Informing the development of Australia's national eating disorders research and translation strategy : a rapid review methodology

Background Eating disorders (EDs) are highly complex mental illnesses associated with significant medical complications. There are currently knowledge gaps in research relating to the epidemiology, aetiology, treatment, burden, and outcomes of eating disorders. To clearly identify and begin addressing the major deficits in the scientific, medical, and clinical understanding of these mental illnesses, the Australian Government Department of Health in 2019 funded the InsideOut Institute (IOI) to develop the Australian Eating Disorder Research and Translation Strategy, the primary aim of which was to identify priorities and targets for building research capacity and outputs. A series of rapid reviews (RR) were conducted to map the current state of knowledge, identify evidence gaps, and inform development of the national research strategy. Published peer-reviewed literature on DSM-5 listed EDs, across eight knowledge domains was reviewed: (1) population, prevalence, disease burden, Quality of Life in Western developed countries; (2) risk factors; (3) co-occurring conditions and medical complications; (4) screening and diagnosis; (5) prevention and early intervention; (6) psychotherapies and relapse prevention; (7) models of care; (8) pharmacotherapies, alternative and adjunctive therapies; and (9) outcomes (including mortality). While RRs are systematic in nature, they are distinct from systematic reviews in their aim to gather evidence in a timely manner to support decision-making on urgent or high-priority health concerns at the national level. Results Three medical science databases were searched as the primary source of literature for the RRs: Science Direct, PubMed and OVID (Medline). The search was completed on 31st May 2021 (spanning January 2009-May 2021). At writing, a total of 1,320 articles met eligibility criteria and were included in the final review. Conclusions For each RR, the evidence has been organised to review the knowledge area and identify gaps for further research and investment. The series of RRs (published separately within the current series) are designed to support the development of research and translation practice in the field of EDs. They highlight areas for investment and investigation, and provide researchers, service planners and providers, and research funders rapid access to quality current evidence, which has been synthesised and organised to assist decision-making

Characterization of a novel alpha-conotoxin TxID from Conus textile that potently blocks rat alpha3/beta4 nicotinic acetylcholine receptors

The alpha 3 beta 4 nAChRs are implicated in pain sensation in the PNS and addiction to nicotine in the CNS. We identified an alpha-4/6-conotoxin (CTx) TxID from Conus textile. The new toxin consists of 15 amino acid residues with two disulfide bonds. TxID was synthesized using solid phase methods, and the synthetic peptide was functionally tested on nAChRs heterologously expressed in Xenopus laevis oocytes. TxID blocked rat alpha 3 beta 4 nAChRs with a 12.5 nM IC50, which places it among the most potent alpha 3 beta 4 nAChR antagonists. TxID also blocked the closely related alpha 6/alpha 3 beta 4 with a 94 nM IC50 but showed little activity on other nAChR subtypes. NMR analysis showed that two major structural isomers exist in solution, one of which adopts a regular alpha-CTx fold but with different surface charge distribution to other 4/6 family members. alpha-CTx TxID is a novel tool with which to probe the structure and function of alpha 3 beta 4 nAChRs

Beliefs of adolescent girls concerning the severity and prevalence of bulimia nervosa

The beliefs of adolescent girls concerning an eating disorder problem were investigated. A vignette describing a fictional 16-year-old girl meeting diagnostic criteria for bulimia nervosa (BN) was presented to 522 high school students, followed by a series of questions concerning the severity and prevalence of the problem described. Most respondents believed that BN is a serious problem whose sufferers are deserving of sympathy. However, BN was perceived to be common among adolescent girls, far more common than estimates from epidemiological research would suggest, and many participants had at some stage thought that it “might not be too bad” to have such a problem. In addition, participants with a high level of eating disorder symptoms considered the prevalence of BN to be higher, and its symptoms more acceptable, than asymptomatic participants. These findings suggest that the perception of bulimic behaviours as normative and/or desirable may need to be addressed in prevention programs

Co-designing a point-of-care Digital Decision Support Tool for GPs to better identify and support people with an eating disorder in primary care.

Background: Eating Disorders (EDs) are common and can be difficult to identify and treat. General Practitioners (GPs) report feeling out of their depth with this client group and don’t have access to the specialist supports required. Clinical Decision Support Tools (CDST) can synthesise and simplify evidence for busy practitioners at the point of care; evidence is emerging for their use in a range of settings. InsideOut Institute is undertaking an Australian government funded project to develop a CDST for GPs to better identify and treat people with EDs using evidence-based information. Aims: This presentation will outline the agile development process of a CDST that provides evidence-based feedback to GPs and integrates with GP workflows and technology.Methods: Process Analysis included nationwide consultation & participatory human-centred co-design process with GPs and consumers/carers, plus review of GP workflow and practice software systems. Six key elements were identified for development using agile methodology (user testing incorporated at all stages to gain feedback and insight on use/further development of the tool). Results: The CDST is in the final stage of development, due for completion June 2022. Roll-out and evaluation will then be required. The Process Analysis phase identified a clear need for decision support for GPs to better identify, diagnose and manage people with EDs using evidence-based information; and the need for a solution to ensure integration of the CDST with practice software and workflow processes to optimise ease of uptake. Conclusions: Clarification of content and context will help ensure the CDST will be useful, adaptable and fully integrate

Mental Health in Nursing: Theory and Practice for Clinical Settings

The 5th edition of this highly regarded text has a new title and approach which builds on the foundations of previous editions to acknowledge mental health as essential to holistic nursing practice in every setting. Written by Kim Foster, Peta Marks, Anthony O’Brien and Toby Raeburn - a team of highly respected mental health nursing educators, researchers and clinicians, the new edition has been carefully reorganised to reflect contemporary mental health nursing practice and highlight the value of consumer perspectives. With a key focus on specialist mental health nursing, the new chapters introduce the integration of mental health nursing knowledge and skills across a range of generalist and mental health clinical settings. Mental Health in Nursing, 5th edition is an invaluable resource for all nursing students, whatever their practice area