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Purpose: This study aimed to investigate: (1) the characteristics of people using, or had previously used, assistance animals within community living in Australia; (2) positive and/or negative experiences of these users; and (3) educational resources that may aid public awareness., Materials and Methods: An online survey was distributed through Australian assistance animal organisations and social media channels. Past/current assistance animal users ( n  = 112) responded to questions on demographic and types of animal supports used, experience of assistance animal use, community attitudes experienced, and perspectives about the need for public education. Data were analysed with descriptive and inferential statistics. Content analysis provided additional insights of the positive and/or negative experiences assistance animal users had faced., Results: Nearly all participants used an assistance dog ( n  = 111), and 37 (33%) used the animal for more than one type of support. Seventy percent reported experiencing both positive and negative community attitudes/reactions. Length of time of having an assistance animal was associated with significantly higher prevalence of positive attitudes/reactions, whilst users who received medical support from the animal tended to experience more negative community attitudes/reactions than other users. The majority (90%) agreed that more public education is needed regarding assistance animal public access rights., Conclusions: This study is the first in Australia to undertake a large-scale survey of assistance animal users with a range of disability types. It highlights the benefits and challenges of assistance animals, which could be useful to consider when determining the most appropriate support for an individual.Implications for RehabilitationThere are a range of possible benefits, but also challenges, in the use of assistance animals that should be considered when a person with disability or health conditions, or people advising them, are determining if an animal is the most appropriate support.Assistance animals can provide multiple types of support to one user, so could offer a potential cost-benefit beyond traditional assistive devices or other types of support.To ensure better inclusion of assistance animal users, public education is needed to promote community awareness of the types of animals that meet the definition of an 'assistance animal', and thus have public access rights.In Australia, a nationally consistent government approach to the regulation, accreditation and funding of assistance animals should be established with the aim to address the current fragmented or unfair investment approach and/or discrimination experienced by some individuals.

Purpose: This pilot study examined whether two different types of non-powered mobile arm supports (MAS) enhanced upper limb function and independence with activities of daily living (ADLs) in people with Duchenne muscular dystrophy (DMD)., Method: A mixed methods cross-sectional design was used. Participants were four males with DMD, aged 16 to 20 years ( M  = 18.25 years). Two participants were current MAS users, and two had previously used MAS. To explore experiences of MAS use, semi-structured interviews were undertaken, then transcribed verbatim and analysed thematically. To measure the impact of MAS on arm function and ADLs, participants using MAS completed the Performance of the Upper Limb (PUL) and the DMD Upper Limb Patient Reported Outcome Measure with and without MAS. Participants no longer using MAS only completed the PUL without MAS., Results: MAS enhanced upper limb function and independence with ADLs in three of four participants. Eating and drinking was most often positively impacted by MAS. Access to informal support for MAS set-up, and ongoing input from a clinician or assistive technology (AT) supplier with MAS expertise, were important enablers to successful MAS use. Barriers to use included inadequate upper limb strength, interference of MAS with wheelchair controls, and AT funding delays., Conclusion: MAS should be considered by individuals with DMD and clinicians working with them as the disease progresses and strength declines. Potential barriers to MAS use need to be addressed to ensure maximum utility. AT funding delays must also be minimized to avoid impact on outcomes of people with DMD.Implications for RehabilitationIndividuals with DMD, and clinicians working with them, may consider MAS to aid achievement of functional goals as the disease progresses and upper limb function declines.Both objective and subjective outcome measures should be used when evaluating the effectiveness of MAS.Consideration should be given to the potential interference of MAS with wheelchair controls and the availability of informal or paid supports (e.g., family, support workers, teachers) to aid MAS use.Efficient and timely funding of MAS is required, as delays may negatively impact outcomes for people with progressive neurological conditions, such as DMD.

Background : This study aimed to examine use of electronic assistive technology for social networking by people with disability living in shared supported accommodation (SSA), and compare participants' Electronic Social Networking (ESN) integration with Australian ESN normative data. Method : Telephone surveys and the ESN subscale of the Community Integration Questionnaire-Revised (CIQ-R) were administered with SSA managers. Surveys gathered demographic data, and data on Internet access, technology use and ESN integration, of 91 people with disability who were identified technology users and living in SSA. Participant ESN data were then matched with existing CIQ-R ESN normative data ( N  = 359). Relative risk of reduced ESN integration was calculated. Results : This study identified that, despite access to mainstream technologies, people with disability living in SSA experience low ESN integration, and use ESN for social contact less than other Australians. This group were 210% more likely to report reduced ESN integration than the matched normative sample when key demographic variables were held constant. Conclusions : Factors related to disability, including high care and support needs and greater time spent completing essential activities of daily living (such as personal care), may explain the low electronic social networking integration for people with disability living in SSA identified in this study. Further research that examines factors that influence ESN access and use following disability is necessary to inform practice to bridge the digital divide that exists between this group and other Australians.

SerpinB2, also known as plasminogen activation inhibitor type 2 (PAI-2), is classically viewed as an inhibitor of fibrinolysis. However, we show herein a distinct, hitherto unrecognized role for SerpinB2 in hemostasis. Mice deficient in SerpinB2 expression and mice with an active site mutation in SerpinB2, both showed significant reductions in tail bleeding times. This hemostatic phenotype was associated with platelets, with SerpinB2 and SerpinB2-urokinase complexes clearly present in platelet fractions, and immunohistochemistry of blood clots suggesting SerpinB2 is associated with platelet aggregates. Thromboelastography illustrated faster onset of clot formation in blood from SerpinB2 deficient mice, whereas clotting of platelet-free plasma was unaffected. The results appear consistent with the low circulating SerpinB2 levels and hypercoagulation seen during pre-eclampsia; however, SerpinB2 was not detected in human platelets.

Introduction: The Family Outcome Measure (FOM-40) captures multidimensional data about well-being and capacity of family member as well as the relative with brain injury. This study aimed to produce a profile (positive and negative) of families supporting relatives with traumatic brain injury (TBI) and high support needs., Methods: Thirty-eight dyads (family member plus relative with TBI and high daily support needs) participated in this cross-sectional survey-based pilot study. The survey comprised several published scales, as well as a range of demographic and clinical characteristics of the relative. Non-parametric bivariate analyses were conducted., Results: Independence of the FOM-40 domains was confirmed. Place of residence (shared supported accommodation (SSA)/family home) was an important predictor variable. SSA was strongly associated with lower levels of burden in families. Family home was strongly associated with better adjustment of the relative. Family resilience was positively associated with sustainability of support and comorbidity in the relative., Discussion: Family outcomes were associated with a variety of demographic and clinical characteristics of the relative with TBI including residence, behaviour and mental health symptoms. The results provide meaningful evidence for service providers given the increasing investment in independent living in people with disabilities, and the ongoing reliance on families to supplement paid support.

Electronic assistive technologies (EATs) are fast becoming considered an essential component of everyday life. To date, there has been little research on the use of EAT by people living in shared supported accommodation (SSA), one of the major community-based housing options for people with disability (PwD) in Australia. This study aimed to (1) audit current EAT use by PwD living in SSA, (2) describe the impact of Internet access on EAT use, and (3) examine potential relationships between individual characteristics and EAT use. A customized survey administered with 32 house managers, representing 52 SSAs, gathered data on the EAT use of 254 people. Only 45.7% of residents used EAT, and devices available to the mainstream market were most frequently used. Access to home-based Internet was not a predictor of the number of devices in use. Disability type (congenital or acquired) was found to be significantly correlated with the number of devices in use, however, associations across a number of variables suggest complex mediational interactions. These findings provide an insight into the EAT use trends of PwD living in SSA, indicating that further work needs to be done to support the uptake and continued use of EAT by PwD Implications for Rehabilitation Further work needs to be done to promote the uptake and use of electronic assistive technology (EAT) by people with disability (PwD). Personal characteristics and experiences need to be considered in the prescription of EAT to PwD, as these may explain variations in use between individuals.

Objectives: To determine level of community integration in adults with traumatic brain injury and high support needs (TBI-HSN) compared with multiple matched controls., Setting: Community setting, Victoria, Australia., Participants: Adults with TBI-HSN living in the community (n = 61). Australian normative data (n = 1973) was used for matching purposes (1:4)., Design: Matched analysis from people with and without TBI. Matching aimed to reduce variability expected from age, gender, metropolitan/rural residence and co-resident status., Main Measures: Community Integration Questionnaire (CIQ): total and sub-scales of Home Integration, Social Integration and Productivity., Results: Matched analysis showed large effects favouring the general population, e.g. CIQ total scores were significantly different, F(1, 304) = 5.8, p < 0.0001. Conditional relative risk showed community-dwelling participants with TBI were 540-times more likely to report a poor CIQ total score compared to the general population., Conclusion: Normative CIQ data has enabled meaningful comparisons of the community integration of adults with chronic TBI to the general population in Australia. Evidence makes clear with numeric precision that individuals with TBI and high support needs are much less integrated than their non-TBI counterparts despite living in the community for many years.

Introduction: The ability to deliver the traditional apprenticeship method of teaching clinical skills is becoming increasingly more difficult as a result of greater demands in health care delivery, increasing student numbers and changing medical curricula. Serious consequences globally include: students not covering all elements of clinical skills curricula; insufficient opportunity to practise clinical skills; and increasing reports of graduates' incompetence in some clinical skills., Methods: A systematic Structured Clinical Coaching Program (SCCP) for a large cohort of Year 1 students was developed, providing explicit learning objectives for both students and paid generalist clinical tutors. It incorporated ongoing multi-source formative assessment and was evaluated using a case-study methodology, a control-group design, and comparison of formative assessment scores with summative Objective Structured Clinical Examination (OSCE) scores., Results: Students demonstrated a higher level of competence and confidence, and the formative assessment scores correlated with the Research students' summative OSCE scores. SCCP tutors reported greater satisfaction and confidence through knowing what they were meant to teach. At-risk students were identified early and remediated., Discussion: The SCCP ensures consistent quality in the teaching and assessment of all relevant clinical skills of all students, despite large numbers. It improves student and teacher confidence and satisfaction, ensures clinical skills competence, and could replace costly OSCEs.