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Primary health care-based programmes targeting potentially avoidable hospitalisations in vulnerable groups with chronic disease
No full textThis report reviews outcomes of intervention programmes targeting reductions in potentially avoidable hospitalisations (PAHs) and/or avoidable Emergency Department presentations (ED presentations) among people with chronic disease. The focus is on the role of primary health care and where possible programmes targeting specific vulnerable populations, namely Indigenous Australians, rural and remote residents and those at socioeconomic disadvantage. This report also aimed to examine trends in PAHs and ED presentations among people with chronic disease
Transitions from hospital to primary care
No full textFor older Australians, transitions from hospital to primary care (i.e. general practice, community and/or aged care) are frequently accompanied by discontinuities in medication management, delays in follow‐up care, duplication of tests, adverse events and readmissions to hospital. This RESEARCH ROUNDup describes factors affecting smooth transitions and provides examples of best practice
Pay for performance: Australian landscape, international efforts, and impact on practice
No full textFee-for-service (FFS) funding continues to dominate primary health care in Australia despite calls for reform. FFS, where providers bill for each service they provide, rewards increased activity. This may lead to over-servicing, increased costs (with no controls on prices charged), and negative impacts on quality of care. In contrast, pay-for-performance (P4P) approaches refer to payments to general practitioners (GPs) or practices, according to the number of times a certain standard of performance is met, and have been shown to improve quality.1; 2 Blended funding models have been trialled in Australia, with the 2011-14 Diabetes Care Project (DCP) incorporating P4P and flexible funding, while retaining FFS components. This RESEARCH ROUNDup will examine P4P in the Australian primary health care context and provide lessons from both systematic reviews and international experiences of P4P in primary health care
‘Love Where You Live!’ A Conversation with Diana McCaulay
No full textDiana McCaulay is an award-winning Jamaican novelist and short-story writer. Her first novel, Dog-Heart (Peepal Tree Press, 2010) won a Gold Medal in the Jamaica Cultural Development Commission's National Creative Writing Awards (2008), and was shortlisted for the Guyana Prize (2011), the IMPAC Dublin Award (2012) and the Saroyan Prize for International Writing (2012). She won the Regional Prize for the Caribbean Commonwealth Short Story competition in 2012 for ‘The Dolphin Catcher’. Her second novel, Huracan (Peepal Tree Press, 2014) was also shortlisted for Saroyan Prize for International Writing. In April 2014, she won the Hollick Arvon Caribbean Writers Prize for a non-fiction work in progress, entitled Loving Jamaica: A Memoir of Place and (Not) Belonging. At the same time she is working on her third novel, which at the time of this interview was tentatively called The Dolphin Catcher. McCaulay is the also founder and Chief Executive Officer of the Jamaica Environment Trust (JET), focusing on environmental education and advocacy. Before that she worked in the general insurance industry for eighteen years, in various senior management positions. She is a Chartered Insurer qualified by the Chartered Insurance Institute in the United Kingdom. She holds a Bachelor of Science Degree in Management Studies from the University of the West Indies, and a Master's Degree in Public Administration from the University of Washington, with majors in environmental policy and international development. She served on the Board of Jamaica’s Natural Resources Conservation Authority from 2003 to 2005, and again in 2008, and is a past Chair of the National Environmental Societies Trust and past Vice Chair of the Environmental Foundation of Jamaica. This interview took place in Kingston, Jamaica, June 2015 and was conducted by Russell McDougall. Questions prepared in advance and interspersed contextual notes added after the transcription were prepared in collaboration with Sue Thomas
A Trip to Singapore
No full textA Trip to Singapore describes a clash of cultures and illustrates the curious paradox that by encountering 'the other' we can find ourselves
Three Poems about Absence, translated by the author
No full textFrench poems with English translation by the author
Sicily and Scotland: Where Extremes Meet edited by Graham Tulloch, Karen Agutter and Luciana d’Arcangeli (Troubador Publishing, 2015): Speech by Margaret Baker at the Launch in Adelaide on 15 October 2015.
No full textSpeech given at launch of Sicily and Scotland: Where Extremes Meet edited by Graham Tulloch,
Karen Agutter and Luciana d’Arcangeli (Troubador Publishing, 2015) in Adelaide on 15 October 2015
A Syntenic Cross Species Aneuploidy Genetic Screen Links RCAN1 Expression to β-Cell Mitochondrial Dysfunction in Type 2 Diabetes
No full textThis is an open
access article distributed under the terms of the
Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any
medium, provided the original author and source are
credited.Type 2 diabetes (T2D) is a complex metabolic disease associated with obesity, insulin
resistance and hypoinsulinemia due to pancreatic β-cell dysfunction. Reduced mitochondrial
function is thought to be central to β-cell dysfunction. Mitochondrial dysfunction and
reduced insulin secretion are also observed in β-cells of humans with the most common
human genetic disorder, Down syndrome (DS, Trisomy 21). To identify regions of chromosome
21 that may be associated with perturbed glucose homeostasis we profiled the glycaemic
status of different DS mouse models. The Ts65Dn and Dp16 DS mouse lines were
hyperglycemic, while Tc1 and Ts1Rhr mice were not, providing us with a region of chromosome
21 containing genes that cause hyperglycemia. We then examined whether any of these genes were upregulated in a set of ~5,000 gene expression changes we had identified
in a large gene expression analysis of human T2D β-cells. This approach produced a
single gene, RCAN1, as a candidate gene linking hyperglycemia and functional changes in
T2D β-cells. Further investigations demonstrated that RCAN1 methylation is reduced in
human T2D islets at multiple sites, correlating with increased expression. RCAN1 protein
expression was also increased in db/db mouse islets and in human and mouse islets
exposed to high glucose. Mice overexpressing RCAN1 had reduced in vivo glucose-stimulated
insulin secretion and their β-cells displayed mitochondrial dysfunction including hyperpolarised
membrane potential, reduced oxidative phosphorylation and low ATP production.
This lack of β-cell ATP had functional consequences by negatively affecting both glucosestimulated
membrane depolarisation and ATP-dependent insulin granule exocytosis. Thus,
from amongst the myriad of gene expression changes occurring in T2D β-cells where we
had little knowledge of which changes cause β-cell dysfunction, we applied a trisomy 21
screening approach which linked RCAN1 to β-cell mitochondrial dysfunction in T2D.
Author Summary
Mitochondrial dysfunction and reduced insulin secretion are key features of β-cell dysfunction
in Type 2 diabetes (T2D). Down syndrome (DS) is a genetic disorder caused by
trisomy of chromosome 21 that also displays β-cell mitochondrial dysfunction and
reduced insulin secretion in humans. Given these similarities in β-cell dysfunction in T2D
and DS, we developed a trisomy 21 screening method to identify genes that may be important
in T2D. This approach used different DS mouse models combined with human gene
expression data from T2D β-cells. From this we identified a single candidate, Regulator of
calcineurin 1 (RCAN1). High RCAN1 expression occurs in human and mouse T2D islets.
Increased RCAN1 expression in mice reduced β-cell mitochondrial function and ATP
availability, and this has negative implications for multiple ATP-dependent steps in glucose-
stimulated insulin secretion
A model for (re)building consumer trust in the food system
Get PDFThis manuscript version is made available per the publisher's Author self-archiving policy.
Copyright © The Authors 2016. Published by Oxford University Press. All rights reserved.The article presents a best practice model that can be utilized by food system actors to assist with (re)building trust in the food system, before, during and after a food incident defined as ‘any situation within the food supply chain where there is a risk or potential risk of illness or confirmed illness or injury associated with the consumption of a food or foods’ (Commonwealth of Australia. National Food Incident Response Protocol. Commonwealth of Australia, Canberra, 2012). Interviews were undertaken with 105 actors working within the media, food industry and food regulatory settings across Australia, New Zealand (NZ) and the United Kingdom (UK). Interview data produced strategy statements, which indicated participant views on how to (re)build consumer trust in the food system. These included: (i) be transparent, (ii) have protocols and procedures in place, (iii) be credible, (iv) be proactive, (v) put consumers first, (vi) collaborate with stakeholders, (vii) be consistent, (viii) educate stakeholders and consumers, (ix) build your reputation and (x) keep your promises. A survey was designed to enable participants to indicate their agreement/disagreement with the ideas, rate their importance and provide further comment. The five strategies considered key to (re)building consumer trust were used to develop a model demonstrating best practice strategies for (re)building consumer trust in the food system before, during and after a food incident. In a world where the food system is increasingly complex, strategies for (re)building and fostering consumer trust are important. This study offers a model to do so which is derived from the views and experiences of actors working across the food industry, food regulation and the media