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Dr Tapan Rai

Biography

Tapan is a senior lecturer in Statistical Consulting and Mathematical Sciences Discipline Leader. He is an experienced biostatistician and is currently a chief investigator and biostatistician of record on two NHMRC-funded clinical trials:

  1. Very Early Rehabilitation in SpEech: An RCT of aphasia therapy after stroke. NHMRC Grant, APP1044973, $742,000, 2013-2015
  2. COMPARE- Constraint Induced or Multi-Modal aphasia rehabilitation: An RCT of therapy for stroke related chronic aphasia. NHMRC Grant, APP 1083010, $998,167,  2015-2018.

As a statistical consultant, he has provided advice on research design and data analysis to over a hundred higher degree by research students and early career researchers in the broad areas of Computing, Health, Science and the Social Sciences.

His other achievements include:

  •  Providing biostatistics training to scientific officers at the Therapeutic Goods Administration (TGA) 
  • Providing training on Economic and Statistical Models of Rural Labour Force Transfer to a visiting delegation of Directors and Deputy Directors of the National Statistical Service of The People's Republic of China
  • Serving as an expert witness in the Supreme Court of New South Wales

Professional

Tapan is an experienced consulting statistician. He hprovides statistical and research consultancy to researchers and research teams in wide variety of fields. This includes provision of advice on research design and data analysis to higher degree by research students and early career researchers, and participation as an investigator in competitive grant applications.
Tapan also undertakes contract research and consultancy projects with industry.

Tapan is a Fellow of the Royal Statistical Society and a member of the Statistical Society of Australia. He is a member of the Editorial Board of Statistical Associates Publishing.

Image of Tapan Rai
Senior Lecturer, School of Mathematical and Physical Sciences
B Sc, M Sc, Ph D
Fellow, Royal Statistical Society
 
Phone
+61 2 9514 2145

Research Interests

As a statistical consultant, Tapan has research interests in a wide variety of disciplines. Some of his current research interests include:

1. Biostatistics 2. Design and Analysis of Clinical Trials
3. Rehabilitation of post-stroke aphasia 4. Measures of aphasia recovery 5. Information Security and Privacy in Linked Databases 6. Use of Mobile Devices in Teaching

Can supervise: Yes

Tapan provides short courses on research design, statistical methods and data analysis to higher degree by research students, research groups and industry. Some of his recent short courses include:

University Graduate School

  • Design and Analysis of Experiments
  • Design and Analysis of Surveys

Faculty of Science (Doctoral Students)
  • Multivariate Statistics (with Louise Ryan)

Customized Courses/Presentations
  • Faculty of Nursing Midwifery and Health
Sampling, Sample Size Estimation and Power Analysis
(Part of the postgraduate course: Investigating Health Care Change)
  • Issues in Survey Design and Analysis
(For Research Students Forum)

External:

  • Economic and Statistical Models for Rural Labour Force Transfer
(Invited presentations to visiting delegation of directors and deputy directors of the National Statistical Service of the People’s Republic of China).

Tapan can design, develop and deliver customised short courses/workshops on research methods, design of experiments, statistical methods, and data analysis aimed at postgraduate students, early career researchers, research teams or industry.

Conferences

Uggen, T., Rai, T. & Godecke, E. 2016, 'Selecting outcome measures and statistical models in neurological clinical trials that measure functional outcomes', International Biometric Society Conference, Victoria, BC, Canada.
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Godecke, E., Armstrong, E., Ciccone, N., Middleton, S., Rai, T., Holland, A., Ellery, F., Cadilhac, D., Whitworth, A., Rose, M., Hankey, G. & Bernhardt, J. 2016, 'Very Early Rehabilitation in SpEech (VERSE) after stroke: trial status and recruitment', European Stroke Organisation Conference, Barcelona, Spain.
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Rose, M., Copland, D., Nickels, L., Togher, L., Meinzer, M., Rai, T., Godecke, E., Pierce, J., Foster, A. & Hurley, M. 2016, 'COMPARE: A randomised controlled trial comparing constraint-induced and multi-modal aphasia therapy to usual care in people with chronic aphasia', World Conference in Neurorehabilitation, Philadelphia, PA, USA.
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Godecke, E., Armstrong, E., Middleton, S., Rai, T., Ciccone, N., Holland, A., Whitworth, A., Rose, M., Ellery, F., Cadilhac, D., Hankey, G. & Bernhardt, J. 2016, 'Trial status and recruitment: Very Early Rehabilitation in SpEech (VERSE) after stroke trial', Asia Pacific Stroke Conference, Brisbane, Australia.
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Rose, M., Copland, D., Nickels, L., Togher, L., Meinzer, M., Rai, T., Godecke, E., Kim, J., Cadilhac, D., Pierce, J., Foster, A. & Hurley, M. 2016, 'Progress On Compare: A Randomised Controlled Trial Comparing Constraint-Induced And Multi-Modal Aphasia Therapy To Usual Care In People With Chronic Aphasia', Smart Strokes, Canberra, Australia.
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Godecke, E., Armstrong, E., Ciccone, N., Middleton, S., Rai, T., Holland, A., Whitworth, A., Rose, M., Ellery, F., Cadilhac, D., Hankey, G. & Bernhardt, J. 2016, 'The progress of a complex rehabilitation randomised controlled trial: Very Early Rehabilitation in SpEech (VERSE) after stroke', Speech Pathology Australia National Conference, Perth, Australia.
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Godecke, E., Armstrong, E., Ciccone, N., Middleton, S., Rai, T., Holland, A., Whitworth, A., Rose, M., Ellery, F., Cadilhac, D., Hankey, G. & Bernhardt, J. 2016, 'Therapy fidelity in the Very Early Rehabilitation in SpEech (VERSE) aphasia after stroke randomised controlled trial (RCT): Lessons learned and progress to date', Speech Pathology Australia National Conference, Perth, Australia.
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Godecke, E., Armstrong, E., Ciccone, N., Middleton, S., Rai, T., Holland, A., Whitworth, A., Rose, M., Cadilhac, D., Hankey, G. & Bernhardt, J. 2015, 'A protocol outlining treatment fidelity processes in the Very Early Rehabilitation in SpEech (VERSE) clinical trial', Clinical Aphasiology Conference, Monterey, CA, USA.
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Uggen, T., Rai, T. & Godecke, E. 2015, 'Statistical modelling of post-stroke aphasia recovery', Inter-university Neuroscience & Mental Health Conference, Sydney, NSW, Australia.
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Godecke, E., Armstrong, E., Bernhardt, J., Middleton, S., Rai, T., Holland, A., Cadilhac, D., Whitworth, A., Rose, M., Ciccone, N. & Hankey, G. 2015, 'Assessment of therapy fidelity processes in the very early rehabilitation in speech (verse) clinical trial', International Journal of Stroke, European Stroke Organization Conference, Wiley: 12 months, Glasgow, Scotland, UK, pp. 424-424.
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Godecke, E., Armstrong, E., Bernhardt, J., Middleton, S., Rai, T., Holland, A., Cadilhac, D., Whitworth, A., Rose, M., Ciccone, N. & Hankey, G. 2014, 'Progress on an Australian randomised controlled trial of aphasia therapy after stroke', International Aphasia Rehabilitation Conference, The Hague, The Netherlands.
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Ciccone, N., Godecke, E., Cream, A., West, D., Cartwright, J., Granger, A., Rai, T. & Hankey, G. 2014, 'Group or individual therapy in very early aphasia recovery: Does therapy type matter?', International Aphasia Rehabilitation Conference, The Hague, The Netherlands.
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Godecke, E., Armstrong, E., Bernhardt, J., Middleton, S., Rai, T., Holland, A., Cadilhac, D., Hankey, G., Whitworth, A., Rose, M. & Ciccone, N. 2013, 'An RCT of aphasia therapy after stroke', British Aphasiology Symposium, Manchester, UK.
Godecke, E., Rai, T., Ciccone, N.A., Granger, A.S., West, D., Cream, A., Cartwright, J. & Hankey, G. 2012, 'Does the amount of aphasia therapy in the first 4-5 weeks after stroke improve outcome? Very Early Rehabilitation in SpEech-II (VERSE II)', Cerebrovascular Diseases, European Stroke Conference, Karger, Lisbon, Portugal, pp. 42-42.
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URL: http://content.karger.com/ProdukteDB/miscArchiv/CED_2012_033_s_2/index.html#/1/
Dare, J., Wilkinson, C. & Rai, T. 2011, 'The forgotten Australians: an investigation of alcohol use amongst senior citizens', Australasian Professional Society on Alcohol and other Drugs (APSAD) Conference, Hobart, Tasmania.

Journal articles

Ciccone, N., West, D., Cream, A., Cartwright, J., Rai, T., Granger, A., Hankey, G.J. & Godecke, E. 2016, 'Constraint-induced aphasia therapy (CIAT): a randomised controlled trial in very early stroke rehabilitation', Aphasiology, vol. 30, no. 5, pp. 566-584.
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&copy; 2015 Taylor & Francis. Background: Communication outcomes following stroke are improved when treatments for aphasia are administered early, within the first 3&nbsp;months after stroke, and provided for more than 2&nbsp;hours per week. However, uncertainty remains about the optimal type of aphasia therapy. Aims: We compared constraint-induced aphasia therapy (CIAT) with individual, impairment-based intervention, both administered early and daily after acute stroke. Methods&Procedures: This prospective, single-blinded, randomised, controlled trial recruited participants with mild to severe aphasia within 10&nbsp;days of an acute stroke from acute/subacute Perth metropolitan hospitals (n&nbsp;=&nbsp;20). Participants were allocated by computer-generated block randomisation method to either the CIAT (n&nbsp;=&nbsp;12) or individual, impairment-based intervention group (n&nbsp;=&nbsp;8) delivered at the same intensity (45&#8211;60&nbsp;min, 5&nbsp;days a week) for 20 sessions over 5&nbsp;weeks (15&#8211;20&nbsp;hours total). The primary outcome, measured after completing the intervention, was the Aphasia Quotient (AQ) from the Western Aphasia Battery. Secondary outcomes were the AQ at 12 and 26&nbsp;weeks post stroke, a Discourse Analysis (DA) score and the Stroke and Aphasia Quality of Life Scale (SAQoL), measured at therapy completion, 12 and 26&nbsp;weeks post stroke. There was a 10% (n&nbsp;=&nbsp;2) dropout at the primary end point, both participants were in the CIAT group. The estimates for each treatment group were compared using repeated measures ANOVAs. Data from the 26-week follow-up assessment are presented, however, were not included in the between-group comparisons due to the low number of data points in each group. Outcomes & Results: Within groups analyses comparing performance at baseline, therapy completion, and 12&nbsp;weeks post stroke revealed a statistically significant treatment effect for the AQ (p&nbsp;<&nbsp;.001), DA (p&nbsp;=&nbsp;.002), and SAQoL (p&nbsp;<&nbsp;.001). Between groups analysis found there was no significant difference between the CIAT and individual the...
Godecke, E., Armstrong, E., Rai, T., Middleton, S., Ciccone, N., Whitworth, A., Rose, M., Holland, A., Ellery, F., Hankey, G., Cadilhac, D. & Bernhardt, J. 2016, 'A randomized controlled trial of very early rehabilitation in speech after stroke', International Journal of Stroke, vol. 11, no. 5, pp. 586-592.
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Rationale: The efficacy of rehabilitation therapy for aphasia caused by stroke is uncertain. Aims and hypothesis: The Very Early Rehabilitation of Speech (VERSE) trial aims to determine if intensive prescribed aphasia therapy (VERSE) is more effective and cost saving than non-prescribed, intensive (usual care-plus) and non-intensive usual care (UC) therapy when started within 15 days of stroke onset and continued daily over four weeks. We hypothesize that aphasia therapy when started very early after stroke and delivered daily could enhance recovery of communication compared with UC. Sample size estimates: A total of 246 participants (82 per arm) will provide 80% power to detect a 4.4% improvement on aphasia quotient between VERSE and UC plus at a significance level of =0.05. Setting: Acute-care hospitals and accompanying rehabilitation services throughout Australia, 2014&#8211;2017. Design: Three-arm, prospective, randomized, parallel group, open-label, blinded endpoint assessment (PROBE) trial. Participants: Acute stroke in previous 14 days and aphasia diagnosed by aphasia quotient (AQ) of the Western Aphasia Battery (WAB). Randomization: Computer-generated blocked randomization procedure stratified by aphasia severity according to Western Aphasia Battery, to one of three arms. Intervention: All participants receive UC&#8212;usual ward-based aphasia therapy. Arm 1: UC&#8212;no additional therapy; Arm 2: UC-plus usual ward-based therapy; Arm 3: VERSE therapy&#8212;a prescribed and structured aphasia therapy program. Arms 2 and 3 receive a total of 20 additional sessions (45&#8211;60min, provided daily) of aphasia therapy. The additional intervention must be provided before day 50 post stroke. Study outcome measures: The aphasia quotient of Western Aphasia Battery at 12 weeks post stroke. Secondary outcomes include discourse measures, the Stroke and Aphasia Quality of Life Scale-39 and the Aphasia Depression Rating Scale at 12 and 26 weeks. Economic evaluation: Incremental cost-effectiven...
Kearney, M.D., Burden, K. & Rai, T. 2015, 'Investigating teachers' adoption of signature mobile pedagogies', Computers & Education, vol. 80, pp. 48-57.
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This study investigated how teachers are using distinctive pedagogical features of mobile learning: collaboration, personalisation and authenticity. The researchers developed and validated a survey instrument based on these three established constructs (Kearney, Schuck, Burden, & Aubusson, 2012) and used it to interrogate current mobile learning practices in school and university education. This paper focuses on data from school teachers (n = 107). Findings indicated that teachers' perceptions of authenticity were high but aspects of online collaboration, networking and student agency were rated surprisingly lower than expected, given the rhetoric about enhanced connection and flexible learning opportunities afforded by mobile technologies. Device ownership was identified as one factor influencing adoption of these mobile pedagogies. Implications for effective use of handheld devices in teaching are addressed.
Perrault, K.A., Stefanuto, P.H., Stuart, B.H., Rai, T., Focant, J.F. & Forbes, S.L. 2015, 'Reducing variation in decomposition odour profiling using comprehensive two-dimensional gas chromatography.', Journal of separation science, vol. 38, no. 1, pp. 73-80.
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Challenges in decomposition odour profiling have led to variation in the documented odour profile by different research groups worldwide. Background subtraction and use of controls are important considerations given the variation introduced by decomposition studies conducted in different geographical environments. The collection of volatile organic compounds (VOCs) from soil beneath decomposing remains is challenging due to the high levels of inherent soil VOCs, further confounded by the use of highly sensitive instrumentation. This study presents a method that provides suitable chromatographic resolution for profiling decomposition odour in soil by comprehensive two-dimensional gas chromatography coupled with time-of-flight mass spectrometry using appropriate controls and field blanks. Logarithmic transformation and t-testing of compounds permitted the generation of a compound list of decomposition VOCs in soil. Principal component analysis demonstrated the improved discrimination between experimental and control soil, verifying the value of the data handling method. Data handling procedures have not been well documented in this field and standardisation would thereby reduce misidentification of VOCs present in the surrounding environment as decomposition byproducts. Uniformity of data handling and instrumental procedures will reduce analytical variation, increasing confidence in the future when investigating the effect of taphonomic variables on the decomposition VOC profile.
Perrault, K.A., Rai, T., Stuart, B.H. & Forbes, S.L. 2015, 'Seasonal comparison of carrion volatiles in decomposition soil using comprehensive two-dimensional gas chromatography-time of flight mass spectrometry', Analytical Methods, vol. 7, no. 2, pp. 690-698.
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&copy; The Royal Society of Chemistry. Increased characterisation of decomposition odour has improved existing knowledge regarding the decomposition volatile organic compound (VOC) profile of carrion. Validation of this dynamic decomposition VOC profile is required in order to characterise the variables that affect their production. This study was performed to determine whether the decomposition VOC profile produced under field conditions differed between summer and winter in an Australian environment. Outdoor studies were conducted using pig carcasses as human analogues in order to assess seasonal variation in the decomposition process. Common decomposition VOCs were identified using comprehensive two-dimensional gas chromatography-time of flight mass spectrometry (GCGC-TOFMS). Fewer compounds and reduced abundance of VOCs was observed during winter. Relationships between the levels of detected decomposition VOCs and weather variables were established to be stronger in winter. Weak relationships during summer suggested the potential that an underlying variable (e.g. microbial activity, insect activity) had a stronger relationship to the abundance of decomposition VOCs. The seasonal robustness of the decomposition VOC profile is important to fields relying on the presence of a decomposition odour, i.e. search and recovery of victims in mass disasters, homicides, and missing persons cases. This journal is
Stefanuto, P.-.H., Perrault, K.A., Lloyd, R.M., Stuart, B., Rai, T., Forbes, S.L. & Focant, J.-.F. 2015, 'Exploring new dimensions in cadaveric decomposition odour analysis', Anal. Methods.
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Wilkinson, A.M., Johnson, C.E., Walker, H., Colgan, V., Arnet, H. & Rai, T. 2015, 'Evaluating the Liverpool Care Pathway for care of the terminally ill in rural Australia.', Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, vol. 23, no. 11, pp. 3173-3181.
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This study evaluates a pilot implementation of the Liverpool Care Pathway (LCP), a clinical tool used to guide the care of dying patients in the last days of life, on the end-of-life care for dying patients in three regions in rural Australia.The LCP was implemented at 13 participating sites: nine hospitals (general wards), one community-based palliative care service, and three in-hospital palliative care units. To evaluate the implementation of the LCP, 415 eligible patient records were examined: 223 pre-implementation and 192 post-implementation (116 on the LCP and 76 receiving usual care). The primary analysis compared all patients pre-implementation of the LCP versus all patients post-implementation.Increases were found post-implementation for communication with other health professionals and with patients or family (pre-69 %, post-87 %; p 0.000), use of palliative medications (pre-87 %, post-98 %; p 0.000) and frequency of symptom assessments (pre-66 %, post-82 %; p 0.000). Fewer blood and radiological investigations were conducted and venous access devices used in the post-implementation groups than in the pre-implementation period.This study suggests that when rigorously implemented, the LCP improves important components of end-of-life care for dying patients and their families.
Perrault, K.A., Stefanuto, P.H., Stuart, B.H., Rai, T., Focant, J.F. & Forbes, S.L. 2015, 'Detection of decomposition volatile organic compounds in soil following removal of remains from a surface deposition site.', Forensic science, medicine, and pathology, vol. 11, no. 3, pp. 376-387.
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Cadaver-detection dogs use volatile organic compounds (VOCs) to search for human remains including those deposited on or beneath soil. Soil can act as a sink for VOCs, causing loading of decomposition VOCs in the soil following soft tissue decomposition. The objective of this study was to chemically profile decomposition VOCs from surface decomposition sites after remains were removed from their primary location.Pig carcasses were used as human analogues and were deposited on a soil surface to decompose for 3 months. The remains were then removed from each site and VOCs were collected from the soil for 7 months thereafter and analyzed by comprehensive two-dimensional gas chromatography-time-of-flight mass spectrometry (GCGC-TOFMS).Decomposition VOCs diminished within 6 weeks and hydrocarbons were the most persistent compound class. Decomposition VOCs could still be detected in the soil after 7 months using Principal Component Analysis.This study demonstrated that the decomposition VOC profile, while detectable by GCGC-TOFMS in the soil, was considerably reduced and altered in composition upon removal of remains. Chemical reference data is provided by this study for future investigations of canine alert behavior in scenarios involving scattered or scavenged remains.
Godecke, E., Armstrong, E., Ciccone, N., Middleton, S., Rai, T., Cadilhac, D., Rose, M., Whitworth, A., Holland, A., Hankey, G., Ellery, F. & Bernhardt, J. 2015, 'Establishing large scale therapy delity processes inthe Very Early Rehabilitation in SpEech (VERSE) clinical trial: Lessons learned', International Journal of Stroke, vol. 10, no. S3, pp. 13-13.
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Rai, T., Godecke, E., Armstrong, E., Ciccone, N., Middleton, S., Holland, A., Cadilhac, D., Whitworth, A., Rose, M., Hankey, G., Ellery, F. & Bernhardt, J. 2015, 'Very Early Rehabilitation in SpEech (VERSE) after stroke: On-going trial status', International Journal of Stroke, vol. 10, no. S3, pp. 13-13.
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Rose, M., Copland, D., Nickels, L., Meinzer, M., Rai, T. & Godecke, E. 2015, 'COMPARE: A national randomized controlled trialcomparing two intensive treatments to usual care forindividuals with chronic aphasia', International Journal of Stroke, vol. 10, no. S3, pp. 77-77.
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Buis, R., Rust, L., Nizio, K., Rai, T., Stuart, B. & Forbes, S. 2015, 'Investigating the Sensitivity of Cadaver-Detection Dogs to Decomposition Fluid', Journal of Forensic Identification, vol. 65, no. 6, pp. 985-997.
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Cadaver-detection dogs are regularly used by police and emergency services to locate human remains. Because of ethical restrictions, the dogs are not trained using cadavers, but instead, on pseudo-scents or human tissues, such as blood, bone, and decomposition fluid. However, the accuracy of these training aids as substitutes for human remains is unknown. The aim of this study was to investigate the dogs' sensitivity to human decomposition fluid as a training aid and to determine whether their sensitivity increased with exposure.
Godecke, E., Ciccone, N.A., Granger, A.S., Rai, T., West, D., Cream, A., Cartwright, J. & Hankey, G. 2014, 'A comparison of aphasia therapy outcomes before and after a Very Early Rehabilitation programme following stroke', International journal of language and communication disorders, vol. 49, no. 2, pp. 149-161.
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Very early aphasia rehabilitation studies have shown mixed results. Differences in therapy intensity and therapy type contribute significantly to the equivocal results. This work compares a standardised, prescribed very early aphasia therapy regimen to a historical usual care control group at therapy completion (4-5 weeks post-stroke) and again at follow-up (six months).
Elliott, R., Rai, T. & McKinley, S.M. 2014, 'Factors affecting sleep in the critically ill: An observational study', Journal of Critical Care, vol. 29, no. 5, pp. 859-863.
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Purpose The aims of the current study were to describe the extrinsic and intrinsic factors affecting sleep in critically ill patients and to examine potential relationships with sleep quality. Materials and Methods Sleep was recorded using polysomnography (PSG) and self-reports collected in adult patients in intensive care. Sound and illuminance levels were recorded during sleep recording. Objective sleep quality was quantified using total sleep time divided by the number of sleep periods (PSG sleep period time ratio). A regression model was specified using the PSG sleep period time ratio as a dependent variable. Results Sleep was highly fragmented. Patients rated noise and light as the most sleep disruptive. Continuous equivalent sound levels were 56 dB (A). Median daytime illuminance level was 74 lux, and nighttime levels were 1 lux. The regression model explained 25% of the variance in sleep quality (P = .027); the presence of an artificial airway was the only statistically significant predictor in the model (P = .007). Conclusions The presence of an artificial airway during sleep monitoring was the only significant predictor in the regression model and may suggest that although potentially uncomfortable, an artificial airway may actually promote sleep. This requires further investigation.
Rai, T. & Hall, J.L. 2014, 'Split Leverage: Attacking the Condentiality of Linked Databases by Partitioning', ANZIAM.
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This paper considers the risk of disclosure in linked databases when statistical analysis of micro-data is permitted. The risk of dis- closure needs to be balanced against the utility of the linked data. The current work specifically considers the disclosure risks in permit- ting regression analysis to be performed on linked data. A new attack based on partitioning of the database is presented.
Godecke, E., Armstrong, E., Middleton, S., Rai, T., Holland, A.E., Cadilhac, D., Whitworth, A., Rose, M., Ciccone, N., Hankey, G. & Bernhardt, J. 2014, 'Very Early Rehabilitation in SpEech (VERSE): Progress report', INTERNATIONAL JOURNAL OF STROKE, vol. 9, pp. 48-48.
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Reid, A.L., Millward, M.J., Lee, M., Frank, M.H., Ireland, A., Monshizadeh, L., Rai, T., Heenan, P., Medic, S., Kumarasinghe, P. & Ziman, M. 2013, 'Markers of circulating tumour cells in the peripheral blood of patients with melanoma correlate with disease recurrence and progression', British Journal of Dermatology, vol. 168, no. 1, pp. 85-92.
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Background:&acirc; Multimarker quantitative real-time polymerase chain reaction (qRT-PCR) represents an effective method for detecting circulating tumour cells in the peripheral blood of patients with melanoma. Objectives:&acirc; To investigate whether the phenotype of circulating melanoma cells represents a useful indicator of disease stage, recurrence and treatment efficacy. Methods:&acirc; Peripheral blood was collected from 230 patients with melanoma and 152 healthy controls over a period of 3 years and 9 months. Clinical data and blood samples were collected from patients with primary melanoma (early stages, 0&acirc;II, n = 154) and metastatic melanoma (late stages, III&acirc;IV, n = 76). Each specimen was examined by qRT-PCR analysis for the expression of five markers: MLANA, ABCB5, TGF&Icirc;&sup2;2, PAX3d and MCAM. Results:&acirc; In total, 212 of the patients with melanoma (92%) expressed markers in their peripheral blood. Two markers, MLANA and ABCB5, had the greatest prognostic value, and were identified as statistically significant among patients who experienced disease recurrence within our study period, being expressed in 45% (MLANA) and 49% (ABCB5) of patients with recurrence (P = 0&Acirc;001 and P = 0&Acirc;031, respectively). For patients administered nonsurgical treatments, MCAM expression correlated with poor treatment outcome. Conclusions:&acirc; Circulating tumour cells were detectable at all stages of disease and long after surgical treatment, even when patients were considered disease free. Specifically, expression of ABCB5 and MLANA had significant prognostic value in inferring disease recurrence, while MCAM expression was associated with poor patient outcome after treatment, confirming multimarker qRT-PCR as a potential technique for monitoring disease status.
Godecke, E., Rai, T., Ciccone, N.A., Armstrong, E., Granger, A. & Hankey, G. 2013, 'Amount of Therapy Matters in Very Early Aphasia Rehabilitation after Stroke: A Clinical Prognostic Model', Seminars in Speech and Language, vol. 34, no. 3, pp. 129-141.
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Background and Aim: The effects of very early aphasia therapy on recovery are equivocal. This article examines predictors of very early aphasia recovery through statistical modeling. Methods: This study involved a secondary analysis of merged data from two randomized, single-blind trials conducted in Australian acute and subacute hospitals. Study 1 (n = 59) compared daily therapy to usual ward care for up to 4 weeks poststroke in patients with moderate to severe aphasia. Study 2 (n = 20) compared daily group therapy to daily individual therapy for 20 1-hour sessions over 5 weeks, in patients with mild to severe aphasia. The primary outcome measure was the Western Aphasia Battery Aphasia Quotient (AQ) at therapy completion. This analysis used regression modeling to examine the effects of age, baseline AQ and baseline modified Rankin Scale (mRS), average therapy amount, therapy intensity, and number of therapy sessions on aphasia recovery. Results: Baseline AQ (p = 0.047), average therapy amount (p = 0.030), and baseline mRS (p = 0.043) were significant predictors in the final regression model, which explained 30% (p < 0.001) of variance in aphasia recovery. Conclusion: The amount of very early aphasia therapy could significantly affect communication outcomes at 4 to 5 weeks poststroke. Further studies should include amount of therapy provided to enhance reliability of prognostic modeling in aphasia recovery.
Pugh, J.D., Twigg, D.E., Martin, T. & Rai, T. 2013, 'Western Australia facing critical losses in its midwifery workforce: A survey of midwives' intentions', Midwifery, vol. 29, no. 5, pp. 497-505.
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Objective the ongoing attrition of the midwifery workforce frustrates future workforce planning and the provision of maternity services in Western Australia. This project determined factors contributing to the intention of the midwives to move jobs and/or leave the profession. Design a cross-sectional survey approach was taken for this descriptive research utilising a self-administered questionnaire developed by the Nursing and Midwifery Office, Department of Health, Western Australia. Setting public and private health sectors in Western Australia, AprilMay 2010. Participants 1,600 midwives employed in the public and private health sectors throughout Western Australia were invited to participate: 712 responded (44.5%), one-fifth of the state's registered midwives. Findings most midwives worked part-time in a clinical role in public hospitals. Almost half intended moving jobs within 5 years and/or leaving midwifery. Excluding midwives of retirement age, the most common reasons for intending to move jobs were family commitments, working conditions and role dissatisfaction. Those intending to leave midwifery cited work-life balance, career change and family commitments. Midwives thought addressing the following issues would improve midwifery retention: flexible work arrangements, remuneration, staffing and caseload, workplace culture, professional development and models of care.
Godecke, E., Armstrong, E., Bernhardt, J., Middleton, S., Rai, T., Holland, A., Cadilhac, D.A., Whitworth, A., Rose, M., Ciccone, N. & Hankey, G.J. 2013, 'Very Early Rehabilitation in SpEech (VERSE): the development of an Australian randomised controlled trial of aphasia therapy after stroke', INTERNATIONAL JOURNAL OF STROKE, vol. 8, pp. 44-45.
Godecke, E., Hird, K., Lalor, E., Rai, T. & Phillips, M. 2012, 'Very early poststroke aphasia therapy: a pilot randomized controlled efficacy trial', International Journal of Stroke, vol. 7, no. 8, pp. 635-644.
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Background and purpose Early stroke rehabilitation has shown benefits over spontaneous recovery. Insufficient evidence exists to determine the benefits of early aphasia intervention. We hypothesized that daily aphasia therapy would show better communication outcomes than usual care (UC) in early poststroke recovery. Method This prospective, randomized, single-blinded, controlled trial was conducted in three acute-care hospitals in Perth, Australia, each with over 200 stroke admissions annually. Patients with acute stroke causing moderate to severe aphasia were recruited at a median of three-days (range: 0-10 days) to receive daily aphasia therapy or usual care therapy. Individually tailored, impairment-based intervention was provided for the acute hospital stay or intervention phase (median: 19 days; range: 5-76). Primary outcome measures were the aphasia quotient and functional communication profile at acute hospital discharge or four-weeks poststroke, whichever came first. A random-number generator and sealed envelopes were used to randomize participants. Assessments were completed by a blinded assessor. Results Fifty-nine participants were recruited, with six withdrawals (10%) and seven deaths (12%) at six-months. Ninety percent had ischemic strokes, with 56.5% experiencing a total anterior circulation stroke. The group mean (&Acirc;&plusmn;SD) age was 69.1 (&Acirc;&plusmn;13.9) years. Six participants (18.75%) in the daily aphasia therapy group did not complete the minimum (150 min) therapy required for this study. The daily aphasia therapy intervention phase mean therapy session time was 45 min (range: 30-80) and the total mean amount of therapy for the daily aphasia therapy participants was 331 min (range: 30-1415). Four (15%) participants in the usual care group received therapy. The collective total therapy provided to these participants was 295 min over seven sessions. Usual care participants received an average of 10.5 min of therapy per week during the intervention phase. At th...

Reports

Rai, T. 2014, A review of back pain related Work Cover NSW cases by nominal insurers 2008-2011, no. 201300174, pp. 1-44, Sydney.
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Rai, T. & Ryan, L. 2014, Vein Visualization Trial - 2nd Interim Report, pp. 1-17, Sydney.
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Rai, T. & Ryan, L. 2014, Vein Visualization Trial - Interim Analysis, pp. 1-20, Sydney.
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Rai, T. 2014, Report on Project Protocols, no. 2014002036, pp. 1-88, Sydney.
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Rai, T. 2013, Factors influencing the success of vaginal birth after a caesarean section, no. 2013001375, pp. 1-21, Sydney.
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Rai, T. 2013, The Statistical Methodology Used to Assess the Effect of Limestone Addition to General Purpose Cement, no. 2013001253, pp. 1-17, Sydney.
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Rai, T. 2013, Data Analysis of Cobalt and Chromium Ion Levels in Arthroplasty Patients, no. 2013001271, pp. 1-38, Sydney.
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Rai, T., Pettitt, A. & Hall, J. 2013, Disclosure Risks Associated With Statistical Modelling of Linked Data, pp. 1-18, Brisbane.
Pettitt, A., Rai, T., Alexander, S., Carstens, J., Gamachchi, A., Hall, J. & Stebila, D. 2013, Disclosure-Protected Regression Coefficients with Linked Micro-Data, pp. 1-3, Brisbane.
Rai, T. 2013, Report on the 2013 Library Materials Availability Survey, pp. 1-8, Sydney.
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1. National Health and Medical Research COuncil 2. Australian Red Cross Blood Service 3. Barnardos Australia 4. NSW Police Force 5. Edith Cowan University 6. La Trobe University