Research Activities
Professor Jennie Ponsford is the Director of the Monash-Epworth Rehabilitation Research Centre (formerly known as the Bethesda Rehabilitation Research Centre) which was created in 2000. Its aim is to conduct research in trauma rehabilitation, with a view to reducing long-term disability. Five other psychologists work part-time in the centre to form a dynamic research team. They are: Meagan Carty, Lisa Johnston, Mary Karamitsios, Monique Roper and Rochelle Whelan.
The Research Centre is self-funded by research grants. The TAC is the largest financial supporter of the Centre, providing substantial funding for the longitudinal head injury outcome study and associated projects. The NHMRC, Monash University, the Jack Brockhoff Foundation, William Buckland Foundation, Australian Research Council and the Department of Human Services have also supported specific projects. The Research Centre has strong links with the Department of Psychology at Monash University and numerous doctoral students conduct research within the Centre.
Impact of Research
The research being conducted by the MERRC is recognised internationally, as is evident from the significant number of invited international conference presentations made by Professor Ponsford, her inclusion on panels constituted by the US Department of Defense and the World Health Organisation, her invitation to submit reviews to high profile journals such as the British Medical Journal, Current Opinion in Neurology and Nature Clinical Practice Neurology, and the calibre of its numerous journal publications. The average impact factor for publications in the past five years is 3.12, which is very high considering that publications in the field of rehabilitation generally have low impact factors. The information booklets produced in the mild TBI outcomes studies have been requested by over 100 different clinical and research bodies worldwide and translated into several languages. This work is thus having a significant impact on the field.
The NHMRC
The NHMRC allocated a project grant in 2005 for the following project: Fatigue, attention and sleep following traumatic brain injury. More than sixty percent of patients with a traumatic brain injury (TBI) report experiencing fatigue which interferes with their rehabilitation and daily lifestyle. Sleep disturbance is also often reported following TBI. This study aims to investigate the nature, causes and progression of fatigue and sleep disturbance following TBI and their possible interrelationships. Magnetic Resonance Imaging (MRI) is being used to investigate possible neuropathological factors associated with these disorders.
Partnership with the Transport Accident Commission
Since 1998, the Monash-Epworth Rehabilitation Research Centre has received substantial funding support from the Transport Accident Commission. This funding has been directed towards numerous research projects examining outcome following traumatic brain injury. Findings from this research are fed back to the TAC on a regular basis and have resulted in policy changes in their systems of care. Regular workshops are held with TAC staff to ensure they are kept up-to-date with current findings and fully understand the long-term needs of their clients.
Partnership with Monash University
Monash University currently provides a Monash Strategic Grant for the following project: Psychiatric Disorders following traumatic brain injury. The overall aim of this project is to investigate the nature, incidence and causes of psychiatric disorders following traumatic brain injury, with the ultimate goal of improving management of these problems. Magnetic Resonance Imaging (MRI) is being used to investigate the association between lesion location and psychiatric disorder.
Mild Head Injury Booklets - Partnership with Department of Human Services
Following the publication of findings from studies evaluating the impact of the provision of an information booklet to adults and children who have sustained mild traumatic brain injury, these booklets have been produced in large numbers, originally with the aid of a grant from the Jack Brockhoff Foundation. A revised booklet has been written specifically for children. The Department of Human Services has supported the introduction of the booklets into the Emergency Departments of all Victorian Hospitals. The Department provided funding for information sessions to be conducted in each of these Emergency Departments They also provided funds for the reprinting of the booklets and for an evaluation of their usefulness from the perspective of the patients receiving them. The evaluation study was conducted at several metropolitan and country hospitals including: Ballarat Base Hospital, Geelong Hospital, Northern Hospital, Sandringham and District Hospital and Epworth Hospital. Patients who agreed to participate were contacted by telephone. Fifty such interviews were conducted and the response from patients was found to be very positive.
The publication of the study evaluating the use of the children's booklet in the international journal, "Paediatrics", and more recently the publication of results of the evaluation of the adult booklet in the "Journal of Neurology, Neurosurgery and Psychiatry", has generated a large number of requests for copies of the booklet from all over the world. Both the child and adult head injury booklets can be downloaded from this website as Word files (see below). The booklets are copyright and can not be reproduced without the permission of the authors. The booklets are currently being translated into other languages.
Mild Head Injury - Children
Mild Head Injury - Adults
Current Research Projects
- Longitudinal head injury outcome study.
CIs: J. Ponsford, J. Olver, M. Ponsford - Sexuality following traumatic brain injury.
CI: J. Ponsford - Investigation of substance use following traumatic brain injury.
CI: J. Ponsford - Psychiatric disorders following traumatic brain injury.
CIs: J. Ponsford, K. Gould L. Johnston, R Goodinson - The influence of genetic factors, specifically the Apolipoprotein gene, and age at injury on outcome following head injury.
CIs: J. Ponsford, D. Senathi-Raja, M Schönberger - The influence of cultural background on rehabilitation and outcome following traumatic brain injury.
CIs: J. Ponsford, M Karamitsios, L. Mbakile - The processes of adjustment during community-based rehabilitation following head injury.
CIs: M. Schönberger, J. Ponsford, H. Harrington, A McKay, M Mealings, S. Lambert. - A study of brain changes, cognitive function, self-awareness and functional outcome following traumatic brain injury.
CIs: G Spitz, C. Richardson, J. Ponsford, M. Schönberger - Factors influencing outcome following orthopaedic and traumatic brain injury.
CIs: J Dahm, J. Ponsford - Efficacy of Motivational Interviewing and Cognitive Behaviour Therapy for Anxiety and depression following traumatic brain Injury.
CIs:M Hsieh, J. Ponsford, M O’Donnell, N. Lee, A. McKay, D. Wong, M Schönberger - Fatigue and Sleep Disturbance following Traumatic Brain Injury.
CIs: J. Ponsford, M. Grant, S. Lee - Light therapy for sleepiness and fatigue following traumatic brain injury.
CIs: K. Sinclair J. Ponsford, S. Rajaratnam, S. Lockley - Efficacy of an intervention to reduce alcohol use following traumatic brain injury.
CIs: L Tweedly, J. Ponsford, N.Lee - Goal Management following traumatic brain injury.
CIs: J. Ponsford, M. Grant, S. Lee - Use of virtual reality to assess executive function.
CIs: J. Ponsford, B. Renison, R Testa, B Richardson - Impact of methylphenidate on attention following traumatic brain injury.
CIs: J. Ponsford, C. Willmott - Assessment and intervention following mild head injury.
CIs: J. Ponsford, P. Cameron, M. Fitzgerald, M Grant, A Mickocka-Walus - Multi-Family Groups following traumatic brain injury.
CIs: G. Couchman, J Ponsford, A Kelly - The experience of traumatic brain injury in Botswana.
CIs: L. Mbakile, J. Ponsford, L. Manderson - Safer Roads to Recovery: Assessing Readiness for Driving after Traumatic Brain Injury.
CIs: J. Charlton, M. Bedard, S. Marshall, J. Ponsford, R. Stolwyk, P. Ross - Early Decompressive Craniectomy for patients with severe traumatic brain injury and refractory intracranial hypertension Study.
CIs: J. Cooper, J. Rosenfeld et al.
Future Directions for the Centre's Research
- In order to secure ongoing funding for the longitudinal head injury outcomes study we plan to work on developing models predicting TAC costs and patient outcomes. We will work collaboratively with the TAC on this, in addition to continuing our existing Longitudinal Head Injury Outcomes Study, pending agreement to further funding by the TAC.|
- We are enhancing the biological focus of our research. In addition to our continuing genetic studies, we have commenced a prospective imaging study, in which we will also be gathering very comprehensive collateral data on cognitive and psychological function, to better understand these changes relate to brain changes over time, working in collaboration with imaging experts Erin Bigler and Jerome Maller. This study commenced in June 2010.
- The driving assessment project funded by the VNI will represent a new direction for the centre and an opportunity to collaborate with the Monash Accident Research Centre and researchers from the University of Ottawa.
- We aim to develop and evaluate treatments for all the major problems facing individuals with traumatic brain injury – including fatigue, anxiety and depression, for which studies are underway, as well as attention and sleep disturbance. Following from the study showing efficacy of methylphenidate in improving attention we aim to apply for grants to conduct a longer term effectiveness study. There is also potential to conduct a study of the efficacy of melatonin to alleviate sleep disturbance, in collaboration with A/Prof Shantha Rajaratnam. Another area in which we aim to conduct further research is the rehabilitation of executive difficulties.
- We have re-commenced our orthopaedic outcomes study, albeit without funding, with a view to seeking collaboration with the Monash Worksafe Research Institute.
