, Health Science, and the Medicine programs volunteered for the workshop and participated in a low-fidelity clinical simulation workshop. Each consented to participate in inter-professional clinical simulation sessions; where each facilitated session included a theoretical case study, a group physiology and pharmacology tutorial, and a video-recorded, low-fidelity clinical experience, involving a simulated patient. Each student was assessed by a facilitator in real-time and post simulation by their patient. All students self-evaluated their own communication and clinical reasoning, skills and patient interaction, post-simulation. All participants contributed to a facilitated debriefing and reflection group discussion, post-simulation. After watching the video recording of their session, students received constructive feedback from the facilitator and subsequently completed a post-workshop evaluation. Results: The opportunity to apply theoretical knowledge in the clinical simulation, personal insights gained by each student on their communication, clinical reasoning and their collaboration with students from other programs were recognised and evalulated positively. Facilitator feedback identified that data gathering, interpretation of clinical findings and verbal reporting of findings to

their colleagues or patients challenged some students. Interestingly, students, who had self-identified prior experience with their profession and presented confidently to the patient, were assessed favourably by the patient. In contrast, clinical facilitator feedback identified significant communication deficits arising from student attitude during interaction with their patient. Strengths and limitations of the sessions were identified in the post-workshop evaluation but the sessions were a valuable learning experience for students and facilitators. Conclusion: In general, students’ clinical reasoning skills required further development, whilst the quality of professional communication skills varied by discipline group.

___

The effect of third trimester micronutrient supplements on gestational length of well women at term. McAlpine, J.1, 2 Vanderlelie, J.1, Perkins, A.1

1 School of Medical Science, Griffith Health Institute, Griffith University Gold Coast Campus, Southport QLD. 2 Department of Women’s and Newborn Health, Gold Coast University Hospital, Southport, QLD. Introduction/Aim: Normal labour is defined by the spontaneous onset of contractions between 37 and 42 weeks gestation. Pregnancy beyond 42 weeks is considered prolonged, a situation commonly associated with increased morbidity and mortality to both mother and fetus, prompting medical management to minimise associated risk. A number of factors are known to contribute to initiation of parturition including maternal micronutrition; indeed the efficacy of key micronutrients in the management of pre-eclampsia and preterm birth is well known. However, research is yet to be conducted examining the influence of micronutrient supplements on parturition at term. Methods: The Environments for Healthy Living (EFHL) Study is a prospective longitudinal study conducted by Griffith University. This research used the existing EFHL and Queensland perinatal data collection, performing a retrospective analysis of this cohort and determining the relationship between third trimester micronutrient supplementation and the length of gestation of well woman at term. The final dataset comprised of 1257 well women birthing at the Gold Coast and Logan Hospitals at term; data pertaining to gestational length in relation to a number of demographic, obstetric, supplement and outcome variables was analysed using SPSS v20. Results: Women taking third trimester zinc, folic acid and iron supplements in combination with a multivitamin were found to have

44

experienced a mean gestation of up to 4.34 days longer (RC 0.119-0.134, p=0.008-0.039) than those who did not take a supplement (RC -0.132, 95% CI: -0.520, -0.039, p=0.023) when controlling for known confounders. Subsequently, women taking these supplement combinations were more likely to have experienced a post-dates gestation. Conclusion: Length of gestation demonstrates significant associations with micronutrient supplementation practices. Well women consuming third trimester micronutrient supplements in addition to multivitamins experienced a longer gestation at term compared to women taking no micronutrients. This resulted in a higher incidence of post-dates pregnancy in the supplemented group.

___

What do healthcare professionals know about antibiotic resistance? A systematic review. McCullough, AR.1, Parekh, S.2, Rathbone, J.1, Hoffmann, T.1, Del Mar, CB.1 1 Centre for Research in Evidence Based Practice, Bond University, Gold Coast, Australia 2 Center of National Research on Disability and Rehabilitation, Griffith Health Institute, Meadowbrook, Australia Introduction/Aim: Antibiotic resistance is a major global health threat. We sought to systematically determine healthcare professionals’ knowledge of and attitudes towards antibiotic resistance. Methods: We searched four databases from inception until July 2014 using relevant search terms and conducted forward and backward citation searches on included articles. We included quantitative studies in any language measuring healthcare professionals’ knowledge or attitudes to antibiotic resistance using fixed response questionnaires. We excluded studies with abstract-only data and those limited to knowledge or attitudes towards MRSA. Two reviewers independently screened titles and abstracts followed by full texts of relevant articles. Disagreements were resolved by a third reviewer. Data were extracted on study population, clinical setting and the proportion (%) of participants who answered affirmatively (agree/strongly agree or yes) to relevant fixed response questions and the mean (range) was calculated for related responses across studies. Results: Out of 37 included studies, 19 (51%) were conducted in hospital settings, 9 (24%) in primary care, 1 (3%) in both settings and 8 (22%) in universities. Participants included: medical practitioners 28 (76%) studies, nurses 6 (16%), pharmacists 5 (14%) and dentists 3 (8%). Most participants were aware that using too many

antibiotics (85% [9-100%]); using antibiotics for an inappropriate indication (81% [26-98%]); and using broad-spectrum antibiotics (89% [70-100%]); causes resistance. Nevertheless, 11 (30%) studies measuring attitudes towards antibiotic resistance at a practice, local, national or international level found that fewer participants (62% [22-93%]) thought that antibiotic resistance was a problem for their practice compared to the local (79% [63-93]), national (92% [65-100]) or international level (85% [69-97]). Conclusion: Healthcare professionals are aware that antibiotic use causes antibiotic resistance, but few perceive their own prescribing of antibiotics to be a contributor. Future research should explore how this perception relates to prescribing behavior, as target for future interventions.

___

Simvastatin and atorvastatin decrease in vitro release of neuroinflammatory mediators in microglial-like differentiated THP-1 monocytes McFarland, A.J.1, Davey, A.K.1, Arora, D.S.1, Grant, G.D.1, McDermott, C.M.2, Lewohl, J.M.3, Anoopkumar-Dukie, S.1

1School of Pharmacy, Griffith University, Gold Coast, Australia 2Department of Biomedical Science, Bond University, Gold Coast, Australia 3School of Medical Science, Griffith University, Gold Coast, Australia Introduction: Statins (HMG-CoA reductase inhibitors) are amongst the most commonly prescribed medications worldwide, and are indicated in the treatment of dyslipidaemia. Recently, concerns over possible negative cognitive effects of statins have increased, however mechanisms underlying these are unclear. As inflammatory markers are directly associated with deficits in cognitive function, identifying statins’ effects on neuroinflammation may help to better understand the effects of statins on cognition. Aim: This work looks to determine the inflammatory effects associated with statins using an in vitro model of neuroinflammation. Methods: PMA-differentiated THP-1 monocytes (dTHP-1) were employed as a validated model for surrogate microglia in vitro. Neuroinflammation was induced in dTHP-1 cells through 24 h treatment with 0-10 µM lipopolysaccharide from Escherichia coli (055:B5). The release of prostaglandin E2 (PGE2) and pro-inflammatory cytokines interleukin (IL)-1β and tumour necrosis factor (TNF)-α were quantified by ELISA. Nitric oxide (NO) and reactive oxygen species (ROS) production were determined fluorometrically using 4,5-diaminofluorescein diacetate (DAF-2 DA) and

45

dichlorodihydrofluorescein diacetate (DCFH-DA) respectively. To determine effects of statins in neuroinflammation in vitro, dTHP-1 cells were pretreated with simvastatin or atorvastatin (0-100 µM) prior to LPS treatment, and the same panel of neuroinflammatory mediators screened. Results: LPS treatment increased PGE2, IL-1β and TNF-α production in dTHP-1 cells in a dose-dependent manner. Exposure to either statin prior to LPS treatment reduced the LPS-induced increases in PGE2, IL-1β and TNF-α. Similarly, LPS-induced increases in ROS and NO production were attenuated by pre-treatment with both statins. Conclusion: These results suggest that the statin compounds simvastatin and atorvastatin reduce mediators of neuroinflammation in vitro. As neuroinflammation is a potential early intervention stage to prevent or treat cognitive dysfunction, it suggests that these compounds may have neuroprotective properties. Further studies are warranted to determine whether these findings are maintained in an in vivo system.

___

Finding new molecular targets for Parkinson’s Disease through gene hunting in Queensland families with inherited parkinsonism

George D.Mellick

Eskitits Institute for Drug Discovery Griffith University

Background: Parkinson’s disease (PD) is a complex, incurable, multifactorial neurological condition affecting 1% of people over 60 years of age. Once considered the archetypal non-genetic disease, the genetic basis for several forms of familial parkinsonism is now well established. Although rare, families with a clear pattern of inheritance can be studied to identify the abnormal gene variantthat results in the phenotype. This information has provided a good return for investment, revealingnew clues about the cause and identifying targets that may influence the neurodegenerative process in all people with the disease. We are currently investigating families with inherited Parkinsonism (multiple members with disease showing clear Mendelian patterns of inheritance) to identify genes of high penetrance responsible for the disease.Aim: To use the latest gene sequencing technologies to identify novel genes and molecular pathways involved in the cause of PD. These are likely targets for the development of disease biomarkers and neuroprotective therapies. Methods: Families with inherited Parkinsonism are recruited through the Queensland Parkinson’s Project, which is a collaborative research study cohort of over 4000 community dwelling patients with PD and controls

from Queensland, recruited since 2005. The index case in each family is screened for pathogenic mutations implicated in parkinsonism and related disorders including copy number variation analysis. We perform next generation exomesequencing in affected cousin pairs in suitable families to identify potentially functional variants that segregate with disease. True causal variants are confirmed through the genotyping of thousands of additional PD patients (including those from other mutli-incident families). Results: Of our>1500 PD patients,16% have an additional first-degree family member with PD. Fifty families have three or more affected members suitable for our analysis. To date we have identified causal genetic lesions in 14 families: 12 posses the common LRRK2 G2019S and two carry VPS35 D620N. Weare currently Exome sequencing members an additional 15 families (screened negative for known variants to reveal a short list of novel genetic variants in each family that segregate with disease. Conclusions: Finding new genes for familial parkinsonism is helping define a protein network required that, when perturbed, leads to PD. These discoveries provide the targets, mechanistic insights, biomarkers and models to assist in developing novel therapeutics.

___

N The role of simulation-based education for developing intercultural communication skills in allied health and nursing students Waite, M.1, Tuttle, N. 1, Neville, G. 2, Howells, S. 1, & Bialocerkowski, A.1 1 School of Allied Health Sciences, Griffith University, Gold Coast, Australia 2 School of Nursing and Midwifery, Griffith University, Gold Coast, Logan and Nathan, Australia Introduction/Aim: Core professional and communication skills, such as intercultural communication, are applicable across all health disciplines and therefore may be developed in an interprofessional learning environment. The aim of this study was to determine the effectiveness of an interprofessional intercultural communication workshop involving the use of simulated-based education. Methods: Ethical approval was granted for this study. A total of 138 students from the Griffith University Bachelor of Nursing (n= 41), Master of Physiotherapy (n= 67), and Master of Speech Pathology (n= 30) programs participated in the workshop. Prior to the workshop, students completed an interactive online learning module on cultural

46

awareness in healthcare. In the workshop, students worked in multidisciplinary groups of five or six, and participated in one and observed two simulated patient scenarios representing a range of cultures and clinical presentations. Students were invited to complete questionnaires prior to and immediately following the workshop. These were designed to measure students’ reaction to the learning activity, and perceived cultural competence and attitudes towards interprofessional learning. Results: Ninety-two students (68%) completed both pre- and post-workshop surveys. Intrinsic Motivation Inventory scores indicated moderate to high levels of interest, competence, tension, confidence and perceived usefulness for developing communication skills (means ranged from 4.0-5.7 on a seven-point scale). Comparison of pre- and post-workshop responses revealed significant improvements for items on the cultural competency questionnaire (p< .01, Wilcoxon Signed-Ranks Test), indicating improvements in attitudes, knowledge and comfort with working with patients from a different culture. Significant improvements in teamwork and collaboration (p = .001) and positive professional identity (p= .004) indicated a positive change in students’ attitudes towards working within the interprofessional learning environment. Conclusion: The results of this study demonstrate the potential simulation-based education delivered in an interprofessional context has for enhancing students’ exposure to and developing skills in working with individuals from other cultures and professions.

___

The transmission of HIV and STIs among female sex workers in Ba Ria – Vung Tau, Vietnam Tri Nguyen, Donald Stewart, Patricia lee. School of Medicine, Griffith University, Australia Introduction and aim: Female sex workers (FSWs) are at heightened risk of sexually transmitted infections (STIs) and HIV. The purpose of the research is to study the socio-demographic and behavioral characteristics and the HIV/STIs prevalence among FSWs in Ba Ria – Vung Tau, Vietnam. Methods: All 420 direct and indirect FSWs were sampled by using a cross-sectional survey. FSWs were examined, diagnosed and treated gynaecologically if required. All tests for syphilis, gonorrhoea, chlamydia and HIV were implemented in the study. Results: A total of 166 direct and 254 indirect FSWs participated in the survey. Their median age was 27 years within a range of 18 – 43 years. Education levels among FSWs were low. The median age of first sexual intercourse of the FSWs were 18

years. Most of the FSWs had oral sex (88.8%). A high proportion (82.4%) of the FSWs had consumed alcohol. Among them, 51.2% of the FSWs have had sex when they were drunk. Of the 177 FSWs have reported that they have had sex when they drunk, almost haft of direct FSWs have had unprotected sex. Among the 420 FSWs who participated in the survey, 2.6% (11/420) were found to be HIV positive. There was a difference in HIV prevalence among direct and indirect FSWs (4.8% and 1.2%, p=0,022). Nearly 7 percent of the FSWs were infected with Syphilis. Similarly, the percentage (7.9%) of the FSWs were found with Gonorrhoea and a doubly higher percentage (16.4%) of them were suffering from Chlamydia. On the aggregate, the percentage of FSWs with any one of the STIs (Gonorrhoea or Chlamydia) was highest 21.4%. Conclusion: The prevalence of HIV among the FSWs was 2.6% and the percentage of the FSWs were infected with Syphilis, Gonorrhoea and Chlamydia were found to be infected with 6.9%, 7.9% and 16.4%, respectively.

___

O Immediate effect of eccentric exercise on Achilles and gastrocnemii tendon strain Steven J. Obst1, Richard Newsham-West1, Rod S. Barrett1

1School of Allied Health Sciences and Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Australia Introduction: Mechanical loading of the Achilles tendon-aponeurosis during eccentric contractions could induce transient and regional changes in strain behaviour that could have important implications for tendon injury risk and rehabilitation. The aim of this study was to use freehand 3D ultrasound to examine the immediate effect of eccentric exercise on length and strain of the free Achilles tendon and gastrocnemii tendon-aponeurosis in vivo. Methods: Participants (n = 14) underwent two testing sessions in which tendon length and strain were measured using freehand 3D ultrasound at rest and during two isometric plantarflexion contractions immediately before and after either: 1) 3 15 single leg isolated eccentric heel drops; or 2) 10 min rest. Results: There was a significant time-by-session interaction for length and strain at each torque for the free Achilles tendon (P < 0.05), but not for MG or LG tendon-aponeurosis. Pairwise comparisons reveal a significant increase in free Achilles tendon length and strain post-exercise in the eccentric session only (P < 0.05). Conclusions: Adaptations of the Achilles

47

tendon-aponeurosis following eccentric heel drop exercise were localised to the free tendon. Increased compliance of the free tendon following eccentric exercise may temporarily increase the risk of injury during high strain activities, but enhance adaptation during low strain activities. These findings are important in the context of eccentric-based Achilles tendon rehabilitation, and highlight the value of examining regional strain behaviour of the Achilles tendon-aponeurosis following acute exercise.

___

Preliminary evaluation of the The Bond Diabetes Intervention: a patient-directed group-based lifestyle modification program for the management of type 2 diabetes. Odgers-Jewell, K.1, Isenring, E.1, Hughes, R.1, Leveritt, M.2

1 School of Health Sciences, Bond University, Robina, Australia 2 School of Human Movement Studies, University of Queensland, St Lucia, Australia Introduction: Diabetes is the fastest growing disease nationally and internationally, with one Australian being diagnosed every eight minutes (1). Diabetes is now the seventh leading cause of death in Australia (1). Group based education for type 2 diabetes patients has been recognized as a more cost effective intervention than individual education, due to the reduced time and funding required to educate numerous patients in one sitting (3). Group education programs offer many potential advantages over individual visits, with group programs allowing time for the provision of more detailed information, decreasing time demands on health workers already busy schedules, allowing the easy incorporation of families and carers, and facilitating patient support from others facing the same challenges (4). Aim: This study aimed to pilot and evaluate an unstructured, patient-directed group education program for type 2 diabetes management. Methods: Fifteen type 2 diabetes patients participated in two group education programs run at the local community centre. Both programs were unstructured and the areas of discussion were not predetermined, but instead originated from the participants. The groups met for two hours each week for a six week period and were facilitated by the first author (an Accredited Practicing Dietitian). Patients met with the first author on an individual basis in the week preceding the commencement of the group education program, where anthropometric data was obtained and four questionnaires were completed. These measures were repeated on the final day of the program. Results: Preliminary results indicate

improvements in weight and waist measurements, as well as improvements in quality of life, nutrition knowledge, diabetes knowledge, and diabetes self-efficacy. Focusing on a patient-centered approach with patient directed discussions allowed patients to explore the questions and issues directly affecting them instead of covering a broad range of topics that they may not be interested in. Conclusion: The results of this study indicate that unstructured, patient-directed group education programs can improve type 2 diabetes patient outcomes. Group interactions and a patient-centered approach may have a greater impact on patient outcomes than other group program attributes in the group-based management of type 2 diabetes.

___

P Associations between obesity, dietary intake and socio-economic factors in Australian children Pitt E1, Cameron C1, Thornton L2, Gallegos D3 and Comans C1. 1 Griffith Health Institute, Griffith University, Logan, Australia 2 Centre for Physical Activity and Nutrition, Deakin University, Melbourne, Australia 3 School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia Introduction/Aim: Previous research indicates the quality of Australian children’s diets falls well below national guidelines. There is also limited Australian research on nutrition and diet in childhood, particularly around dietary patterns of children under the age of 5 years. This research aims to identify patterns of dietary intake in children at 3 years of age and to investigate associations between early childhood dietary patterns and both demographic and socio-economic indicators. Methods: Cross-sectional analysis of 1,536 three-year old South East Qld and Northern NSW children from the Environments for Healthy Living (EFHL) project. Logistic regression analysis was used to explore associations between dietary intake and socio-economic factors. Key indicators of dietary intake investigated include consumption of fruit, vegetables, pre-prepared foods, take-away foods, sugary snacks, juice, added sugar and milk. Results: Mothers who have a TAFE certificate or apprenticeship were 60% more likely to have children who consumed vegetables compared to mothers who did not complete high school. Consumption of fruit and 1 serve of milk or more were also significant positive predictors of consuming

48

vegetables. In contrast, families who find it very difficult to manage financially were 66% less likely to consume takeaway compared to families who reported being financially comfortable. Children who consume pre-prepared meals once per week or more were almost 5 times more likely to consume take-away foods. Similarly, children who consumed multiple sugary snacks daily were almost 2.5 times more likely to consume takeaway. Conclusion: Healthy dietary habits such as consuming vegetables is significantly predicted by other indicators of healthy dietary intake such as fruit consumption and reduced frequency of consuming takeaway foods. The reverse is also true in which high frequency of consuming pre-prepared meals and sugary snacks is highly predictive of unhealthy dietary intake such as takeaway food consumption. This data supports previous research confirming that the diets of young Australian children are cause for ongoing concern.

___

Alpha-Synuclein as an Extracellular Trigger of Neuroinflammation R. Radford1, B. Vieira1, T.C. Dickson2, G.J. Guillemin3, R. Chung3, D.L. Pountney1, 1 Griffith Health Institute, Griffith University, Gold Coast, Australia. 2 Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia. 3 School of Advanced Medicine, Macquarie University, Sydney, Australia. Introduction/Aim: Several neurodegenerative diseases, including Parkinson’s disease and multiple system atrophy (MSA) exhibit aggregation in and release from neurons of the pre-synaptic protein, alpha-synuclein. As degenerating neurons release alpha-synuclein it may mediate astrocyte activation or result in intracellular inclusion bodies in neighbouring cells following endocytosis. MSA exhibits widespread astrogliosis together with glial alpha-synuclein cytoplasmic inclusions (GCIs) in mature oligodendrocytes. In the current study, astrocyte activation was analyzed by quantitative morphometry and by using molecular markers. Methods: We quantified astrocyte activation by morphometric analysis of MSA cases, and investigated the correlation to distance to nearest GCI as a proxy for extracellular alpha-synuclein. We obtained 'skinned' three-dimensional models of GFAP-positive astrocytes in MSA and control tissue (n = 75) from confocal z-stacks and measured the astrocyte process length and thickness and radial distance to GCI. In parallel studies, the influence of alpha-synuclein addition to primary Wistar rat neural cell

cultures was examined and injection of pathological alpha-synuclein into C57 mouse brain was investigated. Results: Astrocytes proximal to GCI-containing oligodendrocytes (r < 25 μm) had significantly (p, 0.05) longer and thicker processes characteristic of activation than distal astrocytes (r > 25 μm), with a reciprocal linear correlation (m, 90 μm2) between mean process length and radial distance to the nearest GCI (R², 0.7). In primary cell culture studies, alpha-synuclein addition caused ERK-dependent activation of rat astrocytes and perinuclear alpha-synuclein inclusions in mature (MOSP-positive) rat oligodendrocytes. Activated astrocytes were also observed in close proximity to alpha-synuclein deposits in a unilateral rotenone-lesion mouse model. Moreover, unilateral injection of MSA tissue-derived alpha-synuclein into the mouse medial forebrain bundle resulted in widespread astrocyte and microglial activation in the alpha-synuclein-injected, but not sham-injected hemisphere. Conclusions: Taken together, our data suggests that the action of localized extracellular concentrations of alpha-synuclein may trigger both astrocyte and oligodendrocyte MSA pathological features.

___

R Exclusion of Alpha-Synuclein aggregates from Calbindin-D28K cells in the unilateral rotenone-lesioned mouse model of Parkinson’s disease Rcom-H’Cheo-Gauthier, A.N.¹, Weetman, W.¹, Sharry, S.¹, Meedeniya, A.C.B.1, Pountney, D.L.¹

1 Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: Neurodegeneration in Parkinson’s disease is associated with formation of neuronal inclusion bodies composed mainly of aggregated α-synuclein (α-syn) protein. Expression of the Ca2+-buffering protein, Calbindin-28K (CB), correlates with neuronal survival in Parkinson’s disease and elevated intracellular free Ca2+ can trigger α-syn aggregation and inclusion body formation in model systems pointing to the influence of Ca2+ regulation in neurodegeneration1. Methods: In a unilateral mouse model, lesioning of the medial forebrain bundle of C57 black mice (WT, neurturin-/-, Aged WT) with the mitochondrial inhibitor, rotenone, was performed to trigger neurodegeneration and α-syn inclusions. Western blot was used to measure the total level of expression of CB. Immunofluorescence was used to measure CB and α-syn aggregates distribution. Results: Immunofluorescence of brain tissue sections revealed more frequent CB+ cells within lesioned

49

hemisphere than within control hemisphere Large α-syn aggregates (>1µm) were 4-fold more frequent in the lesioned hemisphere compared to the non-lesioned hemisphere (p, 0.01). NTN-/- mice showed a greater frequency of CB+ cells than WT mice, especially in the lesioned hemisphere. α-Syn inclusions were almost completely absent in CB+ cells. Western analysis showed total CB expression was 20% higher (p, 0.05) in treated compared to control hemisphere in the aged animals and 25 % higher in aged compared to young mice in the lesioned hemisphere (p, 0.05), but not significantly different between young and aged in the unlesioned hemisphere. Conclusion: These findings show α-syn aggregation is excluded from CB+ neurons and that increased sensitivity of aged animals to lesion is unrelated to differential CB+ expression, but may involve reduced trophic support.

___

The effectiveness of simulated-patient based simulation in developing Exercise Physiology student confidence Reeves, N.1, Waite, M.2 1 Griffith University, Gold Coast, Australia 2 Griffith University, Gold Coast, Australia Introduction/Aim: Exercise Physiology (EP) student confidence in patient communication, assessment and management is reportedly an underdeveloped skill. Clinical educators and students indicate that additional exposure to a wide variety of ‘practice’ clinical experiences will better equip them to effectively engage with patients when undertaking clinical practicum. As part of the Simulated Telemedicine Environment Project for Students (STEPS) project EP students had the opportunity to participate in uni- and multidisciplinary simulation modules. This study reports on the impact that simulated learning had on meeting the key learning outcome of promoting student confidence. Methods: Students enrolled in the 2014 Graduate Diploma of Exercise Science program (n=14) participated in four simulated-patient based modules, two before and two concurrently with their clinical practicum. The modules where themed around the principle clinical patient populations accredited EPs treat: musculoskeletal, neurological, metabolic and cardiorespiratory. Students were required to complete a range of pre simulation activities before entering a high fidelity simulation environment where they conducted either an assessment or delivered a treatment plan to their patient. Students completed a pre and post questionnaire at each simulation module, where they were asked to indicate their level of confidence on a

5-point scale. Results: Across the four modules the response rate was ninety-eight percent. Confidence in patient communication scores increased by a mean of 0.41 within each module, and by 0.29 across the four modules. Assessment confidence scores increased within each module by an average of 0.39, and across the four modules by 0.28. A patient management skills component was added to the third and fourth modules with increases in student confidence in this area of 0.55 within each module and 0.51 across the modules. Conclusion: Whilst other factors, including clinical practicum, would be contributing to EP student confidence, this study shows the value of simulated-patient based simulation in supporting the development of confidence across the main areas of patient interaction.

___

Patient perceptions of the role of nutrition for pressure injury prevention in hospital Roberts, S., Desbrow, B., Chaboyer, W. Introduction/Aim: Pressure injuries (PI) are a major problem in hospitals. Nutrition is an important aspect of pressure injury prevention (PIP), however there is no data on patients’ understandings around nutrition for PIP. This study aimed to explore (a) patients’ perceptions of the role of nutrition in PIP; and (b) patients’ experiences with dietitians in the hospital setting. Methods: In this interpretive study, adult medical patients at risk of PI due to restricted mobility participated in a 20 to 30 minute interview using a semi-structured interview guide. Interview questions were grouped into 2 domains; perceptions on the role of nutrition for pressure ulcer prevention; and experiences with dietitians. The recorded interviews were transcribed and analysed using content analysis. Results: The sample comprised 13 females and 7 males. Their mean age was 61.3 ±12.6 years (mean ± SD), and their average hospital length of stay was 7.4±13.0 days. Within the first domain, ‘patient knowledge of nutrition in pressure injury prevention’, there were varying patient understandings of the role of nutrition for PIP. This is reflected in 5 themes; (1) recognizing the role of diet in PIP; (2) promoting skin health with good nutrition; (3) understanding the relationship between nutrition and health; (4) lacking insight into the role of nutrition in PIP; and (5) acknowledging other risk factors for PI. Within the second domain, patients described their experiences with and perceptions on dietitians. Two themes emerged, which expressed differing opinions around the role and reputation of dietitians. These included (1) receptive of dietitian input; and (2) displaying ambivalence towards dietitians’ advice. Conclusion: Hospital patients at risk for PI development have

50

variable knowledge of the preventive role of nutrition. Patients had differing perceptions of the importance and value of information provided by dietitians.

___

Maternal betel-nut chewing and its association with preterm delivery. Rowais H, Rehan R, Hodgson Dr D, Dhaliwal J, Abdeen H. Abstract: Betel-nut (areca nut) is a seed of the areca palm, which is commonly chewed in the Tropical Pacific and Asia. Previous studies have highlighted the carcinogenic activity of betel-nut but there is little understanding of its effect during pregnancy1. The Solomon Islands is small sovereign country, which has one of the largest proportions of betel-nut chewers. This study attempts to correlate maternal and foetal health outcomes amongst betel-nut chewing during pregnancy. Methods: To retrieve appropriate date, a retrospective chart review of all maternity admissions of KiraKira hospital were reviewed from January 2013 to June 2014. Relevant data was recorded from admissions and antenatal charts. Results: There were 265 complete records of antenatal data in which 198 women (75%) consumed betel nut during pregnancy. There was a significant association between premature birth and maternal betel nut chewing (chisquare 4.35, p=0.037). Of the 208 full-term births, 58 (39%) were in mothers who chewed betel-nut. Using simple linear regression, there was no significant association between birthweight (grams) and maternal betel nut chewing status (β=59.5, 95%CI -73.7 to 192.7, p=0.380). As expected, there was a significant association between birthweight and prematurity (β=-188.2, 95%CI -328.5 to -47.8, p=0.009). Multivariable linear regression demonstrated little change in the coefficient for maternal betel-nut chewing status, after adjusting for prematurity (β=88.4, 95%CI -45.8 to 222.5, p=0.196). That is, we found no evidence that maternal betel-nut chewing affects birthweight. Discussion: As pre-term labour is associated with a higher rate of maternal/foetal complications, it is essential to convey this message to general population. Through patient education and health promotion, we hope to reduce the rates of maternal betel-nut chewing in the Solomon Islands and lead to lower rates of foetal complications. Summary: Betel-nut chewing during pregnancy was associated with an increased risk of preterm delivery. No association with birth weight or head circumference was found.

___

Using Digital Image Correlation to Examine in-vivo localised Achilles tendon strain Ryan, M.1, Lewis, D.1, Newsham-West, R.1 Barrett, R.1 1 Griffith Health Institute, Griffith University, Nathan, Australia Introduction /Aim: Strain is important for tendon health given its direct relationship to cell-matrix load response. Yet our understanding of regional strain within an in-vivo Achilles tendon during active loading is very limited. The present study used digital image correlation (DIC) to estimate strain at the superficial and deep regions of the proximal Achilles free tendon. The secondary objective was assessing repeatability and agreement of DIC against a conventional method for evaluating global tendon strain that integrated ultrasound and 3D motion-capture. Methods: Nine subjects (2 female, 7 male; age: 26.7±6.4 years; height: 179.5 ± 7.6cm; weight: 83.8 ± 22.7kg) took park in this study. Following preconditioning, participants carried out three trials applying 40 Nm of torque against a fixed torque transducer (Futek TFF600, USA) over a 1.5 second period while a high-resolution (14-7 MHz) ultrasound probe (Ultrasonix, Canada) was secured to the posterior calf. Images were processed using specialized software (EchoSoftTM, USA). Two regions of interest (ROI) were selected from the proximal AT originating at the soleus-Achilles muscle tendon junction bisected into superficial and deep components. DIC based strain is represented as a mean value of the composite pixel deformation. Global AT strain was also assessment by integrating 3D motion capture (Optitrack, USA) with ultrasound imaging and dynamometry. Results: There was significantly (p < 0.05) greater strain in the deep (5.7 ± 3.9 SD) than the superficial proximal AT (4.3 ± 3.2 SD). Intra-class correlation values for the DIC strain for between-trial and between-day repeatability were greater than 0.78. DIC reported strain was 2.17% greater than a conventional laboratory method. Conclusion: There appears to be non-uniformity of strain experienced at the proximal Achilles free tendon but future research is needed to understand localised strain behavior under different exercise and pathology conditions.

___

51

S Cardiac dysfunction and ischaemic intolerance in murine type II diabetes mellitus is reversed by sustained ligand-activated preconditioning See Hoe, LE.1, Zemljic-Harpf, AE.2, Schilling, JM.2, Peart, JN.1, Roth, DM.2, Patel, HH.2, Headrick, JP.1

1 Griffith Health Institute, Griffith University, Southport, Australia 2 VA San Diego Healthcare System, La Jolla, United States of America Introduction/Aim: Classic preconditioning is impaired in aged and diabetic hearts; however, opioid-mediated sustained ligand-activated preconditioning (SLP) is effective in aged myocardium. We aimed to test the efficacy of SLP in a mouse model of type II diabetes mellitus (T2DM). Methods: T2DM was induced in young male C57/Bl6 mice by a single ip injection of streptozotocin (75 mg/kg) combined with a 60% high fat diet for 10 weeks. Placebo and SLP-treated (5 days subcutaneous 75 mg morphine pellet) mice were assessed for glucose handling and myocardial dysfunction using a glucose tolerance test (GTT) and echocardiography respectively. Hearts were then langendorff-perfused to assess contractile function, ischaemic tolerance and cell death. Post-ischaemic isolated mitochondria were subjected to Ca2+-induced swelling and O2 consumption analysis to examine mitochondrial dysfunction. Cardioprotective caveolin-3 and Akt levels were determined by western blot. Results: T2DM induced significant weight gain (30%), impaired glucose homeostasis, in vivo cardiac dysfunction, ex vivo ischaemic intolerance, exaggerated cell death, mitochondrial dysfunction, and reduced caveolin-3 and P-Akt expression. SLP normalised blood glucose and insulin, significantly restored in vivo cardiac function, improved post-ischaemic functional recovery, reduced cell death and Ca2+-induced mitochondrial swelling, and partially restored caveolin-3 expression in T2DM hearts. Post-ischaemic respiratory function was only sensitive to SLP in T2DM and not healthy mitochondria. SLP significantly reduced baseline P-Akt in healthy myocardium, while P-Akt in T2DM remained unchanged. Conclusion: T2DM-dependent cardiac dysfunction and ischaemic intolerance are reversed by SLP, in association with mitochondrial preservation, shifts in glucose homeostasis and protective signalling. This highlights novel SLP as a potential intervention in disease states refractory to conventional approaches.

___

How paid peer support is conceptualised in non-government mental health services. Prof Amanda J Wheeler.1, Michelle Crozier , Victoria Stewart1,2 , Helena Roennfeldt1, Peter Walsh1

1 Population and Social Health Research Program, Griffith University, Logan, Australia 2 School of Human Services and Social Work, Griffith University, Logan Australia Introduction/Aim: Mental illness is common in Australia, with almost one person in five experiencing a high prevalence mental health disorder in any one year and 45% during their lifetime. With the current focus on recovery in mental health service delivery, interest in peer support has grown. Over the last decade, there has been rapid growth in the employment of peer support workers in the U.S., Australia, New Zealand and more recently the U.K. Peer support includes support or services provided to people experiencing mental health concerns by other people who have experienced overcoming mental health concerns themselves. The aim of this research is to provide insight into how consumer operated peer support is explained and delivered currently in Queensland. Methods: Funders are increasingly demanding evidence that program models work. In response, consumer-operated programs and peer workers must demonstrate their role in supporting people’s recovery. Whilst it has been difficult to determine the efficacy of peer support services, there is some evidence that peer support workers can promote empowerment and increased self-esteem, self-efficacy and self-management, social inclusion and engagement, and the hope that recovery is possible. This research involves a multi-methods approach (i.e., a combination of interviews, focus groups and document analysis). A concept map was developed from a literature review of existing peer support programs nationally and internationally. This map was used to guide the focus and interview questions and provide a coding framework for data. Data was gathered from two peer support organisations through focus groups, interviews and document analysis. Results: A peer support framework was developed from the data obtained and feedback was obtained from the organisations. Conclusion: It is anticipated that the peer support framework developed through this research will provide guidance to the further development of peer support services in Queensland as well as inform future research.

___

52

T Patients’ perceptions of participation in nursing care on medical wards Tobiano, G.1, Bucknall. T.2,3, Marshall, A.1,5, Guinane, J.2, Chaboyer, W.1,5 1 Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, Gold Coast, Australia 2 School of Nursing and Midwifery, Deakin University, Victoria, Australia

3 Alfred Health, Victoria, Australia 4 Gold Coast University Hospital, Queensland, Australia

5 National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients, Griffith Health Institute, Griffith University, Queensland, Australia Introduction/Aim: Hospitals are not safe places for patients, with 1 in 10 patients experiencing an adverse event. Patient participation is increasingly recognized as a vital strategy to improve patient safety and is a core concept of patient-centred care. The aim of this study was to explore patients’ perceptions of participating in nursing care. Methods: As part of a larger ethnographic study, in-depth semi-structured interviews were conducted with 20 patients in two hospitals, one public and one private, in two states. Purposeful maximum variation sampling was operationalized to recruit participants that differed in areas such as age, gender and mobility status. Interviews were audiotaped, transcribed, and then analysed using inductive qualitative content analysis. A patient advocate examined the findings to provide meaning. Results: Participants age ranged from 30-92 years, 12 females participated and 11 mobilised independently while the remaining patients required nurse assistance for mobilisation. Four categories were uncovered in the data which included: 1) valuing participation; 2) exchanging intelligence; 3) on the lookout; and 4) balancing power. The category valuing participation showed patients’ willingness for participation, viewing it as a worthwhile task. Exchanging intelligence, the second category, was a way of participating where patients’ knowledge was built and shared. The next category, being on the lookout, was a type of participation where patients monitored their care, showing an attentive approach towards their own safety. The final category, balancing power was characterized by patients feeling their opportunities for participation were restricted, due to a sense of unbalanced power. Conclusion: Patients were motivated to and valued participation. Cultivating this motivation may be crucial to patient

empowerment and practices of safety-monitoring, a fundamental strategy to addressing patient safety issues in hospitals.

___

Midwife psycho-education for reducing childbirth fear: a randomised controlled trial. Toohill J.1, Fenwick J.1,2, Gamble J.1, Creedy DK.1.

1 Griffith Health Institute, School of Nursing & Midwifery, Griffith University, Meadowbrook. 2 Gold Coast University Hospital Introduction/Aim: In Scandinavian countries childbirth fear affects around 20% of women and is linked to adverse maternal outcomes including poor postpartum mental health and high rates of caesarean section. Without appropriate care, women reporting high fear may see surgery as their only birth option. Scant research exists in Australia, and no randomised control trial has investigated a midwifery-led intervention to assist women with childbirth fear. This paper reports on the efficacy of a midwifery-led telephone psycho-education intervention to reduce women’s level of childbirth fear. Methods: Between May 2012 and June 2013, 1410 women attending 3 hospitals in south-east Queensland were screened for childbirth fear (WDEQ ≥66) at their antenatal booking appointment. Demographic, obstetric and psychometric measures were collected at recruitment and 36 weeks of pregnancy. Approximately 1:4 women were randomised to either the control or intervention group. The telephone-based psycho-education intervention was delivered by trained midwives at 28 and 34 weeks of pregnancy. Exclusion: Interpreter required, aged <16 years or >24 weeks pregnant. Results: The sample was representative of the Australian birthing population. Prevalence of fear was 24% overall (nulliparous 31.5%; multiparous 18%). Parity, depressive symptoms, decisional conflict, lack of partner support and perception of low childbirth knowledge predicted childbirth fear. Women receiving the intervention reported reduced childbirth fear at 36 weeks compared to women in the control group (55% vs. 26%, p=.0001). Analysis revealed a significant difference between the intervention and control groups on post-intervention scores for childbirth fear (p = 0.005). Conclusion: Midwives trained to address childbirth fear in pregnant women is a critical primary health strategy to improve women's quality of reproductive life; and potentially improve perinatal mental health, reduce non-medically indicated caesarean section rates, and reduce health care costs. Implications for practice will be discussed.

___

53

Health services utilization of women following a traumatic birth Turkstra E.1, Creedy D.K.2, Fenwick J.2 3, Buist A.4, Scuffham P.1, Gamble J.2 1 Centre for Applied Health Economics, Griffith Health Institute, Griffith University, Australia

2 Griffith Health Institute, Griffith University, Australia 3 Gold Coast Hospital, Australia 4 University of Melbourne, Australia Introduction/Aim: Perinatal mental health difficulties are more common than often thought, are likely to recur in other pregnancies or later in life, can become chronic and have long-term consequences for the mother, her infant, and relationship with her partner and other children. In this paper, we discuss the impact of high childbirth distress compared to no childbirth distress on health related quality of life and health services utilization. Methods: Women (n = 890) were recruited in the third trimester of pregnancy and screened for trauma symptoms within 24-72 hours of birth. Women were allocated to a high distress group (n=262) and compared to a cohort of matched women without childbirth trauma (referred to as non-distressed group; n=138). Health related quality of life and health services utilization data were collected at six weeks, six and twelve months following birth by telephone. Results: Women in the high distress group had lower health related quality of life at 12 months compared the women in the non-distress group (EQ-5D: 0.90 vs. 0.93, p= 0.008). Additionally, highly distressed women had a higher number of visits to the general practitioner (3.5 vs. 2.6 visits in first year, p=0.002) and did utilize more additional services (e.g. maternal health clinics and home visits by midwives). No difference in health care utilization for the infants was observed. Conclusion: High distress during childbirth has long lasting impaired health effects for the mother and increases health care utilization. Providing counselling antenatal and postnatal may improve the recovery for those women with a traumatized birth. Additionally, support during labour may also improve longer term outcomes.

___

U Dressing and securement devices for central venous access devices: a Cochrane systematic review Ullman AJ1,2, Cooke ML1,2, Mitchell M1,2,3, Lin F2, New K4,5, Long DA2,6, Mihala G7, Rickard CM1,2

1School of Nursing and Midwifery, Griffith University, Nathan, Australia. 2NHMRC Centre of Research Excellence in Nursing, Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, Nahtan, Australia. 3Princess Alexandra Hospital, Brisbane, Australia. 4Grantley Stable Neonatal Unit, Royal Brisbane and Women’s Hospital, Brisbane, Australia. 5The University of Queensland, School of Nursing and Midwifery, Brisbane, Australia. 6Paediatric Intensive Care Unit, Royal Children’s Hospital, Herston, Australia. 7School of Medicine, Griffith University, Meadowbrook, Australia Introduction/Aim: Central Venous Access Devices (CVADs) play a vital role in the management of acute and chronic illness, but complications are common. There is a large range of dressing and securement products available for clinicians to access. This review aimed to compare the available dressing and securement devices for CVADs, in terms of catheter related bloodstream infection (BSI), catheter colonisation, entry and exit site infection, skin colonisation, skin irritation, failed catheter securement, dressing condition and mortality. Methods: Randomized controlled trials that have evaluated the effectiveness of dressing and securement devices for CVADs were included. Standard Cochrane Collaboration methodology was used. Results: Twenty-two studies with 7,436 participants and nine different were included. There were low or unclear risks of bias in most included studies. The rates of catheter related BSI was unchanged for gauze and tape versus standard polyurethane (SPU). There was a significant reduction in catheter-related BSI for all medication impregnated dressings in comparison to all others (RR 0.63, 95% CI 0.43 to 0.93, P = 0.02) and there was evidence of a significant effect of the use of chlorhexidine gluconate –impregnated (CGI) versus SPU dressings on the frequency of catheter-related BSI per 1,000 patient days (RR 0.58, 95% CI 0.31 to 0.84, P = 0.008). There was a significant reduction of catheter tip colonisation in CGI versus SPU dressings (RR 0.58, 95%CI 0.47 to 0.72, P < 0.0001), but not for gauze and tape versus SPU (P = 0.68). Conclusion: There

54

is some evidence that CGI dressings reduce the incidence and frequency of catheter-related BSI, in comparison to other dressing types, including SPU. Future research may adjust the estimates of effect for the products included in this review and is needed to assess the effectiveness of new products.

___

W Simulated Telemedicine Environment Project for Students (STEPS) Tuttle, N.1, Waite, M.1, Bialocerkowski, A.1 1 Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: Increasing demand for health professionals and the resulting increase in university training programs across a range of health disciplines has resulted in shortage of clinical placement capacity. The Simulated Telemedicine Environment Project for Students (STEPS) was undertaken to increase clinical placement capacity and to supplement clinical placements to enable students to have exposure to areas of practice that may not occur in traditional clinical placements. Each of the disciplines involved in the project - dietetics, exercise physiology, nursing, pharmacy, physiotherapy and speech pathology – used a different structure and had different aims, but all involved actors as simulated patients and included the use of telemedicine in at least some of their simulations. Methods: A common, theoretically-based framework for evaluation across the disciplines was developed, which included quantitative and qualitative questionnaires for students regarding the reaction, learning and behavior levels of the Kirkpatrick model; and for the telemedicine system’s usability. Results: To date, over 400 students have received over 5,000 hours of simulated learning, which is on track to exceed the target of 7154 simulation hours by the end of 2014. Preliminary data analysis has been completed for simulations in dietetics, physiotherapy and speech pathology. Intrinsic Motivation Inventory scores and perceived impact on communication, assessment and management were all moderate-high (3.8-6.3 and 4.6-5.4 out of 7, respectively). Student confidence significantly increased for all disciplines in communication, and also in assessment and management for dietetics and speech pathology (p<0.05). The System Usability Scale scores ranged from 65.9-72.2 across the disciplines (68 indicates usability). Qualitative information largely supported the quantitative data. Conclusion: Although the use of telemedicine has resulted in numerous challenges,

the STEPS project has provided many opportunities as well as significant learning outcomes. The challenge will now be how to continue at least some of the benefits as funding to support similar projects is reduced.

___

Pre-operative self-efficacy education for patients undergoing joint replacement surgery (POEt): A pilot randomised controlled trial. Cooke, M.1, Walker, R.1, Aitken, L.1,2, Freeman, A3, Pavey, S4, Cantrill, R1. 1 Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, Nathan, Australia 2 Intensive Care Unit, Princess Alexandra Hospital, Woolloongabba, Australia 3 Acute Pain Service, The Queen Elizabeth II Jubilee Hospital, Coopers Plains, Australia 4 Acute Pain Service, Gold Coast Hospital and Health Service District, Southport, Australia

Introduction/Aim: Hip and knee replacements are major surgical procedures associated with significant post-operative pain and anxiety, impacting on patient’s recovery and rehabilitation. Self-efficacy strategies are increasingly being used in pre-operative education programs to enable patients to manage their illness and symptoms. The aim of this study was to: 1) evaluate the feasibility of testing an education intervention to improve self-efficacy in patients undergoing hip or knee replacement using pre-defined feasibility criteria (recruitment, retention and protocol fidelity); 2) use pilot data to refine the protocol and; 3) determine values of pain, anxiety, self-efficacy and satisfaction with pain management for patients undergoing hip or knee replacement following delivery of an education intervention, to inform sample size calculations. Methods: A single-blinded, parallel, randomised controlled trial design was used. Eligible and consenting patients were randomly assigned to an intervention or control group. Intervention group participants were given a DVD demonstrating self-efficacy activities (i.e. goal setting and relaxation practices), to undertake before admission. Assessments occurred at 6 time-points: pre-operatively; day of surgery, and then 4 additional points along the post-operative recovery continuum until 6 weeks after discharge. Care providers and outcome assessors were blinded to group allocation. Results: Fifty-five percent of screened patients were eligible and 81% enrolled (n=91). Missing data ranged from 0 –21%. Nineteen percent of participants were lost to follow-up in the control group and 20% in the DVD group. Protocol adherence in the DVD group varied between 6% - 78% engagement with goal

55

setting and 13% - 69% with relaxation strategies. Conclusion: Measured outcomes were similar for decreased pain and anxiety, increased self-efficacy, satisfaction with pain management during hospitalisation and health utilisation following discharge for both groups suggesting a lack of feasibility. Lessons learned in relation to blinding, recruitment, intervention and outcome measures may guide the development of a larger trial.

___

Ischemic tolerance and mitochondrial respiration in hearts targeted with the pharmacological blockade, mdivi-1, of mitochondrial fission protein Dynamin-related-protein-1 (Drp-1). Wendt, L.1, See Hoe LE.1, Sachaphibulkij, K.1, Peart, JN.1, Headrick, JP.1 1 Griffith Health Institute, Griffith University, Southport, Australia Introduction/Aim: Mitochondrial division is regulated by the mitochondrial fission protein Dynamin-related protein-1 (Drp-1) and is upregulated in hearts subject to ischaemia-reperfusion, resulting in myocardial dysfunction. We aimed to examine the effects of pharmacological blockade of mitochondrial fission protein Drp-1 upon mitochondrial morphology and functional tolerance to ischaemia-reperfusion in mouse hearts. Methods: 16-week-old male C57/BI6 mouse hearts were langendorff-perfused and administered a Drp-1 inhibitor, mdivi-1 [1 μM], for 20 mins, followed by 25 mins ischemia and 10 mins reperfusion. Functional recoveries (left ventricular developed pressure, LVDP) and cell death were assessed post-ischaemia. Mitochondria were isolated from the left ventricle post-reperfusion, and O2 consumption was quantified using the Oxygraph-2k instrument. Protein expression of total-Drp-1 (Ser637), phospho-Drp1 (Ser637), and cardioprotective Akt and Erk were assessed via western blot in cytosolic and mitochondrial fractions. Results: Functional tolerance to ischaemia-reperfusion was improved in hearts subjected to Drp-1 inhibition with mdivi-1. Additionally, Drp-1 inhibition augmented post-ischaemic mitochondrial O2 consumption in complex I and II. This was coupled to a reduction in post-ischaemic total-Drp-1 expression in mitochondrial and cytosolic fractions. Conclusion: These preliminary findings suggest that mdivi-1 preserves mitochondrial morphology and respiratory function, highlighting Drp-1 as a regulator of mitochondrial function and a potential target for therapeutic intervention.

___

A formal plan for self-disclosure enhances supported employment outcomes among young people with severe mental illness Philip Lee Williams 1, 2 , Chris Lloyd 2, Ellie McGahey 2, Geoff Waghorn 3, Shirley Morrissey 2 1 Lives Lived Well 2 Griffith Health Centre, Griffith University Gold Coast Campus 3 Queensland Centre for Mental Health Research Introduction/Aim: Young people with mental illness experience high levels of unemployment that can be related to stigma and discrimination. This may occur when a young person discloses personal information, such as their mental illness diagnosis, in the workplace. The aim was to investigate the predictive validity of a formal plan for managing personal information (PMPI) during the early stages of supported employment. The focal question was: does the use of a brief structured plan to manage personal information lead to more employment outcomes for young people with a mental illness? Methods: A sample of 40 young unemployed mental health service users (mean age 23.9 years) who were also attending employment services on the Gold Coast, were asked about their disclosure preferences. If they preferred not to disclose at all, they did not complete a plan for managing personal information. If they preferred to disclose some personal information, they were provided with assistance to complete the PMPI. Baseline information was gathered from two equal groups of 20 individuals. Employment status was ascertained at a six-week follow-up interview. Results: Those who completed the PMPI had 4.9 times greater odds of employment at six weeks than those who preferred not to disclose any personal information. They also reported higher levels of satisfaction with their interactions with support staff and a greater sense of autonomy over self-disclosure. Conclusions: A formal plan to manage personal information has promising predictive validity with respect to job seekers. The PMPI is recommended to be implemented as a clinical tool for all young job seekers. Further research is recommended to further examine other properties of this decision making tool.

___

56

A Characterization of mesothelioma cancer stem cells and their metabolic signature Elham Alizadeh Pasdar1, Michael Smits1, Renata Zobalova1,2, Lan-Feng Dong1, Jiri Neuzil1,2,*

1School of Medical Science, Griffith University, Southport, Australia, 2Institute of Biotechnology, Academy of Sciences of the Czech Republic, Prague, Czech Republic. Introduction /Aim: Populations of tumour cells display remarkable diversity in their phenotypic traits including their drug resistance and ability to form metastases. This heterogeneity has recently been explained by the cancer stem cell (CSC) model. CSCs have distinct molecular and biological signature but little is known about their mitochondrial and metabolic features. In this study we investigate the presence of CSCs in established malignant mesothelioma (MM) cell lines and characterised their molecular and metabolic features. Methods: CSCs was prepared using standard sphere forming methods. OXPHOS was measured using Oroboros Oxygraph. Lactate and ATP measured using commercial kits. Mitochondrial membrane potential was measured by TMRM staining and flowcytometry. Glucose up take evaluated by staining with fluorescent glucose and flowcytometry. Results: Our data reveal that like somatic stem cells, MM CSCs exhibit lower levels of normalised oxidative phosphorylation, use glycolysis as their main source of energy production, thus have increased levels of lactate and glucose uptake and lower level of ATP. They also feature enhanced mitochondrial membrane potential and ROS generation. Knock-down of CD24, a prominent marker of MM CSCs alters the cells to exert more differentiated trait, which is reflected in their metabolic features. These include lower levels of ROS, mitochondrial membrane potential, glucose uptake and lactate and increased levels of ATP. Our data show that higher mitochondrial membrane potential in MM CSCs makes it possible to kill these cells very efficiently with mitochondrially targeted vitamin E succinate. Conclusion: Cancer stem cells exhibit distict mitochondrial and energetic features that can be used for their characterization and isolation. These features can also be exploited to design new agents with the ability to efficiently eliminate cancer stem cells.

___

Why physical activity matters for older adults and what it means for them? Arnautovska, U.1, Hamilton, K.1, Occhipinti, S.1 1 School of Applied Psychology, Griffith University, Mt Gravatt, Australia Introduction /Aim: Empirical evidence shows that physical activity engagement in older adults can significantly protect against age-related illness and disease. In spite of these benefits and existing physical activity programs and initiatives, many older adults are still insufficiently active. Methods: The current research adopted qualitative research methodology to explore older adults’ understandings of physical activity behaviour. Twenty older adults (11 females, 9 males; aged 67-87 years) living in South East Queensland, Australia participated in semi-structured interviews. Questions focused on eliciting discussions about older adults' perceptions of physical activity and how these perceptions were conceptualised within the process of ageing. Interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis with NVivo. Results: Most older adults perceived physical activity as necessary in order to maintain their health and enjoyment of life. Many of them held a ‘use it or lose it’ view of physical activity and emphasised the importance of staying active and persevering in being physically active regardless of the presence of health problems or lack of enjoyment. Older adults who were regularly active, compared to those who were insufficiently active, viewed physical activity more strongly as a means to counteract age-related illness or maintain their independence. Conclusion: The findings from this qualitative exploration suggest that older adults' understandings of physical activity are closely linked to their views on the role of physical activity within the process of ageing and the perception of ageing itself. These identified perspectives offer an in-depth understanding of physical activity behaviour among older adults and could be useful for improving efforts to increase physical activity in this at-risk group.

___

57

B A Five Year Follow-up Study of a Pregnancy Domestic Violence Program to Promote Routine Enquiry during Pregnancy A. Baird, Kathleen.1, Author, B.2 Salmon, Debra 1 Griffith Health Institute, Griffith University, Logan Campus, Australia. 2 University of the West of England, Bristol, England, UK Introduction/Aim: Over the last decade there has been a growing awareness for the need for health professionals to become more pro-active when responding to domestic violence and abuse. While the use of brief questioning by professionals is known to lead to higher rates of disclosure, however, there continues to be reluctance on behalf of some health professionals to embrace enquiry into domestic abuse. This paper reports on a five year follow-up study, which aimed to measure the degree to which progress identified at practitioner level in 2004/2005 (in relation to knowledge, attitudes and efficacy) have been maintained in 2010. Methods: The methodological approach adopted for this follow-up study included both process and outcome data from midwives. This meant adopting quantitative and qualitative approaches in the form of semi-structured questionnaires and focus group interviews. Analysis is underpinned by questionnaire data from midwives in 2010; with 2004/5 follow-up data used as the comparator. In addition, focus group data is presented from community and hospital based midwives to explore in-depth the implications for practice. Collecting the views and experiences of midwives in relation to routine enquiry for domestic abuse allowed for detailed contextualisation of the quantitative findings from a practitioner perspective. Ethical review and approval was awarded through the LREC. Results: Five years on, the statistical evidence suggests that the skills, knowledge and confidence associated with antenatal enquiry for domestic abuse developed through the 2004/5 program have been maintained. However, it was midwives attitudes in relation to their role in domestic violence that had changed significantly, with all (100%) of those surveyed reporting that enquiry was now considered a fundamental part of their role. In addition, interviewees reported a strong sense of pride in supporting women, and providing opportunities for women to appraise their abusive relationships. Conclusion: Antenatal and postnatal care provides a rare opportunity for midwives to build up a rapport with the women in their care where women may feel safe enough to discuss a history of abuse. The availability of domestic violence trained staff will not only increase

the chances of a woman being asked about domestic abuse, but will also provide support to practitioners by sharing their knowledge and experiences with other members of staff.

___

Evaluation of an NBN enabled pilot of remote monitoring for older people using telehealth Nancarrow S1, Banbury, A1,2, Buckley, J3, Roots A1, Barlow K1 1 Southern Cross University, Lismore, NSW Australia 2 Feros Care Limited, Coolangatta, Qld, Australia Aim: To describe the evaluation of the NBN enabled telehealth pilot of Feros Care’s My Health Clinic at Home (MHCAH) which involves daily vital-sign monitoring, triaged by a telehealth nurse and video-conferencing. Methods: A mixed methods, prospective, uncontrolled study design was used to capture learning on the processes of implementation and the impact of the project on clients. Data sources included surveys, pre-post test clinical data, audit data, evidence from meetings and interviews and focus groups. Results: Overall, 181 of 200 clients recruited to the trial between April 2013 and June 2014 were included in the evaluation. Clients (64%) self-referred into the pilot with the goals of monitoring their own health (68%) and identifying problems before they became serious (65%). Clients reported that as a result of participating in MHCAH, they better understood their vital sign monitoring (48%) and consequently: could better manage their own health (48%); were better informed (44%) and more confident (25%) to discuss their health with their doctor. Clients also reported making medication changes (17%), positive dietary changes (34%); and increased their physical activity (33%). Overall, client self-rated general health improved (mean improvement 0.303, SD= 0.80, 95% CI 0.16 – 0.45, 118 df, p=0.000), with more participants reporting that their health is “excellent” or “very good” health at the end of the trial. Clients also reported making fewer doctor visits (24%); fewer visits to the emergency department at the local hospital (p=0.021) and fewer non-local hospital admissions (p=0.000) compared with the preceding year. Conclusion: Findings suggest that MHCAH empowers clients to better understand and manage their own health, and may be associated with improved health outcomes and reduced service use. Having regular, daily access to a telehealth nurse reassured clients, and triggered changes to services and behaviour that are likely to have influenced outcomes.

___

58

Nutrition care and personal trainers: a website analysis. Barnes, K.1, Ball, L.1, 2, Desbrow, B.1, 2 1 School of Allied Health Sciences, Griffith University, Gold Coast, Australia 2 Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction /Aim: National guidelines for diet and physical activity exist to prevent disease; yet less than 10% of Australians reach the targets. Fitness professionals are ideally placed to provide nutrition advice as they have contact with many individuals looking to modify these health-related behaviours. In recognition of this, registering bodies such as Fitness Australia describes a scope of practice for members that includes the promotion of national nutrition guidelines such as the Australian Guide to Healthy Eating. This study aimed to understand the scope of nutrition services promoted by registered fitness businesses on the Gold Coast and compare these to the defined scope of practice. Methods: All registered fitness businesses (Fitness Australia) located within two Gold Coast federal electorates (Moncrieff and Fadden) were identified. Inductive content analysis of webpages and social media sites was conducted. Promotional materials were: “Within scope” if sites referred to national nutrition guidelines, identified nutrition/dietetic services or omitted nutrition content altogether; “At risk” if sites advertised services such as diet plans that could potentially be based on national nutrition guidelines; or “Beyond scope” if sites advertised services such as personalised diet plans developed on opinion or anecdotal evidence. Results: Of the businesses identified 15%, 34%, and 51% advertised services “Within scope”, “At risk”, and “Beyond scope”, respectively. Involvement of nutrition and dietetic services were advertised for 14% of businesses, while 2% of business did not advertise nutrition content. Of the businesses “At risk” or “Beyond scope”, 57% offered personal diet plans from a personal trainer. Conclusion: A large proportion of registered fitness businesses on the Gold Coast are advertising nutrition services beyond those suggested by the registering body’s scope of practice. Further research into the quality and competency of nutrition advice from fitness professionals may help to determine potential for this environment to act as a setting for evidence-based health promotion.

___

Simulated Immersive Learning Clinical Scenarios (SILCS) for Pharmacy Practice Education Baumann-Birkbeck, L.1,2, Khan, S. 1,2, Anoopkumar-Dukie, S.1,2, Klopper, C.J.3, Faichney, J.4, Grant, GD.1,2 1 School of Pharmacy, Griffith University, Gold Coast, Australia

2 Griffith Health Institute, Griffith University, Gold Coast, Australia 3 School of Education and Professional Studies, Griffith University, Gold Coast, Australia

4 School of Information and Communication Technology, Griffith University, Gold Coast, Australia Introduction/Aim: Currently, over-the-counter medicines training is delivered to students in a traditional didactic manner, to achieve competency in the provision of pharmacy-only and pharmacist-only medications. Simulation technology is being increasingly incorporated into healthcare education to promote active engagement and outcome-based learning, and their ability to replicate authentic professional practice scenarios. This study examined the effects of a novel interactive simulation tool for measuring competency and engagement, designed for second-year pharmacy students, to develop their over-the-counter medicines knowledge, whilst replicating the pharmacy environment and patient interaction. Methods: Interactive simulations were created by the incorporation of several technologies (including SitePal™ highly realistic avatars) and delivered using Wix™. The cases are interactive and take on a number of directions, depending on the student’s action. To measure student engagement and evaluate competency, student choices were recorded and tracked using click software. Eye-tracking was employed using Gazepoint™ equipment. Pre- and post-activity surveys were completed by the students to measure perceived satisfaction and engagement, to assess competency in the provision of over-the-counter medicines, and to provide feedback. Student engagement with the activity was then compared to student performance to determine the tool’s efficacy as a learning resource. Additionally, the tool’s suitability as a competency measure was investigated. Results: Preliminary trials have demonstrated consistently positive student responses and feedback. Students reported that they found the tool to be useful and highly engaging. Student feedback described the tool to be as effective or more effective than the standard teaching practice. The tool also supported student performance, measured in an assessment of

59

knowledge and competency, pre- and post-scenario. Conclusion: The simulation tool for the provision of over-the-counter medicines education, encourages student engagement and promotes positive learning outcomes. Furthermore, preliminary results suggest the tool has value as a viable measure of competency assessment in this field.

___

C Australian Dental Students' Knowledge of Oral Manifestations of Common Systemic Conditions Carter, A.1, Kroon, J.2 1 Griffith Health Clinics, School of Dentistry and Oral Health/Griffith Health Institute, Griffith University, Gold Coast, Australia 2 School of Dentistry and Oral Health / Population and Social Health Research Programme, Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: Systemic medical diseases are sole named because of their holistic and systemic involvement with human anatomy, and often present within or around the oral cavity. Accordingly, dental students and practitioners alike should recognize possible manifestations (oral pathology) of common illnesses. Early diagnosis may lead to early intervention, so knowledge is quintessential for effective evidence based patient management; the foundation for this knowledge is laid down at University. The study aimed to assess dental students’ knowledge of the oral presentations of common systemic diseases. Methods: 222 Australian dental students undertaking their 3rd, 4th and 5th years of Dental Science at Griffith University were surveyed from October to December 2013. A cross-sectional questionnaire, based on previous similar studies was designed by the authors. Informed consent forms were attached to each survey. Ethical clearance was gained from HREC Griffith University. Data was presented using descriptive statistics, tested for normality using Kolmogorov Smirnoff, analysed with chi-square, Friedman, and Wilcoxon tests. Results: Each question had a mean response rate of 81%. Friedman tests showed statistically significant differences between year levels, χ2(23)=1757.976, p=.000. 5th year students were in general the most knowledgeable, with an average correct response rate of 79%. Over 80% of students in each year identified tetracycline as an enamel staining agent in utero; that C. Albicans is the commonest cause of oral candidiasis; that Human papillomavirus (HPV) causes oral papillomas and condylomas; and linear gingival erythema, necrotising ulcerative

periodontitis/gingivitis, and halitosis are possible oral manifestations of HIV-associated diabetes. Conclusion: 5th year student level of knowledge concerning oral and dental manifestations of common systemic diseases was highly acceptable. There was however a slight deficiency in the 3rd year knowledge. Further research into dental student knowledge may aid improvement of dental education, with an emphasis on a higher sample size and assessment of other Universities for standardization.

___

Improving Compliance with Venous Thromboembolism Prophylaxis Conroy, S.1 Mason, R.1 Sanmugarajah J.1 1. Medical Oncology Department, Gold Coast University Hospital, Queensland, Australia Introduction/Aim: Venous thromboembolism (VTE) is the largest preventable cause of death in hospitalised patients. Despite the fact that effective prophylactic measures have been readily available for decades, VTE continues to cause significant morbidity and mortality to the inpatient population. We aimed to assess compliance with VTE prophylactic measures on the oncology ward at the Gold Coast Hospital before and after re-education of staff. Methods: Medical records were reviewed for deep vein thrombosis (DVT) risk assessment, documentation of contraindication and prescription of prophylaxis for all patients admitted to the oncology ward in a two-month period prior to intervention (pre-intervention group). The findings of this audit were presented at multidisciplinary ward meetings and re-iteration of the importance of DVT prophylaxis was stressed. Further, nursing staff and pharmacists were encouraged to remind medical teams to perform DVT risk assessments. Following this, a similar audit was performed for a two-month period (post-intervention group). Results: Of the 259 patients in the pre-intervention group, less than half (42%) received a DVT risk assessment. A total of 71 patients (27%) received DVT prophylaxis during admission. 188 (73%) patients did not receive prophylaxis and of these 131 (70%) had active cancer, further increasing the DVT risk. Of patients who did not receive prophylaxis, 91 patients did not have a documented contraindication to prophylaxis. Of the 263 patients in the post-intervention group, 171 patients (65%) received DVT risk assessment. A total of 128 patients (49%) received prophylaxis, and after excluding patients with documented contraindications to prophylaxis this accounted for 74% of all patients. Conclusion: This audit has provided an opportunity for assessment of DVT prophylaxis on our ward, and the process of auditing in itself has increased

60

compliance rates. Education at multidisciplinary meetings and working with nursing and allied health staff has improved DVT prophylaxis rates. This is an easy, less costly intervention to improve compliance, which can be practiced by most wards and hospitals.

___

WRist Acupressure for Post-operative nausea and vomiting: A pilot study Cooke, M.1, Ivan Rapchuk2, Suhail A. Doi3, Amy Spooner4, Tameka Wendt4, Jessica Best4, Melannie Edwards4, Leanda O’Connell4, Donna McCabe4, John McDonald5, John Fraser6, Claire Rickard1.

1 Griffith Health Institute, Griffith University, Nathan, Australia 2Department of Anaesthesia and Perfusion, Critical Care Research Group, The Prince Charles Hospital 3Clinical Epidemiology Unit, School of Population Health, University of Queensland 4Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital 5Microbiology and Immunology Research Group, Griffith University 6Critical Care Research Group, The Prince Charles Hospital and University of Queensland Introduction/Aim: Post-operative nausea and vomiting are undesirable complications following anaesthesia and surgery. It is thought that acupressure might prevent nausea and vomiting through an alteration in endorphins and serotonin levels. This pilot trial aimed to test pre-defined feasibility outcomes and provide preliminary evidence for the efficacy of PC 6 acupoint stimulation versus placebo for reducing post-operative nausea and vomiting in cardiac surgery patients. Methods: Two-group, parallel, superiority, randomised control pilot trial. Results: Eighty patients were randomly assigned to either an intervention PC 6 acupoint stimulation via beaded intervention wristbands group (n = 38) or placebo sham wristband group (n= 42). The main outcome was assessment of pre-defined feasibility criteria with secondary outcomes for nausea, vomiting, rescue anti-emetic therapy, quality of recovery and adverse events. Conclusion: Findings suggest that a large placebo-controlled randomised controlled trial to test the efficacy of PC 6 stimulation on PONV in the post-cardiac surgery population is feasible and justified given the preliminary clinically significant reduction in vomiting in the intervention group in this pilot. The intervention was tolerated well by participants and if wrist acupressure of PC 6 acupoint is proven effective in a large trial it is a simple non-invasive intervention that could easily be incorporated into practice.

___

H Validity and reliability of a novel back extensor muscle strength test Harding, A.¹ Little, A.³ Weeks, B.K.¹ ² Horan, S.A.¹ ² Watson, S.L.¹ ² Beck, B.R.¹ ² ¹ School of Allied Health Sciences, Griffith University, Gold Coast, Australia ² Centre for Musculoskeletal Research, Griffith Health Institute, Gold Coast, Australia ³ School of Medicine, Griffith University, Gold Coast, Australia Introduction: Back extensor muscle strength (BES) is central to back function. BES is also related to incidence of vertebral fractures. The accurate measurement of BES in the clinical setting is limited by the requirement for expensive, large-scale equipment. We developed a simple, quick and inexpensive BES measurement protocol using a handheld dynamometer (HHD). The goal of the current study was to assess the validity and reliability of our novel BES HHD test, compared to a recognised ‘gold standard’. Method: We performed a cross-sectional validation study, with short and long term test-retest reliability analyses. Healthy men and women over 18 years attended two testing sessions, seven days apart. Each session involved three trials of standing maximal isometric BES measures with a HHD (Lafayette Manual Muscle Testing Systems, USA) and three trials with an isokinetic dynamometer (Biodex Medical Systems, New York, USA). The order of testing was randomised. Validation of BES (kilograms) derived from the novel HHD test against Biodex-derived back extensor torque (Newton metres), and test-retest reliability of each instrument were examined with Pearson’s correlations. Results: Fifty-two participants (26M, 26F) aged 46.4 ± 20.4 years were recruited. A strong positive relationship was observed between peak BES measured with the HHD and Biodex (r = 0.824, p < 0.001). Short–term repeated measures of HHD BES were strongly related (r = 0.984, p < 0.001) and long-term test-retest reliability was excellent (r = 0.926, p < 0.001), which compared favourably to those for Biodex measures (r = 0.978, p < 0.001 and r = 0.957, p < 0.001 respectively). Conclusion: Our novel HHD BES test exhibited excellent validity and reliability against the traditional muscle strength gold standard - isokinetic dynamometry. The HDD BES test would be easily incorporated into research and clinical settings. Future work is required to establish age-relevant reference norms.

___

61

I Functional Capacity Evaluations in the 21st Century Innes, E.1 1 Southern Cross University, School of Health and Human Sciences, Gold Coast, Australia Introduction: The health benefits of work have been well established, and it is know that the longer people are off work, the less likely they are to return. The use of functional capacity evaluations (FCEs) to determine an injured worker’s capacity for work has been used for several decades as part of an overall approach in return to work planning. In the 1990s the focus of FCE research was to determine the reliability and validity of various systems. In the 21st century, the emphasis of research is on validity, primarily predictive, and the impact and influence of FCE results on clinical decision-making. Objective: To synthesise qualitative and quantitative research examining the use of FCEs in clinical practice, how FCE results may influence clinical decision-making, and the use of FCEs with various musculo-skeletal impairments and disabilities. Method: A realist review enables a theory-driven, mixed-method approach as an alternative to conventional systematic reviews. Such an approach offers the potential to expand the knowledge base in complex areas, such as FCEs and related assessment approaches. This review locates and analyses the relevant literature, applying principles of realist synthesis to produce a theory-driven review of this complex topic. Results: While a previous systematic review of FCEs concluded there was no evidence for or against the use of FCEs regarding the effectiveness of FCE-based return-to-work recommendations to prevent re-injury, the extent of FCE research is much broader than this. Issues to be presented include the utility of FCEs in clinical decision-making and whether FCEs lead to better outcomes for injured workers. Conclusion: Determining the appropriate use and interpretation of FCEs can influence clinicians’ planning and implementation of effective return to work programs. Understanding current research on FCEs will enable clinicians to be more effective in their practice.

___

K Joint kinematic calculation based on 3D gait analysis data: Standard clinical practices versus contemporary musculoskeletal approaches Kainz H1,2, Modenese L1, Carty CP1,2, Boyd RN3, Lloyd DG1. 1 Griffith Health Institute, Center for Musculoskeletal Research, Gold Coast, Australia 2 Queensland Health, Royal Children’s Hospital, Brisbane, Australia 3Queensland Cerebral Palsy and Rehabilitation Research Centre, Brisbane, Australia Introduction/Aim: Joint kinematics can be calculated by either Direct Kinematics (DK), used mostly in clinical gait laboratories, or Inverse Kinematics (IK) that is generally used together with a model including muscle representation so enabling additional musculoskeletal analyses. Direct comparison between the results yielded by both approaches is difficult due to different definitions of joint coordinate frames and possible errors due to scaling and marker placement. The aim of the current study was to create patient-specific kinematic models based on MRI images to exclude every possible source of error deriving from the geometry of the models and evaluate the difference in joint kinematic estimates between DK and IK. Methods: MRI and 3D gait analysis data were collected from three children with cerebral palsy. The pelvis and bones of the lower limbs were manually segmented using Mimics (Materialise, Belgium). Joint centers and coordinate frames were defined based on the individual’s anatomical structures. NMSbuilder (NMSPhysiome) was used to create a DK and IK based patient-specific model for each participant. Joint kinematic waveforms between both MRI based models, the standard clinical DK and the standard IK model were compared using a modified version of the coefficient of multiple correlation (CMC). Results: The comparison between the standard clinical DK and the standard IK model showed an average CMC values of 0.83±0.20. Kinematics between the MRI based DK and IK model showed better agreements with an average CMC values of 0.96±0.07. Conclusion: Under ‘perfect’ condition based on medical imaging data DK and IK lead to very similar joint kinematic outputs. Future research should therefore focus on evaluating the most reliable and accurate ways to scale generic models, place markers and estimate joint centers and axes because these factors seem to have a bigger impact on joint kinematics than the choice of the kinematic calculation approach.

___

62

L Food Accuracy and Adequacy in Hospitalised Patients Requiring Special Diets Larby, A.1, Desbrow, B.2, Roberts, S.3 1 Griffith University, Gold Coast, Australia 2 Griffith University, Gold Coast, Australia 3 Gold Coast University Hospital, Gold Coast, Australia Introduction/Aim: A hospitalised patient’s essential care not only includes medical management, but access to appropriate and adequate nutrition. If a patient requires a therapeutic diet for medical reasons (e.g. clear fluids diet) and they are exposed to inappropriate food/beverage items it poses an acute risk to patient safety. In addition, for those individuals on therapeutic diets, the risk of eating inadequately and becoming malnourished as a consequence, is higher than those without dietary restriction. Hence the aim of this study was to, 1) assess and describe the accuracy (i.e. safety) of meals delivered to patients receiving medically required therapeutic diets and 2) evaluate the adequacy (i.e. ability to meet patients’ nutritional requirements) of these meals. Methods: A two week observational investigation of inpatients requiring therapeutic meals across mixed wards at a Queensland tertiary hospital was conducted. Sixty- seven inpatients (31 females) aged 60.0±19.4 years had meal accuracy assessed for up to two days. Of these, food intake was able to be continuously monitored for a minimum of 24 hours in 48 patients allowing for the determination of nutritional adequacy. Errors were defined by type (e.g. provision of a restricted food), severity (e.g. critical vs non-critical) and source (e.g. foodservice). Nutritional adequacy was determined by a comparing daily energy and protein intakes to individually estimated requirements. Intakes were considered adequate if consumption was ≥75% of requirements. Results: Of 347 therapeutic meals observed, 69 (19.9%) were inaccurate. A larger proportion of these errors were critical (64.8%) of which over half were due to a direct contraindication to the prescribed diet (53.2%). Foodservice was the most common error source. Of the patients with complete intake data, 5 & 7 (10.4%, 14.6%) consumed adequate energy and protein to meet their nutritional requirements. Conclusion: Patients requiring therapeutic diets in hospital are frequently exposed to food and/or beverage errors that may pose an acute threat to their safety. In addition, long term administration of these diets may result in patients being unable to adequately meet nutritional requirements.

___

N Acute effect of exercise on Achilles tendon strain: A systematic review Leila Nuri.1, Michael Ryan.2, Richard Newsham-West.3 1,2,3 Centre of musculoskeletal research, Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction: Strain is an important mediator for Achilles tendon (AT) homeostasis. Exercise has been shown to acutely alter the mechanical properties and metabolic activity of tendon. However, it remains largely unknown to what extent there is a systematic effect of specific exercise modalities on the strain behaviour across the free tendon and whole AT (combination of free tendon and Gastrocnemius aponeurosis). Aim: The aim of this study was to review the literature to determine whether there is systematic and region-specific effect of an acute bout of exercise on AT strain in healthy men and women. Methods: A systematic search of the Medline, Web of Science, CINAHL, Scopus, SPORTDiscus, and Cochrane library was conducted in June 2014, supplemented by citation tracking. Studies were considered eligible if they reported the strain of AT immediately before and after completion of acute bout of exercise in healthy people aged 18 to 70. Two independent reviewers selected the eligible studies and assessed the study quality using the modified Galna assessment tool. Data on study participant characteristics, intervention protocol, methodology, tendon measurement site, and intervention effect were extracted. Results: Of 1645 studies identified, 8 met all the inclusion criteria across the following exercise conditions such as static stretching, isometric, concentric contraction, running jogging and walking. Study heterogeneity precluded formal meta-analyses. Overall, there is evidence that single bout of exercise caused no significant changes in whole AT strain. However, a significant increase in AT strain was found post-exercise in the isolated free AT of women. Conclusion: Female free AT strain was shown to experience significant changes after acute exercise. However, the effects of different modes, intensities and frequencies of exercises on free AT strain in both genders remains poorly understood.

___

63

P In vitro and in vivo activity of Melaleuca alternifolia Concentrate against West Nile Virus infection A. Pliego-Zamora1,2, J. Edmonds2, A. Khromykh2, and S.J. Ralph1 1 School of Medical Sciences, Griffith University, Gold Coast, Australia 2 Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, Australia Introduction: West Nile Virus (WNV) is a mosquito-borne, RNA virus that can cause serious disease in humans and animals for which no therapies are currently available1,2. Melaleuca alternifolia concentrate (MAC) is an extract derived from the essential oil of M. alternifolia and it is known to possess in vitro and in vivo antiviral properties against other RNA viruses such as Dengue virus. Methods: Two different strains of WNV were used: WNVKUNV and WNVNY99. Viral particles were incubated in MAC and the number of infectious particles was quantified. Vero cells were infected with WNVNY99 or WNVKUNV and treated with MAC 2h post-infection. The cytopathic effect (CPE), viral growth and replication kinetics were determined at 72h post-infection, using SytoxGreen cell-viability assay, plaque assay and quantification of NS1 positive cells by flow cytometry and immunofluorescent microscopy, respectively. Cell cycling analyses were used to investigate the mechanism of action of MAC. For in vivo experiments, C57BL/6 WT weanlings and IRF-3/-7 adult mice were inoculated with WNVKUNV and treated with MAC. Results: MAC treatment decreased: the infectivity of WNV particles by 10-fold at 15h after incubation, the CPE by 30%, the viral growth kinetics by 100-fold and the expression of NS1 by more than 50%. The mechanism of action of MAC against WNV is cell-cycle related, as the percentage of cells in G0/G1 phase increased compared with control-treated cells. MAC delayed the time of death in weanling WT mice and adult IRF-3/-7 and reduced the brain viral titres in IRF-3/-7 mice by 1000-fold. Conclusion: MAC possesses potent antiviral and virucidal activities in vitro. It is suggested that MAC could arrest the cells in G0/G1 phase thus avoiding the viral replication. In vivo, MAC delays the WNV infection and increases the time of survival. However, the frequency and delivery of the treatment requires optimisation. Reference: 1.Mackenzie, J.S., D. J. Gubler, et al. (2004). “Emerging flavivirues: the spread and resurgence of Japanese encephalitis, West Nile and dengue viruses”. Nature Medicine 10 Suppl 1(12s):

S98-S109. 2. Gould, E.A. and T. Solomon (2008). “Pathogenic flaviviruses.”The Lancet 371 (9611):500-509

___

R Can the energy drink ingredient taurine, be a killer as well as a protector? Gillian M.C. Renshaw1, Karina Dawson1, Sue Parker1.

1School of Allied Health Sciences, Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: Evidence indicates that taurine has a protective role in ischemia-reperfusion injury [1] and mitochondrial Ca2+ handling[2]. The effect of taurine has not been examined in a hypoxia and anoxia tolerant animal. We examined the effect of calcium loading in a hepatocyte culture from the hypoxia and anoxia tolerant epaulette shark + taurine, in response to a fixed anoxic challenge followed by reperfusion compared to its normoxic control to examine the effect of taurine. Methods: Isolated hepatocytes were seeded into 24 well plates at 5 x 105, allowed to attach overnight, then either exposed to an anoxic challenge for 1 hour followed by 3 hours of re-oxygenation or exposed to normoxia. The levels of necrosis and apoptosis were examined in calcium loaded primary hepatocyte cultures at baseline levels in L15 culture media, 50-fold, 100-fold or 200-fold above baseline [Ca2+]. Camptothecin was used as a positive control for cell death. Propidium iodide (PI) and annexin V were used to determine the level of necrosis and early apoptosis respectively in cultures + taurine. Results: There was an elevation in necrosis in normoxic taurine treated hepatocytes in the presence of 200-fold excess [Ca2+] over baseline levels compared to cultures without taurine. Conversely, taurine protected normoxic and anoxic cells from a lethal dose of camptothecin. A 90% lower level of necrosis was observed in anoxia treated cells when [Ca2+] was either 100 or 200 times the baseline [Ca2+] than at baseline. Early apoptosis was higher in (+) taurine in the normoxia but not the anoxia treated cells. Conclusion: A pronounced taurine-induced susceptibility to necrosis was evident in normoxic hepatocytes at high [Ca2+] but not at low [Ca2+] yet taurine treated normoxic cells exposed to a lethal dose of camptothecin had a lower level of necrosis than untreated cells

___

64

T Massive chromophobe renal cell carcinoma presenting with an acute small bowel obstruction. King J, O’Kane D, Tsing V. Department of Urology, Gold Coast University Hospital, Southport, Queensland Introduction: Incidental finding of large chromophobe renal cell carcinoma (ChRCC) in an elderly female presenting with a small bowel obstruction. Case Description: A 70-year-old female, presented to the emergency department with abdominal pain, distension, and vomiting. The patient was markedly distended in the left upper quadrant where a mass was clearly palpable. The patient had been asymptomatic and healthy, as she had no other medical history. (?delete 14 words vs. 13). Plain abdominal X-ray and computed tomography displayed evidence of a right sided closed loop bowel obstruction and a large calcified left sided renal mass. The incidental finding of a large (25x20x12cm) exophytic mass of the left kidney was identified. The mass was solid, lobulated, and contained linear calcifications radiating from a central necrotic scar. There was no evidence of metastatic spread. The patient underwent a laparotomy and left radical nephrectomy which was completed under the combined care of the general surgery and urology units. Discussion: This case illustrates an essentially incidental presentation of a large ChRCC in an asymptomatic 70-year-old female. The cause of the small bowel obstruction appeared to be related to an adhesive band in the right iliac fossa, independent of the left renal tumour. Despite the size of the ChRCC, there was no evidence of tumour invasion within the surrounding structures. Although studies have shown that radiological features of ChRCC are relatively variable, the tumour in this case displays many features previously described as characteristic of ChRCC.

___

V Influence of SUMOylation Inhibitors on a Parkinson’s disease Cell Model Vijayakumaran, S, Wong, MB, Pountney, DL. Griffith Health Institute, School of Medical Science, Griffith University, Gold Coast, Australia Introduction/Aim: An array of cellular responses attempt to defend cells from the formation of protein

aggregates in neurodegenerative diseases, including Parkinson’s disease (PD), by removing or detoxifying the aggregated proteins. SUMO-1 participates in the autophagy response to protein aggregates via SUMOylation of lysosomal Hsp90. In this study, the influence of two specific chemical inhibitors of the SUMOylation E1 enzyme, ginkgolic acid and anacardic acid, and the SUMOylation E2 enzyme inhibitor, spectinomycin, was determined on a cellular model of PD. Methods: Depolarization of SH-SY5Y neuroblastoma cells with 50 mM KCL was used to induce calcium influx and α-synuclein aggregation analogous to that observed in PD. Immunofluorescence confocal microscopy was used to determine aggregate burden and autophagy status with and without inhibitor pre-treatment. Results: Immunofluorescence revealed a decrease in the frequency of α-synuclein aggregates under both ginkgolic acid (p<0.01) and anacardic acid (p<0.1) treatments at 10µM. It also revealed that there was a significant reduction of punctate co-localization of SUMO-1 and the lysosome marker, Cathepsin D, under ginkgolic acid (p<0.001) and anacardic acid (p<0.01) treatments at 10µM. Furthermore, there was significant up-regulation of LC3 (p<0.05), marking autophagosomes, under ginkgolic acid treatments from 3µM to 10µM and under anacardic acid treatments from 6µM to 10µM. Similar results were obtained under the influence of spectinomycin. Conclusion: The findings suggest that inhibition of the SUMOylation pathway disrupts SUMO-1 co-localization with lysosomes. The increased levels of LC3-positive autophagosomes and decline in the frequency of protein aggregates in cell culture suggest that macroautophagy may have a key role in mediating protein aggregate clearance in response to SUMO-1 inhibition. On-going studies are analyzing Hsp90-SUMOylation and its relation to autophagy under SUMO-1 inhibition.

___ W Ischemic tolerance and mitochondrial respiration in hearts targeted with the pharmacological blockade, mdivi-1, of mitochondrial fission protein Dynamin-related-protein-1 (Drp-1). Wendt, L.1, See Hoe LE.1, Sachaphibulkij, K.1, Peart, JN.1, Headrick, JP.1 1 Griffith Health Institute, Griffith University, Southport, Australia Introduction/Aim: Mitochondrial division is regulated by the mitochondrial fission protein Dynamin-related protein-1 (Drp-1) and is upregulated in hearts subject to ischaemia-

65

reperfusion, resulting in myocardial dysfunction. We aimed to examine the effects of pharmacological blockade of mitochondrial fission protein Drp-1 upon mitochondrial morphology and functional tolerance to ischaemia-reperfusion in mouse hearts. Methods: 16-week-old male C57/BI6 mouse hearts were langendorff-perfused and administered a Drp-1 inhibitor, mdivi-1 [1 μM], for 20 mins, followed by 25 mins ischemia and 10 mins reperfusion. Functional recoveries (left ventricular developed pressure, LVDP) and cell death were assessed post-ischaemia. Mitochondria were isolated from the left ventricle post-reperfusion, and O2 consumption was quantified using the Oxygraph-2k instrument. Protein expression of total-Drp-1 (Ser637), phospho-Drp1 (Ser637), and cardioprotective Akt and Erk were assessed via western blot in cytosolic and mitochondrial fractions. Results: Functional tolerance to ischaemia-reperfusion was improved in hearts subjected to Drp-1 inhibition with mdivi-1. Additionally, Drp-1 inhibition augmented post-ischaemic mitochondrial O2 consumption in complex I and II. This was coupled to a reduction in post-ischaemic total-Drp-1 expression in mitochondrial and cytosolic fractions. Conclusion: These preliminary findings suggest that mdivi-1 preserves mitochondrial morphology and respiratory function, highlighting Drp-1 as a regulator of mitochondrial function and a potential target for therapeutic intervention.

___

66

A The prevalence of cardiovascular disease and associated risk factors among adult population in the Gulf Cooperation Council: A systematic review Mrs Najlaa Aljefree¹ and Faruk Ahmed², PhD 1 Griffith Health Institute, Griffith University, Gold Coast, Australia 2 Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: Cardiovascular disease (CVD) is a principal cause of mortality and disability globally. This paper aims to analyse the epidemiological data on CHD, strokes, and the associated risk factors among adult population in the Gulf countries. Methods: A systematic review of published articles between 1990 and 2013 was conducted using Pro-Quest Public Health, MEDLINE, PubMed and Google Scholar databases, and the WHO website. Results: The analysis included 62 relevant studies. CHD prevalence was reported in one national study in Saudi Arabia as 5.5%. The annual incidence of strokes ranged from 27.6 to 57 per 100 000 in the Gulf countries with ischaemic stroke being the most common subtype. The prevalence of diabetes was remarkably higher among Acute Coronary Syndrome (ACS) patients in Saudi Arabia compared to the other Gulf countries, with hypertension and diabetes being the most common risk factors among stroke and ACS patients in the Gulf States. Based on the available data within the region, the prevalence of overweight and obesity is remarkably high in the GCC states. Overweight and obesity ranged from 31.2% to 43.3% and 22% to 34.1% in males, and from 28% to 34.3% and 26.1% to 44% in females respectively in the GCC. The prevalence of hypertension, diabetes, inactivity and smoking were 26% to 50.7%, 9.3% to 46.8%, 24.3% to 93.9% and 13.4% to 52.3% in males, and were 20.9% to 57.2%, 6% to 53.2%, 56.7% to 98.1% and 0.5% to 20.7% in females respectively. Dietary patterns among adults showed that the majority of adults were consuming a high amount of snacks, fatty foods, sugar and fast food. Conclusion: There was a lower incidence of strokes in the GCC countries and those affected were younger than in some developing and developed countries. Despite the lack of data on the prevalence of CHD on the region, a high prevalence of key risk factors was reported. The Gulf region will face a soaring epidemic of CVD mortality and morbidity in the coming years because of the high prevalence of CVD risk factors and the relatively younger population. Effective preventative strategies and education programs are crucial, as well as better health care systems.

___

Understanding the neuroprotective effects of resveratrol in a cell-based model of alcohol-induced neuroinflammation Amiet, B., Colson, N., Lewohl, J. Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: Chronic alcoholism and related disorders of alcohol misuse is known to result in changes in brain structure and neurodegeneration. Excessive alcohol consumption results in changes in expression of selected miRNAs which regulate the genes underlying the adaptive response of neurons in the human prefrontal cortex. The objective of this project was to develop a cell-based model to gain a finer understanding of the underlying mechanisms of ethanol-induced neuroinflammation and to determine if this can be ameliorated by the natural phytochemical, resveratrol. Methods: Treatment conditions were optimised by exposing HEK293T cells to resveratrol at different concentrations, for various lengths of time and delivered as either a pre-treatment or a co-treatment with ethanol. Resazurin assays were used to determine cell viability throughout the optimisation process and a dose-dependent curve was generated. Following optimisation, a direct ethanol exposure model was carried out by exposing HEK293T cells to different combinations of resveratrol and/or ethanol for either an acute or chronic time course with and without a withdrawal period. Resazurin assays were used as an end point assay and Real-Time PCR was used to detect changes in expression of selected miRNAs. Results: Optimisation of treatment and exposure conditions allowed for the development of the acute and chronic direct ethanol-exposure models. Cellular viability changes were observed between samples exposed to ethanol only and those treated with resveratrol, and thus changes in miRNA expression were also observed. Conclusion: Preliminary findings from this project will contribute to our understanding of the neurodegenerative mechanisms in the human brain and furthermore allow us to identify the therapeutic properties of resveratrol that may be used in the treatment of alcohol misuse as well as other neurodegenerative conditions.

___

67

Lower limb sagittal plane running kinematics: A comparison of barefoot and shod conditions Arnold, BJW 1, Weeks, BK 1, 2 and Horan, SA 1, 2 1 School of Allied Health Sciences, Griffith University, Gold Coast, Australia 2 Centre for Musculoskeletal Research, Griffith Health Institute, Griffith Australia Introduction/Aim: Over the past decade there has been significant interest in barefoot running. Commensurately, a number of biomechanical studies have been undertaken to compare kinematics between barefoot and shod conditions. Most studies, in fact, have examined such differences in a laboratory environment, with participants running on a treadmill. For most people, however, running on a treadmill is an unfamiliar task and therefore their running technique may change over time as they ‘adjust’. Therefore, the aim of this study was to examine temporal changes in running kinematics and differences between footwear conditions. Methods: 21 young healthy adult men (age 21.9 ±2.9 years) free from musculoskeletal injury and with minimal treadmill running experience volunteered. Participants were randomly allocated to barefoot (n=8) or shod (n=13) conditions. Participants were asked to run for 20 minutes at a comfortable pace on an instrumented treadmill, using a10-camera Vicon motion analysis system their kinematic data (ankle dorsiflexion, knee and hip flexion at initial contact) were collected every 2 minutes. A two-way ANOVA with factors of time and footwear condition was used to test our hypotheses. Results: For ankle dorsiflexion, no effect of time (F=0.064, p=1.00), footwear condition (F=0.008, p= 0.927), or an interaction (time*footwear condition) (F=1.057, p=0.994) could be detected. A significant effect of footwear condition was observed at the knee (F=38.847, p<0.001) with greater flexion exhibited for barefoot running compared to the shod condition; however, there was no effect of time (F=0.064, p=1.00), nor an interaction (F=0.223, p=0.994). No significant effect of time (F=0.405, p=0.943), footwear condition (F= 0.055, p=0.814), nor an interaction (F=0.167, p=0.998) was observed for hip flexion. Conclusion: Whilst we observed a difference in sagittal plane kinematics at the knee between barefoot and shod conditions, we did not observe any temporal changes over time for either footwear condition at the hip, knee or ankle.

___

Factors influencing non-attendance to a medical appointment in a regional Australian primary health care setting: a mixed methods approach Nancarrow, S1., Avila, C. 1, Bradbury, J.1, Ackter, S. 1 and Doran, F. 1

1School of Health and Human Sciences, Southern Cross University, Gold Coast, NSW

Introduction: Non-attendance at medical appointments risks patients’ health and drains resources. A regional general practice with a low-socioeconomic catchment, serving a large Aboriginal population, provided the setting for an investigation of factors influencing non-attendance. Methods: A mixed methods design was used. Quantitative: A retrospective cohort study on the patient database of appointments between 2011- 2013 was conducted. Logistic regression modelling was used to determine risk factors (odds ratios (OR)) for failure to attend (FTA). Qualitative: All staff were invited to explore their perceptions of non-attendance; influential factors; at-risk groups and mitigation strategies via individual interview, group discussion and/or written responses. Verbatim transcripts were analysed with the assistance of NVivo10 qualitative data analysis software. Thematic analysis was undertaken. Results: Quantitative: Indigenous Australians were three times more likely to miss a scheduled appointment than non-Indigenous Australians (OR=3.00, 95%CI: 2.85–3.17), with a trend towards Aboriginal women being at the highest risk (OR=1.27, 95% CI: 0.95, 1.71). Aboriginality was the only significant predictive factor for missed appointments in children and young people with Aboriginal children 2.91 (95% CI: 2.19–3.88) times more likely to miss an appointment than non-Aboriginal children. Qualitative: Free medical care, transport provision, responsive appointment times and reminder systems reduced practical barriers to attendance, but were seen to devalue allocated appointments. Staff perceived Aboriginal patients as particularly wary of authority, which combined with poor health literacy impacted negatively on uptake of diagnostic tests, health monitoring and adherence to medication. Conclusions: The identification of high rates of non-attendance by Aboriginal females and children requires further investigation and could have significant public health implications in terms of ‘closing the gap’. Wider social issues including low socio-economics status and low health literacy are perceived as important determinants of non-attendance for some groups, where locally modifiable factors such as reminder systems and transport are in place.

___

68

B An exploration of midwives’ understanding and experiences of antenatal questioning relating to intimate partner violence against women during pregnancy Dr Kathleen Baird, Professor Debra Creedy, Jennifer Eustace, Amornrat Saito

Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, Logan Campus, Australia. Aim: To investigate midwives’ knowledge of intimate partner violence (IPV) against women during pregnancy. Introduction: There is growing awareness for health professionals to become pro-active when responding to intimate partner violence (IPV). While the use of brief questioning is known to lead to higher rates of disclosure by women, many health professionals are reluctant to use a framework of enquiry to ensure each women feels safe to disclose; possibly because they lack the confidence and knowledge to do so. Methods: A mixed methods design was used. A convenience sample of midwives was recruited through the Australian College of Midwives to complete an online survey about knowledge, training, and practice. Some respondents were also interviewed. Collecting the views and experiences of midwives in relation to routine enquiry allowed for detailed contextualisation of findings from a practitioner perspective. Data Analysis: Survey responses were analysed using descriptive statistics. Shapiro-Wilk test was significant (<0.001), therefore non-parametric tests such as Spearman rho, Mann-Whitney U-test, and Kruskal Wallis test were used. Qualitative data analysis of the interviews was inductive, allowing the patterns to arise from the data. Ethics: Ethical approval was obtained from Griffith University Human Research Ethics Committee. Results: Factors associated with midwives’ actual knowledge of IPV were investigated. Overall knowledge levels were good but common misconceptions were evident. There was a significant relationship between knowledge scores and reported education and training on IPV. Midwives who reported some training had a higher score for knowledge compared to those who had no training (Mann Whitney =1,272, p = .003). Telephone interview data also suggests that midwives feel unprepared to support a woman who discloses about IPV and require further education. Conclusion: Despite some midwives having very little or no IPV education, they believed that antenatal enquiry in the antenatal period was important. However, they considered that ongoing education and support was vital in supporting them

to carry this role and address the unique needs of each woman.

___

Maximising research opportunities through collaboration and capacity building Marshall, A.P., Baker, M., Keijzers, G., Crilly, J., Young, J., Stapelberg, C. 1 Griffith Health Institute, Griffith University, Gold Coast, Australia 2 Gold Coast University Hospital, Southport, Queensland, Australia Introduction/Aim: In the year following the move to the Gold Coast University Hospital (GCUH) we aimed to describe research capacity and capability within the Gold Coast Hospital and Health Service (GCHHS), providing a benchmark against which future research activity could be evaluated. Methods: As part of a mixed-methods study we conducted semi-structured interviews with 22 health care professionals. Data were transcribed verbatim. Inductive content analysis was used to identify themes. Results: All participants described involvement in research designed to improve the providing of healthcare to patients and families within the GCHHS. Participants identified a number of key requirements they believed to be important for developing a tertiary health service. Building collaborations both internally and externally was seen as necessary to form successful teams capable of conducting high quality research. Such collaborations included strong academic partnerships which were considered important to address gaps in research expertise that were identified as existing in some areas within the health service. All participants highlighted challenges in navigating the research process and identified skilled mentorship as a necessary requirement for novice and early career researchers, although how to access to such mentorship was not always clear. At an organisational level, challenges in embedding research into clinical work was described although there was the perception that this could be overcome through more overt organisational support for research which is necessary to limit missed opportunities. There was recognition of the importance the organisation placed on developing as a research-infused health service however the need to shift from rhetoric to reality was emphasised. Conclusion: GCHHS is developing as a tertiary health services with potential to be a leader in health-related research. It is essential that resources are made available to support the implementation of structure and processes to support the conduct of high quality research within the organisation.

69

Oral Cancer; An Evaluation of Knowledge and Awareness Between Undergraduate Dental Students, Dentists and The General Public.

Bakr, M1, George, R1, Khan, U2, Skerman, E1. 1 School of Dentistry and Oral Health, Gold Coast Campus Griffith University QLD 4215, Australia. 2Dalby Dental Clinic, Dalby, Western Darling Downs, QLD 4405, Australia.

Introduction/Aim: Oral cancer is a disease with well-known modifiable risk factors, with smoking and excessive alcohol consumption the principal risk factors in the western world. Despite this knowledge, mortality rates associated with oral cancer have remained alarmingly constant over the last ten years within Australia. As the majority of oral cancer lesions are detected in the advanced stages, the long term prognosis for patients is poor. This reiterates the importance of early detection of oral cancer lesions. The aim of this study was to evaluate the level of knowledge regarding oral cancer held by undergraduate dental students, dentists and members of the general public in relation to the signs, symptoms and risk factors associated with the disease. Concurrently, we aspired to raise awareness of the importance of early detection of oral cancer lesions and highlight areas where knowledge is insufficient or incorrect. Methods: The evaluation of oral cancer knowledge was conducted within GriffithUniversity - Australia, with two hundred and fifty self-report questionnaires distributed amongst undergraduate dental students, dentists and dental patients as they interacted within the School of Dentistry and Oral Health. Results:Findings from this study have indicated that the knowledge about oral cancer, its signs, symptoms and risk factors is limited, with the exception of smoking and persistent ulceration, amongst the dental personnel and dental patients. Conclusion:This study highlights the need to raise awareness and increase knowledge pertaining to oral cancer not only in the general community but also amongst the people who represent the future of dentistry.

___

A decade of Medicare Chronic Disease Management: Contribution of Dietetics to Individual and Group services from 2004-2013. Cant, R.1, Ball, L.2

1School of Nursing and Midwifery, Monash University, Melbourne Australia 2Health Practice Innovation, Griffith Health Institute, Griffith University, Brisbane, Australia

Introduction/Aim: Since its inception in 2004, the Medicare Chronic Disease Management (CDM) program has enabled eligible patients to receive subsidized services from a range of allied health professionals operating in Australian primary care settings. The aim of this study was to review changes in utilisation of dietetics services through the Medicare Chronic Disease Management program since inception, and describe recent patient uptake. Methods: Dietetics service data were extracted from published Medicare statistics for the periods (i) January 2004 to December 2013 and (ii) January to December 2013. Data comprised individual dietetic services by state and patient demography, and group services data for provider professions regarding type 2 diabetes: dietitians, diabetes educators and exercise physiologists. Associations between dietetics’ individual service utilisation and workforce statistics were investigated using Pearson product-moment correlation co-efficient. Results: Individual dietetics Chronic Disease Management consultations in private practice have increased annually since 2004. Dietetics has remained the third largest provider. In 2013, a total of 302,910 individual consultations were conducted; 7% of Allied Health consultations. Likewise, individual services for Indigenous Australians increased since 2008. Group services for type 2 diabetes comprised <2% of dietetics services. Dietitians provided more group services than diabetes educators but considerably fewer than exercise physiologists. Middle-aged and older patients were common, with highest uptake by those aged 55-74 years. Total and per capita utilisation rates were considerably higher in NSW, Victoria and Queensland compared to less populous states, although this disparity has reduced since 2010. Conclusion: Dietetics services within the Medicare Chronic Disease Management program continues to be highly utilised. There appears to be opportunity for dietitians to increase group dietetics service provision for type 2 diabetes, as well as services in less populated states and territories in Australia.

___

The impact of an isolated afterload stress on left ventricular mechanics: A two-dimensional speckle-tracking echocardiographic study. Balmain, B.1, Stewart, G.1, Yamada, A.1, Haseler, L.1, Chan, J.1,2, Sabapathy, S.1 1Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Australia 2The Prince Charles Hospital, Brisbane, Gold Coast Introduction: Isometric handgrip exercise (IHG), via invocation of the exercise-pressor reflex, elicits an increase in systemic blood pressure and

70

provides a functional model to assess the impact of afterload on left ventricular (LV) function. However, IHG also increases heart rate, which may independently influence LV function. The aim of this study was to examine the efficacy of an optimised ventricular afterload model, by documenting the effects of IHG coupled with a period of post-exercise circulatory occlusion – known to sustain exercise-induced increases in afterload without an increase in heart rate – on echocardiographic indices of LV contractile mechanics. Methods: 2-dimensional speckle-tracking echocardiography was used to assess LV basal and apical rotation, and LV torsion in 19 healthy participants (23±2 yr) at rest, during 3 min of IHG, and during 3 min of forearm circulatory occlusion (OCC) immediately following IHG. Blood pressure and heart rate were measured concurrently. Results: IHG elicited a significant (p<0.001) increase in mean arterial blood pressure (Rest: 91±1, IHG: 122±2 mmHg) and heart rate (Rest: 65±2, IHG: 91±4 beats.min-1). In contrast, mean arterial pressure remained elevated (116±2 mmHg; p<0.001 v Rest), while heart rate returned to resting levels (68±3 beats.min-1; p=0.159 v Rest) during OCC. Basal rotation remained unchanged from rest through IHG and OCC; however, apical rotation decreased significantly (p<0.01) by 10±5% during IHG and 26±12% during OCC. LV torsion decreased from Rest to IHG (12±5%; p=0.015) and Rest to OCC (21±4%; p=0.001). Conclusion: An increase in afterload generated by IHG, and isolated by a brief period of circulatory occlusion, impairs aspects of LV contractile mechanics. Decreases in LV torsion in response to IHG and OCC were driven primarily by dampened apical rotation. We propose that a protocol including isometric exercise followed by circulatory occlusion provides an optimised in vivo method for studying the effects of afterload on LV function.

___

Recommending Exercise for Osteoporosis: What will patients do? Beck, Belinda 1,2 1 School of Allied Health Sciences, Griffith University, Gold Coast, Australia 2 Centre for Musculoskeletal Research, Griffith Health Institute Introduction: The greatest barrier to effective exercise prescription is lack of compliance. Rapid, high load exercise is required to enhance bone, but is not traditionally recommended for people with osteoporosis owing to perceived limitations of safety, feasibility and acceptability. In fact, clinicians routinely prescribe more ‘appealing’ or ‘feasible’ low intensity exercise such as walking for osteoporosis, despite known limited effectiveness

for bone. Improving osteoporosis management depends on melding more effective exercise prescription with patient and clinician acceptability. Aim: To determine the nature of acceptable and feasible exercises for individuals at risk of osteoporotic fracture. Methods: Individuals over 65, or over 45y with osteoporosis, were recruited from the community to complete a 19-item survey. Non-ambulant and cognitively-impaired individuals were excluded. Age, sex, living arrangements, current level of activity, relevant medical history/disability, exercise habits, preferences and perceived capacity were recorded. Means (±SD) and percentage distributions of responses were calculated. Results: 165 (86.7% F) Australians (71±1 years; 99% Caucasian; 97% living independently; 9% ‘sedentary’, 53% ‘lightly active,’ 35% ‘active’ and 3% ‘very active’), completed the survey. 31% suffered a degree of musculoskeletal disability, 25% had back pain, 19% had poor balance and 12% had a cardiorespiratory condition. Almost 99% felt they were capable of walking, 90% stretching, 75% lifting weights and Tai Chi, 73% swimming, 69% squatting, 67% dancing, 57% cycling, 52% hopping, 45% jumping, 39% climbing, and 36% running. Of the osteogenic exercises, 76% indicated they would be willing to lift weights, 73% to squat, 60% to skip, 57% to hop, 49% to jump, and 42% to run, if prescribed for their bone health. Conclusion: Results suggest the majority of individuals at risk of osteoporotic fracture are willing, and consider themselves able, to engage in the types of exercises that benefit bone, including high intensity loading. Once safety of such exercises is established, less conservative, more effective exercise prescription should be advocated for individuals with osteoporosis.

___

Understanding the molecular basis of hereditary neuroendocrine neoplastic pathology of paraganglioma 2 Bezawork-Geleta, A1, Dougan, DA1, Neuzil, J2 and Truscott, KN1.

1 Department of Biochemistry, La Trobe Institute for Molecular Science, La Trobe University, Melbourne, Australia 2 Mitochondria, Apoptosis and Cancer (MAC) Research Group, Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: Mutations in succinate dehydrogenase (SDH) subunits and assembly factors cause a range of clinical conditions. One such condition, hereditary paraganglioma-2 (PGL2), is caused by a G78R mutation in the assembly factor SDH5 whose role is to mediate SDHA flavination. However, the factors that contribute to

71

the loss-of-function of SDH5G78R remain unknown. Methods: We examined the SDH5G78R pre-protein processing, structural state in solution, the dynamics of its association with SDHA and its stability within mitochondria to get insight if impairment to its import, structure or stability contributes to dysfunction. The contribution of matrix AAA+ proteases to SDH5 turnover both in mitochondria and in vitro using purified recombinant SDH5 was also determined. Results: we found that the import and maturation of human SDH5G78R was normal, while its stability was significantly reduced with 20% of the protein remaining after 180 min compared to 80% for the wild-type protein. Importantly, the metabolic stability of SDH5G78R could be restored to wild-type levels by depleting mitochondrial LON (LONM). Degradation of SDH5G78R by LONM was confirmed in vitro; however, in contrast to the in organello analysis, wild-type SDH5 was also rapidly degraded by LONM. Depletion of SDHA also resulted in a reduction to the steady-state levels of SDH5, confirming that SDH5 is unstable in the absence of SDHA. Blue native PAGE analysis showed that the imported SDH5G78R formed a transient complex with SDHA while this complex was stabilised in LONM-depleted mitochondria. Conclusion: Collectively, these data demonstrate that in the disease state a labile complex exists between SDHA and SDH5G78R; however, due to the efficient proteostatic network in the mitochondrial matrix, the effects of the mutation are exacerbated, suggesting a tailored inhibition of LONM-mediated SDH5G78R degradation may provide a therapeutic opportunity for individuals predisposed to develop PGL2.

___

Validation of fentanyl patch adhesion scoring tool for use in clinical application Bista, SR.1, Hardy, J.2, Tapuni, A.2, Fu, J.2, Gibbons, K.2, Good, P.2, 3, Norris, R.1, 2, 4, Haywood, A.1

1School of Pharmacy, Griffith Health Institute, Griffith University, Gold Coast, Australia 2Mater Research Institute, The University of Queensland, South Brisbane, QLD, Australia 3St Vincent’s Private Hospital, Brisbane, Australia 4SydPath, St Vincent’s Hospital, Sydney, NSW, Australia Background and Aims: The therapeutic efficacy of a transdermal delivery system is directly related to the adhesion of the patch. Partial adhesion is likely to result in a lower plasma concentration. A validated scoring system assessing adhesion at the time of sampling for pharmacokinetic studies is required. The US Food and Drug Administration (FDA) have developed a patch adhesion scoring

tool for industrial purpose. However the tool has never been validated for clinical use. The aim of this study is to validate the FDA scoring system for the adhesion of fentanyl patches in cancer patients. Methodology: A library of images was created from photographs of fentanyl patches/placebo on the limbs/chest of patients/volunteers. Thirty photographs, reflecting varying degrees of adhesion, were selected for each of series A and B, with 10 photographs common to both series. Each series was shown to 30 health professionals asked to score the photographs using the FDA scoring system. Validity was assessed using Spearman’s Rank Correlation and reliability by Cohen’s Kappa (k). Photo editing software (Adobe Photoshop C6 Extended) was utilised to assign control scores to each photograph. Results: Validity was high for both series (≥0.954). Inter-reliability ranged from 0.327 - 0.858 (combined k=0.547) and 0.433 - 0.910 (combined k=0.620) in series A and B respectively, with lower k’s being associated with FDA scores 1 and 2. The combined agreement across both series was 0.585. Intra-rater agreement of the 10 common images was 0.605 (SE 0.028). Conclusion: The FDA scoring system is an adequate tool for assessing fentanyl patch adhesion in clinical practice.

___

A descriptive study of patients presenting to the Emergency Department with a mental health illness and the impact of a patient flow strategy in a Queensland hospital Bost, N.1,2, Crilly, J.1,2, Wallen K.2 1 Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, Gold Coast campus, Australia 2 Gold Coast Hospital & Health Service, Queensland Health Introduction: Emergency department (ED) presentations to Australian public hospitals are increasing on average 3.6% per annum, contributing to ED overcrowding and hospital access block. EDs are the primary point of entry for many patients with mental health illness (MHI) who require treatment for acute, often distressing, symptoms. Aim: The aims of this study were to 1. Describe and compare characteristics and outcomes between MH and non mental health (NMH) ED presentations and 2. Describe and compare characteristics and outcomes of patients who presented to the ED with MH illness before and after the implementation of a MH patient flow strategy which consisted of the use of MH triage guidelines and changes to the referral and transfer process from ED to MH. Methods: This was a descriptive, retrospective study. All patient

72

presentations to one Queensland ED between 5th September 2011 and 4th September 2012 were included. Results: There were 66,678 ED presentations; 4.5% (n=3,037) were coded for MHI. When compared to the NMH group, a higher proportion of the MHI patient presentations had an ED length of stay (LoS) of more than 4 hours (57% vs. 46%, p<0.001) and a higher proportion required hospital admission (38% vs. 21%, p<0.001). Following the implementation of the MHI patient flow strategy there was an improvement in the frequency of MHI patients being discharged from the ED within 4 hours (pre: 40% vs post: 47%; p<0.001). For patients requiring hospital admission for MH illness, the proportion waiting longer than 8 hours in ED decreased (pre 29% vs. post: 21%, p<0.001). Conclusion: Our findings indicate that while there was an improvement in ED LoS, further ED initiatives are required for all patient presentations, particularly those with MHI who do not require hospital admission. This requires a coordinated and ongoing approach across the hospital to improve timely care and reduce pressure on the busy ED.

___

Deep learning through a greater “sense of purpose” Kerr, I.1, Salajegheh, A.2, Ayres, A.2, Brennan, T.2, Harrison, C.3, Donald, K.2 1 Melbourne Medical School, The University of Melbourne, Melbourne, Victoria Australia 2 School of Medicine, Griffith Health Institute, Griffith University, Gold Coast, Queensland Australia 3 Monash Medical School, Monash University, Monash Victoria Australia Introduction: The OSCE is an accepted format to assess clinical skills. Assessment driving learning and being an important vehicle for learning are acknowledged concepts in educational literature. Methods: A group of Year 2 students of a four year medical program developed OSCE stations for a formative exam. Input from academic staff ensured that the stations were of comparable quality and standard to those used in summative examinations. The developed stations were used in a non-compulsory Year 2 formative OSCE. The study compared the summative exam results in 3 groups:- a) the station writers, b) formative OSCE examinees and c) those sitting only the summative assessment. Summary of results: The means of groups (/800) a, b and c were 490, 481, 473 respectively measured by ANOVA, with group (a) significantly higher mean mark compared to (c) (SE=6.75, p= 0.012). Conclusions: Student development of OSCE stations resulted in students being required to deconstruct the respective skills

and consider the sub skills involved in the process. This improved students ability to demonstrate, in a summative OSCE that the skill had been learned. The student and academic staff collaboration resulted in improved staff student relationships. Involvement of students in the development of OSCE stations results in an improvement in their clinical skills. Take-home message: Student involvement in development of assessment items motivates deep learning through a greater “sense of purpose” with a consequent improvement in their clinical skills.

___

Demoralization: an update of the literature over the past decade Lynne Briggs Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: The controversial debate about demoralization centres on whether it constitutes a syndrome of despair, distress and hopelessness that distinguishes it from clinical depression, or whether it is a normal response to difficult circumstances. This debate has increased considerably over the past decade as some researchers are postulating that demoralization should be seen as a syndrome in its own right. Objective: to provide an update on the literature over the last decade in regards to the development of demoralization, the psychological features, assessment tools and treatment. Method: The literature search included six main databases (CINAHL, Medline, Pubmed, PsycINFO and Proquest). Each database was searched for records pertaining to demoralization. Search terms were restricted to the most relevant words (demoralization and subjective incompetence). Results: Although demoralization shares some key characteristics found in clinical depression there are certain significant differences in the clinical features, a major one being the lack of anhedonia. Conclusion: The findings from the literature reviewed suggest that the overlap of symptoms between demoralization and clinical depression complicates clinical presentations and makes differentiating between the two disorders difficult. It also highlighted the need for further research to confidently separate demoralization from clinical depression and the requirement for different assessment and treatment approaches.

___

73

Myocyte Enhancer Factor 2c, an Osteoblast Transcription Factor Brunt, AR., Forwood, MR., Morrison, NA. School of Medical Science and the Griffith Health Institute, Griffith University, Gold Coast, Australia. Controlling the differentiation potential and fate of cultured osteoblasts is a useful tool for stem cell-mediated therapies for fracture and other orthopaedic problems. Dimethyl sulfoxide (DMSO) is a small amphipathic solvent molecule capable of stimulating cell differentiation. In primary human osteoblasts, DMSO dose-dependently enhanced the expression of osteoblast differentiation markers alkaline phosphatase activity and extracellular matrix mineralization (Stephens et al., 2011). Similar DMSO-mediated mineralization enhancement is observed in primary osteoblast-like cells differentiated from mouse mesenchymal cells derived from fat. Using a mouse pre-osteoblast model cell line MC3T3-E1, we report that DMSO treatment is correlated with enhanced mineralization and the increased expression of osteoblast-expressed genes. Myocyte enhancer factor 2c (Mef2c) was the transcription factor most induced by DMSO, suggesting a role for Mef2c in osteoblast gene regulation. Immunohistochemistry confirmed expression of Mef2c in osteoblast-like cells in mouse mandible, cortical, and trabecular bone. shRNAi-mediated Mef2c gene silencing resulted in defective osteoblast differentiation, decreased alkaline phosphatase activity, matrix mineralization and knockdown of osteoblast specific gene expression. A flow on knockdown of bone-specific transcription factors, Runx2 and osterix by shRNAi knockdown of Mef2c, suggests that Mef2c lies upstream of these two important factors in the cascade of gene expression in osteoblasts. The co-transfection of Mef2c and Runx2 into MC3T3-E1 cells induced a significant increase in osteoblast differentiation markers alkaline phosphatase activity and extracellular matrix mineralization at 10-days following the induction of osteoblast mineralization (p<0.05). These data suggest that Mef2c is a transcription factor that acts in osteoblasts to regulate osteoblast specific genes.

___

Developing an alcohol policy assessment toolkit: application in the western Pacific Carragher. N1, Byrnes, J.2, Doran, C.1 , Shakeshaft, A. 1 National Drug and Alcohol Research Centre, University of New South Wales University, Sydney, Australia

2 Centre for Applied Health Economics, Griffith Health Institute, Griffith University, Meadowbrook, Australia 3 Hunter Medical Research Institute, University of Newcastle, New Lambton, Australia Aim: To demonstrate the development and feasibility of a tool to assess the adequacy of national policies aimed at reducing alcohol consumption and related problems. Methods: We developed a quantitative tool to assess the level of stringency and enforcement of 16 alcohol control policies (Toolkit for Evaluating Alcohol-policy Stringency and Enforcement – TEASE 16). TEASE-16 was applied to policy data from nine study areas in the Western Pacific: Australia, China, Hong Kong, Japan, Malaysia, New Zealand, the Philippines, Singapore and Viet Nam. Correlation and regression analyses were then used to examine the relationship between alcohol policy scores and income-adjusted levels of alcohol consumption per capita. Results: Vast differences exist in how alcohol control policies are implemented in the western Pacific. Out of a possible 100 points, the nine study areas achieved TEASE-16 scores that ranged from 24.1 points for the Philippines to 67.5 points for Australia. Study areas with high policy scores – indicating relatively strong alcohol policy frameworks – had lower alcohol consumption per capita. Sensitivity analyses indicated scores and rankings for each study area remained relatively stable across different weighting schemes, indicating that TEASE-16 was robust. Conclusion: TEASE-16 could be used by international and national regulatory bodies and policy-makers to guide the design, implementation, evaluation and refinement of effective policies to reduce alcohol consumption and related problems.

___

C Talking Circles: nurturing health and wellbeing Cartmel, J. Casley, M. Smith, K. Griffith Health Institute, Griffith University, Nathan, Australia Introduction/Aim: ‘Talking Circles’ can be used to discuss and listen to children’s ideas about things that matter to them. They are an innovative technique for having conversations between and with children to promote and support their right to participate (Article 12) and to play (Article 31). They are used to nurture children’s wellbeing. The ‘Talking Circles’ research began as part of a Griffith University community partnership project titled “ Gathering the wisdom of children”. Methods: The use of ‘talking circles’ in Australian school age care

74

settings for children aged 5- 12 years was examined to investigate about effectiveness to support high quality outcomes for children in relation to their wellbeing. Action research approaches were used to develop and examine the conversations to nurture the social and emotional competence and wellbeing of children, particularly leadership skills, sense of purpose and resilience. Results: The children named the conversations ‘Talking Circles’. Use of the talking circles had many benefits for the children and educators who gained confidence in their abilities to communicate with each other and manage the power imbalance that can occur in adult child interactions. Key findings from the research about talking circles where children were playing with ideas and concepts through intentional conversations were:

• Strengthened friendships and attachments • Reduced children’s stress • Shared feelings, concerns • Self discovery • Collaborative responses to community

issues Conclusion: The ‘Talking Circles are an effective strategy to link children and professionals to develop responses to their local contexts.

___

Different perceptions of when mobilisation should begin in intensive care unit (icu) patients among health care professionals? Courtney Clark1, Karen Kin-Yue Koo2, Surendran Sabapathy1, Carol Hodgson3 and Norman Morris1

1 School of Allied Health Sciences and Heart Foundation Research Centre, Griffith University. 2 Department of Medicine & Division of Critical Care, University of Western Ontario London, Ontario, Canada 3The Australian and New Zealand Intensive Care Research Centre, Monash University Introduction/Aim: ICU patients often develop new neuromuscular disorders secondary to their critical illness. While there is good evidence that early mobilisation can reduce the impact of these disorders, clinical pratice of early mobilsation remains low in most ICUs within Australia and New Zealand. One important barrier to mobilisation may be different perceptions amongst health care professionals about when to begin mobilisation. To compare the perceptions of when mobilisation should begin between ICU physicians, nurses and physiotherapists. Methods: As part of a larger survey using a previously validated survey tool sent to ICU’s in Australia and New Zealand, participants were asked “Generally speaking, when do you think mobilisation should be initiated in the ICU?”. Results: Ninety-eight surveys were returned. Most ICU physicians (n=26), nurses (n=33) and

physiotherapists (n=36) agreed that patients should begin mobilisation prior to discontinuation of sedative and vasoactive medications, patient extubation and before ICU discharge (>80% of respondents). Respondents (>70%) frequently agreed that patient’s cardiorespiratory status should be stable (no escalation in haemodynamic or ventilator support) prior to mobilisation. Physiotherapists and ICU physicians agreed that mobilisation should begin at ICU admission whereas nurses in general suggested that ICU admission should not necessarily initiate mobilisation (χ2=13.7, p<0.01). Physiotherapists and nurses were more likely to want a conscious and co-operative patient, whereas there was a trend for ICU physicians to consider this less essential (χ2=5.1, p=0.078). Conclusion: The survey suggests most health care professionals believe ICU patients should begin mobilisation when they are stable, prior to the removal of sedative or vasoactive medications, extubation and before ICU discharge. Further work on understanding different perceptions among health care provider maybe helpful in establishing guidelines to facilitate mobility in ICUs.

___

Using Daily SMS to Support Adherence to Homework in Psychotherapy: Client Acceptability and Satisfaction with Treatment Clough, B.A.1, & Casey, L.M.1 1 Griffith Health Institute, Griffith University, Mt Gravatt, Australia Introduction/Aim: Poor client adherence to therapeutic tasks is a significant problem in psychotherapy, leading to suboptimal treatment outcomes and reduced efficiency of services. Technological adjuncts may be able to improve client adherence, however it is unclear how clients will respond to use of these adjuncts. The aim of the current research was to investigate the acceptability and feasibility of a daily Short Message Service (SMS) intervention for clients attending weekly psychotherapy. Methods: Participants (N = 32) were participating in an ongoing project, “Facing the Fear”, and had been randomly allocated to the SMS condition. Participants received daily SMS messages for the duration of a group therapy treatment program. Measures relating to treatment outcome, engagement, treatment satisfaction, and acceptability of the intervention were administered. Results: A significant treatment effect from pre to post time points was found, whereby participants experienced symptom reduction over the course of treatment. Client satisfaction and acceptability was high, with clients reporting positive attitudes towards the SMS intervention, particularly with regards to

75

increased motivation and perceptions of support. Conclusion: The current study indicates that SMS interventions may be well received and form part of an effective psychological treatment program. This study was conducted as a preliminary investigation of the intervention with regards to feasibility and acceptability. With a larger sample size, future research will examine the efficacy of the intervention with regards to adherence and treatment outcomes.

___

Validity and reliability of three lower limb musculoskeletal functional movement tests in young adult women with anterior knee pain Connolly, MJ 1, Horan, SA 1,2, Weeks, BK 1,2 1 School of Allied Health Sciences, Griffith University, Gold Coast, Australia 2 Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University Background: The single-leg squat (SLS), single-leg hop (SLH) and drop vertical jump (DVJ) are three common musculoskeletal functional movement tests. Movement patterns exhibited during functional movement tests are clinically useful in guiding treatment and monitoring outcomes. In fact, physiotherapist ratings are associated with hip and knee kinematics of healthy adults during SLS performance. The validity and reliability of such ratings for the SLS, SLH, and DVJ, however, is unknown for clinical populations. Thus, the aim of the study was to examine the validity and reliability of each test in women with anterior knee pain (AKP). Methods: Ten women (age: 23.2±2.8 years) with AKP and ten women (age: 23.1±1.8 years) free from musculoskeletal impairment were recruited. Frontal plane video was collected as participants performed each of the three movement tests. Three-dimensional movement data were simultaneously recorded using a motion capture system (Vicon, Oxford). Ten physiotherapists were recruited to assess the quality of each movement using a ten-point ordinal scale. One-way ANOVA and intraclass correlation coefficients were used to test our hypotheses. Results: SLS performance was lower for the AKP group compared to the control group (ratings: 5.2±2.3 vs. 6.4±2.1, p<0.001). There was no difference in SLH performance between the AKP group and control group (ratings: 6.2±2.2 vs. 6.4±2.0, p=0.544). DVJ performance was similar between groups (ratings: 6.1±2.2 vs. 6.4±1.9, p=0.461). Inter-rater reliability was excellent for the SLS (ICC=0.89), excellent for the SLH (ICC=0.85), and excellent for the DVJ (ICC = 0.91). Intra-rater reliability was good-excellent for the SLS (ICC=0.74-0.80), good for the SLH (ICC=0.63-0.75), and moderate-good for DVJ

(ICC=0.55-0.69). Conclusion: Only the SLS is capable of discriminating between women with and without AKP. Inter- and intra-rater reliability was high for all three functional movement tests.

___

ED Nurses working in the Watch House: Understanding the impact on their working environment Crilly, J.1,2, Lincoln, C.1,3, Greenslade, J.4, Timms, J.2 Fisher, A.2 1 Griffith Health Institute, Griffith University, Gold Coast, Australia 2 Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast, Australia 3 Clinical Forensic Medicine Unit, Queensland Department of Health, Gold Coast, Australia Introduction/Aim: Changes in the community profile in terms of chronic illness, drug use, criminal activities, violence and ageing population has been reflected in the types of patient presentations made to busy emergency departments (EDs) and the nature of health care requirements within the custodial environment. As such, how health care is delivered in these settings has also changed. This study aimed to determine the impact on working environment for emergency nurses following the implementation of a new model of care that involved ED nurses working in the Watch House. Methods: A cross-sectional, descriptive correlational research study was undertaken. A survey design, using a previously tested instrument (the Working Environment Score, WES-10), was used to determine perception of working environment amongst ED nurses who did and did not work in the Watch House during a 66 day trial period. The WES-10 has four subscales (Nervousness, Conflict, Workload, Self Realization). After recoding, higher scores are indicative of more positive workplace experiences. Correlation analysis was undertaken between subscales, time period (before vs. after) and workplace (watch house plus ED [watch house emergency nurse, WHEN] vs. ED only nurses). Results: Questionnaires were returned by 34 nurses during the pre-WHEN period and 41 nurses during the post-WHEN period. For ED nurses on the whole, satisfaction with their working environment was relatively high. WHENs appeared to be more satisfied with their working environment than non-WHENs, particularly after having the opportunity to participate in the WHEN trial, with workload perception being the subscale changing most. Conclusion: Our findings can be used to allow for further model refinement, justify the development of other ‘alternative ED workplace settings / models of care delivery’ and create a more satisfied ED nursing work force. Further utilisation of the WES-

76

10 is recommended within other ED settings to determine its stability and outcome variations.

___

D The dual effect of taurine on the maintenance of mitochondrial membrane potential. Karina Dawson1, Sue Parker1 Gillian M.C. Renshaw1

1School of Allied Health Sciences, Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: The amino sulphonic acid, taurine has a protective role in mitochondrial Ca2+ handling[1]. Since the effect of taurine has not been examined in a hypoxia and anoxia tolerant animal, the ability of mitochondria to maintain their membrane potential during calcium loading + taurine was tested in response to an anoxic challenge followed by re-oxygenation or normoxia. We used primary hepatocyte cultures to determine whether taurine had a protective effect on mitochondria. Methods: Hepatocytes were isolated from the hypoxia and anoxia tolerant epaulette shark and seeded into a 24 well plate at 5 x 105 and allowed to attach overnight. Plates were either exposed to an anoxic challenge for 1 hour followed by 3 hours of re-oxygenation or exposed to normoxia (controls). JC10 staining was used to examine the mitochondrial membrane potential (MMP) in calcium loaded primary hepatocyte cultures at 0-fold, 50-fold, 100-fold or 200-fold above baseline [Ca2+] in L15 culture medium. Camptothecin was used as a positive control for cell death. Results: Calculation of the ratio of red/green JC10 staining revealed i) that taurine had a protective effect on MMP at normoxia in the presence of [Ca2+] or camptothecin; ii) JC10 staining revealed that mitochondria were hyperpolarised in the anoxia/re-oxygenated hepatocytes; iii) in anoxia/re-oxygenated hepatocytes exposed to 200 x [Ca2+] there was a 22.3% lower MMP with taurine compared to those without taurine. Conclusion: In normoxia, MMP was unaffected by elevated [Ca2+] despite the observed increase in necrosis and apoptosis at elevated [Ca2+]. Taurine treatment was associated with a decreased MMP in response to anoxia and re-oxygenation at 200 x [Ca2+]. In the absence of taurine, MMP was maintained at a higher level in anoxia/re-oxygenated hepatocytes.

___

Further manipulations to the alcohol and sodium content of beer for post exercise rehydration. B. Desbrow1, D Cecchin1, A Jones1, G Grant1, C Irwin1, M. Leveritt2. 1. Griffith University, Gold Coast, Australia 2. University of Queensland, Brisbane, Australia Purpose: We have previously demonstrated that the addition of 25 mmol⋅L-1 sodium to low alcohol (2.3% ABV) beer enhances post exercise fluid retention when compared to full strength (4.8% ABV) beer with and without electrolyte modification. The current investigation explored the effect of further manipulations to the alcohol and sodium content of beer on fluid restoration following exercise. Method: Twelve male volunteers were dehydrated by 2.03±0.19% body mass (mean±SD) using a cycling-based exercise protocol. Participants were then randomly allocated a different beer to consume on four separate occasions. Drinks included a low alcohol beer with 25 mmol⋅L-1 of added sodium [LightBeer+25], a low alcohol beer with 50 mmol⋅L-1 of added sodium [LightBeer+50], a mid-strength beer (3.5% ABV) [Mid] or a mid-strength beer with 25 mmol⋅L-1 of added sodium [Mid+25]. Total drink volumes in each trial were equivalent to 150% of body mass loss during exercise, consumed over a 1h period. Body mass, urine samples and regulatory hormones were obtained before and hourly for 4h after beverage consumption. Results: Total urine output was significantly lower in the LightBeer+50 trial (1450±183 mL) compared to the LightBeer+25 (1796±284 mL), Mid+25 (1786±373 mL) and Mid (1986±304 mL) trials (all p<0.05). This resulted in significantly higher net body mass following the LightBeer+50 trial (-0.97±0.17kg) compared to all other beverages (LightBeer+25 (-1.30±0.24 kg), Mid+25 (-1.38±0.33 kg) and Mid (-1.58±0.29 kg), all p<0.05). No significant changes to aldosterone or vasopressin were associated with different drink treatments. Conclusion: The electrolyte concentration of a commercial low alcohol beer appears to have more significant impact on post exercise fluid retention than small changes in the alcohol content of beer.

___

77

Determination of Muscle synergies from hybrid of EMG datasets and optimisation David G. Lloyd1, Thor F.Besier2, Massimo Sartori3, Pavan Teja, D.1

1Centre for Musculoskeletal Research; School of Allied Health Sciences; Griffith University, Australia 2Auckland Bioengineering Institute; University of Auckland, New Zealand 3Department of Neurorehabilitation Engineering; Bernstein Focus Neurotechnology Göttingen; University Medical Center Göttingen, Germany Introduction/Aim: Musculotendon forces are vital to understand the strain distribution throughout the Achilles tendon in both healthy and injured tendons. The musculotendon forces can be measured directly using implanted buckle transducers or non-invasively estimated via motion analysis of animal’s movement. However, it is not possible to implant every rabbit with buckle transducer. Consequently, forces can be calculated using non-invasive methods, like an electromyography (EMG)-driven musculoskeletal model or synergy-driven musculoskeletal model. Muscle synergies are extracted by decomposing high number of processed activations into excitation primitive (XP) synergy modules and weightings. In rabbits, it is not possible to acquire a high number of EMGs from each individual specimen. This study aims to determine the XP synergy modules and weightings for all the muscles with and without- EMG signals. Methods: The synergy modules and weightings will be derived from the dataset consisting of a high number of EMGs from various muscles across various trials and individual rabbits belonging to a healthy, tendinopathy, and a combination of both groups. It is also possible to predict the excitations of the missing muscles using optimisation which adjusts the weightings of the synergies to best track the experimental joint moments and normalised linear envelopes. Conclusion: These combined methods enable high dimensional dataset to be created that can then be decomposed into final XP synergy modules and weightings. These XP synergy modules can then be used to reconstruct the excitation patterns for each muscle to estimate the musculotendon forces.

___ Jumping through hoops and too much hush hush – rural women in NSW tell their stories of accessing an abortion Doran, F.1, Hornibrook, J.2, 1School of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia

2Adjunct Senior Research Fellow, Mount Isa Centre for Rural & Remote Health, James Cook University, Qld., Australia Introduction: Little is known about rural women’s overall experiences of access to abortion services and the barriers they encounter. Geographical distance is just the beginning – women also face stigma, poor access to follow up medical appointments, lack of appropriate information and isolation in dealing with logistics of child care, cost and negative attitudes of health care professionals. A study was done to fill a knowledge gap, provide insight into the context of service access and contribute to improving access to health care for rural women. Aim: To identify factors that rural NSW women experience in accessing abortion services. Methods: In-depth qualitative interviews were undertaken with rural women living in NSW who had an abortion in the previous 15 years. Results: Fifteen women participated in the study. Women travelled between 2-9 hours one way to clinics across NSW, Qld and the ACT. Common themes related to stigma and silence; jumping through hoops for referrals and access; logistics such as early morning child-care, travel, accommodation and borrowing money. All women had a surgical abortion and many were unclear about choices for medical abortion. Suggestions on improving access were to have services “closer to home” and to “make the whole process easier”. As one woman said “it’s not rocket science”. Conclusion: Rural women in this study experienced many barriers to accessing health care from social and medical stigma to geography and lack of support services for an unplanned situation which required medical intervetnion. It is essential that quality health care is not compromised by lack of appropriate referrals which can delay care and cause distress to women. Rural women could be better supported with increased access to appropriate, affordable and available health care. This requires commitment across the health sector – remove the hoops and let go the “hush hush” on real issues rural women are managing with little social and medical support.

___

Effects of Selective Androgen Receptor Modulator Treatment on Bone Structure and Strength in Obese, Hypogonadic Male Rats. 1Elliott GE, 1 Donner DG, 3Beck B, 2Forwood M, 1Du Toit EF. 1Heart Foundation Research Centre, Griffith Health Institute, Griffith University, QLD, Australia 2Griffith Health Institute, Griffith University, Gold Coast, QLD, Australia

78

3Exercise Science, School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia Introduction: Hypogonadism is a syndrome of decreased testosterone production and secretion often seen in elderly and/or obese males and associated with osteoporosis. Current treatment with testosterone replacement therapy (TRT) preserves bone mineral density (BMD) but has adverse effects on other organs/systems. Selective androgen receptor modulators (SARM’s) such as trenbolone preserve BMD in hypogonadic lean animals without eliciting the negative side effects seen with TRT. We assessed the efficacy of tenbolone to maintain BMD and strength in a hypogonadic obese rodent model. Aims: The aim was to evaluate the effects of trenbolone acetate treatment on femoral BMD and content (BMC), femoral strength, femoral bone cortical thickness and area and compare its effects with those of testosterone. Methods: Male Wistar rats (300g) received a control (CTRL, n=10) or an obesogenic diet (OGD, n=40) for 20 weeks. After 8 weeks feeding rats had sham surgery (SHAM, n=20) or an orchiectomy (ORX, n=30). Mini-osmotic pumps were implanted for vehicle/drug delivery (vehicle -1mM cyclodextrin (VEH), n=30, testosterone (TEST), n=10 or trenbolone acetate (TREN) at 2mg/kg/day, n=10) for the remaining 8 weeks. DEXA scans were performed to determine body composition, BMD and BMC. After sacrifice femoral bend testing and cortical measurements were performed. Results: ORX reduced femoral mid-shaft BMD and cortical thickness and area compared to SHAMs, while both TREN and TEST prevented these changes. TREN treatment of the OGD+ORX rats improved femoral mid-shaft strength, ultimate force (p<0.01), stiffness (p<0.05) and energy to failure (p<0.05) while TEST treatment only improved energy to failure (p<0.01). Conclusion: TREN treatment protected against BMD loss and increased femoral mid shaft strength in androgen deficient obese animals. These data suggest that TREN may be a more suitable therapy for the prevention of bone loss and weakening in obese and androgen deficient males.

___

E Consumer-directed care: workload impact for people with acquired brain injury and their carers Ehrlich, C..1, Muenchberger, H.1., McIntyre, M.1. 1 Griffith Health Institute, Griffith University, Meadowbrook, Australia Introduction/Aim: In Australia the introduction of a National Disability Insurance Scheme is currently underway. One of the central principles of this scheme is to increase consumer (or self)-directed care, where the person with the disability and their family can make independent decisions about who their support services will be and what they will purchase by way of supports. This approach assumes two fundamental outcomes: that consumers will be better engaged in their own care management on a daily basis, and that funding resources will be redirected from service agencies to consumers. The aim of this study is to better understand the impact of the workload of existing care relationships and the factors that contribute to individual ability to become consumer-directed care ‘managers’. Methods: Qualitative methods were utilized. Twenty-one participants with an acquired brain injury as well as their carers consented to participation in the research and were involved in face-to-face interviews. Data were transcribed verbatim and analyzed using standard thematic analysis techniques. Results: Caring for a person with acquired brain injury involved three distinct roles, each with different workload burdens. These roles were a personal assistant role, a care provider role and a family support role. In addition to the workload associated with caring for the person with an ABI, carers also had to adapt to change and manage their own emotions and worry, which necessitated additional responsibility and workload demands. Varying workload burden was related to a complex relationship between personal, social, injury and medical factors unique to each person. Conclusion: Although consumer-directed care can result in greater choice and control for individuals with a disability, for people with an acquired brain injury (ABI), organizing and accessing multiple services adds layers of complexity to care and lifestyle decision making requires considerable support. The ability to undertake a care management role to coordinate the multiple services required is largely dependent on the amount of work that is required to support the person with ABI in the community and the ability to distribute the workload between support networks.

___

79

The Effect of Chronic Pravastatin Therapy on Ischaemic Tolerance and Oxidative Stress Defence Mechanisms in Obese, Insulin Resistant Rats . 1Evans O, 1Donner DG, 2Beck B, 3Vanderlelie J, 1Du Toit EF. 1Heart Foundation Research Centre, Griffith Health Institute, Griffith University, QLD, Australia 2Exercise Science, School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia 3Griffith Health Institute, Griffith University, QLD, Australia Introduction: Increasing levels of oxidative stress found in obesity have been implicated in co-morbidities such as atherosclerosis. There are also suggestions of decreasing levels of antioxidant defence mechanisms which, along with increased levels of oxidative stress, can further exacerbate myocardial injury caused during ischaemia/reperfusion. Some statins have been shown to decrease levels of oxidative stress and enhance antioxidant defence mechanisms. The effect of pravastatin on anti-oxidant defence has not been studied. Aims: To assess the effects of chronic pravastatin therapy on the concentrations of antioxidants and antioxidant activity. We also assessed the effects of pravastatin on ischaemic tolerance and related this to levels of oxidative stress defence mechanisms. Methods: 60 Wistar rats were randomly divided into 4 groups receiving a standard rat chow diet (C - control) or obesogenic diet (OB). C and OB rats were treated with either vehicle (V) or pravastatin (PRAVA-7.5mg/kg/day) via oral gavage for 6 weeks. Hearts were perfused on the Langendorff perfusion system and subjected to regional ischaemia/reperfusion for determination of tolerance to ischaemia. Colorimetric analysis was performed to determine levels of oxidative stress and antioxidant defence mechanisms in cardiac tissue. Results: The OB diet showed no significant (p>0.05) increase in levels of oxidative stress (1.03±0.07nmol/mg) compared to C diet (1.07±0.06nmol/mg). The OB diet had no significant (p>0.05) effect on myocardial Glutathione Peroxidase (GPX) (0.388±0.03U/mg) or Thioredoxin Reductase (TrxR) activity (0.26±0.02μmol/min/ml) compared to control diet (0.45±0.07U/mg and 0.28±0.03μmol/min/ml respectively). There was no significant difference (p>0.05) in rate pressure product recovery between OB diet animals treated with vehicle and with pravastatin (78.85%±7.05%, 74.14±7.52% respectively) and control diet treated with vehicle or pravastatin (67.89%±8.44%, 72.05%±5.91% respectively). Conclusions: The current findings suggest that this obesogenic diet induced obesity did not significantly increase levels

of myocardial oxidative stress or anti-oxidant enzyme activity. Neither did obesity decrease myocardial ischaemic tolerance in this model. Pravastatin therapy in either lean (C) or obese animals had no effect on antioxidant defence system levels or ischaemic tolerance in this rodent model.

___

F The effect of the delivery route of siRNA lipoplexes in shaping the innate immune response Sora Fallaha, Daniel Clarke, Nigel McMillan Cancer Research Center, Griffith Health Institue, School of Medical Science, Griffith University, Gold Coast Campus, Southport, QLD, Australia Introduction/Aim: RNA interference (RNAi) is a potent gene-regulating mechanism that controls genes by specifically knocking down their expression via the use of small interfering RNAs (siRNAs). We have previously demonstrated a “bi-functional siRNA” that exhibits in vivo gene silencing plus the ability to activate innate immune responses. Due to this combined potency, such siRNAs may offer a better RNAi-based therapy. One main consideration is the delivery method and to date, no-one has investigated whether the mode of delivery alters the systemic immune response. Methods: Here we investigate various delivery routes of highly stimulatory siRNAs delivered in vivo using HFDM (or Hydration-of-Freeze-Dried-Matrix) liposomes and examine the cytokine profile in the blood of mice. SiRNA-lipoplexes were tested in vitro against mouse-derived TC-1 and RAW264.7 cells to demonstrate efficacy before testing in vivo in Balb/c mice, using different delivery routes (intravenous (IV), intraperitoneal (IP), intranasal (IN) and subcutaneous (SC)). Following administration, the degree of immune stimulation was assessed at 0, 8 and 24 hours by measuring the changes in blood serum or tissue culture media of a range of cytokines (IL-12, IL-1β, TNFα, CCL2, IL-6, and IL-4) using the BioPlex 200 bead array. Results: In vivo data showed that the IV route demonstrated the highest cytokine levels when compared to IP, SC, and IN, IP and SC were next, and IN route last. Hence, moderate immune stimulation can be established via IP and SC administration. Furthermore, comparing poly (I:C) and siRNA immunostimulatory potentials, poly (I:C) (highly immunostimulatory) is more potent immunostimulatory than siBPmod. Conclusion: This has provided a comprehensive understanding of the kinetics of immunostimulation affected by the route of delivery. Our findings suggest that the level

80

of siRNA-induced stimulation is rather low and we should therefore consider taking advantage of this property in RNAi therapies, such as anticancer treatments, rather than the current practice of trying to avoid it at all costs.

___

Motor evoked potentials reveal crossed-effects for the First Dorsal Interosseus muscle Feldman, M.1,2, Simmonds, M.1, 3, Kavanagh, J.1, 2 1 School of Allied Health Sciences, Griffith University, Gold Coast, Australia 2 Centre for Musculoskeletal Research, Griffith University, Australia 3 Heart Foundation Research Centre, Griffith University, Australia Introduction: When performing maximal muscle contractions on one side of the body, the same muscle on the opposite side of the body will typically exhibit unintended activity. The mechanisms underlying crossed-effects are most likely at the level of the motor cortex, however it is unknown what combination of dominant and non-dominant limb contractions correspond to the greatest modulation at the level of the cortex. The aim of this study was to examine cortical excitability and muscle activity in a limb when the opposite limb is either active or at rest. Methods: Twelve healthy subjects (age, all right hand preferred) participated in the experiment. Abduction force was measured at the proximal interphalangeal joint for both index fingers with Xtran 250N S-beam load-cells (Applied Measurements). Electromyography (EMG) was recorded bilaterally from the first dorsal interosseous (FDI) muscle. Transcranial magnetic stimulation was delivered to the motor cortex of the non-dominant hand using a D702 figure-of-eight coil connected to a single-pulse Magstim 2002 (Dyfed, UK). Stimulation was delivered when both limbs were at rest, when the dominant limb FDI was maximally contracted, when the non-dominant limb was maximally contracted, and when both limbs were maximally contracting. Results: Compared to the resting condition, Motor evoked potential (MEP) amplitude significantly increased in the non-dominant FDI for all other contraction conditions. However, when MEP data was normalized to the amplitude of unintended muscle activity (EMG RMS), the condition where the dominant limb was contracting and the non-dominant limb was resting was similar to the bilateral resting condition. Conclusion: It appears that the mechanism underlying unintended activity in the contralateral limb is not isolated to the motor cortex. Instead, it is possible that brainstem and spinal cord mechanisms contribute to crossed-effects observed during single limb contractions.

What, why and how women accede or manage childbirth fear: a qualitative investigation of Australian women participating in a RCT. Fenwick J.1,2 RM PhD, Toohill J.1 RM PhD Candidate, Gamble J.1 RM PhD, Creedy DK.1 RN PhD 1 Griffith Health Institute, Griffith University, Meadowbrook, Queensland, Australia 2 Gold Coast University Hospital, Queensland, Australia Introduction/Aim: One in five women suffer childbirth fear causing distress leading to non-medically indicated requests for caesarean section. Scandinavian countries routinely offer counselling to women with childbirth fear, however in Australia there are no dedicated services to meet these women’s emotional needs. In Australia we know little about women’s childbirth fear concerns or if these align to those reported in the international literature. This presentation describes the sources, responses and moderators of childbirth fear in a group of pregnant women assessed as having high levels of childbirth fear who participated in a midwife psycho-education intervention. Methods: 43 tape recorded telephone conversations with fearful pregnant women participating in a RCT known as BELIEF (Birth Emotions, Looking to Improve Expectant Fear) were reviewed. Comparative analysis was used to identify common concepts and generate themes that represented women’s perspectives of childbirth fear. Results: Three themes were conceptualised: fear stimuli; fear responses; and fear moderators. Lack of confidence to birth, fear of the unknown, internalising other women’s negative stories, perineal tearing and labour pain were common concerns for first time mothers. For multiparous women: not having had personal negative feelings and experiences resolved following their previous birth influenced current expectations for their upcoming birth. Themes common to both groups were; unmet information and support needs, feelings of loss of control and lack of input in to decision-making. Some women however, chose to avoid birth planning in order to cope during pregnancy. Conclusion: Australian women had similar childbirth concerns to those reported in the international literature. Unique to this study was finding two opposing discourses; one of preoccupation with negative events and the other; avoidance of planning for birth. Provision of woman centred maternity models that assist women to modify their fears in early pregnancy are required to promote positive anticipation and preparation for birth.

___

81

KCl potentiates subsequent responses to noradrenaline of the porcine urethra by enhancing ROCK and Ca2+ release. Oladayo S Folasire1, Russ Chess- Williams1,

Donna Sellers1

Faculty of Health Sciences& Medicine. Bond University1, Gold Coast, Queensland, Australia. Introduction: Potassium chloride (KCl) has long been used in pharmacology to induce depolarisation and produce a non-receptor mediated contraction of smooth muscle to test tissue viability and also allow normalization of responses. However, recently it has been shown that KCl may also cause calcium sensitisation by activating the Rho kinase (ROCK) pathway in some smooth muscle preparations (Borysova et al., 2011). The effect of KCl on smooth muscle sensitization and contraction in the urethra has not been investigated. Aim: To investigate the effects of KCl-pretreatement on subsequent noradrenaline-induced contractions of the porcine urethra. Methods. Strips of urethra were mounted in organ baths at 370C in Krebs-bicarbonate solution. Test tissues were pre-contracted with KCl (60mM) for 5mins (control tissues were not pre-contracted). After 5mins, the tissues were washed for 30mins and then contracted to noradrenaline (100µM) in the presence or absence of the rho-kinase inhibitor fasudil (10µM), the PKC inhibitor calphostin C (1µM), and the inhibitor of intracellular calcium release cyclopiazonic acid (10µM). Result. Pre-incubation of tissues with KCl resulted in significant potentiation of subsequent noradrenaline-induced contractions by (83.6±43.48%, Mean±SEM, n=5-10; p<0.05). This potentiation was still observed when PKC was inhibited. However, inhibition of ROCK or intracellular Ca2+ release abolished the potentiation of responses by KCl and reduced noradrenaline contractions by 54.6±8.4% and 48.4±11.0% respectively. The potentiating effects of KCl were long lasting and were even greater 3 hours after pre-incubation with KCl (90.34±14.292%, P<0.05). Discussion/Conclusion: Prior exposure of urethral tissues to KCl causes potentiation of subsequent noradrenaline induced contractions of the urethra, which may be associated with both Ca2+ sensitization and enhanced Ca2+ release from the sarcoplasmic reticulum.

___

G A competency based training program for midwives to deliver psycho-education for women with childbirth fear. Gamble J 1; Toohill J PhD Candidate 1; Fenwick J 1,2; Creedy DK 1. 1. Griffith Health Institute, Griffith University, Meadowbrook, Queensland, Australia. 2. Gold Coast University Hospital, Queensland, Australia. Introduction/Aim: Midwives have considerable contact with pregnant women and therefore need specific skills to work with women experiencing childbirth fear. We developed a midwife-led psycho-education intervention for pregnant women reporting high childbirth fear. The BELIEF (Birth Emotions and Looking to Improve Expectant Fear) training program includes the development of micro-counselling skills, health education strategies and life coaching skills with an emphasis on solution-focused approaches to support childbearing women. This presentation describes the evidence-base and development of the training program, its implementation and evaluation. Methods: Midwives (n=6) were employed within a large randomised control trial to deliver BELIEF to the intervention group (n=150 pregnant women). Midwives completed a training program that included intensive workshops, written material, web-based resources, a DVD of counseling skill vignettes related to the counseling framework, supervision of counseling, and assessment for competence. Teleconferences were then offered monthly to provide peer and supervisory support for the midwives providing psycho-education to women with high childbirth fear. The multi-method evaluation of the training program consisted of supervision notes, integrity checks, focus groups with midwives, and a client satisfaction survey. Results: On average midwives achieved competency to provide psycho-education after two video recorded attempts. Satisfaction with training and supervision was high and midwives reported increased confidence to address emotional issues with women, and that their scope of practice was enhanced. Women were highly satisfied with midwives providing psycho-education. Conclusion: Psycho-education skills can be readily learnt and integrated into practice and can provide responsive emotional care to women. Midwives are well placed to counsel women to assist them manage negative feelings about birth thereby alleviating perinatal psychological morbidity. Targeted training, skill development and supportive supervision can enhance midwives’ competence.

___

82

Does parenteral nutrition promote microbial growth? A review of clinical and laboratory findings. Gavin, N.C. 1,2, McMillan, D. 1,3, Keogh, S. 1,2, Rickard, C.M. 1,2

1 Griffith Health Institute, Griffith University, Nathan, Australia 2 Royal Brisbane & Women’s Hospital, Brisbane, Australia 3 Inflammation and Healing Research Cluster, University of the Sunshine Coast, Sippy Downs, Australia Introduction/Aim: Our aim was to synthesize clinical research findings regarding microbes colonising patients receiving parenteral nutrition (PN) versus those don’t, and to synthesize the laboratory studies of microbial growth in PN versus control solutions. Methods: A systematic review of journal articles reporting microbial colonisation of patients receiving PN and without PN, or laboratory papers reporting microbial growth curves in any PN and control solutions. Results: One paper reported findings of colonised PN and non-PN central venous access devices (CVADs) rather than combining the data. A total of 1140 CVADs were analysed: 23/237 (9.7%) PN and 13/903 (1.4%) non-PN CVADs were colonised. The majority of CVADs were colonised with aerobic Gram-positive cocci (12/23, 52% PN vs 8/13, 61% non-PN CVADs), followed by fungal colonisation (6/23, 26% PN vs 4/13, 31% non-PN CVADs) and aerobic Gram-negative rod colonisation (3/23, 13% PN vs 1/13, 8% non-PN CVADs). Six papers presented microbial growth curves using a variety of PN and control solutions. A selection of microbes representing aerobic Gram-positive cocci, aerobic Gram-negative cocci, aerobic Gram-negative rods and fungi were grown in a range of PN and control solutions. Lipid solutions, broth and normal saline supported growth of the tested microbes. Candida grew in all test solutions (lipids, glucose, amino acids, 3-in-1, 0.9% normal saline (NaCl), 5% glucose, broth). Conclusion: There appeared to be no difference in the types of microbes colonising patients with or without PN administration, but sample sizes were small and further research is needed. A variety of microbes can grow in clinically administered solutions although microbial growth in 0.9% NaCl was slower than in lipids. Patients requiring PN are often acutely unwell with immune deficiencies which increase risk of catheter colonisation.

___

Therapeutic challenges in cancer pain management: a systematic review of methadone George R, Good P, Afshariman B, Movva R, Haywood A, Khan S, Hardy J Background and Aims: The proven therapeutic efficacy of methadone in cancer pain is hindered by a challenging pharmacokinetic-pharmacodynamic profile, considerable inter-patient variation, and increasing concern about the complexities of dosing. The aim of this study was to assess the evidence for the use of methadone in cancer pain management. Methodology: A systematic literature search was performed for randomised controlled trials (RCTs) published post the 2007 Cochrane review of methadone in cancer pain. Trial quality was assessed using the Oxford Quality Scoring System and Cochrane Handbook of Systematic risk of bias evaluation. Results: Of the 152 abstracts found, four were RCTs (272 participants). Two RCTs compared the efficacy and safety of methadone to placebo or active control and two investigated rotation to methadone from other opioids. The studies used different routes of administration, dosing, initiation and titration of methadone and distinct pain scoring tools and did not address the issues raised by the Cochrane review. Conclusion: There is a need for further studies using standardised methodology to evaluate the optimal dosing strategy of methadone, the effect on different types of pain and the role of pharmacokinetics and pharmacogenomics in clinical outcomes. To this end, a study to assess whether there is a relationship between methadone dosing, patient pain and plasma or saliva concentrations of the methadone R and S enantiomers is currently proceeding at Mater Health Services and St Vincent’s Private Hospital. The application of knowledge gained from this study may allow for dose individualisation of methadone in clinical practice.

___

Application of next generation sequencing in solid cancers Gopalan V, Lam AK Cancer Molecular Pathology, Griffith Health Institute, Griffith University, Gold Coast Introduction/Aims: The introduction of next-generation sequencing (NGS) has the ability to easily sequence the whole genome, whole exome, transcriptome and epigenome. The data produced with NGS can improve the current knowledge of oncogenic pathways and can provide molecular targets which can be utilized in the diagnosis and

83

treatment of cancer. This study aims to provide an overview of the current NGS approaches, the particular issues surrounding the application in solid cancers and future direction of this technology. Methods: A literature search was conducted using the PubMed Database and Google scholar. Literatures specific to the application of NGS in human cancers and those written in English were included. Over 200 peer-reviewed articles published during 2004-2014 were analyzed. Results: Applications of NGS technologies have been increased over last 2 years and this technology has been studied in most of the solid tumours ranging from pre-cancerous tumours and invasive metastatic carcinomas. Over 10,000 gene signatures have been identified in human cancers. Many studies signified the role of NGS in making definite diagnosis in pathologically challenging cases by identifying novel single-nucleotide variants, copy number variations and translocations. Some studies reported that NGS was robust and sensitive in detecting gene mutations compared to Sanger sequencing. Also, compared to traditional sequencing platforms NGS is a better sensitive tool in detecting mutational profiling on fine needle aspiration cytological specimens. There are significant challenges that exist with NGS technologies which include sample selection, interpretation and storage of data output. Special consideration is warranted when considering tumour samples as they are typically contaminated with surrounding normal tissue and stromal tissue. Conclusion: NGS has wide range of clinical applications in personalized cancer treatment, detection of circulating cancer DNA and single molecule sequencing. In addition, NGS is a faster, more accurate and cost effective methods which will help in the advancement and implementation of novel and targeted therapies in cancer.

___

Financial toxicity: a potential side-effect of prostate cancer treatment among Australian men Louisa G Gordon1,2, , Merehau C Mervin1,2, Anthony Lowe1,2

1 Griffith University, Griffith University, Griffith Health Institute, Centre for Applied Health Economics, Meadowbrook, QLD 4131, Brisbane 2 Prostate Cancer Foundation of Australia, Sydney Aim: To understand the extent, nature and variability of the current economic burden of prostate cancer among Australian men. Methods: An online cross-sectional survey was developed that combined pre-existing economic measures and new questions tailored to this context. The main outcomes were self-reported out-of-pocket costs of

prostate cancer diagnosis and treatment, changes in employment status and household finances. Men were recruited from prostate cancer support groups throughout Australia. Descriptive and bootstrapped statistical analyses were undertaken to quantify and explore out-of-pocket costs by sub-groups of participants at different times since their diagnosis. Results: A total of 289 men responded to the survey during April and June 2013. Our study found that men recently diagnosed (within 16 months of the survey) (n=65) reported spending a median AU$8,000 (interquartile range AU$14,000) for their prostate cancer treatment while 75% of men spent up to AU$17,000 (2012). Men with private health insurance (71%) reported medical cost spending double (median cost AU$6,000) that of men with no private health insurance (median cost AU$3,000). We found some variation in reported cost between states of residence with the highest median cost being in Queensland (AU$6,500) and the lowest in South Australia (AU$875). For 20% of men, the cost of treatment had caused them ‘a great deal’ of distress. On average, respondents in paid employment at diagnosis stated that they had retired 4-5 years earlier than planned because of a diagnosis of prostate cancer. Conclusion: The findings suggest a large variability in medical costs for prostate cancer treatment with 5% of men spending $250 or less in out-of pocket expenses and some men facing very high costs and experiencing financial distress. The financial burden of prostate cancer can create hardship for some men from the reduced capacity to work combined with considerable out-of-pocket medical expenses.

___

The use of stable 13C and 15N isotope profiles of seized piperazine-containing tablets for forensic intelligence purposes Nicola Beckett 1, 2, Sarah Cresswell 1, I. Darren Grice 2, 3, James F. Carter 4 1 School of Natural Sciences, Griffith University, Nathan campus, Queensland, 4111 2 Institute for Glycomics, Griffith University, Gold Coast campus, Queensland, 4222 3 School of Medical Science, Griffith University, Gold Coast campus, Queensland, 4222 4 Queensland Health Forensic and Scientific Service, Coopers Plains, Queensland, 4108 Introduction/Aim: Benzylpiperazine (BZP) and trifluoromethylphenylpiperazine (TFMPP) belong to a class of psychoactive designer drugs circulating the drug market, which are synthesized easily from the parent drug piperazine. Their popularity as ‘party pills’ or ‘herbal pills’ grew exponentially, before their illegalisation in 2008. The increasing detection of these piperazine analogues reflects

84

their use as mimics to already scheduled illegal drugs such as ecstacy. In recent years Queensland Police have detected approximately 50% of all illicit drug labs in Australia, indicating the accelerating increase in illicit drug production and particularly in areas such as the Gold Coast. As a result the desire for more powerful techniques to assist law enforcement is essential. Methods: Conventionally, chemical profiling of illicit drugs is performed using Gas Chromatography Mass Spectrometry (GCMS), which aims to gain information on drug sources, batch linkages, synthetic route/s employed and identify the precursor chemicals used in a drug’s preparation. In this study we have employed isotope analysis (13C and 15N stable isotopes) to provide additional information not afforded by conventional GCMS analysis on 23 BZP and TFMPP containing tablets seized on two independent occasions by NT Police, Australia. Results & Conclusion: The isotopic data and statistical analysis results indicate a common source of manufacture for the BZP samples, and interestingly suggests different sources for the TFMPP isolated from the corresponding BZP containing tablets. The use of IRMS in this case study demonstrates the ability to obtain information regarding the BZP/TFMPP sources for forensic intelligence purposes, that to date has been unattainable via conventional chemical analysis.

___

Rheology and Red Cell Mechanics of Haemochromatosis Red Cells vs. Healthy Donor Red Cells Janelle Guerrero1, Anne Morpeth2, Michelle Dittko2, Dr. Michael Simmonds1 and Dr. Indu Singh1 1 Griffith Health Institute, Griffith University, Gold Coast, Australia and 2 Sullivan Nicolaides Pathology, Queensland, Australia Introduction/Aim: Hereditary Haemochromatosis (HH) is an inborn error of iron metabolism resulting in the progressive accumulation of iron in the human body and, eventually, iron overload. Untreated, it can lead to secondary complications such as diabetes, skin pigmentation, and cirrhosis as a result of iron deposition in essential organs. The most economical form of treatment for this condition is that of therapeutic phlebotomy; that is, the removal of one unit (about 450ml) of blood to decrease iron levels. In most clinics, this blood is discarded instead of being used by the Red Cross Blood Services, however studies have shown that there is little to no significant differences between HH red cells and healthy donor red cells that implicate adverse effects in recipients of HH blood. This project aims support existing evidence of this in

order to advocate for the use of HH blood in transfusion. Methods: Blood was collected from 8 healthy donors and 8 HH patients after obtaining ethics clearance and participants consent. Full Blood Examination was performed for all haematological parameters and blood cell morphology. Serum iron studies differentiated two populations. Rheology of red cells was evaluated including the aggregability and defomability of cells from both populations at varying shear rates. Results: No significant changes were observed in FBE parameters and blood cell morphology between two populations. Rheologically, the properties of RBCs in flow at varying shear rates showed minor differences in deformability but were considered insignificant. Conclusion: Absence of significant differences between the red cells of HH patients and health donors suggests that blood of HH patients should not be discarded and utilized for preparation of blood products required for transfusion and other therapeutic needs. Further research is required to evaluate any possibility of transfusion reaction in vitro between blood donated by these patients and recipients in need of transfusion.

___

H The effects of key biologically active coffee constituents on SH-SY5Y neuroblastoma cells Susan Hall1,2, Shailendra Anoopkumar-Dukie1,2, Catherine McDermott3, Gary D Grant1,2

1 Griffith Health Institute, Griffith University, Queensland, Australia 2 School of Pharmacy, Griffith University, Queensland, Australia 3 Department of Biomedical Science, Bond University, Queensland, Australia Introduction/Aim: Coffee is one of the highest consumed beverages worldwide and contains a number of biologically active constituents. Coffee has been shown to have beneficial effects in a number of disease states including depression. Given the numerous cohort studies showing caffeinated coffee to significantly reduce the risk of developing symptoms of major depressive disorder, it appears likely that the antidepressant-like effects are due to combinations of caffeine with other constituents. Numerous constituents have been identified to be biologically active including caffeine, chlorogenic acid, caffeic acid and ferulic acid. Studies investigating possible antidepressant-like effects of these compounds alone, but not in combination, have been undertaken to date. The aim of this study is to evaluate the toxicities of these key biologically active coffee constituents alone and

85

in combination on undifferentiated and differentiated SH-SY5Y neuroblastoma cells, a cell-line routinely used in neurotoxicology studies. Methods: Undifferentiated and differentiated SH-SY5Y neuroblastoma cells were exposed to various concentrations of key biologically active coffee constituents, both individually and in combination, for 24 hours and viability was subsequently evaluated using the Resazurin (Alamar blue) proliferation assay and the LDH assay. Additionally, the formation of reactive oxygen species (ROS) was investigated using the DCF assay. Results: Numerous concentrations of caffeic acid and chlorogenic acid were shown to reduce the viability of SH-SY5Y cells using the resazurin proliferation assay and the LDH assay (p<0.05). In addition to this, these compounds were shown to increase intracellular ROS compared to control in the same cell-line. When caffeine and ferulic acid were combined with these compounds, cell viability and ROS were not significantly different to control. Conclusion: In conclusion, caffeine and ferulic acid appear to provide protective effects against chlorogenic acid and caffeic acid-induced toxicities and ROS production in SH-SY5Y neuroblastoma cells. This may provide an insight into the antidepressant-like properties observed with caffeinated coffee consumption.

___

A Systematic Review of the Therapeutic Options in the Management of Paediatric Conduct Disorders Hambly, J.1, Haywood, A.1,2, Khan, S.1,2. 1School of Pharmacy, Griffith Health Institute, Griffith University, Gold Coast, Australia 2Mater Medical Research Institute Introduction/Aim: Conduct disorder is a multifactorial, aggressive, behavioural disorder in children and adolescents with a reported prevalence of 1-10% accounting for over 70% of pre-pubertal and approximately 50% of post-pubertal referrals. Conduct disorder adversely affects daily functioning, education and socialising; placing increased health burdens on caregivers and the community. If unmanaged and progression into adulthood occurs there is potential for increased substance abuse, poor relationships, antisocial behaviours, and other mental health problems. The present systematic review assessed the pharmacotherapeutic options evaluating their safety and efficacy while also identifying knowledge gaps to guide future research. Methods: Randomised controlled trials (RCTs) in patients aged 0-18 years retrieved from Cochrane Central and MEDLINE were analysed through Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. Evidence

was rated through Strength of Recommendation Taxonomy (SORT). Results: Twenty-three RCTs were retrieved and twelve met inclusion criteria. Studies including atypical antipsychotics (n=3), selective noradrenaline reuptake inhibitors (n=1), lithium (n=1), divalproex (n=3), alpha adrenergic agonists (n=1) were included. Antipsychotics appear to be effective and were well tolerated. Psychostimulants and other agents demonstrated mixed response with a number of studies highlighting lack of clinical significance and increased incidence of adverse effects. Conclusion: Risperidone is the only licenced (Australia) medication for use in aggressive behaviour management. Other medications are used in an off-label manner with inconclusive information on efficacy and safety. The role of nutrient (macro and micro) supplements is an ongoing research area to address the etiopathogenesis of such a complex and challenging condition.

___

Parental attitudes, beliefs, and motivations toward young children's active and sedentary behaviours Kyra Hamilton1 Teagan Spinks1 Katherine White2 David Kavanagh2 Anne Walsh3

1 School of Applied Psychology, Griffith University, Mount Gravatt, QLD, Australia 2 School of Psychology and Counselling, Queensland University of Technology, Kelvin Grove, QLD, Australia 3 School of Nursing, Queensland University of Technology, Kelvin Grove, QLD, Australia Introduction/Aim: Current guidelines propose preschool-aged children should achieve a minimum of three hours physical activity (PA) each day and have screen-time limited to less than one hour per day. Despite these guidelines, in Australia preschool-aged children spend very little time being physically active but a substantial amount of time engaged in screen-based activities. As parents have considerable control over their child’s health behaviours during the younger years, it is important to understand those influences that guide parents’ decisions about their child’s active and sedentary behaviours and apply this knowledge to the design of interventions. Methods: Drawing on the Theory of Planned Behaviour, Study 1 (N = 20) interviewed parents of children aged 2-5 years to identify commonly held beliefs about engaging their child in adequate PA and limited screen-time. The findings informed Study 2 (N = 208), a prospective quantitative assessment to determine the predictors of parental decision making for these important childhood health behaviours. Results: Study 1

86

identified a range of salient beliefs for these behaviours including beliefs about normative expectations, and the advantages, disadvantages, barriers and facilitators to engaging young children in adequate PA and limited screen-time. Study 2 determined the PA beliefs (e.g., promote good sleeping, pressure from family members, lack of time) and screen-time beliefs (e.g., increase parental distress, pressure from friends, inconvenience), as well as the social cognitive factors (e.g., parental attitudes, normative pressures, perceptions of control) that predicted parents’ decisions for engaging their child in appropriate PA and limited screen-time. Conclusion: Identifying key determinants of parental decision making for their child’s health is integral to developing effective interventions aimed at improving active and reducing sedentary lifestyle behaviours in young children in a nation with growing obesity rates. Future interventions can draw on these processes when designing and implementing programs aimed at modifying these important child health behaviours.

___

Understanding perceptions of healthy lifestyle behaviours in pre-school aged children Wiseman, N.1, Harris, N.2. 1 School of Medicine, Griffith University, Nathan, Australia 2 Population and Social Health Research Program, Griffith Health Institute Introduction/Aim: Early childhood is considered a window of opportunity for lifestyle interventions as this is a critical life-stage in which children accumulate knowledge and skills around behaviours such as eating and physical activity. For effective health promotion programs to be designed and implemented, it is crucial to develop a better understanding of children’s knowledge and perceptions of health and health behaviours. This will enable early childhood educators and early years health promoters to implement interventions that are developmentally appropriate. The aim of this study was to examine pre-school aged children’s (aged 3-5 years) knowledge of healthy lifestyle behaviours including physical play and food choices. Methods: The study included quantitative pre and post impact evaluation of a healthy lifestyle intervention using an innovative computerised photo-pair food and exercise questionnaire and an age appropriate test of executive function. The study included 80 children aged 3-5 years and was structured with an intervention and a control group. Quantitative data was analysed using SPSS v22. Results: Results indicated that, for the intervention group, there was a significant improvement in the

overall knowledge of healthy lifestyle behaviours post intervention, particularly in the identification of healthy and unhealthy nutritional habits. Interestingly, there was no associated change in preferences for healthy lifestyle behaviours. Further, while participant’s level of executive function increased significantly over the duration of the intervention, this increase did not make a significant contribution in explaining the change in children’s knowledge or preferences of lifestyle behaviours. Conclusion: The study highlighted that age-appropriate lifestyle interventions with pre-school aged children can lead to improved knowledge of healthy lifestyle choices. However, improvement in knowledge of healthy lifestyle behaviours does not necessarily lead to positive changes in food and activity preferences that inform choices.

___

Investigation of microRNA as a Potential Biomarker for Chronic Fatigue Syndrome Ally Hawthorn1*, Ekua Weba Brenu1, Teilah Huth1, Thao Nguyen1, Samantha Johnston1, Sharni Lee Hardcastle1, Naomi Wong1, Rachel Passmore1, Sandra Ramos1, Don Staines1, Sonya Marshall-Gradisnik1. 1National Centre for Neuroimmunology and Emerging Diseases, Griffith Health Centre, School of Medical Science, Griffith University, Gold Coast, QLD, Australia Key Words: Chronic Fatigue Syndrome, Immune, miRNA. Introduction/Aim: Chronic Fatigue Syndrome/ Myalgic Encephalomyelitis (CFS/ME) is a debilitating disorder characterised by significant immunological dysfunction. Recently, emerging evidence suggests that alterations in regulatory molecules such as microRNAs (miRNA) may have a potential role in the pathomechanism of CFS/ME. miRNAs are a novel group of molecules involved in controlling cellular processes such as proliferation, differentiation and apoptosis. The purpose of this study was to determine the role of miRNAs in CD4+ T cells of CFS/ME patients compared with healthy controls. Methods: The Centre for Disease Prevention and Control (CDC) 1994 case definition was used as the diagnostic selection criteria for CFS/ME patients. CD4+ T (Th1, Th2, Th17 and regulatory T cells (Treg)) cells were extracted from whole blood samples of 22 CFS/ME patients (aged 48.79 ± 10.693) and 12 healthy controls (aged 51), via a MACS CD4+ Isolation kit. RNA extraction and subsequent cDNA synthesis, reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) were performed in order to determine the levels of expression of 10 miRNAs, miR-155, miR-21, miR-16, miR-17-5p, miR-16, miR-128, miR-142-3p, miR-146a, miR-150, miR-126, and miR-181. Results:

87

The expression of miR-146a (p= 0.001) and miR-126 (p= 0.029) were significantly higher in CFS/ME patients compared with healthy controls. Conclusion: In CFS/ME patients, abnormal levels of T cells have been reported, in particular, Tregs have been shown to be elevated suggesting an increase in Treg suppression in CFS/ME. Incidentally, increases in miR-146a and miR-126 may contribute to a significant influence the suppressive function of Tregs as miR-146a and miR-126 have been shown to be involved in the regulation of Treg function.

___

Anti-oxidant systems and the role of the trace element selenium in placental health Holland, O. J., Khera, A., Vanderlelie, J. J., Perkins, A. V. School of Medical Science, Griffith Health Institute, Griffith University Gold Coast Campus. Southport, QLD Australia Introduction/Aim: A healthy placenta is critical for a healthy pregnancy, and so a healthy start to life. Problems during pregnancy can have on-going impacts, as disorders such as preeclampsia and intrauterine growth restriction are associated with many long-term cardiovascular disorders. There is extensive evidence to show that increased oxidative stress plays a key role in the development and pathology of several complications of pregnancy. We have conducted investigations into endogenous anti-oxidant systems of the placenta, focusing on the role of essential trace elements in placental biology and how supplementation of these trace elements may improve placental health. This presentation will focus on the trace element selenium and its role in preeclampsia. Methods: Trophoblast cell lines and explants of first trimester placental tissue were cultured ±selenium. Female rats were feed a diet ±selenium for four weeks before being mated. Levels of anti-oxidant enzymes were measured by ELISA, mitochondrial number was measured as the ratio of nDNA to mtDNA, mitochondrial biogenesis markers were measured by western blot, mitochondrial reparation was measured by respirometry, and oxidative stress was measured with a protein carbonyl assay. Results: In vitro we have found that supplementation with selenium can increase endogenous anti-oxidant expression, improve mitochondrial respiration and lead to mitochondrial biogenesis in trophoblast cell lines, as well as improved mitochondrial respiration in placental tissue explants. In pregnant rats, dietary selenium depletion generated placental oxidative stress and a preeclamptic-like syndrome. Furthermore, in human studies, lower levels of selenium were observed in preeclamptic mothers

when compared to normal controls. Conclusion: These data suggest that there may be a link between the increased placental oxidative stress seen in preeclampsia and insufficient dietary selenium. Thus, selenium supplementation might provide an effective method of protecting the placenta from oxidative stress, lowering the incidence of complications of pregnancy.

___

A comparison of lower limb dynamic postural control in young adult women with and without anterior knee pain Horan, SA 1,2, Connolly, MJ 1, Arnold, BJW, Weeks, BK 1,2 1 School of Allied Health Sciences, Griffith University, Gold Coast, Australia 2 Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University Background: Dynamic postural control involves the maintenance of a stable base of support whilst undertaking a prescribed task. In individuals with a history of lower limb injury or pain, it has been suggested that an inability to control balance on one leg may be a contributing factor. Interestingly, the effect of anterior knee pain (AKP) on dynamic postural control has not been clearly elucidated. Thus, the aim of the study was to examine dynamic postural control in young adult women with and without AKP. Further we were interested in the predictive ability of dynamic postural control against common lower limb musculoskeletal functional tests. Methods: Ten women with AKP (age: 23.2±2.8 years) and ten women free from musculoskeletal impairment (age: 23.1±1.8 years) were recruited. Dynamic postural control was examined using the Star Excursion Balance Test (SEBT) which involved participants standing on one leg and reaching with the other leg in eight different directions. Participants also performed three common lower limb musculoskeletal screening tests which were rated for quality, including the single leg squat, the single leg hop and the drop vertical jump. One-way ANOVA and stepwise linear regression were used to test our hypotheses. Results: Total SEBT performance (345±32cm vs 377±19cm, p=0.015) and SEBT performance away from the weight bearing leg (134±10cm vs 150±8cm, p=0.002) was lower for the AKP group compared to the control group. There was no difference in SEBT performance toward the weight bearing leg for the AKP group compared to the control group (121±15cm vs 131±9cm, p=0.114). Variance in total SEBT was predicted by single leg squat performance (R2 = 0.525, P<0.001), however, the inclusion of single leg hop and drop vertical jump performance did not improve the predictive ability of

88

the model. Conclusion: Young adult women with AKP exhibit poorer lower limb dynamic postural control than healthy controls. Further, dynamic postural control is associated with single leg squat performance.

___

Examining the level and determinants of the ecological literacy of university students Horton, E.1, Harris, N. 1 1 School of Medicine, Griffith University, Gold Coast, Australia Introduction/Aim: Ecological Literacy (EL) is a new and emerging construct that is acknowledged as central to guiding choices individuals make about the environment and their personal resource usage. A range of definitions for EL have been proposed in the literature however it remains in formative stages of understanding and application (Disinger & Roth, 1992). For the purpose of the present study, an ecologically literate individual is defined as “someone who, both individually and collectively with others, makes informed decisions concerning the environment, is willing to act on these decisions, and participates in civic life” (Hollweg et al., 2011). In order to assess EL in the selected population, it is understood to consist of variables relating to environmental knowledge, disposition, and engagement in environmentally responsible behaviour (ERB). Research assessing the EL of university students is limited, despite universities being identified as an important environment within which to foster EL. There are even fewer studies examining what determines the level of EL of university students, which has limited understanding and development in this area. The aim of this research is to measure the level of EL of university students, as well as examine its relationship to sense of community, locus of control (LOC), self-efficacy and various demographic variables. This research will help improve understanding of how these factors influence the EL of university students, and how this might inform future efforts to enhance EL within university settings. Methods: A questionnaire examining the level and determinants of EL of university students was developed using validated and reliable scales from current literature, and administered to Griffith University students both face-to-face and online. The questionnaire was designed to measure EL and test additional research questions and related hypotheses, and included a range of items and scales to assess demographic characteristics, components of EL, sense of community and specific personality traits (self-efficacy and LOC). The questionnaire was administered both face-to-face and online to a convenience sample of current Griffith university

students. Results: Data analysis is taking place throughout October for the purpose of a dissertation for completion of a Masters of Public Health. Results can be sent to the organizing committee immediately following submission of the dissertation on the 31st October, 2014. Conclusion: It is expected that the EL of university students will be low to moderate. Relationships between various personal characteristics and the level of EL are expected to be detected, as supported by previous literature. It is also anticipated that sense of community will be positively correlated with level of EL, as students who participate in a collective group are hypothesized to be more likely to recognize and appreciate the interconnections between human and ecological life, which is central to the conceptualization of EL. Disinger, J. F., & Roth, C. E. (1992). Environmental

Literacy. ERIC/CSMEE Digest. Hollweg, K. S., Taylor, J. R., Bybee, R. W., Marcinowski, T. J., McBeth, W. C., & Zoido, P. (2011). Developing a framework for assessing environmental literacy. Washington, DC: North American Association for Environmental Education.

___

I Cellular localization and expression pattern of FAM 134B (JK1) in human bowel cancer Farhadul Islam1, Vinod Gopalan1, Riajul Wahab1, Alfred K-Y Lam1

1Cancer Molecular Pathology, Griffith Health Institute, Griffith University, Gold Coast. Introduction: FAM 134B (Family with sequence similarity 134, member B) is a novel gene of unknown function, located at 5p15.1, downstream to δ-catenin, encoding a cis-Golgi transmembrane protein. Current functional studies on FAM134B suggest that it is a growth-related gene and it plays a critical role in cancer pathogenesis. This research aims at examining the expression pattern and localization of FAM 134B in different subset of colorectal cancer tissues and cell lines. Methods: Localization of FAM 134B in three cancer cell lines (SW-480, SW-48 and HCT 116) and normal epithelial cell (FHC) was studied by immunocytochemistry and immunofluorescence microscopy. Localization in human tissues of different stage of colorectal cancer was identified with immunohistochemistry. FAM 134B expression levels were quantified at protein and mRNA levels in both tissues and cell lines using western blot and real-time PCR. Results: Microscopic analysis demonstrated that FAM 134B is a transmembrane

89

protein and it is located in the membrane and cytoplasm of colon cancer cells. Also, the FAM 134B expression showed significant changes in different stages of cancer. In the advanced stage colon cancer cells (HCT116), the level of FAM 134B expression reduced remarkably compared to FHC and early stage cancer cells (SW480). As the stage advances, FAM 134B mRNA levels showed notable reduction in colon cancer cells compared to FHC. Similarly, the translation product of this gene also altered in different cell lines. We observed gradual reduction of FAM 134B protein levels in colon cancer cells with highly advanced pathological stages. These results are in accordance to the previous studies of this gene. Conclusion: The present study unveils the possible role of FAM 134B in cancer pathogenesis. Reduced expression in more advanced cancer indicated that it might act as a suppressor of cancer progression.

___

J Investigating the pathogenesis of non-antibody mediated transfusion related acute lung injury (TRALI) James, C1., Kundur, A1., Vider, J1., Singh, I1.

1 Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: TRALI is characterized by neutrophil migration, capillary leakage and pulmonary oedema within 6 hours of blood transfusion. It can be antibody-mediated or non-antibody mediated. Little is known about non-antibody TRALI. Our aim is to establish an in vitro model to investigate the effect of neutrophils, Lipopolysaccharide (LPS), hydrogen peroxide (H2O2) and unconjugated bilirubin (UCB) on endothelial cells. Methods: Human Lung Microvascular Endothelial Cells (HMVEC-LBI) from Lonza (CC-2815) were cultured following the Lonza Endothelial Cell Protocol and seeded in a 96 well plate. Neutrophils were then separated using the Sigma Aldrich Histopaque Kit (11191 and 10771). A comparison model was set up to see the effects of Neutrophils, 5 concentrations of LPS (2.5-25 ng/ml), 3 concentrations of H2O2 (50-200 μm) and 4 concentration of UCB (5-50 μm) on HMVEC-LBI. Viable lung endothelial cells were examined microscopically and by measuring endothelial cell damage marker Lactate Dehydrogenase (Thermo Scientific). Results: Endothelial cell viability was significantly affected by H2O2 or unconjugated bilirubin treatment, but not by LPS, plasma or co-culture with neutrophils alone. However, co-treatment with LPS and neutrophils attenuated the viability of the HMVEC-LBI. Conclusion: H2O2 was

found to be the most efficient model to induce lung endothelial cell damage. However the minimal concentrations inducing the damage from the dose response study is still higher than physiological. It seems LPS and neutrophils together did show some activation without causing severe damage. Though, we still need to investigate whether activated neutrophils are the cause or effect of the endothelial damage, which in vivo leads to TRALI. A reliable model will largely contribute to non-antibody TRALI research and possibly preventive measures. A number of other factors still have to be considered to fully understand TRALI mechanisms.

___

Impact of the Medicare Chronic Disease Management Program on Australian dietitians’ private practices. Jansen, S.1, Ball, L.1, Lowe, C.2 1 Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, Queensland 2 Dietitian Services Qld, Zillmere, Queensland Introduction/Aim: In 2004, Medicare introduced the Chronic Disease Management (CDM) program, to facilitate patients with chronic disease to receive five subsidised consultations with multidisciplinary health professionals. It is important to investigate the influence of the CDM program on dietitians' practices to determine how to support dietitians to provide sustainable, high quality care to patients. This study explored private practice dietitians’ perceptions of the impact of the CDM program on the conduct of their private practice, and subsequent care provided to patients. Methods: 25 Accredited Practising Dietitians working in private practice participated in an individual semi-structured telephone interview. Interview questions focused on dietitians’ perceptions of the proportion of patients receiving care through the CDM program, fee structures, adhering to reporting requirements, and auditing. Transcript data were thematically analysed using a process of open-coding. Results: Half of the dietitians (12/25) reported that most of their patients (>75%) received care through the CDM program. Many dietitians (19/25) reported providing identical care to patients using the CDM program and private patients, but most (17/25) described spending substantially longer on administrative tasks for CDM patients. Dietitians experienced pressure from doctors and patients to keep their fees low or to bulk-bill patients using the CDM program. A third of interviewed dietitians (8/25) expressed concern about the potential to be audited by Medicare. Recommendations suggested to improve the CDM program included increasing the consultation length and subsequent rebate available for dietetic consultations, and increasing the number

90

of consultations to align with dietetic best practice guidelines. Conclusion: The CDM program creates challenges for dietitians working in primary care, including how to sustain the quality of patient-centred care and yet maintain equitable business practices. To ensure the CDM program appropriately assists patients to receive optimal care for chronic disease management, further review of the CDM program within the scope of dietetics is required.

___

Reliability and Validity of two Dental Anxiety scales in a Sri Lankan population Jayashantha, P.1, 2, Usgodaarachchi, U.³, De Silva, V.4, Johnson N.W.1

1 Population and Social Health Research program, Griffith Health Institute, Gold Coast Campus, Griffith University, Queensland, Australia. p.jayashantha@griffith.edu.au 2 Dental Hospital, Sri Lanka Air Force, Colombo, Sri Lanka. Tel. 0094112495495, 0094714164239. drpulpj@yahoo.com 3 Family Health Bureau, Ministry of Health, Sri Lanka 4 Faculty of Medicine, University of Colombo, Sri Lanka Introduction: Dental anxiety is one of the most common psychological problems encountered in provision of dental care. Measuring this is an important and challenging task, particularly as most of the scales developed have been tested in the general population of Western countries. This study aimed to validate the Modified Dental Anxiety Scale (MDAS) and Dental Fear Survey (DFS) questionnaire among a Sri Lankan population. Methods: MDAS is a self-reporting scale consisting of five items which inquire about dental situations. DFS asks respondents to rate their anxieties on 20 dental-specific situations related to avoidance of dental treatment, somatic symptoms of anxiety and anxiety caused by dental stimuli. Both were translated and culturally adapted for the Sinhala language. One hundred five Air Force personnel (30% female) aged 20-44yrs attending the dental centres at the Ratmalana and Katunayake Air Force Bases completed both scales before their treatment commenced. Treating dentist/s (who did not know how their patients had answered the questionnaire) rated their anxiety status after the treatment episode. Twenty percent of the sample who returned for second visit within one month was asked to complete the questionnaires again for test-retest data. Internal consistencies were assessed by computing Cronbach’s alpha while Spearman's rho was used to compute the test-retest reliabilities. Construct validity was assessed with Kappa

statistics by correlating the responses to the MDAS and DFS. ROC curve analysis was used to examine the criterion validities, by comparing the questionnaire responses with the dentists' ratings on Anxiety Rating Scale. Results: Reliability of the two scales were high (Internal Consistency; MDAS=0.897 & DFS=0.956). With ROC analysis the cut-off points for MDAS (12) and DFS (40) were decided. Test-retest reliability at one month also showed a high level of agreement (Kappa; MDAS=0.788 & DFS=0.877). Conclusion: Sinhalese versions of DFS and MDAS were reliable and valid instruments for the measurement of dental anxiety among a selected Sri Lankan population. Keywords: dental anxiety, dental anxiety scales, validity, reliability, Sri Lanka

___

Schoolies and the On Site Health Tent: Providing evidence of outcome and practice change A N.B. Johnston 1,2, N. Bost 1,2, M. Aitken 2, K. Gilmour 1, C. Strong 3, J. Timms 2, T. Donnelly 2, J.Crilly 1,2.

1 Centre for Health Practice Innovation, GHI, Griffith University QLD 2 Gold Coast Hospital & Health Service 3 Queensland Ambulance Service Key words: ambulance, school leavers, treatment tent, emergency department. Introduction/Aim: Around 25,000 young people (~ 85% under 18 years of age) will leave their homes for 7 nights in November each year, often for their first experience without adult carers, to attend the ‘Schoolies’ week on the Gold Coast. Providing safe and cost-effective health care to these school-leavers offers healthcare services unique challenges. It has required the development and refinement of an onsite health service (called the Ambulance Treatment Centre, or ATC) in a community setting that includes a tent facility coupled with a very specific inter-professional staffing mix. The aim of this study is to describe patient and health service outcomes from the emergency department (ED) or ATC during a three-week period in 2013 – one week pre, the week of Schoolies and one week post the QLD Schoolies celebrations. Method: A descriptive, observational, comparative study design will be employed for this study. Demographic (e.g. age, gender) and clinical characteristics (e.g. illness/injury severity or triage category, mode of arrival, diagnosis) and outcomes (e.g. time of arrival, time to see clinician, ED length of stay, discharge disposition) of patients between the ages of 16–18 years (ED) and/or who identify as school leavers (ED/ATC) across the three weeks will be presented. Results: Once the study Site Specific

91

Assessment is received, we will undertake and present descriptive and inferential statistics (using SPSS) to describe the samples and identify whether differences across time periods occurred. Conclusion: This project will provide an evidence-based understanding of practice delivery and clinical outcomes for School-leavers based on an interprofessionally coordinated investigation. Findings may be useful to inform future “Schoolies” and other large community events that occur around Australia where there is a transient increase in the local youth population with their specific associated potential health care needs, ensuring enhanced practice and clinical outcomes.

___

Bridging Sexualities and Dementia: Resource Evaluation Jones, C.1, Moyle, M..1,2

1 Griffith Health Institute – Centre for Health Practice Innovation, Griffith University, Nathan, Australia 2 School of Nursing and Midwifery, Griffith University, Nathan, Australia Introduction/Aim: The ‘Sexualities and Dementia: Education Resource for Health Professional’, funded by the QLD Dementia Training and Study Centre, was released in 2013. This education resource was aimed at addressing the evidence-practice gap in the education and training of health care professionals with regard to sexuality in older people, particularly those with dementia. Appropriate response to the needs, desires and concerns of older people and/or support for their sexual rights in aged care cannot be realised without health care professionals having a requisite level of knowledge and skills. Methods: A series of full day workshop, based on the developed education resource, was delivered nationally between 2013 to 2014. Results: This paper will present the outcomes, achievements and lessons learnt from the development and delivery of this education resource. A total of 71.4% of participants rated their respective workshops as ‘excellent’ & 67.9% of participants in this workshop strongly agreed with the statement “I was satisfied with the workshop overall”. Generally, a high level of engagement amongst participants across all workshops was observed. Particularly, the issues relating to cognitive capacity, consent, privacy, autonomy and the person before and after dementia induced highly charged and intense discussions amongst participants. Furthermore, participants were keen to share their views and experiences and provided many real-life cases for discussion during the workshops. Conclusions: Future directions in influencing policy and practice change in order to provide a care environment that supports and

nurtures the expression of sexuality for older people especially for those with dementia are needed. Future work can focus on the: (1) sexual expression by ATSI & CALD older people; (2) sexual expression by older people living in the community; and (3) development of a generic policy & guidelines for use by organisations.

___

Roles of free magnesium ions and bound magnesium as substrates in glutathione production in human erythrocytes Joypaul, S1. 1 Griffith School of Allied Health Sciences, Griffith University, Gold Coast, Australia* Aim: To analyse the roles of free magnesium ions and bound magnesium in the production of the antioxidant glutathione in red blood cells. Methods: Altering amounts of magnesium were made available to lysed red blood cells and the speed of glutathione production was measured over a 35-minute incubation period. Concentrations of Mg2+

ions and MgATP, two important cofactors in glutathione synthesis, were then determined after concentrations of important magnesium buffers (ATP, 2,3-bisphosphoglycerate, hemoglobin and EGTA) were worked out. Through the use of magnesium binding constants for each buffer, a program was written in Mathematica (Wolfram Research, Champaign, IL, USA) to calculate the concentrations of Mg2+ and MgATP present at the various concentrations of total magnesium used in our experiments. 38 equilibrium binding equations and 8 conservation of mass equations were incorporated into the model. Results: Results showed that as concentrations of total magnesium supplied to red cell lysates increased from 0 mM to 3.0 mM, rate of glutathione synthesis also increased from 0µmolL-1min-1 to about 33 µmolL-1min-1. Furthermore, the rate of glutathione production in red blood cells was more sensitive to levels of bound magnesium (in the form of MgATP) than to concentrations of free magnesium ions (Mg2+). A 0.5mM decrease in MgATP from the normal 3.0 mM intracellular level was sufficient to reduce glutathione production by nearly 50%. A significant decrease in the rate of glutathione production (p < 0.05) however, was not observed until free magnesium ion concentration had fallen to about 100µM (75% below normal intracellular values of 400µM). Conclusion: The results of this study have shown that the rate of glutathione synthesis was most sensitive to the concentration of MgATP in comparison to free magnesium ions. Such findings will contribute to a better understanding of the pathological mechanisms associated with various

92

diseases, particularly those arising from hypomagnesia.

___

K The Praecox Program: Pilot study of an online educational program to improve neonatal palliative care practice Kain, VJ 1, Pritchard, MA 2 ; Yates, P 3; Curtis, M 4 1 Griffith University, Brisbane; 2 The University of Queensland, Brisbane; 3 Queensland University of Technology, Brisbane; 4 Royal Women’s and Brisbane Hospital, Grantley Stable Neonatal Unit. Introduction: The 2012 Australian Commonwealth Senate enquiry into palliative care highlights the urgent need for an evidence-based neonatal palliative care program, the paucity of which has been shown to impede clinician response and impact negatively on family outcomes. Aim: The aim of this research is to address the Senate recommendations, specifically, by developing and evaluating an evidence-based education intervention to optimise clinician competence and support for families. Phase 1 is the development and evaluation of Module 1 (of 4) An insight into neonatal palliative care, an online evidence-based education resource. Methods: Development of the Module: Based upon the principles of palliative care, the education and training recommendations (6.63-67) of the Senate enquiry1 and NHMRC levels of evidence and, its evaluation using a validated instrument2, to be administered pre and post completion of Module 1. The evidence based knowledge and attitudes of staff will be assessed using a randomised, wait-listed controlled convenience sample of multidisciplinary clinicians at a Queensland tertiary level 3 neonatal unit. Results: This research has developed a peer-reviewed funded research methodology capable of addressing the Senate enquiry recommendations into neonatal palliative care. Conclusion: Potentially this neonatal palliative care education intervention will enable a standardized evidence based approach that is likely to impact clinician and family outcomes. Based upon the findings of this pilot phase, the program will be modified accordingly and further funding sought to develop the remainder of the modules for evaluation. 1. Wilkinson D, Brookes V, Hodgson J, et al: Perinatal and neonatal palliative care: Australian infants need palliative care too. Commonwealth of Australia Senate Enquiry: Palliative care in Australia Submission 23/2/2012, 2012. 2. Kain VJ, Gardner G, Yates P: Neonatal Palliative Care Attitude Scale: Development of an Instrument

to Measure the Barriers to and Facilitators of Palliative Care in Neonatal Nursing. Pediatrics 123:e207-213, 2009.

___

Individuals with Essential Tremor can reduce tremor with resistance training Kavanagh, J.1, 2 and Keogh, J.3 1 School of Allied Health Sciences, Griffith University, Gold Coast, Australia 2 Centre for Musculoskeletal Research, Griffith University, Australia 3 Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia Introduction: Essential tremor (ET) patients can exhibit increased postural, kinetic, and intention tremors which often result in a decreased quality of life. Given that resistance training (RT) can reduce tremor amplitude and improve upper limb fine motor control in older adults, it is surprising that few studies have explored RT as a therapy for older adults with ET. This study determined if a generalised upper-limb RT program improves manual dexterity and reduces tremor in older individuals with ET. Methods: Ten ET patients (71± 5 yr) attended 3 supervised RT sessions per week for 6 weeks, where bicep curl, wrist flexion and wrist extension exercises were performed each session. Force tremor was quantified as the standard deviation and coefficient of variation in index finger abduction force during isometric contractions at 10% and 60% MVC. All tests were performed with the most and least affected limbs. Results: Bicep curl, wrist flexion and wrist extension MVC significantly increased following RT. Force tremor significantly decreased during isometric finger abduction at 10% and 60% MVC for both the most affected limb (~27 %) and least affected limb (~12%). Conclusion: A generalised RT program for the upper limb is capable of improving upper limb function and reducing force tremor. It also appears that the greatest benefits following RT may be gained for the limb that has been most affected due to the disorder. Overall, RT appears to be a viable therapy for improving upper limb-function in individuals with ET.

___

Preliminary Process Evaluation of MD Students Research Pilot Project (SRPP) N. Kaviani1, C. Sly3, K. Heathcote1, D. Plummer1, 2, M. Young1, 2, J. Saville1, J. Sun1, 2 1 School of Medicine, Griffith University, Gold Coast campus, Q4222

93

2 Griffith Health Institute, Griffith University, Gold Coast campus, Q4222 3 Medical Education Unit, Gold Coast University Hospital, Southport, Gold Coast, 4222 Introduction/Aims: Research training is an integral and critical component of the Graduate Entry Medical Program (GEMP) at Griffith University. Enabling medical students to engage in research can potentially improve their development as evidence based practitioners and facilitate future engagement with scientific research. This paper reports the early findings of the Students Research Pilot Project (SRPP), a collaboration between Queensland Health and Griffith University School of Medicine. The SRPP aims to: ascertain the administrative infrastructure and processes required to support students, clinicians/Health Service; identify academic, administrative and clinical resources required for facilitating research training into the MD program and describe the experience and outcomes for students and supervisors. Methods: A cohort of 20 students was recruited on 30 June 2014 to commence 18 months of research, in addition to their medical studies. Students are working on a range of clinically based research projects under the supervision of clinician researchers at the Gold Coast Health and Princess Alexandra Hospitals. Academic and Administrative staff from the School of Medicine, and the Health Services are supporting participants, coordinating the 18 month project and documenting the process. Results: The key features emerging from pilot work show; the logistic challenges of ‘scaling up’ research into medical training; the importance of not compromising student outcomes, staff load and goodwill; the need to acknowledge existing Health Services student clinical placement, training capacity and commitments, the need to better understand the organisational complexity at the University and Hospital levels; the need to broaden the definitions of research and extend the scope of possible projects; the importance of integrating different evaluation strategies; and collaborating with the key stakeholders in the early stages and throughout the process. Conclusion: The SRPP will continue to identify pathways for integrating research into medical training. As an iterative process, it may improve the interface for collaborative research between education and clinical practice Institutions.

___

The Therapeutic Potential of Haspin Kinase Inhibition Induced synthetic lethality in HPV associated Cancer Kelly, M1. McMillan, N. Clarke, D. 1 Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction: Contrary to common belief, cervical cancer still poses a substantial global burden in the post vaccination era, and current therapies are generalized and invasive, eliciting adverse side effects. The development of targeted therapies for HPV mediated cancers has been explored by previous work identifying novel therapeutic targets utilising the synthetic lethality effect. Haspin Kinase is one of these novel protein targets and has been related to established therapeutic target Aurora kinase. Methods: In this study modern molecular methods are used to inhibit Haspin kinase and explore the synthetic lethality effect in an in vitro model of HPV mediated cancer. DNA recombination and transfection techniques allowed for the creation of a HPV negative cell lines expressing isolated proteins of the HPV16 genome to explore their role in synthetic lethality. Genetic knock down by small interfering RNA and small molecule inhibition provided methods of Haspin kinase inhibition. Treated cells then underwent multiple analyses such as mRNA expression analysis via qPCR, short and long term cell viability analysis and cell cycle analysis to determine whether the effect was significant. Results: Although previous research indicated potential for the role of Haspin kinase in cancer, the results of this study provided neither indication of the involvement of Haspin kinase in the synthetic lethality effect nor any significant interaction between Haspin and HPV16 proteins. This was concluded by comparing short and long term viability across genetically modified cell lines expressing varying levels of HPV16 proteins. It is imperative to note, however, that due to insufficient antibodies, there was no confirmation that either method of inhibition was actually functionally inhibiting the protein kinase, potentially providing an explanation for the incongruence between this study and previous studies. Conclusion: Although promising, the synthetic lethality effect of Haspin inhibition in HPV16 positive cancers was not significant when compared to HPV16 negative cancers.

___

94

Removing visual feedback for a single limb alters between-limb force tremor relationships during isometric bilateral contractions Kenway, L.1,2, Bisset, L.1,2, Kavanagh, J.1,2 1 Griffith Health Institute, Griffith University, Nathan, Australia 2 Centre for Musculoskeletal Research, Griffith University, Australia Aim: This study examined how force tremor and muscle activity are altered between-limbs when a visual target is removed for one limb during bilateral index finger abduction. Methods: Isometric index finger abduction force was examined in healthy adults (23 ± 4yr) when both index fingers abducted simultaneously. Abduction forces ranged from 5% to 20% MVC, and these target forces were displayed on a PC monitor in front of the subject. Force tremor and first dorsal interosseus (FDI) activity were first collected while subjects viewed visual targets for both index fingers, and then when the visual target was removed for the non-dominant index finger. Results: Subjects successfully matched the force amplitudes generated for both limbs regardless of visual condition. When the visual target was removed for one limb, force tremor increased in this limb (p < 0.01). Different power spectral profiles were evident for each FDI EMG when targets were available for both limbs (p < 0.05), however when one target was removed, the pattern of FDI EMG for the limb without a visual target closely reflected FDI EMG for the limb which had the visual target. Conclusion: The CNS actively modulates muscle activity in each limb to perform visually-guided isometric contractions. Given that the goal was to match force output with both limbs, the requirements of the task must be established from the limb that had a visual target, and a copy of those motor commands appear to have been sent to the FDI of the limb without a visual target.

___

Dietary habits, nutrition knowledge and quality of life of adults with high blood pressure at Gold Coast, Australia Saman Khalesi1, Siddharth Sharma2, Deepak Doshi3, Jing Sun1,

1 Griffith Health Institute and School of Medicine, Griffith University, Australia 2Diagnostics, Emergency and Medical Services, Gold Coast Hospital and Health Services, Australia; School of Medicine, Griffith University, Australia 3Emergency Department, Campbelltown Hospital, Australia; School of Medicine, University of Western Sydney

Introduction/Aim: High blood pressure is a major risk factor of cardiovascular disease, affecting almost one third of adults in Australia. Poor dietary habit (high salt and fat and low fruit and vegetable intake) is strongly associated with high blood pressure. Inadequate level of nutrition knowledge and inability to make healthy food choices may also be related to poor dietary habits and quality of life, and the development of hypertension. Currently there is a lack of studies focusing on these factors and their possible association among adults with high blood pressure in Australia. The purpose of this study is to evaluate the current dietary habits, nutrition knowledge and quality of life of adults with high blood pressure at Gold Coast, Australia, and to explore any association between these factors. Methods: A cross-sectional community-based study was used. Individual (adults 18 years of age and older) are invited via advertisement and flyers to complete a questionnaire in the Gold Coast City. Individuals were included if they had blood pressure of 130/85 mm Hg and higher, were diagnosed with high blood pressure, or on medication to control blood pressure. The questionnaire included questions on knowledge of nutrition with focus on high blood pressure, food frequency, food choices and dietary habits, and quality of life. Multiple linear regression was used to analyses the association between these factors and blood pressure. Results: The findings demonstrate that current dietary habits of individuals with high blood pressure needs to be improved and is not as recommended to control or prevent high blood pressure. Further, there is a strong positive association between knowledge of nutrition, healthier dietary habits, and better quality of life among individual with high blood pressure. Conclusion: Findings from this study may inform future intervention programs to lower blood pressure level and prevent hypertension.

___

Differential Expression of Chemokines, Chemokine Receptors and Proteinases by Foreign Body Giant Cells (FBGCs) and Osteoclasts Usman A. Khan1,2, Saeed M. Hashimi2, Shershah Khan2, Shareen Elshiyab2, Mahmoud M. Bakr2, Mark R. Forwood1 and Nigel M. Morrison1 1 Griffith Health Institute, School of Medical Science, Griffith University, Gold Coast, Australia 2 Griffith Health Institute, School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia Osteoclasts and foreign body giant cells (FBGCs) are both derived from the fusion of macropahges. These cells are seen in close proximity during foreign body reactions, therefore it was assumed

95

that they might interact with each other. The aim was to identify important genes that are expressed by osteoclasts and FBGCs which can be used to understand peri-implantitis and predict the relationship of these cells during foreign body reactions. Bone marrow macrophages (BMM) were treated with receptor activator of nuclear factor kappa B ligand (RANKL) to produce osteoclasts. Quantitative PCR (qPCR) was used to identify the genes that were expressed by osteoclasts and FBGCs compared to macrophage controls. TRAP staining was used to visualise the cells while gelatine zymography and western blots were used for protein expression. Tartrate-resistant acid phosphatase (TRAP), matrix metallo proteinase 9 (MMP9), nuclear factor of activated T cells 1 (NFATc1), cathepsin K (CTSK) and RANK were significantly lower in FBGCs compared to osteoclasts. Inflammation specific chemokines such as monocyte chemotactic protein (MCP1 also called CCL2), macrophage inflammatory protein 1 alpha (MIP1α), MIP1β and MIP1γ, and their receptors CCR1, CCR3 and CCR5, were highly expressed by FBGCs. FBGCs were negative for osteoclast specific markers (RANK, NFATc1, CTSK). FBGCs expressed chemokines such as CCL2, 3, 5 and 9 while osteoclasts expressed the receptors for these chemokines i.e. CCR1, 2 and 3. Our findings show that osteoclast specific genes are not expressed by FBGCs and that FBGCs interact with osteoclasts during foreign body reaction through chemokines.

___

Selenium supplementation increases mitochondrial number in trophoblast cells Alisha Khera, Tony Perkins School of Medical Science, Griffith University Gold Coast Campus, QLD, Australia Introduction: Mitochondria are the major site of reactive oxygen species (ROS) and excessive ROS causes cellular damage and has been associated with complication of pregnancy such as preeclampsia. In previous studies (1) we have shown that selenium is able protect and scavenge the trophoblast cells through the antioxidant enzymes Gpx and Thx-Red, when they induce free radicals. The present study is conducted to demonstrate how selenium increases mitochondrial function of the trophoblast cells and activates mitochondrial biogenesis through various pathways which further activates transcription factors such as nuclear respiratory factor-1 (NRF1) and peroxisome proliferator-activated receptor coactivator -1alpha (PGC-1α) (2). Methods: Trophoblast cells (BeWo, JEG-3 and Swan-71) were treated with Na Selenite (100nM) for 24 hours. Cellular respiration was then measured from an Oxygraph-2k Oroboros high

respirometry chamber operated at 37°C. The qPCR experiment and citrate synthase experiment were done to demonstrate that selenium treated cells have higher mitochondrial number. Results: The study conducted on trophoblast cells exposed to selenium supplementation revealed that selenium treatment (100 nM) for 24 hours effectively increases the mitochondrial number and biogenesis. The oxygen consumption was higher in the cells treated with NaSe as compared to the non-treated cells. The mitochondrial respiration indicated that oxygen flow was significantly increased in selenium supplemented cells. qPCR data revealed that mitochondrial ratio was also higher in the cells treated with selenium. Conclusion: These data suggest that selenium increases mitochondrial biogenesis. The benefit side of selenium is mediated through lowering ROS production and thus protecting mitochondrial function. This gives the special importance of maintaining adequate selenium during pregnancy and especially in pregnancies complicated by conditions such as preeclampsia.

___

Caveolar, Ischaemia-Reperfusion and Senescence-Related miRNA expression in the Aging Murine Normoxic and Post-Ischaemic Hearts Can J. Kiessling1, Melissa E. Reichelt2, John P. Headrick3, Jason Peart3, Kevin J. Ashton1 1 Bond University, QLD, Australia 2 University of Queensland, QLD, Australia 3 Griffith, Southport, QLD, Australia Introduction/Aim: Differential microRNA (miR) has been observed during myocardial infarction, and has been associated with ageing and senescence in the heart. Ageing in the heart has been shown to involve complex molecular and cellular changes. These include decreased caveolar formation, increased fibrosis with a loss of contractile tissue, mitochondrial DNA deletions and significant transcriptional changes, which may explain the age-related loss of ischaemic tolerance. These transcriptional changes may be in part due to changes in regulatory miRNA expression. Methods: Hearts were isolated from 8-, 16-, 32- and 48-week C57BL/6 male mice (n=6 per group) and subjected ischaemic stress (20 min global ischaemia, 60 min Langendorff perfusion). Post-ischaemic hearts were assayed for differential expression of candidate miRNAs using SYBR green RT-qPCR. Candidate miRNAs targeting caveolar forming protein Cav-3 (miR-22, -92a, -485) and miRs associated with ischaemia-reperfusion (miR-1, 15, 92a) and aging/senescence (miR-34a,-34c, 378). Five genes (miR-16, miR-103, miR-191, RNU1A, U6 snRNA)

96

were tested for use as a stable reference gene using geNorm. Results: Results showed significant down-regulation of miR-378 in the aging normoxic and post-ischaemic hearts, while miR-34c was significantly up-regulated in the ischaemic hearts with no change in miR-34a expression. Ischaemia-reperfusion related miR-1 expression decreased in the normoxic and post-ischaemic aging hearts although this was not statistically significant. Significant down-regulation of miR-15 and 92a was found in normoxic aging hearts with post-ischaemic hearts showing non-significant down-regulation of both miR-15 and 92a. Of miRs targeting Cav3, both miR-22 and 92a was found to be significantly down-regulated although this pattern did not match Cav3 expression in the aging normoxic and post-ischaemic hearts. Conclusion: The aging heart shows significant decrease of miR-378 and increase of 34c before senescence. Ischaemia-reperfusion related miR-15 and 92a showed significant down-regulation in aging normoxic hearts. Cav3-related miRs did not correlate with Cav3 mRNA expression in the aging hearts used in this study.

___

Composition of renal tract calculi on the Gold Coast – A decade of stones King J, O’Kane D, How E, McClintock S, Smith N, Pisko J, McDougall P, Tracey C. Introduction/Aim: The objective of this study was to investigate whether the changing population demographics of the Gold Coast, as well as other society changes over the last decade, had lead to changes in the composition of renal tract calculi that are treated at the Gold Coast Hospital. Methods: We searched the Gold Coast Hospital laboratory database from 2000-2012 for all renal tract calculi that were analyzed during this period. The percentage constituent compound of each calculus was tabulated. We divided each compound into 3 groups depending on the percentage of the compound that was found in each stone; >85%, 50-84%, 1-49%. These data were analysed using linear regression. Results: There were 1437 renal tract calculi analysed during these 13 years. There was a steady annual increase in the number of calculi analysed, from 83 in 2000 to 170 in 2012 (R 0.770, p<0.01). The most prevalent stone type throughout the years were those containing >85% calcium oxalate (49.34% ± 6.25), followed by those containing >85% uric acid (14.63% ± 3.16). Although the total numbers of renal calculi analysed have increased, the percentage of stones >85% calcium oxalate has not changed (R 0.014, p=0.965), nor has the percentage of stones >85% uric acid (R 0.013, p=0.967). The number of cystine stones did not change over the time period, with an average of 1 per year. Conclusion: As the

population of the Gold Coast has risen we have seen an increase in the number of renal tract calculi being analysed each year. However, despite the changing population demographics and society changes over the last 13 years on the Gold Coast there has been no significant change in the composition of renal tract calculi that present to the urology department.

___ Retroperitoneal angiomyolipoma: a case report and review King J, Strahan A, McClintock S. Introduction/Aim: Retroperitoneal angiomyolipoma is a rare tumour that is difficult to diagnose pre- operatively. We present a case of retroperitoneal angiomyolipoma that highlights its diagnostic dilemma. We also performed a literature review and present a review of retroperitoneal angiomyolipoma. Methods: A single case study of a retroperitoneal angiomyolipoma. Results / Conclusion: Retroperitoneal neoplasms are uncommon and their pre-operative diagnosis can be challenging. Causes of retroperitoneal tumours include: lymphoma, liposarcoma, leiomyosarcoma, schwanoma, paraganglioma, neurofibromas, other rare tumours, and retroperitoneal lymph node metastasis; most commonly from testicular malignancies [10]. Many of these tumours have radiographically non-specific features. Importantly, well differentiated liposarcomas have: smooth margins, a lobular contour, predominate attenuation of fat, enhancing internal septations of soft tissue; which are the same radiographic findings of an angiomyolipoma [11]. Although AML is considered a benign tumour, a malignant epithelioid variant of AML has been described with 50% metastasising [12]; two cases in the literature having an extra-renal retroperitoneal primary [13,14]. Immunohistochemical studies may be used to deferentiate between classical AML and the epithelioid variant [12]. Our case highlights the difficulty in diagnosis of retroperitoneal tumours and also reports on another case of retroperitoneal AML. Retroperitoneal AMLs are extremely rare tumours. Renal AMLs are easily identified on radiographic imaging but extra-renal AMLS are not as easily identified. Any retroperitoneal mass that is not convincing for classical AML could be a tumour with metastatic potential. A small asymptomatic retroperitoneal AML can be safely followed with surveillance; but larger lesions or atypical lesions should be surgically removed. References: 1. Lienert A, Nicol D. Renal angiomyolipoma. Br J Urol Int 2012;110(4):25-27 2. Bissler JJ, Kingwood JC. Renal angiomyolipomata. Kidney Int 2004;66:924-934

97

3. Liwnicz B, Weeks D, Zuppan C. Extrarenal angiomyolipoma with melanocytic and hibernoma-like features. Ultrastruct Pathol 1994;18:443-448 4. Nelson C, Sanda M. Contemporary diagnosis and management of renal angiomyolipomas. J Urol 2002;168:1315-1325 5. Welling R, Lungren M, Coleman R. Extrarenal retroperitoneal angiomyolipoma mimicking metastatic melanoma: CT and FDG PET correlation. Clin Nucl Med 2012;37:705-706 6. Inahara M, Takei K, Naito H, Equchi M. Extrarenal angiomyolipomas with spontaneous rupture: a case report. Hinyokika Kiyo 2008;54:485-488 7. Gupta C, Malani A, Gupta V, Singh J, Ammar H. Metastatic retroperitoneal epithelioid angiomyolipoma. J Clin Pathol 2007;60:428-431 8. Murphy D, Glazier D. Extrarenal retroperitoneal angiomyolipoma: Nonoperative management. J Urol 2000;163:234-235 9. Chen S, Lin A, Chen K, Chang L. Renal angiomyolipoma – experience of 20 years in Taiwan. Eur Urol. 1997;32:175 10. Neville A, Herts B. CT characteristics of primary retroperitoneal neoplasms. Crit Rev Comp Tomogr. 2004;45(4),247-270 11. Israel G, Bosniak M, Slywotzky C, Rosen R. CT differentiation of large exophytic renal angiomyolipomas and perirenal liposaromas. AJR 2002;179:769-773 12. Ooi S, Vivian J, Cohen R. The use of the Ki-67 marker in the pathological diangnosis of the epithelioid variant of renal angiomyolipoma. Int Urol Nephrol 2009;41:559-565 13. Gupta C, Malani A, Gupta V, Singh J, Ammar H. Metastatic retroperitoneal epithelioid angiomyolipoma. J Clin Pathol 2007;60:428-431 14. Lau S, Marchevsky A, McKenna R, Luthringer D. Malignant monotypic epithelioid angiomyolipoma of the retroperitoneum. Int J Surg Pathol 2003;11:223-228

___

Phase I/II placebo-controlled randomized clinical trial of etanercept in Australian patients with progressive dementia Knox, K., Mey, A., Todd, J., Low, P., Ralph, S. 1 Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: Progressive dementia (including Alzheimer's disease, frontotemporal dementia and semantic dementia) represents a significant health problem worldwide. Currently, no approved medical therapies can prevent the long-term clinical deterioration caused by these conditions. Etanercept (ENBREL) has been approved by the US Federal Drug Administration to treat

inflammatory diseases such as rheumatoid arthritis. ENBREL has a well-characterized safety profile and is approved for such use in Australia. Recently, US studies found an ENBREL injection into a region at the base of the neck gave marked and rapid improvements in the mental alertness and responses of dementia patients. The aim of this trial is to apply the ENBREL therapy in Australia in a randomized clinical study and determine whether this therapy is able to improve the daily activity and functioning of patients with dementia. Methods: The treatment is based on a new application for an existing drug approved for the treatment of psoriasis and rheumatoid arthritis. Prospective patients are evaluated for suitability using medical imaging, haematology and chemistry, medical, cognitive and behavioural assessments. Eligible patients are randomly assigned to receive either the active drug or placebo. Patients receive a weekly injection for 8 weeks, and undergo behavioural, cognitive and medical assessments. Results: The Griffith University Alzheimer’s trial, underway at the new clinic facilities at the Griffith Health Centre on the Gold Coast, is running smoothly. The research team has achieved excellent progress so far. Next month, we will be at the mid-way point with the first cohort of 20 patients having completed their involvement in the trial. Conclusion: Preliminary findings from a similar study conducted in the UK demonstrate positive patient outcomes in behavioural and cognitive measures. In our study, observational reports from carers strongly support these findings. The trial is still actively seeking and continuing to recruit patients for enrolment. All interested in participating are encouraged to contact alzheimers-trial@griffith.edu.au and should consult the further information on the website http://www.griffith.edu.au/health/griffith-health-institute/research/alzheimers-trial about the enrolment process.

___

Community Research Placements or Oral Health Promotion as part of the Oral Health Curriculum Kroon, J. 1 1 Griffith Health Institute/School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia Introduction/Aim: Community Research Projects (CRP) were introduced into the Griffith University oral health curriculum to provide students with a community-based learning experience in Public Oral Health. Based on student feedback in the Student Experience of the Course (SEC) evaluations, and to comply with Australian Dental Council accreditation requirements, CRP (2008-2012) was replaced with Oral Health Promotion (OHP) from 2013. Compare

98

SEC results between CRP and OHP to determine student perceptions on community-based learning in Public Oral Health. Methods: Griffith University requires an SEC evaluation at the end of every semester to improve future delivery of a course. These are voluntary and are completed online and anonymously by enrolled students. Quantitative data on the question “Overall I am satisfied with the quality of the course” and qualitative data on the questions “What did you find particularly good about this course?” and “How could this course be improved?” were analysed. Results: On average 54.5% of students enrolled for CRP and 60.5% enrolled for OHP completed a SEC. The mean score for the question “Overall I am satisfied with the quality of the course” increased from 3.3/5 (2008) to 4.0/5 (2012) for CRP, whereas the mean score for this question was 4.4/5 in 2013, two year after the change to OHP. 28.2% of students in CRP listed working in groups/teamwork, and 40.3% in OHP community interaction and hands-on experience, as what they found particularly good about their course. For CRP 18.5% of students listed issues obtaining ethical approval for their project, and 52.9% in OHP the peer review process, as in need of improvement. Conclusion: Student course evaluation data indicate that the change from CRP to OHP had a positive impact on community-based learning in Public Oral Health and greatly enhances the student experience as part of the oral health program at Griffith University.

___

Review of Health Technology Assessment for Transcatheter Aortic Valve Implantation Sanjeewa Kularatna1,2. Joshua Byrnes1,2, Cindy Mervin1,2, Paul A. Scuffham1,2

1Centre for Applied Health Economics, School of Medicine, Griffith University, Queensland, Australia 2Population and Social Health Research Programme, Griffith Health Institute, Griffith University, Queensland, Australia Introduction/Aim: Severe aortic stenosis is life threatening condition in older age. The usual treatment for aortic stenosis is surgical aortic valve replacement (SAVR). However, for the patients who are at high risk for open heart surgery and inoperable patients medical management was the only available option. The transcatheter aortic valve implantation (TAVI) is a relative new, minimally invasive intervention which can provide significant survival gains to this patient group. However, TAVI is expensive and usually not reimbursed by governments. Health technology assessments (HTA) can advise governments to make reimbursement decisions. The aim of this review was to assess the published health technology

assessments on TAVI. Methods: A systematic literature review was conducted among published literature as well as in HTA registries. The HTAs were selected using Preferred Reporting System for Systematic Reviews and Meta-Analysis guidelines. The selected publications were assessed based on the Consolidated Health Economic Evaluation Reporting Standards (CHEERS check list). Results: Only three HTAs on TAVI were available for the review; one from Canada, one from Belgium and one from the UK. The three HTAs considered the placement of aortic transcatheter valves (PARTNER) trial data to build cost-effectiveness models. The Belgium study denied reimbursement of TAVI except to anatomically inoperable patients. The UK HTA determined, for patients not suitable for SAVR, TAVI is cost effective than medical management. The Canadian HTA recommended TAVI only for the inoperable patients and restricted their use for institutions with broad-based experience. Conclusion: The models used in the three HTAs used some unrelated data as model inputs. Moreover, arbitrary utility were used for the outcome estimates. Information on TAVI cost effectiveness has been updated since the available HTAs were published. Therefore, we recommend for a new HTA, based on a decision model with the updated information, following ISPOR good practice and CHEERS guidelines.

___

L Low-level laser therapy (LLLT) attenuates muscle damage in delayed onset muscle soreness (DOMS) Laakso, E-L.1, Rodrigues NC2, Bocaletti S3, Ohmsen P4, Loureiro A1, Nogueira R1, Renno ACM2, Renshaw G1, Bulmer AC1 1 Griffith Health Institute, Griffith University, Gold Coast, Australia 2 Department of Physiotherapy, Federal University of Sao Carlos, Sao Carlos, Brazil 3 Department of Exact Science, Estadual University of Sao Paulo, Jaboticabal, Brazil 4 Sports Physician, Mermaid Beach Sportsmedicine Clinic, Gold Coast, Australia Introduction/Aim: Unaccustomed exercise with eccentric muscle contraction causes delayed onset muscle soreness (DOMS). LLLT (810 nm) prior to eccentric muscle loading has been found to attenuate the increase of muscle proteins in blood serum and decrease in muscle force of participant knee extensor muscles. The aim of this study was to investigate the effects on DOMS and inflammatory markers of infrared (780 nm) laser irradiation, applied before and after an eccentric

99

exercise protocol (EEP) targeted at the biceps brachii muscle. Methods: Eight consenting males were divided in to active LLLT or sham LLLT groups and all participants underwent eccentric exercise training. The LLLT source was applied twice: immediately before and immediately after the EEP. A Compu-Lase SM2000 (Spectra-Medics Pty Ltd.) laser was used (GaAlAs 780 nm, 50 mW; beam aperture 5 mm) and applied at 12 sites using a standardised template for delivery of the LLLT to 3 areas (of 4 application points) of the target muscle. The laser diode was operated in continuous mode, 5 J energy / point; total energy 60 J / session; fluence 12 J/cm2; power density 500 mW/cm2; treatment time 20 s / point. Blood samples were taken from participants before EEP, immediately after the second laser exposure, and at 24, 48, 72, 120 and 168 hours following EEP. Results: IL-6 concentration increased significantly from baseline at 8 h in the sham group (P<0.05), and was significantly greater than the laser group at the same time point (P<0.05). Creatine Kinase levels increased after 24, 48 and 72 h in the sham group. Conclusion: The results suggest a partial attenuation of muscle damage by laser therapy applied before and after an eccentric exercise protocol. [This abstract was presented as a poster at the September 2014 congress of the World Association for Laser Therapy]

___

Actinic keratosis and Squamous Cell Carcinoma Lalji A1,2,3, Khiroya N1,5, and Lalji M1,4 1Bond university, Gold Coast, Queensland, Australia 2St Vincent’s hospital, Melbourne, Victoria, Australia 3Griffith university, Gold Coast, Queensland, Australia 4Princess Alexandra hospital, brisbane, Queensland, Australia 5Gold Coast hospital, Gold Coast, queensland, Australia Background: Actinic keratosis or solar keratosis is a common skin lesion caused by sun damage that progresses to squamous cell carcinoma. It has been suggested that actinic keratosis is in fact SCC in situ. Objective: This literature review was conducted to investigate the differences between actinic keratosis and squamous cell carcinoma and whether actinic keratosis should in fact be managed as squamous cell carcinoma. Methods: A literature review was conducted to assess the differences between actinic keratosis and squamous cell carcinoma. We conducted searches of Pubmed, Cochrane and Medline for articles published between January 1, 2000, and April 30, 2014, using the following search terms: actinic keratosis, solar

keratosis, skin cancer, squamous cell carcinoma, dermoscopy, sun exposure, ultra violet radiation, and dysplasia Studies published in English were selected for inclusion in this review as were additional articles identified from bibliographies. Results: It is difficult to distinguish between both actinic keratosis and squamous cell carcinoma. Perhaps a classification system for actinic keratosis including early in situ SCC type AK1, early in situ SCC type AK2 and in situ SCC type actinic keratosis is needed. Conclusion: Actinic keratosis invades the basement membrane and as such may progress into invasive SCC. Superficially actinic keratoses are not distinguishable from a superficial SCC and as such may go unrecognized or inaccurately diagnosed.

___

Extra-adrenal pheochromocytoma (paraganglioma) of the urinary bladder: clinicopathological features of 4 cases collected over 3 decades. Alfred Lam1,2 1 Griffith Health Institute, Griffith University, Australia 2 Pathology, Gold Coast University Hospital, Australia Introduction/Aim: Extra-adrenal pheochromocytoma (paraganglioma) of the urinary bladder is a rare tumour. The aims of the study are to analyse the prevalence and characteristics of this tumour in a large population of paragangliomas over 3 decades. Methods: A comprehensive review of the pathological records of paragangliomas and identify the features of urinary bladder paragangliomas.Results: This search resulted in the identification of 39 patients with paragangliomas. Of these, 44% (n=17) were in carotid body, 26% (n=10) were jugulotympanic and 10% (n=4) inferior para-aortic (in retroperitoneum). Other than these, four urinary bladder paragangliomas were noted and accounted for 10% of all paragangliomas. They were noted in 2 men and 2 women with occurred in ages were 28, 41, 53 and 81. The main clinical presentations were haematuria. Only the 28-year-old female patient has hypertension and “attacks” related to micturition. None of the patients were diagnosed before pathological examination. The other patients are clinically non-functional. All the patients had solitary tumour. On pathological examination, the tumours ranged from 30mm to 130 mm and they were all stained with neuroendocrine makers by immunohistochemistry. The 81-year-old woman had a biphasic tumour and the tumour was a composite paraganglioma-ganglioneuroma. No recurrence or distant metastases were detected in these tumours. Conclusion: Paraganglioma of the urinary bladder

100

accounted for some cases of extra-adrenal pheochromocytoma. The histology could be diverse and a high index of suspicion was needed to detect the lesion.

___ Inter limb differences in indices of bone and muscle strength in people with unilateral tibial stress injury Lambert, C.1, Weeks, BK.1, 2 and Beck, BR.1, 2 1 School of Allied Health Sciences, Griffith University, Gold Coast, Australia 2 Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University Introduction/Aim: Tibial stress injury (TSI) is an overuse condition common in military and athletic populations that frequently occurs unilaterally. It is not known if specific morphological and functional characteristics or side dominance predispose the injured limb to increased risk of TSI. The identification of such characteristics would allow preventative strategies to be developed for TSI. We therefore aimed to determine if specific morphological and functional characteristics or side dominance were associated with the symptomatic limb in unilateral TSI. Methods: A cross sectional, within-subject study was undertaken. Men and women, aged 18-40 years, with unilateral TSI were recruited from the community and clinical settings. Whole body, lumbar spine, and bilateral proximal femoral bone mass were examined by DXA (XR-800, Norland). Indices of tibial and leg muscle strength (pQCT, XCT3000, Stratec), along with calcaneal bone quality (QUS, Lunar Achilles Insight, GE) were assessed bilaterally. Single lower limb isometric strength was assessed bilaterally using a hand-held leg strength dynamometer (TTM Muscular Meter). Physical activity participation (BPAQ, TEGNER) and dietary calcium (AusCal) were assessed by questionnaire. One-way ANOVA and chi-square analyses were used to examine between-limb differences and symptomatic limb/dominance relationships using SPSS. Results: Eleven participants (7F, 4M) aged 19-39 years (25.4 ±5.8) met inclusion criteria. No differences in indices of bone or muscle strength were observed between symptomatic and asymptomatic limbs, and little association was observed between the symptomatic limb and limb dominance. However, relationships were observed in total area and trabecular area at the 4% tibial site (p=0.033), total density (p=0.033) and cortical thickness (p=0.003) at the 66% tibial site, and femoral neck and trochanteric BMC (p=0.003). Conclusion: Overall, no limb-specific morphological or functional parameter was associated with incidence of TSI.

Small sample size likely influenced the ability to detect between-limb differences suggesting more data is required to address the research question.

___

Expression of 14-3-3 isoform transcripts in HEK 293T cells in response to regulation by microRNA or neuroinflammation Larsen, K., Lewohl, J.M. Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: Chronic alcohol abuse results in brain damage and can lead to reduced brain weight, brain atrophy and neuronal loss as well as changes in gene expression and microRNAs. The aim of this study was to investigate miRNAs and inflammatory factors that regulate the expression of 14-3-3s, a family of molecular chaperones known to be differentially regulated in the brain of human alcoholics. Methods: We examined the influence miR-203, miR-144 and miR-7 have on 14-3-3 expression by transfecting a miRNA mimic, inhibitor and a mimic plus inhibitor for each of these miRNAs into HEK293T cells. The expression of the seven different 14-3-3 transcripts was measured using real-time PCR. Following this we explored the influence of inflammatory factors on 14-3-3s expression using a model that indirectly exposes neuronal cells to ethanol and LPS. THP-1 microglia-surrogates were then exposed to ethanol and LPS stimulating the inflammatory response. The media from these differentiated THP-1 cells containing cytokines released due to inflammation will be applied to HEK293T cells and changes 14-3-3 expression measured. Results: Although these miRNA had predicted target sites in the 3'UTR of each 14-3-3 isoform, there was no significant change in the expression of any 14-3-3 transcripts following transfection of the miRNA mimics (miR-203, miR-7 and miR-144). This suggests that these isoforms either do not have binding sites for these particular miRNAs or that they are regulated at the protein level. Changes in gene expression of each 14-3-3 isoform following exposure to inflammatory mediators will also be presented. Conclusion: Knowledge of the changes in 14-3-3s gene expression can lead to further understanding of molecular mechanisms that control differential expression of genes in the brain bring us closer to finding a novel therapeutic or diagnostic target for the CNS dysfunction resulting from longer-term alcohol abuse.

___

101

The role of Rho-kinase in phenylephrine and 5-HT-induced contractile activity of the porcine ureter Lim, I.1, Sellers, D.1, Chess-Williams, R.1 1 Faculty of Health Sciences & Medicine, Bond University, Gold Coast, QLD Introduction/Aim: Ureteral calculus is frequently accompanied by ureteral colic, which is understood to be caused by constriction ureteral smooth muscle (Canda et al, 2007). In a previous study, we showed that porcine ureters from older animals generated greater contractions to α-adrenoceptor stimulation, and smaller contractions to 5-HT (Lim et al, 2013). Since calcium sensitisation via the Rho-kinase pathway has been proposed to play a significant role in smooth muscle contraction (de Godoy & Rattan, 2011), our aim was to investigate the role of Rho-kinase in phenylephrine and 5-HT-induced contractile activity in isolated ureters from old and young pigs. Methods: Contractile responses of isolated smooth muscle to EC50 (low) and maximal (high) doses of phenylephrine and 5-HT were examined in distal ureteral tissues from young (20 weeks) and old (56 weeks) pigs, in the absence and presence of Rho-kinase inhibitors, Y-27632 (10µM) or fasudil (30µM). Tissues developed spontaneous contractile activity and responses were expressed as AUC as a percentage of the maximal contraction. Results: Fasudil significantly attenuated (P<0.0001, n=6) ureteral contractions to low and high doses of phenylephrine by 86.81±4.18% and 81.96±0.97% in younger animals. In response to 5-HT, fasudil reduced contractions by 83.69±2.97% and 77.67±3.16 at low and high doses (P<0.0001, n=6). In older animals, similar effects were observed. Contractions to phenylephrine were reduced by 82.01±1.71% and 78.69±3.01%, and to 5-HT, by 80.16±3.43% and 79.31±3.24% at low and high doses respectively (P<0.0001, n=6). The Rho-kinase inhibitor Y-27632 produced similar effects with both agonists in tissues from young and old animals. Conclusion: These results show that Rho-kinase mediates contractile responses to phenylephrine and 5-HT in isolated ureteral tissues and the effect is similar in both young and old animals.

___

Validity and reliability of a simple lower extremity strength test Little, A.³ Harding, A.¹ Weeks, B.K.¹ ² Horan, S.A.¹ ² Watson, S.L.¹ ² Beck, B.R.¹ ² ¹ School of Allied Health Sciences, Griffith University, Gold Coast, Australia ² Centre for Musculoskeletal Research, Griffith Health Institute, Gold Coast, Australia ³ School of Medicine, Griffith University, Gold Coast, Australia Introduction: Lower limb muscle strength is a major determinant of physical capacity of elderly people. However, due to the requirement for expensive, large-scale equipment, the accurate measurement of lower limb (LL) strength in a clinical setting is often limited. A protocol using a simple, inexpensive dynamometer targeting isometric lower extremity strength (LES) has previously been reported, however the validity of the test has not been examined. Our goal was to assess the reliability and validity of LL dynamometry for measuring LES compared to an established muscle strength test gold standard. Method: Cross sectional validation study with short and long term repeated measures reliability analysis. Healthy men and women >18 years of age with no recent surgery or medical conditions that may affect muscle mass or strength attended two testing sessions separated by one week. Each session involved an isometric LES test (3 trials) with the simple LL dynamometer (TTM Muscular Meter, Tokyo), then three isometric knee extension trials using an isokinetic dynamometer (Biodex Medical Systems, New York). Test-retest reliability and validation of the LES test was examined by Pearson’s correlations. Results: Fifty-one participants (26M, 25F) aged 46.7 ±20.8 years volunteered to participate. A strong positive relationship was observed between LES measured with the leg dynamometer and LES measured with Biodex (r = 0.84, p <0.001). Repeated measures of LES with the leg dynamometer were strongly associated (r = 0.96-0.98, p <0.001). Test-retest reliability for the leg dynamometer was excellent (r = 0.97, p <0.001), which compared favourably to that for the Biodex (r = 0.94, p <0.001). Conclusion: Our findings indicate excellent validity and reliability of the simple LES test against the gold standard. The test would be easily incorporated into clinical settings. The next step will be to develop age-relevant reference norms for the purpose of patient comparisons.

___

102

Competitive employment for people with severe mental illness: Challenges to implementing evidence-based practices in Australia Chris Lloyd 1 Philip Lee Williams 1,2, Geoff Waghorn 3, Tawanda Machingura 4 1 Griffith Health Centre, Griffith University Gold Coast Campus 2 Lives Lived Well 3 Queensland Centre for Mental Health Research 4 Recovery Service, Gold Coast Hospital and Health Service Introduction/Aim: Competitive employment has potential benefits for people with severe and persistent mental illness. Implementation of new practices to high fidelity with evidence-based practice leads to higher competitive outcomes. The aim was to explore the program outcomes and barriers to implementing evidence based practices in supported employment of a recently implemented program on the Gold Coast. Method: A prospective observational design was used to evaluate both program outcomes and fidelity to the evidence-based practices of supported employment. The cohort was defined as all those that entered the program within a 21 month period, across three sites in partnership with the same public funded community mental health service. Each participant was followed for a minimum of six months. Fidelity to the Individual Placement and Support (IPS) evidence-based principles and practices were measured at all locations. Results: Results indicate improved employment outcomes across all three sites compared to the national average. However they vary depending on both the strength of local partnerships as well as fidelity to the evidence-based principles and practices. Program outcomes Site A Site B Site C Fidelity 64/75

(fair) 67/75 (good)

63/75 (fair)

Number of referrals in 21 months

52 28 34

Program commencements

27/52 (51.9%)

27/28 (96.4%)

25/34 (73.5%)

Non-commencement reason: Participant declined Ineligible for DES program Unknown

11/25 4/25 10/25

1/1

7/9 2/9

Commenced competitive employment

9/27 (33.3%)

10/27 (37.0%) *

3/25 (12.0%)

Commenced any vocational activity (competitive employment, other vocational activity)

19/27 (70.3%)

15/27 (55.5%)

5/25 (20.0%)

Completed 13 weeks competitive employment

8/27 (29.6%)

4/27 (14.8%)

1/25 (4.0%)

Time taken from referral to commence job searching (days) Mean (SD)

51.2 (39.8)

40.4 (17.6)

47.2 (32.3)

Time taken from referral to commence competitive employment (days) Mean (SD)

97.3 (31.8 91.4 (82.8)

275.6 (296.3)

Number of jobs held (of those who commenced employment)

1.5 (0.8) – Range 1-3

1.6 (0.9) – Range 1-3

Missing data

Hours worked per week Mean (SD)

19.8 (5.6) 23 (11.5)

11 (3.6)

Job Diversity (number of different job types compared to total number of jobs)

8/9 8/10 1/3

Conclusions: Delivering improved access to employment services through a joint partnership to complement existing mental health services requires strong local leadership, regular local technical support, and a strong commitment to adopt all the evidence based practices in supported employment. The results of this evaluation indicate that doing so could improve employment outcomes to levels expected of high fidelity evidence based supported employment programs. This evaluation adds to the growing evidence base supporting the implementation of the Individual Placement and Support Model in public mental health services in the Australian context.

___

Is negative mood really a trigger for food desire? Loxton, N.J12, Bothma, A.3 1 School of Applied Psychology, Behavioural Basis of Health, Griffith Health Institute, Griffith University, Mt Gravatt, Australia 2 Centre for Youth Substance Abuse Research, The University of Queensland, St Lucia, Australia 3 School of Psychology, The University of Queensland, St Lucia, Australia Introduction/Aim: The increasing rate of obesity is so pervasive that the World Health Organization now ranks obesity in the top 5 global health problems. One argument as to the rapid rise in recent years has been the increase in readily available, high calorie food and exposure to food images. The tendency of some people to use food

103

to assuage negative moods has long been proposed in triggering the desire to eat. A recent study challenged whether negative mood was a key trigger in the desire to eat. The aim of the current study was to extend this study by studying. Methods: 171 women watched either 1) a sad video (negative mood) or a documentary (neutral mood) and 2) exposed to a series of food images (food cue) or matched non-food images (non-food cues). Half were presented with the video first followed by the images and the other half were presented with the images first followed by the video. Results: Like the earlier study, those shown the sad video first reported a significant reduction in the desire to eat relative to those shown the documentary. Those exposed to the food images reported a significant increase in desire to eat (regardless of the video previously viewed). For those shown the food images first, there was a significant increase in the desire to eat relative to those shown the non-food images. The desire to eat was reduced following watching the subsequent video. Conclusion: These findings further support the argument that exposure to images of food, but not negative mood triggers the desire to eat. These findings suggest that public health interventions reducing exposure to unhealthy food images may be fruitful in reducing the rise in obesity.

___

M Neuromotor characteristics in people with lateral epicondylalgia: A systematic review of electromyographic studies. Nagarajan, Manickaraj.1, Leanne, B.1, Michael, R.1, Michael, Y.1 1 Centre for Musculoskeletal Research, School of Allied Health Science, Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction: The aim of this study is to systematically review the literature on neuromotor characteristics of forearm muscle measured using electromyography (EMG), in people with lateral epicondylalgia (LE). Methods: A systematic search was undertaken and the included articles were assessed using a modified Downs and Black quality index, and ISEK-EMG reporting standards. Summary statistics (mean and SDs) were extracted, and compared between the LE group and healthy control (HC) group and/or between the affected and unaffected arms. Result: Five out of seven studies reported neuromotor variables for extensor carpi radialis (ECR) muscle, and showed significant changes in people with LE compared to HC. The ECR muscle activation patterns were inconsistent (increased, decreased or unchanged) across the

included studies. Increased activation of extensor carpi ulnaris and pronator teres muscles, and increased fatigue in extensor digitorum muscle were also reported in LE cohorts compared to HC cohorts. No significant differences were reported between arms for any neuromotor characteristics. Conclusions: Altered neuromotor characteristics appear to primarily effect ECR muscle in people with LE compared to HC. The inconsistent trends observed in ECR muscle activation may be due to variation in methodology across the included studies. Absence of significant neuromotor characteristics differences between affected and unaffected arms suggests that central nervous system changes may be a neurophysiological feature of LE. The results of this review suggest the assessing forearm muscle neuromotor impairments may be useful in the clinical diagnosis and management of LE, which is not addressed in current conventional management.

___

A novel role for bilirubin in protecting from dietary induced dyslipidemia and improving fat-free mass, leading to protection from ischemic stress and coronary intervention Cholan, Pradeep*^, Bakrania, Bhavisha*, Beck, Belinda#, Wagner, Karl-Heinz&, Panchal, Sunil$, Brown, Lindsay$, Winearls, James, R.^, Du Toit, Eugene F.*, Bulmer, Andrew C.*^

*Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Southport, Australia. # Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Southport, Australia & Department of Nutritional Science and Research Platform in Active Aging, University of Vienna, Vienna, Austria. $School of Health, Nursing and Midwifery, University of Southern Queensland, Toowoomba, Australia. ^Critical Care Research Group and Intensive Care Unit, Gold Coast University Hospital, Southport, Australia. Introduction/Aim: Bilirubin, a breakdown product of hemoglobin, possesses anti-inflammatory and antioxidant properties, and could provide resistance to-and predict future cardiovascular disease in humans. The first aim of this study was to correlate blood bilirubin levels and resistance to ischemia-reperfusion injury in a high fat-high carbohydrate (HFHC) fed rodent model. The second aim was to establish the relationship between bilirubin concentration and heart function in Coronary Artery Bypass Grafting (CABG) patients recruited from the Gold Coast University Hospital. Method: Littermate Wistar-wild and hyperbilirubinaemic Gunn rats were fed a HFHC diet for 16 weeks. Blood analysis was

104

conducted on a monthly basis during dietary administration to observe the effect of elevated bilirubin on lipid status. Echocardiography was performed at the beginning and end of the study to estimate changes in cardiac structure and function. Furthermore, insulin resistance was tested after HFHC feeding via glucose gavaging and blood analysis. Rat hearts were then studied for their resistance to ischaemia-reperfusion injury using the ex vivo working heart model. For clinical studies, patient data was obtained from AUSLAB and Phillips Excellera databases after ethical approval from the Gold Coast University Hospital. Result: Gunn rats were significantly lighter than their counterparts after the HCHF diet (P<0.05). Body composition determined from DXA, revealed a significant increase in fat free mass in Gunn rats after HCHF feeding (P<0.05). This result indicated that elevated bilirubin is associated with resistance to dietary induced dyslipidemia and increased fat-free mass accrual and may protect the heart from ischemic insult. Our clinical results remain inconclusive; however, indicate that persons undergoing CABG have very low bilirubin levels, suggesting that they may be at increased risk of atherosclerosis, evidenced by the need to undergo CABG surgery. Conclusion: High bilirubin is associated with reduced weight and increased fat-free mass and improved cardiac function after ischemic insult.

___

Potential role of miR-34 family in thyroid cancer prognosis Hamidreza Maroof1, Ali Salajegheh1, Alfred KY Lam1

1Cancer molecular pathology, School of Medicine, Griffith Health Institute (GHI), Griffith University, Australia

Introduction/Aims: Cancer is the second leading cause of death in the world. The causes of cancer are diverse, complex, and only partially understood. Altered expression of the microRNA-34 family has been determined to be involved in the pathogenesis of many cancers. Expression analysis of the microRNA-34 family has suggested that they play significant roles in many aspects of cancer biology including proliferation, invasion/metastasis, migration, senescence/aging, angiogenesis, epigenetic silencing and methylation by regulation of the expression of their target genes. Methods: In this study we have examined for the first time, the expression of miR-34 family (miR-34a, miR34b and miR-34c) in 5 different thyroid cancer cell lines with different pathological nature and morphological features. Human papillary thyroid carcinoma (K1) without metastasis, metastasizing human papillary

thyroid carcinoma (B-CPAP), lymph node metastasis of a human thyroid carcinoma with a papillary origin (8505C), human undifferentiated thyroid carcinoma (MB-1) and human undifferentiated thyroid carcinoma metastases in lymph node (BHT-101) and human normal thyroid follicular cell line (Nthy-ori 3-1) were obtained from Sigma-Aldrich (Sigma-Aldrich, St. Louis, MO, USA) and German Collection of Microorganisms and Cell Cultures (DSMZ, Braunschweig, Germany). miRNA were extracted, cDNA were prepared and real-time PCR were performed according to the manufacturer’s protocol (Qiagen, Hilden, NRW, Germany). Results were collected and the fold changes calculated for each sample group using the 2-ΔΔCt method. Results: The significant underexpression of miR-34 family was detectable in all types thyroid carcinoma (p<0.05). A noticeable declining trend in the expression of miR-34b were noticed when the cancer become more aggressive or metastatic.Conclusions: The results of this study indicate that the expression of miR-34 family is possibly linked to the prognosis of the thyroid tumors. More functional studies are needed to enlighten our understanding about the nature of this family and their involvement in cancer development and prognosis in thyroid cancer.

___

Sports Dietitians Australia Position Statement: Sports Nutrition for the Adolescent Athlete Desbrow, B1,2, McCormack, J1, Burke, L3, Cox, G.3, Fallon, K4, Hislop, M5, Logan, R6, Marino, N7, Sawyer, S8,9,10, Shaw, G3, Star, A1,2, Vidgen, H11, Leveritt, M12

1. School of Allied Health Sciences, Griffith University, Gold Coast, Australia 2. Research Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, Gold Coast Australia 3. Department of Sports Nutrition, Australian Institute of Sport, Canberra, Australia 4. School of Medicine, The Australian National University, Canberra, Australia 5. Brisbane Sports and Exercise Medicine Specialists, Brisbane, Australia 6. EatWise4Life, Toowoomba, Australia 7. Sports Medicine Australia, Melbourne, Australia 8. Royal Children’s Hospital, Melbourne, Australia 9. Department of Paediatrics, The University of

Melbourne, Melbourne, Australia 10.

Murdoch Children’s Research Institute, Melbourne, Australia 11. School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia

105

12. School of Human Movement Studies, University of Queensland, Brisbane, Australia Introduction/Aim: It is the position of Sports Dietitians Australia (SDA) that adolescent athletes have unique nutritional requirements as a consequence of undertaking daily training and competition in addition to the demands of growth and development. Methods: SDA established an expert multidisciplinary panel to undertake an independent review of the relevant scientific evidence and consulted with its professional members to develop sports nutrition recommendations for active and competitive adolescent athletes. Results & Conclusion: The position of SDA is that dietary education and recommendations for these adolescent athletes should reinforce eating for long term health. More specifically, the adolescent athlete should be encouraged to moderate eating patterns to reflect daily exercise demands and provide a regular spread of high quality carbohydrate and protein sources over the day, especially in the period immediately after training. SDA recommends that consideration also be given to the dietary calcium, Vitamin D and iron intake of adolescent athletes due to the elevated risk of deficiency of these nutrients. In order to maintain optimal hydration, adolescent athletes should have access to fluids that are clean, cool and supplied in sufficient quantities before, during and after participation in sport. Finally, it is the position of SDA that use of nutrient needs should be met by core foods rather than supplements, as the recommendation of dietary supplements to developing athletes over-emphasises their ability to manipulate performance in comparison to other training and dietary strategies.

___

Using mixed methods to enhance understanding: An example from critical care nursing research. McKinnon, M.1 Mitchell, M.1,,2. 1 Griffith Health Institute, Griffith University, Nathan, Australia 2 Princess Alexandra Hospital, Intensive Care Unit, Brisbane, Australia Introduction/Aim: In 2010 the Princess Alexandra hospital, Royal Darwin Hospital, and the National Critical Care Trauma Response Centre partnered to ensure an adequate nursing response in Darwin in times of disaster. The strengths, weaknesses and efficacy of the partnership were recently evaluated using mixed methods. This paper describes the rationale for this methodology, including an

appraisal of the value of this approach. Methods: Both quantitative and qualitative methods were applied to facilitate a comprehensive investigation, that took into account the perspectives of a range of stakeholders in Brisbane and Darwin. Data collection was multi-modal including online and hardcopy surveys, focus groups and in-depth interviews. Separate surveys and interview schedules were devised for distinct stakeholder groups (e.g. executive staff, nursing staff). Open-ended survey questions allowed respondents to clarify their response, or provide additional information. Descriptive statistics were generated in SPSS (version 19) and thematic analysis was undertaken using NVivo (version 10). Results: A strength of the partnership was the selection of highly skilled and committed staff and enhanced disaster preparedness at each involved institution. Limitations were noted in relation to communication and some aspects of staff orientation and training. While the quantitative results identified strengths and areas for improvement, the qualitative results provided detailed information on the specific changes desired along with descriptive information on how change might best be achieved. Conclusion: This study drew on the strengths of both quantitative and qualitative techniques to answer pertinent research questions in a critical care nursing setting. The triangulation of methods allowed the findings from each individual method to be compared and contrasted allowing a more robust evaluation than had a single method been used. The application of mixed methods was particularly useful in terms of integrating and fostering an understanding of, the perspectives of the diverse stakeholder groups involved in the partnership.

___

Role of metallothioneins in neuroprotection against alpha-synucleinopathies McLeary, F.A.1, Khoo, T.K.1, Chung, R.2, Mellick, G.D.3, Pountney, D.L1 1 Griffith Health Institute, Griffith University, Nathan, Australia 2 School of Advanced Medicine, Macquarie University, Sydney, Australia. 3 Eskitis Institute for Drug Discovery, Griffith University, Mt Nathan, Australia Introduction/Aim: Intraneuronal aggregates of α-synuclein (α-syn) are the major pathological hallmark of Parkinson’s disease (PD) and dementia with Lewy bodies (DLB) and are linked to neurotoxicity. Multiple triggers of α-syn aggregation have been implicated, including raised copper. The potential neuroprotective role of the copper- and zinc-binding proteins, metallothioneins (MT), has been explored in relation to copper-induced α-syn

106

aggregation. As endogenous MT induction has also been observed in another α-syn disease1, current studies are exploring MT levels and distribution across different brain regions in DLB tissue compared to normal controls and examine copper-MT in plasma/urine samples from PD and unaffected cases as a potential biomarker. Methods: Up-regulation of endogenous expression of MT was induced in SHSY-5Y neuroblastoma cells by the synthetic glucocorticoid analogue, dexamethasone, and food additive β-thujaplicin. After treatment with dexamethasone/β-thujaplicin to induce endogenous MT expression, immunofluorescence confocal microscopy was used to quantify protein aggregates in cells with and without 100µM copper treatment. Isoform-specific over-expression was by MT-2/3-GFP transient transfection. Similar methods of immunofluorescence are being used to observe MT levels in DLB and control brain tissue. Plasma and urine sample collection for quantitative MT protein assay is underway. Results: Dexamethasone treatment resulted in a significant (p, 0.01), dose-dependent up-regulation of MT expression and a significant reduction in copper-dependent α-syn intracellular aggregates (p, 0.01). Ubiquitous (MT-2) and brain-specific (MT-3) isoforms were investigated by transient transfection of the GFP fusion proteins, resulting in equal α-syn aggregate suppression by each isoform. Conclusion: MTs show neuroprotective capability against copper-induced α-syn aggregation, with the effective up-regulation by dexamethasone yielding a concomitant reduction in α-syn aggregation, and may represent a useful disease biomarker.

___

Consumer healthcare priorities using the Nominal Group Technique: analysis of multiple groups. Sara S McMillan1, Adem Sav1, Fiona Kelly1,2, Elizabeth Kendall1, Jennifer A Whitty1, Michelle A King,3 Amanda J Wheeler1. 1 Griffith Health Institute, Griffith University, Meadowbrook, Australia. 2 Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. 3 School of Pharmacy and Griffith Health Institute, Griffith University, Southport, Australia. 4 School of Pharmacy, University of Queensland, Woolloongabba, Australia. Introduction/Aim: A highly structured method used to identify healthcare priorities in health services research is the Nominal Group Technique (NGT). However, there is limited information on how best to analyse data from a large number of groups using this approach. This study aims to address this

ambiguity and provide practical recommendations for other researchers wishing to use this methodology. Methods: A literature review informed the development of an NGT framework and provided insight into the analysis processes used for smaller sample sizes. Twenty-six nominal groups, with 164 participants, were conducted across four Australian regions between December 2012 and April 2013. These groups investigated the healthcare service priorities for carers and people with chronic conditions. Pilot group data was used to compare different analysis methods and their associated outcomes. Results: Researchers using this technique should reduce participant burden by explaining the process step-by-step as participants progress, and to allow a maximum of five priorities for participants to choose from. A complex analysis process is involved for large nominal group data-sets, using both quantitative and qualitative processes. Researchers should consider both the sum of votes, i.e. strength, and voting frequency, i.e. popularity, when determining priorities. Thematic analysis is needed to compare across groups, and subsequent analysis should involve all themes generated per group. Conclusion: Careful consideration should be given to the analysis process of multiple nominal groups to ensure that the results truly reflect participant priorities. This study provides a researcher-friendly guide for conducting effective nominal groups, thereby allowing health consumer voices to be clearly heard. This project is funded by the Australian Government Department of Health as part of the Fifth Community Pharmacy Agreement Research and Development Programme managed by The Pharmacy Guild of Australia. The financial assistance provided must not be taken as endorsement of the contents of this report.

___

Presynaptic scaling: a novel homeostatic scaling plasticity Lin Y.Q.1, Menon, H.2, Gonzalez J.M.1, Noakes, P.G3 and Karunanithi S.1,2. 1 ARLDN, University of Arizona, USA 2 Griffith Health Institute & School of Medical Science, Griffith University, Gold Coast, Australia 3 SBMS, University of Queensland, St. Lucia, Australia Introduction/Aim: Throughout their lifetime, neurons are continuously modified and rebuilt. Despite these changes, the outputs of their targets are reproducable, driving the same repertoire of behaviours. How is this achieved? Homeostatic adaptations at synapses significantly contribute to the process. Here we describe an unusual adaptation that we discovered which operates in

107

such a capacity at the Drosophila larval neuromuscular junction, termed presynaptic scaling. Methods: Larval muscles receive glutamatergic synaptic inputs from the highly and less active 1b and 1s motor neurons, respectively. In transgenic animals, the activity pattern of just the 1s neuron innervating muscle 2 is chronically reversed in vivo by expressing modified K+ channel transgenes. In our analysis of control (C) and transgenic (T) animals, we combined electrical recordings from single 1b and 1s synaptic boutons, whole cell recordings, and light and serial electron microscopy. Results: Genetically enhancing just 1s neuronal activity reduced 1s bouton neurotransmitter output (quantal content) by 28.3% (P<0.02; n: C=9; T=8). Unexpectedly, a similar reduction (25.1%; P<0.04; n: C=9; T=8) is also observed at synaptic boutons formed by the unmanipulated 1b neuron. The proportional downscaling of neurotransmitter output at both bouton types is referred to as presynaptic scaling. Presynaptic scaling maintains the relative 1b-1s neurotransmitter output differences at a ‘set point’ to potentially maintain differential muscle activation for driving different movements. Presynaptic scaling also reduces total synaptic drive (21.9%; P< 0.001; n: C=8; T=6) in a direction to renormalize the muscle’s activity. Presynaptic scaling induction appears to require elevations in the expression of the Drosophila vesicular glutamate transporter (DVGLUT) in the 1s neuron. Conclusion: Presynaptic scaling stabilizes the circuit by operating to maintain both target activity and presynaptic diversity at set points, despite manifestations of abnormal activity even in just single input neurons.

___

Validating the Speed and Agility Motor Screen (SAMS) as a motor performance-related fitness measure for children. Milne, N1, Hing, W1 1 Bond Institute of Health and Sport, Bond University, Robina, Australia Introduction/Aim: This study aimed to assess the test-retest reliability and concurrent-validity of the Speed and Agility Motor Screen (SAMS) as a motor-performance-related fitness measure for children and determine if the SAMS could better predict poor motor-proficiency in overweight/obese children compared to the general paediatric population. The final aim was to establish if a SAMS cut-off time could be determined to identify children who may benefit from further investigation of their gross-motor skills. Methods: A concurrent validity and test-retest reliability study design was implemented with a convenience sample of 233 school-aged children (n=M-120;F-113), aged 5-17

years (Mean±SD:11.44 ± 2.18yrs), from public, Catholic and Independent schools. Completed measures included: Bruininks-Oseretsky-Test-of-Motor-Proficiency-2nd Edition (BOT2) and the SAMS. A representative sample (n=77) also completed Body-Mass-Index (BMI) measurements (Mean ±SD: BMI percentile = 50.27±30.86). Results: The SAMS was found to have strong test-retest reliability (ICC=0.87, 95% CI: 0.710, 0.816). The motor components of balance (15.8%), bilateral-coordination (2.8%), strength (18.7%), running-speed and agility (22.9%) were all significant contributors to the SAMS completion time. The SAMS had low-to-moderate predictive-validity for determining gross-motor ability in the general population of children (r2=0.214, p=0.00) but a strong predictive-validity with overweight/obese children (r2=0.641, p=0.001). Children who took ≥5.43s to complete the SAMS had significantly lower motor proficiency than children who took <5.43s. Conclusion: The authors conclude that the SAMS is a valid and reliable screening measure that can be used to predict poor gross-motor proficiency in overweight/obese children. The SAMS is designed to be used in conjunction with health-related fitness measures, by those who work with children (e.g. Coaches, Health-Physical-Education Teachers, Health-Professionals) when concerns exist regarding motor-proficiency as a possible contributor to poor health and fitness and to guide referral decisions.

___

Preferences of Clients and Carers for Community Rehabilitation Services: Findings from Qualitative Research and a Discrete Choice Experiment

Moretto, N.1,2, Whitty, J.A.1,2,3, Currin, M.L.4, Kendall, E.2, Kuipers, P.5, Comans, T.A.1,2. 1 Griffith Health Institute, Centre for Applied Health Economics, Griffith University, Logan, Australia 2 Griffith Health Institute, Population and Social Health Research Program, Griffith University, Logan, Australia 3 School of Pharmacy, The University of Queensland, Woolloongabba, Australia 4 Queensland Health, Community Rehabilitation Service, Primary and Community Health-Metro South HSD, Brisbane, Queensland, Australia 5 Centre for Community Science, Griffith University, Logan and Metro South Health, Logan, Australia Introduction/Aim: Client outcomes are improved when clients and carers are involved in decisions about their health care; however, few studies have determined client preferences for Community Rehabilitation care. Utilising an innovative Discrete

108

Choice Experiment (DCE) methodology and applying it to a novel setting, this research aims to identify key program features important to Community Rehabilitation clients and carers. Methods: A consecutive sample of 38 clients and 9 carers were recruited from Community Rehabilitation centres in the Metro South Health Services District, Queensland, Australia. A Montreal Cognitive Assessment test was administered to clients. Participants completed either a client- or carer-version of a pilot DCE. Attributes/levels were based on a literature review and qualitative research using semi-structured interviews of Community Rehabilitation clients. Participants indicated their preference between two alternative community rehabilitation services based on the following attributes; location of service, goals of therapy, frequency of therapy, coordination of additional services, and cost to the client. An efficient design was used (12 choice sets) with participants randomised to one of two blocks. Choices were modelled using a binomical logistic regression model. Results: Clients strongly preferred a one-on-one consultation with their therapist at a clinic rather than at their own home. Clients also preferred a frequency of once or twice per week with a home exercise program over once per week with additional contact by phone or videophone/skype. Carers showed similar preferences to clients; however, carers preferred the addition of phone support, compared to clients. The attributes related to goal, coordination, and cost did not affect the choice for either clients or carers. Conclusion: Results suggest location and frequency of the Community Rehabilitation service are important features to both clients and carers. This information could improve current and planned Community Rehabilitation services in Australia. Additional research is required to further extend the findings of this pilot study.

___

Does the dietetic educator workforce have enough meat on its bones? A professional profile of the dietetic educators preparing Australia’s future dietitians Morgan, K.1 Hughes, R. 2 1 Faculty of Health Sciences and Medicine, Bond University, Robina, Australia 2 Office of Research Services, Bond University, Robina, Australia Introduction/Aim: The surge in demand for dietetic programs offered in Australian universities has resulted in a simultaneous increase in the number of dietitians required to work in this sector. However, the size and professional attributes of the Australian dietetic educator workforce remains

largely unknown. This impedes dietetic workforce development and planning. The aim of this study was to describe the Australian dietetic educator workforce by profiling the education, experience, practice and research attributes of dietetic educators employed in dietetic programs in Australian universities. Methods: A cross-sectional survey was electronically distributed to dietitian academics contributing to the education of students in dietetics programs at Australian universities (n=150). Subjects were asked to complete and return their professional profiles from which the data was collated for statistical analysis. Results: Responses were received from dietetic educators (n=91) at all of the 18 universities offering dietetics programs in Australia (RR=61%). More than half of the sample (54%) indicated that their highest formal qualification in dietetics was at a level lower than a PhD, while around two in every five respondents (39%) reported having no formal qualification in education. Around half (51%) of respondents cited clinical dietetics as their main area of practice specialisation and the largest proportion (40%) of respondents had 1-5 years’ experience as a dietetic educator. Conclusion: The dietetic educator workforce is largely comprised of dietitians with clinical dietetic experience who have been in dietetic education for a relatively short period of time. The proportion of dietetic educators with expertise in dietetic education or experience in the non-traditional areas of dietetic practice is small. Strategies are required to assess and build the capacity of the dietetic educator workforce to ensure that dietetic preparation effectively matches future dietetic practice. Exploring the perspectives of dietetic educators on dietetic workforce preparation will contribute intelligence to inform dietetic workforce development.

___

Association between anatomical stature and metacarpal bone dimensions in developing females. Mortimore, S.1, Raikos, A.1, Wood, W. 1, Moro, C.1 1 Faculty of Health Sciences and Medicine, Bond University, Robina, Australia Introduction/Aim: Forensic and anatomical specialists have used skeletal development as a method to determine the age, stature and gender in remains of unknown adult subjects. However, this becomes difficult during childhood development. As such, there would be benefit in identifying methods for determining a child’s age, stature and developmental status exclusively based upon simple skeletal measurements. This study aimed to identify associations between the development of the metacarpal bones (MTC) in young females with

109

their age and stature. Methods: X-ray images of left hands were taken annually over 4-5 years from juvenile females living in the Pari village near Port Moresby (1968-1974). Images were digitised with a Microtek ScanMaker 9800XL+, the second and third MTC measured (length, width and diaphyseal length) using ImageJ software and data exported to Microsoft Access. Growth data was compared using a Pearson correlation coefficient and table of critical values used for statistical testing with P<0.05 being significant (two-tailed test). Data was presented as mean±SD (cm) or Pearson’s correlation coefficient (r). Results: Between 8-17 years old, annual increases in female stature and anthropological measurements were apparent in height (3.77±1.71) and weight (4.95±5.52). The second-MTC also increased in length (0.23±0.16), width (0.03±0.19) and diaphysis-length (0.25±0.17), while the third-MTC increased in length (0.17±0.14), width (0.03±0.04) and diaphysis-length (0.17±0.18). There were associations between anthropometric measurements and the development of the MTC. Correlations were observed (n=53) between stature, and the second (r=0.96, P<0.01) and third (r=0.829,P<0.01) MTC length. In addition, there was significant elongation associated with height in both the second-MTC (r=0.829,P<0.01) and third-MTC (r=0.784,P<0.01). Conclusion: A female juvenile’s height can be determined through measurements of second and third metacarpal bone length, width and diaphysial length, with an appropriate degree of accuracy. The metacarpal bones demonstrated consistent growth throughout development and can be used as a measure to determine stature.

___

N A novel method to assess drug interactions Naicker, P.1, 2 , Grant, G.1, 2 , Anoopkumar-Dukie, S.1, 2, Kavanagh, J.2, 3

1 School of Pharmacy, Griffith University, Gold Coast, Australia 2 Griffith Health Institute, Griffith University, Gold Coast, Australia 3 Centre for Musculoskeletal Research, Griffith University, Gold Coast, Australia Introduction/Aim: Recent studies that have assessed antihistamines effects on fine motor function, have found that both first- generation (sedating) and second-generation (non-sedating) antihistamines can influence fine motor function regardless of sedation state. While there appears to be a dissociation between antihistamines effects on sedation and movement, little is known about the mechanisms implicated in antihistamine associated neuromotor dysfunction. In order to determine

whether central pathways are responsible for the neuromotor deficits observed with antihistamine usage, a different technique to that of your traditional central assessments will be employed. Eye tracking technology will be combined with the cognitive task, the attention network test (ANT) to determine whether oculomotor measures obtained during performance of the ANT will reflect results of the cognitive test itself. While the ANT assesses drug effects on attention, oculomotor measures collated during task performance such as pupil diameter, are believed to reflect cognitive processing in tasks requiring an increased level of mental effort. Methods: Seven medically healthy participants (25 ± 4 years) were enlisted into a human double-blind, placebo controlled, four-way crossover study. Promethazine, Hyoscine hydrobromide, Hyoscine butylbromide and Placebo were the drugs ingested. Participants performed the ANT while size was measured, pre-ingestion, 0.5- and 2-hr post-ingestion of drugs with varying anticholinergic profiles, including an antihistamine with known neuromotor effects. Results: Promethazine significantly affected ANT results compared to Placebo, Hyoscine butylbromide and Hyoscine hydrobromide. Furthermore during performance of the ANT, Promethazine increased pupil size compared to Placebo. Conclusion : It appears that combining eye tracking technology with the ANT provides for an efficient and unbiased method for examining the central drug interactions.

___

Occupational Health & Metabolic Risk Factors: A Pilot Intervention for Transport Workers Naug, H.1, Roberts, M.1, Colson, N. 1, Singh, I.1 , Kaur, A. 1 , Kundur, A. 1 , Tukovic, L. 1 1 Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: Heavy vehicle transport workers have a high incidence of obesity and obesity-related diseases. The sedentary nature of their work, poor eating habits, and pressure to cover long distances and meet timetable deadlines makes a work and healthy lifestyle balance difficult to achieve. Epidemiological studies have reported a correlation between chronic metabolic disorders, mortality and physical inactivity or “sitting time”. The fact that transport workers are considered “lone” workers means that a strong community-focused intervention is required in order to encourage change in the cultural environment of the workers in these occupations. The aim of this pilot study is to quantify the incidence of obesity and metabolic risk factors for chronic disease among two populations of heavy transport vehicle drivers and to evaluate the efficacy of an educational group lifestyle

110

intervention on the incidence of these risk factors. Methods: The project involved 3 stages: 1. Recruitment and collection of baseline data: BMI, diet and lifestyle questionnaires, blood measurements including cholesterol, LDL, HDL, fasting glucose, hs-CRP. 2. Intervention. Group education sessions were scheduled each fortnight with the themes of Diabetes, Physiology of Inactivity, and Diet/Nutrition. These sessions were specifically tailored to the needs of transport workers. 3. Final blood collection and evaluation. Results: Our results indicate that a percentage of drivers were obese and pre-diabetic and that over the time period of the intervention improvements in blood glucose and HDL lipoprotein cholesterol were observed. Moreover, the results of the intervention indicate that the structural organization of the workplace can have a strong impact on the efficacy of community-based change. Conclusion: This workplace educational intervention was beneficial in improving the awareness of healthy lifestyle options for heavy vehicle drivers. As a pilot study, we have developed resources and tools that can be further improved to become an adaptable workplace intervention program.

___

Glucose-lowering effect of probiotics and prebiotics: evidence from clinical trials Nikbakht-Nasrabadi, E.1,2, Sun, J.1,3 1 Griffith Health Institute, Griffith University, Gold Coast, Australia 2 Population and Social Health Research Program 3 Heart Foundation Research Centre

Introduction/Aim: High blood glucose over a long period is the main characteristic of diabetes mellitus. Moreover, many complications are the result of untreated high concentration of blood sugar. The interaction between human gut microbiota and high blood glucose is a controversy subject which gains scientists’ attention in recent years. Probiotics and/ or prebiotics could be used as alternative therapy in patients with high blood glucose. The aim of present systematic review was to investigate the efficacy of probiotics and/ or prebiotics on patients’ blood glucose. Methods: Literatures were searched through multiple electronic databases without imposing time limitations. Clinical trials which assessed the impact of probiotics and/ or prebiotics on blood glucose of diabetes type 2 patients were included. Review articles and those assessed the effect of probiotics and/ or prebiotics in gestational diabetes, or animal studies were excluded. Results: Nine studies were finalized for this paper. Six of them investigated effect of probiotics and the rest of three assessed the efficacy of the mixture of probiotics and

prebiotics (symbiotic) on blood glucose. Among the six papers, two of them didn’t get any effective result. Two others reported slightly and not significantly lowering effect. The other two claimed probiotic supplementation prevented the rise in blood glucose. Among remained three papers, one of them reported effectiveness property of this product. One of them didn’t find any effect. The other one expressed tended to be a significant lowering effect. Conclusion: In vivo studies show that probiotic and/ or prebiotic containing food may reduce the concentration of blood glucose. Effect of probiotics and prebiotics on serum glucose is due to different factors such as strain of the bacteria, and duration of the intervention. Therefore further studies are needed in order to clarify the role of probiotics, prebiotics or symbiotic on human’s blood glucose.

___

O Quality of life among men and women after meniscus tear Ogrodzka, K.1, Bac, A.2, Tomasz Ridan, T.3, Fryźlewicz, P.1

1 Department of Clinical Rehabilitation, Section of Rehabilitation in Traumatology, University School of Physical Education, Krakow, Poland 2 Department of Occupational Therapy, Section of Clinical Forms of Occupational Therapy, University School of Physical Education, Krakow, Poland

3 Department of Physiotherapy, Section of Kinesiotherapy, University School of Physical Education, Krakow, Poland Introduction/Aim: The aim of the study was to investigate the quality of life of women and men after meniscectomy. Methods: The study group included 43 people (22 women and 21 men). The study was based on the results of a questionnaire, created by the authors of the research and the SF-36 Questionnaire. Results: Men compared to women in most scales of the questionnaire assessed their condition better, except for physical limitations and pain. Average correlation was found only between the women BMI and the results of the questionnaire. Others correlations were weak. Conclusion: Women’s quality of life after meniscectomy was worse than men’s. The majority of the respondents were satisfied with the treatment effects.

___

111

The Effect of Chronic Pravastatin Therapy on Myocardial Mechanical Function and Infarct Size in an Obese Rodent Model.

1Oi M, 1Peart J, 1Donner DG, 2Beck B, 1Du Toit EF. 1Heart Foundation Research Centre, Griffith Health Institute, Griffith University, QLD, Australia 2Exercise Science, School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia Introduction: Statins used for the treatment of dyslipidaemia have been implicated in the aetiology of systemic insulin resistance. Myocardial insulin resistance decreases myocardial tolerance to ischaemia/reperfusion (I/R) and increases I/R injury. Pravastatin (PRAVA) is a class of statin thought to improve lipid profiles without adversely affecting insulin sensitivity. Aims: To assess the effect of PRAVA on: 1) lipid profiles, insulin sensitivity and myocardial tolerance to ischaemia and, 2) myocardial pro-survival Reperfusion Injury Salvage Kinase (RISK) pathway signalling in a rodent model. Methods: 60 Wistar rats were divided into 2 groups receiving a standard rat chow diet (C - control) or obesogenic diet (OB). C and OB rats were treated with either vehicle (V) or pravastatin (PRAVA-7.5mg/kg/day) for 8 weeks. Body composition (Dual Energy X-ray Absorptiometry - DEXA scans), insulin sensitivity (glucose tolerance tests - GTTs) and serum lipid profiles (spectrophotometry) were documented. Hearts were perfused on the Langendorff perfusion system and subjected to ischaemia/reperfusion for infarct size quantification (tetrazolium chloride staining). Results: The OB diet increased body fat content (153±21.1g for C and 310±25.3g for OB (p<0.05)) while PRAVA treatment had no effect on body fat content (310±10.6g for OB+PRAVA). PRAVA increased insulin sensitivity in control (GTT area under the curve - 424.125±49.3units2 for C+V vs. 16.5±72.6units2 C+PRAVA, p<0.05) and OB (GTT area under the curve 459±41.6units2 for OB+V vs. 192±63.1units2 for OB+PRAVA, p<0.05) rats. Myocardial infarct size was similar for V treated C and OB rats (30.7±9.88% of AAR (area at risk) C+V vs. 14.7±4.15% of AAR OB+V, p>0.05). Chronic PRAVA treatment had no significant effect on myocardial infarct size (17.4±3.56% C+PRAVA and 33.6±7.16% OB+PRAVA). Conclusions: The current findings suggest that PRAVA improved insulin sensitivity without having any cardioprotective benefits in rodent heart models. These data suggest this lipid lowering drug has no direct myocardial cardioprotective effects.

___

Hi, who’s been exercising? Investigating how colorectal cancer survivors discuss exercise and physical activity within online discussion forums Olsen, A.1, Sargeant, S.1, Keogh, J.1 1Bond University Faculty of Health Sciences and Medicine Introduction: Colorectal cancer patients use Internet online discussion forums to search for disease-related information, supportive interaction, and daily living advice (Meier, Lyons et al. 2007: Yli-Uotila, Rantanen et al. 2014). Specifically, they seek information relating to physical activity – an issue widely reported for other cancer specialities but less so for colorectal disease (Armstrong and Powell 2009). Such online use suggests peer experiences with exercise are valued as well as advice from health professionals. Method: Open access Cancer Survivors Network colorectal discussion boards were searched for threads mentioning physical activity or exercise. Threads initiated by colorectal cancer patients or survivors were included. From >6000 entries the inclusion criteria yielded 75 threads for analysis. Positioning theory as defined by Harre and van Langenhove (1991) was used to identify how online forum discussion members position themselves when discussing exercise amongst the group. Results : The form threads revealed that exercise as a topic seemed to polarise the forum contributors . Two main positions emerged: On the one hand, exercise advocates who were not health professionals were zealous in their positioning of physical activity to the extent where they were ostracised by other members. Alternatively, members were much more defensive of their choice not to exercise despite being aware of health benefits. Conclusion :Discussions about the role of exercise in relation to colorectal cancer, patient-hood and survivorship can be seen as threatening within online communities. The adoption of forced positioning of others who do not adopt an exercise program for their recovery can possibly affect conversations that survivors may have with their clinicians. An increase in clinician awareness of how colorectal patients experience and discuss exercise during their treatment can inform discursive clinical practice, including the development of survivorship care plans addressing colorectal-specific concerns with exercise.

___

112

P Medication compliance as an outcome of behavioural intervention in management of hypertension: a systematic review Palagama, S. P. W. 1, Calahorrano, A. Z. 2, Khalesi, S. 2, Sun, J. 3 1 : Masters student in Medical research, School of Medicine Griffith University 2 : PhD candidates, School of Medicine Griffith University 3 :Senior lecturer, School of Medicine Griffith University Introduction/Aim: Hypertension affects 26.4% of adults worldwide. Uncontrolled hypertension leads to fatal prognoses if not lifelong morbidity. In spite of heightened awareness, only 40% of patients have their blood pressure under control. The commonest reason attributed this is the lack of adherence. This systematic review investigated the impact of behavioural interventions on medication adherence and blood pressure control among patients with hypertension. Methods: After a thorough literature survey, comprehensive search criteria were developed to include studies on medication adherence in hypertension and the effects of behavioural interventions. An electronic search was performed on five data bases, Medline, Pubmed, Scopus, CINAHL and Psycinfo. The search was limited for randomized controlled trials (RCT), involving adults (>18 years), published in English between 2008 and 2013. A narrative systematic review style was adopted as there was no consistency between the scales used for measuring the adherence. Hence a meta-analysis was not performed. Results: Ninety RCTs were initially identified and reviewed by two independent authors. Sixteen articles were identified to be included in the systematic review. Eleven trials demonstrated statistical significant improvement of medication adherence as a result of behavioural intervention. Eight out of 16 articles demonstrated statistically significant improvement of blood pressure control, six out of which improved both systolic and diastolic pressure while one had only systolic pressure improvement. One trial had a statistically significant improvement of systolic blood pressure with a deterioration of diastolic blood pressure. Conclusion: There was a significant improvement of the medication adherence as a result of behavioural intervention. However the evidence available to establish an improvement in blood pressure control as a result of behavioural interventions is currently insufficient.

___

Life beyond Traumatic Brain Injury: Exploring possibilities for health promotion Parekh, S1, Kendall, E.1 1 Centre of National Research on Disability and Rehabilitation, Griffith University, Logan, Australia Introduction/Aim: Traumatic Brain injury (TBI) is a leading cause of death and disability as well as a major burden on health care systems around the globe. The complex nature of TBI leaves people vulnerable to secondary health problems such obesity and cardiovascular disease. Although innovative web-based interventions designed to promote healthy lifestyles are successful in general population, there is little health promotion aimed at individuals with TBI. Prevalent health risks in this population (eg. smoking, alcohol use, poor nutrition and physical activity) have been overlooked during rehabilitation. This study aims to explore the possibilities for health promotion. Methods: An online survey was distributed by Synapse, a Qld non-profit TBI organization. The survey included questions on: socio-demographic factors, health behaviours, health literacy, chronic conditions, economic circumstances and participants’ use of technology. Results: Currently,15 complete surveys have been returned (Male= 12; female=3; Average Age 49 years). None had returned to their pre-injury employment and 50% were unemployed post-injury. Although participants generally reported healthy lifestyles, 60% had 2 or more chronic comorbidities, suggesting that health concerns may not be associated with health behaviours alone. Significant sleep problems were reported by the majority of participants, which may contribute to disease. Participants had regular contact with primary care physicians and frequently used technology to locate health information. However, most were unsure about what action to take to protect their health. Conclusion: It is possible that this survey attracted those who were more health conscious than the general TBI population. However, the existence of severe sleep problems and multiple chronic comorbidities highlights a potential area for intervention in future. The fact that participants all used technology provides an opportunity to develop e-health interventions that can promote healthier sleeping patterns.

___

113

A household latrine to prevent soil transmitted helminth infection in rural villages in Central Java: the BALatrine intervention Park, MJ1, Gray, Darren2, Laksono, Budi3, Clements, Archie2, Stewart, Donald1

1School of Medicine, Griffith University, Brisbane, Australia 2Research School of Public Health, Australian National University, Canberra, Australia 3Yayasan Wahana Bakti Sejatera (YWBS) Foundation, Semarang, Indonesia Background: Many latrine campaigns in developing countries fail as the introduced latrine technology often is not matched to the human resources and the local environment. One possible solution is a low cost, locally designed and constructed, all-weather latrine (the ‘BALatrine’), together with education promoting appropriate hygiene-related behaviours. This article reports on a pilot study testing a combined physical-and-educational intervention to control soil-transmitted helminth (STH) infections. Methods: In two villages in Central Java (control and intervention), we measured knowledge about transmission and symptoms of STH infection, environmental contamination with human faeces, and STH-infection status (flotation method). These variables were measured before, and 8 months after, the BALatrne intervention was implemented. Results: Adjusted for age, gender, and STH-infection status at baseline, the odds of being STH-negative at follow-up were 2.6 times higher for residents of the intervention village than for residents of the control village (95%CI, 1.62 to 4.26). Over the 8 months, the percentage of residents with correct knowledge about STH infection was higher in the intervention village than in the control village. Environmental contamination was essentially unchanged in the control village, but greatly decreased in the intervention village. Conclusion: The combined BALatrine-and-education intervention increased the odds of being STH-negative, increased the village residents’ knowledge about STH infection, and reduced environmental contamination with human faeces. Following on from this longitudinal pilot study, a large cluster-randomised controlled trial has commence (ACTRN12613000523707).

___

Accessing the Unconscious Visual Pathway using Continuous Flash Suppression Parker, G. J.1, Hine, T. J.2 1 Griffith Health Institute and School of Applied Psychology, Griffith University, Australia 2 Behavioural Basis of Health, School of Applied Psychology, Griffith University, Mt Gravatt, Australia Introduction/Aim: Image suppression techniques are powerful methodological tools for examining the unconscious processing of visual stimuli, by disrupting input to the visual cortex. Continuous flash suppression (CFS; Tsuchiya & Koch, 2005) is the most effective technique within the extant research literature, and is quickly becoming the most commonly used method of inducing perceptual suppression. CFS was used in the current study to investigate the presence of a subcortical ‘low-road’ visual pathway, evolved to rapidly detect and unconsciously elicit adaptive responses to threat-related stimuli (LeDoux, 1996). The study also aimed to investigate the visual factors that are processed outside of awareness and contribute to the emergence of stimuli into consciousness, by employing a ‘breaking-CFS’ paradigm. Methods: Forty participants were recruited, comprising undergraduate psychology students who were either high on spider-fear (n = 20) or low on spider-fear (n = 20). Intact and scrambled spider-related images and neutral images were presented subliminally under CFS to participants, while measures of anxiety, heart rate, and reaction time were recorded. Results: Intact spider images broke suppression faster than their scrambled counterparts, which were equivalent on low-level visual features, indicating the contribution of emotional valence to the unconscious processing of visual stimuli, rather than spatial features alone. Intact spider images also broke suppression more frequently than intact neutral images. These results, however, were observed across both groups, with spiders representing a salient threat-related stimulus to both the high spider-fear group and the low spider-fear group. d’ signal detection scores revealed that both the high spider-fear group and the low spider-fear group were able to accurately identify the valence of unseen hostile stimuli on unconsciously processed trials. Furthermore, both groups exhibited faster threat reaction times on trials where no break in suppression occurred, compared to trials where spider images became visible. Conclusion: The results of the study provide behavioural evidence supporting the presence of a low-road visual pathway, which appears innate in all humans, and its evolved role in the unconscious processing of threat and facilitation of adaptive, defensive motor responses to threatening stimuli.

114

Assessment of the intestinal tight junction proteins FABP2, zonulin, LPS, and claudin-3 in Chronic Fatigue Syndrome Passmore, R.1, Wong, N.1, Hardcastle, S.1, Brenu, E.1, Ramos, S.1, Johnston, S.1, Marshall-Gradisnik, S.1, Hawthorn, A.1, Nguyen, T.1, Huth, T.1. 1 NCNED, Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: Chronic Fatigue Syndrome (CFS) is a disease of unknown cause, characterised by a wide variety of symptoms including sleep disturbances, memory and concentration difficulties, aches and pain, muscle tension, depression, autonomic dysfunction, gastrointestinal disturbances, and headaches. The purpose of this study was to investigate a possible cause of the gastrointestinal symptoms within the disease by examining the tight junction proteins LPS, FABP2, claudin-3, and zonulin. Methods: The CFS patients (n=17, diagnosis by CDC criteria) and healthy controls (n=17) patients utilised in this double-blind study were age and sex matched. Serum concentrations of LPS, FABP2, claudin-3, and zonulin were analysed using ELISA kits specific for each protein. Results: There were no significant differences in any of the four tight junction proteins when comparing CFS patients to healthy controls. CFS patients had slightly higher serum levels of LPS and zonulin than healthy controls, but the difference was not deemed significant (F=0.179, P=0.675; F=0.413, P=0.525). Claudin-3 levels were slightly higher in control patients than CFS patients, however not significantly (F=0.369, P=0.548). Serum FAB-P2 levels were very similar in both groups (F=0.11, P=0.916). Conclusion: Serum levels of four intestinal proteins involved in correct tight junction functioning were not significantly different in CFS patients compared to healthy controls. This suggests that malfunctioning tight junctions, and the associated ‘leaky gut’ problems which cause irritable bowel symptoms in some diseases are not the cause of intestinal problems in Chronic Fatigue Syndrome. Further research into other possible causative mechanisms for bowel issues in CFS patients is required in order to help in understanding the pathology of this illness.

___

Unpacking the link between self-perception of wellness and risky behaviours in emerging adulthood Paukste, E.1, Harris, N. 1, Sebar, B. 1 1 Population and Social Health Research Program, Griffith Health Institute, Griffith University, Australia

Introduction/Aim: Risky lifestyle behaviours associated with alcohol, motor vehicles, sexual relations, and other lifestyle activities have short and long-term health implications. While there are many interventions targeting such behaviours, they remain prominent across society, in particular during emerging adulthood. There are gaps in our understanding of what mediates engagement by young adults in risky lifestyle behaviours. An emerging body of literature is focusing on the relationship between self-perception of wellness and lifestyle behavioural choices. The purpose of this quantitative study was to investigate the association between self-perception of wellness and risky lifestyle behaviours of emerging adults (18-25 years of age) living in South-East Queensland and Northern New South Wales, Australia. Methods: Cross sectional quantitative online and paper-pencil survey was conducted with over 1000 young adults on the basis of convenience sampling. Participants completed a number of measures of subjective wellness including satisfaction with life, social connectedness and social and psychological wellbeing together with questions on a range of risky lifestyle behaviours including tobacco, alcohol and marijuana use, driving and sexual behaviour. Data was analysed using SPSS 21. Results: Preliminary analysis of the collected data suggests significant relationships between some dimensions of wellness and risky lifestyle behaviours. The strength of association varied across behaviours. Of particular note are the associations identified with the lifestyle behaviours that are considered to involve greater individual risk. Conclusion: The study provides evidence on the association between perceived wellness and risky lifestyle behaviours in emerging adulthood. Further research is required to unpack this association, which in turn can then inform the development of interventions to promote health in this population. Top 21 Genes causing Pheochromocytoma and Paraganglioma Suja Pillai.1, Vinod Gopalan, .1 Robert smith. 1,, Alfred Lam. 1

1 Cancer Molecular Pathology, Griffith Health Institute, Griffith University, Gold Coast Introduction: Pheochromocytoma (PCC) and paraganglioma (PGL) are rare neuroendocrine tumours that arise in adrenal medulla or the extra-adrenal sympathetic and parasympathetic paraganglia respectively with a collective incidence of about 1 in 300,000 per year. Most cases are sporadic, but up to 25% of patients with pheochromocytoma have a hereditary basis for the disease. This study is envisioned to investigate the number of genes associated with these rare tumours. Methods: The literature search was

115

conducted with the help of PubMed database and Google scholar and included review articles, case reports published from 1995 to 2014, written in English, using as query: "Genetics and Pheochromocytoma" for PCC and “Genetics and Paraganglioma” for PGL. Results: Both PCC and PGL are characterized by mutations in twenty one specific genes, which have been mainly discovered via family based studies. These genes were mostly involved in hypoxic response. These genes include Neurofibromin 1 (NF1), Von Hippel-Lindau tumour suppressor (VHL), Multiple endocrine neoplasia 1(MEN1), Endothelial pas domain(EPAS1), Rearranged during transfection (RET), Succinate dehydrogenase subunit A-D genes (SDHA-D), Succinate dehydrogenase assembly factor 2 (SDHAF2), Prolyl hydroxylase (PHD1andPHD2),Kinesinfamilymember1B(KIF1B), Transmembraneprotein127(TMEM127), Myc associated factor X(MAX),Isocitratedehydrogenase(IDH), Fumarate hydratase(FH), Harvey rat sarcoma viral oncogene(HRAS), Glial cell derived neurotropic factor(GDNF), Cyclin dependent kinase inhibitor(CDKN2A),and Guanine nucleotide binding protein(GNAS).These mutations account for at least one-third of pheochromocytomas and paragangliomas, the highest inheritable proportion of any known human tumour. Mutations in succinate dehydrogenase B (SDHB) have been considered the most important clinically, as PCCs and PGLs carrying them have relatively high rates of malignancy, as high as 50%. Conclusions: Knowledge of these genes can ensure a more effective detection and treatment of these tumours. All patients with PCC/PGL should be offered a molecular genetic screening and it should not be restricted to mutations of the genes of SDH complex alone.

___

Reflection on a journey through a dietetics career: 10 years on from the aspiring dietitian study. Plint, H.1, Ball, L.1, 2, Hughes, R.3, & Desbrow, B.1, 2

1 School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia 2 Griffith Health Institute, Centre for Health Practice Innovation, Griffith University, Gold Coast, Queensland, Australia 3 Bond University, School of Health Sciences, Gold Coast, Queensland, Australia

Introduction/Aim: Ten years ago, a study investigating the attitudes and beliefs of aspiring students applying for a postgraduate, accredited dietetics program was undertaken. This study revealed that many individuals chose dietetics due

to their broad interest in nutrition, health and helping others. However, literature addressing the career journey of dietitians, specifically career choice, success, and satisfaction is limited. Understanding the workforce experiences of health graduates enables education providers to produce graduates aligned with the employment environment. The current study aimed to revisit participants from the original study and explore the careers of these dietitians in their first ten years after graduation. Methods: A qualitative, cohort follow-up investigation with participants from the “aspiring dietitians study” was conducted during March and April 2014, utilising semi-structured, in-depth telephone interviews, with open-ended questions. The interviews focused on factors influencing career journey, career success, satisfaction, skill development and knowledge of the dietetic profession. The interviews were transcribed verbatim and underwent thematic analysis. Results: Numerous factors had influenced careers, including career-based opportunities, job availability and lifestyle with many participants working in a different area of dietetics to that originally of interest. This was in part, due to a broader knowledge of the scope of dietetic practice, which differed immensely to when commencing dietetic studies. Participants acknowledged many elements of career success with a stronger emphasis placed on individual judgement of their career opposed to external factors. Helping people and seeing results were frequently highlighted as contributing to a satisfying career. On reflection, the majority of participants would undertake dietetics training if given their time again. Conclusion: The results suggest that after a decade within the profession many individuals remain satisfied with their career choice. Greater emphasis should be placed on improving students’ awareness of the array of opportunities available to graduates considering the growth and change of the dietetic profession.

___

Morphometric analysis of metacarpal bone development in females from isolated populations Pointer, E1., Raikos, A1., Wood, W1., Moro, C.1

1 Faculty of Health Sciences and Medicine, Bond University, Robina, Australia Introduction/Aim: The International Biological Programme was a worldwide study obtaining anthropometrical data from remote regions. Much of the data collected has never been investigated and with the onset of new computer imaging and software, research into population variations can occur. Of interest are databases of X-Rays depicting the metacarpal bones, identified as

116

potential measures of skeletal development. In Papua New Guinea (PNG) populations, a major difference between studied subpopulations was their nutritional intake. Highlanders (Bundi village) diet consisted predominantly of vegetables (sweet potato) and rice. Coastal areas (Pari village) also consumed vegetables and rice, but had increased protein intakes from fishing and farming. The aim of this study was to examine anthropometrical data obtained from 11-year old females living in these two distinct regions of PNG, and compare these to Australian females. Methods: X-rays taken of the hand and wrists of 11 year old females from PNG (1968 to 1974) and Brisbane (1983) were digitized and analysis completed. Measurements for metacarpals were collated with anthropometrical data. An ordinary single-measures-ANOVA with Tukey’s Post-Test was performed for statistical analysis. Results: There was a significant difference in growth between females living in the coastal regions compared to the highlands in PNG, with coastal females being taller and heavier (P<0.01). Regarding skeletal development: the length, cortical thickness, width and diaphysis length (all P<0.01) were larger in coastal residents for the second metacarpal; with length, cortical thickness and diaphysis length (all P<0.01) being larger in the third metacarpal. There were fewer differences between the coastal females, and Brisbane control subjects, with only the length and cortical thickness (P<0.05) being larger in the Brisbane samples. All measurements were different between the highlands and Brisbane populations. Conclusion: In PNG, the variation in diet appears to be influential on skeletal bone development. In particular, in the growth of the second metacarpal, while the coastal females were very similar in development to the Brisbane females. This study presents the concept that efficient protein intake from a young age may be a driving factor for normal growth and development.

___

R Multiple proliferation-survival pathways are simultaneously active in BRAF V600E mutated and undifferentiated thyroid carcinoma cells Md Atiqur Rahman1, Ali Salajegheh1, Robert Anthony Smith1, Alfred King-yin Lam1 1Cancer Molecular Pathology Group, Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction and aims: BRAF is an oncogene and oncogenic mutation in BRAF is involved in pathogenesis in ~8% of cancers. A few small molecular kinase inhibitors are developed to target mutant BRAF protein and maximum response rate

of these BRAF inhibitors is not more than 50%. The aim of the research is to study the pathway of BRAF mutation in undifferentiated thyroid carcinoma. Methods: Undifferentiated thyroid carcinoma cell lines with different BRAF mutation status were cultured. Protein was extracted from these cell lines and pathway status was checked through Western blot. In addition, transfection of mi-RNA126 mimic was performed in these cell lines and the effect was observed by cell viability assay and Western blot. Results: We observed active extracellular signal-regulated kinases (ERK) and protein kinase B (AKT) in all BRAF mutated and undifferentiated thyroid carcinoma cell lines tested. Moreover, transient experiment on BRAF mutated and undifferentiated thyroid carcinoma cell lines showed ~51% proliferation suppression could be induced by miRNA126 mimic that suppresses KRAS and p85β protein expression. Conclusion: Both ERK and AKT proliferation-survival pathways are found simultaneously active in BRAF mutated undifferentiated thyroid carcinoma. Targeting one pathway may end up with developing drug resistance. In addition, miRNA-126 could be used to treat BRAF mutated and undifferentiated thyroid carcinoma.

___

Pre-implementation of Point of Care Testing in a General Practice Surgery Niamh Ramsay1, Tracey Johnson2, Tony Badrick1

1Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Robina, QLD. 4229 2 Inala Primary Care, Inala, QLD, 4007 Introduction/Aim: The burden of chronic disease on the individual and community should be addressed by implementing a better patient management. This study examined various aspects of pathology testing including PoCT in general practice. It is novel to previous research in that it assessed the potential impact of PoCT in a GP setting in three areas of lower socio-economic status.Methods/Results: Three general practice clinics were involved, and over the course of three months, a number of different aspects of patient compliance with regards to completing pathology testing were investigated. It was considered that there could be multiple barriers preventing patients from having requested pathology test including gender, ethnicity, first language, fasting requirements, or access to transport. These potential factors were compared amongst the involved clinics to determine their frequency and relevance. A value stream map of each clinic was also constructed to compare workflow and effectiveness of approach when ensuring pathology requests were completed by each clinic. From these

117

results, a cost analysis was conducted to determine the economic impact of this task on staff. Conclusion: It was concluded that with the introduction of PoCT, these issues with non-compliance of pathology requests, as well as the costs associated with patient recall methods by staff, could be minimised.

___

Solving research waste: better duplicate detection with Systematic Review Assistant deduplication module John Rathbone1, Matt Carter1, Tammy Hoffmann1, Paul Glasziou1

1Centre for Research in Evidence Based Practice, Bond University, Gold Coast, Queensland, Australia Introduction/Aim: A major problem arising from searching across bibliographic databases is the retrieval of duplicate citations. Although reference management software use algorithms to remove duplicate records this is only partially successful and necessitates removing the remaining duplicates manually. This time consuming task leads to wasted resources. We sought to evaluate the effectiveness of a newly developed deduplication program against Endnote. Methods: A literature search of 1988 citations was manually inspected and duplicate citations identified and coded to create a benchmark dataset. The Systematic Review Assistant deduplication module (SRA-DM) was iteratively developed and tested using the benchmark dataset and compared with Endnote auto-deduplication. The accuracy of deduplication was reported by calculating the sensitivity and specificity. Further validation tests, with three additional benchmarked literature searches comprising a total of 4563 citations were performed to determine the reliability of the SRA-DM algorithm. Results: The sensitivity (84%) and specificity (100%) of the SRA-DM was superior to Endnote (sensitivity 51%, specificity 99.83%). Validation testing on three additional biomedical literature searches demonstrated that SRA-DM consistently achieved higher sensitivity than Endnote (90% vs 63%), (84% vs 73%) and (84% vs 64%). Furthermore, the specificity of SRA-DM was 100%, whereas the specificity of Endnote was imperfect (average 99.75%) with some unique records wrongly assigned as duplicates. Overall, there was a 42.86% increase in the number of duplicates records detected with SRA-DM compared with Endnote auto-deduplication. Conclusion: Systematic Review Assistant deduplication module offers users a reliable program to remove duplicate records with greater sensitivity and specificity than Endnote. This application will save researchers and information specialists time and avoid research waste. The deduplication program is freely available online.

The Dangers to Children of Coconut Tree Trauma in Solomon Islands. Rajan Rehan1, Jasryn Dhaliwal1, Heddi Rowas1, Hashim Abdeen1, Peter Jones2

1 Final Year Medical Student, 2 Dean of Medicine, Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia Introduction: Kirakira is small community of 3,000 people and is the capital of Makira-Ulawa province in Solomon Islands. Kirakira is an impoverished community with a small 30 bed hospital with limited resources. This audit was conducted by final year students from Bond University as part of a selective clinical placement. Methods: The audit included admissions to the hospital from 2011 to 2014. Trauma-related admissions were identified and classified according to the patient’s age, sex, description of injury, mechanism of injury and whether they were transferred to the National Referral Hospital (NRH) in Honiara for further treatment. Injuries due to Coconut tree trauma were classified as being due to falls from the tree, falling branches or from falling coconuts. Results: There were 3455 admissions and 23(0.7%) non neonatal deaths over the three year period. 126(3.6 %) admissions were referred on to the NRH for further treatment. 277 (8.02%) admissions were trauma-related with 57(21%) of these referred on to the NRH. 142 (55%) of the trauma admissions involved children. Coconut Tree trauma was the commonest cause of a traumatic admission to hospital. There were 49 Coconut Tree trauma admissions including 35 from falls, 12 from falling branches and 2 from falling coconuts. 80% of Coconut tree trauma involved Males and the median age of those injured was 13. Primary School age children aged 6-14 years were most at risk for Coconut Tree Trauma. 15(31%) of the Coconut tree trauma admissions were referred to NRH for further treatment. Conclusions: Coconut Tree Trauma is common in Kirakira and is an important preventable cause of serious injury that particularly affects primary school aged boys in Kirakira, Solomon Islands. A public education campaign that focuses on this at risk age group warning of the dangers of climbing Coconut trees should be considered.

___

118

Assessment of Acquired Capability for Suicide in Clinical Practice Rimkeviciene, J.1, Hawgood, J.1,O’Gorman, J.1, De Leo, D.1 1 Australian Institute for Suicide Research and Prevention, Griffith University, Australia Introduction/Aim: Interpersonal theory of suicide (IPT) proposes interaction between three constructs, thwarted belongingness, perceived burdensomeness, and acquired capacity for suicide, predicts proximal risk of death by suicide. Instruments to assess all three constructs are available. However research on the validity of one of them, Acquire Capability for Suicide Scale, has been limited, especially in terms of its clinical relevance. This study aimed to explore the utility of the different versions of ACSS in clinical assessment. Methods: The present study examined three versions of the scale: the full 20-item version, a 7-item version, and a single item version representing self-perceived capability for suicide. 55 patients attending a specialist clinic for treatment of suicidal behaviour were administered the scales on two occasions with an interval of approximately two weeks. Their scores were compared to a sample of 58 volunteers drawn from the community. Results: Both ACSS versions and the single item were found to show reasonable levels of reliability and to correlate as expected with reports of suicidal ideation, self-harm, and attempted suicide. The item assessing self-perceived acquired capacity for suicide showed highest correlations with all levels of suicidal behaviour. However, no version of this scale on its own showed a capacity to postdict suicide attempts in the combined sample. Conclusion: It is concluded that the versions of the scale have construct validity but little practical application. An assessment using a single item on self-perceived acquired capacity for suicide outperforms the full and shortened versions of ACSS in clinical settings.

___

Adenosine A2A receptor expression in human peripheral blood cells is down-regulated with essential hypertension. Rose’Meyer, R.1, Ho, M-F.1 1 Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: Essential hypertension is considered to be a multifactoral disorder and its aetiology has yet to be clearly identified. As the adenosine receptors have a significant role in mediating vasodilation, alterations in their structures or signalling pathways may be involved in the

development of hypertension. This study aimed to measure the mRNA and protein expression levels of the adenosine A2A receptor in peripheral blood mononuclear cells and determine whether they are altered with essential hypertension. Methods: The study utilised blood samples from 17 hypertensive and 10 normotensive subjects who were unrelated. The gene expression levels for the adenosine receptors were detected using real time PCR. 18S rRNA and beta-actin were utilised as housekeeping genes. Western blot was used to confirm the expression changes at the protein level. Results: Hypertensive participants were aged 50.8±5 years old and their blood pressure were 126±10/82±6 mmHg, which were not significantly different to the normotensive group (p>0.05). ECG analysis of each participant showed that sinus rhythm presented in all participants and none of the subjects exhibited left ventricle hypertrophy. Adenosine A2A receptor mRNA and protein levels were down-regulated in the human peripheral blood cells from the hypertensive group when compared to control samples (p <0.05). Conclusion: The relative expression levels of adenosine A2A receptor in the hypertensive group were significantly different to the normotensive group. Alterations in blood cell adenosine receptor populations reflect changes that occur in essential hypertension that are not a direct result of high blood pressure.

___

S Measurement of forearm muscle haemodynamics via near-infrared spectroscopy: the impact of hand circulatory occlusion. Sabapathy, S.1, van Beekvelt, M.2, Constantini, K.1, Cross, T.1,3 1Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Australia 2Department of Neuroscience, Norwegian University of Science and Technology, Norway 3Division of Cardiovascular Diseases, Mayo Clinic, USA Introduction: Near-infrared spectroscopy (NIRS), coupled with the venous occlusion technique (NIRS-VOT), has been used to quantify limb muscle blood flow. However, it is difficult to compare results between studies using NIRS-VOT because of the inconsistent application of distal (e.g., hand or foot) circulatory occlusion during measurements. The aim of this study was to examine the influence of hand circulatory occlusion, via supra-systolic wrist-cuffing, on resting forearm muscle blood flow and metabolism as determined by NIRS-VOT. Methods: Twenty-five healthy adults (7 females; 28 ± 4 yr) completed, in random order, a series of five venous

119

occlusion trials with supra-systolic wrist-cuffing (WC+) and five trials without wrist-cuffing (WC-). NIRS data were obtained from the flexor digitorum superficialis (FDS) muscle – inter-optode distance = 35 mm; differential path-length factor = 4.0; sampling frequency = 100 Hz. NIRS-derived parameters included tissue blood flow, vascular conductance, oxygen consumption, venous oxygen saturation, and fraction of oxygen extracted from arterialised blood (FOE). Arterial oxygen saturation and blood pressure measurements were obtained simultaneously from the contra-lateral arm. Results: Heart rate and mean arterial pressure during WC+ were similar to WC-. In contrast, WC+ resulted in a significant (P<0.05) reduction in FDS blood flow (36 ± 23%), vascular conductance (37 ± 23%), oxygen uptake (14 ± 31%) and venous oxygen saturation (14 ± 12%). Conversely, FOE was significantly higher during WC+ (14 ± 13%; P<0.05). The coefficient of variation for the NIRS-derived parameters was similar between WC+ and WC-. Conclusion: Hand circulatory occlusion, via wrist cuffing, reduces arterial inflow and oxygen consumption of the FDS muscle derived from NIRS-VOT, but does not affect the reproducibility of hemodynamic and metabolic parameters. These findings highlight the need for investigators to be cognisant of the influence that supra-systolic wrist-cuffing bears on the resting forearm when using NIRS-VOT to quantify muscle haemodynamics and metabolism.

___

A novel approach to treat Her2high breast carcinomas: Targeting the Electron Transport Chain and the role of mitochondrial Her2 Sachaphibulkij, K.1, Dong, L.F.1, Bezawork-Geleta A.1, Pasdar, E.A.1, Endaya, B.1, Yan, B.1 and Neuzil, J.1, 2 1. Griffith Health Institute, Griffith University, Gold Coast, Australia 2. Institute of Biotechnology, Academy of Sciences of the Czech Republic, Prague, Czech Republic. Introduction/Aim: Cancer is one of the prevailing causes of death worldwide. The prognosis of this disease is poor and may be attributed by high rates of mutations leading to heterogeneity of tumours, and thus requiring an invariant target to selectively combat malignant cells. Her2high breast carcinomas occur in up to 30% of breast cancer patients and remain to be the hardest to treat breast cancers. Our group focuses on novel therapeutic approaches to target such resistant cancers. Methods: MCF-7 cells with varying amounts of Her2 were used. Her2 localisation was evaluated by fractionation. Mitochondrial membrane potential and respiration were analysed using flow cytometry and oxygraph

respectively. The complexes in the ETC were assessed using BN-Page. The effect of treatment was assessed by MTT assay and western blotting. Cells were xenografted subcutaneously into Balb/c nude mice and treated with mitochondrial targeting compounds intraperitoneally to assess tumour volumes through ultrasound imaging.Results: The central dogma of Her2 being present at the plasmatic membrane has allowed for the development of commercially available antibody-based therapies epitomised by Herceptin. However, Herceptin is not always efficient, possibly since Her2, as shown by our studies, is predominantly located in the mitochondria. We also show that Her2high cells exhibit higher mitochondrial membrane potential but exhibit lower respiration through oxidative phosphorylation compared to Her2low cells. Further investigation of these cells show increased levels of mitochondrial complex I and the respirasome. However, the mechanism of Her2 translocation to mitochondria is not entirely understood. Conclusion: Our intriguing findings led us to anticipate that targeting the mitochondria could be an effective mode of therapy especially, but not limited to, Her2high breast carcinomas. We, thus, synthesised a mitochondrially targeted anti-cancer agent targeting the ETC. This compound, a mitochondrial targeted analogue of tamoxifen, suppresses Her2high breast carcinomas more efficiently than their Her2low counterparts.

___

Determinants of receptor binding by pili of enterotoxigenic E. coli Madhavan, V.1, Sakellaris, H.1 1 School of Medical Science, Griffith University, Gold Coast, Australia Introduction: Enterotoxigenic E. coli (ETEC) is a major public health problem around the globe. It is responsible for nearly 200 million cases of diarrhoea and 380,000 deaths annually, mainly in children less than 5 years of age. ETEC also infects travelers to endemic regions and military personnel in the field. Pili mediate the adherence of ETEC to, and colonization of, the intestinal epithelium. This is the critical, first step in the infection process. Therefore, vaccines that elicit antibodies to pili have the potential to block the adherence of ETEC to the intestine and thereby prevent the establishment of disease. Thus an understanding of the determinants of ETEC pilus binding has important implications in the design of pilus-based vaccines. In this study we examined the role of two pilus protein subunits, CfaB and CfaE, in pilus binding to the glycosphingolipid receptor molecule, asialGM1 (aGM1). Methods: Site directed mutations were generated in the minor pilus subunit, CfaE, and

120

whole pili were tested for their ability to bind to aGM1 and cultured intestinal epithelial cells. A complementary approach involved the purification of isolated pilus subunits which were then tested for binding to aGM1 by ELISA. Results: Site-directed mutagenesis of CfaE abolished the binding activity of ETEC pili. Consistent with this result, the purified CfaE protein subunit bound to aGM1 but the CfaB subunit failed to bind. Conclusion: This study contradicts previous reports that the major pilin subunit, CfaB, binds aGM1 and proves the role of CfaE in this activity instead. These results have significant consequences for the design of pilus subunit vaccines for the prevention of ETEC infections.

___

Young Iranian women wellbeing through community participation Salehi, A.1, Neil, H.1, Sebar, B.1 Coyne, E.2

1 Griffith Health Institute, Griffith University, Gold Coast, Australia 2 Griffith Health Institute, Griffith University, Logan, Australia Introduction/Aim: Research exploring health and wellbeing outcomes has identified that social capital components such as community and civic participation have a significant influence on health and wellbeing. This study investigated the correlation between community participation, health and wellbeing among young Iranian women. Methods: Using a cluster convenience sampling technique, 391 young Iranian women completed a survey developed from the British General Household Social Capital scale. Different elements of community participation were measured as independent variables. Satisfaction with Life Scale, Quality of Life (WHO) and the International Health and Behaviors survey were used as outcome variables. Descriptive, correlation and regression analysis were completed for this study. Results: The results identified that the frequency of participation in community groups was low among young Iranian women particularly in local and national community groups such as associations, political groups, charities, and environmental groups. Statistical analysis show that the higher civic/community participation resulted in higher quality of life, higher satisfaction with life, and healthier lifestyle behaviors. In addition there are significant differences in terms of community/civic participation, ethnicity, level of religiosity, education, employment, income, type of occupation, and parental status. Conclusion: In this study, a positive link was found between community participation and wellbeing outcomes. In order to improve individual, community and societal

wellbeing, interventions which increase women’s social participation particularly local and national community participation should be a priority.

___

The pitting test: An investigation into an unstandardized assessment of oedema Sanderson, J. 1, Tuttle, N Dr.1, Box, R Dr.2, Reul-Hirche, H.3, Laakso, L A/Prof.1

1 Griffith University, Gold Coast, Australia 2 Queensland Lymphoedema Breast Oncology Physiotherapy, Brisbane, Australia 3 Royal Brisbane Women’s Hospital Introduction/Aim: The pitting test is an unstandardized test utilized by health professionals to examine an area suspected to be oedematous. The presence or absence of pitting effect is associated with the volume of oedema in the superficial interstitial space, but is also a key criterion for staging of lymphoedematous tissue. This study investigated the breadth of pitting test techniques that therapists use to assess lymphoedematous and non-lymphoedematous tissue. Methods: Six physiotherapists assessed six unilateral lymphoedema patients by doing four pitting tests. The pitting test locations were in a proximal and distal location on the affected and unaffected limbs. Three therapists were experienced in lymphoedema assessment and three had no lymphoedema assessment training, although were familiar with the presentation of oedema and the pitting test. An electronic sensor from the Tekscan Grip system was placed between the therapists thumb and the test location for recording of thumb contact area, pressure applied during the pitting test and duration it was sustained for. Results: The average contact area applied by the therapists’ thumb ranged between 0.16cm2 to 6.84cm2, average pressure ranged between 1.30 and 14.36N/cm2, and average duration ranged between 1.10 and 76.00 seconds. The lymphoedema experienced therapists performed the pitting test with a significantly larger thumb contact area (p<.001), higher pressure (p<.001), and longer duration (p<.001) than the inexperienced therapists. Therapists were consistent in their chosen technique in terms of contact area, pressure and duration applied during the pitting tests, although the technique differed between therapists. Conclusion: The large range of pitting test techniques in this small sample is supportive of the requirement for further investigation into the pitting quality of tissues to enable the standardization of the assessment.

___

121

Creating a Smoke Free Workplace: Using multiple approaches to assist staff to quit Sebar, B.¹ ², Morgan, K.², Bennett, M.³ Blest, K.² Lewington, L²

¹Griffith Health Institute, Griffith University, Gold Coast, Australia ²School of Medicine, Griffith University, Gold Coast, Australia ³Queensland Health, Gold Coast Health, Gold Coast, Australia Introduction: It is well documented that smoking cessation interventions within workplace settings can be effective. The new Gold Coast University Hospital has prohibited staff, patients and visitors from smoking anywhere on hospital grounds. Alongside the no smoking policy, Queensland Health has implemented a “quit smoking for life” program which supports staff to reduce or quit smoking. This program includes the roll out of a smoking management clinic which comprises pharmacotherapy, education sessions and follow up support. Methods : A mixed method approach was used to identify the barriers and enablers for staff to access the clinic. Quantitative interviews were conducted with 30 staff who have not attended the clinic. Twenty follow-up qualitative interviews were also conducted with staff who attended one or more sessions. Results : The results indicate that the total smoking ban at work was an impetus to quit. Furthermore, they found that the ability to use the clinic during work hours, the free NRT patches and the flexibility of the program to suit busy schedules enabled them to successfully change their smoking behaviours. Importantly, the follow up support and the close rapport with the facilitator was identified as an enabler to continue using the service. The main barriers identified included the belief that going cold turkey was a more effective way to quit and the stigma associated with being a smoker discouraged some workers from taking up the program with colleagues. Conclusion: This research supports current public health thinking which argues that to effectively address public health priorities a range of interventions are needed that operate both at the policy and the individual level. While simply restricting smoking at work will result in some decrease in smoking levels, providing support to individuals will enable smokers to take advantage of the smoke free environment and adopt healthier behaviours.

___

The role of human papillomaviruses in the aetio-pathogenesis of head & neck cancer and approaches to gene therapy Mushfiq H. Shaikh1,2, Daniel Clarke1, Nigel McMillan1, Newel W. Johnson2

1 Molecular basis of diseases, School of medical science, Griffith Health Institute, Griffith University, Gold coast, Australia 2 Infectious Diseases and Cancer Research Group, School of dentistry and oral health, Griffith Health Institute, Griffith University, Gold coast, Australia Introduction/Aim: Malignancies of the upper aero-digestive tract are one of the ten most common cancers worldwide. Certain Human papillomaviruses (HPVs) are well-established risk factors for cervical cancer and for a subset of head and neck squamous cell carcinoma (HNSCC); however, their true role and importance in the progression of HNSCC remain unclear. Here we overview the role of HPV oncogenes in HNSCC development and the accountability of short interfering RNA (siRNA) technology as a novel therapeutic approach against HPV-positive head and neck cancers. Methods: UMSCC104, the HPV type16-positive head and neck cancer (HNC) cell line was the main focus, while a cervical cancer cell line CaSki (HPV type 16) was used as a positive control and HPV-negative HNC cell SCC25 as a negative control. Cell lines were transfected with siRNA before examining gene knockdown, transfection efficiency and siRNA efficacy. Results: Our data show that E6E7 siRNA effectively knocks down the E7 gene in CaSki cells, and to a lesser degree in UMSCC104 cells (20% only) compared to the untreated cells respectively. Cell metabolic and cell viability assays suggest that the siRNA was not working efficiently in UMSCC104 cells, however UMSCC104 were shown to have lower transfection rates compared to CaSki, which may contribute to this effect. In addition, colonogenic assays showed that siRNA knockdown affected continued CaSki cell growth, though little effect was seen in the UMSCC104 cell line. Conclusion: Our data justifies the role of oncogene E7 in cervical cancer propagation and the functional effectiveness of siRNA in knocking down E7, leading to cancer cell death. On the contrary, the HNC cell line (UMSCC104) seems to show resistance to siRNA mechanism and transfection that ultimately questions the functional role of E7 in HNC progression and also its effectiveness as a therapeutic approach in HPV-positive HNSCC treatment, though more work is needed to confirm.

___

122

Critical Evaluation of a Targeted ROTEM® Guided Coagulation and Haemostasis Management Programme in Severe Trauma and Critical Bleeding Shuttleworth, M.1, Singh, I.1, Bulmer, A. 1, Winearls, J. 2, Campbell, D2, Rose’Meyer, R1

1Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Southport, Australia. 2Critical Care Research Group and Intensive Care Unit, Gold Coast University Hospital, Southport, Australia Introduction/Aim: Trauma remains the leading cause of death in young adults, approximately 50% of which are due to bleeding in the first 24 hours after injury. The complexity of the coagulopathy associated with severe trauma has resulted in significant institutional variation in the management of these patients. Whilst the implementation of Massive Transfusion Protocols in the setting of severe trauma has resulted in improved outcomes, an accepted strategy for trauma-induced coagulopathy management is under debate. Rotational Thromboelastometry (ROTEM®) - based coagulation management offers an attractive alternative to fixed ratio transfusion protocols, providing the means to tailor/target individual patients haemostatic therapy. It is postulated that ROTEM based treatment algorithms can reduce the massive transfusion of blood and blood products, both of which are associated with increased morbidity, mortality and costs. Methods: Following ethical approval, a case controlled study was performed at the Gold Coast University Hospital (GCUH), a level 1 Trauma Centre. Coagulation management of trauma patients admitted to the GCUH ICU was guided by ROTEM® (ROTEM®-group, n=77). Data concerning blood and blood product transfusion rates, duration of stay at ICU, hospitalisation and transfusion-associated costs were compared to trauma patients admitted to Gold Coast Hospital (GCH) ICU, whose coagulation management was guided by standard laboratory tests (SLT) (SLT-group, n=77). Results: The implementation of ROTEM®-guided coagulation management was associated with a reduction in the administration of blood products, ICU length of stay, hospitalisation and mortality. The transfusion requirements of PRBC were decreased by 15.7%, FFP by 52.1%, platelets by 33.3% and Prothrombinex by 73.3%, however cryoprecipitate transfusion rates increased by 69.9%. Furthermore, in the ROTEM®-guided group, hospitalisation decreased by 9.0%, ICU length of stay decreased by 43.0% (additionally used as a surrogate marker for bleeding complications and adverse transfusion-related outcomes), and the difference in mortality was

66.6%. Conclusions: The implementation of a POC ROTEM®-guided programme was successful in the treatment of bleeding trauma patients. The exposure of patients to allogeneic blood products was additionally reduced, thus allowing the limited blood resources to be used more efficiently.

___

Streptococcus agalactiae asymptomatic bacteriuria and uropathogenesis: Roles of epithelial cell binding and immune activation. Smith, J.P.1, Ipe, D.S.1, Sullivan, M.J.1, Duell, B.L., Ulett, G.C.1 1 Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: Streptococcus agalactiae is responsible for approximately 2% of all urinary tract infections (UTI). The pathogenesis of these infections is poorly defined. Therefore, this study was undertaken to elucidate the binding capacity, cytotoxicity and immunogenicity of specific clinical isolates of uropathogenic S. agalactiae (UPSA) and asymptomatic bacteriuria S. agalactiae (ABSA) to bladder uroepithelium. Methods: Optimized in vitro antibiotic protection assays were utilized to determine the ability of representative UPSA and ABSA strains to adhere to and invade human 5637 uroepithelial cells. A mouse model of UTI was also utilized to define the ability of these bacteria to colonize bladder tissue in vivo. We measured the cellular cytotoxicity and immunogenicity using lactate dehydrogenase and multiplex cytokine assays, respectively. Results: We found that UPSA adhered to uroepithelial cells significantly greater than ABSA at 1 hour-post-infection (hpi) (6.4x104

CFU.ml-1 vs. 4.0x104 CFU.ml-1, p=0.028). Conversely, significantly greater recovery of ABSA was seen at 3 hpi (2.6x102 CFU.ml-1 vs. 1.2x103 CFU.ml-1, p=0.0038) and 24 hpi (6.6x101 CFU.ml-1 vs. 5.7x102 CFU.ml-1, p=0.039). In contrast, in vivo recovery of UPSA compared to ABSA at 24 hpi was not statistically significant (p=0.052). In vitro, UPSA was significantly more cytotoxic at 1 hpi compared to ABSA (p=0.0007). Cytokine induction was significantly greater for UPSA compared to ABSA infection, especially for IL-1α, IL-7, IL-13, MIP-1α and TNF-α. Comparing UPSA to ABSA at 24 hpi in vivo, cytokine responses were not significant, excepting IL-1α. However, compared to mock-infected-controls, significant cytokine expression was detected. Conclusion: These results show that UPSA binds to and kills human uroepithelial cells more efficiently compared to ABSA. Various host-factors, such as inflammatory mediators are induced more potently by UPSA in vitro, however this was not reflected in vivo. Therefore, to more fully define the pathogenesis of UTI due to S.

123

agalactiae, other variables should be considered in future research.

___

Developing a microbiota signature from gut microbiota’s metabolites Mohsen Sohrabi1, Abu Hasanat Md. Zulfiker1, Li Zhang2, Raj G Nair3, Lakshman P Samaranayake4, Adnan Ahmetagic1, David Andrew Good1,5 and Ming Q Wei1

1School of Medical Science, Griffith Health Institute, Griffith University, Gold Coast, Australia 2Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, Nathan, Australia 3School of Dentistry and Oral Health, Griffith Health Institute, Griffith University, Gold Coast, Australia 4School of Dentistry, University of Queensland, Brisbane, Australia 5School of Physiotherapy, Australian Catholic University, Banyo, Australia Introduction/Aim: Recent studies have demonstrated the correlation between intestinal microbiota and human diseases such as obesity, inflammatory bowel disease and gastrointestinal cancers to name a few. Next generation sequencing (NGS) has revolutionized human bacterial identification and taxonomy. However, NGS is time-consuming, costly and requires significant bioinformatics knowledge. Thus, these drawbacks limit its use as an easy and rapid method in disease diagnosis. Volatile organic compounds (VOCs), on the other hand, are of the biggest bacterial metabolites which have been used as diagnostic markers of infectious and non-infectious diseases. This paper presents the results of a pilot study to assess whether human microbiota VOCs could be used as an alternative for microbiota profiling. Methods: Human faecal bacterial mixed culture, Escherichia coli faecal culture and non-inoculated bacterial culture media were used for headspace VOCs analysis and comparison. Volatile organic compounds extraction was performed using headspace solid phase micro-extraction. Separation and analysis of extracted VOCs was done using gas chromatography/mass spectrometry. Chromatogram alignments and metabolites abundance were calculated using online XCMS software. Results: Comprehensive multiple group analysis (ANOVA) indicated that there were about 1000 significant ion-peaks across three different groups (p≤0.01). The capability of these significant ion-peaks in differentiation of groups could be confirmed by principal component analysis (PCA). The Welch t-test comparison of faecal inoculated culture media with non-inoculated culture media showed that faecal bacteria could produce 502 significant up-regulated ion-peaks (p≤0.01, fold

change ≥1.5) in bacterial culture media. VOCs analysis also showed that there were 231 significant up-regulated ion-peaks in faecal inoculated culture media in comparison with E. coli inoculated culture media. Conclusion: The pilot study showed bacterial VOCs were able to clearly separate faecal microbiota from single bacterium in culture media. The results of this study demonstrate the potential use of bacterial metabolites, such as VOCs as a signature of cultivable human microbiota profile.

___

Exploring the Barriers and Rewards to Working as a Dietitian in Mental Health Sopher, L.1, Williams, L.T.1,2 1 Nutrition and Dietetics, Griffith University, Australia 2 Griffith Health Institute, Griffith University, Australia Introduction/Aim: While the nutrition related needs of mental health patients are high, the dietetic mental health workforce is small. The credentialing competencies have recently been revised to include a greater focus on mental health, but factors affecting participation in this workforce are unknown. The aim of this study was to explore the facilitators and barriers to job satisfaction in practising mental health dietitians (MHD). Methods: Constructivist Grounded Theory (CGT), an exploratory qualitative methodology, was used to investigate the aim. All dietitians working in mental health were invited via national email group and 17 volunteered. One on one interviews were conducted by telephone or in person and lasted approximately one hour. The barriers and rewards to working as a MHD were explored as part of a broader semi-structured interview protocol developed after a review of the literature. Interviews were recorded, transcribed verbatim and validated by the participants. The data was analysed as it was collected, using a CGT methodology. Results: Participants worked in acute, sub-acute and community based settings and were experienced MHDs, with 14 of the 17 participants having graduated more than five years previously, 12 of whom had worked in mental health for more than five years. Barriers to the role included being a small and under resourced workforce, the risk of burnout associated with staffing limitations and a lack of recognition by dietetic peers. Rewards identified included high level of satisfaction in assisting clients, intervening over long periods of time and work that was varied and stimulating. Conclusion: This investigation into the perceived barriers and rewards of MHDs provides important insights to the factors dictating the fledging size of this workforce. If mental health clients are to reduce

124

their risk of nutrition related disease, these workforce barriers need to be addressed.

___

Patterns of Cannabis Use, Psychotic-Like Experiences and Personality Styles in Young Cannabis Users. Lauren K Spriggens1 and Associate Professor Leanne Hides.2

1 Griffith Health Institute and School of Applied Psychology, Griffith University, Mt Gravatt, Australia 2 Institute of Health and Biomedical Innovation, and School of Psychology & Counselling, QUT, Kelvin Grove, Australia. Introduction/Aim: To examine the influence of personality traits on the relationship between cannabis use and psychotic like experiences (PLEs) in young adults. Methods: 499 lifetime cannabis users aged 18 to 25 years completed an online survey assessing PLEs using the positive scale of the Community Assessment of Psychic Experiences (CAPE) and personality styles using the Brief Schizotypal Personality Questionnaire (SPQ-B) and the Substance Use Risk Profile Scale (SURPS), a measure of trait hopelessness, anxiety-sensitivity, impulsivity and sensation seeking. Cannabis use was assessed using items from the Youth Risk Behaviour Survey (YRBS) and a self-report measure of the lifetime level of cumulative cannabis use. Results: Cannabis use as well as schizotypy and the four SURPS personality risk profiles were significantly associated with the frequency of PLEs in young cannabis users. The cumulative level of lifetime cannabis exposure, trait schizotypy and hopelessness were the strongest predictors of PLEs in the multivariate analysis. Little evidence of a moderating effect of the personality risk profiles on the relationship between cannabis use and PLEs was found. Trait hopelessness was found to have a moderating effect on the relationship between the recency of cannabis use and the frequency of PLEs. Conclusion: The cumulative level of lifetime cannabis exposure, trait schizotypy and hopelessness were associated with PLEs in young cannabis users. Individuals with high levels of trait hopelessness who use cannabis may be at higher risk of PLEs. Future research is required to increase understanding of the relationship between cannabis use and PLEs, using more complex moderation models containing personality traits along with other risk factors for PLEs.

___

Why Food Addiction is not Drug Addiction: The Exacerbating Influence of Food-Induced Aberrant Homeostatic Signalling on Food Addiction Symptomatology. Stanley, P.1, O’Donovan, A1, 2, Schwartz, J 1 School of Applied Psychology

2 Griffith Health Institute, Griffith University, Nathan, Australia 3. School of Medicine The current dominant conceptualisation for food addiction (FA) is based on shared neurobiological and behavioural similarities with drug dependence. Thus far, FA has been conceptualised almost exclusively as a centrally-mediated process: whereby susceptibility towards, and maladaptive consumption of hyperpalatable foods with ‘addictive’ properties facilitates dietary-induced neurochemical changes to central systems which serve to intensify and perpetuate the disorder. Similar to drugs of abuse, which are not required for survival under normal circumstances (i.e. in the absence of a life-threatening withdrawal syndrome) and are not homeostatically regulated, palatable food is therefore consumed for reasons independent of energy status (e.g. hedonic properties). However, in contrast to drugs of abuse, food intake is necessary for survival and is additionally homeostatically regulated via a complex array of chemical peripheral signals with known influential links to central systems. Whilst many have suggested that the biological necessity for food may undermine the appropriateness of comparisons between FA and drug dependence, we suggest that food-induced peripheral and central aberrations may synergistically influence the development of FA. Specifically we contend that: food-induced downregulation of homeostatic and/or hedonic systems can similarly promote overconsumption, which in Western societies typically equates to an excess intake of hyperpalatable foods, which is a mediating factor for the development, intensification and perpetuation of FA symptomatology. Accordingly, we introduce The Two Factor Model of FA and Obesity and discuss its relevance in terms of samples of morbidly obese individuals, such as those with severely disordered eating who elect to undergo bariatric surgery as a last resort to adaptively manage food intake and body mass. Importantly, we do not suggest that FA be defined in terms of homeostatic processes, rather, that in contrast to other addictions, homeostatic processes are a unique aspect of FA which may indirectly influence the development, intensification and/or perpetuation of the disorder.

___

125

Altered ventricular mechanics after 60 min of high-intensity endurance exercise: Insights from speckle-tracking echocardiography during semi-recumbent cycling Glenn Stewart1,2, Akira Yamada1, Luke Haseler1,2, Justin Kavanagh2,3, Gus Koerbin4,5, Jonathan Chan1,6 , Surendran Sabapathy1,2

1 Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Australia; 2 School of Allied Health Sciences, Griffith University, Australia; 3 Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Australia; 4 ACT Pathology, The Canberra Hospital, Australia; 5 Faculty of Education, Science, Technology and Maths, University of Canberra, Australia; 6 Cardiology Division, The Prince Charles Hospital, Australia Introduction: Transient reductions in myocardial strain coupled with cardiac-specific biomarker release have been reported following prolonged exercise (>180min). However, it is unknown if: a) shorter duration exercise (60min) can perturb cardiac function; or b) if exercise-induced reductions in strain are masked by hemodynamic changes that are associated with passive recovery from exercise. Methods: Left (LV) and right ventricular (RV) global longitudinal strain (GLS), LV torsion (LVT), and high-sensitivity cardiac troponin (hs-cTnT) were measured in fifteen competitive cyclists (Age: 28 ± 3 yr; VO2peak: 4.8 ± 0.6 L·min-1) before and after a 60-min high-intensity cycling intervention (CRIT60). Strain and torsion were assessed echocardiographically during passive rest and during low-intensity cycling exercise (power output: 96 ± 8 W) in a semi-recumbent position. Results: During passive rest, hemodynamic conditions were different from pre- to post-CRIT60 (MAP: 96 ± 1 vs 86 ± 2 mmHg, p<0.001) and there were no changes in strain or torsion. In contrast, during low-intensity exercise hemodynamic conditions were unchanged from pre- to post-CRIT60 (MAP: 98 ± 1 vs 97 ± 1 mmHg, ns), but strain decreased (LVGLS: -20.3 ± 0.5% vs -18.5 ± 0.4%, p<0.01; RVGLS: -26.4 ± 1.6% vs -22.4 ± 1.5%, p<0.05), while LVT remained unchanged. Serum hs-cTnT increased by 345% after the CRIT60 (6.0 ± 0.6 vs 20.7 ± 6.9 ng⋅L-1, p<0.05). Conclusion: This study demonstrates that exercise-induced functional and biochemical cardiac perturbations are not confined to ultra-endurance sporting events, and transpire during exercise that is typical of day-to-day training undertaken by endurance athletes. The clinical significance of cumulative exposure to endurance exercise warrants further study.

___

T The use of point of care Rotational Thromboelastometry for haemostatic management of patients undergoing cardiovasular bypass surgery Tarbit, E.1, Bulmer, A.1, Winearls, J.2, Singh, I1, Rose’Meyer, R1, Dr Ben Anderson2

1 Griffith Health Institute, Griffith University, Southport, Australia 2 Intensive Care Unit, Gold Coast University Hospital, Southport, Australia Introduction/Aim: Cardiovascular disease (CVD) is one of the leading causes of death in Australia and commonly leads to surgical interventions, which requires the use of blood products. Almost 20% of blood product transfusions are cardiac surgical patients, which may expose them to the potentially detrimental effects of transfusion. A prospective evaluation of a ROTEM (Rotational Thromboelastography) targeted haemostasis algorithm was carried out on 100 consecutive patients undergoing cardiac surgical procedures at the Gold Coast University Hospital (GCUH). The ROTEM provides rapid determination of haemostatic competency to establish individual administration of blood products. This study evaluates the implementation of a ROTEM Targeted Coagulation and Haemostasis Treatment Algorithm to determine whether using our ROTEM algorithm to manage perioperative cardiac surgical bleeding would reduce total blood loss, the volume of transfused blood products, improve patient outcomes and thus provide economical advantages over using an empirical approach or standard laboratory tests for haemostatic management. Methods: Data was collected from patients undergoing cardiovascular bypass surgery at GCUH. Data included ROTEM analysis pre and post surgery, use of blood products, blood loss and demographic information. This project had ethics approval from the Gold Coast University Hospital. Results: Most patients undergoing cardiac surgery were males and overweight (BMI>25kg/M2). Blood loss in Coronary Artery Bypass Graft patients was found to be significantly greater than patients who undergo other types of cardiac surgery (p<0.05). Analysis of ROTEM outputs showed that coagulation data could be obtained at 5 minutes rather than 10minutes and was correlated maximal clot firmness (p<0.01). Finally, it was also determined that the APACHEII severity score had a significant contribution to the length of hospital stay of a patient undergoing cardiac surgery (p<0.05). Conclusion: The use of the A5 value instead of the A10 haemostatic data from ROTEM provides rapid and valid data for patient treatment. ROTEM blood

126

analysis was successful in managing bleeding in cardiac patients and allowed conservation of blood products.

___

Amyand’s Hernia – a rare finding from a common presentation and procedure. Chandler, S.1, Tesar, J.2, Dissabandara, L.3 Tesar, J. 1 Fourth Year Medical Student, Griffith University, Gold Coast, Australia 2 Fourth Year Medical Student, Griffith University, Gold Coast, Australia 3 Associate Lecturer Anatomy, Griffith University, Gold Coast, Australia Introduction/Aim: Inguinal hernias are a very common condition treated by General Surgeons. The poster aims to describe a rare variation of inguinal hernia involves the appendix (Amyand’s Hernia) and describe its classification and related implications on treatment. Methods: During an anatomy dissection elective, a male cadaver contained an inguinal mass. The external oblique aponeurosis was identified and divided parallel to the skin incision down to the external ring. The spermatic cord was identified and after careful division from the spermatic fascia a hernia sac was identified and found to contain the vermiform appendix. The case report will contain a review of the literature on Amyand’s Hernia and describe the presentation classification, management and relevant pathophysiology and anatomy. Results: Amyand’s Hernia is a rare condition whose aetiology and presentation is closely related to that of a standard inguinal hernia. It is usually discovered intra-operatively and it is important to be aware of the complications of such a condition and the relevant implications on management. The question of how to approach these complications drove Losanoff and Basson to create a classification and staging system to dictate treatment. This staging system indicates that even in mild cases of inflammation the appendix should be removed and that use of mesh repairs be limited to cases without an inflamed appendix or perforation. Conclusion: Amyand’s Hernia is a rare form of inguinal hernia and is most commonly diagnosed intra-operatively. A recent review reported its incidence to be between 0.4% and 0.6% which is lower than the classical reporting of its incidence at 1% of inguinal hernias. There are a variety of presentations for an Amyand’s hernia and a classification system based around the potential complications of this condition. Despite its rarity it is important for surgeons to be aware of the staging system as it serves to guide management decisions.

___

The prevalence of Attention Deficit Hyperactivity Disorder, a systematic review and meta-analysis: Has it changed and why it matters. Thomas, R., Doust, J., Sanders, S., Beller, E., Glasziou, P. Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, Australia Introduction/Aim: Prevalence estimates of Attention Deficit Hyperactivity Disorder in published studies vary widely. Suggested reasons include differing diagnostic criteria (i.e., different Diagnostic Statistical Manuals [DSM]) and inconsistent methods (e.g., information source, measurements). Prevalence estimates of 20 to 30% have fuelled controversy about the disorder and questioned whether it is overdiagnosed. Prevalence estimates matter because they are reported and they provide anchors for parents and diagnosing clinicians. We had three research questions. Had prevalence estimates increased over time? What impacts do study variables have on prevalence? What is the pooled prevalence of ADHD? Methods: We searched relevant databases for studies with point prevalence estimates of ADHD between 1975 and 2014. These dates included field trial and publication periods of DSM III, III-R and IV. We extracted publication information, sampling frame and procedure, demographic variables, and DSM criteria. We screened 5134 studies and included 178. We conducted random effects meta-analyses and meta-regression models to explore factors that may contribute to heterogeneity. Results: DSM III pooled prevalence estimate for ADHD was 5.5% (95% CI 3.9, 7.1), 4.6% (95% CI 3.3, 5.8) for DSM III-R and 7.5% (95% CI 7, 8.1) for DSM IV. They were not statistically significantly different from each other. The overall pooled prevalence of ADHD was 7% (95% CI 6.5, 7.5). In a multivariate meta-regression, after adjusting for DSM version, measurement, and region, prevalence estimates for ADHD were significantly lower when using DSM III-R criteria compared with DSM III or IV and in Europe compared with North America. Conclusion: This study provides a bench mark prevalence estimate for ADHD. Using DSM IV criteria, the pooled prevalence estimate is 7.5%. If actual diagnoses from national or state medical records exceed this estimate then overdiagnosis or misdiagnosis of ADHD may have occurred for some children. If fewer, then it may be due to underdiagnosis or misdiagnosis.

___

127

Health on a Plate: Exploring the effectiveness of the healthy food plate for communicating the NHMRC’s 2013 Guidelines for healthy eating. Street, S.1, Todd, A.1,2, Algreen-Ussing, B.1, Fitzgerald, D1. 1 Griffith Health Institute, Griffith University, Gold Coast, Australia 2 Mater health Services, Brisbane, Australia Introduction/Aim: The National Health and Medical Research Council (NHMRC) Australian Dietary Guidelines are designed to inform the public about healthy eating and assist health professionals to deliver healthy eating advice to patients. The “Guide to healthy eating” is a graphical representation of the 2013 Australian Dietary Guidelines, which uses a healthy food plate. To our knowledge no studies have been published to date that examine effectiveness of the “Guide to healthy eating” presentation of nutrition information. The aim of this project is to determine if the Healthy Food Plate model is an effective tool for translating and communicating dietary advice from the 2013 NHMRC guidelines for healthy eating. Methods: A quasi-experimental, three factor, repeated measures design was employed with BMI (Healthy BMI range vs. Obese BMI range) and Participant Status (Clinician vs. Patient) as the between-group measures, and exposure to the Australian Guide to Healthy Eating “Healthy Food Plate” (Pre-exposure vs. post-exposure) as the within-groups repeated measure. Individual differences in BMI and Participant Status were the basis for allocation to study groups. The primary outcome measure was the Nutrition Knowledge Grid (NKG), a 3 x 8 matrix that measures nutrition knowledge on two dimensions: Nutritional Category Knowledge and Food Group Knowledge. Results: The healthy food guide resulted in a shift of food items between the categories of Go, Slow and Whoa (represented by the colours green, yellow and red), and between food group categories. Conclusion: The results of this study provide insight into how well the Australian Guide to Healthy Eating Food Plate imparts knowledge of dietary advice to clinicians and patients, informing the use of the Healthy Eating Food Plate as a tool to educate patients and clinicians about the national dietary guidelines.

___

Mapping Hof1 SH3 domain binding site on Las17 nucleation promoting factor Trinh, A.V., Munn, A.L. Griffith University, Molecular Basis of Disease Gold Coast, Australia

Introduction/Aim: Actin networks are dynamic structures that undergo constant remodeling to regulate important events such as: cell polarity, morphology, vesicular trafficking, endocytosis and cytokinesis. These processes are guided by the coordinated activities of many conserved actin-associated proteins and signaling molecules that govern the precision of spatial and temporal assembly of actin structures. In fact, dysfunction in actin machineries can lead to various of diseases; among them congenital myopathies, compromised immunity, neurodegeneration, and cancer. Recent research revealed some proteins containing SH3 domain which bind to proline-rich protein like Las17, a nucleation-promoting factor which boost Arp2/3 nucleators’ activity in actin filament elongation, are essential for the organization and polymerization of actin. Therefore the inter-relationship between Hof1 SH3 domain, a protein required for cytokinesis, and Las17 was subjected for investigation. Methods: Mapping the binding site of Hof1 SH3 domain on Las17 was possible by utilizing the modular nature of transcription activators in yeast two-hybrid assay. Molecular techniques were used to modify DNA sequences to find the binding site as these DNA pieces were introduced into yeast two-hybrid vectors and inserted into Saccharomyces cerevisiae. Results: Results showed wild type Las17 protein gave clear positive interaction to Hof1 SH3 domain, further analysis narrowed down to the central region of Las17, containing proline rich sequences. Conclusion: This preliminary data suggests SH3 domain of Hof1 might play a role in recruitment of Las17 that enhances actin polymerization necessary for actomyosin ring formation required in cytokinesis.

___

Role of polyphenols in attenuating obesity and obesity-induced inflammation Ms Lada Tucakovic, Dr Natalie Colson, Dr Indu Singh Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: The prevalence of human obesity and its related metabolic disorders has escalated dramatically in the past decades worldwide. Obesity is a causative factor of numerous diseases such as heart problems, hypertension, hyperlipidemia and type 2 diabetes. It has been accepted for over a decade that obesity is connected with chronic low-grade inflammation as well. There is strong evidence supporting the therapeutic use of polyphenols such as stilbenes, flavonoids and curcuminoids can prevent and/or treat obesity and diabetic complications associated with it. They are widely accepted in health

128

promotion due to their antioxidant, anti-inflammatory, anti-carcinogenic, anti-obesity, anti-diabetic and anti-aging properties. The aims of the project are to investigate anti-inflammatory and anti-obesity actions of anthocyanin-rich Queen Garnet Plum (QGP) juice and its potential to regulate adipocyte function as well as regulation of adipokines gene expression and gene expression of metabolic enzymes. Methods: Three clinical trials were/will be conducted. The first trial involved 20 healthy volunteers who consumed QGP juice for 28 days. In trial two volunteers were required to exercise in addition to QGP juice consumption. The third trial will include three groups: obese, diabetic and healthy individuals. Results: Decreased serum leptin and statistically significant increase in adiponectin serum level have been recorded after QGPJ supplementation. Non- significant decrease in weight, waist circumference and BMI have been recorded after QGPJ supplementation as well. Conclusion: The dietary polyphenols have potential nutritional strategies for the prevention of obesity and associated inflammation as well as increase in insulin sensitivity in diabetic people.

___ U Bedside to bench: clinical cases of cystitis and ABU that have revealed new molecular mechanisms of how bacteria thrive in urine Ipe, D.S.1, Ulett, G.C.1 1 Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: Bacteria that colonize the urinary tract have, in some cases, evolved a capacity to utilize human urine for growth. The most well characterized organisms are Escherichia coli that cause asymptomatic bacteriuria (ABU). This phenotype may influence how bacteria colonize the urinary tract. Like E. coli, Streptococcus agalactiae causes urinary tract infections in adults including symptomatic infections (cystitis, pyelonephritis) and ABU. Methods: In this study, we describe clinical cases of acute and asymptomatic S. agalactiae urinary tract infection and use these cases to discuss ABU and bacterial utilization of urine. Results: We show that ABU S. agalactiae (ABSA) is much more able to utilize human urine for growth in comparison to uropathogenic S. agalactiae (UPSA). Strong fitness for urine metabolism in ABSA was associated with a metabolic profile encompassing L-Malic acid utilization, as revealed using phenotype metabolic arrays. Genome sequencing identified divergence in malic enzyme-encoding genes in ABSA compared to UPSA which was confirmed by direct PCR-product sequencing.

Conclusion: Distinct metabolic and related genetic traits of S. agalactiae linked to a novel but robust phenotype of growth in human urine is postulated to aid the organisms’ persistence in the lower urinary tract and contribute to ABU in adults.

___

V Is there a relationship between food literacy and adolescents’ dietary intake? Vaitkeviciute, R.1,2, Ball, L.1,3, Harris, N.1,2 1 Griffith Health Institute, Griffith University, Gold Coast, Australia 2 Population and Social Health Research Program 3 Centre for Health Practice Innovation Introduction/Aim: The concept of food literacy offers an integrative framework for investigating and understanding the factors shaping food intake and dietary patterns at an individual level. The review investigated the relationship between food literacy and adolescents’ dietary intake. Methods: A systematic review of the literature. The review included searches of six databases with no restriction on the year of publication or language. Studies were limited to adolescent population aged 10 to 19 years. Results: Thirteen studies were eligible for inclusion. None of the studies investigated all aspects of food literacy. Eight studies reported a positive association between food literacy and adolescents’ dietary intake. For example, adolescents with greater food knowledge and frequent food preparation behaviours were shown to have healthier dietary practices. Three studies found a mixed association of food literacy and adolescents’ dietary intake. For example, adolescents who frequently helped to prepare dinner had healthier dietary intake, but food shopping tasks were associated with less healthy food choices. Two studies found no association between measures of food literacy and adolescents’ dietary intake. Conclusion: Food literacy may play a role in shaping adolescents’ dietary intake. More rigorous research methods are required to effectively assess the causality between food literacy and adolescents’ dietary intake in order to confirm the extent of the relationship. None of the studies incorporated a holistic and comprehensive tool to measure food literacy. However, findings suggest that food skills and behaviours learned in adolescence are sustained later in life. In addition, the review suggests that improving food literacy may improve individual’s food skills and healthier dietary behaviours. Evidence recommends public health practitioners and policy makers to consider new public health strategies which focus on

129

increasing understanding of food literacy in adolescence.

___

Munc18 as a marker of neuroinflammation in neurodegenerative diseases Vieira, B.1, Radford R.1, Pountney, D.L1 1 Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction/Aim: Glial cells represent more than 90% of all CNS cells, and include astrocytes, microglia and oligodendrocytes. Current research is focused on unravelling the many functions of glial cells in homeostasis and pathology. Their activation involves changes in morphology, function and production of signaling molecules. These dynamic phenomena are categorized as either microgliosis or astrogliosis, and are part of the neuroinflammatory response. The current work investigates astrogliosis in neurodegenerative diseases, including Parkinson’s (PD) and Parkinson’s-related diseases (PRDs), such as, Dementia with Lewy Bodies (DLB) and Multiple Systems Atrophy (MSA). These disorders lead to chronic neuronal dysfunction and neuroinflammation is one of the key mechanisms of disease progression. Based on previous data, this project investigated whether Munc18, a protein normally implicated in vesicle trafficking in brain cells, is upregulated in cellular and animal models of PD, and PRD brain tissue. Methods: The methods included the use of immunohistochemistry and 3D reconstructions with confocal fluorescence microscopy in order to measure levels of Munc18, by counting Munc18 vesicles and determining immunofluorescence signal intensities. The following tissues / cellular models were investigated: (i) human brain tissue of patients with DLB; (ii) human brain tissue of patients with MSA; (iii) mouse brain tissue from a mouse model of PD; (iv) human astrocytoma cell line (1321N1) submitted to treatments with the pro-inflammatory cytokine, IL-6. Results: Current results indicate that Munc18 expression is upregulated with increased numbers of cytoplasmic Munc18 vesicles upon IL-6 treatment compared to controls, concomitant with adoption of characteristic activated cytomorphology. Munc18 was also observed to mark frequent activated astrocytes in human MSA tissue, with occasional Munc18-positive astrocytes also observed in human DLB tissue sections and in the unilateral rotenone mouse model of PD. Conclusions: The results to date indicate that Munc18 has potential use as a tissue biomarker for neuroinflammation in neurodegenerative diseases.

___

miR-205: a promising perspective in future of antiangiogenic approach in cancer. Haleh Vosgha1, Ali Salajegheh1, Robert A Smith1, Alfred KY Lam1

1 Cancer Molecular Pathology Group, School of Medicine, Griffith Health Institute (GHI), Griffith University, Queensland, Australia

Introduction/Aim: MicroRNAs have been described as one of the novel class of molecular regulators. Due to the crucial role miR-205 plays in angiogenesis, as well as the necessity of angiogenesis in malignancy, miR-205 has been found in association with several types of cancer. Vascular endothelial growth factor (VEGF) promotes angiogenesis and is a potent mediator of vascular permeability, as well as being a key mediator of tumour-associated neoangiogenesis and progression. In this study, we have investigated the role of miR-205 on VEGF-A as the major initiator and modulator of angiogenesis in thyroid cancers. Methods: 2 papillary thyroid cancer cell lines, K1 without history of metastasis and B-CPAP with the history of metastasis and one normal thyroid cell line (Nthy-ori 3-1) were used in this study. The expression of VEGF-A and miR-205 were measured using real time PCR. Exogenous transient miR-205 were used and the expression of VEGF-A were then checked by immunofluorescence and western blot techniques. Results: Real time PCR has shown significant under-expression of miR-205 in our cancer cell lines compared to normal thyroid cells. VEGF-A RNA and protein were overexpressed. After transfection of miR-205 mimic into K1 and B-CPAP, the reduction of VEGF-A protein expression obtained by immunofluorescent and western blot confirms the regulatory role of miR-205 in angiogenic events in those thyroid cancer cell lines. Conclusion: These findings add weight to our previous understanding about the angiogenic role of miRNA-205 in cancer. These experiments provide information on the functional consequences of VEGF manipulation via miRNA on cancer. The data will provide primary information regarding the utility of miRNA as an alternative approach for specific anti-angiogenic therapy in cancer.

___

130

W Nuclear/Cytoplasmic localization and stage dependent expression of GAEC1 in colorectal cancers Riajul Wahab1, Vinod Gopalan1, Farhadul Islam1, Alfred K-Y Lam1 1Cancer Molecular Pathology, Griffith Health Institute, Griffith University, Gold Coast.

Introduction: Gene amplified in esophageal cancer 1 (GAEC1) is a novel oncogene located at 7q22.1. Our previous studies show that GAEC1 has oncogenic properties and it plays an important role in carcinogenesis. At current, there is lack of information regarding its localization and molecular function. This study aims to identify GAEC1 expression patterns and its physical location in colorectal cancers. Method: To analyze the expression changes of GAEC1, colon cancer tissues and cell lines (SW-480, SW-48 and HCT 116) from different pathological stages were recruited. The mRNA and protein were extracted from different cell lines by using standard protocol.GAEC1 mRNA expression was studied using real time-PCR and protein quantification were analyzed using western blot. Immunocytochemistry and Immunohistochemistry were performed to assess the localization and changes of GAEC1 in cells and tissues respectively. Result: The level of GAEC1 protein expression was significantly higher in colon cancer cell lines (SW480, SW48 and HCT116) in compare to non-cancer colon epithelial cell (FHC). Among the cancer cell lines, GAEC1 expression was higher in colon cancer cells of stages II or III (SW480 & SW48) compared to stage IV colon cancer cell line (HCT116). GAEC1 mRNA expression levels followed the same pattern as in the protein expression level in different stages of colon cancer. GAEC1 protein was localized in the nucleus and cytoplasm of colon cancer cells. However, the normal colon tissues and FHC cells expressed GAEC1 only in its nucleus. Conclusion: The changes in GAEC1 protein and mRNA in different stages of colon cancer indicate that GAEC1 expression is critical in colon cancer initiation and progression. Also, changes in the localization of GAEC1 in cancer cells imply its translocation properties and more studies need to be done to confirm its functional role in molecular carcinogenesis.

___

An Investigation of Men’s Satisfaction with Modes of Intimate Expression in Homosocial Friendships Benjamin Walters 1 and Stefano Occhipinti 1

1 School of Applied Psychology, Griffith University; Behavioural Basis of Health; and Griffith Health Institute Introduction: Men’s interpersonal relationships are often thought to be characterised by a dearth of emotional and disclosure-based expression. This has often been hypothesised to result in a lack of relational intimacy which, in turn, fosters negative health outcomes for men (e.g., alexithymia; higher prevalence of suicide). However studies investigating the intimacy of men’s relationships have yielded inconsistent results. The present study aimed to investigate the degree to which men experience subjective intimacy (and the methods used to achieve this) in a relationship paradigm that is generally thought to involve minimal emotional expression: men’s homosocial friendships. Methods: Semi-structured interviews were conducted with 13 men, covering topics such as: distinguishing features of close male friends versus acquaintances; aspects of interactions participants derive intimacy from; the degree to which participants were satisfied with their homosocial friendships; and examples and explanations of specific interactions which made the participant feel close to a male friend. Analysis of the transcripts was conducted using Thematic Analysis. Results: Analysis identified several prominent themes (55% corpus coverage) suggesting men derive and communicate intimacy through implicit behavioural cues embedded in activity based interactions. Fewer themes (23.6% corpus coverage) were found demonstrating men’s use of disclosure and emotion based modes of expression. Themes relating to satisfaction indicated that all men interviewed perceived their homosocial interactions (and the styles of communication utilised therein) as satisfying and associated with meaningful intimacy. Conclusion: Results support previous findings that men do not rely heavily on direct emotional and disclosure-based modes of expression; however, they contradict the assertion that this causes a lack of relational intimacy, at least in the context of homosocial friendships. It is possible that the negative health outcomes identified by previous research may be more influenced by expectations articulated by masculine gender role norms than men’s use of indirect modes of expression.

___

131

LIFTMOR: Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation: an RCT study protocol Watson, S.1,2, Weeks, B.1,2, Horan S.1,2, and Beck BR.1,2

1. School of Allied Health Sciences, Griffith University, Gold Coast, Australia 2. Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University Introduction: High intensity (HI) exercise loading is required to improve bone mass, but is not recommended for individuals with osteoporosis owing to a potential increased risk of fracture. Current therapeutic recommendations of low to moderate intensity exercise for osteoporosis are of little direct benefit to bone, acting only indirectly to protect from fracture by way of reducing falls. The development of a targeted safe, effective HI exercise program to prevent osteoporotic fracture would be a paradigm-shifting advance in a field that has stagnated for the last decade. Our goal then is to determine the safety and efficacy of a HI progressive resistance training (PRT) program targeted to reduce risk of osteoporotic fracture in postmenopausal women with low bone mass. Methods: An RCT is underway to test the efficacy of an 8-month HI PRT program to improve indices of bone strength and falls risk in postmenopausal women. One-hundred women over 60 years of age with low bone mass (screened for conditions and medications that influence bone and physical function) are to be recruited from the community via media release and word-of-mouth advertising. Eligible participants will be randomized to either twice-weekly, supervised HI PRT or a home-based program of low intensity falls-prevention exercise. Testing will occur at baseline and 8 months and will include validated measures of: bone-relevant PA history, dietary calcium, quality of life, physical activity enjoyment, functional performance (TUGT, FRT, VJ, 5xSTS, back extensor and lower limb strength) and falls risk factors (muscle strength, balance and previous falls), whole body and regional bone, muscle and fat mass (DXA, pQCT and QUS), compliance and safety. We will use an intention-to-treat approach and analyse our primary outcomes (Lumbar spine and femoral neck BMD) with repeated measures ANOVA. Ethics: The experimental protocol has been approved by Human Ethics Research Committee (Approval number AHS/07/14/HREC).

___

Characterisation of the mechanical loads and metabolic intensity of the CAPO Kids exercise intervention for healthy primary school children Weeks, B.1, Nogueira, R.1, and Beck, B.1 1 Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Gold Coast, Australia Introduction: Sedentary behaviour is associated with obesity and other chronic diseases at all ages. Increasing physical activity with in-school interventions, focusing on energy expenditure and bone loading reduces risk of a number of costly chronic diseases. The bone response to loading is optimized by brief exposures to loads that are applied dynamically at high magnitude and high rate, while beneficial metabolic adaptations to physical activity are more dependent on aerobic intensity and energy expenditure. The aim of the study, therefore, was to characterise the metabolic and musculoskeletal load intensity of the recent successful CAPO Kids paediatric exercise intervention. Methods: Forty-eight pre and early pubertal children from the CAPO Kids trial wore a SenseWear armband (BodyMedia, Pittsburgh, PA, USA) to estimate energy expenditure during a 10-minute CAPO Kids exercise intervention session. Eleven participants additionally performed 11 of the most common CAPO Kids intervention maneuvers on a force platform (AMTI, MA, USA) to determine peak vertical ground reaction forces (BW) and rates of force application (BW/s). Results: In total, 28 boys and 20 girls (10.4 ± 0.5 years old) were included in the study. Energy expenditure associated with the 10-minute session was 39.7 ± 9.3 kcal at an average of 4.0 kcal/min. The intensity of physical activity was considered ‘vigorous’ to ‘very vigorous’ for 34% of the session. Peak vertical ground reaction forces for the CAPO Kids maneuvers ranged from 1.3 ± 0.2 BW (cartwheels) to 5.4 ± 2.3 BW (360° jump). The fastest rates of force application were recorded for the jump-lunge (143.6 ± 144.9 BW/s) and the 360° jump (132.4 ± 78.6 BW/s). There were no sex differences in energy expenditure or vertical ground reaction force magnitudes or rates.Conclusion: CAPO Kids generates adequate load intensity to stimulate positive health adaptations in both metabolic and musculoskeletal systems of pre and early pubertal children.

___

132

The relationship between occupational status change and self-reported health in the African immigrant community in Chicago, Illinois. Wenham, K.1, Sebar, B.2, Lee, P.2 1 Griffith Health Institute, School of Medicine, Griffith University, Logan, Australia 2 Griffith Health Institute, School of Medicine, Griffith University, Gold Coast, Australia Introduction/Aim: It is common for migrants to experience negative occupational status inconsistencies after migration, often due to lack of recognition of qualifications, language and cultural barriers, poor transferability of education, experience or skills, lack of knowledge and experience in the local work context, and discrimination. Negative occupational status is linked to poor health outcomes such as mental health issues, stress and ischemic heart disease. Working below one’s educational level can also increase the risk of workplace injury. The current research investigates the effect of occupational status inconsistencies on the self-reported health of African immigrant men in Chicago. Methods: The study employed a cross sectional design using a questionnaire survey with a sample of 206 African-born men living in Chicago. While many African-born men in Chicago work in the taxi industry, the sample represented workers across a range of occupations, from unskilled through to professional. Results: There were significant correlations between self-reported health and change in occupational status, highest educational attainment, educational disparity and age. A logistic regression showed lower socioeconomic status and a decrease in occupational status were predictive of poorer self-reported health in this sample. Conclusion: The study concludes that negative status inconsistencies impact the health of African immigrant men. Given that over half of the participants had lived in the United States for ten or more years, it would appear that this effect may persist over time, however a longitudinal research design would be required to verify this. If this persistence exists, it is in contrast to previous research with migrants from different backgrounds, which found that negative occupational status inconsistencies decrease over time in the host nation. The findings suggest that programs to enable African immigrant men to access suitable employment may have a positive effect on their health status.

___

Abnormal metabolism of fibroblasts from COPD patients was restored by versican siRNA treatment Jing Zhang1, Lian Wu2*, Mervyn Merrilees3, Jieming Qu4, Chun-xue Bai1, 1 Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China 2 Department of Pharmacology & Clinical Pharmacology, University of Auckland, New Zealand 3 Department of Anatomy with Radiology, University of Auckland, New Zealand 4 Department of Pulmonary Medicine, Huadong Hospital, Shanghai Medical College, Fudan University, China * Corresponding author: Lian Wu, lwu@auckland.ac.nz Introduction/Aim: Previous research strongly suggests that a molecule found in the extracellular matrix, called versican, inhibits the assembly of elastic fibres in lung tissue, preventing repair and new elastic fibre formation, and leading to development of Chronic Obstructive Pulmonary Disease (COPD). The aim of the present study is to determine if targeting versican, by over-expression of versican antisense and the versican V3 isoform, and application of short siRNA sequences, can reduce the abnormally increased versican production by fibroblasts from COPD patients, thereby increasing mature elastic fibre formation. If we can demonstrate that reducing versican leads to increased expression and production of mature elastic fibres by fibroblasts from COPD patients, this may potentially lead to a new treatment for COPD. Methods: Primary cultured cells (lung fibroblasts) from 12 patients, including 6 control patients without COPD, were selected for examination based on clinical lung function tests. These primary cells lines were treated with versican siRNA to determine if elastin production could be restored. Results: Our study has demonstrated that versican siRNA treatments effectively suppress versican mRNA expression (reduced about 90%) and versican protein production in both COPD and non COPD cell lines (P<0.05); versican siRNA treatments significantly increased insoluble elastin production in COPD cell lines (P<0.05); versican siRNA treatments had no significant effects on elastin mRNA expression in both COPD and non COPD cell lines (P>0.05). Conclusion: As we previously reported, versican inhibits the assembly of insoluble elastin in lung. Our results show that versican siRNA treatments effectively reduce versican mRNA expression and production, which leads to increased deposition of insoluble elastin. These findings point to a new treatment strategy for preventing or repairing elastin loss in COPD.

133

Y The impact of myocardial ischemia on transmural mechanics using multi-layer speckle tracking echocardiography Akira Yamada1, Luke Haseler1, Karl Mulcahy2, Matthew Ischenko3, David Platts3, Vicki Speranza3, Christian Hamilton-Craig3, Darryl Burstow3, Shanil Dhanji4,Glenn Stewart1, Surendren Sabapathy1, Jonathan Chan1,2,3 1 Heart Foundation Research Centre, Griffith University, Queensland, Australia 2 Gold Coast Heart Centre, Queensland, Australia 3 The Prince Charles Hospital, Queensland Health, Queensland, Australia 4 Bond University, Queensland, Australia Introduction/Aim: Transmural variation in myocardial mechanics is dependent on the complex multi-layers of myocardial fibre orientation. Longitudinal myocardial contraction predominantly originates from the inner endocardial layer. We hypothesize that endocardial longitudinal strain is a sensitive marker of early myocardial ischemia. Methods: Thirty patients (mean age 68±8, EF 61±11%) underwent dobutamine stress echocardiography (DbE) as per clinical indication. Images were acquired between 50-80 frames/sec by 2D speckle tracking echocardiography at rest and peak dose DbE. Multi-layer peak systolic longitudinal (LongS) and peak systolic circumferential strain (CirS) analysis were measured from the inner endocardial (endo), mid, and outerepicardial (epi) layers using the latest GE EchoPAC BT012 post processing software. Myocardial ischemia was defined as deterioration in wall motion score at peak dose with correlation by coronary angiography. Results: Of total of 464 segments, 351 were normal and 43 were ischemic at peak dose. There was a transmural gradient of LongS (%) and CirS(%) from the endocardium to epicardium in normla segts at rest (LongS Endo -22.9±7.8, LongS Mid -19.9±6.0, LongS Epi -17.8±4.4, p<0.0001); (CirS Endo -32.7±10.9, CirS Mid -23.5±7.9, CirS Epi -17.3±6.4, p<0.0001). Endocardial LongS was the most sensitie marker for ischemia during DbE. Changes in all 3 layers of CirS could not differentiate normal from ischemic segts. (Table)

Strain at Peak Dose (%)

NORMAL ISCHEMIC P value

LongS Endo

-24.3 ± 13.7 -16.0 ± 6.6 0.0001*

LongS Mid -20.9 ± 9.7 -15.3 ± 5.7 0.0002* LongS Epi -17.9 ± 7.2 -16.2 ± 4.8 022 CircS Endo -37.5 ± 15.1 -33.0 ±

10.7 0.06

CircS Mid -26.6 ± 11.2 -23.5 ± 7.9 0.08 CircS Epi -19.5 ± 8.9 -17.2 ± 7.1 0.11

Conclusion: LongS is superior to CircS in the detection of myocardial ischemia. This alteration in transmural myocardial mechanics is likely to reflect early subendocardial ischemia.

___

Gold coast hospital and health service: survey of research active health professionals Marshall, A.P., Baker, M., Keijzers, G., Crilly, J., Young, J., Stapelberg, C. 1 Griffith Health Institute, Griffith University, Gold Coast, Australia 2 Gold Coast University Hospital, Southport, Queensland, Australia Introduction/Aim: There are ~6, 121 employees within the Gold Coast Hospital and Health Service (GCHHS) including 2, 400 registered nurses, 854 medical officers and 630 allied health professionals. The study aimed to identify and describe research activities undertaken by these health professionals and to identify areas for improvement. Methods: All GCHHS employees were invited to participate in an online survey. Contact with potential participants was made through organisation wide email distribution lists. This approach was supported by using identified ‘Research Champions’ across the organisation who promoted completion of the survey. Survey data were analysed using descriptive and inferential statistics. The study was approved by the local Human Research Ethics Committee. Results: A total of 151 respondents completed the online survey. The respondents were relatively young; more than half (55%) of those surveyed were under the age of 41 years. Although sixty two percent of participants had more than 10 years’ clinical experience most (67%) described themselves as being in an early career research stage. 31% were currently enrolled in Higher Degree by Research (HDR) and three quarters (75%) had previous experience with HREC approved research. Of those involved in research, around one third was involved in funded research. More than 50% indicated that they were willing to mentor novice researchers and there was a good balance between those with quantitative and qualitative experience. Logistics, funding and support were noted with respect to why HREC research involvement was not pursued. Conclusion: The survey identified health professionals involved in research and indicated the types of activities with which they were involved. Areas for opportunity to develop included: i) optimal integration within the clinical

134

environments of an emerging group undertaking post-graduate training; ii) utilising persons willing to mentor others to grow capacity within the GCHHS. This study is useful in terms of informing improvements to systems surrounding research processes within the GCHHS.

___

Z Potential for Layered Double Hydroxides-Based, Innovative Drug Delivery Systems Kai Zhang 1,*, Zhi Ping Xu 2, Ji Lu 2, Zhi Yong Tang 3,4, Hui Jun Zhao 4, David A. Good 1,5 and Ming Qian Wei 1,*

1 School of Medical Science & Griffith Health Institute, Gold Coast Campus, Griffith University, Southport, QLD 4222, Australia; E-Mail: kai.zhang4@griffithuni.edu.au 2 Australian Institutes for Bioengineering & Nanotechnology, University of Queensland, St Lucia, QLD 4072, Australia; E-Mails: gordonxu@uq.edu.au (Z.P.X.); ji.lu@uqconnect.edu.au (J.L.) 3 National Centre for Nanoscience and Technology, Chinese Academy of Sciences, Beijing 100190, China; E-Mail: zytang@nanoctr.cn 4 Griffith Schools of Environment, Gold Coast Campus, Griffith University, Southport, QLD 4222, Australia; E-Mail: h.zhao@griffith.edu.au 5 School of Physiotherapy, Faculty of Health Science, Australian Catholic University, Brisbane, QLD 4014, Australia * Authors to whom correspondence should be addressed;E-Mails: kai.zhang4@griffithuni.edu.au (K.Z.); m.wei@griffithuni.edu.au (M.Q.W.); Tel.: +61-7-5678-0745 (K.Z. & M.Q.W.); Fax: +61-7-5552-8908 (K.Z. & M.Q.W.). Abstract: Layered Double Hydroxides (LDHs)-based drug delivery systems have, for many years, shown great promises for the delivery of chemical therapeutics and bioactive molecules to mammalian cells in vitro and in vivo. This system offers high efficiency and drug loading density, as well as excellent protection of loaded molecules from undesired degradation. Toxicological studies have also found LDHs to be biocompatible compared with other widely used nanoparticles, such as iron oxide, silica, and single-walled carbon nanotubes. A plethora of bio-molecules have been reported to either attach to the surface of or intercalate into LDH materials through co-precipitation or anion-exchange reaction, including amino acid and peptides, ATPs, vitamins, and even polysaccharides. Recently, LDHs have been used for gene delivery of small molecular nucleic acids, such as antisense, oligonucleotides, PCR

fragments, siRNA molecules or sheared genomic DNA. These nano-medicines have been applied to target cells or organs in gene therapeutic approaches. This review summarizes current progress of the development of LDHs nanoparticle drug carriers for nucleotides, anti-inflammatory, anti-cancer drugs and recent LDH application in medical research. Ground breaking studies will be highlighted and an outlook of the possible future progress proposed. It is hoped that the layered inorganic material will open up new frontier of research, leading to new nano-drugs in clinical applications.

___

Identification and assessment of function of bioactive extracts from Australian cane toad skins Abu Hasanat Md. Zulfiker1, Mohsen Sohrabi1, I. Darren Grice2, Ming Q. Wei1 1 School of Medical Science & Griffith Health Institute, Griffith University, Gold Coast, Australia 2 Institute for Glycomics and School of Medical Science, Griffith University, Gold Coast, Australia Introduction/Aim:Recently, extracts from toad skins have shown potential therapeutic benefits for a range of diseases. For example, aqueous extracts of Chinese toad skins have been used to treat pain, swelling, heart failure as well as several cancers with minimal to no side effects, generating a ten billion dollar market in China. This project focuses on investigating aqueous (AE) & 60% ethanol extracts (EE) of Queensland cane toad (Bufo marinus) skins (CTS), in terms of their chemical basis for exhibiting therapeutic potential in cancer therapy. Methods: Several aqueous-based extraction systems were designed and optimized to isolate known ‘neuro-active’ markers identified previously in the skins. AE and EE were found to provide the optimum extraction of known markers. The two extracts were analyzed by Mass Spectrometry (UPLC-MS-Q-TOF with ESI and AJSI) to generate a list of identified and unidentified (to date) constituents in each extract. The cytotoxicity of AE and EE were determined using the WST-8 assay. Results: To date approximately sixty different compounds have been identified from both extracts. Indolealkylamines and bufadienolides were detected as major groups of active components, these compounds having been found in the Chinese toad extracts previously and shown cytotoxic activities. However, numerous constituents identified in this study have not been reported previously in toad skins, although some have been reported in other toad species. AE & EE were assessed for their cytotoxicity in two normal cell lines (neuronal and smooth muscle cell) and one

135

cancer cell line (lymphoma). Results indicate that both extracts demonstrate cytotoxic activity in the lymphoma cell line, but show no toxicity in both the neuronal and smooth muscle cell lines, even at higher doses. Conclusion: The functional effects demonstrated by these extracts provide good encouragement for further investigation and development of them as potential anticancer agents. However, further assays need to be conducted and active constituents identified to characterize the mechanism of actions and significance of these extracts. A novel use of a devastating pest (Queensland cane toad) also adds appeal to this work.

___

136