Monash Epworth Rehabilitation Research Centre

Transcription

1 Monash Epworth Rehabilitation Research Centre Self Review Document Hoddle Street Richmond, VIC, 3121 Ph (03)

2 Table of Contents About the Monash Epworth Rehabilitation Research Centre. 4 Key Staff Governance structure and Management Organisation Chart... 5 Current Staff in the MERRC Centre 6 Affiliated Staff 8 Current Research Studies Longitudinal head Injury study. 9 Sexuality following traumatic brain injury 9 Investigation of substance use following traumatic brain injury. 9 Psychiatric disorders following traumatic brain injury The influence of genetic factors, specifically the Apolipoprotein gene, and age at injury on outcome following head injury. 10 The influence of cultural background on rehabilitation and outcome following traumatic brain injury. 10 Efficacy of motivational interviewing and cognitive behaviour therapy for anxiety and depression following traumatic brain injury.. 11 Light therapy for sleepiness and fatigue following traumatic brain injury.. 11 Efficacy of melatonin for sleep disturbance following traumatic brain injury. 11 Safer Roads to Recovery: Assessing readiness for driving after traumatic brain injury.. 12 The return of memory following traumatic brain injury: The critical role of the medial temporal lobe, prefrontal cortex, and associated brain areas. 12 Reducing Behaviours of Concern following Traumatic Brain Injury Program Phase 1: BoC Case File Audit and Qualitative Study.. 13 Cognitive Rehabilitation An exploration of Current Practice. 13 Current Postgraduate Students 14 Doctoral Thesis Completions.. 19 Honours Thesis Completions.. 20 Journal Publications: Conference Presentations:

3 Conference Organisation : Grants Received.. 32 Grants Received in Research Collaborations

4 About the Monash Epworth Rehabilitation Research Centre Mission Statement The aim of the Monash Epworth Rehabilitation Research Centre is to conduct ethical, innovative and internationally competitive research investigating outcomes and the effectiveness of intervention programs for individuals with brain injury or orthopaedic injury sustained as a result of trauma, with the ultimate aim of maximising their functional, psychological and social outcomes. Aims & Objectives The Centre aims to: develop its trauma research programmes in a clinical context; translate outcomes from the research into more effective rehabilitation of individuals with traumatic injuries, with the ultimate aim of maximising their quality of life; provide a supportive environment in which doctoral students can receive research training; develop collaborations within the university, Epworth hospital and the wider research and clinical community, locally, nationally and internationally; support its research activities through competitive grant funding publish findings in internationally reputable journals; disseminate findings widely through conference presentations. Core Business Activities The Centre was established in 2000, following the appointment of Professor Jennie Ponsford to the School of Psychology and Psychiatry (now School of Psychological Sciences) at Monash University, bringing together the resources and expertise of Monash University with that of Epworth Hospital, which runs rehabilitation programs for victims of trauma. It has been self funding since its inception. The Transport Accident Commission (TAC) is the largest financial supporter of the Centre, having provided substantial funding for the longitudinal head injury outcome study and associated projects for over 19 years, beginning in Specific projects have also been supported by the NHMRC, Victorian Neurotrauma Initiative, Monash University, ISCRR, Jack Brockhoff Foundation, William Buckland Foundation, Australian Rotary Health Research Fund, the Wenckhart Foundation, RACV and the Department of Human Services. 4

5 Key Staff Governance structure and Management Organisation Chart Head of School of Psychological SciencesMonash University Chief Executive Epworth Hospital National Trauma Research Institute (NTRI) Centre of Excellence in TBI Research (CETBIR) Fellows Dr Cally Richardson Dr Kelly Sinclair NHMRC Centre of Excellence in TBI Psychosocial Rehabilitation MERRC DIRECTOR Professor Jennie Ponsford CLINICAL ASSOCIATES Prof John Olver Dr Michael Ponsford Dr Adam McKay Dr Catherine Willmott Dr Dana Wong Ms Pamela Ross Dr Rene Stolwyk Research Projects Members of Staff HDR Students The Monash Epworth Rehabilitation Research Centre is directed by Professor Jennie Ponsford. She reports to the Head of the School of Psychological Sciences at Monash University and the Chief Executive of Epworth Hospital. Professor John Olver and Drs Michael Ponsford, Adam McKay, Dana Wong, Rene Stolwyk,, Catherine Willmott and Pamela Ross from Epworth Hospital and Monash University are Clinical Associates and all other staff report directly to Professor Ponsford. 5

6 Current staff in the Monash Epworth Rehabilitation Research Centre Professor Jennie Ponsford, BA (Hons), MA (Clin Neuropsych), PhD, MAPsS is Director of the Centre. She is also Professor of Neuropsychology in the School of Psychology and Psychiatry in the Faculty of Medicine, Nursing and Health Sciences at Monash University. This appointment, made in 2005 is a joint appointment with Epworth Hospital, who contributes 20% of her salary, the rest of which is funded by Monash University. She devotes two days of her working week to the Centre s activities and clinical work, with 1.5 days devoted to administrative work in the School and 1.5 days to teaching. She is the founding Director of the Doctor of Psychology in Clinical Neuropsychology programme, into which she teaches. She is also a member of Epworth s Research and Ethics Committee and teaching Hospitals Steering Committee. She is a Chief Investigator on the Centre of Excellence in TBI Research administered by the National Trauma Research Institute at the Alfred Hospital and funded by ISCRR, and also a chief investigator on an NHMRC Centre of Excellence in Traumatic Brain Injury Psychosocial Rehabilitation. As the former manager of the Psychology Department at Bethesda Rehabilitation Hospital (now Epworth Hospital), where she was employed between 1982 and 1999, Professor Ponsford has had broad clinical experience in the field of traumatic brain injury and has conducted extensive research investigating outcomes and the impact of rehabilitation following mild, moderate and severe head injury. She has been the recipient of numerous large grants as chief investigator, has published over 180 journal articles, book chapters and two books on the subject, and is regularly invited to speak at international conferences, having made over 150 conference presentations. She serves on the Editorial Boards of seven international journals and served on an NHMRC project grant review panel in Professor Ponsford is currently a member of the Executive of the International Brain Injury Association, is a committee member and Honorary Fellow of the Australian Society for the Study of Brain Impairment, of which she has also been President, is a member of the Governing Board of the World Federation of Neurorehabilitation, and is the Immediate Past President of the International Neuropsychological Society. Professor Ponsford oversees all the activities of the Centre, including grant applications, project management, staff supervision and preparation of reports and publications. Dr Marina Downing: PhD is employed 0.6FTE as a Research Fellow whose primary role is to analyse data and write papers for the Longitudinal Head Injury Outcomes Study. Dr Lisa Johnston: PhD is employed 0.4 FTE as a Research Fellow who assists with grant submissions and manages the prospective study of Psychiatric Disorders being conducted within the Longitudinal Head Injury Outcomes Study. Ms Meagan Carty: BSc (Hons), is employed 0.5 FTE to manage the Longitudinal Head injury Outcome Study and oversee recruitment for all other studies. Ms Mary Ryan: R.N. a trained nurse, is employed 0.4 FTE as a research assistant working on the Longitudinal head Injury Outcome Study, locating contact details and organising appointments for patients and collecting saliva samples and questionnaires. 6

7 Dr Kate Gould : BBNSc (Hons), DPsych (Clinical Neuropsychology) is employed 0.4 FTE as a Research Fellow to conduct a quantitative and qualitative study investigating behaviours of concern in TAC clients with traumatic brain injuries. Dr Kelly Sinclair: BSc (Hons), DPsych (Clinical Neuropsychology) is employed 0.6FTE as a Research Fellow together with Dr Cally Richardson to conduct a systematic review of cognitive rehabilitation in Australia. This research is funded by CETBIR as part of the National Trauma Research Institute. Dr Gershon Spitz: BA (Hons) PhD is employed 1.0 FTE as a Research Fellow to analyse data and produce papers stemming from the Longitudinal Head Injury Outcome Study. In addition to this he co ordinates the project examining the recovery of memory following Post Traumatic Amnesia. Ms Lingani Mbakile: BA(Hons), MSc, DPsych (Clinical Neuropsychology) candidate is employed 0.2 FTE to conduct follow up and psychiatric telephone interviews for the Longitudinal head Injury Outcome Study. Dr Cally Richardson : BPsych (Hons) DPsych (Clinical Neuropsychology) is employed 0. 6 FTE as a Research Fellow to conduct a systematic review of current practice of cognitive rehabilitation in Australia. This research is funded by CETBIR as part of the National Trauma Research Institute. Ms Yvette Alway: BPysch (Hons) DPsych (Clinical Psychology) candidate is employed 0.4 FTE to manage a current NHMRC grant to evaluate the efficacy of Motivational Interviewing and Cognitive Behaviour Therapy (MI CBT) for anxiety and depression following traumatic brain injury, her position being funded by the NHMRC grant. Ms Jane Dahm: BSc (Hons) DPsych (Clinical Neuropsychology) candidate is employed 0.2FTE to conduct telephone interviews and home visits with patients from non English backgrounds for the Longitudinal Head Injury Outcomes Study. Ms Alicia Dymowski: BBNSc(Hons), DPsych (Clinical Neuropsychology) candidate is employed 0.2FTE to assist with grant submissions. Ms Jacqui Owens: BPsych (Hons), DPSych (Clinical Neuropsychology) candidate is employed 0.2FTE to assist with the VNI funded Light Therapy and Melatonin Studies. Ms Sylvia Nguyen : BHealth Sci (Hons) and MPsych(Clin), DPsych (Clinical Neuropsychology) candidate is employed to conduct psychiatric telephone interviews and home visits for clients participating in the MI CBT study. Ms Coco Bernand: BSc (Hons), DPSych (Clinical Neuropsychology) candidate is employed 0.2 FTE to conduct follow up telephone interviews for the Longitudinal Head Injury Outcomes Study. Dr Kerrie Haines: DPsych has been employed sessionally to conduct therapy with clients being treated within the current NHMRC grant to evaluate the efficacy of Motivational Interviewing and Cognitive Behaviour Therapy for anxiety and depression following traumatic brain injury, her position being funded by the NHMRC grant. 7

8 Affiliated staff Professor John Olver, MBBS, FACRM, FAFRM (RACP), MD, who is Director of Rehabilitation at Epworth Healthcare, and a Professor in the Department of Medicine at Monash University, has been involved with the Centre since its inception. He has directed the head injury rehabilitation program at Epworth for 20 years. He conducts follow up interviews with traumatically brain injured patients 1,2,3, 5 and 10 years after injury as part of the Longitudinal Head Injury Outcome Project and is a regular presenter of findings from the outcome studies at national and international conferences. Dr Michael Ponsford, MBBS, FACRM, FAFRM (RACP), Consultant in Rehabilitation Medicine is also actively involved with research conducted at the centre, having been involved in the care of head injury patients at Epworth/Bethesda for many years. He also conducts follow up interviews with traumatically brain injured patients 1,2,3,5 and 10 years after injury as part of the Longitudinal Head Injury Outcome Project and is involved in other specific projects. Dr Adam McKay, BSc (Hons), M Sc, PhD, is employed as a lecturer in the School of Psychological Sciences at Monash University and as a Senior Clinical Neuropsychologist at Epworth. He is involved in supervising both doctoral and honours projects and is a co investigator on the the Motivational Interviewing/Cognitive behaviour therapy for anxiety and depression following TBI, and the study of efficacy of cognitive behavior therapy for fatigue following TBI, having assisted in developing and delivering the therapeutic approaches used in these studies. Dr Dana Wong, BSc(Hons), MPsych(Clin.Neuro.), PhD is employed as a lecturer in the School of Psychological Sciences at Monash and working in private practice as a clinical neuropsychologist. She has been involved in supervising both doctoral and honours projects and is a co investigator on the Motivational Interviewing/Cognitive behaviour therapy for anxiety and depression following TBI, and the study of efficacy of cognitive behavior therapy for fatigue following TBI,having assisted in developing and delivering the therapeutic approaches used in these studies. Ms Pamela Ross, B AppSci, is a Senior Occupational Therapist at Epworth currently enrolled in a PhD under the supervision of Professor Ponsford and collaborating on the project examining predictors of return to driving following TBI. Dr Catherine Willmott : BSci (Hons), M Sc, PhD, is employed as a Senior Lecturer in the School of Psychological Sciences Monash University and is the Co Director of the Monash Psychology Centre. Catherine has been involved in supervising both honours and doctoral projects. Currently she involved in on going projects examining the Efficacy of Methylphenidate to enhance attention following TBI, the neuro imaging and genetic correlates of attentional performance following TBI and the efficacy of approaches to for attention training following TBI. 8

9 Current Research Studies: Longitudinal head injury outcome study J. Ponsford, J. Olver, M. Ponsford, M Carty, M. Downing, G. Spitz Project Synopsis: Traumatic brain injury is the leading cause of acquired disability in young people, resulting in a complex range of physical, cognitive, behavioural and emotional changes. The elucidation of the long term problems experienced by those who sustain traumatic brain injury owes much to the Longitudinal Head Injury Outcome Project, which has been conducted at Epworth Hospital (formerly Bethesda) since1995. All patients admitted to Epworth Hospital with head injuries are routinely invited to attend a follow up clinic at 1, 2, 3, 5, 10 and 20 years post injury. They are interviewed by a rehabilitation physician and complete questionnaires documenting their level of mobility, functional independence, living situation, relationship status, vocational activities, neurological, cognitive, behavioural and emotional problems experienced and drug and alcohol use. It has provided comprehensive information regarding the difficulties experienced by these individuals and their families over long periods of time after injury. Findings have been published in over 70 international peer reviewed journal articles, and in over 110 national and international conference presentations. This is one of the largest and most comprehensive databases worldwide and to our knowledge the only one incorporating follow up over more than 20 years after injury. Sexuality following traumatic brain injury J. Ponsford, R. Stolwyk, M. Downing Project Synopsis: Despite extensive documentation of relationship problems following traumatic brain injuries, there have been relative few studies examining sexuality in this group. As part of the longitudinal head injury outcome study we have surveyed patients at 1,2,3,5, 10 and 20 years post injury, aiming to identify the nature and frequency of changes in sexual behaviour, affect, self esteem and relationship quality, and their interrelationships and changes over time. We have validated a scale to assess these aspects of sexuality in individuals with TBI, the Brain Injury Questionnaire on Sexuality. Factors predicting these problems have been identified, as a basis for the development of interventions. In we had three papers on this work published in the Journal of Head Trauma Rehabilitation and made several presentations of the work at national and international conferences. Investigation of substance use following traumatic brain injury J. Ponsford, G. Spitz, M. Carty Project synopsis: Studies have found that a significant number of individuals with TBI report a history of substance abuse, and alcohol and drugs are implicated as causal factors in 36 51% of TBI cases. The deleterious effects of substance abuse on medical, neurological, neurobehavioural, and functional outcomes have been demonstrated Despite this, many of the alcohol and drug use problems remain unidentified, and are consequently neglected during the rehabilitation process. Although there appears to be an initial decline in substance use following TBI, a recent review indicated that a subpopulation of patients continue, or even begin to abuse substances post injury. However, studies examining the rates of alcohol illicit drugs longitudinally have been scarce. Therefore the aims of this study 9

10 are to examine pre injury drug and alcohol use compared with the normal population, and to investigate the development of alcohol and drug use over time. This includes the identification of variables that predict drug and alcohol use. Psychiatric disorders following traumatic brain injury J. Ponsford, K. Gould, L. Johnston, Y. Alway, A. McKay Project Synopsis: Psychiatric disorders are common following traumatic brain injury (TBI), and exacerbate disability and impede psychosocial and vocational reintegration. The aim of this project is to prospectively examine the frequency, course, and predictors of psychiatric disorders over the first five years following TBI. Specifically, the pre injury injury related and post injury factors associated with the development, course and remittance of psychiatric disorders will be examined. Further, as the impact of a TBI extends beyond the injured individual, a secondary aim is to examine the influence of family dynamics on both patient and family psychosocial adjustment following TBI. The influence of genetic factors, specifically the Apolipoprotein gene, and age at injury on outcome following head injury J. Ponsford, R. Burke, D. Senathi Raja, C.Willmott. Project synopsis: Traumatic Brain Injury can result in significant disability, but outcome is variable. The impact of known predictors accounts for a limited proportion of the variance in outcomes. Apolipoprotein E genotype has been investigated as an additional source of variability in injury severity and outcome, with mixed findings reflecting variable methodology and generally limited sample sizes. This study aims to examine whether possession of the Apolipoprotein E 4 allele was associated with greater acute injury severity and poorer long term outcome in patients referred for rehabilitation following TBI. We are now also investigating the impact of catechol O methyltransferase (COMT Val158Met) allele status on cognitive and functional recovery following TBI. The influence of cultural background on rehabilitation and outcome following traumatic brain injury J. Ponsford, J.Dahm. Project synopsis: Most TBI outcome studies focus on white, Anglo Saxon English speaking patients who identify with the dominant health care system. Little is known of the experience of TBI individuals from non Englishspeaking backgrounds and potential influences of cultural factors upon attitudes and responses to rehabilitation. This study is examining the influence of linguistic cultural background, and beliefs about injury and recovery on participation in rehabilitation and subsequent outcomes in two groups with mild severe TBI, one of English speaking background (ESB) and another of culturally and linguistically diverse background (CALD). As the cohort grows in size we also aim to differentially compare groups from different countries. 10

11 Efficacy of Motivational Interviewing and Cognitive Behaviour Therapy for Anxiety and depression following traumatic brain Injury. J. Ponsford, M. O Donnell, N. Lee., M. Hsieh, A. McKay, D. Wong Project synopsis: There is a high incidence of psychiatric disorders following TBI, most commonly anxiety and depression. Consequently, there is a need for effective psychological treatments to enhance psychosocial outcomes for this group. This NHMRC funded randomised controlled trial is examining the efficacy of a cognitive behaviour therapy (CBT) based treatment program adapted for a community sample with moderate severe TBI. Motivational Interviewing (MI) is also being evaluated as a preparatory intervention to increase motivation to change and engagement in treatment. Adult participants are randomly assigned to one of three treatment conditions, (1) MI+CBT, (2) CBT only and (3) treatment as usual (control). Assessment includes a semi structured clinical interview to determine psychiatric diagnoses; and measures of anxiety, depression, psychosocial functioning, coping style and cognitive functioning. The interventions are guided by manuals adapted for participants with TBI, with an emphasis on flexibility to tailor therapy to individual needs and cognitive difficulties. Preliminary results from individual cases in this ongoing study suggest potential benefit from the treatment program. A high comorbidity of depression and anxiety is also evident, highlighting the challenges in assessing and treating psychiatric disorders following TBI. The study results will inform clinical practice by providing evidence about relative effectiveness of interventions for individuals with TBI who suffer from anxiety/depression. Light therapy for sleepiness and fatigue following traumatic brain injury K. Sinclair, J. Ponsford, S. Rajaratnam, S. Lockley Project synopsis: This novel study, is funded by the Victorian Neurotrauma Initiative (now TAC) the first randomised controlled trial of a non pharmacological treatment for post TBI sleepiness and fatigue. It builds on our existing work investigating the prevalence and nature of fatigue and sleepiness post TBI, and demonstrating the efficacy of light to improve alertness in healthy volunteers. The primary aim of this study is to evaluate, in a randomized controlled trial, the effect of blue light therapy (Philips Home Healthcare Solutions Apollo) versus yellow light therapy (placebo) and treatment as usual on subjective daytime sleepiness and fatigue. It is hypothesized that participants will show reduced daytime sleepiness and fatigue, improved sleep quality, attention, reaction time, and health related quality of life, and reduced depression following blue light therapy, compared with those receiving yellow light therapy or treatment as usual. If successful in alleviating fatigue and daytime sleepiness and/or their impact on individuals lifestyles, blue light therapy could be readily implemented into clinical practice, as it is relatively unobtrusive and inexpensive to deliver. Efficacy of Melatonin for sleep disturbance following Traumatic Brain Injury J. Ponsford, S. Rajaratnam, N. Grima Project synopsis: Sleep disturbance is a common problem in individuals who have sustained a Traumatic Brain Injury (TBI), with over half of those with moderate to serve TBI still experiencing difficulty with sleep 10 years post injury. Presently, there is no evidence based treatment for these complaints, despite their high prevalence. Recently published research, suggests that reduced concentrations of Melatonin may explain the 11

12 reported sleep disturbance in this population. Melatonin is involved in the circadian control of the sleep wake cycle. Numerous studies have demonstrated efficacy and safety of exogenous Melatonin treatment of sleep complaints. In light of these findings, the current study, funded by an NHMRC Project grant, is the first randomised controlled trial of Melatonin for sleep disturbance following TBI. It is anticipated that TBI patients who receive Melatonin therapy will show reduced latency to sleep onset, and improved sleep quality. If Melatonin therapy is successfully shown to improve sleep, this could substantially improve the quality of life in TBI patients. Safer Roads to Recovery: Asessing Readiness for Driving after Traumatic Brain Injury J. Charlton, R. Stolwyk, J. Ponsford, M. Bedard, S. Marshall, P. Ross. More than two thirds of traumatic brain injury (TBI) survivors return to driving. Despite this, limited research investigating driving performance following TBI has been conducted. The aims of this collaborative study funded by the Victorian Neurotrauma Initiative and Ontario Neurotrauma Foundation are to examine, objectively, the nature and causes of driving difficulties following TBI as a basis for developing more reliable and valid assessment procedures for readiness to return to driving and thereby improving the safety of drivers with TBI. Key objectives are to examine: (1) which specific driving behaviours are compromised post TBI; (2) which pre injury, injury related, sensori motor, cognitive, personality factors are associated with these driving difficulties; and (3) to identify the degree to which off road, simulated and on road assessment predict naturalistic driving behaviour. Driving performance will be investigated in simulated, on road and naturalistic driving conditions. Findings from this study will significantly contribute to a currently limited evidence base available for rehabilitation clinicians assessing driver readiness. This research will guide the development of more sensitive driving evaluation procedures including cognitive screening, simulated and on road assessment. Findings will also form the basis of more effective driving retraining programs, thereby contributing to improved safety and mobility for those with TBI who return to driving. The return of memory following traumatic brain injury: The critical role of the medial temporal lobe, prefrontal cortex, and associated brain areas. J.Ponsford, M.Mundy Project synopsis: Post traumatic amnesia (PTA) is a hallmark period following traumatic brain injury (TBI) that is characterised by profound memory impairment. The length of time individuals remain in PTA has emerged as one of the strongest predictors of acute as well as long term functional outcome. No study has examined the correspondence between impaired memory processes present during this period and the disruption to underlying brain regions and networks. The frontal and temporal lobes are most frequently affected following TBI. Anatomical structures within these regions are essential for memory processing. The prefrontal cortex is critical for processing information in working memory, whereas the medial temporal lobe comprises a system of structures critical for transferring information from working to long term memory. It is not known, however, 12

13 to what extent changes to these brain structures reflect the memory impairment exhibited in PTA. This pilot project aims to identify the brain regions and networks implicated in impaired memory in patients with traumatic brain injury during PTA using fmri and to examine changes in BOLD activation in specific brain structures or networks that may modulate the recovery of memory following PTA. Reducing Behaviours of Concern following Traumatic Brain Injury Program Phase 1: BoC Case File Audit and Qualitative Study. J. Ponsford, M. Hopwood, J. Kennardy, K. Gould Behaviours of concern following traumatic brain injury (TBI) including aggression, agitation, sexual inappropriateness and lack of initiation present significant challenges for the person with TBI, the people who care for and support them, service organisations and wider society. These behaviours often result in social isolation, relationship breakdown and dislocation from accommodation, and create a significant burden for the person living with TBI, families or other carers. There is concern within the TAC that a group of clients with behaviours of concern is excessively reliant on attendant care support and that this reliance is increasing over time in some cases. A recent analysis of these clients established that a significant percentage of these cases exhibited problematic behaviours of concern on the Overt Behaviour Scale. The broad objective of this project is to identify the factors underpinning chronic behaviours of concern in TAC clients, as a basis for development and evaluation of a program to alleviate these behaviours, enhance client independence and participation and reduce costs. Cognitive rehabilitation following traumatic brain injury: An exploration of current practice C. Richardson, K.Sinclair, P.Bragge, M.Bayley, J, Ponsford Traumatic brain injury (TBI) can lead to diverse long term physical, cognitive, behavioural, and emotional changes. Cognitive difficulties including memory, learning, and problem solving issues can interfere with daily activities. Cognitive rehabilitation can address these difficulties thereby improving quality of life for individuals and their families. As yet there has been no systematic review of current practice of cognitive rehabilitation in Australia. This study examined 1) current practice in adult cognitive rehabilitation following moderate to severe TBI in Australia and 2) what factors influence the care provided to patients requiring cognitive rehabilitation following TBI in these settings. 13

14 Current Postgraduate Students Lingani Mbakile: DPsych in Clinical Neuropsychology Co supervisors J. Ponsford, L.Manderson Thesis title: The experience of families of those with brain injury in Botswana. Project Synopsis: Outcome following TBI for those who sustain the injuries and its impact on caregivers and families has been the subject of numerous studies, but most of these have been conducted in Western societies, such as North America, Europe and Australia. The differences in attitudes towards TBI across different cultures have been highlighted by a number of researchers and it has been shown that these may impact on long term outcome and adjustment. There is no such information available from Botswana. The primary focus of this study is to examine the experience of traumatic brain injuries in Botswana their causes, current treatment practices, the attitudes and beliefs about TBI and the changes and difficulties experienced by those injured, their caregivers and health care workers. Based on the information derived from these investigations, to develop a culturally sensitive resource manual for individuals with TBI and their families in Botswana and generate recommendations for health care workers in relation to management. Lingani has presented at two international conferences and ihas written two of the three papers that will consititute her thesis. Jane Dahm: DPsych in Clinical Neuropsychology Primary supervisor J. Ponsford Thesis title: Comparison of outcomes following traumatic brain injury and orthopaedic injury Project synopsis: Our prospective study evaluating outcome one and two years following severe orthopaedic trauma, relative to a control group, found significant ongoing disability and psychological problems, with little or no improvement between one and two years. Pain, anxiety, depression and/or PTSD symptoms were the strongest predictors of outcome on most variables, with older age also contributing. Injury severity and type did not predict outcome, although lower limb fractures were associated with greater pain and poorer physical outcomes. We are now conducting a ten year follow up on this cohort and will compare their outcomes with those of a group of TBI patients. Jane is currently in the process of writing her thesis and has submitted two of the three planned papers from her thesis. 14

15 Yvette Alway: DPsych in Clinical Psychology Primary supervisor J. Ponsford, A. McKay, K. Gould. Thesis title: A Prospective Examination of the Frequency, Course, and Predictors of Psychiatric Disorders following Traumatic Brain Injury Project synopsis: Psychiatric disorders are common following traumatic brain injury (TBI), and exacerbate disability and impede psychosocial and vocational reintegration. The aim of this project is to prospectively examine the frequency, course, and predictors of psychiatric disorders over the first five years following TBI. Specifically, the pre injury injury related and post injury factors associated with the development, course and remittance of psychiatric disorders will be examined. Further, as the impact of a TBI extends beyond the injured individual, a secondary aim is to examine the influence of family dynamics on both patient and family psychosocial adjustment following TBI. Yvette recently presented findings from this project at the ASSBI conference in Perth, and was awarded with the Luria prize for the best presentation by a Doctoral student.. Natalie Grima: DPsych in Clinical Neuropsychology Primary Supervisor J. Ponsford Thesis title: Efficacy of Melatonin for sleep disturbance following Traumatic Brain Injury Project synopsis: Sleep disturbance is a common problem in individuals who have sustained a Traumatic Brain Injury (TBI), with over half of those with moderate to serve TBI still experiencing difficulty with sleep 10 years post injury. Presently, there is no evidence based treatment for these complaints, despite their high prevalence. Recently published research, suggests that reduced concentrations of Melatonin may explain the reported sleep disturbance in this population. Melatonin is involved in the circadian control of the sleep wake cycle. Numerous studies have demonstrated efficacy and safety of exogenous Melatonin treatment of sleep complaints. In light of these findings, the current study is the first randomised controlled trial of Melatonin for sleep disturbance following TBI. It is anticipated that TBI patients who receive Melatonin therapy will show reduced latency to sleep onset, and improved sleep quality. If Melatonin therapy is successfully shown to improve sleep, this could substantially improve the quality of life in TBI patients. Pamela Ross: PhD student Co supervisors: J. Ponsford Thesis title: Safer Roads to Recovery: Asessing Readiness for Driving after Traumatic Brain Injury Project Synopsis: More than two thirds of traumatic brain injury (TBI) survivors return to driving. Despite this, limited research investigating predictors of driving performance following TBI has been 15

16 conducted. The aims of this retrospective study involving patients with traumatic brain injury who have been assessed at Epworth over the past 10 years, are to examine the factors associated with passing a driving assessment, and the experience of return to driving after the assessment process has been completed, as a basis for the development of guidelines for clinicians involved in the assessment process. Alicia Dymowski: DPsych in Clinical Neuropsychology Co Supervisors: J. Ponsford and C. Willmott Thesis title: Alleviating attentional disturbances following traumatic brain injury. Project synopsis: Project Synopsis: Traumatic brain injury (TBI) is the leading cause of mortality and morbidity of individuals aged under45 years of age. The most prevalent cognitive deficit resulting from moderate to severe TBI is impaired attention. The first aim of this project is to investigate the performance of individuals with TBI on attention and executive functioning tasks compared to matched healthy controls. The second aim is to conduct a 7 week double blind, placebo controlled clinical trial to investigate the efficacy of methylphenidate (MP), a central nervous system stimulant, in improving attention and speed of thinking after TBI. The third aspect of this study is to investigate the efficacy of computerised Attention Process Training 3 (APT3) compared to individualised strategy training in improving attention following TBI. This research will likely lead to improved rehabilitation of attention deficits following TBI. Jacqui Owens: DPsych in Clinical Neuropsychology Co supervisors: C. Willmott, J. Ponsford. Thesis title: The association between neuroanatomical correlates of attention and working memory, and response to methylphenidate in traumatic brain injury rehabilitation Project synopsis: Attention and working memory deficits are one of the most common deficits seen after moderate to severe traumatic brain injury (TBI). Methylphenidate is a psychoactive drug that has shown promise in alleviating attention deficits seen post TBI. However, response to the drug can be varied which may reflect differences in underlying neuropathology. This study aims to investigate the relationship between underlying neuropathology, particularly white matter damage, and attentional performance as well as response to methylphenidate in moderate to severe TBI patients. 16

17 James Gooden : DPsych in Clinical Neuropsychology Co Supervisor: J, Ponsford, R. Stolwyk Thesis title: Awareness and driving following traumatic brain injury. Project synopsis: This study involves a sample of individuals who have recently sustained a TBI as they begin their return to driving. The study forms part of a larger international project investigating the predictors of a safe return to driving following TBI. In order to assess self awareness and driving, a new measure is being developed that specifically examines a participant s awareness of their driving abilities. Part of this development process will include psychometric validation to ensure the measure is both valid and reliable. Additionally, James is exploring how awareness relates to changes in driving behaviour three months after passing a driving assessment in order to understand the longer term implications of difficulties such as impaired awareness. James will present papers based on hispreliminary findings at the Mid Year meeting of the international Neuropsychological Society in Jerusalem, 9 11 July 2014, and the conference of the Neuropsychological Rehabilitation Special Interest Group of the WFNR in Cyprus, July 14 15, Sylvia Nguyen: DPsych in Clinical Neuropsychology Co Supervisor: J, Ponsford, S. Rajaratnam, A. McKay. Thesis title: Efficacy of cognitive behavioural therapy in managing fatigue and sleep disturbance following traumatic brain injury Project synopsis: Fatigue and sleep disturbance are among the most common, persistent, and debilitating problems following traumatic brain injury (TBI). The proposed randomized controlled trial aims to evaluate the effectiveness of cognitive behaviour therapy (CBT), including physical exercise therapy in alleviating self reported fatigue and sleep disturbance following TBI. It is hypothesized that participants receiving CBT will report less day to day fatigue and/or improved sleep quality 8 weeks after commencement of the therapy and at 3 month follow up, compared with a wait list control group. Participants will be assessed pre intervention, post intervention, and at 3 months follow up on measures of sleep and fatigue, anxiety/depression, and health related quality of life. Actigraphic recording will occur from recruitment to end of treatment to obtain objective measures of sleep efficiency and latency to sleep onset. If successful in alleviating fatigue and sleep disturbance and their impact on lifestyle, CBT could substantially improve the quality of life of individuals with TBI. As the intervention is relatively unobtrusive and inexpensive to deliver, it could be implemented into clinical practice soon after completion of the trial. Coco Bernard: DPsych in Clinical Neuropsychology 17

18 Supervisors: A. McKinlay, J, Ponsford, Thesis title: Assessing concussion symptoms in children with mild traumatic brain injury Project synopsis: Existing concussion symptom checklists have been developed based on symptoms reported by adults. Little is known about the appropriateness of such checklists for children, especially young children. The overall aim of this study, being conducted at Sunshine Hospital, is to evaluate the concussive symptoms exhibited by young children following a TBI event and to develop an age appropriate concussive symptom checklist for use by professionals. Jessica Trevena Peters: DPsych in Clinical Neuropsychology Co supervisor: J.Ponsford, A.McKay Thesis title: Efficacy of early therapy for patients in post traumatic amnesia. Project synopsis: Traditionally rehabilitation in traumatic brain injury has been delayed until after the emergence from post traumatic amnesia (PTA), a period of confusion following coma, in order to minimize agitation and maximize learning potential. However this practice has never been evaluated. This may miss the potential to make earlier rehabilitation gains. In this randomized controlled trial we will examine the efficacy of providing training in daily living skills to TBI patients still in PTA in improving functional outcome at discharge and reducing length of hospital stay. Outcomes of this world first pilot may influence practice in brain injury services world wide. This study has commenced, with support of grants from the Epworth Research institute and a Monash University Strategic grant in 2013 and an ISCRR grant commencing in Jan 2014 and ending in June Celia Pais: DPsych in Clinical Neuropsychology Co supervisor: J. Ponsford, D. Wong, K. Gould Thesis title: Factors predictive of post traumatic growth following traumatic brain injury Project synopsis: A majority of studies have focused on reducing the negative impact of traumatic brain injury (TBI) on cognition, psychological health and interpersonal relationships. In the past few years recent studies have emerged which suggest that positive psychological outcomes or posttraumatic growth (PTG) can also be achieved following TBI. PTG has been shown to correlate with desirable rehabilitation outcomes such as reduced levels of psychological distress and improved wellbeing. Studies of PTG within the TBI population are however at their infancy and have been limited by the depth and scope of variables which have been investigated. If salient personal characteristics can be shown to be predictive of PTG, clinicians could gain valuable insight on how to encourage positive growth following TBI. This study aims to determine whether pre injury personality traits, value 18

19 consistent living, severity of head injury and psychiatric diagnosis may be related to or predictive of PTG following TBI. A cross sequential design will be utilized with data collected at time points ranging across one year intervals from 6 months to 6 years post injury. A one year follow up will be conducted to assess change over time. Doctoral Thesis Completions Cally Richardson: DPsych in Clinical Neuropsychology Primary Supervisor J.Ponsford Thesis title: The evolution of self awareness following traumatic brain injury. Project synopsis: This research is examining how we can best measure awareness as current approaches often fail to adopt measures that fully encompass different aspects of awareness. To do this we also need to have a better understanding of biological, cognitive, psychological and social factors that influence awareness and the time course of awareness after injury. In the current study we are administering measures to assess, firstly what is known as metacognitive awareness which is basic knowledge of the difficulty and pre existing knowledge of the cognitive processes required for a particular task. This is opposed to online awareness which is activated during a task and requires judgment about one s abilities and limitations in relation to the current situation. We are following up TBI patients at 3, 6, and 12 months following their injury. At each time point patients undergo a relatively short battery of tests that assess their attention, memory, and executive functions, questionnaires and a computerised task assessing metacognitive and online awareness, as well as undergo an MRI examination. This study has the potential to directly impact the treatment and rehabilitation of TBI survivors. By examining the trajectory of organic brain changes, cognitive functions, and awareness over the first year after injury it will provide a basis for understanding and predicting the challenges and difficulties experienced by TBI survivors. Cally has recently graduated from the DPsych in Clinical Neuropsychology and has had two of her three submitted papers accepted for publication. Honours Thesis Completions in Caroline Roberts: Honours in Psychology Supervisors: J. Ponsford, G. Spitz Thesis Title: The Duration of Post Traumatic Amnesia on the Westmead PTA Scale: Order of Item Recovery and Comparison with Retrospective Reports 19

20 The duration of post traumatic amnesia (PTA) is considered one of the best indicators of TBI severity and has been found to predict a number of outcome variables, including the length of hospitalisation, independence, employment and cognitive function. The accurate measurement of PTA duration is therefore of vital importance. PTA duration is traditionally assessed retrospectively by requesting a patient recall their first memory following the incident after they have regained full consciousness. However, limitations surrounding the reliability of this method have lead to the development of quantitative, prospective measures such as the Westmead PTA Scale (WPTAS), the most commonly used scale in Australia. Despite the widespread use of the scale, few studies have examined the recovery of PTA on the WPTAS and it is not known how PTA duration on the scale compares with a patient s first memory. This project therefore aims firstly to examine the order of item recovery on the WPTAS and secondly to compare the progression of PTA on the scale with retrospective patient reports ascertained by telephone interview. Caroline was awarded first class honours on completion of her Honours year at Monash, graduating first overall in her Honours Year and awarded the APS prize. She is currently enrolled in the Doctorate of Clinical Neuropsychology at Monash University and will extend her studies of PTA following TBI. Shayden Bryce: Honours in Psychology Supervisors: J. Ponsford, G. Spitz Thesis title: Substance Abuse Following Moderate to Severe Traumatic Brain Injury: A Comparison of Measures Substance abuse is a commonly diagnosed disorder following traumatic brain injury (TBI) that has the potential to impede the recovery process. Therefore the assessment of post injury substance abuse appears to be important for facilitating more positive prognoses. The SCID is the gold standard in psychiatric evaluation, however it is time consuming and expensive. Briefer drug/alcohol screening measures are much simpler and can be administered by untrained staff. However, there has been limited validation of these scales for assessing alcohol and drug use in the TBI population. That is, research examining the degree of correspondence between the gold standard measures, namely the SCID, and screening instruments in a TBI population is limited. In a general hospital setting, the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Abuse Screening test (DAST) are two widely recommended substance abuse screening measures. Moreover these measures have been used in previous TBI research. However, their concurrent validity, relative to the SCID, has not be assessed in this population. Therefore this project aims to examine the association between the AUDIT and the DAST, and the diagnosis of substance use using the SCID, at specified time intervals. 20

21 Awarded first class honours on completion. Paper based on the study accepted for publication in the Journal of Head Trauma Rehabilitation. Currently enrolled in the Doctorate of Clinical Neuropsychology at Monash University. Toni Wittiel: Honours in Psychology Supervisors: C.Willmott, J.Ponsford Thesis title: The Impact of COMT VAL158MET on Cognitive Outcomes Following Traumatic Brain Injury. In looking to enhance the understanding of outcomes following brain injury, recent literature has examined genetic explanations of individual variability. One promising candidate gene is the gene COMT VAL158MET. COMT codes for the enzyme Catechol O Methyltransferase (COMT) which mediates the degradation of catecholamines particularly within the pre frontal cortex (Turnbridge, Harrison, & Weinberger, 2006). This is of particular importance as these neurotransmitters play a critical role in efficient cognitive functioning, with a delicate optimum balance necessary to process contextually relevant cognitive information while inhibiting background information (Arciniegas & Silver, 2006). In light of COMT s role in modulating the breakdown of catecholamines in the PFC it is easy to see how genetically inhereted polymorphisms could impact upon cognitive outcomes following TBI. To date, only two studies have examained the influence of COMT on cognitive outcomes in a brain injured sample, both with promising findings. However, these studies are limited in that they employed a relativley small sample size and found only modest significance. The current project aims to examine the relationship between cognitive outcome post injury and COMT status in a TBI population. Toni s honours thesis was awarded first class honours and has been acepted for publication in the Journal of Neurotrauma. She is currently enrolled in the Doctorate of Clinical Neuropsychology at Monash University. 21

22 Journal Publications: June Dahm, J., Wong, D., Ponsford, J. (2013). Utility of the Depression Anxiety Stress Scales in assessing depression and anxiety following traumatic brain injury. Journal of Affective Disorders, 151 (1): Spitz, G., Bigler, E.D., Abildskov, T., Maller, J.J., O Sullivan, R., & Ponsford, J.L., (2013). Regional cortical volume and neuropsychological functioning following traumatic brain injury. Brain and Cognition, 83: Wong, D., Dahm, J., & Ponsford, J. (2013). Factor structure of the Depression Anxiety Stress Scales in individuals with traumatic brain injury. Brain Injury, Early online, 1 6. doi: / Ponsford, J.L., Downing, M., Olver, J., Ponsford, M., Acher, R., Carty, M., & Spitz, G. (2013). Longitudinal follow up of patients with traumatic brain injury: Outcome at 2, 5, and 10 years postinjury. Journal of Neurotrauma, ahead of print. doi: /neu Spitz, G., Maller, J.J., Ng, A., O Sullivan, R., Ferris, N. & Ponsford, J.L. (2013). Detecting lesions following traumatic brain injury using susceptibility weighted imaging: A comparison with FLAIR, and correlation with clinical outcome. Journal of Neurotrauma, Ahead of print doi: /neu Sinclair, K., Ponsford, J., & Rajaratnam, S. (2014). Actigraphic Assessment of Sleep Disturbances following Traumatic Brain Injury. Behavioral Sleep Medicine, 12 (1), DOI: / Published: 2014 Jan 2 (Epub 2013 Feb 08). Ponsford, J. & Sinclair, K. (2014). Sleep disturbance and fatigue following traumatic brain injury (Review). Psychiatric Clinics of North America. Volume 37, Issue 1, March 2014,

23 Sinclair, K., Ponsford, J., Taffe, J., Lockley, S.W., Rajaratnam, S.W.,(in press). Randomised controlled trial of blue light therapy for fatigue following traumatic brain injury. NeuroRehabilitation and Neural Repair, Accepted 17 July, Willmott, C., Ponsford, J., Downing, M., Carty, M. (in press). Frequency and Quality of Return to Study following Traumatic Brain Injury. Journal of Head Trauma Rehabilitation, Accepted 11 September, 2013 Ponsford, J., Kelly, A., Couchman, G. Self concept after traumatic brain injury: A control group comparison. Brain Injury. Accepted 18 th October, Gould, K.R, Ponsford, J.L., & Spitz, G. (2013). Contributions of cognitive impairments to anxiety disorder following traumatic brain injury. Journal of Clinical and Experimental Neuropsychology,36 (1), 1 14, DOI: / Richardson, C., Ponsford, J., & McKay, A. A cross sectional analysis of self awareness deficits after traumatic brain injury from 3 months to 20 years post injury: the importance of injury severity and emotional distress in self and close others. Journal of Head Trauma Rehabilitation, Accepted 3 Dec Ponsford, J., Schönberger, M., & Rajaratnam, S. (in press) A model of fatigue following traumatic brain injury. Journal of Head trauma Rehabilitation, Accepted 17 January, 2014 Ponsford, J., & Spitz, G. (2014). Stability of employment over the first three years following traumatic brain injury. Journal of Head Trauma Rehabilitation. Published on line 8 May 2014 DOI: /HTR Schönberger, M., Ponsford, J. McKay, A., Wong, D., Spitz, G., Harrington, H., & Mealings, M. (2014). Development of psychological adjustment during the course of community based rehabilitation of traumatic brain injury: A preliminary study. Neuropsychological Rehabilitation, 24 (2) DOI: /

24 Grant, M., Ponsford, J., & Bennett, P. (2014) Goal Attainment Scaling in brain injury rehabilitation: strengths, limitations and recommendations for future applications. Neuropsychological Rehabilitation, Published online 1 May, DOI: / Couchman, G., McMahon, G.. Kelly, A., Ponsford, J., (2014) A new kind of normal: Qualitaitve Accounts of Multi Family Group Therapy for Acquired Brain Injury. Neuropsychological Rehabilitation, Published online 13 May 2014: http//dx.doi.org/ / Willmott, C., Witheil, T., Burke, R., Spitz, G., & Ponsford, J.(in press). COMT Val158Met and cognitive and functional outcomes after traumatic brain injury. Journal of Neurotrauma. Accepted 28 April, Bragge, P., Kua, A., Stergiou Kita, M., Marshall, S., Pattuwage, L., Pitt, V. Piccenna, L., Ponsford, J., Tate, R. Teasell, R. Velikonja, D., Wiseman Hakes, C., Bayley, M. (in press). Quality of Guidelines for Cognitive Rehabilitation following Traumatic Brain Injury. Journal of Head Trauma Rehabilitation, Acceoted 20 April, 2014 Bayley, M. Bragge, P. Douglas, J., Ponsford, J. Togher, L.,,Green, R. Tuskstra, L., Kua, A. INCOG guidelines for Cognitive Rehabilitation following Traumatic Brain Injury: Methods and Overview. Journal of Head Trauma Rehabilitation, Accepted 20 April, Ponsford, J., Janzen, MacIntyre, Bayley, M., Bragge, P., Tate, R., & Velikonja, D., (in press) INCOG Recommendations for management of cognition following TBI Part I: Post Traumatic Amnesia. Journal of Head Trauma Rehabiilitation, Accepted 2 May Ponsford, J. Bragge, P., Wiseman Hakes, C., Togher, L., Velakonja, D., Tate, R., Bayley, M. (In press) INCOG Recommendations for management of cognition following TBI Part II: Attention and information processing speed. Journal of Head Trauma Rehabilitation, Accepted 30 April,

25 Tate,R., Bayley,M., Douglas, J. Kita, M. Ponsford,,J., Bragge, P., Velikonja, D. Kennedy,M. (in press). INCOG Recommendations for management of cognition following TBI: Part III. Journal of Head Trauma Rehabilitation, Accepted 26 April, Togher, L., Wiseman Hakes, C., Turkstra, L., Douglas, J.. Bragge, P., Bayley, M., Stergiou Kita, M., Ponsford, J., Teasell, R. INCOG Recommendations for Management of Cognition: Part IV. Cognitive Communication. Journal of Head Trauma Rehabilitation, Accepted 29 Aprii, Velikonja, D., Bragge, P., Bayley, M, Green, R. Tate, R Janzen, S., McIntyre, A., Ponsford, J. INCOG Recommendations for management of cognition following TBI Part V: Memory. J ournal of Head Trauma Rehabilitation, Accepted 28 April, Dahm, J., & Ponsford, J. Comparison of long term outcomes following traumatic injury: What is the unique experience for those with brain injury compared with orthopaedic injury? Paper submitted to Injury, February, Revised and resubmitted March Accepted pending minor revisions, 10 June Mihaljcic, T., Stolwyk, R. Ponsford, J., Haines, T. (in press). Development of a New Self Awareness of Falls Risk Measure. Archives of Gerontology and Geriatrics. Accepted 9 June Bryce, S; Spitz, G.; Ponsford, J. (in press). Screening for substance use disorders following traumatic brain injury: Examining the validity of the AUDIT and DAST. Journal of Head Trauma Rehabilitation, Accepted 27 May Ross, P., Ponsford, J., Di Stefano, M., Spitz, G. Predictors of On Road Driver Assessment Performance after Traumatic Brain Injury. Paper submitted to Archives of Physical Medicine and Rehabilitation, December, Revised and resubmitted June 2013 Further revised and resubmitted October, Further revised and resubmitted March Richardson, C., McKay, A., Ponsford, J. (in press).. Does feedback influence awareness following traumatic brain injury? Neuropsychological Rehabilitation, Accepted 17 June,

26 Richardson, C., McKay, A., Ponsford, J. The trajectory of awareness across the first year after traumatic brain injury: The role of biopsychosocial factors. Paper submitted to Brain Injury, November, Revised and resubmitted June Bosch, M., McKenzie, J.E.,Mortimer, D., Tavender, E.J., Francis, J.J., Brennan, S.,E. Knott, J.C., Ponsford, J.L., Pearce, A., O Connor, D.A., Grimshaw, J.M., Rosenfeld, J.V., Gruen, R.L., Green, S.E. on behalf of the trial investigators. Implementing evidence based recommended practices for the management of patients with mild traumatic brain injuries in Australian emergency care departments: a CRT study protocol. Revised and resubmitted June, Tam, S., McKay, A., Sloan, S., & Ponsford, J. The Experience of Challenging Behaviours Following Severe TBI: A Family Perspective. Paper submitted to Brain Injury, October, Currently under revision. Gould, K., & Ponsford, J. A longitudinal examination of positive changes in quality of life after traumatic brain injury. Paper submitted to Brain Injury, February, Ross, P., Ponsford, J., Di Stefano, M., Charlton, J., & Spitz, G. On the road again after traumatic brain injury: Driver safety and behavior following on road assessment. Paper submitted to the Journal of Head Trauma Rehabiilitation, May, Gabbe, B.J., Braaf, S., Fitzgerald, M., Judson, R., Harrison, J., Lyons, R., Ponsford, J., Collie, A., Ameratunga, S., Attwood, D., Christie, N., Nunn, A., Cameron, P. RESTORE: REcovery after Serious Trauma Outcomes, Resource use and patient Experiences study protocol. Paper submitted to Injury Prevention, June, Roberts, C., Ponsford, J., Spitz, G. Order of Item Recovery on the Westmead Post Traumatic Amnesia Scale (WPTAS). Paper submitted to Neuropsychology, June,

27 Roberts, C., Spitz, G. Ponsford, J., Comparing Prospectively Recorded PTA Duration with Retrospective Accounts One to Six Years Post Injury. Paper submitted to the Journal of Neurology, Neurosurgery and Psychiatry, June

28 Conference Presentations: Ponsford, J. Sexuality following traumatic brain injury. Invited keynote address. Identity after Brain Injury.Conference of the Oliver Zangwill centre, Newmarket Racecourse, Cambridgeshire, UK, 5 July, Ponsford, J. Sexuality following traumatic brain injury: A much ignored problem in neurorehabilitation. Paper presented at the 10 th Conference of the Neuropsychological Rehabilitation Special Interest Group of the World Federation for NeuroRehabilitation, Maastricht, The Netherlands, 9 10 July, 2013 Gould, K., Ponsford, J., Johnston, L., Always, Y., & Spitz, G. Contribution of cognitive impairments to anxiety disorder following traumatic brain injury. Paper presented at the 10 th Conference of the Neuropsychological Rehabilitation Special Interest Group of the World Federation for NeuroRehabilitation, Maastricht, The Netherlands, 9 10 July, Mbakile, L.,Ponsford, J., & Manderson, L. The experience of traumatic brain injury in Botswana. Paper presented at the 10 th Conference of the Neuropsychological Rehabilitation Special Interest Group of the World Federation for NeuroRehabilitation, Maastricht, The Netherlands, 9 10 July, Stolwyk, R. A longitudinal comparison of patient and close other reports of neuropsychological change 1 to 5 years following traumatic brain injury. Datablitz presented at the 10 th Conference of the Neuropsychological Rehabilitation Special Interest Group of the World Federation for NeuroRehabilitation, Maastricht, The Netherlands, 9 10 July, Mihaljcic, T., Stolwyk, R., Ponsford, J. Developing a measure of self awareness of falls risk and functional ability in the older population undergoing inpatient rehabilitation. Poster presented at the 10 th Conference of the Neuropsychological Rehabilitation Special Interest Group of the World Federation for NeuroRehabilitation, Maastricht, The Netherlands, 9 10 July, Ponsford, J. It s not only the injury that matters, but also the kind of head. Presidential Address delivered at the Mid Year meeting of the International Neuropsychological Society, Amsterdam, July 10 13,

29 Willmott, C., Ponsford, J., Downing, M., & Spitz. Frequency and quality of return to study following traumatic brain injury. Paper presented at the Mid Year meeting of the International Neuropsychological Society, Amsterdam, July 10 13, Schönberger, M., Herrberg, M. & Ponsford, J. Fatigue as a cause, not a consequence of depression and daytime sleepiness: A cross lagged analysis. Paper presented at the Mid Year meeting of the International Neuropsychological Society, Amsterdam, July 10 13, Mbakile, L.,Ponsford, J., & Manderson, L. The experience of traumatic brain injury in Botswana. Poster presented at the Mid Year meeting of the International Neuropsychological Society, Amsterdam, July 10 13, Richardson, C., Ponsford, J., & McKay, A. Self awareness following traumatic brain injury. Poster presented at the Mid Year meeting of the International Neuropsychological Society, Amsterdam, July 10 13, Ponsford, J. Long term outcome following traumatic brain injury. Invited lecture given as part of a symposium on traumatic brain injury at the 4 th Scientific Meeting of the Federated of the European Societies of Neuropsychology (FESN), Berlin, Germany, September 12 14, Ponsford, J. What influences outcomes? Invited keynote address. Finding the Right Balance: Fifth National Brain Injury Conference, St Andrew s Healthcare, East Midlands Conference Centre, University of Nottingham, UK, October 30, Ponsford, J. What is the post concussion syndrome? Invited keynote address. Conference on mild traumatic brain injury and injuries in sports, hosted by Rehaklinik Belllikon and Suvacare, FIFA Stadium, Zurich, Switzerland, November 27 28, Ponsford, J. Outcome predictors and rehabilitation following mild TBI. Invited keynote address. Conference on mild traumatic brain injury and injuries in sports, hosted by Rehaklinik Belllikon and Suvacare, FIFA Stadium, Zurich, Switzerland, November 27 28,

30 Ponsford, J. Traumatic brain Injury: The challenge to improve outcome. Invited Keynote Presidential Address presented at the presented at the 42 snd Annual meeting of the International Neuropsychological Society, Seattle, USA, February 12 15, Ponsford, J. Its Not Only the Injury that Matters, but Also the Kind of Head. Keynote address presented at the Tenth World Congress on Brain Injury, of the International Brain Injury Association, San Francisco, 20 23, March, Dahm, J. & Ponsford, J. Comparison of long term outcomes following traumatic brain injury and orthopaedic trauma. Poster presented at the 42 snd Annual meeting of the International Neuropsychological Society, Seattle, USA, February 12 15, Ponsford, J. Sexual changes following traumatic brain injury: A much ignored problem. Invited seminar, Eighth World Congress for NeuroRehabilitation, Istanbul, Turkey, April 8 12, Ponsford, J., Downing, M., Spitz, G., Olver, J., Ponsford, M. Outcome 2, 5 and 10 years following traumatic brain injury. Paper presented at the 37 th Annual Brain Impairment Conference, Perth, 8 10 May, Ponsford, J., Downing, M., Stolwyk, R. Sexual changes following traumatic brain injury. Paper presented at the 37 th Annual Brain Impairment Conference, Perth, 8 10 May, Wong, D., Sinclair, K., Seabrook, E. McKay, A., Ponsford, J. Patterns of smartphone use in individiduals with traumatic brain injury. Poster presented at the 37 th Annual Brain Impairment Conference, Perth, 8 10 May, Ponsford, J. Traumatic brain injury: The challenge to improve outcome. Invited lecture, Service de readaptation en neurologie et paraplegie, Clinique romande de readaptation, Avenue Grand Champsec 90, Sion, Switzerland, 27 May, Wong, D., Sinclair, K., Seabrook, E. McKay, A., Ponsford, J. Patterns of smartphone use in individuals with traumatic brain injury. Poster presented at the Epworth Research Week, Melbourne, May,

31 Spitz, G., Maller, J.J., Ng, A., O Sullivan, R., Ferris, N.J., Ponsford, J.L. Detecting Lesions after Traumatic Brain Injury Using Susceptibility Weighted Imaging:A Comparison with Fluid Attenuated Inversion Recovery and Correlation with Clinical Outcome. Poster presented at the Epworth Research Week, Melbourne, May, Grima, N., Ponsford, J., Rajaratnam, S.W., Pased, M.P. Characterising sleep dysfunction following traumatic brain injury: A meta analysis.. Poster presented at the Epworth Research Week,Melbourne, May, Gould, K., & Ponsford, J. A longitudinal examination of quality of life after traumatic brain injury. Poster presented at the Epworth Research Week, Melbourne, May, Richardson, C., Sinclair, K., Bragge, P., & Ponsford, J. Cognitive rehabilitation following traumatic brain injury: An exploration of current practice. Poster presented at the Epworth Research Week, Melbourne, May, Richardson, C., McKay, A. & Ponsford, J. Factors associated with self awareness following traumatic brain injury. Poster presented at the Epworth Research Week, Melbourne, May, Conference Organisation Jennie Ponsford was a Scientific Planning Committee Member 2013 Mid Year Meeting International Neuropsychological Society Amsterdam, The Netherlands July 10 13, 2013 Jennie Ponsford was a Scientific Planning Committee Member 42nd Annual Meeting International Neuropsychological Society February 12 15, 2014 Seattle, Washington 31

32 Program Chair 2015 Mid Year Meeting International Neuropsychological Society July 1-4, 2015 Sydney, Australia Grants Awarded/Continuing in NHMRC Project Grant Motivational Interviewing with Cognitive Behaviour Therapy for Anxiety and Depression following Traumatic Brain Injury J. Ponsford, M.O Donnell, N. Lee $442, Victorian Neurotruama Initiative/Ontario Neurotruama Foundation Collaborative Project Grant Safer Roads to Recovery: Assessing Readiness for Driving after Traumatic Brain Injury J Charlton, M Bedard, J. Ponsford, S. Marshall, R. Stolwyk, P. Ross, S. Gagnon $450,286 over two years Victorian Neurotrauma Initiative Efficacy of light therapy for sleepiness and fatigue following TBI J.Ponsford, S. Rajaratnam, S.Lockley ( Chief Investigator) $281,446 32

33 Transport Accident Commission Longitudinal Head Injury Outcomes Study J.Ponsford, J.Olver (Chief Investigator) $1,281, NHMRC Project grant Efficacy of melatonin for sleep disturbance following traumatic brain injury J. Ponsford, S. Rajaratnam $217, NHMRC Centre of Research Excellence in traumatic brain injury psychosocial rehabilitation S McDonald, V. Anderson, J. Ponsford, R. Tate, L. Togher, T Ownsworth, J. Fleming, J. Douglas ( Chief Investigators) $2,500, Auatralian and New Zealand College of Aanesthetists Recovery and Well being after Major Surgery: complications, functional recovery, and the measurement of disability free survival P. Myles, D. McIlroy, M. Shulman, J Wallace, J. Ponsford $30, Epworth Research Institute Major grant Efficacy of Attention Process Training and Methylphenidate in TBI rehabilitation Dymowski, A., Ponsford, J., Willmott, C., Olver, J., Whyte, J., Ponsford, M. $49,949 33

34 ARC Linkage grant Chronic pain and functional impairment following traumatic injury: an investigation into the impact of compensation status and experience Georgiou Karistianis, A/Prof Nellie; Giummarra, Dr Melita; Cameron, Prof Peter A; Gibson, Prof Stephen; Ponsford, Prof Jennie L; Fielding, Dr Joanne; Jennings, Dr Paul A $310, Epworth Research Institute Grant The efficacy of early rehabilitation after traumatic brain injury. A,McKay, Ponsford. J., Olver. J., Suda. R., & Ponsford, M. $32, Institute for Safety Compensation and Recovery Research (ISSCR) Reducing Behaviours of Concern Following Traumatic Brain Injury Program Phase 1: BoC Case File Audit and Qualitative Study. J.Ponsford, M.Hopwood, J.Kennardy $ 90, Institute for Safety Compensation and Recovery Research (ISSCR) Post traumatic amnesia: Mechanisms, assessments and efficacy of early treatment Following TBI (Project Plan N ) J.Ponsford, A.McKay, J.Olver, R.Suda, J Trevena Peters, G.Spitz $ 409, William Buckland Foundation The efficacy of early rehabilitation after traumatic brain injury J.Ponsford, A.McKay, J.Olver, R.Suda, M.Ponsford $26,600 34

35 2014 Epworth Research Institute Grant (ERI) Cognitive behavioural therapy for fatigue following traumatic brain injury. J.Ponsford, A.McKay $ 21, The RECOVERY ICU Project: a cross disciplinary, innovative strategy to test the value of Recovery Focussed Management (RFM). J.Cooper, P.Myles, J.Kulkarni, J.Ponsford $ 85,200 Research Collaborations Centre of Excellence in Traumatic Brain Injury Research (CETBIR) Jennie Ponsford is one of the team leaders in the NTRI Centre of Excellence in traumatic Brain Injury Research (CETBIR), lead by Professor Russell Gruen, Director of National Trauma Research Unit (NTRI). Other leaders include Professor Peter Cameron,Professor of Emergency Medicine, Monash University & Academic Director, Trauma and Emergency Centre, Alfred Hospital; Professor Jamie Cooper, Associate Director, National Trauma Research Institute (NTRI) and Head Trauma ICU, Alfred Hospital; Professor Jeffrey Rosenfeld, Director of Neurosurgery, Alfred Hospital and Head Department of Surgery Monash University; and Professor Mark Fitzgerald, Director of Emergency & Trauma Centre at the Alfred Hospital. This Centre aims to build and maintain capacity for research excellence by bringing research leaders together to support high quality, multidisciplinary and collaborative research, host fellows in acute and rehabilitation projects, and train the next generation of research leaders. Objectives: Support the conduct and development of innovative, high quality, multi centre and collaborative research in traumatic brain injury Foster and continue to build capacity in the TBI research workforce Provide opportunities to expand and improve collaborations between TBI research teams Leverage existing national and international research collaborations, and explore new 35

36 collaborations Position Victorian researchers well to obtain ongoing competitive funding support. Currently two research fellows are funded by the CETBIR for 2014 Cally Richardson and Kelly Sinclair NHMRC Centre for Excellence in TBI Psychosocial Rehabilitation Jennie Ponsford is part of a team of chief investigators who have been the recipients of an NHMRC Centre of research Excellence in in Traumatic Brain Injury Rehabilitation grant, entitled the CRE in Traumatic Brain Injury Psychosocial rehabilitation: Breaking down barriers for social reintegration has an overarching aim to break down the barriers that currently prevent people with TBI returning to the community. It embraces basic research into remediation for emotional, social and communication disorders through to evaluation of clinical techniques to improve participation, focusing on selfcompetency, i.e., fatigue, mood, self awareness and self regulation and social competency, i.e. speech, social cognition, social skills and communication. Each member of the team is expert in different facets of remediation research. Professor Skye McDonald, who leads the team, is a neuropsychologist and world leader in the assessment and remediation of social cognition and communication disorders following TBI. Professor Vicki Anderson is a pediatric neuropsychologist with internationally recognised expertise in models of social function and interventions post child TBI. Professor Jennie Ponsford is a world renowned clinical neuropsychologist for research into evidencebased management of mild and moderate severe TBI, longitudinal outcomes and predictors. Professor Robyn Tate is a clinical neuropsychologist with an international profile in rehabilitation and outcome evaluation following TBI. Professor Leanne Togher is a world renowned speech pathologist for her work in communication and adult TBI. Dr Angela Morgan is a speech pathologist whose internationally acclaimed research is focused on new discoveries in genes, brain and behaviour associated with childhood communication disorders. Dr Jennifer Fleming is an occupational therapist with expertise in the assessment and rehabilitation of awareness and metacognitive skills. Dr Tamara Ownsworth is a clinical neuropsychologist internationally recognised for work on the rehabilitation of metacognitive impairments after TBI. Jacinta Douglas has combined skills in speech pathology and clinical neuropsychology research, underpinned by 30 years of clinical experience in TBI. Bruce Murdoch is a world renowned speech pathologist for physiologically based techniques to examine neurological communication disorders. This CRE will be a world first, providing a platform to tackle psychosocial deficits on a number of coordinated fronts addressing psychosocial deficits from basic impairment through to participation, focusing on self competency, i.e., fatigue, mood, self awareness and self regulation and social competency, i.e. speech, social cognition, social skills and communication. All CRE researchers are engaged in translational clinical research that has a multi disciplinary focus in contrast to the way in which (discipline specific) training of clinicians occurs. The CRE will be a pivotal interface to translate 36

37 research to clinical practice. This CRE will provide the structure and support for research training for clinicians from allied health professions via scholarships, postdocs, websites, meetings, mentoring and across site training. The CRE will enable skills sharing, unify divergent approaches, reduce duplication, and facilitate data collection across sites, thus improving the efficacy of all researchers. It will capitalise on the internationally recognised expertise and funding of members. With increased collaboration, the potency and productivity of research efforts will be magnified, enhancing Australia s profile in improving TBI outcomes. Other collaborations: Collaboration has also been developed with A/Professor Meaghan O Donnell from the Australian Centre for Post Traumatic Mental Health and Dr Nicole Lee towards the development of interventions studies for psychological disorders in individuals with traumatic brain injury. Meaghan and Nicole are both Chief Investigators on a current NHMRC grant on which Jennie Ponsford is CIA, the aim of which is to investigate the Efficacy of Motivational Interviewing and Cognitive Behaviour Therapy for Anxiety and Depression following Traumatic Brain Injury. They are collaborating closely with research team, providing clinical supervision to clinicians delivering the therapy. The Centre also has a close collaborative relationship with Dr Richard O Sullivan the Director of Magnetic Resonance Imaging (MRI) at Epworth Hospital, who contributes to research on imaging following traumatic brain injury. Collaborations have been forged with Professor Erin Bigler of Brigham Young University in Utah, USA, and with Dr Jerome Maller at the Alfred Psychiatry Research Centre for analysis of the scans for current imaging studies, funded by the Victorian Neurotrauma Initiative. Research on sleep disorders and pharmacological interventions is carried out in collaboration with Associate Professor Shantha Rajaratnam in the School of Psychology and Psychiatry at Monash University, Associate Professor Steven Lockley of Harvard and Brigham Young University in Boston and with members of staff from the Monash Sleep laboratory. A collaboraiton with the Dr Judith Charlton from the Monash University Accident Reseaarch Centre and Drs Michel Bedard and Shawn Marshall from the University of Ottawa has resulted in a collaborative project entitled: Safer Roads to Recovery: Asessing Readiness for Driving after Traumatic Brain Injury.This is funded by the Victorian Neurotrauma Foundation and Ontario Neurotrauma Foundation. 37

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