New South Wales Vegetation Classification and Assessment : part 1, plant communities of the NSW Western Plains

For the Western Plains of New South Wales, 213 plant communities are classified and described and their protected area and threat status assessed. The communities are listed on the NSW Vegetation Classification and Assessment database (NSWVCA). The full description of the communities is placed on an accompanying CD together with a read-only version of the NSWVCA database. The NSW Western Plains is 45.5 million hectares in size and covers 57% of NSW. The vegetation descriptions are based on over 250 published and unpublished vegetation surveys and maps produced over the last 50 years (listed in a bibliography), rapid field checks and the expert knowledge on the vegetation. The 213 communities occur over eight Australian bioregions and eight NSW Catchment Management Authority areas. As of December 2005, 3.7% of the Western Plains was protected in 83 protected areas comprising 62 public conservation reserves and 21 secure property agreements. Only one of the eight bioregions has greater than 10% of its area represented in protected areas. 31 or 15% of the communities are not recorded from protected areas. 136 or 64% have less than 5% of their pre-European extent in protected areas. Only 52 or 24% of the communities have greater than 10% of their original extent protected, thus meeting international guidelines for representation in protected areas. 71 or 33% of the plant communities are threatened, that is, judged as being ‘critically endangered’, ‘endangered’ or ‘vulnerable’. While 80 communities are recorded as being of ‘least concern’ most of these are degraded by lack of regeneration of key species due to grazing pressure and loss of top soil and some may be reassessed as being threatened in the future. Threatening processes include vegetation clearing on higher nutrient soils in wetter regions, altered hydrological regimes due to draw-off of water from river systems and aquifers, high continuous grazing pressure by domestic stock, feral goats and rabbits, and in some places native herbivores — preventing regeneration of key plant species, exotic weed invasion along rivers and in fragmented vegetation, increased salinity, and over the long term, climate change. To address these threats, more public reserves and secure property agreements are required, vegetation clearing should cease, re-vegetation is required to increase habitat corridors and improve the condition of native vegetation, environmental flows to regulated river systems are required to protect inland wetlands, over-grazing by domestic stock should be avoided and goat and rabbit numbers should be controlled and reduced. Conservation action should concentrate on protecting plant communities that are threatened or are poorly represented in protected areas

Clinically Applicable Sociolinguistic Assessment for Cognitive-Communication Disorders

Purpose: The third International Cognitive-Communication Disorders Conference was held in early 2022, providing an opportunity for researchers and clinicians to discuss management of cognitive-communication disorders (CCDs). Presentations that addressed social discourse initiated broader conversations about implementing sociolinguistic methods in research and clinical contexts. Given the heterogeneity of CCDs and sociocultural contexts, a person-centered approach is needed. Sociolinguistic methods are inherently relevant and salient to the individual\u27s communication context and partners. Sociolinguistic analyses provide information about language skills, cognitive-communication skills, and social cognition. The purpose of this article is to share a model of social communication and provide descriptions of current methods that can be used by researchers and clinicians to capture the complexity of social communication, thereby advancing our knowledge and practice. Conclusion: Although there is a growing literature base that supports the inclusion of sociolinguistic methods, there remains a disconnect between the literature and clinical application that current researchers and practitioners have an opportunity to address

Maternal distress in late pregnancy alters obstetric outcomes and the expression of genes important for placental glucocorticoid signalling

The experience of maternal distress in pregnancy is often linked with poorer obstetric outcomes for women as well as adverse outcomes for offspring. Alterations in placental glucocorticoid signalling and subsequent increased fetal exposure to cortisol have been suggested to underlie this relationship. In the current study, 121 pregnant women completed the Perceived Stress Scale, State Trait Anxiety Inventory and Edinburgh Postnatal Depression Scale in the third trimester of pregnancy. Placental samples were collected after delivery. Maternal history of psychiatric illness and miscarriage were significant predictors of poorer mental health in pregnancy. Higher anxiety was associated with an increase in women delivering via elective Caesarean Section, and an increase in bottle-feeding. Birth temperature was mildly reduced among infants of women with high levels of depressive symptomology. Babies of mothers who scored high in all stress (cumulative distress) measures had reduced 5-min Apgar scores. High cumulative distress reduced the expression of placental HSD11B2 mRNA and increased the expression of placental NR3C1 mRNA. These data support a role for prenatal distress as a risk factor for altered obstetric outcomes. The alterations in placental gene expression support a role for altered placental glucocorticoid signalling in the relationship between maternal prenatal distress and adverse outcomes

Fidelity protocol for the Action Success Knowledge (ASK) trial: A psychosocial intervention administered by speech and language therapists to prevent depression in people with post-stroke aphasia

Introduction: Treatment fidelity is a complex, multifaceted evaluative process which refers to whether a studied intervention was delivered as intended. Monitoring and enhancing fidelity is one recommendation of the TiDIER (Template for Intervention Description and Replication) checklist, as fidelity can inform interpretation and conclusions drawn about treatment effects. Despite the methodological and translational benefits, fidelity strategies have been used inconsistently within health behaviour intervention studies; in particular, within aphasia intervention studies, reporting of fidelity remains relatively rare. This paper describes the development of a fidelity protocol for the Action Success Knowledge (ASK) study, a current cluster randomised trial investigating an early mood intervention for people with aphasia (a language disability caused by stroke). Methods and analysis: A novel fidelity protocol and tool was developed to monitor and enhance fidelity within the two arms (experimental treatment and attention control) of the ASK study. The ASK fidelity protocol was developed based on the National Institutes of Health Behaviour Change Consortium fidelity framework. Ethics and dissemination: The study protocol was approved by the Darling Downs Hospital and Health Service Human Research Ethics Committee in Queensland, Australia under the National Mutual Acceptance scheme of multicentre human research projects. Specific ethics approval was obtained for those participating sites who were not under the National Mutual Agreement at the time of application. The monitoring and ongoing conduct of the research project is in line with requirements under the National Mutual Acceptance. On completion of the trial, findings from the fidelity reviews will be disseminated via publications and conference presentations. Trial registration number ACTRN12614000979651

Measuring service encounters with the traumatic brain injury population

Functional therapy tasks are frequently cited as being important for the successful carry-over of treatment objectives. Service encounters, such as shopping or enquiring for information on the telephone, are typical community integration activities used with the traumatically brain injured (TBI) population. This paper explores the use of systemic functional linguistics in the measurement of performance in service encounters using Generic Structure Potential (GSP) analysis. Results are presented for GSP analysis of service encounters on the telephone to a bus timetable information service, and the police, for five TBI individuals and five matched controls. Service encounters differed according to the complexity of information requested and the interpersonal, or tenor relationships between participants. Differences were evident between TBI and control interactions in the use of generic structural elements. Variation in generic structure was demonstrated across the two types of service encounter. The potential of GSP to measure the dynamic linguistic patterns in everyday TBT interactions is discussed

What guides student learning in the clinical years: A mixed methods study exploring study behaviours prior to the UK Medical Licensing Assessment (UKMLA).

PURPOSE: Student study behaviours that prioritise the UKMLA content map over the local curriculum are a significant risk for UK medical education. To mitigate this, we describe a student-centred faculty process to improve local curriculum guidance based on an evaluation of student study behaviours, concerns and needs. Responses informed the build of an online curriculum map. METHODS: A mixed methods approach was adopted, including an online anonymous survey exploring student study behaviours and preferences for curricular guidance. This was followed by student-led focus groups to explore emergent themes further. Qualitative data underwent reflexive thematic analysis. RESULTS: 121 students responded to the survey, of which 12 consented to participate in two student-led focus groups. Five key themes emerged, including motivation for learning, student use of the intended curriculum, student experience of the enacted curriculum, the hidden curriculum, and expectations of an online curriculum map. CONCLUSIONS: A participatory framework enabled shared aims and responsive outcomes for curricular development in the run up to the UKMLA. Student responses led to clarification of guidance, reorganisation of learning resources and optimal design of an online curriculum map which linked all content in a visible, UKMLA aligned framework, accessible to all students and teachers

Statistical analysis plan for the COMPARE trial: a 3-arm randomised controlled trial comparing the effectiveness of Constraint-induced Aphasia Therapy Plus and Multi-modality Aphasia Therapy to usual care in chronic post-stroke aphasia (COMPARE)

BackgroundWhile high-quality meta-analyses have confirmed the effectiveness of aphasia therapy after stroke, there is limited evidence for the comparative effectiveness of different aphasia interventions. Two commonly used interventions, Constraint-induced Aphasia Therapy Plus (CIAT Plus) and Multi-modality Aphasia Therapy (M-MAT), are hypothesised to rely on diverse underlying neural mechanisms for recovery and may be differentially responsive to aphasia severity. COMPARE is a prospective randomised open-blinded end-point trial designed to determine whether, in people with chronic post-stroke aphasia living in the community, CIAT Plus and M-MAT provide greater therapeutic benefit compared to usual care, are differentially effective according to aphasia severity, and are cost-effective. This paper details the statistical analysis plan for the COMPARE trial developed prior to data analysis.MethodsParticipants (n = 216) are randomised to one of three arms, CIAT Plus, M-MAT or usual care, and undertake therapy with a study trained speech pathologist in groups of three participants stratified by aphasia severity. Therapy occurs for 3 h blocks per day for 10 days across 2 weeks. The primary clinical outcome is aphasia severity as measured by the Western Aphasia Battery-Revised Aphasia Quotient (WAB-R-AQ) immediately post intervention. Secondary outcomes include WAB-R-AQ at 12-week follow-up, and functional communication, discourse efficiency, multimodal communication, and health-related quality of life immediately post intervention and at 12-week follow-up.ResultsLinear mixed models (LMMs) will be used to analyse differences between M-MAT and UC, and CIAT-Plus and UC on each outcome measure immediately and at 12 weeks post-intervention. The LMM for WAB-R-AQ will assess the differences in efficacy between M-MAT and CIAT-Plus. All analyses will control for baseline aphasia severity (fixed effect) and for the clustering effect of treatment groups (random effect).DiscussionThis trial will provide relative effectiveness data for two common interventions for people with chronic post-stroke aphasia, and highlight possible differential effects based on aphasia severity. Together with the health economic analysis data, the results will enable more informed personalised prescription for aphasia therapy after stroke.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN 12615000618550 . Registered on 15 June 2016

Placental FKBP51 mediates a link between second trimester maternal anxiety and birthweight in female infants

Abstract Prenatal distress is associated with adverse outcomes in affected offspring. Alterations in placental glucocorticoid signalling and subsequent foetal overexposure to glucocorticoids have been implicated as an underlying mechanism. Infant sex is emerging as an important factor in disease susceptibility. This study aimed to examine the effects of maternal distress across pregnancy on birth outcomes and placental glucocorticoid genes in a sex-dependent manner. Participants completed psychological distress questionnaires throughout pregnancy. Placental HSD11B2, NR3C1 and FKBP51 were analysed by real time PCR and cortisol was measured in new-born hair. Second trimester stress was negatively correlated with birthweight in males and positively correlated with placental NR3C1 mRNA in females. Second trimester anxiety was negatively correlated with birthweight and placental FKBP51 mRNA in females. In mediation analysis, placental FKBP51 mRNA expression was found to mediate the link between prenatal anxiety and birthweight. New-born cortisol was negatively correlated with second trimester anxiety and positively correlated with female placental FKBP51 mRNA levels. Again, FKBP51 mRNA was found to mediate the link between anxiety and new-born cortisol. These results highlight a role for FKBP51 in the placental response to prenatal distress in females. The precise role that placental FKBP51 has in foetal and infant development has not been extensively studied and warrants further investigations