Ian Cameron

The University of Sydney · Kolling Institute of Medical Research

Background: In Australia, 243 000 individuals live in approximately 2700 residential aged care facilities yearly. In 2019, a National Aged Care Mandatory Quality Indicator Program (QI Program) was implemented to monitor quality and safety of care in facilities. We examined the validity of the QI Program indicators using explicit measure review cri...

Purpose This paper aims to assess the face validity to inform content validity of the Quality of Life – Aged Care Consumers (QOL-ACC), a new measure for quality assessment and economic evaluation in aged care. Design/methodology/approach Semi-structured interviews were conducted with older adults (66–100 years) receiving aged care services at home...

Background: To develop and validate the stratify-hip algorithm (multivariable prediction models to predict those at low, medium, and high risk across in-hospital death, 30-day death, and residence change after hip fracture). Methods: Multivariable Fine-Gray and logistic regression of audit data linked to hospital records for older adults surgica...

With an ageing global population and an increasing focus on aging in place, the number of people in need of geriatric rehabilitation (GR) is rapidly increasing. As current GR practice is very heterogenous, cross-country comparisons could allow us to learn from each other and optimise the effectiveness of GR. However, international GR research comes...

Background The SARS-CoV-2 (COVID-19) pandemic has resulted in significant changes to health care delivery and the patient’s experience in hospital. Changes for those who contracted COVID-19 or were close contacts included isolation and quarantine, visitor restrictions and changes to usual models of care to reduce viral transmission. Traditional mod...

Unlabelled: Pharmacological management of bone health warrants investigation into factors influencing initiation of bone protection medication (BPM) at discharge after a hip fracture. This sprint audit identified reasons attributed to low BPM treatment levels at hospital discharge which can guide improvement in the prevention of future fractures....

Background The 2018 Cochrane review update on interventions to prevent falls in older people in care facilities concludes that there is low-quality evidence that exercise prevents falls in this population. We described the trial characteristics of the recent 2021 Cochrane update and undertook an intervention component analysis (ICA). An ICA involve...

Background our aim was to assess the effectiveness of medication review and deprescribing interventions as a single intervention in falls prevention. Methods Design systematic review and meta-analysis. Data sources Medline, Embase, Cochrane CENTRAL, PsycINFO until 28 March 2022. Eligibility criteria randomised controlled trials of older partici...

Background: falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs. Current guidelines are inconsistent, with no up-to-date, globally applicable ones present. Objectives: to create a set of evi...

Study design Cross-sectional survey. Objectives To describe design and methods of Australian arm of International Spinal Cord Injury (Aus-InSCI) community survey, reporting on participation rates, potential non-response bias and cohort characteristics. Setting Survey of community-dwelling people with SCI at least 12 months post-injury, recruited...

Background Road traffic injuries (RTIs), primarily musculoskeletal in nature, are the leading cause of unintentional injury worldwide, incurring significant individual and societal burden. Investigation of a large representative cohort is needed to validate early identifiable predictors of long-term work incapacity post-RTI. Therefore, up until two...

Study design Cross-sectional population-based survey for the Australian cohort of the International Spinal Cord Injury (InSCI) Community Survey. Objectives To differentiate subgroups of people with spinal cord injury (SCI) who self-report good and poor overall quality of life (QoL) using domains of the International Classification of Functioning (...

Background: Health literacy (HL) is rarely addressed in rehabilitation research and practice but can play a substantial role in the recovery process after an injury. We aimed to identify factors associated with low HL and its relationship with 6-month health outcomes in individuals recovering from a non-catastrophic road traffic injury. Methods:...

Background Frailty in older people is associated with increased risk of falls, longer length of stay in hospital, increased risk of institutionalisation and death. Frailty can be measured using validated tools. Multi-component frailty interventions are recommended in clinical practice guidelines but are not routinely implemented in clinical practic...

Objective: A prospective cohort study to investigate how injury and early post-injury psychosocial factors influence health outcomes 12 months after road traffic injury. Methods: Residents of New South Wales, Australia, with road traffic injury in the period 2013-16 were recruited. Explanatory factors were evaluated for outcomes over 12 months u...

Background To synthesise the evidence for the effectiveness of inpatient rehabilitation treatment ingredients (versus any comparison) on functioning, quality of life, length of stay, discharge destination, and mortality among older adults with an unplanned hospital admission. Methods A systematic search of Cochrane Library, MEDLINE, Embase, PsychI...

Globally, populations are ageing and the estimated number of hip fractures will increase from 1.7 million in 1990 to more than 6 million in 2050. The greatest increase in hip fractures is predicted in Low- and Middle‑Income Countries (LMICs), largely in the Asia-Pacific region where direct costs are expected to exceed $US15 billion by 2050. The aim...

Background: Frailty is common in older people and is characterised by decline across multiple body systems, causing decreased physiological reserve and increased vulnerability to adverse health outcomes. It is estimated that 21% of the community-dwelling population over 65 years are frail. Frailty is independently predictive of falls, worsening mo...

Background Falls remain a common and debilitating problem in hospitals worldwide. The aim of this study was to investigate the effects of falls prevention interventions on falls rates and the risk of falling in hospital. Design Systematic review and meta-analysis. Participants Hospitalised adults. Intervention Prevention methods included staff a...

Background WhipPredict, which includes prognostic factors of pain-related disability, age and hyperarousal symptoms, was developed and validated for prediction of outcome in people with whiplash associated disorders (WAD). Patient expectations of recovery was not an included factor, though is known to mediate outcomes. The aim of this study was to...

Background It is common for people with persistent spasticity due to a stroke to receive an injection of botulinum toxin-A in the upper limb, however post-injection intervention varies. Aim To determine the long-term effect of additional upper limb rehabilitation following botulinum toxin-A in chronic stroke. Method An analysis of long-term outco...

Background: People who live in aged care homes have high rates of illness and frailty. Providing evidence-based care to this population is vital to ensure the highest possible quality of life. This study (CareTrack Aged, CT Aged) aimed to develop a comprehensive set of clinical indicators for guideline-adherent, appropriate care of commonly manage...

Background/Objectives To examine the validity of high-contrast visual acuity and the Mini-Mental State Exam (MMSE) as tools for identifying at-risk older drivers. Design Prospective multi-site observational cohort study. Setting Community sample drawn from cities of Brisbane and Canberra, Australia. Participants 560 licensed drivers aged 65–96 y...

Objective To explore physiotherapists’ perceptions of mechanisms to explain observed variation in early postoperative practice after hip fracture surgery demonstrated in a national audit. Methods A qualitative semi-structured interview study of 21 physiotherapists working on orthopaedic wards at 7 hospitals with different durations of physiotherap...

Background: Discharge planning is a routine feature of health systems in many countries that aims to reduce delayed discharge from hospital, and improve the co-ordination of services following discharge from hospital and reduce the risk of hospital readmission. This is the fifth update of the original review. Objectives: To assess the effectiven...

Design: Cohort study embedded in a clinical trial. Setting: Community, Bangladesh. Objectives: To determine the incidence, severity and time course of pressure injuries over the first two years following discharge from hospital in people with spinal cord injuries (SCI) in Bangladesh. Methods: Participants (n = 186) were contacted by telephon...

Objective: To examine the frequency and timing of inpatient engagement in meaningful activities within rehabilitation (within and outside of structured therapy times) and determine the associations between activity type, goal awareness, and patient affect. Methods: This prospective observational study performed behavioral mapping in a 42-bed inp...

Introduction Musculoskeletal (MSK) conditions constitute the highest burden of disease globally, with healthcare services often utilised inappropriately and overburdened. The aim of this trial is to evaluate the effectiveness of a novel clinical PAthway of CarE programme (PACE programme), where care is provided based on people’s risk of poor outcom...

Background/aim: Annals of Geriatric Medicine and Research held its inaugural international editorial board virtual meeting on September 16, 2021, to brainstorm ideas for sustainable growth. This special article summarizes the key concepts obtained from the webinar proceedings, with further development of ideas from ensuing discussions occurring af...

Background: Hip fracture is a major cause of morbidity and mortality in older people, and its impact on society is substantial. After surgery, people require rehabilitation to help them recover. Multidisciplinary rehabilitation is where rehabilitation is delivered by a multidisciplinary team, supervised by a geriatrician, rehabilitation physician...

Additional physiotherapy in the first postoperative week was associated with fewer days to discharge after hip fracture surgery. A 7-day physiotherapy service in the first postoperative week should be considered as a new key performance indicator in evaluating the quality of care for patients admitted with a hip fracture.Introduction To examine the...

This third edition of a trusted resource brings together the latest literature across multiple fields to facilitate the understanding and prevention of falls in older adults. Thoroughly revised by a multidisciplinary team of authors, it features a new three-part structure covering epidemiology and risk factors for falls, strategies for prevention a...

Abstract Background Serious injuries and fatalities among vulnerable road users on two wheeled motorised vehicles have increased across Australia and internationally in the past decade yet fallen for motor vehicle occupants. Almost half of all reported motorcycle injury crashes cause serious injury or death, nearly double that of motor vehicle poli...

To the authors’ knowledge, no study has been conducted on life expectancy for aged care facility residents with hip fracture. We assessed life expectancy of 240 residents of aged care facilities in Australia who experienced recent hip fracture treated with surgery. 149 deaths occurred over a mean follow-up of 1.2 years. Being female and having bett...

It is imperative that the surgical treatment of hip fractures is followed up with rehabilitation to enhance recovery and quality of life. This randomized controlled trial aimed to determine if an individualised, combined exercise–nutrition intervention significantly improved health outcomes in older adults, after proximal femoral fracture. We comme...

Background Spinal cord injury (SCI) is associated with autonomic imbalance and significant secondary conditions, including cardiac and brain dysfunction that adversely impact health and wellbeing. This study will investigate the effectiveness (intention-to-treat) of a neuro-cardiac self-regulation therapy to improve autonomic and neural/brain activ...

Introduction: After first stroke, the transition from rehabilitation to home can be confronting and fraught with challenges. Although stroke clinical practice guidelines recommend predischarge occupational therapy home visits to ensure safe discharge and provision of appropriate equipment, there is currently limited evidence to support this recomm...

This report is a review of ageing and end of life issues for people with a severe traumatic brain injury or a spinal cord injury

Objective: to explore physiotherapists’ perceptions of mechanisms to explain observed variation in early postoperative practice after hip fracture surgery demonstrated in a national audit. Methods: a qualitative semi-structured interview study of 21 physiotherapists working on orthopaedic wards at 7 hospitals with different durations of physiothe...

Objectives To assess the impact of a Consumer Directed Care (CDC) model of service delivery on the quality of life of older people receiving home care packages. Methods Quality of life was assessed using validated instruments. The relationship between quality of life and length of time exposed to CDC was examined using descriptive statistical and...

In increasingly constrained health and aged care services, strategies are needed to improve quality and translate evidence into practice. In dementia care, recent failures in quality and safety have led the WHO to prioritise the translation of known evidence into practice. While quality improvement collaboratives have been widely used in healthcare...

People who sustain injury in a road traffic crash (RTC) have significant risk of psychiatric morbidity, but effective screening for identifying at-risk individuals soon after the RTC is lacking. We investigated whether pre-injury vulnerability can assist as an early screen to manage this risk. We recruited 120 adults who sustained physical injury i...

Background Statistical analysis plans describe the processes of data handling and analysis in clinical trials; by doing so they increase the transparency of the analysis and reporting of studies. This paper reports the planned statistical analysis plan for the Whiplash ImPaCT study. For individuals with whiplash injury, Whiplash ImPaCT aims to asse...

Background/objectives: We investigated the impact of ceasing routine falls risk assessment tool (FRAT) completion and instead used clinical reasoning to select fall mitigation strategies. Design: Two-group, multi-site cluster-randomized active-control non-inferiority trial. Setting: Hospital wards. Participants: Adult inpatients admitted to...

Background There is growing evidence that a range of pre-injury, injury related and post-injury factors influence social and health outcomes across the injury severity spectrum. This paper documents health related outcomes for people with mild, moderate and severe injury after motor vehicle crash (MVC) injuries in New South Wales, Australia. Metho...

Background: Serious injuries and fatalities among vulnerable road users on two wheeled motorised vehicles have increased across Australia and internationally in the past decade, yet fallen for motor vehicle occupants. Almost half of all reported motorcycle injury crashes cause serious injury or death, nearly double that of motor vehicle police-repo...

Background Traumatic injuries can have long-term negative impacts on health, especially psychological health. A biopsychosocial approach is recommended to identify those likely to experience psychosocial stress, however large individual differences exist in stress reactivity and post-injury health that remain unexplored. Therefore, we investigated...

Objective: To compare the accuracy of the whiplash specific risk-screening tool (WhipPredict) with a modified generic short-form Orebro Musculoskeletal Pain Screening Questionnaire (SF-ÖMPSQ-M) for predicting poor recovery. Design: Inception cohort study. Methods: 202 participants with acute whiplash completed WhipPredict and SF-ÖMPSQ-M at bas...

Objective To compare demographics, treatment and health outcomes for individuals hospitalised with a hip fracture and examine predictors of postacute discharge destination. Methods A retrospective analysis of data from the Australian and New Zealand Hip Fracture Registry of individuals aged ≥50 years hospitalised with a hip fracture from 2015 to 2...

After a hip fracture operation, an older person’s recovery is enhanced if they are provided with an optimistic, well-coordinated rehabilitation programme. A rehabilitation approach should start as early as possible to prevent functional decline and complications and ideally include a multidisciplinary team (physiotherapy, occupational therapy, nutr...

Little is known about life expectancy in nursing home residents with hip fracture. We assessed life expectancy of 240 residents of residential aged care facilities who were aged more than 70 years old and experienced recent hip fracture treated with surgery. 149 deaths occurred over a mean follow-up of 1.2 years. Being female (coefficient (β) = 0.8...

Background: Adequate (≥800 IU/day) vitamin D supplement use in Australian residential aged care facilities (RACFs) is variable and non-optimal. The vitamin D implementation (ViDAus) study aimed to employ a range of strategies to support the uptake of this best practice in participating facilities. The aim of this paper is to report on facility lev...

Objective: To identify factors independently associated with late claim closure, a proxy for recovery, in older (65+ years) compared to younger (17-64 years) adults following road traffic crash injury (RTI). Methods: Multivariable analysis of statewide compensation data from New South Wales (NSW), Australia, for NSW residents aged ≥17 years inju...

Baby Boomers are ageing, yet little is known as to what their expectations are likely to be for the community health service sector or what the challenges this cohort might create. Interviews were conducted with 11 experienced Australian baby boomer carers to identify the key characteristics that might influence their future community aged care ser...

Background: Non-pharmacological interventions including physical activity programmes, occupational therapy and caregiver education programmes have been shown to lead to better outcomes for people with dementia and their care partners. Yet, there are gaps between what is recommended in guidelines and what happens in practice. The aim of this study...

Study design: Randomised controlled trial. Objectives: To determine the effectiveness of a sustainable community-based intervention designed to prevent serious complications and death 2 years after discharge in people with spinal cord injury in Bangladesh. Setting: Bangladesh. Methods: A pragmatic randomised controlled trial was undertaken....

Background: Studies report rates of mild cognitive impairment (MCI) in spinal cord injury (SCI) range between 10 and 60%. This broad estimate of MCI in SCI is most likely a result of: (i) inconsistent operationalization of MCI; (ii) heterogeneity among individuals with SCI; (iii) failure to account for MCI subtypes, thereby adding to the heterogen...

This study examined the patterns of informal (unpaid) caregiving provided to people after moderate to severe traumatic brain injury (TBI), explore the self-reported burden and preparedness for the caregiving role, and identify factors predictive of caregiver burden and preparedness. A cross-sectional cohort design was used. Informal caregivers comp...

Background: Mild to moderate road traffic injury (RTI) in people of working age is associated with limited recovery. Less is known about RTI recovery in older age. This study explored the perspectives and factors associated with recovery and health-related quality of life following mild to moderate RTI in older age in New South Wales, Australia....

Objectives People who have experienced a work-related injury can experience further work injuries over time. This study examines predictors of subsequent work-related injuries over 24 months among a cohort of injured workers. Methods Participants were those recruited to the earlier Prospective Outcomes of Injury Study (POIS) who had a work-related...

Purpose Reablement is a strategy recommended in clinical practice guidelines that could maximise functioning and quality of life in people living with dementia. This project sought to develop a practical handbook for health professionals illustrating the best, currently available evidence via newly-developed composite reablement programs. Material...

In increasingly constrained health and aged care services, strategies are needed to improve quality and translate evidence into practice. In dementia care, recent failures in quality and safety have led the World Health Organisation to prioritise the translation of known evidence into practice. While quality improvement collaboratives have been wid...

Objective To model the potential financial implications of Australian programs supporting cognitively impaired community‐dwelling older people. Methods Markov cohort models of (a) an observational study of a residential dyadic training program for carers and people with dementia (GTSAH) and (b) a frailty intervention (FIT) in a cognitively impaire...

Background People who sustain road traffic injuries often have poor health outcomes. While outcomes are often worse in people with a compensation claim, especially in fault-based schemes versus no-fault schemes, few studies have directly compared outcomes across scheme types. Objective To compare health and work outcomes between people who had no c...

Objectives The need for support following traumatic brain injury (TBI) is well documented. Yet the evidence is limited about the types of support required, how support needs change over time, and the effect of level of disability. This study addresses this limitation in the evidence. Method Longitudinal design with a state-wide inception cohort of...

Background Seeking compensation has been shown to have an adverse effect on the psychological health and recovery of injured patients, however, this effect requires clarification. Methods A total of 2019 adults sustaining a traffic injury were recruited. Of these, 709 (35.1%) lodged a compensation claim. Interviews occurred at 1-, 6- and 12-month...

Mixed methods study Community, Bangladesh To understand how a community-based intervention for people with spinal cord injury (SCI) in Bangladesh was delivered as part of a randomised controlled trial and to gauge the perceptions of participants and healthcare professionals to the intervention. A community-based intervention was administered to 204...

Background: Access to rehabilitation services for people living in residential care facilities is frequently limited. A randomised trial of a hospital outreach hip fracture rehabilitation program in residential care facilities has demonstrated improvements in mobility at four weeks and quality of life at 12 months but was not considered cost-effec...