30913 research outputs found
Sort by
Coproducing Aboriginal patient journey mapping tools for improved quality and coordination of care
Get PDFJournal Compilation © La Trobe University 2017 Open Access CC BY-NC-NDThis paper describes the rationale and process for developing a set of Aboriginal patient journey mapping tools with Aboriginal patients, health professionals, support workers, educators and researchers in the Managing Two Worlds Together project between 2008 and 2015. Aboriginal patients and their families from rural and remote areas, and healthcare providers in urban, rural and remote settings, shared their perceptions of the barriers and enablers to quality care in interviews and focus groups, and individual patient journey case studies were documented. Data were thematically analysed. In the absence of suitable existing tools, a new analytical framework and mapping approach was developed. The utility of the tools in other settings was then tested with health professionals, and the tools were further modified for use in quality improvement in health and education settings in South Australia and the Northern Territory. A central set of patient journey mapping tools with flexible adaptations, a workbook, and five sets of case studies describing how staff adapted and used the tools at different sites are available for wider use
Corporatisation of general practice — Impact and implications
Get PDFIn Australia, general practice is largely private, ranging from small sole traders through to large partnerships comprising six or more practitioners. Over time, a number of corporate practices, which are registered under the Corporations Act 2001, have emerged on the Australian health care landscape. The corporate model also varies in size, depending on location (urban, rural) and types of services provided by the company. This review examines the impact and implications of corporatisation of general practice in Australia in terms of market competition, quality of care, patient outcomes, costs of care, and the health care workforce
'When you sleep on a park bench, you sleep with your ears open and one eye open': Australian Aboriginal peoples' experiences of homelessness in an urban setting
No full text© AIATSIS Aboriginal Studies PressAboriginal and Torres Strait Islander people are ten times more likely than non-Indigenous people to be homeless, which is an indicator of the level of health and social disparity that exists between the two groups. This paper presents the experiences of homelessness for a group of ten Aboriginal people located in Adelaide. Using Bourdieu's theoretical approach, we explore how these individuals interact with their environment, notably in the context of historical institutional disadvantage, and explore how this affects health and wellbeing. We highlight the subjective nature of homelessness, which is influenced by factors such as culture, age, and poor mental and physical health. We demonstrate the complex, diverse needs and heterogeneous nature of homelessness for Aboriginal people, which occur in the context of an enduring, specific historical experience of disadvantage, where the pathways into homelessness may vary and where homelessness may not always be perceived as negative. All participants experienced racism and reported resultant ill effects. Our study indicates the need for effective responses to homelessness to take account of the historical context of dispossession in developing culturally sensitive responses that reflect the nuances and diversity among homeless Aboriginal and Torres Strait Islander people
Host Organisation Perspectives on the Impacts of International Volunteering
Get PDFCopyright © Flinders University 2016. This report is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/Summary of results. The impacts of international development volunteering are multidimensional. They touch host organisations and volunteers, range from skills building and organisational change to employability and life experience, and can change participants’ world views, their understanding of development and aid, and their attitude to volunteering. In this report we focus on the volunteer perspectives on volunteering as a form of development assistance, and on three important areas of impact: capacity development, relationship building, and cosmopolitan orientations.
Development volunteering. According to research participants, volunteering can be distinguished from other forms of development work by a stronger focus on the host organisation’s priorities and on developing collaborative relationships. Less pressure to produce outputs creates more opportunity for sharing knowledge and experience with local colleagues. This can make the impacts of volunteering more sustainable, but also less predictable.
Capacity development. All volunteers hope to contribute positively to the capacity of their host organisation. They learn that capacity cannot be developed unilaterally through their own efforts but with the active engagement of their host organisation colleagues. When volunteers understand this and have succeeded in establishing a solid collaborative learning space, they find that they are able to work towards significant changes in the host organisation’s ability to mobilise and attract resources, plan and operate strategically, improve the quality of service and performance, and broaden its network of partnerships. In working with host organisations, volunteers also develop their own capacity to translate their skills to a different context, work with cultural difference and diverse knowledges, and understand their host country’s economic and political systems, development challenges, and cultural norms and values.
Relationship building impacts Most volunteers see relationship building as an important means of capacity development and as a valued outcome of volunteering. As a means, building relationships with host organisation staff is a pre-requisite to achieving the above-mentioned capacity development outcomes. Volunteers achieve much more if they work as a member of a team in their host organisation, rather than as a lone capacity builder working to a pre-established program. The host organisation, too, must invest in the relationship and find how and where the volunteer’s skills and knowledge can be most effectively used. Time, a shared language, cultural confidence, experience with managing volunteers in the organisation and clarity about where the volunteer’s accountability lies, are all necessary ingredients for building productive and equitable relationships.
Public diplomacy impacts. Volunteers see the people-to-people relationships they build in host organisations and beyond as a significant outcome of volunteering. The personal friendships and bonds with people from their host country facilitated information exchange which increased the knowledge stock on both sides and laid the foundations for a better, deeper, mutual understanding. Many volunteers found that host organisations and communities made them feel welcome, but they also encountered stereotypes of Westerners (both positive and negative), and questioned some of their own taken-for-granted assumptions about their host country and Australia. Volunteering gives participants the opportunity to act on their sense of solidarity and shared humanity with others, while at the same time gaining a deeper understanding of cultural difference and the importance of contex
Behaviour of the Pleistocene marsupial lion deduced from claw marks in a southwestern Australian cave
No full textThis work is licensed under a Creative Commons Attribution 4.0 International License. The images
or other third party material in this article are included in the article’s Creative Commons license,
unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license,
users will need to obtain permission from the license holder to reproduce the material. To view a copy of this
license, visit http://creativecommons.org/licenses/by/4.0/The marsupial lion, Thylacoleo carnifex, was the largest-ever marsupial carnivore, and is one of the
most iconic extinct Australian vertebrates. With a highly-specialised dentition, powerful forelimbs
and a robust build, its overall morphology is not approached by any other mammal. However, despite
>150 years of attention, fundamental aspects of its biology remain unresolved. Here we analyse an
assemblage of claw marks preserved on surfaces in a cave and deduce that they were generated by
marsupial lions. The distribution and skewed size range of claw marks within the cave elucidate two key
aspects of marsupial lion biology: they were excellent climbers and reared young in caves. Scrutiny of
>10,000 co-located Pleistocene bones reveals few if any marsupial lion tooth marks, which dovetails
with the morphology-based interpretation of the species as a flesh specialist
Fluid dynamic lateral slicing of high tensile strength carbon nanotubes
No full textThis work is licensed under a Creative Commons Attribution 4.0 International License. The images
or other third party material in this article are included in the article’s Creative Commons license,
unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license,
users will need to obtain permission from the license holder to reproduce the material. To view a copy of this
license, visit http://creativecommons.org/licenses/by/4.0/Lateral slicing of micron length carbon nanotubes (CNTs) is effective on laser irradiation of the materials
suspended within dynamic liquid thin films in a microfluidic vortex fluidic device (VFD). The method
produces sliced CNTs with minimal defects in the absence of any chemical stabilizers, having broad
length distributions centred at ca 190, 160 nm and 171 nm for single, double and multi walled CNTs
respectively, as established using atomic force microscopy and supported by small angle neutron
scattering solution data. Molecular dynamics simulations on a bent single walled carbon nanotube
(SWCNT) with a radius of curvature of order 10 nm results in tearing across the tube upon heating,
highlighting the role of shear forces which bend the tube forming strained bonds which are ruptured by
the laser irradiation. CNT slicing occurs with the VFD operating in both the confined mode for a finite
volume of liquid and continuous flow for scalability purposes
Sociodemographic disparities in survival from colorectal cancer in South Australia: a population-wide data linkage study
No full textCopyright © Beckmann et al. 2016
Open AccessThis 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. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background: Inequalities in survival from colorectal cancer (CRC) across socioeconomic groups and by area of
residence have been described in various health care settings. Few population-wide datasets which include
clinical and treatment information are available in Australia to investigate disparities. This study examines
socio-demographic differences in survival for CRC patients in South Australia (SA), using a population-wide
database derived via linkage of administrative and surveillance datasets.
Methods: The study population comprised all cases of CRC diagnosed in 2003-2008 among SA residents
aged 50-79 yrs in the SA Central Cancer Registry. Measures of socioeconomic status (area level), geographical
remoteness, clinical characteristics, comorbid conditions, treatments and outcomes were derived through record
linkage of central cancer registry, hospital-based clinical registries, hospital separations, and radiotherapy services data
sources. Socio-demographic disparities in CRC survival were examined using competing risk regression analysis.
Results: Four thousand six hundred and forty one eligible cases were followed for an average of 4.7 yrs, during which
time 1525 died from CRC and 416 died from other causes. Results of competing risk regression indicated higher risk of
CRC death with higher grade (HR high v low =2.25, 95 % CI 1.32-3.84), later stage (HR C v A = 7.74, 95 % CI 5.75-10.4),
severe comorbidity (HR severe v none =1.21, 95 % CI 1.02-1.44) and receiving radiotherapy (HR = 1.41, 95 % CI 1.18-1.68).
Patients from the most socioeconomically advantaged areas had significantly better outcomes than those from the least
advantaged areas (HR =0.75, 95 % 0.62-0.91). Patients residing in remote locations had significantly worse outcomes than
metropolitan residents, though this was only evident for stages A-C (HR = 1.35, 95 % CI 1.01-1.80). These disparities were
not explained by differences in stage at diagnosis between socioeconomic groups or area of residence. Nor were they
explained by differences in patient factors, other tumour characteristics, comorbidity, or treatment modalities.
Conclusions: Socio-economic and regional disparities in survival following CRC are evident in SA, despite having
a universal health care system. Of particular concern is the poorer survival for patients from remote areas with
potentially curable CRC. Reasons for thes
Zolav®: a new antibiotic for the treatment of acne
No full textThis work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php
and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).BACKGROUND:
Acne is a prominent skin condition affecting >80% of teenagers and young adults and ~650 million people globally. Isotretinoin, a vitamin A derivative, is currently the standard of care for treatment. However, it has a well-established teratogenic activity, a reason for the development of novel and low-risk treatment options for acne.
OBJECTIVE:
To investigate the effectiveness of Zolav(®), a novel antibiotic as a treatment for acne vulgaris.
MATERIALS AND METHODS:
Minimum inhibitory concentration of Zolav(®) against Propionibacterium acnes was determined by following a standard protocol using Mueller-Hinton broth and serial dilutions in a 96-well plate. Cytotoxicity effects on human umbilical vein endothelial cells and lung cells in the presence of Zolav(®) were investigated by determining the growth inhibition (GI50) concentration, total growth inhibition concentration, and the lethal concentration of 50% (LC50). The tryptophan auxotrophic mutant of Escherichia coli strain, WP2 uvrA (ATCC 49979), was used for the AMES assay with the addition of Zolav(®) tested for its ability to reverse the mutation and induce bacterial growth. The in vivo effectiveness of Zolav(®) was tested in a P. acnes mouse intradermal model where the skin at the infection site was removed, homogenized, and subjected to colony-forming unit (CFU) counts.
RESULTS:
Susceptibility testing of Zolav(®) against P. acnes showed a minimum inhibitory concentration of 2 µg/mL against three strains with no cytotoxicity and no mutagenicity observed at the highest concentrations tested, 30 µM and 1,500 µg/plate, respectively. The use of Zolav(®) at a concentration of 50 µg/mL (q8h) elicited a two-log difference in CFU/g between the treatment group and the control.
CONCLUSION:
This study demonstrates the potential of Zolav(®) as a novel treatment for acne vulgaris
Plausibility of freshwater lenses adjacent to gaining rivers: Validation by laboratory experimentation
Get PDFPublisher version available following 6 months embargo from date of publication (9 November 2016) in accordance with publisher copyright requirements.The occurrence of freshwater lenses in saline aquifers adjoining gaining rivers has recently been demonstrated as being theoretically possible by way of analytical solution. However, physical evidence for freshwater lenses near gaining rivers is limited largely to airborne geophysical surveys. This paper presents the first direct observations of freshwater lenses adjacent to gaining rivers, albeit at the laboratory-scale, as validation of their plausibility. The experimental conditions are consistent with the available analytical solution, which is compared with laboratory observations of lens extent and the saltwater flow rate, for various hydraulic gradients. Numerical simulation shows that dispersion can account for the small amount of mismatch between the sharp-interface analytical solution and laboratory measurements. Calibration and uncertainty analysis demonstrate that accurate mathematical predictions require calibration to laboratory measurements of the lens. The results provide unequivocal proof that freshwater lenses can persist despite gaining river conditions concordant with theoretical lenses predicted by the analytical solution, at least within the constraints of the experimental setup
Optimizing the detection of methicillin-resistant Staphylococcus aureus with elevated vancomycin minimum inhibitory concentrations within the susceptible range
No full textThis work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.
php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work
you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For
permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).Background: Determination of vancomycin minimum inhibitory concentration (MIC) can
influence the agent used to treat methicillin-resistant Staphylococcus aureus (MRSA) infection.
We studied diagnostic accuracy using E-test and VITEK® 2 against a gold standard broth
microdilution (BMD) methodology, the correlation between methods, and associations between
vancomycin MIC and MRSA phenotype from clinical isolates.
Methods: MRSA isolates were obtained from April 2012 to December 2013. Vancomycin MIC
values were determined prospectively on all isolates by gradient diffusion E-test and automated
VITEK® 2. The Clinical and Laboratory Standards Institute reference BMD method was performed
retrospectively on thawed frozen isolates. Diagnostic accuracy for detecting less susceptible strains
was calculated at each MIC cutoff point for E-Test and VITEK® 2 using BMD ≥1 μg/mL as a
standard. The correlation between methods was assessed using Spearman’s rho (r). The association
between MRSA phenotype and MIC for the three methods was assessed using Fisher’s exact test.
Results: Of 148 MRSA isolates, all except one (E-test =3 μg/mL) were susceptible to vancomycin
(MIC of ≤2 μg/mL) irrespective of methodology. MICs were ≥1.0 μg/mL for 9.5%
of BMD, 50.0% for VITEK® 2, and 27.7% for E-test. Spearman’s r showed weak correlations
between methods: 0.29 E-test vs VITEK® 2 (P=0.003), 0.27 E-test vs BMD (P=0.001), and
0.31 VITEK® 2 vs BMD (P=0.002). The optimal cutoff points for detecting BMD-defined less
susceptible strains were ≥1.0 μg/mL for E-test and VITEK® 2. E-test sensitivity at this cutoff
point was 0.85 and specificity 0.29, while VITEK® 2 sensitivity and specificity were 0.62 and
0.51, respectively. Multiresistant MRSA strains tended to have higher MIC values compared to
nonmultiresistant MRSA or epidemic MRSA 15 phenotypes by E-test (Fisher’s exact P<0.001)
and VITEK® 2 (Fisher’s exact P<0.001).
Conclusion: Overall diagnostic accuracy and correlations between MIC methods used in
routine diagnostic laboratories and the gold standard BMD showed limited overall agreement.
This study helps optimize guidance on the effective use of vancomycin