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Introduction: The one unifying and distinguishing feature of all neuropsychiatric illnesses is the co-occurrence of cognitive dysfunction. Cognitive training (CT) was developed to enhance neural connectivity and cognition and improve day-to-day functioning. However, the benefits of CT are still debated. This current systematic review aimed to examine the efficacy of CT and to identify diagnostic and CT characteristics associated with superior outcomes across a range of psychiatric disorders. Method: Studies investigating CT in psychiatric illnesses were extracted from Embase, PubMed, CINAHL, PsycINFO, and PsycARTICLES up to 17 August 2023. Inclusion criteria were randomised control trials (RCT) and English language. The primary search strategy included terms relating to cognitive training, cognitive remediation, cognitive enhancement, or cognitive rehabilitation and randomised control trials, clinical trials, or experiments. Risk of bias was assessed using RevMan Web version 8.1.1. Narrative synthesis was used to analyse findings. Due to the heterogeneity of participant demographics, diagnoses, and interventions, meta-analyses were considered inappropriate. Results: Fifteen studies, including a total of 1075 participants, were identified. Approximately 67% of studies reported significant improvements in at least one trained domain of cognitive function after CT, and 47% observed improvements in psychiatric symptoms or function. Cognitive transfer effects were not observed. Sample sizes for studies were generally small, and most CT durations were 6 weeks or less. Conclusions: Findings suggest that CT can improve cognitive function in trained domains, though little evidence of cognitive transfer effects was observed. Due to the lack of standardisation in CT format and delivery, and inadequate measures of psychiatric symptoms or daily function, there is insufficient evidence to conclude whether or not this technique may benefit cognitive impairment in psychiatric disorders, or lead to subsequent improvement in disease symptomatology. Further studies of longer duration and using consistent methodologies must be conducted to identify the benefits of CT in psychiatric disorders. [ABSTRACT FROM AUTHOR]

Objective: This systematic review aimed to summarise and synthesise research conducted in psychiatric mother‐baby units (MBUs) in relation to patients, their families, or staff, published from 1st January 2016 to 1st May 2024. Method: Quantitative, qualitative, and mixed‐method studies were included for review if they were published in peer‐review journals in English and reported research on MBUs between January 2016 and May 2024. From the initial yield of 10,007 unique studies, 53 studies were included for review. Results: MBU research was found to more frequently investigate maternal characteristics rather than the benefits of MBU treatment compared to studies conducted prior to 2016. Most studies that did investigate impact of admission showed favourable results, however few follow‐up studies and studies comparing MBU outcomes to other clinical settings were undertaken. Little research has been conducted to investigate the differential impacts of MBU admission on different diagnoses and long‐term (>1 year) patient outcomes. There was a dearth of research investigating partners of women in MBUs and few studies conducted on infant outcomes. Conclusions: MBUs were consistently found to improve mental health systems and mother‐infant attachment in patients after admission. More research investigating patient support networks and child health, impact of diagnosis on outcomes, and studies with adequate follow‐up are required. [ABSTRACT FROM AUTHOR]

Background: Mental health issues and parenting difficulties in the perinatal period are common, and have significant negative impacts on individuals, families, and broader society. Community-based peer support programs might be an effective adjunct to standard mental health interventions in perinatal mental health issues, specifically where low-cost interventions are required, or access to professional care is limited. Methods: A systematic review will be undertaken. Searches will be conducted on four electronic databases (Pubmed, Embase, Cinahl, and PsycINFO), using terms related to perinatal mental health and peer support. Literature will be screened by title and abstract and then by full text. Selected studies will be evaluated using the Quality Assessment with Diverse Studies (QuADS) tool. Data relevant to community-based perinatal peer support intervention characteristics and outcomes will be extracted, and synthesised narratively. Discussion: This review will contribute to the existing evidence about perinatal mental health peer support, by synthesising information about community-based interventions specifically. The findings will be used to inform the design, implementation, and evaluation of a community-based perinatal mental health peer support program in urban and rural/remote hospital and health services in Australia. Trial registration: Systematic review registration: CRD42023451568. [ABSTRACT FROM AUTHOR]

A relationship between excessive sugar consumption and cognitive function has been described in animal models, but the specific effects of sugars in humans remains unclear. This systematic review and meta-analysis aimed to evaluate the current knowledge, research characteristics, and quality of evidence of studies investigating the impacts of free and added sugars on human cognition in healthy participants. The review identified 77 studies (65 experimental trials, n = 3831; 9 cross-sectional studies, n = 11,456; and 3 cohort studies, n = 2059). All cohort studies and eight of the nine cross-sectional studies found significant positive correlations between added sugar consumption and risk of cognitive impairment. Four studies identified reduced risk of cognitive impairment associated with natural fructose-containing foods. The majority of randomised control trials assessed short-term glucose facilitation effects on cognitive outcomes. The results from these studies suggest the need for a tightly regulated blood glucose level, dependent on individualised physiological factors, for optimal cognitive function. A meta-analysis of a subset of studies that assessed the impact of glucose on recall found improvements in immediate free recall compared to controls (p = 0.002). The findings highlight the potentially detrimental effect of excessive, long-term, or prenatal added sugar consumption on cognitive function. Further research is needed to examine the specific effects of free and added sugars on cognitive function. [ABSTRACT FROM AUTHOR]

Introduction: Schizophrenia spectrum disorders are characterised by notable deficits in executive function, working memory, attention and social cognition. Previous studies in cognitive remediation therapies, of various dose and duration, have shown behavioural and neurobiological improvements. The current pilot study will be the first to test the Cogmed Working Memory Training (CWMT) program in schizophrenia spectrum disorder. Methods: This pilot study was conducted using purposive sampling of consumers with schizophrenia spectrum disorders from a forensic mental health inpatient unit in Australia was used. Eleven participants completed 30 sessions of CWMT over a 2-month period. One participant completed 28 sessions. The primary outcome measure was the CogState Schizophrenia Battery (CSB). Secondary measures included the Brock Adaptive Functioning Questionnaire (BAFQ) and the Allen Cognitive Level Screen (ACLS). Measures were taken before and after the intervention, and at 6-months follow-up to detect maintenance of improvements. Results: Significant improvements were seen in social cognition and emotionality. Trends toward improvement in executive function and working memory were observed in younger participants, but were not significant. Conclusion: Findings indicate that the CWMT may be a beneficial tool for improving social cognition in patients with schizophrenia. CWMT interventions of longer than 2 months may be required to see measurable improvements in other cognitive functions. Age-related cognitive impairment should be controlled for in future studies. Larger studies should be conducted to confirm these findings. [ABSTRACT FROM AUTHOR]

Background: Nurse practitioners (NP) have an expanded scope of practice beyond that of a registered nurse. In kidney care, nephrology NP can manage patients at various points along the chronic kidney disease (CKD) trajectory. Objectives: To profile the characteristics, service patterns, and domains of practice of nephrology NP in Australia. Design: A cross‐sectional online secure survey. Participants: Nephrology NP (NP students) who were members of the Renal Society of Australasia and working in Australia (n = 73). Measurements: Data collected were demographic and practice characteristics, and domains of practice (using the modified Strong Model of Advanced Practice). The survey also sought qualitative perspectives of the enablers and barriers to sustainability nurse practitioner healthcare delivery services. Results: Nephrology NP (n = 45) primarily worked in adult services, managing those receiving haemodialysis, peritoneal dialysis, or patients with earlier grades of CKD. Providing direct comprehensive care was the dominant domain of advanced practice although administrative activities took up considerable time each week. Support from nurse leaders and medical colleagues was identified as key enablers for sustainability of these services whereas succession planning, and workload were the main barriers. Conclusions: This study found a highly qualified, experienced but older nephrology nurse practitioner workforce who provide an additional model of health service delivery which can meet the growing CKD burden. Internationally, this level of nurse provides an opportunity for a career pathway to maintain nurses in direct clinical roles and to expand the nephrology nursing workforce. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Mental health clients experience higher estimated rates of domestic violence, yet mental health services are less likely to screen for domestic violence. What the paper adds to existing knowledge?: This paper qualitatively explores the perspectives and experiences of mental health practitioners in inpatient and community teams in a publicly funded hospital and health service (i.e. public mental health service).Mental health practitioners described a lack of domestic violence training, as well as a lack of knowledge of domestic violence and support mechanisms for victims, when domestic violence is disclosed by clients.The paper highlights the unique difficulties and barriers experienced by clinicians in screening for domestic violence while also dealing with clients suffering a mental health crisis. What are the implications for practice?: The paper sheds more light on the issue of domestic violence in mental health in terms of screening, and identifies avenues for improvement in mental health services; particularly the need for staff training and education. Introduction: Domestic violence is particularly prevalent within mental health client groups, though screening for domestic violence within mental health services is often overlooked. Aim: To investigate the experiences and opinions of domestic violence screening by mental health clinicians in a publicly funded hospital and health service. Methods: Semi‐structured interviews were conducted with twelve clinicians working in publicly funded mental health services in Queensland, Australia. Transcripts were thematically analysed. Results: Four main themes emerged from the data: staff training and experience; prioritizing domestic violence screening; attitudes to domestic violence; and victim support. Participants discussed a lack of training for, or expectations of, domestic violence screening in mental health services. They also highlighted a lack of resources enabling them to appropriately respond when domestic violence was identified. Discussion: Education, attitudes and resources relating to domestic violence are major factors that should be addressed for the successful screening and treatment of clients in mental health. Implications for Practice: This paper informs services of the gaps in knowledge and care around domestic violence and mental health. A less medicalized approach to the treatment of mental health should be adopted, and domestic violence training introduced for all healthcare practitioners, to improve client outcomes. [ABSTRACT FROM AUTHOR]

Aim: The primary aim of this analysis was to identify if two standard measures incorporated into the comprehensive geriatric assessment; specifically, malnutrition risk and body mass index (BMI), could predict 12‐month mortality in older patients with solid tumours. The secondary aim was to evaluate if malnutrition risk and BMI were associated with chemotherapy outcomes (discontinuation/modification of treatment) in older patients with solid tumours. Methods: Older patients (aged ≥70 years) with solid cancers were recruited from the outpatient oncology clinic of a tertiary hospital in Brisbane, Australia. Participants' nutritional parameters, BMI, and malnutrition risk (determined using the Malnutrition Screening Tool (MST)) were recorded at baseline. Mortality data and chemotherapy outcomes were recorded for 12 months. Results: Seventy‐four participants (67% males, median age 77 (±4.4) years) were recruited. Nearly half the cohort was at‐risk of malnutrition at baseline (n = 39, 46%). Chemotherapy was prescribed to 39% (n = 29) of the cohort. For patients receiving chemotherapy neither being underweight nor having a low or medium risk of malnutrition was associated with adverse chemotherapy outcomes or 12‐month mortality. At a bivariate level, malnutrition risk was significantly associated with 12‐month mortality in patients who did not receive chemotherapy (P = 0.018), but not BMI. Conclusions: This analysis indicates that malnutrition risk was a potential indicator of 12‐month mortality in cases where chemotherapy was considered unfeasible. However, this was not an independent risk factor. Further investigation using a larger sample is required to determine the association between malnutrition risk, quality of life and mortality in patients who are not considered to be fit for chemotherapy. [ABSTRACT FROM AUTHOR]

Background: Disordered sleep is common among people with chronic kidney disease (CKD). While it may compound the burden of CKD, there is a gap in the literature to address the specific role of disordered sleep. Aims: To describe the sleep profile of people with CKD and explore associations with validated measures of well-being. Methods: Participants with Grade 3-5 CKD were recruited from kidney outpatient clinics and dialysis units. Demographic and lifestyle data were collected. Sleep quality, symptom burden and quality of life were assessed using the Pittsburgh Sleep Quality Index, iPOS-Renal and EQ-5D-L validated instruments, respectively. Data were expressed descriptively and relationships between sleep quality and well-being analysed using multiple regression. Results: Among 47 participants, 47% were female and the median age was 74 (interquartile range 67--80). The median sleep quality score was 6 (4--11) out of a possible 21 (with 0 representing no difficulty and 21 representing severe difficulty). Sleep-related symptoms were common, with 46%, 32% and 45% experiencing moderate or worse weakness, drowsiness and difficulty sleeping, respectively. Despite this, HRQoL was generally preserved, with a median score of 70 (50--88). Difficulty sleeping was associated with worse sleep quality (p<0.001) but neither age, overall symptom burden nor HRQoL showed significant associations with sleep quality. Conclusion: In this cohort, self-reported sleep quality and HRQoL were generally high. Given the progressive nature of CKD, individuals with CKD may adapt their lifestyle to altered sleep patterns. The subset of people who report severe sleep symptoms may benefit from tailored interventions. [ABSTRACT FROM AUTHOR]

Background: Nurse practitioners are advanced practice nurses with an expanded scope of practice beyond that of a registered nurse. Nurse practitioners in Australia manage patients at various points along the chronic kidney disease (CKD) trajectory although there has been limited investigation into their current practice patterns. Objectives: To describe the extent and nature of nephrology nurse practitioners (NNP) practice. Methods: Cross-sectional online survey was distributed to 73 NNP who were members of the Renal Society of Australasia. Data collected were demographic characteristics, practice setting features, clinical service patterns and activities. Descriptive statistics were used to analyse data. Results: Forty-five NNP completed the survey (response rate 61.6%). The majority were aged > 50 years (71.1%), female (88%) with a Masters level qualification (71.1%) and >20 years' experience in nephrology nursing (73.3%). NNP primarily worked in adult services (93.3%), managing those receiving haemodialysis or peritoneal dialysis (37.8%) or for those with CKD grades 1 - 4 (33.3%). Mean length of NNP service was 10.33 ± 3.1 years and they managed a median of 20 patients per week. Activities involved prescribing medications (86%), requesting diagnostic investigations (79.1%), and referring to other clinicians (83.7%). Conclusion/Implications for Practice: NNP are providing care across the continuum of CKD. They are highly qualified and experienced, although older which raises concern for sustainability and succession planning. Advanced practice positions such as the NNP are an opportunity to offer a career pathway to maintain nurses in direct clinical roles and to expand the nephrology nursing workforce. [ABSTRACT FROM AUTHOR]

Background: Globally, Chronic Kidney Disease (CKD) is growing, and more than 10% of Australian adults have CKD. Early intervention and lifestyle risk modification has been shown to halt or slow the progression of CKD. Nephrology nurse practitioners (NNP) have an extended scope of practice compared with other nurses; they can order and interpret diagnostic investigations, make patient referral to other health professionals, and prescribe medications, and could manage earlier CKD grades. Aim: To describe the clinical outcomes of patients with CKD who are managed by a NNP. Methods: A retrospective study was conducted of patients attending an NNP outpatient clinic, between 2012 and 2018. Demographic and clinical data were extracted from hospital records and analysed. Results: Over this period 253 patients were solely managed by the NNP. Patients' mean age was 70.27 ± 10.48 years, most were in CKD grade 3B (41.5%), had renovascular disease (31.6%), and had a mean of 4.46 ± 2.57 comorbid conditions. At one year after entry to the NNP clinic, blood pressure, smoking status and triglyceride clinical targets were achieved by 82.6%, 81.1%, 66.1% of patients respectively although very few had healthy BMIs (6.9%). Also, one year after entry, eGFR had improved by ≥5ml/min/1.72min2 in 24.4% of patients, remained stable in53.6% and had deteriorated by ≤5ml/min/1.72min² in 22%. Conclusion: NNPs can be effective in meeting important clinical targets which slow the progression of CKD. Nurse practitioners can transform traditional medical models of healthcare delivery, freeing up medical practitioners to manage more complex or acute patients. [ABSTRACT FROM AUTHOR]

Pregnancy represents a crucial timepoint to screen for disordered eating due to the significant adverse impact on the woman and her infant. There has been an increased interest in disordered eating in pregnancy since the COVID-19 pandemic, which has disproportionately affected the mental health of pregnant women compared to the general population. This systematic review is an update to a previous review aiming to explore current psychometric evidence for any new pregnancy-specific instruments and other measures of disordered eating developed for non-pregnant populations. Systematic searches were conducted in PubMed, ProQuest, PsycInfo, CINAHL, Scopus, MEDLINE, and Embase from April 2019 to February 2024. A total of 20 citations met criteria for inclusion, with most studies of reasonable quality. Fourteen psychometric instruments were identified, including two new pregnancy-specific screening instruments. Overall, preliminary psychometric evidence for the PEBS, DEAPS, and EDE-PV was promising. There is an ongoing need for validation in different samples, study designs, settings, and administration methods are required. Similar to the original review on this topic, we did not find evidence to support a gold standard recommendation. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) affects more than 10% of the Australian adult population. It is a progressive disease that involves multiple physiological systems and is associated with several comorbid conditions, making it particularly burdensome on patients and the healthcare system. Alternative models of healthcare delivery are required to slow the progression to kidney failure. Aim: To describe the characteristics, patient profiles, and health outcomes of patients with CKD attending a nephrology nurse practitioner-led clinic. Design: Longitudinal health-service exploratory design. Methods: Following ethics approval, data were extracted from a chronic kidney disease registry for all consenting patients who attended a nephrology nurse practitioner-led clinic. Data were analysed descriptively. Results: Over the study period, 253 patients (122 male and 131 female) attended the clinic. The mean age was 70.27 ± 10.48 years, and at baseline most had either chronic kidney disease grade 3A (32.8%) or 3B (41.5%). For the majority of those who remained in the clinic, kidney function remained stable or slightly improved. A large proportion were within recommended target ranges for systolic (85.6%) and diastolic (98%) blood pressure although many had high BMI (mean 31.99 ± 6.47) and HbA1c (57.1%). Conclusion: The nephrology nurse practitioner-led clinic demonstrated effectiveness in addressing CKD targets for patients and provides an opportunity to transform traditional primary and specialist healthcare delivery. [ABSTRACT FROM AUTHOR]

Introduction: Suicide in children is a significant and unacceptable global phenomenon. This paper provides a descriptive overview of the children presenting in the first five years (2016-2021) of the implementation of the Zero Suicide Framework (ZSF) and Suicide Prevention Pathway (SPP) at a Child and Youth Mental Health Service in Queensland, Australia., Methods: Basic demographic variables (sex, age, socioeconomic status), and changes in presentations over time, are presented for 1,048 children. Completeness of selected SPP components relating to care planning and universal interventions are examined as an indicator of fidelity to the SPP model of care. The paper then focuses on the cohort of children who received care through the SPP in 2020, describing their demographic characteristics and baseline clinical scores., Result: There was an increase in admissions each year and children presented with a diverse range of clinical needs. The SPP greatly increased the provision of first line interventions for patients., Discussion: A standardized approach to suicide prevention improves consistency in management. These findings may inform the use of the ZSF/SPP in child mental health settings globally., Competing Interests: AP is the founder of SafeSide Prevention/SafeSide Australia which licensed educational materials from University of Rochester. SafeSide receives fees for education, consultation, and leadership services for healthcare organizations and government. The University of Rochester receives royalties from SafeSide and declares this financial interest. A conflict of interest management plan is in place at the University of Rochester and routinely communicated and monitored per University guidelines. AP receives book royalties from Cambridge University Press. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Branjerdporn, McCosker, Jackson, Gillespie, McDowell, Chand, Joshi, Pisani, Stapelberg, Welch, Turner and Woerwag-Mehta.)