Support needs and experiences of young people living in families with mental illness

Introduction: Children and adolescents living in families affected by mental illness are at elevated risk of developing mental health problems. A range of interventions have been designed to help these young people; however, the effectiveness of these programs is, in some cases, mixed. Our aim was to understand in detail the support needs and experiences of a group of Australian children and adolescents living in families with mental illness. Methods: Our study is a qualitative in nature. In 2020−2021, we interviewed 25 Australian young people (Mage = 13.60, SD = 2.26, 20 females and 5 males) living with family members affected by mental illness to understand their (the young people's) experiences, and to identify the types of support that these young people considered important or effective. We conducted reflexive thematic analyses of interview data, underpinned by interpretivist assumptions. Results: We identified seven themes within two higher-order categories reflecting our aims to understand (1) lived experiences within families affected by mental illness (i.e., increased responsibilities, missing out, and stigmatization), and (2) support experiences, needs, and preferences (i.e., respite, shared experiences with like-minded others, education, and flexibility). Conclusions: Our findings hold substantial practical value by informing services, interventions, and conversations that better support young people living in families affected by mental illness

Exercise in the treatment of youth substance use disorders: Review and recommendations

Substance use disorders among youth represent a significant public health concern. It is well established that regular exercise provides important physical and mental health benefits; however, evidence for the role of exercise as an adjunct component within substance use disorder treatment is scarce. In this review, we identify factors associated with the development and persistence of substance use disorders among youth, identify current treatment modalities, and present evidence to support the efficacy of incorporating exercise participation during rehabilitation. We also provide a series of recommendations for future research that explores the feasibility and effectiveness of exercise participation as a complement to substance use disorder treatment among youth

Which Hop Tests Can Best Identify Functional Limb Asymmetry in Patients 9-12 Months After Anterior Cruciate Ligament Reconstruction Employing a Hamstrings Tendon Autograft?

# Background Hop tests are commonly employed to evaluate functional limb symmetry after anterior cruciate ligament reconstruction (ACLR). # Purpose To investigate the ability of eight hop tests to identify functional limb asymmetry in patients after ACLR. # Study Design Prospective cohort. # Methods Fifty patients were assessed 9-12 months following ACLR. Functional performance on both the operated and non-operated limb was assessed via eight hop tests, assessed in a randomised order. These included the: single (SHD), triple (THD) and triple crossover (TCHD) hop for distance, 6m timed hop (6MTH), single medial (MHD) and single lateral (LHD) hop for distance, single countermovement jump (SLCMJ) and timed speedy hop (TSHT). Differences in Limb Symmetry Indices (LSIs) across hop tests were compared, while Pearson’s correlations were undertaken to investigate the significance and strength of the association between hop test LSIs. # Results Significant differences were observed across hop LSIs (p\<0.0001). Mean LSIs for the SHD (95.0%), 6MTH (95.0%), THD (96.1%) and TCHD (95.3%) were ≥90% and significantly greater (p\<0.05) than the MHD (87.3%), LHD (87.5%), SLCMJ (83.4%) and TSHT (86.5%), which were all \<90%. The LSI for the SLCMJ was significantly lower (p\<0.05) than all other hop tests. While significant correlations existed across the majority of hop LSIs, the strongest correlations existed between the SHD, THD and TCHD (r=0.70-0.80), and lowest correlations between the TSHT and the other hop tests (r=0.26-0.49). # Conclusions The LHD, MHD and TSHT, as well as the SLCMJ in particular, were best able to demonstrate functional limb asymmetry in patients following ACLR. These hop measures should be incorporated into hop test batteries, if the purpose is to detect the presence of lingering functional deficits. # Level of Evidence Level 3

Characteristics and quality of life of patients presenting to cancer support centres: Patient rated outcomes and use of complementary therapies

Background: In order to effectively target and provide individualised patient support strategies it is crucial to have a comprehensive picture of those presenting for services. The purpose of this study was to determine the characteristics and patient rated outcomes of individuals presenting to SolarisCare cancer support centres and their choices regarding complementary and integrated therapies (CIT).Methods: A cohort with a current or previous cancer diagnosis aged 18 - 87 years presenting to a SolarisCare centre during a 5-day period completed a questionnaire. Four SolarisCare centres participated in the trial including regional and metropolitan locations. Outcomes included medical and demographic characteristics, CIT variables and patient rated outcomes (PROs) including quality of life (QoL).Results: Of the 95 participants (70.3%) who completed the survey, the mean age was 60.5 years with 62% currently receiving treatment. Eighty percent of the sample had at least one other comorbid condition, with the most popular CIT being relaxation massage. Of the PROs, QoL was significantly lower than norms for the Australian population and other mixed cancer populations. No notable differences were seen between genders, however significantly poorer outcomes were found for the younger age group. Fifty percent of the population did not meet physical activity recommendations, and musculoskeletal symptoms explained between 25-27% of variance in QoL.Conclusions: A greater understanding of the health profiles of patients presenting to supportive care centres and their use of CIT, provides Western Australian health professionals with key information to ensure the safety of supportive care practices, as well as fosters optimal patient outcomes and enhances the integration of supportive care strategies within mainstream medical care

Positive patient experiences in an Australian integrative oncology centre

Background: The purpose of this study was to explore the experiences of cancer patients\u27 utilising complementary and integrative therapies (CIT) within integrative oncology centres across Western Australia.Methods: Across four locations 135 patients accessed CIT services whilst undergoing outpatient medical treatment for cancer. Of the 135 patients, 66 (61 ± 12 y; female n = 45; male n = 21) agreed to complete a personal accounts questionnaire consisting of open-ended questions designed to explore patients\u27 perceptions of CIT. All results were transcribed into nVivo (v9) and using thematic analysis, key themes were identified.Results: Of the 66 participants, 100% indicated they would recommend complementary therapies to other patients and 92% stated CIT would play a significant role in their future lifestyle . A mean score of 8 ± 1 indicated an improvement in participants\u27 perception of wellbeing following a CIT session. Three central themes were identified: empowerment, support and relaxation. Fourteen sub-themes were identified, with all themes clustered into a framework of multifaceted views held by cancer patients in relation to wellbeing, role of significant others and control.Conclusions: Exploration of patients\u27 experiences reveals uniformly positive results. One of the key merits of the environment created within the centres is patients are able to work through their cancer journey with an increased sense of empowerment, without placing them in opposition to conventional medical treatment. In order to effectively target integrative support services it is crucial to explore the experiences of patients in their own words and use those forms of expression to drive service delivery

An analysis of exercise science and exercise physiology work-integrated learning supervision in Australia

Currently, 33 Universities in Australia offer exercise science (ES) and/or exercise physiology (EP) programs linked to Exercise and Sports Science Australia (ESSA). Within these programs, work-integrated learning (WIL) is a mandated component for all enrolled students. Paramount to successful delivery of WIL is adequate, competent practicum supervision. This, in turn, is essential to evidence-based practice training and development of work-ready ES and EP students. However, while these industry professionals are key leaders in WIL, there is significant variability in supervisory practice, including experience, training and approach to supervision. This research aims to identify characteristics and demographic profile of supervisors in this setting, as well as capture their experience and perceived needs to better support ES and EP students on WIL placement. It builds on previous research, a report published by researchers from four Australian Universities on the state of EP placement supervision across Australia (Sealey et al., 2013). While this research provided a valuable starting point from which to develop evidence-based support, the industry has since changed and grown exponentially. For example, 4,481 students in 2018 alone commencing an ES, EP or combined degree, making collection of such data imperative to forecast industry ability to provide sufficient WIL and areas for expansion. Additionally, earlier studies did not include ES-related WIL, which is a prerequisite and provides foundation clinical WIL for those students progressing to EP. Survey data collected captured both quantitative and qualitative information to gain a broader perspective of the supervision landscape. This information will provide crucial base-line data of the current WIL environment across Australia and enable the development and delivery of targeted support and training for supervisors, and ultimately the students placed under their leadership

The Stride program: Feasibility and pre-to-post program change of an exercise service for university students experiencing mental distress

Rates of mental illness are disproportionately high for young adult and higher education (e.g., university student) populations. As such, universities and tertiary institutions often devote significant efforts to services and programs that support and treat mental illness and/or mental distress. However, within that portfolio of treatment approaches, structured exercise has been relatively underutilised and greater research attention is needed to develop this evidence base. The Stride program is a structured 12-week exercise service for students experiencing mental distress. We aimed to explore the feasibility of the program and assess pre- and post-program change, through assessments of student health, lifestyle, and wellbeing outcomes. Drawing from feasibility and effectiveness-implementation hybrid design literatures, we conducted a non-randomised feasibility trial of the Stride program. Participants were recruited from the Stride program (N = 114, Mage = 24.21 years). Feasibility results indicated the program was perceived as acceptable and that participants reported positive perceptions of program components, personnel, and sessions. Participants’ pre-to-post program change in depressive symptomatology, physical activity levels, mental health-related quality of life, and various behavioural outcomes were found to be desirable. Our results provide support for the feasibility of the Stride program, and more broadly for the delivery and potential effectiveness of structured exercise programs to support university students experiencing mental distress

Structured exercise programs for higher education students experiencing mental health challenges: background, significance, and implementation

The incidence of mental illness is greatest among young adults, and those enrolled in higher education may be particularly vulnerable compared to the general young adult population. Many higher education institutions employ student support staff tasked with implementing strategies to improve student wellbeing and mental illness. However, these strategies tend to be focused on clinical therapies and pharmacological interventions with limited lifestyle approaches. Exercise is an effective method for addressing mental illness and promoting wellbeing, yet widespread provision of structured exercise services to support treatment options for students with mental health challenges has not been fully realized. In an effort to guide exercise strategies for student mental health, we synthesize considerations for developing and delivering exercise programs in higher education settings. We draw directly from the evidence base on existing exercise programs in higher education; and the broader behavior change, exercise adherence, health psychology, implementation science, and exercise prescription literatures. Our broad considerations cover issues regarding program engagement and behavior change, exercise ‘dose’ and prescription, integration with other on-campus services, and robust research and evaluation. These considerations may provide impetus for widespread program development and implementation, as well as informing research focused on protecting and improving student mental health

Structured exercise programs for higher education students experiencing mental health challenges: background, significance, and implementation

The incidence of mental illness is greatest among young adults, and those enrolled in higher education may be particularly vulnerable compared to the general young adult population. Many higher education institutions employ student support staff tasked with implementing strategies to improve student wellbeing and mental illness. However, these strategies tend to be focused on clinical therapies and pharmacological interventions with limited lifestyle approaches. Exercise is an effective method for addressing mental illness and promoting wellbeing, yet widespread provision of structured exercise services to support treatment options for students with mental health challenges has not been fully realized. In an effort to guide exercise strategies for student mental health, we synthesize considerations for developing and delivering exercise programs in higher education settings. We draw directly from the evidence base on existing exercise programs in higher education; and the broader behavior change, exercise adherence, health psychology, implementation science, and exercise prescription literatures. Our broad considerations cover issues regarding program engagement and behavior change, exercise ‘dose’ and prescription, integration with other on-campus services, and robust research and evaluation. These considerations may provide impetus for widespread program development and implementation, as well as informing research focused on protecting and improving student mental health

TEST-RETEST RELIABILITY OF THE AEROBIC POWER INDEX SUBMAXIMAL EXERCISE TEST IN CANCER PATIENTS

The purpose of this study was to investigate the reliability of the Aerobic Power Index (API) submaximal cardiorespiratory exercise test, as well as associated variables of oxygen uptake (ml·kg-1·min-1) and ratings of perceived exertion (RPE) in cancer patients who are generally unable to complete maximal or lengthy aerobic fitness tests. Twenty male and female participants (11 male; 9 female) aged between 18 and 70 y (mean = 53.28 ± 11. 82 y) were recruited with medical consent within 4 weeks of completing chemotherapy treatment for a lymphohaematopoietic cancer (LHC). Of the twenty recruited participants' 2 were excluded from analysis due to disease relapse or complications unrelated to testing occurring within the month following testing. Intra-class correlation coefficient (ICC) scores for power output (W·kg-1) and oxygen uptake (ml·kg-1·min-1) were highly reliable (R1 = 0.96 and 0.96, respectively) and the ICC for RPE was moderately reliable (R1 = 0.83). Technical error of measurement results for power output (W·kg-1), oxygen uptake (ml·kg-1·min-1) and RPE were 0.11W·kg-1, 1.18 ml·kg-1·min-1 and 1.0 respectively. A Pearson's product-moment correlation demonstrated a strong relationship between power output (W·kg-1) and oxygen uptake (ml·kg-1·min-1) for both trials (r = 0.93 and 0.89, respectively). Results demonstrate that the API test is a highly reliable protocol for use with a LHC population and can be considered a clinically feasible, safe and tolerable exercise tes