Macquarie Medical Imaging (MMI) has acquired new state-of-the-art equipment designed to make having a mammogram a more comfortable experience while returning some control to the patient.

A clear image is reliant on compressing the breast tissue between the machine’s plates, both horizontally and vertically, making it anything between uncomfortable and extremely painful for patients.

However, the new GE Senographe Pristina is the first digital breast tomosynthesis (DBT) system to allow the patient to control the level of compression.

In clinical trials, this feature has been shown to not only reduce pain but also provide a better image, as when patients are in control, they tend to choose more than the minimum level of compression necessary for a clear image.

The Pristina has soft, curved surfaces and arm rests that allow the patient to relax their muscles, while older-style machines have hand grips that encourage them to tense up.

It also features 3D imaging that provides superior diagnostic accuracy for radiographers while delivering the same amount of radiation as 2D imaging equipment.

MMI Lead Radiographer, Kirstin Geyer, says having a mammogram has traditionally been a stressful, painful time for many women.

“When someone comes in for a mammogram, they may have found a lump or have had their own experience or family history of breast cancer, and there is understandably a lot of fear and anxiety associated with that,” she says.

“The compression, the hard, cold surfaces of some equipment and the uncomfortable positions they require only add to that.

“We anticipate this new machine will help make the experience better by giving the patient some control over the process. Our radiographers are here to fully support them every step of the way.”

The new machine was delivered and commissioned in the first week of October and used for the first time this week.

The clinic is one of the first in Australia to offer GLA:D BACK, which was developed by the University of Southern Denmark.

The nine-week program is suitable for adults of all ages who have had recurring lower back pain for at least three months and who do not have other significant health issues.

Following an initial consultation for assessment and goal setting, patients complete two education sessions, then 16 exercise classes that include back and leg strengthening that they can continue to do at home after completing the course.

One of GLA:D BACK’s key benefits is its strong evidence base. Researchers from Macquarie’s Department of Health Sciences have been working with the University of Southern Denmark to evaluate the program in Australia since 2019 and are continuing to collect data.

The latest research report showed that immediately after completing the course, patients reported a 31 per cent drop in the intensity of their pain, and their physical function improved by 25 per cent.

MQ Health Associate Physiotherapist Philip Arndt says GLA:D BACK is different from other treatments in that it helps people understand their pain better and manage it in the long term.

“The focus is on regaining natural movement patterns and reinforcing key messages about back pain, such as exercise strengthens the back, and pain does not equal harm,” he says.

“Maintaining back strength and flexibility is beneficial for managing pain, so we encourage people to continue doing the exercises they learn through GLA:D BACK after they finish the course.”

The cost of the initial consultation and group exercise sessions can be partially covered by physiotherapy extras for people holding private health insurance. Medicare can subsidise up to five visits to a physiotherapist if your GP completes a chronic conditions treatment plan.

MQ Health Physiotherapy also offers the GLA:D Hip and Knee program, which works on similar principles and is targeted to people with osteoarthritis of the hip or knee.

Contact MQ Health Physiotherapy Clinic to discuss whether GLA:D BACK or GLA:D Hip and Knee are suitable for your condition.

Learn more about what GLA:D BACK involves

Training is also available at Macquarie University for physiotherapists and chiropractors who want to provide GLA:D BACK to their patients.

Speech Pathology Manager Prue Gourley says MQ Health’s Speech and Hearing Clinic regularly helps Macquarie University staff and students who stutter and want to learn strategies so they can feel more comfortable presenting.

“Presenting to groups is a big part of academic life, whether you’re an MRes student, a lecturer or a researcher who wants to speak at conferences,” says Ms Gourley.

“Stuttering tends to be made worse by anxiety, so the situations where we feel the most pressure to perform can also feel like the hardest to overcome.

“There is no cure for stuttering, but we can help you learn behavioural strategies that can be very effective in managing it.

“Being disempowered from communicating is debilitating, but there are options. Stuttering doesn’t have to hold you back from what you want to achieve.”

The condition usually starts in childhood, but the cause remains unknown. Boys stutter more than girls and about 80 per cent of children who stutter experience spontaneous resolution within 12 to 24 months.

For adults who stutter, different strategies will work for different people, with two of the most common interventions being self-imposed timeout and speech restructuring.

In self-imposed timeout, the person learns to pause when they feel a stutter coming on, while speech restructuring involves learning to speak to a different pattern, slightly elongating words. This latter strategy is used by President Biden.

Clients will usually do a block of intensive weekly sessions with a speech pathologist, followed by refreshers as required.

Services at the MQ Health Speech and Hearing Clinic are provided by Masters of Speech Pathology students under the supervision and guidance of certified practising speech pathologists.

They support both adults and children, and therapy can be provided face-to-face, or by phone, Zoom or Teams.

For more information about the clinic’s services, or to request an appointment, visit the MQ Health website.

Dr Josephine Chau, Senior Lecturer in Public Health, Department of Health Sciences

Many workplaces have adopted sit-stand desks, which allow you to sit down or stand up with the push of a button or lever, to reduce the harms of prolonged sitting.

But how much better is standing? And are there risks of too much standing? Here’s what the research says about the risks of too much sitting and standing, and whether it’s worth investing in – or ditching – a sit-stand desk.

What are the hazards of too much sitting?

People who sit a lot have higher chances of developing chronic diseases such as type 2 diabetes, heart disease and some cancers, and having a shorter lifespan. Prolonged sitting can also lead to musculoskeletal complaints, particularly in the neck and back.

Excessive sitting is even more harmful to health among people who do very little exercise or who do not meet the recommended levels of physical activity.

Being physically active is important for reducing the health risks linked to being sedentary, but it may not fully cancel out the negative effects of spending long hours sitting each day.

Prolonged standing can be harmful too

Extended periods of standing can be harmful to musculoskeletal health. Prolonged standing may lead to musculoskeletal symptoms such as muscle fatigue, leg swelling, varicose veins, and pain and discomfort in the low back and lower extremities (hips, knees, ankles and feet).

Recent research suggests limiting standing to about 40 minutes at a time, without a break, would reduce the chances of developing muscle and joint aches and pains due to prolonged standing. This applies to people who may or may not have had symptoms before.

Not everyone who stands for prolonged periods will experience these musculoskeletal symptoms, and some people may be more resilient to the effects of prolonged standing than others.

However, even if you take a break from standing, if you have previously developed standing-related aches and pains, you’re more likely to experience them again when you resume standing.

Break up extended periods of sitting

Reducing or interrupting sitting by standing up or moving around can improve your blood circulation, metabolism, heart health, mental health and lifespan.

Modelling studies show that swapping one hour of sitting each day for one hour of standing leads to improvements in waist circumference, fat and cholesterol levels.

The benefit is even greater when sitting is replaced with walking or moderate-to-vigorous activity.

Interrupting prolonged sitting time with as little as two minutes of walking every 20 minutes or five minutes of walking every 30 minutes can improve blood glucose, fat and cholesterol levels.

Other research shows breaking up prolonged sitting time with three minutes of light walking or simple resistance exercises, such as squats and calf raises, every 30 minutes is also effective.

The evidence on sit-stand desks

Sit-stand desks can effectively reduce sitting time during the workday among desk-based workers. Sit-stand desk users tend to alternate between sitting and standing postures, instead of standing up for extended periods.

However, the extent of developing a new habit of working while standing up varies, and many users revert to their previous way of working sitting down in the longer term.

Sit-stand desks alone are not sufficient to reduce desk-based workers’ sitting time. Employers and organisations must factor this into their workplace policies, environment and culture to ensure “sit less and move more” initiatives are effectively delivered and sustained.

Should I ditch my sit-stand desk?

If you already have a sit-stand desk, whether you should keep or get rid of it will depend on a range of factors.

Think about your usage patterns. Do you use your desk regularly in a standing position, or do you mainly use it sitting down?

Consider your comfort. Does standing or sitting for prolonged periods while working lead to any discomfort or fatigue in your body? If so, you may need to adjust your sit-stand routine or include extra supports, such as a floor mat for more comfortable standing or a foot rest for safer sitting, to avoid injury.

Assess your desk ergonomics. Is your sit-stand desk set up ergonomically safe for working in both sitting and standing positions? Proper ergonomics are essential to ensure you work in a safe and comfortable way in the office and from home.

Reflect on your health needs. Will reducing and breaking up prolonged sitting time with standing alleviate discomfort due to sitting or contribute to improving your metabolic and heart health? Standing up and moving around regularly throughout the workday will achieve similar benefits regardless of your desk type.

If you have an existing health condition or ongoing musculoskeletal symptoms, seek advice from a health care professional or ask your employer about organising an assessment with an ergonomics specialist. Expert guidance can help you make an informed decision about your sit-stand desk.

Finally, weigh up the cost and space requirements of your sit-stand desk. If you are not using it in a standing position much, maybe it’s just taking up space and not providing a return on your investment.

Ultimately, the decision to keep or ditch your sit-stand desk will come down to a balance of these considerations.

Being physically active is most important

Physical activity guidelines from governments and health-related agencies, such as those from Australia and the World Health Organization, recommend adults limit the amount of time spent sitting. Interrupting and replacing sitting time with physical activity of any intensity – even light intensity – has health benefits.

The WHO further recommends adults “aim to do more than the recommended levels of moderate- to vigorous-intensity physical activity” to reduce the harmful health effects of high levels of sitting.

In other words, just standing is not enough to reduce the harms of prolonged sitting. We need to sit less and move more.

Josephine Chau, Senior Lecturer in Public Health, Macquarie University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The Woolcock Institute of Medical Research’s Professor Ron Grunstein, a sleep expert of more than 30 years, says the Woolcock has commenced a world-first program of research into orexin agonists – a class of drugs that stimulate receptors for the neurotransmitter orexin – that is absent or lacking in patients with narcolepsy.

Narcolepsy – a chronic condition that affects up to 6,000 Australians – is characterised by excessive daytime sleepiness, sleep paralysis, dream-like hallucinations, automatic behaviour, and, in the case of about 60 to 70 per cent of patients, cataplexy – the partial or total loss of muscle control in response to emotion such as laughter.

Cataplexy, hallucinations and sleep paralysis are all manifestations of rapid eye movement sleep intruding into wakefulness.

Little is known about the mechanisms that underpin this disorder, but patients with narcolepsy and cataplexy have low or undetectable levels of orexin in the fluid surrounding the brain.

Only a small group of neurons in the lateral hypothalamus (a part of your brain that controls behaviours like sleep, hunger, body temperature and arousal) make orexins. In turn, these neurons project widely to brain centres that promote alertness. Orexin signalling to other parts of the brain prevent cataplexy, hallucinations and sleep paralysis.

In classic narcolepsy, there’s a degeneration or complete loss of orexin neurons, meaning that people with narcolepsy don’t make much or any orexin. In some other forms of severe sleepiness, there is a problem with orexin neuron signalling.

“There are a few companies developing different orexin-like drugs, and preliminary studies show that these drugs have a remarkable ability to keep people with narcolepsy awake and productive,” Professor Grunstein says.

Researchers from the Macquarie University Motor Neuron Disease (MND) Research Centre have been awarded more than $3 million in funding by Australian charity FightMND.

Professor Roger Chung and Dr Lyndal Henden received project grants, Associate Professor Kelly Williams and Dr Stephanie Rayner received fellowships, and student Flora Cheng received a PhD scholarship.

The funding focuses on investigating disruptions to molecular programming that cause MND; identifying further genetic mutations linked to the disease; developing a way to control gene therapies more precisely; understanding the causes of protein aggregation in neurons; developing a small-molecule treatment to clear away the build-up of pathological proteins in neurons; and furthering the understanding of these build-ups.

Professor Roger Chung: Discovery Grant – $1 million: This grant will fund a project that aims to identify how the disruption of molecular programming inside neurons causes MND. The research will use next-generation RNA sequencing techniques to develop a high-resolution map of gene expression in neurons and determine how those change in patients with MND.

Professor Chung has also received a $300,000 Impact Grant to fund research into developing a method for the precise control of therapeutic gene expression resulting from gene therapy. Currently, when gene therapy is administered, it expresses the therapeutic transgene continuously to work throughout the patient’s life. This project aims to develop a way of allowing the therapy to be switched off when it has fulfilled its purpose.

Associate Professor Kelly Williams: Mid-career Fellowship – $680,000: Uncovering disease-causing genes in MND has transformed clinical practice and led to the development of gene therapies. During this four-year fellowship, three complimentary research projects will aim to identify genes with links to inherited MND, sporadic (or non-familial) MND, and instances where only one twin in a pair develops the disease. Large-scale national and international genomics resources will be used, including those generated from samples in the Macquarie University Neurodegenerative Diseases Biobank.

Dr Stephanie Rayner: Early-career Fellowship – $580,000: TDP-43 is a protein that builds up in the neurons of MND patients, ultimately resulting in cell death. This grant will fund the development of a small molecule treatment to enhance the clearance of TDP-43 aggregates by tagging them for the body to recycle. As part of the four-year fellowship, Dr Rayner will spend six months based at Stanford University in the United States and 18 months at the University of Sydney, before returning to Macquarie.

Dr Lyndal Henden: Impact Grant – $300,000: This two-year project will compare DNA from the blood and brain tissue of patients with sporadic MND, with a view to uncovering brain-specific genetic defects. Genetic defects are the only proven cause of MND, and they have great potential for use in diagnostics and the development of gene therapies. However, only a small proportion of patients with sporadic MND have an identified defect known to cause the disease, potentially because the DNA analysed is usually taken from blood rather than from MND-affected brain tissue.

Flora Cheng: Angie Cunningham PhD scholarship and Grant-in-Aid Award – $205,000: This funding will support a three-year PhD project that aims to understand the interplay between protein-binding RNA and RNA-binding proteins in cells that contain pathological TDP-43. It will provide unique insight into how individual protein constituents contribute to the build-up or inappropriate placement of TDP-43, and the pathogenic mechanisms of toxicity.

FightMND was co-founded in 2014 by AFL legend Neal Daniher, who was diagnosed with MND in 2013. The charity is one of the world’s largest independent funders of MND research, investing more than $95 million in research and care initiatives in Australia in the past nine years.

Learn more about the work of the Macquarie University MND Research Centre.

The National AI in Healthcare Policy Workshop was convened by the Australian Alliance for AI in Healthcare (AAAiH), facilitated by Dr Norman Swan AM, and supported by several high-profile groups including the Australian Institute of Health Innovation (AIHI), CSIRO’s Australian e-Health Research Centre, RMIT, the Australasian Institute of Digital Health, and the Digital Health Cooperative Research Centre.

Attendees included representatives from the Department of Industry, Science and Resources, as well as federal, state and territory departments of health and representatives from key stakeholder and regulatory bodies.

Professor Enrico Coiera, Director of the Centre for Health Informatics at AIHI and a founding member of AAAiH, says the group is strongly supportive of the government’s active interest in developing industry-appropriate policy and governance for AI.

While Australia regulates AI that is used in medical devices through the Therapeutic Goods Administration, clinicians and consumers need to be aware that any AI that has not gone through rigorous testing is likely not fit for use in patient-facing settings.

Large language models such as ChatGPT are a good example of this, as they have not been certified for use in any aspect of patient care.

“AAAiH is developing policy options to not only assist in dealing with the specific challenges of using AI safely, effectively and securely in healthcare, but also to support companies investing in bringing AI to healthcare settings,” Professor Coiera says.

“A whole-of-system approach will be required from government, industry and research due to the increasing opportunity for AI to be expanded into Australian healthcare settings, bringing with it not only prospects for enormous benefit, but also areas of concern.”

Other key issues are the potential for breaches of privacy, the importance of localisation due to differences across clinical settings, and the need for robust government policy.

The policy recommendations discussed at the workshop will be released later this year. They will build on current healthcare-specific regulatory structures and cover three areas:

• safety, quality, ethics and security governance for healthcare AI
• supporting the development of a healthcare AI industry in Australia
• building the capabilities of the healthcare workforce and consumers to be effective users of AI.

AAAiH is a national community of practice with more than 100 member organisations drawn from industry, health service providers, academia and consumer organisations.

Camera-based technology coupled with machine-vision algorithms allows FLASH™ Navigation to use multiple light sources and advanced sensors to map and visualise a patient’s surface anatomy in just seconds.

Dr Brian Hsu, adult and paediatric spine surgeon at Macquarie University Hospital has a particular interest in spinal deformity, complex cervical reconstructions, spinal osteotomies and degenerative cervical and lumbar conditions.

“As an enabling technology, 7D is advantageous in certain aspects of surgery,” Dr Hsu says.

“The rapidly produced 3D images enable us to see where we are within the anatomy, and within the bone. The 7D device guides with relative ease and collects the topographical detail needed, which is very useful to the surgeon – and also the patient, who benefits from a shorter overall operating time.

“Older-style navigation systems and robotic systems require the surgeon to follow a more convoluted process, placing markers and imaging under CT imaging for each and every segment of the spine. This is a significant dose of radiation for the patient and can result in an extended time under general anaesthetic.”

While similar to an intraoperative CT, FLASH™ Navigation does not use radiation and the images it produces are compared with a preoperative CT scan. A typical spinal fusion for a paediatric scoliosis patient requires the insertion of up to 20 pedicle screws in 10 vertebral segments. When using FLASH™, this procedure usually takes about four hours of surgical time, benefiting the patient with less time under anaesthetic and reduced blood loss during surgery.

Dr Hsu is an active member of the Scoliosis Research Society, North American Spine Society and the American Academy of Orthopaedic Surgeons, and is an officer of the international knowledge sharing foundation AO Spine Asia Pacific. He is a member of the Society of Minimally Invasive Spine Surgery and a Fellow of the Hong Kong Academy of Medicine.

Dr Hsu is actively engaged in teaching and education both locally and internationally and currently supervises a group of Spine Fellows at Macquarie University and The Children’s Hospital at Westmead. Dr Hsu regularly teaches advanced bioskills workshops and presides over several educational conferences.

We all know the feeling of being ‘rusty’ after not doing a complex task for a while, but to what extent can that affect our ability to perform it?

A team from Macquarie University’s Performance and Expertise Research Centre, led by Professor of Organisational Psychology Mark Wiggins, is investigating the subject of cognitive-skill decay to understand how it can be detected and ultimately prevented.

The team is looking at whether reducing the frequency with which someone performs an important operational function like driving, flying, or managing an electricity network can result in the loss of important diagnostic skills used for troubleshooting and problem- solving.

“This study arose from the pandemic lockdowns, when pilots were grounded and we were all driving less, but it is particularly important at a time when AI is performing an increasing number of functions for us,” Professor Wiggins says.

“In an emergency, the knowledge, experience and skill of the human operator are vital in diagnosing the situation and deciding how to respond, for example, during a forced landing in a plane.

“We are working to the hypothesis that we’ll see a change in the person’s situational assessment skills, including a reduced capacity to see and respond to hazards.”

As part of the project, the team is recruiting drivers, pilots and electricity network operators to take part in studies at the University’s Simulation Hub.

Chief investigator Dr Ben Morrison is preparing to run the simulator studies, and says that for the driving component, they are looking for 200 people of all ages who are driving less now than they used to.

“That might be because they’ve been working from home more or they’ve been taking public transport more often,” he says.

“Participants will come into the lab three times, each time for about an hour. Testing will involve answering some questions about driving habits and spending 10 to 15 minutes going through different scenarios in our computer driving simulator.

“We think that skills decay happens quite quickly, but we need to know at what point people are likely to experience a significant drop-off in performance so that we can devise ways of helping them maintain those skills before they lose them.”

Participants need a full driver licence and will receive a $30 gift card after each visit.

If you would like to take part, or would like more information, please email Dr Morrison.

Macquarie University has won a $10.5 million competitive tender from the Australian Department of Education to provide the first Voluntary Mental Health Check Tool (VMHCT) for schools and students across Australia.

This revolutionary screening tool will help identify students struggling with mental health and wellbeing at a given time, as well as assist schools by recommending appropriate pathways to care.

“Macquarie University is honoured to deliver this vital mental health tool for Australian schoolchildren, cementing our place as a global leader in youth and digital mental health,” says Professor Patrick McNeil, Deputy Vice-Chancellor (Medicine and Health), and Executive Dean, Faculty of Medicine, Health and Human Sciences.

“We are committed to improving the lives of our community through our groundbreaking research and significant partnerships, such as this with the Department of Education.”

Led by Distinguished Professor Ron Rapee, Macquarie researchers have successfully trialled a simple mental health screening program in many New South Wales schools, with funding support from the Bupa Foundation. The trial proved highly effective in identifying young people in need of support and received glowing feedback from schools and students.

Dr Lauren McLellan from the University’s Centre for Emotional Health, now part of the newly formed Lifespan Health and Wellbeing Research Centre, will head up the multidisciplinary VMHCT team as the director.

Dr McLellan says they will draw on this research as they develop the new tool in conjunction with schools, teachers, school counsellors and other important stakeholders in each state.

“About 14 per cent of young Australians struggle with mental health problems like depression, anxiety, difficulties with attention, or eating concerns. These young people experience difficulties across many areas of their lives, as well as at school. Sadly, only a quarter of them receive help from a health service,” explains Dr McLellan.

“If we can identify students early, we can get them the help they need as soon as possible, improving their lives in and out of school. We will work closely with the education sector to ensure this essential tool is as effective and far-reaching as possible.”

The VMHCT will be available in schools from Term 1, 2024.

For more information, visit the VMHCT website.

Exciting job opportunities are available to join the VMHCT service team. Currently, the Project and Operations Manager role is being advertised. Other jobs soon to be advertised include the Partnership and Engagement Manager, Education and Clinical Delivery Manager, Marketing and Campaigns Consultant, and Project Assistant, among other roles. Visit the Careers at Macquarie webpage (search ‘VMHCT Project’), or email Dr McLellan to register your interest.