The effectiveness of non-pharmacologic interventions in improving psychological outcomes for heart transplant recipients : a systematic review

Background The International Society for Heart and Lung Transplantation recommended in 2006 that intervention studies to maximize psychological outcomes after transplantation should be conducted. Potentially, studies reporting on the effectiveness of non-pharmacological interventions in improving psychological outcomes for heart transplant recipients may have been published since the call for this research. Thus, further evidence may currently be available to inform policy and practice decision-making regarding the implementation of such interventions. Accordingly, an evaluation of the evidence is required. Objectives The objective of this review was to identify the effectiveness of non-pharmacological interventions on psychological outcomes for heart transplant recipients.

Not all systematic reviews are systematic : a meta-review of the quality of current systematic reviews and meta-analyses for remote monitoring in heart failure

Background/aims: Remote monitoring for heart failure has not only been evaluated in a large number of randomised controlled trials, but also in many systematic reviews and meta-analyses. The aim of this meta-review was to identify, appraise and synthesise existing systematic reviews that have evaluated the effects of remote monitoring in heart failure. Methods: Using a Cochrane methodology, we electronically searched all relevant online databases and search engines, performed a forward citation search as well as hand-searched bibliographies. Only fully published systematic reviews of invasive and/or non-invasive remote monitoring interventions were included. Two reviewers independently extracted data. Results: Sixty-five publications from 3333 citations were identified. Seventeen fulfilled the inclusion and exclusion criteria. Quality varied with A Measurement Tool to Assess Systematic Reviews (AMSTAR scores) ranging from 2 to 11 (mean 5.88). Seven reviews (41%) pooled results from individual studies for meta-analysis. Eight (47%) considered all non-invasive remote monitoring strategies. Four (24%) focused specifically on telemonitoring. Four (24%) included studies investigating both non-invasive and invasive technologies. Population characteristics of the included studies were not reported consistently. Mortality and hospitalisations were the most frequently reported outcomes 12 (70%). Only five reviews (29%) reported healthcare costs and compliance. A high degree of heterogeneity was reported in many of the meta-analyses. Conclusions: These results should be considered in context of two negative RCTs of remote monitoring for heart failure that have been published since the meta-analyses (TIM-HF and Tele-HF). However, high quality reviews demonstrated improved mortality, quality of life, reduction in hospitalisations and healthcare costs.

Alternative models of cardiac rehabilitation : a systematic review

The traditional hospital-based model of cardiac rehabilitation faces substantial challenges, such as cost and accessibility. These challenges have led to the development of alternative models of cardiac rehabilitation in recent years. The aim of this study was to identify and critique evidence for the effectiveness of these alternative models. A total of 22 databases were searched to identify quantitative studies or systematic reviews of quantitative studies regarding the effectiveness of alternative models of cardiac rehabilitation. Included studies were appraised using a Critical Appraisal Skills Programme tool and the National Health and Medical Research Council's designations for Level of Evidence. The 83 included articles described interventions in the following broad categories of alternative models of care: multifactorial individualized telehealth, internet based, telehealth focused on exercise, telehealth focused on recovery, community- or home-based, and complementary therapies. Multifactorial individualized telehealth and community- or home-based cardiac rehabilitation are effective alternative models of cardiac rehabilitation, as they have produced similar reductions in cardiovascular disease risk factors compared with hospital-based programmes. While further research is required to address the paucity of data available regarding the effectiveness of alternative models of cardiac rehabilitation in rural, remote, and culturally and linguistically diverse populations, our review indicates there is no need to rely on hospital-based strategies alone to deliver effective cardiac rehabilitation. Local healthcare systems should strive to integrate alternative models of cardiac rehabilitation, such as brief telehealth interventions tailored to individual's risk factor profiles as well as community- or home-based programmes, in order to ensure there are choices available for patients that best fit their needs, risk factor profile, and preferences.

The Convergence Review and the principle of Australians' access to and opportunities for participation

The recent Australian Convergence Review’s second principle states: “Australians should have access to and opportunities for participation in a diverse mix of services, voices, views and information”. However, in failing to define its own use and understanding of the terms ‘access’ and ‘participation’ the Convergence Review exposes itself to criticism. These terms would no doubt be made unambiguously clear should the Review’s recommendations move towards policy, and this paper contributes to this discussion by framing access and participation, from the perspective of the ‘produser’ (Bruns, 2008), around three separate but related issues: the failure to frame the discussion that will be undertaken by the Australian Law Reform Commission’s 2012 2013 Copyright Inquiry; the prioritising of the market over and above media accountability and the health of the public sphere; and the missed opportunity to develop a national framework for digital literacy and advanced digital citizenry.

Screening in early childhood for risk of later mental health problems : a longitudinal study

Depression in childhood or adolescence is associated with increased rates of depression in adulthood. Does this justify efforts to detect (and treat) those with symptoms of depression in early childhood or adolescence? The aim of this study was to determine how well symptoms of anxiety/depression (A-D) in early childhood and adolescence predict adult mental health. The study sample is taken from a population-based prospective birth cohort study. Of the 8556 mothers initially approached to participate 8458 agreed, of whom 7223 mothers gave birth to a live singleton baby. Children were screened using modified Child Behaviour Checklist (CBCL) scales for internalizing and total problems (T-P) at age 5 and the CBCL and Youth Self Report (YSR) A-D subscale and T-P scale at age 14. At age 21, a sub-sample of 2563 young adults in this cohort were administered the CIDI-Auto. Results indicated that screening at age 5 would detect few later cases of significant mental ill-health. Using a cut-point of 20% for internalizing at child age 5 years the CBCL had sensitivities of only 25% and 18% for major depression and anxiety disorders at 21 years, respectively. At age 14, the YSR generally performed a little better than the CBCL as a screening instrument, but neither performed at a satisfactory level. Of the children who were categorised as having YSR A-D at 14 years 30% and 37% met DSM-IV criteria for major depression and anxiety disorders, respectively, at age 21. Our findings challenge an existing movement encouraging the detection and treatment of those with symptoms of mental illness in early childhood.

The use of navigation to achieve soft tissue balance in total knee arthroplasty : a randomised clinical study

Background: Achieving soft tissue balance is an operative goal in total knee arthroplasty. This randomised, prospective study compared computer navigation to conventional techniques in achieving soft tissue balance. Methods: Forty one consecutive knee arthroplasties were randomised to either a non-navigated or navigated group. In the non-navigated group, balancing was carried out using surgeon judgement. In the navigated group, balancing was carried out using navigation software. In both groups, the navigation software was used as a measuring tool. Results: Balancing of the mediolateral extension gap was superior in the navigation group (p=0.001). No significant difference was found between the two groups in balancing the mediolateral flexion gap or in achieving equal flexion and extension gaps. Conclusions: Computer navigation offered little advantage over experienced surgeon judgement in achieving soft tissue balance in knee replacement. However, the method employed in the navigated group did provide a reproducible and objective assessment of flexion and extension gaps and may therefore benefit surgeons in training.

Family coping: issues and challenges for cancer nursing

A large body of research now exists suggesting that families are dramatically affected by a diagnosis of cancer, and that they have a wide range of support needs. In particular, evidence suggests that the emotional strains of living with a family member who has cancer are an especially difficult coping challenge, and that such strains have a significant impact on the day-to-day lives of family members. Despite this evidence, there has been little analysis to date on the nature of the families' experience with cancer and what implications the unique features of family relationships and interactions in the context of cancer have for nursing practice. Some of these specific features of the families' experience with cancer are examined in this article. It is suggested that enormous scope exists for improving nurses' contribution to care for families of people with cancer. Specific recommendations for achieving such improvements include a critical review of the constraints that exist on efforts to care for families, and the development of approaches to care that appreciate the interconnectedness of family responses and the considerable needs of family members for emotional and practical support.

Review : "Networking : commercial television in Australia : a history" -- Nick Herd

Nick Herd begins his institutional history of Australian commercial television in the early 1890s, when an amateur inventor named Henry Sutton designed the ‘telephane’ with the intent of watching the Melbourne Cup in his home town of Ballarat. The ‘race that stops a nation’ was not broadcast live on television until 1960, but Sutton’s initiative indicates how closely sport and television were aligned in Australia even before the medium existed. The first licensed commercial stations to begin regular broadcasting went on air in Sydney and Melbourne shortly before the 1956 Melbourne Olympic Games, although Herd claims that this was ‘almost accidental’ rather than planned. (49) Only Melbourne viewers were able to see some events live, many via television sets in Ampol service stations following the company’s last minute sponsorship of coverage on Melbourne station GTV-9...

Review : "Birthday Boy" -- Sejong Park

Synopsis and review of Sejong Park's film Birthday Boy. Includes credits. Birthday Boy has won over 40 awards at film festivals around the world including Best Animated Short at the prestigious SIGGRAPH Computer Animation Festival in 2004 which qualified the film for the 2005 Academy Awards even before Park and fellow students had graduated from the Australian Film, Television and Radio School (AFTRS). It was subsequently nominated for the Oscar for Best Animated Short Film, losing to another extraordinary short, Chris Landreth’s tribute to pioneering Canadian animator Ryan Larkin, Ryan. Other awards include the Prix Jean-Luc Xiberras at the Annecy International Animated Film Festival in 2005 (which had a special focus on Korea) and Best Short Animation at the 2005 BAFTA awards. It has screened at over 100 film festivals around the world, and is the most awarded film in the almost forty year history of the AFTRS...

Review : "Everynight...Everynight" -- Alkinos Tsilimidos

Synopsis and review of the Australian prison film Everynight...Everynight (Alkinos Tsilimidos, 1994). Includes cast and credits. An opening title states that Everynight… Everynight is a true story, but due to “legal implications”, the characters have been fictionalised. Another title dedicates the film to the memory of Christopher Dale Flannery, an infamous underworld figure known as ‘Mr Rent-a-Kill’ who spent time in H Division in the 1970s and 1980s. Originally from Melbourne, Flannery was a major figure in the Sydney ‘gang wars’ of 1984-85, dramatised in the television series Underbelly: A Tale of Two Cities (2009). He disappeared in mid-1985; there are several conflicting stories about his fate. The character of Bryant appears to have been based on Stan Taylor who had spent time in H Division with Flannery. Taylor was sentenced to life imprisonment without parole in 1988 for the 1986 bombing of police headquarters in Melbourne...

Review : "For the Term of His Natural Life" -- Norman Dawn

Synopsis and review of For the Term of His Natural Life (Norman Dawn, 1927). Includes cast and credits. For the Term of His Natural Life was one of the last Australian silent films, and also one of the most significant in the history of Australian cinema. At the time of its production, controversy raged over its depiction of convict life, its scale and cost (which was reported to be around 50,000 pounds at a time when most Australian films had budgets of less than 2,000 pounds1) and the fact that the director, several of the crew and the leading cast members were American. Australasian Films launched a publicity campaign of unprecedented scale to counter opposition to the film’s subject matter and the charge that they were “seeking to make capital out of the drab and sordid days of Australia”.2 The film’s expense was turned into a virtue: hundreds of unemployed men were used as extras, while the film also provided work for many within the Australian film industry and, according to Australasian, enabled the establishment of new production companies. The American imports who earlier had been accused of being “party to the slaughtering” of the Australian film industry, were feted for their artistic contributions, and the concerns raised in federal parliament about an American “invasion” were deflected by claims about what the local industry could learn from those with Hollywood experience.3 The publicity campaign was successful, as the film proved enormously popular at the Australian box office in its initial run. But the coming of sound film in 1928 had a considerable impact on audiences for silent films like For the Term, and its early local success was not repeated in subsequent seasons or in overseas markets...

Review : "Ghosts...of the Civil Dead" -- John Hillcoat

Synopsis and review of the Australian prison film Ghosts...of the Civil Dead (John Hillcoat, 1988). Drawing heavily from the book In the Belly of the Beast by American author and long-term prisoner Jack Henry Abbott, as well as from the historical and philosophical work of Michel Foucault (the credits include ‘Foucault Authority – Simon During’), Ghosts… Of the Civil Dead is a searing critique of the so-called ‘new generation’ prison system developed in the United States and recently introduced in Australia. Director John Hillcoat and producer Evan English conducted extensive research for the film, including spending time at the National Institute of Corrections, a think tank in Colorado, and visiting numerous institutions like the ‘new Alcatraz’ at Marion Illinois and other maximum security prisons across the United States. Using a mix of professionals and non-actors, including former prisoners and prison guards, the ‘story’ was workshopped during a lengthy rehearsal period with many actual events and experiences of participants incorporated into the film. The end result deliberately blurs the line between American and Australian prison experience to make the political point that what had happened in the US – from where many events and characters, and much of the architecture and design of the prison are drawn – was beginning to happen in Australia. The film emphasises the vicious cycle of institutionalisation, and highlights the role state authorities play in manufacturing, provoking and manipulating violence and fear both in prisons and in wider society as a means to augment policing and surveillance of the population, to oppress the working classes, and to maintain the political status quo...

Review: "Stir" -- Stephen Wallace

Synopsis and review of the Australian prison film Stir (Stephen Wallace, 1980). Includes cast and credits. Stir was written by a former prisoner, Bob Jewson, who had witnessed first hand a notorious riot at Bathurst Gaol in New South Wales in February 1974, the second serious disturbance at the prison in four years. In 1979, prisoners at Parramatta Gaol staged a peaceful sit-in to protest against the New South Wales’ government’s decision not to pursue criminal charges against prison officers for their actions during the 1974 Bathurst riot. The bashing of China Jackson and his cellmate in the first scene of Stir follows a sit-in, with the rest of the film drawing heavily on events around the 1974 Bathurst riot. The director later claimed that he wanted to call the film ‘The Riot at Bathurst Prison’, but was persuaded by nervous bureaucrats to apply the veneer of fiction. The film was retitled Stir, and set in the fictional Gatunga Gaol. Like other films in this genre, Stir draws heavily on the experiences of former prisoners and warders. The Prisoners’ Action Group played a leading role in the planning and preparation of the film, and many former inmates and guards were employed as extras. And in common with many films in this genre, Stir is concerned to humanise the plight of prisoners. Through the depiction of the routines of punishment, violence and retribution by which order in the institution is maintained, and through careful evocation of the atmosphere of fear and intimidation that prisoners (and warders) live with every day, Stir, again like other films in this genre blames the authorities and the system itself for events like those portrayed here. As producer Richard Brennan says in an interview on the 2005 DVD release of the film, “prisons create monsters”...

Review : "The Square" -- Nash Edgerton

Synopsis and review of the Australian crime film The Square (Nash Edgerton, 2009). Includes cast and credits. The Square is the feature film debut of director Nash Edgerton, well-known in Australian film circles not only for his award-winning music videos and short films Deadline (first prize winner at Tropfest in 1997) and Spider, but also for his work as an actor, editor, producer, writer and stuntman on countless Australian films and television programs. The film was co-written by Edgerton’s regular partner and brother Joel, who also plays the arsonist Billy. Joel is familiar to Australian and international audiences for his television work in The Secret Life of Us as well as numerous film roles...