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Article ; Online: Practice recommendations and referrals, perceptions of efficacy and risk, and self-rated knowledge regarding complementary medicine: a survey of Australian psychologists.

Thomson-Casey, Carrie / McIntyre, Erica / Rogers, Kris / Adams, Jon

BMC complementary medicine and therapies

2024 Volume 24, Issue 1, Page(s) 13

Abstract: Background: Many people with mental health problems use a range of complementary medicine (CM), including over the counter products, practices, and utilise the services of CM practitioners. Psychologists are likely to consult with clients using CM, in ... ...

Abstract	Background: Many people with mental health problems use a range of complementary medicine (CM), including over the counter products, practices, and utilise the services of CM practitioners. Psychologists are likely to consult with clients using CM, in some form, as part of their broader mental health care. The aim of this research was to determine the number of types of CM products, practices, and practitioners are recommended and/or referred by Australian psychologists as part of their clinical practice, as well as explore the relationship between psychologists' perspectives on the risk and relevance of engaging with CM in psychology. Methods: Survey data was collected from psychologists in clinical practice who self-selected to participate in the study via an online 79-item questionnaire exploring core aspects of CM engagement in psychology clinical practice. Results: Amongst the 201 psychologists, 5% reported not recommending any type of CM, with 63% recommending four or more types of CM. Further, 25% had not referred to a CM practitioner, while 33% had referred to four or more types of CM practitioner. Psychologists are recommending and referring to CM even when they perceive their knowledge of CM to be poor, and that engaging with CM was a risk. Conclusion: This study provides insights into psychologist perceptions of CM within psychology practice and how these perceptions are associated with rates of recommending and referring to CM as part of their clinical practice. These findings may inform the development of CM relevant education and guidelines for psychologists.
MeSH term(s)	Humans ; Australia ; Complementary Therapies ; Surveys and Questionnaires ; Referral and Consultation ; Attitude of Health Personnel
Language	English
Publishing date	2024-01-02
Publishing country	England
Document type	Journal Article
ISSN	2662-7671
ISSN (online)	2662-7671
DOI	10.1186/s12906-023-04288-y
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Article ; Online: Food allergy symptoms in adults and children using the Food Allergy Research & Education Patient Registry.

McIntyre, Amanda / Lee, Kristine E / Patel, Gayatri B / Mathur, Sameer K / Singh, Anne Marie

The journal of allergy and clinical immunology. In practice

2023 Volume 12, Issue 1, Page(s) 249–251.e1

MeSH term(s)	Child ; Adult ; Humans ; Food Hypersensitivity/diagnosis ; Food Hypersensitivity/epidemiology ; Food ; Allergens ; Educational Status ; Registries
Chemical Substances	Allergens
Language	English
Publishing date	2023-09-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	2843237-X
ISSN	2213-2201 ; 2213-2198
ISSN (online)	2213-2201
ISSN	2213-2198
DOI	10.1016/j.jaip.2023.09.021
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Article ; Online: Dissecting deep brain stimulation evoked neural activity in the basal ganglia.

Noor, M Sohail / Steina, Alexandra K / McIntyre, Cameron C

Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics

2024 Volume 21, Issue 3, Page(s) e00356

Abstract: ... externus (GPe) is a key driver of these oscillatory EPs, independent of stimulation location (i.e. STN or ...

Abstract	Deep brain stimulation (DBS) is an established therapeutic tool for the treatment of Parkinson's disease (PD). The mechanisms of DBS for PD are likely rooted in modulation of the subthalamo-pallidal network. However, it can be difficult to electrophysiologically interrogate that network in human patients. The recent identification of large amplitude evoked potential (EP) oscillations from DBS in the subthalamic nucleus (STN) or globus pallidus internus (GPi) are providing new scientific opportunities to expand understanding of human basal ganglia network activity. In turn, the goal of this review is to provide a summary of DBS-induced EPs in the basal ganglia and attempt to explain various components of the EP waveforms from their likely network origins. Our analyses suggest that DBS-induced antidromic activation of globus pallidus externus (GPe) is a key driver of these oscillatory EPs, independent of stimulation location (i.e. STN or GPi). This suggests a potentially more important role for GPe in the mechanisms of DBS for PD than typically assumed. And from a practical perspective, DBS EPs are poised to become clinically useful electrophysiological biomarker signals for verification of DBS target engagement.
Language	English
Publishing date	2024-04-11
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2316693-9
ISSN	1878-7479 ; 1933-7213
ISSN (online)	1878-7479
ISSN	1933-7213
DOI	10.1016/j.neurot.2024.e00356
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Article ; Online: Interaction of obesity and proteins associated with the NLRP3 inflammasome following mild traumatic brain injury.

Eagle, Shawn R / Basantani, Mahesh K / Preszler, Jonathan / Sherry, Natalie / McIntyre, Peyton / Kershaw, Erin E / Puccio, Ava M / Okonkwo, David O

Scientific reports

2024 Volume 14, Issue 1, Page(s) 10178

Abstract: The NOD-like receptor pyrin domain-containing protein 3 (NLRP3) inflammasome has been associated with worse outcomes from severe traumatic brain injury (TBI). The NLRP3 inflammasome is also strongly associated with other pro-inflammatory conditions, such ...

Abstract	The NOD-like receptor pyrin domain-containing protein 3 (NLRP3) inflammasome has been associated with worse outcomes from severe traumatic brain injury (TBI). The NLRP3 inflammasome is also strongly associated with other pro-inflammatory conditions, such as obesity. Little is known about the potential effect of mild TBI (mTBI) on the NLRP3 inflammasome and the extent to which modifying factors, such as obesity, may augment the inflammatory response to mTBI. The purpose of this study was to evaluate the association of NLRP3 inflammasome proteins with obese body mass index (BMI ≥ 30) within 24 h of mTBI after presenting to a level 1 trauma center emergency department. This is a secondary analysis of prospectively enrolled patients with mTBI who presented to the emergency department of one U.S. Level 1 trauma center from 2013 to 2018 (n = 243). A series of regression models were built to evaluate the association of NLRP3 proteins obtained from blood plasma within 24 h of injury and BMI as well as the potential interaction effect of higher BMI with NLRP3 proteins (n = 243). A logistic regression model revealed a significant association between IL-18 (p < 0.001) in mTBI patients with obese BMI compared to mTBI patients with non-obese BMI (< 30). Moderation analyses revealed statistically significant interaction effects between apoptotic speck-like protein (ASC), caspase-1, IL-18, IL-1β and obese BMI which worsened symptom burden, quality of life, and physical function at 2 weeks and 6 months post-injury. Higher acute concentrations of IL-1β in the overall cohort predicted higher symptoms at 6-months and worse physical function at 2-weeks and 6-months. Higher acute concentrations of IL-18 in the overall cohort predicted worse physical function at 6-months. In this single center mTBI cohort, obese BMI interacted with higher acute concentrations of NLRP3 inflammasome proteins and worsened short- and long-term clinical outcomes.
MeSH term(s)	Humans ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism ; Male ; Female ; Obesity/complications ; Inflammasomes/metabolism ; Adult ; Middle Aged ; Brain Concussion/complications ; Brain Concussion/blood ; Body Mass Index ; Interleukin-18/blood ; Interleukin-18/metabolism ; Prospective Studies ; Interleukin-1beta/blood ; Interleukin-1beta/metabolism ; Caspase 1/metabolism
Chemical Substances	NLR Family, Pyrin Domain-Containing 3 Protein ; Inflammasomes ; NLRP3 protein, human ; Interleukin-18 ; Interleukin-1beta ; Caspase 1 (EC 3.4.22.36)
Language	English
Publishing date	2024-05-03
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-024-61089-0
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Article ; Online: The relationship between psychology practice and complementary medicine in Australia: Psychologists' demographics and practice characteristics regarding type of engagement across a range of complementary medicine modalities.

Thomson-Casey, Carrie / McIntyre, Erica / Rogers, Kris / Adams, Jon

PloS one

2023 Volume 18, Issue 5, Page(s) e0285050

Abstract: Introduction: Many people with mental health problems utilise a range of complementary medicine (CM) practitioners, products, and practices. Psychologists are likely to consult with clients who are seeking and using CM, in some form, as part of their ... ...

Abstract	Introduction: Many people with mental health problems utilise a range of complementary medicine (CM) practitioners, products, and practices. Psychologists are likely to consult with clients who are seeking and using CM, in some form, as part of their wider mental health treatment. The aim of this research is to determine how much, and in what ways, Australian psychologists recommend CM products and/or practices, and/or initiate referrals to CM practitioners as part of their clinical practice and to explore if these behaviours have any association with the characteristics of the psychologist or their wider practice. Methods: Survey data was collected from psychologists in clinical practice who self-selected to participate between February and April 2021. Participation in the study was via an online 79-item questionnaire exploring core aspects of CM engagement in psychology clinical practice. Results: Amongst the 202 psychologists who completed the survey, mind/body approaches (90.5%) were the most recommended CM and cultural/spiritual approaches the least recommended CM (7.5%). Participants also reported referring to CM practitioners with naturopaths the most common focus of their referrals (57.9%) and cultural and spiritual practitioners the least common focus of their referrals (6.69%). Our analysis shows the demographic and practice characteristics of a psychologist are generally not predictors of a psychologist's engagement with CM in their clinical practice. Conclusions: Substantial numbers of psychologists recommend CM products and practices and/or refer clients to CM practitioners. Alongside subjecting CM interventions for mental health to an evidence-base assessment, the broader discipline of psychology needs to also consider psychologist engagement with CM in clinical practice in order to help ensure cultural-sensitivity, client safety and client choice.
MeSH term(s)	Humans ; Practice, Psychological ; Australia ; Complementary Therapies ; Mental Health ; Surveys and Questionnaires ; Demography ; Psychology
Language	English
Publishing date	2023-05-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0285050
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Article ; Online: Use of Hotels as a Disposition Alternative to Hospital Admission for Undomiciled Patients Undergoing SARS-CoV-2 Testing.

Lin, Lucia C / McIntyre, Brendan B / McIntyre, Kaitlin / Castillo, Edward / Subramony, Rachna / Kreshak, Allyson

The western journal of emergency medicine

2023 Volume 24, Issue 3, Page(s) 431–435

Abstract: Introduction: The coronavirus 2019 (COVID-19) pandemic has presented various unprecedented challenges to healthcare systems globally, prompting society to adopt new preventative strategies to curb spread of the disease. Those experiencing homelessness ... ...

Abstract	Introduction: The coronavirus 2019 (COVID-19) pandemic has presented various unprecedented challenges to healthcare systems globally, prompting society to adopt new preventative strategies to curb spread of the disease. Those experiencing homelessness have been particularly impacted because of barriers to practicing social distancing, inability to isolate, and poor access to care. Project Roomkey was established in California as a statewide measure to provide non-congregate shelter options for individuals experiencing homelessness to properly quarantine. On goal in this study was to analyze the effectiveness of hotel rooms as a safe disposition alternative to hospital admission for patients experiencing homelessness and who were also positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: This was a retrospective, observational study that included chart review of patients who were discharged to the hotel from March 2020-December 2021. We recorded demographic information, index visit details, number of emergency department (ED) visits both a month prior to and following the index visit, admission rates, and number of deaths. Results: During this 21-month study period, a total of 2,015 patients who identified as undomiciled were tested for SARS-COV-2 in the ED for various reasons. Of those patients, 83 were discharged from the ED to the hotel. Of the 83 patients, 40 (48.2%) ultimately tested positive for SARS-CoV-2 during their index visit. Two patients returned to the ED within seven days with COVID-19-related symptoms, and 10 patients within 30 days. Two patients required subsequent admission with COVID-19 pneumonia. No deaths were recorded within the 30-day follow-up period. Conclusion: The availability of a hotel served as a safe alternative to hospital admission for patients experiencing homelessness and who were either suspected or confirmed to have COVID-19. It is reasonable to consider similar measures in the management of other transmissible diseases for patients experiencing homelessness who require isolation.
MeSH term(s)	Humans ; SARS-CoV-2 ; COVID-19 ; COVID-19 Testing ; Hospitalization ; Hospitals
Language	English
Publishing date	2023-05-03
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	2375700-0
ISSN	1936-9018 ; 1936-9018
ISSN (online)	1936-9018
ISSN	1936-9018
DOI	10.5811/westjem.57639
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Article ; Online: Investigating the impact of developmental coordination difficulties across home, school, and community settings: Findings from the Australian Impact for DCD survey.

Reynolds, Jess E / Alvares, Gail A / Williams, Jacqueline / Froude, Elspeth / Elliott, Catherine / McIntyre, Sarah / Whitehouse, Andrew J O / Evans, Kiah L / Reid, Siobhan L / Cairney, John / Licari, Melissa K

Research in developmental disabilities

2024 Volume 147, Page(s) 104712

Abstract: Aim: To evaluate the participation difficulties experienced by children with developmental coordination disorder (DCD) in home, school, and community environments.: Methods: The Impact for DCD survey was completed by primary caregivers of 4-18-year- ... ...

Abstract	Aim: To evaluate the participation difficulties experienced by children with developmental coordination disorder (DCD) in home, school, and community environments. Methods: The Impact for DCD survey was completed by primary caregivers of 4-18-year-old children with DCD (or synonymous diagnosis) (n = 429). Outcomes and results: The greatest participation difficulties experienced at home included dressing, eating with utensils, self-care tasks and drawing/writing reported by over 70% of families. At school, fine motor difficulties were also frequently reported, with additional difficulties keeping up or completing tasks, and not feeling supported at school. Socialisation challenges and bullying were also commonly reported (34.9%). As a result of participation difficulties at school, 5.4% were home schooled. Many children engaged in community activity, with 72.0% currently engaged in at least one organised sports-based activity. Conclusions and implications: Increased recognition of the widespread impact of DCD in a child's life is crucial at an individual and societal level. Parents reported their children experiencing significant participation restrictions and difficulties. The findings of this large-scale study have revealed that most children with DCD are not receiving the support they need to thrive, especially at school. This largely reflects a lack of understanding and recognition of the condition and its associated challenges.
MeSH term(s)	Child ; Humans ; Child, Preschool ; Adolescent ; Motor Skills Disorders/diagnosis ; Australia ; Schools ; Surveys and Questionnaires ; Social Environment
Language	English
Publishing date	2024-03-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	639175-8
ISSN	1873-3379 ; 0891-4222
ISSN (online)	1873-3379
ISSN	0891-4222
DOI	10.1016/j.ridd.2024.104712
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Article ; Online: Applying the lessons of design thinking: a unique programme of care for acutely unwell, community-dwelling COVID-19 patients.

Devlin, Megan K / McIntyre, Natasha J / Ramer, Matthew D / Kwon, Young Han / Nicholson, J Michael / Mrkobrada, Marko / Kronick, Jami / Calvin, James E / Spicer, Erin

BMJ open quality

2024 Volume 13, Issue 1

Abstract: Background: The COVID-19 pandemic limited access to primary care and in-person assessments requiring healthcare providers to re-envision care delivery for acutely unwell outpatients. Design thinking methodology has the potential to support the robust ... ...

Abstract	Background: The COVID-19 pandemic limited access to primary care and in-person assessments requiring healthcare providers to re-envision care delivery for acutely unwell outpatients. Design thinking methodology has the potential to support the robust evolution of a new clinical model. Aim: To demonstrate how design thinking methodology can rapidly and rigorously create and evolve a safe, timely, equitable and patient-centred programme of care, and to share valuable lessons for effective implementation of design thinking solutions to address complex problems. Method: We describe how design thinking methodology was employed to create a new clinical model of care. Using the example of a novel telemedicine programme to support acutely unwell, community-dwelling COVID-19-positive patients called the London Urgent COVID-19 Care Clinic (LUC3), we show how continuous quality outcomes (safety, timeliness, equity and patient-centredness), as well as patient experience survey responses, can drive iterative changes in programme delivery. Results: The inspiration phase identified four key needs for this patient population: monitoring COVID-19 signs and symptoms; self-managing COVID-19 symptoms; managing other comorbidities in the setting of COVID-19; and escalating care as needed. Guided by these needs, a cross-disciplinary stakeholder group was engaged in the ideation and implementation phases to create a unique and comprehensive telemedicine programme (LUC3). During the implementation phase, LUC3 assessed 2202 community-based patients diagnosed with acute COVID-19; the collected quality outcomes and end-user feedback led to evolution of programme delivery. Conclusion: Design thinking methodology provided an essential framework and valuable lessons for the development of a safe, equitable, timely and patient-centred telemedicine care programme. The lessons learnt here-the importance of inclusive collaboration, using empathy to guide equity-focused interventions, leveraging continuous metrics to drive iteration and aiming for good-if-not-perfect plans-can serve as a road map for using design thinking for targeted healthcare problems.
MeSH term(s)	Humans ; Independent Living ; Pandemics ; COVID-19 ; Outpatients ; Ambulatory Care Facilities
Language	English
Publishing date	2024-02-26
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2399-6641
ISSN (online)	2399-6641
DOI	10.1136/bmjoq-2023-002500
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Article: Hemodynamics Indicates Differences Between Patients With And Without A Stroke Outcome After Left Ventricular Assist Device Implantation.

Sahni, Akshita / Majee, Sreeparna / Pal, Jay D / McIntyre, Erin E / Cao, Kelly / Mukherjee, Debanjan

medRxiv : the preprint server for health sciences

2023

Abstract: Stroke remains a leading cause of complications and mortality in heart failure patients treated with LVAD circulatory support. Hemodynamics plays a central role in affecting risk and etiology of stroke during LVAD support. Yet, detailed quantitative ... ...

Abstract	Stroke remains a leading cause of complications and mortality in heart failure patients treated with LVAD circulatory support. Hemodynamics plays a central role in affecting risk and etiology of stroke during LVAD support. Yet, detailed quantitative assessment of hemodynamic variables and their relation to stroke outcomes in patients with an implanted LVAD remains a challenge. We present an
Language	English
Publishing date	2023-08-08
Publishing country	United States
Document type	Preprint
DOI	10.1101/2023.08.03.23292572
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Article ; Online: The Relation Between Viscous Energy Dissipation and Pulsation for Aortic Hemodynamics Driven by a Left Ventricular Assist Device.

Sahni, Akshita / McIntyre, Erin E / Cao, Kelly / Pal, Jay D / Mukherjee, Debanjan

Cardiovascular engineering and technology

2023 Volume 14, Issue 4, Page(s) 560–576

Abstract: Left ventricular assist device (LVAD) provides mechanical circulatory support for patients with advanced heart failure. Treatment using LVAD is commonly associated with complications such as stroke and gastro-intestinal bleeding. These complications are ... ...

Abstract	Left ventricular assist device (LVAD) provides mechanical circulatory support for patients with advanced heart failure. Treatment using LVAD is commonly associated with complications such as stroke and gastro-intestinal bleeding. These complications are intimately related to the state of hemodynamics in the aorta, driven by a jet flow from the LVAD outflow graft that impinges into the aorta wall. Here we conduct a systematic analyses of hemodynamics driven by an LVAD with a specific focus on viscous energy transport and dissipation. We conduct a complementary set of analysis using idealized cylindrical tubes with diameter equivalent to common carotid artery and aorta, and a patient-specific model of 27 different LVAD configurations. Results from our analysis demonstrate how energy dissipation is governed by key parameters such as frequency and pulsation, wall elasticity, and LVAD outflow graft surgical anastomosis. We find that frequency, pulsation, and surgical angles have a dominant effect, while wall elasticity has a weaker effect, in determining the state of energy dissipation. For the patient-specific scenario, we also find that energy dissipation is higher in the aortic arch and lower in the abdominal aorta, when compared to the baseline flow without an LVAD. This further illustrates the key hemodynamic role played by the LVAD outflow jet impingement, and subsequent aortic hemodynamics during LVAD operation.
MeSH term(s)	Humans ; Heart-Assist Devices ; Aorta, Thoracic/surgery ; Hemodynamics ; Heart Failure/surgery ; Aorta, Abdominal
Language	English
Publishing date	2023-06-20
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2543111-0
ISSN	1869-4098 ; 1869-408X
ISSN (online)	1869-4098
ISSN	1869-408X
DOI	10.1007/s13239-023-00670-6
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