Hundreds of kilometres beneath the Antarctic Ice Sheet lie vast and dynamic subglacial water systems comprised of large lakes, drainage networks and channelised flow paths that fill and drain over a wide range of timescales, from days to decades, and possibly longer.

Despite their surrounding below-freezing conditions, these waters remain in liquid form, due to the immense pressure of the overlying ice, combined with heat from the Earth below and friction generated as the ice flows.

Hidden waters and how behaviours could influence ice flow

In Antarctica alone, just 766 of these subglacial lakes are documented, and only 231 active lakes known. Scientists like Chen Zhao, Senior Research Fellow in Ice Sheet Modelling, together with ice sheet modelling team in University of Tasmania and colleagues from Finland and France have been exploring the hidden water beneath the ice and how their behaviours could influence the ice flow and Antarctica’s contribution to sea level rises.

We simulated subglacial water pressure across Antarctica, revealing vulnerable regions potentially influenced by subglacial water, and mapped both active (blue) and stable (yellow) subglacial lakes and subglacial water channels (black lines). Zhao, C., et al, 2025. Nature Communications.

“Satellite observations show that Antarctica lost about 2,700 billion tonnes of ice between 1992 and 2020, raising global sea levels by over 7mm. Annual ice loss is now more than double the rate of the 1990s,” Zhao explained.

As mass losses from Antarctica and Greenland continue to accelerate, sea levels are expected to rise even faster.

“To understand how quickly and how much Antarctica will contribute to future sea-level rise, my research uses advanced numerical models to simulate how Antarctic ice flows, how it interacts with the subglacial meltwater and ocean, and how these processes control the rate of ice loss.”

A global effort to convert science into future sea-level projections

Converting this science into future sea-level projections is a global effort led through the Ice Sheet Model Intercomparison Project for CMIP6 (ISMIP6). In this project, research teams worldwide run the same climate scenarios across different ice-sheet models to quantify Antarctica’s future contribution to sea-level rise — a collaboration that Zhao’s team is a part of. Results from ISMIP6 feed directly into the IPCC’s global climate assessments, shaping the sea-level rise projections used by governments worldwide.

Hidden hydrology and sea level rise

“As ice slides over the bedrock beneath Antarctica, meltwater trapped at the base of the ice is released and can eventually flow into the ocean. This hidden hydrology — the presence, pressure, movement of water beneath the ice sheet — strongly influences basal sliding and ice-sheet dynamics. If water pressure at the base is high, basal friction drops, and parts of the ice sheet can slide more readily. This makes subglacial water a critical control on ice discharge into the ocean.”

“In the past ISMIP6 and IPCC sea level rise projections, the ice sheet modelling community has largely not considered how evolving subglacial water systems affects basal sliding. The water released from beneath the ice into the ocean can enhance the basal melting beneath floating ice shelves, which in turn weakens the ice and allows even more ice to flow into the ocean.”

“Previous reports have not considered this at all.”

Subglacial waters ‘significant’ in their role in global sea-level rise 

Zhao describes Antarctica’s contribution to global sea-level rise as highly uncertain but potentially immense, with subglacial water acting as a previously underappreciated accelerator of ice loss.

“In our recent paper titled “Subglacial water amplifies Antarctic contributions to sea-level rise’, published in Nature, we revealed that incorporating the evolving subglacial water can amplify ice discharge across the Antarctic Ice Sheet by up to threefold above the standard approach without including subglacial water in the model, potentially contributing an additional 2.2 metres to sea-level rise by 2300.”

“If realised, this scale of rise would redraw coastlines worldwide, placing many of today’s major coastal cities and low-lying island nations at severe and potentially irreversible risk — particularly in Australia and the Pacific Islands, where sea level has already been rising faster than the global average.

“We demonstrate that water at the base of ice sheets influences sliding behaviour and that its exclusion from models can underestimate sea-level rise projections and delay the predicted onset of tipping points.”

A chart contrasting the different contributions to sea-level rise from the Antarctic Ice Sheet depending on how subglacial water pressure is included. Zhao, C., et al, 2025. Nature Communications.

Behind the modelling

Using state-of-the-art ice sheet modelling, the research explored how different assumptions about water pressure at the ice base affect sea-level rise projections from 2015 to 2300.

“Our results indicate that incorporating subglacial water can amplify ice discharge across the Antarctic Ice Sheet by up to threefold above the standard approach, potentially contributing an additional 2.2 metres to sea-level rise by 2300,” Zhao explains.

Notably, a smoothly decreasing basal drag near the grounding line more than doubles grounding line flux by 2300 relative to scenarios where effective pressure is simplified into a spatially constant coefficient. Basin-specific responses vary significantly, with some scenarios advancing tipping points by up to 40 years. These findings underscore the critical need to integrate evolving subglacial hydrology into ice sheet models.

The study shows that when friction beneath the ice near the coast is allowed to decrease realistically as water pressure builds up, more than twice as much ice can flow into the ocean by 2300 compared with models that assume constant conditions beneath the ice. Different parts of Antarctica respond in very different ways, with some regions reaching dangerous tipping points up to 40 years earlier. The results highlight that future sea-level rise cannot be reliably predicted without accounting for the hidden water systems beneath the ice sheet.

When Jasneek Chawla commenced her PhD evaluating the impact of sleep interventions on children with Down syndrome, she didn’t realise just how deeply many families of children with disability were struggling.

“Each time I did a clinic I could see families struggling. Struggling with all aspects of life. Time and time again these families were being told by health professionals to “just get on with it”.

“They didn’t feel they could ask for help.”

Studies show that children with Down syndrome are six times more likely to have sleep problems. And parents and siblings experience the ripple effects. According to Jasneek, significant inequity exists in the provision of sleep health care for these children, and little support for their families who experience the often debilitating effects of sleep deprivation alongside their child.

“While parents acknowledged that sleep disruption had adverse and pervasive impacts on their wellbeing and family dynamics, they accepted sleep difficulties as a regular part of raising any child, particularly one with a disability,” Jasneek explains.

When they did seek treatment, parents often reported receiving insensitive, and inadequate care.

“Healthcare professionals were often normalising children’s sleep difficulties. This was resulting in sub-optimal treatment. At times, they failed to refer families to sleep services.”

Some examples of insensitive guidance were extreme. “One family was told to talk to their child with dog commands.”

Five major themes quickly emerged from her research. “That childrens’ sleep issues are often very complex, made worse by things like pain, or seizures. That sleep disturbance affects the whole household, including siblings.”

The experiences of caregivers were brought to light. “Caregivers experience severe fatigue, too, which impacts their own health, thinking, and ability to work. We also know these parents and families are trying different strategies and treatments to improve sleep. And what’s missing is tailored information … better information and supportive resources.”

Jasneek said that stemming from this and other studies, an amazing community of supporters formed. “A community of people who were willing to help us to try and improve the lives of these children and families.”

A subsequent MMRFF grant study, ‘early sleep interventions to improve outcomes in children with neurodisability’ revealed that the challenges faced by families of children with Down syndrome were mirrored in the lives of families whose children were living with other types of disability. The aim of this large study of 300 caregivers of children with neurodisability was to understand how sleep problems affect families – beyond medical outcomes and into daily life, wellbeing and coping strategies – and improve outcomes for these children through sleep interventions.

Improving sleep diagnosis and treatment for children with neurodisability

In a second phase of her MRFF funded program, Jasneek focused on diagnostic testing for sleep disordered breathing. Children with conditions like Down syndrome, Prader Willi Syndrome and Cerebral palsy have a higher rate of sleep disordered breathing, or SDB, than typically developing children.

On average, this group of children will undergo 3-4 sleep studies across their childhood, sometimes even more. Recognising the difficulties of standard sleep study monitoring for children with neurodisability, Jasneek and her research team set out to evaluate alternatives.

“Standard in-lab polysomnography (PSG) testing equipment is often problematic. It includes a lot of wires and attachments to the child, which many children, particularly those with sensory sensitivities, won’t tolerate. Children also don’t sleep well when in the lab as a result and so you don’t get a good measure of what may be happening at home.”

Working with Professor Sullivan, the founder of CPAP, a new sleep-monitoring mat, the Sonomat contactless mat, better suited to the needs of children with neurodisability, was developed and tested with the goal of validating a more tolerable diagnostic method for sleep-disordered breathing in children with neurodisability.

“This new, non-invasive mat does away with wires and sensors, like nasal prongs and EEG leads, making it much more tolerable.”

The final phase of the research program involves a randomised controlled trial (RCT) of a range of tailored sleep interventions for children with neurodisability, focusing on behavioural sleep problems and trying to determine the best approach to management.

National guidelines

Today, there are no clinical guidelines to support the evaluation and management of sleep problems in children with disability in Australia, or elsewhere in the world. Jasneek hopes that this research will contribute towards the development of appropriate national guidelines to help health professionals such as GPs, general paediatricians and allied health professionals manage sleep issues for children living with neurodisability.

“If we can improve this for families, for caregivers, the difference it will make to their quality of life is significant.”

“We all need sleep. It’s an essential to our lives. When I see families in the clinics, parents tell me I’ve changed their lives by helping them get sleep. All I’ve really done is I’ve simply listened and helped them find ways to manage this themselves, with tailored support.”

Jasneek Chawla is a paediatric respiratory and sleep physician at the Queensland Children’s Hospital in Brisbane, Associate Professor at the University of Queensland and President of the Australasian Sleep Association.

Antarctica and its extraordinary icy landscapes may not be on our minds daily. Yet, this icy continent is changing rapidly, and these transformations are influencing everything from sea levels to ecosystems. 

On most maps, Antarctica is shown as a thin strip at the bottom of the world. For oceanographers, however, Antarctica lies at the centre of the global ocean. The Pacific, Atlantic, and Indian Ocean basins extend north from the continent, and their currents converge around Antarctica, transporting water, heat, salt and nutrients.

“Sea ice, the thin layer of frozen sea water that forms in winter and melts during summer, plays a key role in driving these global ocean currents,” says Edward Doddridge, physical oceanographer from the Institute for Marine and Antarctic Studies in Tasmania.

Unprecedented sea ice loss: the bigger picture
“In recent years we have seen a collapse in Antarctic sea ice. Coverage in 2023 was the lowest ever recorded. And for the first time, sea ice loss was seen in Winter. The scale of ice loss was unprecedented.” 

Doddridge is part an international cohort of scientists working to understand why this sea ice decline is occurring. His research focuses on how heat moves through the oceans to Antarctica, how subsurface heat affects sea ice, and whether observed changes are temporary ‘blips’ or permanent shifts.

His work advances the scientific community’s understanding of the global climate system. In particular, how it is changing, and the impacts of those changes on our world. This work directly informs Intergovernmental Panel on Climate Change (IPCC) reports, used by governments to inform policy.
 

The science beneath the ice 

Doddridge and other ocean and climate scientists rely on computer modelling, satellite data, and more than 4,000 autonomous ocean floats to monitor ocean conditions and ice changes in near-real time.

A key part of Earth’s climate system is the ocean’s ‘overturning circulation’ — a global network of currents that move heat, carbon, and nutrients around the planet. 

Warm, salty water flows from the tropics toward the poles. Around Antarctica, it cools, becomes denser, and sinks deep into the ocean. This water slowly returns to the north, bringing nutrients to the surface and helping to regulate the climate. 

When sea ice melts, it releases fresh water, less dense than salty water. This stabilises the surface layer, making it less likely to sink, and slowing the deep circulation. 

Rising global temperatures warm the upper ocean even further, weaking the sinking motion that drives this circulation.

“If this circulation weakens significantly, it can disrupt how the ocean stores and moves heat, carbon, and nutrients, with far-reaching effects on global climate systems including weather patterns, sea levels, and marine ecosystems.” 

The loss of Antarctic sea ice not only threatens ecosystems. It also threatens wildlife.

“This ice loss heightens the extinction risk for Emperor Penguins. Their breeding colonies, that live on the frozen sea ice, are vulnerable. Their chicks rely on stable sea ice ahead of growing their waterproof feathers.”

“Antarctica and its changing ice and oceans are intrinsic to life on the planet. Antarctica Day is a day on which to pause and consider the importance of that thin strip at the bottom of the map and the alarming changes we have seen unfold in recent years.”
 

Read some of Doddridge’s work and recent contributions here: 

Antarctica and Climate Change Technical Report. A technical report for the National Climate Risk Assessment. 

 Emerging evidence of abrupt changes in the Antarctic environment, published in Nature.

A multidisciplinary paper examining the impacts of Antarctic summer sea ice loss.

Record low Antarctic sea ice coverage indicates a new sea ice state, published in Nature.

Nausea. Vomiting. Abdominal pain. Feeling full quickly after eating. These are some of the symptoms of gastroparesis, or ‘delayed gastric emptying’ – and there is no known cure. Gastroenterologist Dr Vincent Ho, clinical project director of Western Sydney University’s GI Motility Disorders Unit together with other gastroenterology motility specialists is developing new diagnostics and treatment options that address the root cause of this mysterious condition which commonly affects young women.

“With gastroparesis, the normal stomach contractions that move food through the digestive tract are weakened or impaired,” says Dr Ho.

“If left untreated, for some, drastic measures are required, such as feeding tubes. Symptoms can linger for a lifetime.”

Dr Ho is passionate about making a real difference for the lives of people suffering from this condition. In conducting research investigating the underlying cause, he is hoping that more specific treatments may one day help improve the quality of life of people with gastroparesis.

A patient meeting with a turning point

It was back in 2011 when a consultation with a young patient opened Dr Ho’s eyes to the unusual condition of gastroparesis. Investigations indicated that there was nothing wrong with the structure of the stomach. But there was something seriously wrong with its functioning.

“I was privileged to meet a young lady named Ashley, a law clerk in her twenties, who presented to my Campbelltown Hospital gastroenterology clinic with symptoms of nausea, vomiting and fullness. Multiple tests later, Dr Ho discovered that she had a condition called gastroparesis.

“I tried multiple medications, none of which had worked for her. It was a real eye opener. I thought to myself – how am I going to get her better? A large part of me just could not accept that this condition could strike down a young person and leave them so sick without a possibility of a cure.”

Gastrointestinal motility program well underway

Ashley was instrumental in Dr Ho developing a program focusing on gastrointestinal motility disorders including gastroparesis.

“A motility disorder occurs when muscles and nerves in the digestive tract don’t work properly,” explains Dr Ho. “This causes abnormal movement (or ‘motility’) of food, fluid, or waste through the digestive system. In the case of gastroparesis where the food moves very slowly out of the stomach, this means that it’s stuck in the stomach for a prolonged period. Food which is stuck leads to those symptoms of nausea, vomiting and feeling full.”

Ashley ended up having to be tube fed.

“This was a drastic solution. Imagine the impact on someone who is otherwise healthy, having to have a feeding tube inserted.”

“This all happened to her one day when she was recovering from the flu. Gastroparesis can often start after an infection, or gastro and tends to be a chronic problem,” Dr Ho explains.

“Today — as it was back then — not a lot is known about the condition, other than that it predominantly affects young women, and they continue to experience symptoms.”

Cellular research

As principal investigator with the Gastroparesis and Functional Dyspepsia Biobank project through Western Sydney University’s School of Medicine, Dr Ho together with Professor Nicholas Talley at Newcastle University is conducting cellular-level research into why stomach motility fails, and what treatments could help.

“We know that the stomach — like the heart — has a natural ‘pacemaker’ function. Unlike the heart, where in people it can vary between 60-100 beats per minute, the stomach has contractions of three cycles per minute or so. In the digestive system, slow-wave electrical activity — like pulses — keeps the digestive system working properly. In people with gastroparesis, these specialised cells, in the gastrointestinal tract, are dysfunctional.”

Dr Ho wants to understand why or how these rare and fragile cells, called ICC cells (interstitial cells of Cajal) become dysfunctional in gastroparesis.

Dr Ho and his research team at the School of Medicine, Western Sydney University were the first to conduct genomic sequencing of these ICC cells. From the genomic sequencing came interesting insights into the genetic makeup of these cells in healthy humans.

The cells were extracted from stomach samples donated by people who had completed gastric sleeve surgery. The technique used to identify and extract the cells was quite unique and difficult to undertake, requiring a significant effort from the research team to co-ordinate.

The research identified proteins that could shed more light on how these ICC cells become dysfunctional with gastroparesis.

“We know that people with gastroparesis have fewer ICCs, and they are dysfunctional. We are yet to uncover how the patients have developed the dysfunction. Knowing why ICC cells are lost or don’t work properly will enable the development of diagnostics and treatments based on this dysfunction.”

“This will hopefully give us more insights into drug targets,” Dr Ho explains.

Discovery of dietary fibre suited to people with gastroparesis

Dietary fibre is often touted as good for gut health. For people with gastroparesis, fibre is problematic. “This is because it slows digestion and may worsen symptoms such as bloating, nausea, fullness, and stomach pain,” Dr Ho says.

“We are exploring how different types of fibre affect people with gastroparesis. A pilot study that we conducted suggested that some low-viscosity soluble fibres such as partially hydrolysed guar gum and gum arabic, instead of standard fibre like psyllium husk, may be better tolerated without aggravating symptoms.”

Ways to obtain samples from the stomach, minus surgery

Previously, endoscopy could only sample the superficial layers of the stomach. Collecting deeper layers of stomach tissue, which included muscle, required surgery.

“In the past, getting any deep kind of tissue from deep within the stomach has been challenging … we are researching ways, using new technologies, to access deeper samples from the stomach via endoscopy. This could open up the possibility of getting deep stomach tissue samples from people with gastroparesis.”

A minimally invasive way to sample the deeper layers of the stomach would be a game-changer for gastroparesis research. This would enable many more samples to be collected from both healthy individuals and people with gastroparesis. This minimally invasive approach of collecting stomach samples combined with the cellular research Dr Ho is undertaking would provide a much better understanding of how the ICC cells in healthy people can change and become dysfunctional in gastroparesis.

Gastroparesis awareness and advocacy

Dr Ho, together with the gastroparesis community, are raising awareness of the condition through advocacy via a website and Facebook group.

• The GI Motility website, created by Western Sydney University
  This informs patients and referrers about clinical evaluation and care for motility disorders; highlights pioneering research into gut physiology, therapeutic innovation, and device technologies; and engages the broader community and amplifies the voices of patients through support networks and partnerships.
  https://www.westernsydney.edu.au/gimotility/home
• A Facebook community called The Inside Story is a safe, peer-led space where patients and carers connect and share information. Dr Ho was instrumental in helping establish this Facebook community a decade ago.
• The Gastroparesis Australia website
  This website is a source of support, advocacy, and information for people living with gastroparesis.
  Western Sydney University’s GI Motility Unit provides the digital infrastructure for the organisation.

https://www.gastroparesisaustralia.com/

Topics that Dr Vincent Ho is available to present on include:

• Gut health
• Gut science
• Any gut diseases such as IBS, IBD, coeliac disease, eosinophilic oesophagitis, gastroparesis, reflux, colon cancer
• Life as a clinician scientist

About Vincent Ho

Dr Vincent Ho is a 2024 New South Wales Young Tall Poppy Science Award recipient.

Dr Vincent Ho is a gastroenterologist at Campbelltown Hospital and an Associate Professor at the School of Medicine, Western Sydney University. Vincent leads a Translational Gastroenterology Research program at the School of Medicine focusing on basic science and clinical research in the gut. He has a strong passion in education of the science of the gut to health discipline audiences as well as the general public. He is more widely known to the public as the GutDr.

https://gutdr.com/articles/

Every 19 minutes, someone in Australia will have a stroke. One-third of those stroke survivors will have aphasia, a condition affecting their ability to communicate – to speak, understand, read, write, use numbers and gestures. More than 140,000 Australians are living with aphasia – and without timely intervention, aphasia can lead to concerning psychosocial outcomes, including social isolation, depression and a poorer quality of life.

“We use language every day without even thinking of it – when we send an email, listen to a podcast, or talk to a friend,” says speech pathologist and NHMRC Research Fellow Associate Professor Sarah Wallace. Her research focuses on communication disabilities in ageing and post-stroke aphasia, emphasising qualitative, participatory research methods in partnership with people who have lived experience of communication disability.

“People with communication difficulties can find it more difficult to have a say about matters that concern them. When people living with aphasia cannot be heard, it’s difficult for them to connect with the help and support they need. This is why loss of language is so devastating.”

Difficulties often persist long after stroke

Wallace explains that when people with aphasia cannot say the words they want to say, or have difficulty understanding others, day-to-day life can be overwhelmingly difficult. For many people with aphasia, these difficulties can persist long after their stroke.

“About one-third (27%) of people who have a stroke will have aphasia, a 2025 study by PhD candidate Marissa Stone has found . Of those people with aphasia, around two-thirds will continue to have chronic communication difficulties a year later.

“Our research has found important differences in the care that people with aphasia receive in acute hospital settings. We found that patients with aphasia were less likely to be assessed for mood impairment, receive risk factor education or be involved in care plan development.”

People with aphasia were also more likely to have a more severe stroke, more in-hospital complications and in-hospital deaths. They were less independent at discharge, less often discharged home, and more likely to be discharged into residential care.

“This combination of poor outcomes and differences in care quality can result in significant unmet needs.”

Optimising the lives of people living with aphasia

Wallace leads a large research team, LexLab — the Lived Experience Lab — within the Queensland Aphasia Research Centre (QARC; https://shrs.uq.edu.au/qarc). QARC is the first centre of its kind in Australia, dedicated to optimising the lives of people living with aphasia through research, service, and partnerships.

Curiosity, sparked

It was working with people with aphasia in Canberra that sparked Wallace’s interest in aphasia.

“As a speech pathologist in Canberra, I witnessed firsthand the extent of the challenges that people with aphasia experience. Because aphasia is a communication disability, it can be difficult for those who live with it to explain the condition to others or advocate for themselves.”

“In Canberra, I worked with people with aphasia from when they first had a stroke to many, many years later when they had returned home to live in the community. One of the highlights of my time in Canberra was working with the community to host the 2006 Australian Aphasia Association Conference. The AAA is the national peak body and advocacy organisation for people living with aphasia in Australia. During the conference people with aphasia gave presentations and shared their stories and experiences. This really brought home to me just how important it is for people with aphasia to have the opportunity to connect and be heard.”

Co-designing better ways of living well with aphasia

In the years since, co-designing better ways to live well with aphasia has become central to Wallace’s work.

Wallace and her team work with people living and working with aphasia to co-produce interventions (such as technology and therapies), systems and standards that improve quality of care and outcomes for people with aphasia. Key to this is working in partnership with people who have lived experience of aphasia – as well as their families, friends, clinicians and community members.

So far, this work has included co-design of technology such as the Aphasia Research Library, the AphasiaFit app, and the CommuniKey browser extension.

Wallace has also led work to co-create systems and standards for measuring quality of aphasia care and outcomes, such as the ROMA core outcome set, and the MEASuRES minimum dataset. Supporting the development of PhD candidates is a key role for Wallace. These projects have spanned topics including returning to driving with aphasia, raising aphasia awareness, developing outcome measures, and establishing priorities for aphasia services.

“One project that we are really excited about is an international project to raise awareness of aphasia. Dr Claire Bennington co-designed an international aphasia awareness campaign during her PhD. It’s the first campaign of its kind – built by people living with aphasia, shaped by their stories, and driven by a shared vision for change. We are now working to translate our campaign design into action. The Tavistock Trust for Aphasia has offered us AU$72,958 in funding to support this, if we can match it with an additional AU$72,958. So, this week, in Stroke Week, we are launching a campaign to ‘Match the Momentum’. We have set up a JustGiving page to help raise the additional funds and we are encouraging the community to get behind this initiative: https://www.justgiving.com/campaign/qarc-uq-aphasia-awareness

Accessible and meaningful information through co-designed research library

 Wallace and her team co-designed the Aphasia Research Library (https://www.aphasialibrary.org), an online template and searchable database. The Aphasia Research Library supports information access by generating user-friendly research summaries that reflect individual content and communication preferences.

“It was our goal to create an inclusive, user-friendly resource that empowers people with aphasia to access and understand research that is relevant to their lives and will inform their treatment decision making,” Wallace said.\

Wallace and her team are currently seeking funding to expand the library to suit the needs and preferences of all people living with stroke.

When it’s measured, it can be monitored and improved

Wallace leads the MEASuRES project, aimed at establishing routine measurement of important information about who people with aphasia are; the quality of care they receive in hospital, the treatments they receive, as well as the language, communication, emotional wellbeing and quality of life outcomes they experience before and after treatments.

“My interest in this area began with my PhD. I wanted to improve the efficiency and relevancy of aphasia research by developing a core outcome set (a minimum set of outcomes that should be measured in aphasia treatment studies). We worked with researchers, clinicians and people living with aphasia around the world to work out which outcomes were most important to measure. We are now looking at this in hospital environments and trying to collect consistent data and outcomes that help us understand where gaps in care exist and the factors that might improve someone’s outcomes.”

So far, the team has developed a new set of quality indicators for aphasia care and is testing a minimum dataset in partnership with five health services: Metro North Health (QLD), Monash Health (VIC), St Vincent’s Hospital Melbourne (VIC), Sir Charles Gairdner Osborne Park Hospital Group (WA), and Fiona Stanely Fremantle Hospitals (WA). Data collection is well underway, with nearly 70 participants already contributing valuable information.

AphasiaFIT app for managing recovery at home

Wallace, together with her co-investigators at Queensland Aphasia Research Centre, including Mr. Gopal Sinh who has aphasia, have designed a smartphone app to support people living with aphasia in managing their own recovery at home.

Co-designed with people with aphasia, families and clinicians, the app connects users in a private social network, supporting ongoing, individualised care.

Much like a ‘fitness tracker for communication’, it supports goal setting, links goals, therapy and outcomes, and offers visual graphics of progress, and daily wellbeing check-ins via prompts. The app is in prototype form and will be further developed as part of a new project.

Wallace says a highlight of this project was travelling to Perth with Gopal to co-present the research outcomes at the National Australian Aphasia Association Conference and Aphasiology Symposium of Australasia.

Cracking the myths of osteoarthritis treatment: 
Why exercise, not surgery, should be the first step 

Some 2.2 million Australians, or 1 in 4 people over 55 live with knee or hip osteoarthritis. Within 15 years, this figure will reach 3.1 million. Osteoarthritis is the 14th highest cause of disability and rising, costing $4.3 billion annually in healthcare expenses alone, with joint replacement surgery responsible for over 80% of this figure.

Surgery is ‘no silver bullet’ 

As much as 83% of joint replacement surgeries for osteoarthritis could be delayed, or avoided, if patients choose to swap surgery with non-surgical care – education, exercise and weight management.  

“Almost half still report pain years after surgery,” says Dr Felicity Braithwaite, Research Fellow from the University of South Australia.

“Plus, four in five feel they weren’t properly informed about other treatment options before surgery.”

Myths about osteoarthritis mean more are going under the knife

Prevailing societal myths about the best ways to manage osteoarthritis are partly responsible for why many Australians choose to go under the knife, says Dr Braithwaite. 

“These misconceptions are widespread among consumers, clinicians, family and friends, and in the media.”

“People living with OA told us about a huge number of misconceptions around osteoarthritis that are still rampant. People perceive, for example, that the joint is ‘bone on bone’, and that surgery is the only solution for OA.” 

“Other examples of myths they expressed were “exercise causes more wear and tear”, and “when a joint is bone on bone, it needs surgery”.”

Uptake of core management strategies is poor 

Despite being best practice for osteoarthritis, education, exercise and weight loss are still poorly adopted.

“Many people — over half — never try exercise therapy. And only one in three attempt weight loss before having surgery. Surgery rates are projected to rise 276% by 2030 compared with 2013.”

Dr Braithwaite sats these patterns reflect a deep gap between research and real-world practice — a translation problem. 

“We need to stop thinking of surgery as the only option for OA,” says Braithwaite. “The real treatment gap isn’t access to surgery. Rather, it’s a lack of awareness or belief in the proven strategies. These beliefs are stemming from almost everywhere, including healthcare providers, and via public information such as websites and the media. Further, general practitioners are referring to surgeons three times more often than non-surgical care.”

Pain education, science and storytelling

Dr Braithwaite is co-designing fun, educational myth busting videos to help educate the public about osteoarthritis. This series of myth busting messages and campaigns are being co-designed with consumers, clinicians, pain organisations, and marketing experts.

“It is important to teach people that there are alternatives to surgery — and the best way to do this is through using the consumer voice so that the messages are believable, meaningful, and not stigmatising.” 

Codesigning consumer campaigns to tackle myths head on 

As part of a three-year project generously funded by The Hospital Research Foundation-Arthritis, a consumer advisory panel of 10 people with hip, knee, foot and ankle OA was formed. 

“We partnered with these consumers as ‘co-researchers’ to decide how best to use the grant funding. We asked them what they saw as the biggest barriers to best practice management of osteoarthritis, and their suggested solutions. The co-researchers came up with the idea that a society-wide media campaign is needed to tackle misconceptions about OA and best-practice management.” 

Dubbed ‘mainstreaming osteoarthritis’, the campaign is aimed at reducing the negative impacts of common unhelpful misconceptions. The advisory panel identified seven key myths to tackle, co-designing educational videos for each myth for future campaigns.  

Results are showing promise 

“So far, we have co-designed a series of brief videos including informational animations as well as testimonials from real people with OA telling their success stories with best-practice management.” 

Early results from pilot testing indicate these videos are already showing promise: a single viewing of one of the educational videos significantly improved osteoarthritis beliefs in consumers, clinicians and the wider public. It also improved the intention to exercise in people with OA, with 24% saying they were less likely to see a surgeon in the next year1.  

Coming soon: a nationwide media campaign

A future nationwide media campaign is the next goal, according to Dr Braithwaite.

“We are developing educational content that we have co-designed with consumers, using contemporary market research techniques to optimise campaign messages for maximum impact across a broad cross-section of society.”

Explore osteoarthritis myths in the paper titled “Osteoarthritis consumers as co-researchers: identifying consumer insights to improve osteoarthritis management by co-designing translational research solutions”, co-authored with six members of the consumer advisory panel here:

https://pubmed.ncbi.nlm.nih.gov/36924920/  

Dr Felicity Braithwaite is a 2024 SA Young Tall Poppy recipient