Sci Med Research Articles

39 A Model of Gait and Falls in Older Adults with Dementia

Abstract Background Older people with cognitive impairment are at increased risk of falls; however, fall prevention strategies have limited success in reducing fall risks in this population (Fernando E, Fraser M, Hendriksen J et al. Physiotherapy Canada. 2017; 69: 161–170). We aim to present a model of factors contributing to gait and falls in older adults with dementia. Methods The model was developed based on an in-depth review of literature on fall risk factors particularly in people with dementia, and the relationship between cognition and gait, and their joint impact on risk of falls. Results Cognitive and motor functions are closely related as they share neuroanatomy (Rosso AL, Studenski SA, Chen WG et al. J Gerontol A Biol Sci Med Sci. 2013; 68: 1379–1386). This close relationship has been confirmed by imaging, observational and interventional studies. Executive function is the cognitive domain most commonly associated with gait dysfunction (Cohen JA, Verghese J, Zwerling JL. Maturitas. 2016; 93: 73-77). The sub-domains of executive function(Sachdev PS, Blacker D, Blazer DG et al. Neurology. 2014; 10: 634-642) - attention, sensory integration and motor planning affect risk of falls through gait dysfunction; whereas other non-gait associated sub-domains of executive function - cognitive flexibility, judgement and inhibitory control affect risk of falls through risk taking behaviour. Conclusion Gait, cognition and falls are closely related. The comoridity and interaction between gait abnormality and cognitive impairment may be the underlying mechanism behind the high prevalence of falls in older adults with dementia. Gait and cognitive assessment with particular focus on executive function, should be integrated in fall risk screening. Assessment results should inform interventions developed by a multidisciplinary team and may include strategies such as customised gait training and behavioural modulation. A comprehensive multidisciplinary approach could be more effective in reducing fall risks in older adults with dementia.

Trends in Shared Decision-Making Studies From 2009 to 2018: A Bibliometric Analysis

Background: To systematically analyze the global development trends and research focuses of shared decision-making (SDM) studies as a reference for researchers.Methods: We conducted a systematic search of the Web of Science (WoS) Core Collection on April 17, 2019, to retrieve studies related to SDM published from 2009 to 2018. VOSviewer (1.6.10), CiteSpace (5.4.R1) and Excel 2016 were used to analyze key features of SDM studies, including annual output, countries/regions, organizations, journals, authors, references, research hot-spots, and frontiers.Results: Up to April 17, 2019, a total of 6,629 studies on SDM were identified as published between 2009 and 2018. The United States participated in the most studies (n = 3,118), with the University of California-San Francisco ranking first (n = 183). Patient Education and Counseling [impact factor (IF) 2017 = 2.785] published the most studies (n = 257). Legare F participated in the most studies (n = 101), and the paper “Charles C, 1997, Soc Sci Med, V44, P681” occupied the highest co-citation (n = 657) position. The research hotspots and frontiers included “Informed consent,” “Surgery,” “Depression,” “Older adult,” and “Patient-centered care.”Conclusion: The number of studies concerning SDM has continued to increase since 2009, with the United States leading the field. The landscape of the basis of SDM included mainly concept, practice framework and effect assessment of SDM. “Informed consent,” “Surgery,” “Depression,” “Older adult,” and “Patient-centered care” reflected the latest research focuses, and should receive more attention.

PC-FACS

PC-FACS

Counting early deaths due to socioeconomic inequality

Counting early deaths due to socioeconomic inequality

82 Output ratios measurements in stereotactic radiosurgery using cones with a 6 MV FFF beam: comparison between 8 detectors

Introduction. The purpose of this work is to assess 8 detectors performances for output ratio (OR) determination, in clinical 6 MV flattening filter free (FFF) beam of the Truebeam STx Novalis stereotactic radiosurgery linear accelerator for cone irradiation using EBT3 radiochromic films (Ashland) as reference 1 Morales JE. et al. A comparison of surface doses for very small field size x-ray beams: Monte Carlo calculations and radiochromic film measurements. Australas. Phys Eng Sci Med 2014;37,303–9. Google Scholar , 2 Garnier N, Amblard R, Villeneuve R. et al. Detectors assessment for stereotactic radiosurgery with Cones. J Appl Clin Med Phys 2018;19(6), 88–98. Google Scholar , 3 Girardi A. et al. Small field correction factors determination for the IBA razor nano chamber and the IBA razor chamber. Phys Med 2018;52,151–2. Google Scholar .

Frailty in Older Adults with Multiple Myeloma: A Study of United States Veterans

Introduction: Multiple Myeloma (MM) predominantly affects older patients, and treatment in older patients is fraught with challenges due to the spectrum of aging-associated vulnerabilities present in older patients. Age-associated cumulative decline across physiological systems results in a diminished resistance to stressors, including cancer and its treatment, creating a vulnerable state known as frailty. Frailty is associated with increased risk of adverse outcomes in patients with cancer. Identification of frailty in retrospective data, including the electronic medical record, can allow for assessment of prognosis, provide input during treatment selection and facilitate control for confounding, as in comparative effectiveness research. A frailty index (FI) operationalizes frailty using an accumulation of health-related deficits (Rockwood 2007). The deficits accumulation approach to frailty is validated in many populations and settings, including in older patients with cancer receiving chemotherapy and older adults with myeloma. Routinely collected health information in the electronic medical record system may provide a standardized and feasible means of identifying cumulative deficits and generating a FI in older adults with myeloma. The objective of this study was to develop a claims-based FI in veterans with MM. Methods: From the Veterans Administration Central Cancer Registry (VACCR), we identified all patients aged 65 years and older diagnosed with MM between 1999 and 2014. For the construction of the FI using an accumulation of health-related deficits model, we followed the method described by Orkaby et al (Orkaby, J Gerontol A Biol Sci Med Sci, 2018). The FI is calculated by dividing the total number of deficits an individual has by the total number of possible variables, giving a score between 0 and 1. We included 31 deficits in a range of systems including comorbidity, functional status, cognition, mood, sensory loss, and other geriatric domains. We categorized the FI into five groups as recommended: non-frail (FI 0-0.1), pre-frail (0.11-0.20), mild frailty (0.21-0.30), moderate frailty (0.31-0.40), and severe frailty (>0.4). We used Kaplan-Meier curves to demonstrate the relationship between frailty status and mortality in patients with MM. Next, we used cox proportional hazards regression to control for the following factors in the mortality analyses: age, BMI, race, diagnosis year, MM treatment, bisphosphonate use, and statin use. Results: We identified 3807 patients aged 65 years and older diagnosed with MM. Prior to starting treatment for MM, 28.7% of the cohort was classified as non-frail, 41.3% as pre-frail, 21.6% as mildly frail, 6.6% as moderately frail, and 1.7% as severely frail. Increasing frailty status was associated with increased mortality (Figure 1). The median overall survival for non-frail veterans was 38 months, compared to those who were pre-frail (27 months), mildly frail (15 months), moderately frail (8 months), and severely frail (9 months). After controlling for the relevant variables, higher frailty score remained significantly associated with higher mortality (Table 1). Conclusions: In this study, we demonstrate a systematic method of calculating a FI using the readily available administrative and claims data from the Electronic Medical Record in veterans with MM. Frailty status was strongly associated with mortality, independent of age, race, BMI, MM treatment, and statin use. Assessment of frailty status using the readily available electronic medical records data in retrospective data allows for assessment of prognosis. Disclosures Sanfilippo: Bristol-Myers Squibb: Speakers Bureau; Pfizer: Membership on an entity's Board of Directors or advisory committees; Bayer: Membership on an entity's Board of Directors or advisory committees; AstraZeneca: Other: Travel Expenses; NHLBI: Research Funding.

Feasibility and Impact of Embedded Geriatric Consultation for Frail Older Adults with Blood Cancer: A Randomized Controlled Trial

Background: Although frailty influences outcomes in hematologic oncology, little is known about the feasibility and impact of embedded geriatric consultation for frail older adults with blood cancers. Methods: From February of 2015 until May 2018, all patients aged 75 and older presenting for initial consultation for hematologic malignancy at the Dana-Farber Cancer Institute (DFCI) were approached for geriatric screening by a trained clinic assistant. In a 15-minute interview, the assistant used two parallel methods-the phenotype approach (Fried, J Geront A Biol Sci Med Sci, 2001) and the cumulative deficit approach (Rockwood, J Geront A Biol Sci Med Sci, 2007) -to characterize patients as "frail," "pre-frail," or "robust." Patients determined to be frail of prefrail on at least one of the two screening methods who had a scheduled oncology follow-up at DFCI were then randomized to have tandem consultation with an embedded board-certified geriatrician; the schema used an unbalanced allocation design powered to detect differences in one-year overall survival. Patients were followed for hospitalizations and emergency department visits in the first six months after enrollment, documented discussions about goals of care at the end of life during the first year by any DFCI outpatient provider (resuscitation status, hospice, or preferred location for dying using criteria from Mack, Ann Intern Med, 2012), and one-year overall survival. We also undertook a survey of the 65 oncologists and physician extenders who had utilized geriatric services, asking them about consultation usefulness (on a Likert scale where 1= "least" and 5 = "most" useful) for evaluating cognition, informing treatment decisions, connecting patients to resources, and managing non-oncologic comorbidities. We conducted pairwise analyses using McNemar's test to identify the most useful services. Results: Of 186 patients approached, 160 enrolled, with 60 randomized to geriatric consultation and 100 to usual care. Mean age was 80.4 years, 65% were male, and 30% were initially seen in the MDS/leukemia clinic, 31% in the lymphoma clinic and 39% in the myeloma clinic. Of those randomized to geriatric consultation, 48 (80%) completed at least one visit with an embedded geriatrician (95% CI [68%, 88%]). Among the 12 who did not, 3 died before the scheduled consultation, 6 ultimately did not to return to DFCI, and 3 cancelled their geriatric appointments. In an intent-to-treat analysis, patients assigned to consultation were no less likely to die within one year (Figure; HR 0.99, 95% CI [0.58, 1.68]). Results were also not significant in as-treated analysis (HR 0.87, 95% CI [0.49, 1.55]). In negative binomial regression analysis, patients assigned to geriatric consultation had modestly fewer unplanned hospitalizations and emergency room visits than those randomized to usual care, but the results were not significant. The odds of having a documented discussion about goals of care for patients randomized to geriatric co-management were 2.66 (95% CI [0.95, 7.41]; p=.06) times versus for those receiving usual care; for those who actually completed a geriatrician visit, they were 3.07 (95% CI [1.06, 8.82]; p=.04). Of 65 providers surveyed, 37 responded (57%). Mean responses in the "5 = most useful" category for each question were as follows: managing non-oncologic comorbidities 60%, connecting patients to resources 57%, evaluating cognition 49%, and informing treatment decisions 34%. McNemar's tests revealed that managing non-oncologic comorbidities was no more likely to be considered "most useful" than connecting patients to resources (p=.48) and evaluating cognition (p=.06) but more likely than informing treatment decisions (p=.01). Connecting patients to resources was no more likely to be considered "most useful" than evaluating cognition (p=.37) but more likely than informing treatment decisions (p=.04). Conclusion: Embedded geriatric consultation for frail and pre-frail older adults with blood cancers is feasible but may not affect acute care utilization or survival in the first year. In contrast, consultation likely has a substantial impact on the timeliness of discussions about goals of care at the end of life. Oncology providers report that embedded geriatric consultation is useful among many care domains, but most helpful for managing comorbidities and connecting patients to resources. Figure Disclosures Stone: AbbVie, Actinium, Agios, Argenx, Arog, Astellas, AstraZeneca, Biolinerx, Celgene, Cornerstone Biopharma, Fujifilm, Jazz Pharmaceuticals, Amgen, Ono, Orsenix, Otsuka, Merck, Novartis, Pfizer, Sumitomo, Trovagene: Consultancy; Argenx, Celgene, Takeda Oncology: Other: Data and Safety Monitoring Board/Committee: ; Novartis, Agios, Arog: Research Funding. Soiffer:Kiadis: Other: supervisory board; Gilead, Mana therapeutic, Cugene, Jazz: Consultancy; Juno, kiadis: Membership on an entity's Board of Directors or advisory committees, Other: DSMB; Jazz: Consultancy; Cugene: Consultancy; Mana therapeutic: Consultancy.

A Note on Proposed Estimation Procedures for Claims-Based Frailty Indexes.

Two groups (Segal et al. Med Care. 2017;55(7):716-722; Segal et al. Am J Epidemiol. 2017;186(6):745-747; and Kim et al. J Gerontol A Biol Sci Med Sci. 2018;73(7):980-987) recently proposed methods for modeling frailty in studies where a reference standard frailty measure is not directly observed, but Medicare claims data are available. The groups use competing frailty measures, but the premise is similar: In a validation data set, model the frailty measure versus claims variables; in the primary data set, impute frailty status from claims variables, and conduct inference with those imputed values in place of the unobserved frailty measure. Potential use cases include risk prediction, confounding control, and prevalence estimation. In this commentary, we describe validity issues underlying these approaches, focusing mainly on risk prediction. Our main concern is that these approaches do not permit valid estimation of associations between the reference standard frailty measure (i.e., "frailty") and health outcomes. We argue that Segal's approach is akin to multiple imputation but with the outcome variable omitted from the imputation model, while Kim's is akin to regression calibration but with many variables improperly treated as surrogates. We discuss alternatives for risk prediction, including a secondary approach previously considered by Kim et al., and briefly comment on other use cases.

IT CAN'T BE LUPUS...UNTIL IT IS: A CASE OF DIFFUSE ALVEOLAR HEMORRHAGE IN SYSTEMIC LUPUS ERYTHEMATOSUS

SESSION TITLE: Tuesday Medical Student/Resident Case Report Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: 10/22/2019 01:00 PM - 02:00 PM INTRODUCTION: Diffuse Alveolar Hemorrhage (DAH) is a rare, but well-documented phenomenon in systemic lupus erythematosus (SLE). DAH affects only 4% of patients with SLE but has a 50% mortality. CASE PRESENTATION: A 67 year-old female with SLE complicated by lupus nephritis requiring four renal transplants (last in 2015), but currently in remission on maintenance tacrolimus and mycophenolate mofetil with recurrent episodes of hemoptysis and hypoxic respiratory failure. In October 2018 she was admitted with dry cough, scant hemoptysis and developed rapidly progressive respiratory failure requiring intubation. Workup showed normal immunosuppressive levels, elevated white blood count and inflammatory markers. CT revealed diffuse ground glass opacities. Antinuclear antibody (ANA) and anti-double stranded DNA were negative with normal complement levels. Bronchoscopy showed mononuclear predominance with unrevealing microbiology and cytology and no active bleeding despite sequential BAL. She rapidly improved with antibiotics and steroids. In January 2019 she was admitted with similar symptoms of cough, scant hemoptysis, multilobar infiltrates. Again, serologic and bronchoscopic workup were unrevealing, without classical evidence of DAH leading to a broad differential and needing to determine the etiology for the recurrent episodes of hemoptysis. An open lung biopsy was performed and results returned from Mayo Clinic showing acute alveolar hemorrhage, secondary to SLE. Patient was started on high dose steroids. However, 24 hours later she had frank hemoptysis, this time with bronchoalveolar lavage confirming DAH. Unfortunately, despite steroids, dialysis and plasmapheresis, hospital course was complicated by multi-organ dysfunction and she ultimately expired. DISCUSSION: DAH due to SLE is usually in the setting of a flare with thrombocytopenia, hypocomplementemia as well as elevated lupus antibodies. It is often seen within the first 5 years of diagnosis. Our patient had well-controlled disease on immunosuppressive therapy and had consistently negative antibodies and normal complement levels. Her only known risk factor was recurrent lupus nephritis, which is the most associated extrapulmonary manifestation in patients with SLE and DAH. This patient was given high-dose steroids and plasmapheresis; in reviews of DAH in SLE nearly 100% were given steroids, 55% cyclophosphamide and 31% plasmapheresis. Utilizing recombinant factor VII during the massive hemoptysis was considered, but the data to support it was not well-supported. CONCLUSIONS: This may be the first documented patient with well-controlled Lupus, without evidence of a flare, who developed recurrent episodes of DAH from SLE without classical symptoms highlighting need for broad differentials and exact diagnosis. Given the high mortality associated with DAH, it must be recognized that this can occur and recur despite ongoing immunosuppressive therapy. Reference #1: Kusunoki et al. Severe Progressive Diffuse Alveolar Hemorrhage in a Patient with Systemic Lupus Erythematosus. Case Reports in Critical Care. 2018 Reference #2: Kazzaz NM, Coit P, Lewis EE, McCune WJ, Sawalha AH, Knight JS. Systemic lupus erythematosus complicated by diffuse alveolar haemorrhage: risk factors, therapy and survival. Lupus Sci Med. 2015;2(1):e000117. Published 2015 Sep 23. https://doi.org/10.1136/lupus-2015-000117 Reference #3: Ednalino, Christina & Yip, Julie & Carsons, Steven. (2015). Systematic Review of Diffuse Alveolar Hemorrhage in Systemic Lupus Erythematosus: Focus on Outcome and Therapy. Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases. 21. 305-10. 10.1097/RHU.0000000000000291. DISCLOSURES: No relevant relationships by Achal Dhupa, source=Web Response No relevant relationships by Jamie Felzer, source=Web Response No relevant relationships by Shazia Jamil, source=Web Response No relevant relationships by Lakshmi Koripella, source=Web Response

Hip Fracture With Resistance to Care

Hip Fracture With Resistance to Care

Mechanical chest compression – cure or culprit?

Purpose: Mechanical and manual chest compression may cause thoracic injuries and in some cases abdominal injuries. A recent study characterized these injuries and summarized that no studies have found that injuries associated with CPR were fatal although they had been associated with higher morbidity 1 Ondruschka B. et al. Forensic Sci Med Pathol. 2018; 14: 515 Google Scholar . This case series describes injuries following mechanical CPR that in itself were deemed to be fatal should the patient otherwise had survived the cardiac arrest.

Insights from outside BJOG

Insights from outside BJOG

Novel Approaches to Value Assessment Within the Cost-Effectiveness Framework

Novel Approaches to Value Assessment Within the Cost-Effectiveness Framework

Evidence-Based Recommendations for Programming Quizzes to Improve College Student Behavior in Residential Courses

Several researchers have shown quizzes effectively support college student success; however, instructors can implement quizzes in multiple ways. We conducted a systematic review of the literature on quizzes in undergraduate courses using the PRISMA method (i.e., Moher et al. Public Libr Sci Med 6(7):e1000097, 2009. https://doi.org/10.1371/journal.pmed.1000097 ). We searched peer-reviewed journals in the ERIC database and included studies in which researchers manipulated a quiz (or some aspect of a quiz) and measured the effects on out-of-class preparation, class attendance, in-class participation, and/or performance on exams in the context of a traditional face-to-face undergraduate course. We used this body of literature to develop evidence-based recommendations for how instructors can program quizzes to improve college student behavior within their courses and promote overall student success in higher education. Limitations and areas for future research are discussed.

Neighbourhood and mortality in severe mental illness

Neighbourhood and mortality in severe mental illness

CHRONIC LACK OF SLEEP IS ASSOCIATED WITH INCREASED SPORTS INJURY IN ADOLESCENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Background:Although sleep has been identified as an important modifiable risk factor for sports injury, the effect of decreased sleep on sports injuries in adolescents is poorly studied.Purpose:To ...

The nearness to death effect and why NHS pressures are going to intensify

Journal of Paramedic PracticeVol. 11, No. 1 CommentThe nearness to death effect and why NHS pressures are going to intensifyRodney P JonesRodney P JonesSearch for more papers by this authorRodney P JonesPublished Online:12 Jan 2019https://doi.org/10.12968/jpar.2019.11.1.28AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Hanlon P, Walsh D, Whyte B et al.. Hospital use by an ageing cohort: an investigation into the association between biological, behavoural and social risk markers and subsequent hospital utilization. J Public Health Med. 1998; 20(4):467–476 Crossref, Google ScholarJones R. What government data on death rates fail to show. Brit J Healthc Manag. 2017a; 23(8):572–573 Link, Google ScholarJones R. Deaths and medical admissions – what is happening in the UK? Fractal Geometry Nonlinear Anal Med Biol Med Biol. 2017b; 3(1): in press. https://tinyurl.com/yb2n86kr (accessed 6 January 2019) Google ScholarJones R. Year-to-year variation in deaths in English Output Areas (OA), and the interaction between a presumed infectious agent and influenza in 2015. SMU Med J. 2017c; 4(2):37–69. https://tinyurl.com/yczo4pvf (accessed 6 January 2019) Google ScholarJones R. Outbreaks of a presumed infectious pathogen creating on/off switching in deaths. SDRP J Infect Dis Treat Ther. 2017d; 1(1):1–6. https://tinyurl.com/yb58846n (accessed 6 January 2019) Google ScholarJones R. Role of social group and gender in outbreaks of a novel agent leading to increased deaths, with insights into higher international deaths in 2015. Fractal Geometry Nonlinear Anal Med Biol Med Biol. 2017e; 3(1): in press. https://doi.org/10.15761/FGNAMB.1000146. https://tinyurl.com/ydancach (accessed 6 January 2019) Google ScholarJones R. Different patterns of male and female deaths in 2015 in English and Welsh local authorities question the role of austerity as the primary force behind higher deaths. Fractal Geometry Nonlinear Anal Med Biol Med Biol. 2017f; 3(1): in press. https://doi.org/10.15761/FGNAMB.1000145. https://tinyurl.com/yd9929ad (accessed 6 January 2019) Google ScholarJones R. Deaths and medical admissions in the UK show an unexplained and sustained peak after 2011. Eur J Intern Med. 2018a; 47: e14–e16. https://doi.org/10.1016/j.ejim.2017.09.021 Crossref, Google ScholarJones R. Will 2018 set a record for deaths? Brit J Healthc Manag. 2018b; 24(9):464–465 Link, Google ScholarJones R. Periods of unexplained higher deaths and medical admissions have occurred previously – but were apparently ignored, misinterpreted or not investigated. Eur J Intern Med. 2018c; 40:e18–e20. https://doi.org/10.1016/j.ejim.2017.11.004 Crossref, Google ScholarMoore P, Bennett K, Normand C. Counting the time lived, the time left or illness? Age, proximity to death, morbidity and prescribing expenditures. Soc Sci Med. 2017; 184:1–14 Crossref, Google ScholarNHS Digital. Hospital admitted patient care activity, 2017/18. 2018. https://tinyurl.com/y8w8lm5y (accessed 6 January 2019) Google ScholarOffice for National Statistics. Deaths by single year of age tables – UK. 2018a. https://tinyurl.com/y7v5nvvf (accessed 6 January 2019) Google ScholarOffice for National Statistics. Subnational population projections for England, 2016-based. 2018b. https://tinyurl.com/y9d7p2ub (accessed 6 January 2019) Google ScholarPayne G, Laporte A, Deber R, Coyte P. Counting backward to health care's future: Using time-to-death modleing to identify changes in end-of-life morbidity and the impact of aging on health care expenditures. Milbank Q. 2007; 85:213–257 Crossref, Google Scholar FiguresReferencesRelatedDetailsCited byWill the winter of 2019/20 have unusually high service demand? Part 2: StrategyRodney P Jones13 December 2019 | Journal of Paramedic Practice, Vol. 11, No. 12Will the winter of 2019/2020 have unusually high service demand? Part 1: LessonsRodney P Jones5 November 2019 | Journal of Paramedic Practice, Vol. 11, No. 11End-of-life demand is highly volatile and shows unexpected trendsRodney P Jones13 March 2019 | Journal of Paramedic Practice, Vol. 11, No. 3Ignorance isn't bliss: behind the unequal distribution of end-of-life demand and costRodney P Jones4 February 2019 | Journal of Paramedic Practice, Vol. 11, No. 2 2 January 2019Volume 11Issue 1ISSN (print): 1759-1376ISSN (online): 2041-9457 Metrics History Published online 12 January 2019 Published in print 2 January 2019 Information© MA Healthcare LimitedPDF download

Do migrants have a mortality advantage?

Do migrants have a mortality advantage?

AFOMP policy number 6: code of ethics for medical physicists in AFOMP Countries

This policy statement, which is the sixth of a series of documents prepared by the Asia-Oceania Federation of Organizations for Medical Physics (AFOMP) Professional Development Committee, gives guidance on how medical physicists in AFOMP countries should conduct themselves in an ethical manner in their professional practice (Ng et al. in Australas Phys Eng Sci Med 32:175-179, 2009; Round et al. in Australas Phys Eng Sci Med 33:7-10, 2010; Round et al. in Australas Phys Eng Sci Med 34:303-307, 2011; Round et al. in Australas Phys Eng Sci Med 35:393-398, 2012; Round et al. in Australas Phys Eng Sci Med 38:217-221, 2015). It was developed after the ethics policies and codes of conducts of several medical physics societies and other professional organisations were studied. The policy was adopted at the Annual General Meeting of AFOMP held in Jaipur, India, in November 2017.

Dementia Interventions: From Past to Present

Dementia Interventions: From Past to Present