Riding on the Brain's Back: Building a Strong Brain Science Research Community

In 2019, it was estimated that brain-related disorders cost Australia over $74 billion per annum and constituted over 20% of the burden of disease in Australia.1 Yet despite an abundance of research talent and innovation, early and mid-career brain scientists are leaving the research sector at an alarming rate, primarily due to job insecurity.2 At a time where the health of the population and the economy are increasingly reliant on brain science discoveries and applications, it is critical that Australia retain early and mid-career brain scientists to address one of the biggest scientific problems: Because many brain science projects are multi- and interdisciplinary, with both medical and non-medical applications, researchers often fall foul between the rigid mandates of the Australian Research Council and National Health and Medical Research Council (including the Medical Research Future Funding they administer) schemes. Hannah is currently the President of the Australasian Cognitive Neuroscience Society and has previously been the Co-Chair of the EMCR Brain Science Network - https://emcrbrainsciencenetwork.com.au/ Dr Bernadette Fitzgibbon is a neuroscientist at Monash University working to better understand the relationship between neurobiology and chronic illnesses, and how this may be harnessed to advance prevention and intervention strategies. Sarah leads the Behavioural Genomic and Environmental Mechanisms Lab (@BehGems), where her team investigates how environmental factors influence genetic and epigenetic risk factors in psychological disorders within the individual and beyond, transmitted to future generations.

Incidental connection: Cancer and caregiving during COVID-19.

In this brief article, the author describes how her husband was first diagnosed with mesothelioma, an incidental finding of routine medical testing. His first surgery was timed to the beginnings of coronavirus (COVID) lockdown. The staging of his cancer aligned with a new stage of the pandemic, and by the time of his first chemotherapy appointment, patients were no longer allowed to bring family along for outpatient visits. Although the author is an expert and educator on psychosocial care in medicine, she has found herself at a complete loss, teaching herself the ropes of how to connect with his treatment team and practicing ambiguous advo cacy. Her hus band will be in recovery for a long time; they will both be in recovery. Mesothelioma has robbed them of certainty and safety, as cancer often does, and just as COVID has done, to everyone. We are all living in the question mark, in the ambiguity-the Con nection is our loneliness, our isolation, and the uncertainty. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Effect of Orthostatic Hypotension Detected Pre-Operatively on Post-Operative Outcome.

BACKGROUND: Exacerbation of or new onset orthostatic hypotension in perioperative patients can occur. There is complex underlying pathophysiology with further derailment likely caused by acute cardiovascular changes associated with surgery. The implications for post-operative recovery are unclear, particularly in frail and older patients. We retrospectively explored patient notes for evidence of post-operative orthostatic intolerance in relation to pre-operative orthostatic hypotension. METHODS: Supine and 1-minute and 3-minute standing blood pressure measures obtained from adult patients before mainly general, orthopedic or uro/gynecology surgery were compared to post-operative outcome, specifically, evidence in patient notes about falls, feeling dizzy/unsteady and/or fearful to stand. Orthostatic hypotension was defined as a 20 mmHg or more and/or 10 mmHg or more fall in systolic and diastolic blood pressure, respectively, within ~3 minutes of standing after lying supine for an electrocardiogram. RESULTS: Whilst all patients included had a 1-minute standing blood pressure assessment (N = 170), 3-minute assessment was performed less commonly (N = 113). Nevertheless, one-quarter (23.5%; N = 40) of 170 patients had pre-operative orthostatic hypotension. This was not clearly explained by cardiac or neurological disease or by common medications, but did occur more frequently in older patients and in those aged 65 years or more with higher clinical frailty scale scores. The COVID-19 pandemic reduced the number of patients progressing to surgery within the planned study timescale (N = 143/170; 84.1%). Nevertheless, patients with orthostatic hypotension stayed longer in hospital post-operatively and were more likely to have an episode of fall, unsteadiness and/or dizziness documented (un-prompted) in their notes. CONCLUSIONS: These data provide further impetus for research into modifiable perioperative risk factors associated with orthostatic hypotension. These risks are not confined to those with a pre-existing dysautonomia diagnosis.