2014 Gold Coast Health and Medical Research ...

2014

Gol dCoast Heal t handMedi cal Resear ch Conf er ence

OneHeal t h:Enhanci ngResear ch,Pr act i ceandOut comes

4t h-5t hDecember

Mer c ur eGol dCoas tRes or t ,CARRARA, Gol dCoas t ,Queens l and,Aus t r al i a

CHAIR’S WELCOME

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 Griffith Health Institute

Dr Dean Pountney 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)

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VENUE LAYOUT

CONFERENCE PARTNERS

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Celebrating its 10 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.

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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

9.00 – 9.07

Opening Address Prof Ned Pankhurst, Senior Deputy Vice Chancellor Griffith University Keynote Speaker: Prof Peter Hunter, Professor of Engineering Science Director, Auckland Bioengineering Institute University of Auckland

Masters Ballroom

9.10 – 10.00

Computational Physiology: Connecting molecular systems biology with clinical medicine 10.00 – 10.25

Chair: Prof David Lloyd 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

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11.25 – 12.15

12.15 – 1.15 12.30 – 1.20

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

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 Stream 2 Stream 3 Augusta Room Doral Room Pinehurst

1.30 – 2.30 8 mins/2 min Q&A/2 min change 1.32 – 1.40

Session 1 – Free session

Session 2 – Musculoskeletal health and disease

Session - 3 Optimising health outcomes

Chair: Assoc Prof Susan Brandis Exploring primary caregivers’ expectations about the benefits and risks of treatment for acute respiratory

Chair: Prof Mark Forwood The effect of a single Parathyroid Hormone (PTH) injection on the healing of stress fractures

Chair: Prof Claire Rickard The effect of third trimester micronutrient supplements on gestational length of well women at term

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infections in children and involvement in management decisions Mr Peter Coxeter Patient perceptions of the role of nutrition for pressure injury prevention in hospital Miss Shelley Roberts

Dr Mahmoud M Bakr

Miss Janelle McAlpine

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

1.56 – 2.04

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

2.08 – 2.16

Five Year Analysis of a Tailored Community Based Exercise Program for Patients with Symptomatic Heart Failure Dr Jerome Goldstein How paid peer support is conceptualised in non-government mental health services Ms Victoria Stewart Stream 1 Augusta Room

Prevalence and predictors of lateral epicondylalgia 3-5 years after non-surgical management Dr Leanne Bisset Immediate effect of eccentric exercise on Achilles and gastrocnemii tendon strain Mr Steven J Obst

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

Pre-operative self-efficacy education for patients undergoing joint replacement surgery (POEt): A pilot randomised controlled trial Dr Rachel Walker Dressing and securement devices for central venous access devices: a Cochrane systematic review Ms Amanda Ullman A classification tool (GC-CODES) to identify the underlying clinical indication for general anaesthetic at caesarean section Dr Jennie Connell Radioprotection of Bone Allograft using Tocopherol and Ascorbic Acid Miss Athena Brunt

Stream 2 Doral Room

Stream 3 Pinehurst

1.44 – 1.52

2.20 – 2.28

2.40 – 3.40 8 mins/2 min Q&A/2 min change 2.42 – 2.50

2.54 – 3.02

Session 4 – Mental and psychological well being

Session 5 – Cancer

Session 6 – Population health

Chair: Prof Bonnie Barber

Chair: Assoc Prof Donna Sellers

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

Factors affecting childbirth selfefficacy 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

Chair: Prof Helen Chenery

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3.06 – 3.14

3.18 – 3.26

3.30 – 3.38

3.40 – 4.05

4.10 – 5.10 8 mins/2 min Q&A/2 min change 4.12 – 4.20

4.24 – 4.32

Prof Debra Creedy

Mrs Caroline Atkinson

A formal plan for self-disclosure enhances supported employment outcomes among young people with severe mental illness Mr Philip Lee Williams Evaluation of a newly developed measure of Theory of Mind: The Virtual Assessment of Social Cognition Ms Allana Canty Health services utilization of women following a traumatic birth Dr Erika Turkstra

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

Screening: An Application of the Health Beliefs Model Dr Luqman Jubair Prevalence of incidental prostate cancer: a systematic review of autopsy studies Prof Paul Glasziou

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

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

Afternoon tea The Links Pre-function area and The Club Room Stream 1 Augusta Room

Stream 2 Doral Room

Stream 3 Pinehurst

Session 7 – Free session #2

Session 8 – Free session #3

Session 9 – Lifestyle health

Chair: Prof Keith Grimwood

Chair: Prof John Headrick

Chair: Dr Lauren Ball

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

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

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4.36 – 4.44

4.48 – 4.56

Tau, Vietnam Mr Tri Nguyen

review Dr Amanda McCullough

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

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

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

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

5.20 – 6.20

Canapés over Poster Viewing Session

promoting healthy lifestyle behaviours: an integrative review Ms Sarah Cass Chronic Inflammation: The Role of Diet, BMI and Genetic Factors Dr Natalie Colson

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

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

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

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GCMA BREAKFAST SYMPOSIUM

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

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

and

topics:

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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 7.45 – 8.15 8.15 – 8.45 8.45 – 9.15 9.15 – 9.20

Breakfast/welcome Dr Anthony Espinet - Management of post surgical abdominal pain Dr Leigh Dotchin – Neuropathic pain and spinal cord neuromodulation Dr Tim Grice – Shoulder and knee pain – What can be done about them Event concludes Stream 2 Doral Room

8.00 – 9.20 8 mins/2 min Q&A/2 min change 8.02 – 8.10

Brain Health and Disease Symposium Chair: Dr Jo Lewohl Exclusion of Alpha-Synuclein aggregates from Calbindin-D28K cells in the unilateral rotenone-lesioned mouse model of

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8.14 – 8.22 8.26 – 8.34 8.38 – 8.46 8.50 – 8.58

9.02 – 9.10

9.30 – 10.30 9.35

9.41

9.47

9.53

9.59

Parkinson’s disease Mr Alex Rcom-H’Cheo-Gauthier Alpha-Synuclein as an Extracellular Trigger of Neuroinflammation Dr Dean Pountney Mechanisms of gene regulation in alcoholism: role of α-synuclein in the pathophysiology of alcohol abuse Miss Paulina Janeczek Psychological mechanisms for improving cognitive function in cancer survivors: A randomised controlled trial Dr Heather Green Simvastatin and atorvastatin decrease in vitro release of neuroinflammatory mediators in microglial-like differentiated THP-1 monocytes Ms Amelia McFarland Finding new molecular targets for Parkinson’s Disease through gene hunting in Queensland families with inherited Parkinsonism Assoc Prof George Mellick Stream 1 Stream 2 Augusta Room Doral Room 3 minute podium/2 min Q&A/1 min change

Digital poster – session 1

Digital poster - session 2

Chair: Prof Andrea Marshall A Five Year Follow-up Study of a Pregnancy Domestic Violence Program to Promote Routine Enquiry during Pregnancy Dr Kathleen Baird Food Accuracy and Adequacy in Hospitalised Patients Requiring Special Diets Miss Annabel Larby WRist Acupressure for Post-operative nausea and vomiting: A pilot study Prof Marie Cooke

Chair: Assoc Prof Joss Du Toit st Functional Capacity Evaluations in the 21 Century Assoc Prof Ev Innes

Improving Compliance with Venous Thromboembolism Prophylaxis Dr Sophie Conroy Australian Dental Students' Knowledge of Oral

In vitro and in vivo activity of Melaleuca alternifolia Concentrate against West Nile Virus infection Miss Adriana Pliego-Zamora 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 Characterization of mesothelioma cancer stem cells and their metabolic signature Mrs Elham Alizadeh Pasdar Nutrition care and personal trainers: a website analysis

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10.05

10.11

10.17

10.23

Manifestations of Common Systemic Conditions Dr Ava Carter Why physical activity matters for older adults and what it means for them? Ms Urska Arnautovska Validity and reliability of a novel back extensor muscle strength test Miss Amy Harding Simulated Immersive Learning Clinical Scenarios (SILCS) for Pharmacy Practice Education Ms Lyndsee Baumann-Birkbeck Can the energy drink ingredient taurine, be a killer as well as a protector? Assoc Prof Gillian Renshaw

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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 9.32 – 9.40

Session – 10 Health education

9.44 – 9.52 9.56 – 10.04 10.08 – 10.16

10.20 – 10.28

Miss Katelyn Barnes Evaluation of an NBN enabled pilot of remote monitoring for older people using telehealth Ms Annie Banbury Massive chromophobe renal cell carcinoma presenting with an acute small bowel obstruction Dr Vaite Tsing Influence of SUMOylation Inhibitors on a Parkinson’s disease Cell Model Miss Shamini Vijayakumaran Joint kinematic calculation based on 3D gait analysis data: Standard clinical practices versus contemporary musculoskeletal approaches Mr Hans Kainz

Chair: Dr Ben Weeks Do Cochrane summaries help student midwives understand the findings of Cochrane reviews? The BRIEF randomised trial Assoc Prof Elaine Beller The role of simulation-based education for developing intercultural communication skills in allied health and nursing students Ms Georgina Neville Unifying professions: Identifying common values in seven health professions Assoc Prof Sandra Grace 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 Simulated Telemedicine Environment Project for Students (STEPS) Dr Monique Waite

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10.30 – 10.55

10.55 – 11.00 11.00 – 11.50 (40 mins + 10 min Q&A) 12.00 – 1.00 1.00 – 1.30

1.30 – 2.30

Morning break – The Links Pre-function area and The Club Room Masters Ballroom Introduction of Keynote Speaker Chair: Dr Marianne Von Au 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 Best of the Best (Top 5 selected podiums) Chair: Prof Iain Graham Conference awards and close (lunch follows) Mr Ian Langdon – Chairman, Gold Coast Hospital and Health Board Poster Awards • Best Applied Science Poster Award • Best Biomedical Poster Award • Best Clinical Poster Award • Best Digital Poster Award Oral or Digital Poster Awards • First Presentation at a peer reviewed conference • PhD/Hons Student Podium Award • Best Clinician Podium Award Oral only Award • Best of the Best Award (oral) All Categories • People’s Choice Award Lunch Pre-function area and The Club Room

Sponsored by Gold Coast Hospital Foundation Sponsored by Research and Data Analysis Centre Sponsored by HESTA Sponsored by HESTA Sponsored by HESTA Sponsored by HESTA Sponsored by Griffith Health Clinics Sponsored by Griffith Enterprise Sponsored by Gold Coast Medical Typing

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SPONSORS

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

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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 SecretaryGeneral 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. Peter J Hunter FRS, FRSNZ, MNZM Professor of Engineering Science Director, Auckland Bioengineering University of Auckland, New Zealand

Institute,

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

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 1 and organ system levels . The talk will describe the current state of the standards, databases and software being developed to support robust and reproducible multiscale models, and the progress being made towards their clinical application. These standards 2 3 include CellML and FieldML 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 5 databases 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):18691884, 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 20032010. 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 hindex 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.

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.

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 EvidenceBased Medicine Workbook, Clinical Thinking: Evidence, Communication and Decision-making, 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.

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 nonresponsiveness 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.

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 27

A

B

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

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

Atkinson, C.1, Munn, AL.1, Wiegmans, A.2, Khanna,

Mahmoud M Bakr , Wendy L Kelly , Athena 1 1 2 Brunt ,Gemma Diessel , Ward L Massey , Helen 1 1 1 Massa , Nigel A Morrison and Mark R Forwood .

2

KK , Wei, MQ.

1

1

Griffith 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 Sc (PrP ), 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 nonmetastatic 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 realtime 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. ___

1,2

1

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 shortterm 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 TM conducted using Osteomeasure . 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 (P10% 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 Thromboembolism Prophylaxis 1

1

Conroy, S. Mason, R. Sanmugarajah J. 1.

Venous 1

Medical Oncology Department, Gold University Hospital, Queensland, Australia

Coast

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 preintervention 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 1

1, 2

Coxeter, P. , Hoffmann T.

, 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 pregnant women 1,2

childbirth 1

self-efficacy 1,2

in 1,2

Creedy DK , Schwartz L , Toohill J , Baird K , 1,2 1,2 Gamble J & Fenwick J . 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 sociodemographic 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 selfefficacy scores (p 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 patientcentred 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 1, 2

Jayashantha, P. , Usgodaarachchi, U.³, De Silva, 4, 1 V. Johnson N.W. 1

Population and Social Health Research program, Griffith Health Institute, Gold Coast Campus, Griffith University, Queensland, Australia. [email protected] 2 Dental Hospital, Sri Lanka Air Force, Colombo, Sri Lanka. Tel. 0094112495495, 0094714164239. [email protected] 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 testretest 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 1,2

1,2

2

A N.B. Johnston , N. Bost , M. Aitken , K. 1 3 2 2 Gilmour , C. Strong , J. Timms , T. Donnelly , 1,2 J.Crilly . 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 evidencebased 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 1

1,2

Jones, C. , Moyle, M.. 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 evidencepractice 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 1

Joypaul, S . 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 352+ minute incubation period. Concentrations of Mg 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 2+ concentrations of Mg 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 -1 -1 -1 -1 to about 33 µmolL min . from 0µmolL min 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 2+ concentrations of free magnesium ions (Mg ). 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 hypomagnesia. ___

arising

from

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

K The Praecox Program: Pilot study of an online educational program to improve neonatal palliative care practice 1

2

3

Kain, VJ , Pritchard, MA ; Yates, P ; Curtis, M 1

4

2

Griffith University, Brisbane; The University of 3 Queensland, Brisbane; Queensland University of 4 Royal Women’s and Technology, Brisbane; 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 (6.6367) 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 peerreviewed 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

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) 1

3

1

1, 2

N. Kaviani , C. Sly , K. Heathcote , D. Plummer 1, 2 1 1, 2 M. Young , J. Saville , J. Sun 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

The Therapeutic Potential of Haspin Kinase Inhibition Induced synthetic lethality in HPV associated Cancer 1

Kelly, M . McMillan, N. Clarke, D. 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. ___

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. ___

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Removing visual feedback for a single limb alters between-limb force tremor relationships during isometric bilateral contractions 1,2

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Kenway, L. , Bisset, L. , Kavanagh, J.

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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 1

2

Saman Khalesi , Siddharth Sharma , Deepak 3 1 Doshi , Jing Sun , 1

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

2

Usman A. Khan , Saeed M. Hashimi , Shershah 2 2 2 Khan , Shareen Elshiyab , Mahmoud M. Bakr , 1 1 Mark R. Forwood and Nigel M. Morrison 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

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 1

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Can J. Kiessling , Melissa E. Reichelt , John P. 3 3 1 Headrick , Jason Peart , Kevin J. Ashton 1

Bond University, QLD, Australia University of Queensland, QLD, Australia 3 Griffith, Southport, QLD, Australia 2

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

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 agerelated 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. Ischaemiareperfusion 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 downregulated although this pattern did not match Cav3 expression in the aging normoxic and postischaemic 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 downregulation 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%, 5084%, 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, p85% 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 preoperatively. 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 hibernomalike 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;54:485488 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 [email protected] and should consult the further information on the website http://www.griffith.edu.au/health/griffith-healthinstitute/research/alzheimers-trial about the enrolment process. ___ Community Research Placements or Oral Health Promotion as part of the Oral Health Curriculum Kroon, J.

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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. ___

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. ___

Review of Health Technology Assessment for Transcatheter Aortic Valve Implantation

Low-level laser therapy (LLLT) attenuates muscle damage in delayed onset muscle soreness (DOMS)

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Sanjeewa Kularatna . Joshua Byrnes , Cindy 1,2 1,2 Mervin , Paul A. Scuffham 1

Centre for Applied Health Economics, School of Medicine, Griffith University, Queensland, Australia 2 Population 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

L

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Laakso, E-L. , Rodrigues NC , Bocaletti S , 4 1 1 Ohmsen P , Loureiro A , Nogueira R , Renno 2 1 1 ACM , Renshaw G , Bulmer AC 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; 2 2 fluence 12 J/cm ; power density 500 mW/cm ; 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