Author: Bree

Many of us talk to ourselves in our minds–rehearsing conversations, reflecting on our day, or even just narrating life as it unfolds. This internal monologue is known as inner speech, and it’s a normal part of human thought. But in schizophrenia, something is different. For some people, this internal monologue can take on a life of its own – experienced not as self-generated, but as intrusive voices coming from outside. These are called auditory-verbal hallucinations.

A time to reflect

On World Schizophrenia Day, it’s important to reflect not just on the challenges of living with schizophrenia, but also on the growing science helping us understand it. One leading theory suggests that hallucinated voices may actually be a form of misattributed inner speech – internal thoughts that the brain fails to recognise as self-generated.

Understanding brain activity

Research using brain imaging and EEG shows that when people experience auditory-verbal hallucinations, similar brain areas activate as when they hear real voices. But unlike typical inner speech, these experiences often carry a sense of agency – as if someone else is doing the talking.

Why does this happen? Some researchers believe it’s a breakdown in the brain’s ability to predict and monitor its own actions–a kind of self-monitoring error where the brain loses track of its own inner voice. When these systems fail, the brain might not recognise that a thought came from itself, leading to the distressing experience of a foreign voice inside the mind.

Could the past speak or voice trauma

Many people with schizophrenia report that these voices are critical, hostile, or commanding, and frequently commenting on the person’s actions, appearance, or worth in a negative way. There’s also growing evidence that these voices echo phrases or tones reminiscent of past abuse or neglect. In this sense, auditory-verbal hallucinations might not just be a perceptual glitch, but a deeply emotional, memory-linked phenomenon, where the past quite literally speaks.

Distinguishing between self-generated and hallucinated thought

Emerging therapies are exploring whether people can learn to better distinguish self-generated thoughts from hallucinated ones. Techniques like real-time neurofeedback or cognitive training are being tested to improve source monitoring – the brain’s ability to tell who ‘said’ what. Early findings are promising, suggesting that the brain-based interventions may one day complement traditional treatments like medication and psychotherapy.

Understanding the link between inner speech and auditory-verbal hallucinations not only advances our understanding of schizophrenia’s biological underpinnings. It may also provide a potential window into the neural mechanisms behind the condition, and a possible biomarker to guide future treatment. Just as importantly, it can also reduce stigma. People who hear voices aren’t “making it up” or “losing touch with reality” in the way popular culture sometimes suggests. Instead, their experiences reflect complex changes in how the brain processes and attributes thoughts.

For people who hear voices, one of the hardest parts can be explaining the experience to others. The voices may sound as real as someone speaking next to them, or they might be quieter and more ambiguous. They might be continuous, intermittent, or triggered by certain situations. This variability can make it hard for friends, family, and clinicians to fully grasp what the person is going through – and underscores the need for empathy and open-ended listening.

This World Schizophrenia Day, let’s listen with empathy, promote understanding, challenge stigma, and support the science that helps us understand – and honour – the inner lives of those living with schizophrenia.

https://www.healthline.com/health/schizophrenia/schizophrenia-awareness_

Almost half of Australia’s freshwater turtles are now listed as vulnerable, or worse. But in south-east Queensland’s Mary River, the endangered Mary River turtle is being given a fighting chance — thanks to an extraordinary 22-year collaboration between the local community (landholders, Landcare, volunteers) and researchers.

Sixteen years ago, the then-PhD student Mariana Campbell (and today Young Tall Poppy recipient) received a scholarship from the Tiaro & District Landcare Group (TDLG) to investigate the species’ ecology along the lower river catchment. Mariana’s close collaboration with Tiaro & District Landcare Group (TDLG) on the Mary River turtle Conservation Program has continued ever since.

Valuable knowledge improves management

The scientific knowledge on the Mary River turtle’s biology may have largely remained a mystery had it not been for this long-standing partnership. Together, members of the Tiaro community, TDLG, Mariana and several other researchers have built an extensive body of knowledge that spans 17 peer-reviewed papers and six higher degree research theses. Vital insights about the turtle’s ecology, critical habitats, threats, and population now inform environmental planning and water management in the region.

A passion for collaboration that runs deep

This deep collaboration has seen local group members and volunteers monitoring nests, river changes, collecting data, undertaking fieldwork, co-authoring manuscripts, and even obtaining extra funds to support the research.

This project illustrates how science stems far beyond the lab and into rivers, on riverbanks, and in communities that care deeply and take action.

Read Mariana Campbell’s work on the Mary River turtle, conducted in partnership with TDLG:

https://researchers.cdu.edu.au/en/persons/mariana-campbell

Learn more about the critically endangered Mary River turtle and the Tiaro & District Landcare Group:

https://www.tiarolandcare.org.au/maryriverturtle/

https://www.facebook.com/MaryRiverTurtleProjectTiaroLandcare/

Picture courtesy Joel Howland

Fewer killer T cells, which are also less efficient and weaker reinforcements: 

During World Immunisation Week, we look at revelations about how the body responds to influenza over time – and new research reveals why older people are at higher risk of severe influenza infection.

KEY FINDINGS:
> Older people are at higher risk of severe influenza infections because their killer T cells that normally play an important role in stopping the infection are now in lower numbers and less efficient. We gradually lose our most optimal killer T cells, and their backup cells are also of reduced quality, new research has revealed. 

Protecting us from severe disease caused by viruses such as influenza is the busy work of killer T cells, part of our immune system. These cells can remember viruses they have eliminated, which allows them to respond faster – and more strongly – when reinfected with the same virus.

In older people, killer T cells targeting the influenza virus are less effective versus those in younger people. There is a growing body of evidence to explain why this difference occurs.

Researchers observed how the killer T cell populations of a group of adults and older people changed over time (7-12 years). In particular they wanted to find out if they could detect the same Killer T cells across multiple time points.

Commenting on the findings was the University of Melbourne’s Dr Carolien van de Sandt, senior research fellow in the Kedzierska Laboratory:

“The highly functional killer T cells in adults are long lived; we were able to detect the same cell at multiple time points in the same donor. This is good news as it means our body has good defences against influenza for at least 10 years in our adult years.”  

“However the highly functional killer T cells in adults gradually declined over time. We discovered that adults have a high functioning killer T cells ‘in reserve’ which can take over once the initial highly functional cell populations decrease.”

In older people, it was a different picture.

“Once the highly functional populations start to decrease they eventually disappear, the void is filled by less functional killer T cells. As these less functional cells diminish, similarly low-functioning cells replace them, leading to a progressive decline in immune effectiveness.

“We now have a better understanding of why older people are at higher risk of severe influenza infections. Their killer T cells that normally play an important role in stopping infection are now in lower numbers and less efficient. Our most recent study shows their backup cells are also of reduced quality.”

Dr van de Sandt says in light of these findings, it is especially important for older people to get vaccinated at the start of the flu season, to boost other parts of their immune system, helping to protect them against circulating flu viruses. 

Read more of Dr van de Sandt’s work here: 

https://www.doherty.edu.au/news-events/news/t-times-up-when-the-immune-system-is-getting-older-it-gradually-loses-its-top-team-players 

University of Melbourne Dr Carolien van de Sandt, a Senior Research Fellow and early-career researcher at the Doherty Institute, is a 2023 Victorian Young Tall Poppy Award recipient. Dr van de Sandt was recognised for her work in virology and immunity. 

New approaches to induce protective immunity needed?

Current influenza vaccines are designed to generate antibody responses which bind to the outside of the virus and form a shield to prevent the virus from infecting your cells. However, these antibodies are directed against parts of the virus that can change from year to year. Leading to an almost annual update of the vaccine, to make sure it still matches with viruses circulating in the upcoming influenza season.   

Although current influenza vaccines are immensely important in preventing severe disease, particularly in high-risk populations including older people, the vaccine gives the best protection if the vaccine components are well matched with the circulating influenza viruses.  

Dr van de Sandt believes that further improvements to the vaccine can be made. New approaches, for example the mRNA vaccines used during the COVID-19 pandemic, can also boost the bodies killer T cells. Killer T cells recognise parts of the influenza virus that are less likely to change, which means that they can provide a second layer of protection against severe disease.   

“If vaccines that boost the killer T cells become available, our research indicates that they probably work best earlier in life, when we still have these highly functional killer T cells.”

“However, it will be important to investigate whether these novel vaccines will also induce highly functional killer T cells that can be maintained into old age.”

Dr van de Sandt considers the possibility that just boosting these cells will not be sufficient.

“We may need an additional vaccine component to specifically boost their longevity.” 

Dr van der Sandt is available to present on these topics: 

• Influenza 

• Ageing immunity 

• Pandemic risk/preparedness 

• Vaccination

Follow Dr van de Sandt on Twitter: @CvandeSandt, BlueSky: @cvandesandt.bsky.social and LinkedIn: linkedin.com/in/carolienvandesandt 

Exposure to workplace aggression and violence (WAV) in healthcare settings is stressful for staff, and a big burden on budgets. A virtual reality (VR) enhanced training tool pioneered by researchers at Edith Cowan University in Western Australia could soon be set to change things.

The Simulation & Immersive Digital Technology Group (SIDTG) operating out of Edith Cowan University in Western Australia, together with the Department of Health WA, have created a I-VADE, a novel immersive virtual experience allowing both novice and experienced clinicians the opportunity to practice core de-escalation skills in a realistic, safe setting at a time that suits them.

Dr Brennen Mills, who leads the SIDTG, sees real potential given the scalable nature of the immersive VR training to impact workplace aggression and violence training, with traditional training options struggling to find priority in a busy healthcare landscape where finding isolated time for training can be a challenge. “I-VADE allows flexible training to be conducted at times that suit individuals and teams, minus the time drain commonly associated with co-ordinating staffing and resources,” says Dr Mills.

“For frontline healthcare workers, exposure to aggression and violence is an unfortunate reality. These incidents have long-lasting impacts that compromise the ability of the healthcare sector to retain experienced staff.”

Complex scenarios tackled in virtual settings

“Technologies like VR and AR give us a real opportunity to produce complex scenarios in virtual settings, to help mitigate risk. Situations and settings that are difficult to replicate or train for — because of the need for lots of resources — or because they are dangerous can be reproduced to provide training opportunities virtually.”

I-VADE is just one example of projects underway at the SIDTG to create high fidelity, human focused virtual simulations.

“We are also experimenting with AI-driven virtual avatars that would allow novel conversations to take place between users and the AI. This could be particularly meaningful for WAV de-escalation training where situations are often highly volatile,” Dr Mills adds.

De-escalating violence with I-VADE conversational AI

“Clinicians talk out loud to the virtual avatar ‘patient’ (named ‘Barry’) who is extremely frustrated and abusive — and he responds in near real-time.

His response to each verbal interaction is unique, even if users provide the same wording repeatedly. The training simulation incorporates emotive facial animations that align with real-time verbal responses, and Barry’s anger levels either escalate or de-escalate based on the empathy shown by the VR user.

The I-VADE VR program has been supported by the Department of Health WA, after identifying and acknowledging the growing problem of WAV exposure for healthcare workers and patients.

AI and LLMs helping to humanise Barry

The I-VADE – conversational AI project recently received a major upgrade, thanks to a $500,000 innovation grant from the Department of Health WA. The incorporation of AI and large language models (LLMs) have given Barry human-like gestures and mouth movements.

“These upgrades are bringing a new level of authenticity to Barry. He’s a much more sophisticated conversationalist.”

“Dialogue between the person interacting with Barry, and Barry himself feels far more realistic and natural. Powered by AI, he can vary his tone and expression and adapt his responses to the trainee.”

From single scenario prototype to near real-time conversation

After years of co-design and end-user evaluation, The I-VADE program has come a long way since starting life as a single scenario prototype in 2020.

“An enormous amount of forethought and effort went into our prototype scenario, ‘Derek’. We were able to use learnings from Derek to generate a great deal of support from our partners, which led to further investment. We are now well placed to attack this problem on numerous fronts, expanding our original prototype, as well as exploring additional novel AI integrations.”

And what lies ahead? SIDTG is working with the Department of Health WA and other health service providers to implement and rollout I-VADE at scale.

“We can really see this technology make a meaningful difference in the lives of healthcare workforce, empowering them to be safer at work.”

“We can’t wait to see where Barry’s evolution takes us. He is becoming more authentic by the day. Barry has immense potential to improve education and training across many sectors.”

Read more about Dr Brennen Mills’ work with the SITDG here.

Dr Brennen is Senior Lecturer, School of Medical & Health Sciences and Lead, Simulation & Immersive Digital Technology Group at Edith Cowan University.

Dr Brennen Mills is available to speak to schools about:

· How AI will influence virtual reality and gaming in the future

· Virtual reality and gaming for education

· How digital technology can be used to improve training and practice for healthcare and other professionals

Fresh water quenches our thirst, is used to grow our food, and sustains our rivers, springs, and wetlands, as well as the ecosystems they support. You may not think about it, but most of the world’s fresh water, 98% in fact, is stored out of sight, and out of mind. That is, most of the world’s fresh water is stored underground. Groundwater plays many important roles.

While future rainfall is notoriously difficult to project, most models suggest more extreme weather events, shifting temperatures and changing rainfall patterns, which all affect the availability of surface water resources, and increasing reliance on groundwater resources.

Increased groundwater extraction – at what cost?

Increased groundwater extraction can lead to declining water tables, damage to groundwater dependent vegetation and land subsidence which can lead to irreversible reduction in the volumes of water that can be stored underground. As parts of the world get hotter and drier, and with pressures to increase agricultural outputs, the demands placed upon groundwater are expected to increase.

A deeper look at recharge rates

Understanding groundwater recharge, the rain that replenishes underground water systems, is vital for the management of both surface water and groundwater resources. Despite its importance, quantifying recharge rates is surprisingly difficult. Methods to estimate recharge are typically based on measurements of changes in water levels or based on water chemistry.

Recent research led by Charles Darwin University, produced an AI-based recharge model for the entire Australian continent. Their work used almost 200,000 measurements of groundwater chloride, collated from measurements collected by hundreds of scientists, over a 60-year timeframe.

Their resulting recharge dataset, by far the largest ever produced anywhere in the world, produces a detailed assessment about the variability in recharge rates across Australia. From less than 1 mm/y, to over 1 m/y, their estimates show the huge variability in groundwater recharge rates across Australia. The resulting model produced across the entire continent produces baseline recharge estimates, even in regions without other field-based estimates of recharge, providing much needed information to inform water resources management.

Dylan Irvine explains: “Previous large-scale collations of recharge estimates have used results obtained from many different methods. Each method has vastly different assumptions and can produce widely varying estimates.

“The application of a single technique, the most widely used technique in Australia – on a massive dataset – are the strength of this work.”

“This paper is our best efforts to utilise datasets collected over many decades, often from before any of the paper’s authors were even born.”

“Effective water resource management ensures flowing rivers, healthy vegetation, and access to water for irrigation. Any information that can assist effective water resources management is thus vital.”

Outputs from the model and the method used to estimate recharge are available at the following link:

https://hess.copernicus.org/articles/28/1771/2024/https://www.hydroshare.org/resource/5e7b8bfcc1514680902f8ff43cc254b8/