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Additional file 1.

Additional file 2: Table S2. Classification of patient-reported outcomes included in cancer-related core outcome sets.

Purpose: Cancer survivors often make long-term dietary changes, and nutrition is important for survivorship outcomes. Many survivors experience persisting cognitive difficulties, which can impact health behaviors. This study aimed to identify perceived drivers of eating habit changes, and the barriers to making intentional dietary changes, among breast cancer survivors with persisting self-reported cancer-related cognitive impairment. Materials and Methods: A qualitative framework explored survivors' perceptions of dietary habit changes. Thirteen Australian breast cancer survivors (M.time since diagnosis: 23.6 months, standard deviation [SD] 15.3; M.time since completing primary treatment: 14.7 months, SD 15.3) completed semistructured interviews. Questions related to dietary changes since diagnosis and treatment. Major themes were identified from interview transcripts using thematic analysis. Results: While most individuals perceived their diet to be broadly similar to prediagnosis, several changes to diet and eating habits were identified, which were often meaningful to these survivors. Themes relating to survivors' eating habit changes included the following: (1) meal timing and frequency shifts, (2) more plant-based eating, and (3) less variety and more convenience. Changes in eating habits were attributed to the following: (1) persisting treatment-related changes, (2) help and support from others, (3) old treatment habits, (4) preventative health and self-care, and (5) changes to work schedule. Barriers to making intentional dietary changes included the following: (1) too much time and effort, (2) food cravings and enjoyment, and (3) lacking dietary ideas and resources. Conclusions: Many survivors reported long-term changes in dietary habits, some of which align with current recommendations. Causes of dietary habit changes, and barriers to engaging in healthier dietary habits, involved multiple biopsychosocial elements. Additional resources or strategies that assist navigating survivorship challenges and their effects on dietary habits are needed. Future studies should explore whether post-treatment nutritional review with a qualified dietary health professional is helpful for survivors who experience longterm cancer-related cognitive impairment. Refereed/Peer-reviewed

In two studies, we examined primary appraisal as a potential mechanism of workplace mindfulness, grounded in the Transactional Model of Stress and Coping. In Study 1, multilevel structural equation modeling utilizing diary data from 58 employees across 5 working days showed that daily challenge appraisal mediated the positive relationship between mindfulness and high-activation positive affect, and daily threat appraisal mediated the negative relationship between mindfulness and high-activation negative affect. In Study 2, 69 employees participated in a randomized control trial comparing self-directed mindfulness training with a wait-list control. Latent growth curve modeling demonstrated that the intervention produced a greater increase in daily mindfulness relative to the control condition. In turn, the rate of change in daily mindfulness influenced the change rate of appraisal, and daily appraisal influenced affect, as expected. Together, these studies indicate one way in which mindfulness may help employees to thrive at work is by adaptively shaping the stressor appraisal process, and that connecting mindfulness training to primary appraisal may bolster the potential beneficial effects in the work context. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Depression in late life is associated with poorer quality of life and higher mortality. Pain, chronic illness, loneliness, loss of physical abilities, grief, cognitive impairment, and socioeconomic disadvantage all increase the risk of depression in this age group. Treatment for depression in late life includes antidepressant medications, cognitive behavior therapy, interpersonal therapy, and electroconvulsive therapy. The use of virtual reality is also proposed as a potential new treatment for depression that could be made available in aged care settings, and early evidence holds promise. Differentiating between depression, dementia, and delirium plays an important role in diagnosis and treatment, and often relies on a comprehensive neuropsychological assessment. The prevention and treatment of depression in late life requires collaboration and cooperation between families, carers, health professionals, and aged care providers. Refereed/Peer-reviewed

Refereed/Peer-reviewed Post-traumatic stress disorder (PTSD) is a pervasive disorder among both current and ex-serving Australian Defence Force (ADF) members. Studies have shown current psychological and pharmacological treatments for PTSD are suboptimal in veterans, with high dropout rates and poor adherence to treatment protocols. Therefore, evaluating complementary interventions, such as assistance dogs, is needed for veterans who may not receive the ultimate benefit from traditional therapies. The present longitudinal mixed-method study examined the effectiveness of Operation K9 assistance dogs among sixteen veterans with PTSD, specifically, their effects on suicidality, PTSD, depression, and anxiety from baseline to 12 months post-matching. Self-reported measures were completed prior to receiving their dog (baseline) and at three time points (3, 6, and 12 months) following matching. The Clinician-Administered PTSD Scale for DSM-5 was used to assess the severity of every PTSD case. Veterans participated in a semi-structured interview 3 months post-matching. Whilst there was a reduction in the proportion of veterans reporting any suicidality, there was no significant change in the probability of veterans reporting suicidality between time points. There was a significant effect of time on PTSD, depression, and anxiety symptoms. Three major themes emerged from qualitative data analysis: life changer, constant companion, and social engagement. Qualitative data suggest assistance dogs can have a positive impact on important areas of daily life and support veterans in achieving some of the prerequisites for health, including access to services, transport, education, employment, and development of new and diverse social and community connections. Connections were key in improving health and wellbeing. This study exemplifies the power of human–animal relationships and adds emphasis to the need to take these seriously and create supportive healthy environments for veterans with PTSD. Our findings could be used to inform public health policy and service delivery, in line with the Ottawa Charter action areas and indicate that for veterans with PTSD, assistance dogs may be a feasible adjunct intervention.

Refereed/Peer-reviewed

Enhanced cognitive behaviour therapy (CBT-E) has recently generated interest as a potentially useful treatment for eating disorders (ED). In the current study, we conducted a systematic review of the outcome literature on CBT-E, with both narrative and meta-analytic synthesis. We included single-group uncontrolled pre-post design studies and randomised control trials (RCTs) of CBT-E, which allowed us to include a larger number of studies, and also compare the two methodologies in terms of effect size. The primary analysis included 15 CBT-E studies with a total of 948 participants. Narrative synthesis examined bingeing and purging episodes, BMI change, and follow-up results. A large, statistically significant effect supported CBT-E as a treatment for all EDs (g = 1.06). When comparing methodologies, both pre-post design studies (g = 1.15) and RCTs (g = 0.97) yielded large effects. Narrative synthesis outlined reductions in ED behaviours and increases in BMI which were maintained at follow-up. Limitations include that further RCTs of CBT-E are needed to establish clinical effectiveness of this treatment approach for all EDs; however, results from narrative exploration indicate this endeavour would be worthwhile. Despite the limitations, this study provides additional support for CBT-E as a successful treatment across the range of EDs. Refereed/Peer-reviewed

Research on body image commonly focuses on the negative aspects of the construct, and the majority of findings related to body image in general arise from quantitative methods of investigation. Furthermore, little is known about the experiences lesbian women go through as they come out, and what consequence this has on their body image. In this study we examined the experiences of 12 lesbian women and explored how coming out affected their body image. Data were collected via face-to-face interviews and analyzed using thematic analysis. Participants’ ages ranged from 20 to 33 (M=25). The analysis revealed that all participants reported experiencing improved body image after coming out. Other changes related to the presentation of sexual identity in terms of how they dressed, i.e., presenting as either more masculine or feminine.Most participants reported feeling that the sexual and gender minority community was more accepting of different body shapes and sizes compared to the heteronormative society in which they resided. Negative feelings and experiences related to family situations, and occasionally from within themselves.The results are important in understanding how gender and sexual orientation are intertwined to create a distinct experience of body image in lesbian women, and also to illustrate the heterogeneity of body image within subgroups of women. Refereed/Peer-reviewed

Objective: The objective of this exploratory study was to determine the presence and correlates of self-reported cognition in a sample of haematological cancer patients who had undergone allogeneic stem cell transplantation (SCT). Methods: Haematological cancer patients (n = 30) who had undergone allogeneic SCT between one and five years previously and age-matched control participants (n = 30) completed questionnaires assessing cognition, affect, sleep quality and fatigue and an assessment of premorbid IQ. Results: Patients reported significantly poorer perceived cognitive ability (d = 1.12) and greater perceived cognitive impairment (d = 0.96) than controls. Lower fatigue was significantly associated with greater perceived cognitive ability (r = 0.75 patients and controls) and less perceived cognitive impairment (r = 0.80 patients; r = 0.57 controls). Interestingly, depression was significantly correlated with perceived cognitive ability in the control group only (r = 0.80). Hierarchical multiple regressions showed that fatigue was a significant predictor of perceived cognitive ability in patients, accounting for 56% of the variance. Conclusions: This study established that self-reported cognitive ability and cognitive impairment was significantly poorer in haematological cancer patients than controls. Furthermore, fatigue was significantly associated with perceived cognitive ability in patients. Future research should focus on identifying interventions that target fatigue in allogeneic SCT recipients in order to improve quality of life throughout survivorship. Refereed/Peer-reviewed

This observational, cross-sectional study examined students' retrospective recall of emotional distress when studying sensitive topics in psychology, and whether hardiness had a mediated pathway to emotional distress through a mental health condition (MHC). Psychology undergraduates (155 women, 34 men) from South Australian universities completed self-report questionnaires assessing hardiness, retrospective measures of emotional distress when studying a range of topics, their concurrent MHC and lifetime cumulative trauma. As hypothesised, students reported more emotional distress to sensitive topics relative to nonsensitive ones, p < .001 (r = −.69). Hardiness was significantly negatively correlated with MHC, p < .001 (r = −.38). Causal mediation analysis revealed, as predicted, that MHC mediated the effect of hardiness on emotional distress (p < .001). These results are consistent with existing literature on students' reactions to sensitive topics in medical, law and social work education, as well as previous findings of negative associations between hardiness and mental health outcomes. Implications for higher education policy and practice are discussed, including the use of hardiness assessments as an early screening tool for mental health decline. Future research should identify the specific MHCs involved in the mediated pathway from hardiness to course-related emotional distress, and employ longitudinal designs to confirm the temporal ordering of variables. Refereed/Peer-reviewed

Purpose of review: To review recent research on cancer-related cognitive impairment (CRCI) in children, including correlational studies and interventions in which outcomes have included cognitive test performance, neuroimaging or academic performance. Recent findings: Impairments in processing speed, working memory, executive function and attention continue to be demonstrated in survivors of childhood cancers. Children receiving radiation treatment for their cancer demonstrate greater impairment than those who undergo surgery and/or chemotherapy without radiation. However, CRCI still occurs in the absence of radiation treatment, particularly in the domain of attention. Recent neuroimaging studies highlight atypical connectivity of white matter and its associations with cognitive performance. Given impairments in cognitive function and associated neuroanatomical factors, it is not surprising that survivors of childhood cancers experience academic difficulties. However, early intervention may provide one means of improving cognitive and academic outcomes. Summary: Children with cancer are at risk of impairment in the domains of processing speed, attention, working memory and executive function. Those who receive radiation are likely to experience greater CRCI than those who do not receive this treatment. All survivors of childhood cancers should be carefully monitored to provide support and implement evidence-based interventions to ameliorate cognitive late effects. Refereed/Peer-reviewed

Background Core outcome sets seek to improve the consistency and quality of research by providing agreed-upon recommendations regarding what outcomes should be measured as a minimum for a population and setting. The problems arising from a lack of outcome standardization in population-based cancer survivorship research indicate the need for agreement on a core set of patient-reported outcomes (PROs) to enhance data quality, consistency, and comparability. Objective This study aims to identify a core set of PROs, representing the most important issues impacting on cancer survivors' long-term health, functioning and quality of life, to inform population-based research on cancer survivorship. Methods In Phase I, a list of all potentially important outcomes will be generated through focus group discussions with cancer survivors and a review of measures for assessing quality of life in cancer survivorship. The consolidated list will be advanced to Phase II, where a stakeholder consensus process will be conducted with national experts in cancer survivorship to refine and prioritize the outcomes into a core outcome set. The process will consist of a two-round Delphi survey and a consensus meeting. Cancer survivors, oncology health care professionals, and potential end users of the core outcome set with expertise in cancer survivorship research or policy will be invited to participate. In Phase III, recommended measures for assessment of the core outcome set will be selected with advice from experts on the assessment, analysis, and interpretation of PROs. Results As of April 2019, data collection for Phase I is complete and data analysis is underway. These data will inform the list of outcomes to be advanced into Phase II. Recruitment for Phase II will commence in June 2019, and it is anticipated that it will take 6 months to complete the three-step consensus process and identify a provisional core outcome set. The study results are expected to be published in early 2020. Conclusions Expert consensus-driven recommendations on outcome measurement will facilitate the inclusion of survivorship outcomes considered important by cancer survivors and health professionals in future research. Adoption of the core outcome set will enable comparison and synthesis of evidence across studies and enhance the quality of PRO data collected in cancer survivorship research, particularly when applied to address macro-level questions. International Registered Report Identifier (IRRID) DERR1-10.2196/14544

The present study investigated the influence of a weight loss reality TV show on body satisfaction, mood and food consumption. Young Australian women (N = 99) first completed baseline measures of state body satisfaction and mood. They were then randomly allocated to either a weight loss or a home renovation programme and were provided with snack foods during viewing. Post-measures included state body satisfaction, state mood and trait dietary restraint and snack food consumption. BMI moderated the relationship between condition and body satisfaction and mood. Larger women experienced less body satisfaction and less positive mood in response to the weight loss programme. Dietary restraint moderated the relationship between condition and food consumption. A greater percentage of women with lower dietary restraint ate in the control condition; whilst a greater percentage of women with higher dietary restraint ate food whilst watching the weight loss programme. These findings highlight the potential negative impact of weight-focused reality TV on mood, body satisfaction and snack food consumption among some women. Refereed/Peer-reviewed

Objective: To review the evidence for a systematic relationship between cancer patients' pre-treatment expectations (anticipated side effects) and subsequent experience of treatment-related side effects, and to compare this relationship in patients with no prior treatment experience (cognitive expectations) and with some prior treatment experience (conditioned response). Methods: A total of 12,952 citations were identified through a comprehensive search of the literature published on or before November 2016 and screened against inclusion criteria. Studies were eligible if they included participants undergoing curative treatment for cancer, measured a treatment side effect, examined the relationship between anticipation and experience of side effects, and reported quantitative data. Results: Thirty-one studies were included in the review and meta-analysis (total N = 5069). The side effects examined were nausea (anticipatory and post-treatment), vomiting, fatigue, pain, problems with concentration, and skin reactions. Meta-analyses indicated positive associations between anticipation and subsequent experience for all included side effects in patients with no prior treatment exposure (r = 0.153-0.431). Stronger associations were found for all included side effects in patients with previous treatment experience (r = 0.211-0.476), except for fatigue (r = 0.266) and pain (r = 0.235). No significant differences were found when overall effect sizes for patients with and without prior treatment exposure were compared for each side effect, except for anticipatory nausea (p = 0.012). Conclusion: These results may have implications for future interventions that target patients' expectations of cancer treatment-related side effects. Future research could explore patient reports of messages received about likely treatment effects both before and during treatment. Refereed/Peer-reviewed

Previous research has indicated that exposure to traditional media (i.e., television, film, and print) predicts the likelihood of internalization of a thin ideal; however, the relationship between exposure to internet-based social media on internalization of this ideal remains less understood. Social media differ from traditional forms of media by allowing users to create and upload their own content that is then subject to feedback from other users. This meta-analysis examined the association linking the use of social networking sites (SNSs) and the internalization of a thin ideal in females. Systematic searches were performed in the databases: PsychINFO, PubMed, Web of Science, Communication and Mass Media Complete, and ProQuest Dissertations and Theses Global. Six studies were included in the meta-analysis that yielded 10 independent effect sizes and a total of 1,829 female participants ranging in age from 10 to 46 years. We found a positive association between extent of use of SNSs and extent of internalization of a thin ideal with a small to moderate effect size (r = 0.18). The positive effect indicated that more use of SNSs was associated with significantly higher internalization of a thin ideal. A comparison was also made between study outcomes measuring broad use of SNSs and outcomes measuring SNS use solely as a function of specific appearance-related features (e.g., posting or viewing photographs). The use of appearance-related features had a stronger relationship with the internalization of a thin ideal than broad use of SNSs. The finding suggests that the ability to interact with appearance-related features online and be an active participant in media creation is associated with body image disturbance. Future research should aim to explore the way SNS users interact with the media posted online and the relationship linking the use of specific appearance features and body image disturbance. Refereed/Peer-reviewed

Objective: Previous research has indicated that greater exposure to traditional media (i.e. television, film, and print) predicted skin cancer risk factors in adolescents; however, the relationship between social media usage and these outcomes remains unexplored. We examined whether social networking site (SNS) usage, and the particular manner of this use, was associated with skin tone dissatisfaction, sun exposure and sun protection among Australian adolescents. We also explored sex differences in SNS usage related to tanning. Method: A total of 1856 South Australian secondary school students completed the Australian School Students Alcohol and Drug 2014 survey. SNS usage related to tanning comprised posting pictures, posting text, viewing pictures, viewing text and liking or sharing posts. Results: Adolescents spent 214.56 minutes, on average, per day using SNSs. Behaviours related to tanning that involved pictures (i.e. viewing pictures, posting pictures, and liking or sharing content) were significantly associated with more skin tone dissatisfaction, more sun exposure and less sun protection. Females performed all SNS-linked behaviours more frequently than did males, with the exception of posting text. Conclusion: Australian adolescents spend a considerable amount of time using SNSs, and their behaviours related to tanning on these SNSs are significantly associated with skin cancer risk factors. Refereed/Peer-reviewed

Background Innovative strategies are required to reduce care fragmentation for people with multimorbidity. Coordinated models of health care delivery need to be adopted to deliver consumer-centered continuity of care. Nurse-led services have emerged over the past 20 years as evidence-based structured models of care delivery, providing a range of positive and coordinated health care outcomes. Although nurse-led services are effective in a range of clinical settings, strategies to improve continuity of care across the secondary and primary health care sectors for people with multimorbidity have not been examined. Objective To implement a nurse-led model of care coordination from a multidisciplinary outpatient setting and provide continuity of care between the secondary and primary health care sectors for people with multimorbidity. Methods This action research mixed methods study will have two phases. Phase 1 includes a systematic review, stakeholder forums, and validation workshop to collaboratively develop a model of care for a nurse-led care coordination service. Phase 2, through a series of iterative action research cycles, will implement a nurse-led model of care coordination in a multidisciplinary outpatient setting. Three to five iterative action research cycles will allow the model to be refined and further developed with multiple data collection points throughout. Results Pilot implementation of the model of care coordination commenced in October 2018. Formal study recruitment commenced in May 2019 and the intervention and follow-up phases are ongoing. The results of the data analysis are expected to be available by March 2020. Conclusions Nursing, clinician, and patient outcomes and experiences with the nurse-led model of care coordination will provide a template to improve continuity of care between the secondary and primary health care systems. The model template may provide a future pathway for implementation of nurse-led services both nationally and internationally. International Registered Report Identifier (IRRID) DERR1-10.2196/15006

Skin cancer is the most commonly diagnosed cancer in many Western countries. This systematic review provides a comprehensive overview of the relationship between skin cancer knowledge and sun-protective, exposure and tanning behaviours in the general population. A total of 34 studies, published in peer-reviewed journals over three decades, were reviewed and synthesised. Sun-protective behaviour was positively associated with skin cancer knowledge in most cases. Findings were inconsistent regarding other sun-related behaviours. Heterogeneity in measurement compromised the capacity to definitively link knowledge and sun-related behaviours. There is a need for development and utilisation of a standardised skin cancer knowledge scale, and guidelines are suggested. Refereed/Peer-reviewed

Evidence suggests that some cancer survivors experience cognitive difficulties following chemotherapy. However, perceived or subjective cognitive impairment is more frequently reported than prevalence revealed by objective assessments. The aim of this review was to examine the relationship between subjective and objective measures of cognitive impairment following treatment for cancer and to determine the number of studies that found a significant relationship between these measures of cognition. A comprehensive search for articles, published between 1980 and 2012, comparing subjective and objective cognition in cancer patients treated with chemotherapy was conducted. Of 818 potentially relevant articles, 23 studies met the inclusion criteria for the current review and one article was sourced from reference lists of included studies. Only eight of 24 included studies found a significant relationship between objective and subjective measures of cognitive performance. These studies were more likely to involve breast cancer patients and to assess the relationship between memory and perceived cognitive impairment. The failure to consistently find an association between subjective and objective measures of cognition could be explained by variations in assessment methods or the definition of impairment. Alternatively, objective and perceived cognitive impairment may be unrelated because perceived impairment may be an indicator of psychological distress rather than cognitive impairment. Despite these discrepancies, patients’ perceptions of impairment are important due to its significant impact on quality of life. Further research is required to explore whether objective measures of everyday functioning better predict the impact of chemotherapy related cognitive impairment on daily functioning. Refereed/Peer-reviewed

Objective: The authors replicated and expanded on Fabiano et al.’s meta-analysis of behavioral treatments for ADHD, systematically comparing the efficacy of 7 nonpharmacological interventions. Method: A total of 14 controlled treatment studies conducted post-1994—evaluating behavior modification, neurofeedback therapy, multimodal psychosocial treatment, school-based programs, working memory training, parent training, and self-monitoring—were identified,primarily by searching electronic English-language databases. The results were meta-analyzed: mean-weighted effect sizes for the treatment outcomes of 625 participants (382 treatment, 243 controls) were calculated, and moderator analysesexamined contributions of gender, ADHD subtype, and treatment “dosage” to outcome. Results: Behavior modification and neurofeedback treatments were most supported by this evidence. Interventions were generally more efficacious for girls, and least efficacious for the “combined” ADHD subtype. The authors found no dose or age effects. Conclusion: Based on the small, published literature, this study supports some nonpharmacological interventions for ADHD, and indicates directions for more evaluation research into psychological treatments. Refereed/Peer-reviewed

Serving size is a modifiable determinant of energy consumption, and an important factor to address in the prevention and treatment of obesity. The present study tested an hypothesised negative association between individuals’ everyday mindfulness and self-reported serving size of energy dense foods. The mediating role of mindful eating was also explored. A community sample of 171 South Australian adults completed self-report measures of everyday mindfulness and mindful eating. The dependent measure was participants’ self-reported average serving size of energy dense foods consumed in the preceding week. Participants who reported higher levels of everyday mindfulness were more mindful eaters (r = 0.41, p < 0.05) and reported smaller serving size estimates of energy dense foods (r = −.25, p < 0.05). Mindful eating fully mediated the negative association between everyday mindfulness and serving size. The domains of mindful eating most relevant to serving size included emotional and disinhibited eating. Results suggest that mindful eating may have a greater influence on serving size than daily mindfulness. Refereed/Peer-reviewed

We investigated the relationship between the morphology of the corpus callosum (CC) and IQ in a healthy sample of individuals in their late teens and early twenties. The relationship between the area of the CC, measured at the midline, and IQ showed regional differences. We observed that a higher estimated performance IQ was associated with smaller area in the posterior regions of the CC, a finding that differs from a positive association previously observed in a somewhat older adult sample. In contrast, higher estimated verbal IQ was associated with decreased fractional anisotropy of the genu, an anterior portion of the CC. Age effects were also observed such that older age was associated with larger CC area. Our results suggest that CC morphology is related to cognitive performance, which may have implications for clinical populations in whom CC morphology is atypical. usc Refereed/Peer-reviewed

This study examined the potential mediating roles of mindfulness and body awareness in the relationship between exercise and eating behavior. Female exercisers (N = 159) recruited from fitness centers, yoga centers, and the community completed a questionnaire incorporating measures of exercise behavior, body awareness, trait mindfulness, mindful eating, dietary intake, and disordered eating symptoms. Participation in yoga was associated with significantly lower disordered eating (mediated by body awareness), whereas the amount of time spent participating in cardio-based exercise was associated with greater eating disturbance. The relationships between amount of exercise and actual food intake were not mediated by trait mindfulness or body awareness. The differential findings for dietary intake and disordered eating indicate that the body awareness cultivated in different forms of exercise may be more beneficial for clinical populations or those at risk for eating disorders than for modifying actual dietary intake in the general population.