30913 research outputs found
Sort by
Conopeptide-Derived κ‑Opioid Agonists (Conorphins): Potent, Selective, and Metabolic Stable Dynorphin A Mimetics with Antinociceptive Properties
Get PDFVersion of Record reproduced in accordance with ACS Journal Publishing Agreement, section 7, in connection with NHMRC funding mandate.Opioid receptor screening of a conopeptide library led to a novel selective κ-opioid agonist peptide (conorphin T). Intensive medicinal chemistry, guided by potency, selectivity, and stability assays generated a pharmacophore model supporting rational design of highly potent and selective κ-opioid receptor (KOR) agonists (conorphins) with exceptional plasma stability. Conorphins are defined by a hydrophobic benzoprolyl moiety, a double arginine sequence, a spacer amino acid followed by a hydrophobic residue and a C-terminal vicinal disulfide moiety. The pharmacophore model was supported by computational docking studies, revealing receptor–ligand interactions similar to KOR agonist dynorphin A (1–8). A conorphin agonist inhibited colonic nociceptors in a mouse tissue model of chronic visceral hypersensitivity, suggesting the potential of KOR agonists for the treatment of chronic abdominal pain. This new conorphine KOR agonist class and pharmacophore model provide opportunities for future rational drug development and probes for exploring the role of the κ-opioid receptor
Smart Casual: Reading Law
No full textPlease download and read ‘Instructions_zipped_file_download’ PDF prior to accessing the ‘Smart Casual’ module.This resource is part of the Smart Casual suite of professional development modules, which have been developed for and by Australian law teachers. This module explores how to help students build legal reading skills – skills fundamental to legal practice and important in law-related careers. It explores what critically reading law means, how it differs between types of legal documents, and how to help develop students’ close reading skills. This module covers: decoding, comprehension, metacognition, and critical reading strategies for a range of documents: case law, statutes, transactional documents, legal scholarship, policy and government reports.The Commonwealth and the author
Heart failure following cancer treatment: characteristics, survival and mortality of a linked health data analysis
Get PDFThis article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving'.
Copyright (2017) John Wiley & Sons, Inc. All rights reserved
This author accepted manuscript is made available following 12 month embargo from date of publication (Nov 2016) in accordance with the publisher’s archiving policyBackground
Cardiotoxicity resulting in heart failure is a devastating complication of cancer therapy. A patient may survive cancer only to develop heart failure (HF), which has a higher mortality rate than some cancers.
Aim
This study aimed to describe the characteristics and outcomes of HF in patients with blood or breast cancer after chemotherapy treatment.
Methods
Queensland Cancer Registry, Death Registry and Hospital Administration records were linked (1996–2009). Patients were categorised as those with an index HF admission (that occurred after cancer diagnosis) and those without an index HF admission (non-HF).
Results
A total of 15 987 patients was included, and 1062 (6.6%) had an index HF admission. Median age of HF patients was 67 years (interquartile range 58–75) versus 54 years (interquartile range 44–64) for non-HF patients. More men than women developed HF (48.6% vs 29.5%), and a greater proportion in the HF group had haematological cancer (83.1%) compared with breast cancer (16.9%). After covariate adjustment, HF patients had increased mortality risk compared with non-HF patients (hazard ratios 1.67 (95% confidence interval, 1.54–1.81)), and 47% of the index HF admission occurred within 1 year from cancer diagnosis and 70% within 3 years.
Conclusion
Cancer treatment may place patients at a greater risk of developing HF. The onset of HF occurred soon after chemotherapy, and those who developed HF had a greater mortality risk
The clinical value of fluid biomarkers for dementia diagnosis
Get PDF© 2016 Elsevier Ltd. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/We read with interest the Article by Bob Olsson and colleagues1
examining CSF and blood biomarkers for the diagnosis of Alzheimer's disease. Olsson and colleagues recommend the use of the CSF biomarkers total tau, phosphorylated tau, amyloid β42, and neurofilament light protein in the diagnosis of Alzheimer's disease and mild cognitive impairment.1
By contrast, Cochrane reviews2
, 3
based on similar studies have concluded that there is not sufficient evidence to support the routine use of CSF amyloid β or PET in the diagnosis of mild cognitive impairment due to Alzheimer's disease and other dementias. This discrepancy in interpreting the evidence base for diagnostic technologies can only serve to create variations in practice and confusion for both doctors and their patients.
Although the use of biomarkers as diagnostic criteria for Alzheimer's disease might be valuable in research, concerns have been raised about the premature use of such criteria beyond the research setting.4
There is no doubt that many of the changes in CSF and blood biomarkers are associated with Alzheimer's disease and mild cognitive impairment, but such associations by themselves might be inadequate to demonstrate clinical usefulness. Establishment of clinical usefulness requires the use of thresholds for positive and negative results and standard accuracy metrics such as sensitivity, specificity, and likelihood ratios.5
Alternative measures such as correlations or ratios of blood biomarker concentrations in patients and controls might be important to indicate the potential value of a marker in the research phase, but these studies do not provide information about how the test will perform in a typical clinical setting. In clinical practice, patients requiring further testing will not be those with established Alzheimer's disease or cognitively healthy controls.5
The use of such widely differing groups in accuracy studies will result in spectrum bias and does not provide evidence of the performance of the test in a true clinical setting. More definitive evidence from studies done in consecutive series of presenting patients (even if this series includes people with a range of diagnoses) is needed before these biomarkers can be recommended for routine clinical use.5
The true value of the use of a diagnostic test in practice should relate to its benefit for the patient, in terms of outcomes such as quality of life. Even if biomarkers are proven to be highly accurate in diagnosing Alzheimer's disease, the probable patient benefit should still be considered. The value of testing for a diagnosis of mild cognitive impairment, while important for research advances, can be questioned given the uncertain balance between the benefits and harms of a diagnosis while a treatment is not available. This might be particularly important in tests with impressive sensitivity but inadequate specificity, leading to a large number of false positive diagnoses in patients who might never develop dementia.
Some researchers, enthusiastic about promising results for diagnostic tests in a common and debilitating disease, might be frustrated by the requirement for more definitive evidence of the accuracy of diagnostic tests before routine use. However, improvements in clinical practice will only come with more consistent interpretation of evidence before recommendations for adopting new technologies are made.
LF is an Editor for The Cochrane Dementia and Cognitive Improvement Group. SD was previously employed conducting health technology assessments for the Medical Services Advisory Committee, who make recommendations for public funding of diagnostic technologies through Medicare in Australia. All authors were involved in development of clinical practice guidelines for dementia in Australia
Two heads are better than one: Australian tobacco control experts' and mental health change champions' consensus on addressing the problem of high smoking rates among people with mental illness
Get PDFOpen Access. Journal compilation Copyright AHHA 2016Abstract
Objective.
The aims of the present study were to explore the beliefs of Australian experts in tobacco control and change champions working in mental health and tobacco cessation, and to identify measures for addressing the problem of high smoking rates for people with mental illness.
Methods.
Qualitative interviews were undertaken to explore participants' views, and the Delphi technique was used to achieve consensus on ways in which the problem would be best addressed.
Results.
This consensus centred on the need for leadership within the mental health system. The problem was reconceptualised from being solely the responsibility of the mental health sector into an issue that requires the combined resources of a partnership and shared leadership between government and non-government services, public health leaders, policy makers and people with mental illness and their families.
Conclusions.
Collaboration would raise the priority of the issue, reduce the debilitating effect of stigma and discrimination within the mental health sector and would place smoking reduction firmly on the political and public agenda. A recovery-orientated focus would increase the skill base and be inclusive of workers, families and carers of people with mental illness who face smoking issues on a daily basis. Reconceptualising this as an issue that would benefit from cooperation and partnerships would disrupt the notion that the problem is solely the responsibility of the mental health sector
Exploring the use of emoji as a visual research method for eliciting young children’s voices in childhood research
Get PDF03004430.2016.1219730“This is an Accepted Manuscript of an article published by Taylor & Francis in Early Child Development and Care on 17 Aug 2016, available online: http://www.tandfonline.com/10.1080/03004430.2016.1219730"
This author accepted manuscript is made available following 18 month embargo from date of publication (August 2017) in accordance with the publisher’s archiving policyRecognition of the need to move from research on children to research with children has prompted significant theoretical and methodological debate as to how young children can be positioned as active participants in the research process. Visual research methods such as drawing, photography, and videography have received substantive attention in child-centred research paradigms. However, despite their increasing ubiquity in young children’s lifeworlds, technology or media-based visual materials have received little interest. This article reports on a study which used emoji as a visual research method for eliciting young children’s (aged three to five years) understandings and experiences of well-being. Findings elucidate the capacity of emoji as a visual research method for eliciting children’s voices, and considerations for its use in child research
Working at the interface in Aboriginal and Torres Strait Islander health: focussing on the individual health professional and their organisation as a means to address health equity
Get PDFThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.Background
Aboriginal and Torres Strait Islander people experience inequity in health outcomes in Australia. Health care interactions are an important starting place to seek to address this inequity. The majority of health professionals in Australia do not identify as Aboriginal and/or Torres Strait Islander people and the health care interaction therefore becomes an example of working in an intercultural space (or interface). It is therefore critical to consider how health professionals may maximise the positive impact within the health care interaction by skilfully working at the interface.
Methods
Thirty-five health professionals working in South Australia were interviewed about their experiences working with Aboriginal people. Recruitment was through purposive sampling. The research was guided by the National Health and Medical Research Council Values and Ethics for undertaking research with Aboriginal communities. Critical social research was used to analyse data.
Results
Interviews revealed two main types of factors influencing the experience of non-Aboriginal health professionals working with Aboriginal people at the interface: the organisation and the individual. Within these two factors, a number of sub-factors were found to be important including organisational culture, organisational support, accessibility of health services and responding to expectations of the wider health system (organisation) and personal ideology and awareness of colonisation (individual).
Conclusions
A health professional’s practice at the interface cannot be considered in isolation from individual and organisational contexts. It is critical to consider how the organisational and individual factors identified in this research will be addressed in health professional training and practice, in order to maximise the ability of health professionals to work with Aboriginal and Torres Strait Islander people and therefore contribute to addressing health equity
Modelling of the Arrium Closure on the Regional and State Economies
No full text© [2016] Flinders University / Australian Industrial Transformation InstituteSince early 2016 Arrium Ltd has been warning of the potential for closure of its Whyalla
steelworks given the financial impact of debt funded expansion followed by a decline in iron and
steel prices (and general commodity prices). The group disclosed a $60 million cash shortfall at the steelworks which has 1100 workers on staff and an estimated contractor workforce of around 450. Additionally as many as 1000 jobs in total of both staff and contract labour is exposed to any closure of its iron ore operation, which is also under threat due to heavy losses.
The following is a preliminary analysis of the potential economic and employment impacts of closure of Arrium’s operations
Integrative review: Nurses' roles and experiences in keeping children safe
Get PDFThis is the peer reviewed version of the following article: Lines, L.E., Hutton, A.E. and Grant, J.M. (2017). Integrative review: Nurses' roles and experiences in keeping children safe. Journal of Advanced Nursing, 73(2) pp. 302-322, which has been published in final form at: https://doi.org/10.1111/jan.13101. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.Aim
To identify nurses' role and experiences of keeping children safe.
Background
Approaches to preventing, identifying and responding to child abuse and neglect have moved towards a multidisciplinary approach where all professionals are expected to contribute to the goal of keeping children safe. Frequently in contact with children and families, nurses well positioned to contribute to keeping children safe from abuse and neglect. Much has been published around nurses' experiences of their role in keeping children safe, but this literature has not yet been synthesized to determine the challenges and potential scope of this role.
Design
Integrative review following an Integrative Review framework.
Data sources
Studies were identified through a search of the electronic databases CINAHL, Medline, Web of Science, Scopus and Informit to identify literature published between 2005‐2015.
Review methods
All the studies were critically appraised for methodological quality using the Critical Skills Appraisal Programme. Data from each study were extracted and categorized according to the review aims and the study's major findings.
Results
Inclusion criteria were met in 60 studies. Three main findings were identified including nurses' insufficient knowledge, need for validation and improved communication and balancing surveillance and support for vulnerable families.
Conclusions
Nurses have many roles and experiences in keeping children safe but often felt they did not have the knowledge, skills and support to take action in this area. Further research is needed to understand why nurses feel inadequate and disempowered to advocate and intervene on the behalf of children at risk of abuse or neglect
Stroke Epidemiology in an Australian Rural Cohort (SEARCH)
Get PDFCopyright © 2016 World Stroke Organization. Reprinted by permission of SAGE PublicationsBackground
Stroke rates in Australia and New Zealand have been declining since 1990 but all studies have been completed in large urban centers.
Aim
We report the first Australasian stroke incidence study in a rural population.
Methods
The authors applied the principle of complete ascertainment, used the WHO standard definition of stroke and classified ischemic stroke by the TOAST criteria. Data were collected from five rural centers defined by postcode of residence, over a 2-year period with 12 months of follow up of all cases.
Results
There were 217 strokes in 215 individuals in a population of 96,036 people, over 2 years, giving a crude attack rate of 113 per 100,000 per year. The 181 first-ever strokes (83% of total), standardized to the WHO world population, occurred at a rate of 50/100,000 (95% CI: 43–58). The 28-day fatality for first-ever strokes was 24% (95% CI: 18–31) and 77% (95% CI: 71–83) were classified as ischemic (140/181), 15% (95% CI: 10–21) intracerebral hemorrhage, 3% (95% CI: 1–6) due to subarachnoid hemorrhage and 5% (95% CI: 2–9) were unknown. A high proportion of first-ever ischemic strokes (44%) were cardioembolic, mostly (77%) due to atrial arrhythmias. Of the 38 with known atrial arrhythmias prior to stroke, only six (16%) were therapeutically anticoagulated.
Conclusions
This rural companion study of a recent Australian urban stroke incidence study confirms the downward trend of stroke incidence in Australia, and reiterates that inadequate anticoagulation of atrial arrhythmia remains a preventable cause of ischemic stroke