News from Australia

This is one person based on my unreliable memory who I would be a bit worried about:

Dr Carolina Sandler​

  • Senior Lecturer, School of Health Sciences, UNSW
  • Accredited exercise physiologist and clinical researcher with research interests being post-infective fatigue states and cancer survivorship
  • Part of the Fatigue Research program at the Kirby Institute, UNSW.

​

  • CI MRFF 2023 Post-Acute Sequelae of COVID (lead institution Uni of Melbourne)
  • Cancer Institute NSW early career fellowship (partial salary & project funds)
  • Previous clinician and current co-lead of UNSW Fatigue Clinic and Research program.
Relevant publications:

  • Jones, M. D., Casson, S. M., Barry, B. K., Li, S. H., Valenzuela, T., Cassar, J., Lamanna, C., Lloyd, A. R., & Sandler, C. X. (2023). eLearning improves allied health professionals’ knowledge and confidence to manage medically unexplained chronic fatigue states: A randomized controlled trial. J Psychosom Res, 173, 111462. Q1
  • Casson, S., M. D. Jones, J. Cassar, N. Kwai, A. R. Lloyd, B. K. Barry and C. X. Sandler (2022). "The effectiveness of activity pacing interventions for people with chronic fatigue syndrome: a systematic review and meta-analysis." Disabil Rehabil: 1-15. Q1
  • Sandler, C. X., E. Cvejic, B. M. Valencia, H. Li, I. B. Hickie and A. R. Lloyd (2022). "Predictors of Chronic Fatigue Syndrome and Mood Disturbance After Acute Infection." Front Neurol 13: 935442. Q1
  • Sandler CX, Wyller V, Moss-Morris R, Buchwald D, Crawley E, Hautvast J, Katz B, Knoop H, Little P, Taylor R, Wensaas KA, Lloyd AR. (Long COVID and post-infective fatigue syndrome – a review. Open.Forum.Infectious.Diseases.¡.2021;8(10):ofab440. doi: 10.1093/ofid/ofab440
  • Sandler CX, Lloyd AR. Chronic fatigue syndrome: progress and possibilities? (2020) The Medical Journal of Australia. (invited review) 212(9), 428–433. https://doi.org/10.5694/mja2.50553
  • Cvejic E., Sandler CX., Keech A, Barry BK., Lloyd AL., Vollmer-Conna, U. (2017). Autonomic nervous system function, activity patterns, and sleep after physical or cognitive challenge in people with chronic fatigue syndrome. J Psychosom Res. 103:91-94. DOI: 10.1016/j.jpsychores.2017.10.010
  • McBride RL, Horsfield, SL, Cvejic, E, Casson S, Sandler CX, Cassar, J, Vollmer-Conna, U, & Lloyd, AR. (2017) Cognitive remediation training improves performance in patients with chronic fatigue syndrome. Psychiatry Research. 257:400-405. DOI: 10.1016/j.psychres.2017.08.035
  • Li SH., Sandler CX., Casson SM., Cassar J., Bogg T., Lloyd AR., Barry BK. (2016) A randomised controlled trial of online continuing education for health professionals to improve the management of chronic fatigue syndrome: A study protocol. BMJ Open. 7(5):e014133. DOI:10.1136/ bmjopen-2016-014133
  • Sandler CX., Hamilton BA., Horsfield S., Bennett BK., Vollmer-Conna U., Tzarimas C., Lloyd AR. (2016). Outcomes and predictors of response from an optimised, multidisciplinary intervention for chronic fatigue states. Intern Med J, 46(12): 1421–1429. DOI:10.1111/imj.13251
  • Sandler CX., Lloyd AR., Barry BK. (2016). Fatigue Exacerbation by Interval or Continuous Exercise in Chronic Fatigue Syndrome. Med Sci Sports Exerc 48(10): 1875-1885. DOI:10.1249/MSS.0000000000000983
  • Keech A., Sandler CX., Vollmer-Conna, U., Cvejic, E., Lloyd, AR., & Barry, BK. (2015). Capturing the post-exertional exacerbation of fatigue following physical and cognitive challenge in patients with chronic fatigue syndrome. J Psychosom Res. 79(6):537-49. doi: 10.1016/j.jpsychores.2015.08.008.
Speeches/lectures:

  • Developed and delivered lecture content to UNSW undergraduate Exercise physiology students on fatigue conditions including chronic fatigue syndrome, post-cancer fatigue, post-infective fatigue (multiple years from 2012).
 
Moved post

Article in The Coversation. Note, also posted up thread here.

Title is
It’s not just ‘chronic fatigue’: ME/CFS is much more than being tired

Published: June 19, 2025 6.09am BST
By Sarah Annesley, La Trobe University

theconversation.com

It’s not just ‘chronic fatigue’: ME/CFS is much more than being tired

A growing body of scientific evidence shows myalgic encephalomyelitis chronic fatigue syndrome – or ME/CFS – is a biological illness, not a psychological one.
theconversation.com theconversation.com

Eta

I came across it in a ME Research Facebook post. It's from an Australian perspective.

I don't think it's especially effective . It's says it's making the point that it's not just fatigue but then only really emphasises "two core symptoms" - fatigue and pem so for me it fails to get across the whole gamut of immunological and neurological (and often other systemic) symptoms pwme experience.

Then it gets into the psychological debate which it seems is always a minefield...
 
Last edited by a moderator:
Dolphin said:
This is one person based on my unreliable memory who I would be a bit worried about:

Dr Carolina Sandler​

  • Senior Lecturer, School of Health Sciences, UNSW
  • Accredited exercise physiologist and clinical researcher with research interests being post-infective fatigue states and cancer survivorship
  • Part of the Fatigue Research program at the Kirby Institute, UNSW.

​

  • CI MRFF 2023 Post-Acute Sequelae of COVID (lead institution Uni of Melbourne)
  • Cancer Institute NSW early career fellowship (partial salary & project funds)
  • Previous clinician and current co-lead of UNSW Fatigue Clinic and Research program.
Relevant publications:

  • Jones, M. D., Casson, S. M., Barry, B. K., Li, S. H., Valenzuela, T., Cassar, J., Lamanna, C., Lloyd, A. R., & Sandler, C. X. (2023). eLearning improves allied health professionals’ knowledge and confidence to manage medically unexplained chronic fatigue states: A randomized controlled trial. J Psychosom Res, 173, 111462. Q1
  • Casson, S., M. D. Jones, J. Cassar, N. Kwai, A. R. Lloyd, B. K. Barry and C. X. Sandler (2022). "The effectiveness of activity pacing interventions for people with chronic fatigue syndrome: a systematic review and meta-analysis." Disabil Rehabil: 1-15. Q1
  • Sandler, C. X., E. Cvejic, B. M. Valencia, H. Li, I. B. Hickie and A. R. Lloyd (2022). "Predictors of Chronic Fatigue Syndrome and Mood Disturbance After Acute Infection." Front Neurol 13: 935442. Q1
  • Sandler CX, Wyller V, Moss-Morris R, Buchwald D, Crawley E, Hautvast J, Katz B, Knoop H, Little P, Taylor R, Wensaas KA, Lloyd AR. (Long COVID and post-infective fatigue syndrome – a review. Open.Forum.Infectious.Diseases.¡.2021;8(10):ofab440. doi: 10.1093/ofid/ofab440
  • Sandler CX, Lloyd AR. Chronic fatigue syndrome: progress and possibilities? (2020) The Medical Journal of Australia. (invited review) 212(9), 428–433. https://doi.org/10.5694/mja2.50553
  • Cvejic E., Sandler CX., Keech A, Barry BK., Lloyd AL., Vollmer-Conna, U. (2017). Autonomic nervous system function, activity patterns, and sleep after physical or cognitive challenge in people with chronic fatigue syndrome. J Psychosom Res. 103:91-94. DOI: 10.1016/j.jpsychores.2017.10.010
  • McBride RL, Horsfield, SL, Cvejic, E, Casson S, Sandler CX, Cassar, J, Vollmer-Conna, U, & Lloyd, AR. (2017) Cognitive remediation training improves performance in patients with chronic fatigue syndrome. Psychiatry Research. 257:400-405. DOI: 10.1016/j.psychres.2017.08.035
  • Li SH., Sandler CX., Casson SM., Cassar J., Bogg T., Lloyd AR., Barry BK. (2016) A randomised controlled trial of online continuing education for health professionals to improve the management of chronic fatigue syndrome: A study protocol. BMJ Open. 7(5):e014133. DOI:10.1136/ bmjopen-2016-014133
  • Sandler CX., Hamilton BA., Horsfield S., Bennett BK., Vollmer-Conna U., Tzarimas C., Lloyd AR. (2016). Outcomes and predictors of response from an optimised, multidisciplinary intervention for chronic fatigue states. Intern Med J, 46(12): 1421–1429. DOI:10.1111/imj.13251
  • Sandler CX., Lloyd AR., Barry BK. (2016). Fatigue Exacerbation by Interval or Continuous Exercise in Chronic Fatigue Syndrome. Med Sci Sports Exerc 48(10): 1875-1885. DOI:10.1249/MSS.0000000000000983
  • Keech A., Sandler CX., Vollmer-Conna, U., Cvejic, E., Lloyd, AR., & Barry, BK. (2015). Capturing the post-exertional exacerbation of fatigue following physical and cognitive challenge in patients with chronic fatigue syndrome. J Psychosom Res. 79(6):537-49. doi: 10.1016/j.jpsychores.2015.08.008.
Speeches/lectures:

  • Developed and delivered lecture content to UNSW undergraduate Exercise physiology students on fatigue conditions including chronic fatigue syndrome, post-cancer fatigue, post-infective fatigue (multiple years from 2012).
Click to expand...
It would be helpful, I think, if any specific critiques of the papers above could be provided in this thread.
While the titles alone tell a story, the content of the articles is where the NHMRC will look for evidence.
 
From the referenced 2020 narrative review in Med. J. Aust. - seems deeply problematic in its coverage of CBT & GET:
Cognitive behaviour therapy (CBT) is a commonly trialled intervention. In the context of CFS, CBT is best considered as a multifaceted strategy to identify and modify illness behaviours and beliefs to reduce symptom severity and improve functional capacity.84,85 Beliefs that should be challenged include that more sleep will alleviate the fatigue, that avoiding activity is preferable, and that ignoring symptoms and simply pushing beyond activity thresholds will overcome the illness.
Click to expand...
The most recent meta-analysis of the four controlled studies of CBT, including the PACE trial, found no significant differences in physical function scores between intervention and control groups.67,86 However, this analysis excluded several high quality, randomised controlled trials with positive outcomes,87,88 and contrasts with an earlier Cochrane analysis, which suggested CBT was effective in reducing the symptoms of fatigue compared with usual care.89 More recently, with the aim of improving access to treatment, a randomised controlled trial of online CBT with clinical psychologist feedback showed a significant reduction in self-reported fatigue and psychological distress, as well as some improvement in physical functioning in those receiving online CBT versus the waitlist control group
Click to expand...
Graded exercise therapy (GET) has more consistent evidence for benefit, with a meta-analysis showing moderate quality evidence for improvement in measures of physical function and fatigue severity.67 In clinical practice, GET is preceded by activity pacing, which involves identifying thresholds beyond which the prolonged symptom exacerbation follows, and then “pacing” activities in order to maximise use of the constrained energy supplies. GET then involves planned, cautious increases in physical activity without causing sustained worsening of symptoms. A recently updated Cochrane review of eight randomised controlled studies indicated that in comparison to passive control (such as relaxation or flexibility), GET reduced fatigue at end of treatment with moderate certainty.91,92 However, the review indicated that it was not possible to exclude the potential for an exacerbation of symptoms in patients with severe illness.
Click to expand...
 
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