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Objectives. MePACS is a triage and support-based personal alarm emergency response system designed to assist older and/or disabled people to live safely in their homes. The aim of this study was to estimate avoidable ambulance attendances and transports to emergency departments and quantify the cost savings attributed to MePACS compared with a comparison cohort without a personal alarm system. Methods. Alarm activation and demographic data for clients registered in the program from June 2016 to May 2017 and funded through the Personal Alert Victoria program were extracted from routinely collected MePACS electronic data. Information on alarm use, event outcomes and ambulance attendances was extracted. Using published Ambulance Victoria data, a comparison cohort was simulated to model the experience of a similar cohort without access to a personal alarm system who experienced a health emergency and called Australia's emergency call service number. The incremental management cost, incorporating the operation cost of MePACS and ambulance fees, was calculated to compare the potential cost savings of MePACS with the comparison cohort. Results. Among 18 421 eligible clients, there were 7856 emergency alarm activations due to falls or medical events from 4275 clients (79.5% female; 81.1% aged .75 years; 91.8% living alone). MePACS resulted in approximately onethird of ambulance attendances being avoided. Potential annual cost savings of A$1 414 732.8 (A$76.8 per person per year; 95% confidence interval A$60.0-93.6 per person per year; P, 0.001) were attributed to avoidable ambulance utilisations for 18 421 MePACS clients. Conclusion. Triage-based personal alarm systems, such as MePACS, provide a cost-saving strategy because of fewer ambulance attendances and transports to emergency departments for older and/or disabled people living in the community. [ABSTRACT FROM AUTHOR]

Autistic adults experience a higher rate of physical and mental health conditions and lower rates of employment and post-secondary education participation than their non-autistic counterparts, which may affect negatively quality of life. Limited information exists on predictors of quality of life for autistic individuals, or how quality of life compares to non-autistic individuals. Our aims were to (a) examine and compare indicators of physical (e.g. sleep quality) and mental health (e.g. anxiety) on quality of life among a sample of 244 autistic and 165 non-autistic individuals aged 15–80 years and (b) examine factors contributing to quality of life 2 years later among the autistic sample (n = 93). Participants were from two Australian longitudinal studies. The pattern of results for quality of life was similar across the autistic and non-autistic groups, with depression symptomatology, psychological well-being, sleep quality and autonomic symptoms all significantly predicting quality of life. In addition, among the autistic group, baseline quality of life had the greatest influence on quality of life 2 years later. These findings have implications for support services for autistic individuals, implying that in order to improve quality of life, mental health, particularly depression, needs addressing. Given known relationships between sleep and mental health, an intervention addressing these may have greatest clinical impact on quality of life among autistic individuals. Research shows that autistic adults are at risk of a range of physical (e.g. sleep difficulties) and mental health (e.g. anxiety) conditions, as well as lower employment and post-secondary education participation; these all can affect one's quality of life. However, we have little information about what affects quality of life for autistic individuals across the lifespan and whether this differs from non-autistic people. We determined what factors (e.g. mental or physical health challenges) affected quality of life in a large group of autistic individuals aged 15–80 years compared with similar age non-autistic individuals. We also examined what factors affected quality of life of the autistic group 2 years later. We found a similar pattern of results for the autistic and non-autistic groups; depression symptoms, psychological well-being, sleep quality and autonomic symptoms (e.g. sweating) were all significant predictors of quality of life. In addition, among the autistic group, baseline quality of life had the most influence on quality of life 2 years later. These results have implications for support services, as they highlight the relationship between mental health (especially depression) and quality of life. Given that sleep challenges (e.g. insomnia) are related to mental health, an intervention addressing both insomnia and mental health may be most useful in helping autistic individuals improve their quality of life. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) screening participation remains unacceptably low. This study investigated the emotion of disgust as a potential deterrent to intention to screen for CRC. The study utilised a convenience sample of individuals' 40-70 years of age to complete an online survey. Participants included 30 men and 118 women recruited between December 1, 2013 and March 31, 2014. Data on socio-demographics, health status, screening intentions and emotional barriers to bowel screening were collected via an on-line survey. Logistic regression analysis was utilised to investigate predictors of screening intention. Individuals were more likely to report intention to screen if they had prior screening experience, and reported fewer emotional concerns to screening for CRC. Results implicate disgust as a predictor of screening avoidance among participants. Specifically, higher reported faecal disgust was predictive of a 3% decrease in screening intention. This study was the first to empirically position disgust alongside other negative emotional states as an affective barrier to screening for CRC. Trait disgust sensitivity was not a reliable predictor of screening intention. This research suggests that anticipated faecal disgust may contribute to avoidance of screening for CRC. [ABSTRACT FROM AUTHOR]

The Interpersonal Psychological Theory of suicide proposes that the interaction between Thwarted Belongingness, Perceived Burdensomeness, and Acquired Capability for Suicide (ACS) predicts proximal risk of death by suicide. Instruments to assess all three constructs are available. However, research on the validity of one of them, the acquired capability for suicide scale (ACSS), has been limited, especially in terms of its clinical relevance. This study aimed to explore the utility of the different versions of the ACSS in clinical assessment. Three versions of the scale were investigated, the full 20-item version, a 7-item version and a single item version representing self-perceived capability for suicide. In a sample of patients recruited from a clinic specialising in the treatment of suicidality and in a community sample, all versions of the ACSS were found to show reasonable levels of reliability and to correlate as expected with reports of suicidal ideation, self-harm, and attempted suicide. The item assessing self-perceived acquired capacity for suicide showed highest correlations with all levels of suicidal behaviour. However, no version of the ACSS on its own showed a capacity to indicate suicide attempts in the combined sample. It is concluded that the versions of the scale have construct validity, but their clinical utility is limited. An assessment using a single item on self-perceived ACS outperforms the full and shortened versions of ACSS in clinical settings and can be recommended with caution for clinicians interested in assessing this characteristic. [ABSTRACT FROM PUBLISHER]

Background: These trials are the first randomised controlled trials of telephone-based weight management and healthy lifestyle interventions for low back pain and knee osteoarthritis. This article describes the protocol and statistical analysis plan. Method: These trials are parallel randomised controlled trials that investigate and compare the effect of a telephone-based weight management and healthy lifestyle intervention for improving pain intensity in overweight or obese patients with low back pain or knee osteoarthritis. The analysis plan was finalised prior to initiation of analyses. All data collected as part of the trial were reviewed, without stratification by group, and classified by baseline characteristics, process of care and trial outcomes. Trial outcomes were classified as primary and secondary outcomes. Appropriate descriptive statistics and statistical testing of between-group differences, where relevant, have been planned and described. Conclusions: A protocol for standard analyses was developed for the results of two randomised controlled trials. This protocol describes the data, and the pre-determined statistical tests of relevant outcome measures. The plan demonstrates transparent and verifiable use of the data collected. This a priori protocol will be followed to ensure rigorous standards of data analysis are strictly adhered to. [ABSTRACT FROM AUTHOR]

This study examined the accuracy of self-attachment of the activPAL activity monitor. A convenience sample of 50 participants self-attached the monitor after being presented with written material only (WMO) and then written and video (WV) instructions; and completed a questionnaire regarding the acceptability of the instructional methods. Participants positioned the monitor lower than the instructed position on the thigh (WMO −5.15 ± 2.75 cm, WV −4.16 ± 2.15 cm;p = .008 difference) and approximately 2 cm laterally from the thigh midline (WMO 1.90 ± 0.92 cm; WV 2.08 ± 1.24 cm). The orientation of the device was positioned correctly along the midline (within < 1° of vertical). Acceptability was high for both instructional methods although preference was shown for the WV instruction. In conclusion, participants consistently self-attached the activPAL close to the intended placement with either instructional method. The addition of video instruction produced a slightly more accurate attachment and was preferred by the participants. [ABSTRACT FROM PUBLISHER]

Background: Sitting time questionnaires have largely been validated in small convenience samples. The validity of this multi-context sitting questionnaire against an accurate measure of sitting time is reported in a large demographically diverse sample allowing assessment of validity in varied demographic subgroups. Methods: A subgroup of participants of the third wave of the Australian Diabetes, Obesity, and Lifestyle (AusDiab3) study wore activPAL3™ monitors (7 days, 24 hours/day protocol) and reported their sitting time for work, travel, television viewing, leisure computer use and "other" purposes, on weekdays and weekend days (n = 700, age 36-89 years, 45 % men). Correlations (Pearson's r; Spearman's p) of the self-report measures (the composite total, contextual measures and items) with monitor-assessed sitting time were assessed in the whole sample and separately in socio-demographic subgroups. Agreement was assessed using Bland-Altman plots. Results: The composite total had a correlation with monitor-assessed sitting time of r = 0.46 (95 % confidence interval [CI]: 0.40, 0.52); this correlation did not vary significantly between demographic subgroups (all >0.4). The contextual measure most strongly correlated with monitor-assessed sitting time was work (p = 0.25, 95 % CI: 0.17, 0.31), followed by television viewing (p = 0.16, 95 % CI: 0.09, 0.24). Agreement of the composite total with monitored sitting time was poor, with a positive bias (B = 0.53, SE 0.04, p < 0.001) and wide limits of agreement (±4.32 h). Conclusions: This multi-context questionnaire provides a total sitting time measure that ranks participants well for the purposes of assessing health associations but has limited accuracy relative to activPAL-assessed sitting time. Findings did not differ in demographic subgroups. [ABSTRACT FROM AUTHOR]

Patient aggression occurs in old age psychiatry and is problematic. The aim of this study is to identify the factors that influence clinicians' attitudes toward aggression in old age psychiatry. Eighty-five individuals, comprising nurses ( n = 75) and medical and allied health staff ( n = 10), completed the questionnaire. The results show that gender, profession, and work experience do not affect attitudes toward aggression. A low score indicated agreement with an attitudinal statement. However, younger age, better higher level of completed education, and place of work increased the likelihood of participants endorsing the questionnaire's attitudinal statements about aggression. The findings suggest clinicians' attitudes may affect the way they attempt to prevent and manage aggression. [ABSTRACT FROM AUTHOR]