30913 research outputs found
Sort by
Developing a Third-Party Analytics Application Using Australia’s National Personal Health Records System: Case Study
Get PDFThis is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Medical Informatics, is properly cited. The complete bibliographic information, a link to the original publication on http://medinform.jmir.org/, as well as this copyright and license information must be included.Background: My Health Record (MyHR) is Australia’s national electronic health record (EHR) system. Poor usability and
functionality have resulted in low utility, affecting enrollment and participation rates by both patients and clinicians alike. Similar
to apps on mobile phone app stores, innovative third-party applications of MyHR platform data can enhance the usefulness of
the platform, but there is a paucity of research into the processes involved in developing third-party applications that integrate
and use data from EHR systems.
Objective: The research describes the challenges involved in pioneering the development of a patient and clinician Web-based
software application for MyHR and insights resulting from this experience.
Methods: This research uses a case study approach, investigating the development and implementation of Actionable Intime
Insights (AI2), a third-party application for MyHR, which translates Medicare claims records stored in MyHR into a clinically
meaningful timeline visualization of health data for both patients and clinicians. This case study identifies the challenges encountered
by the Personal Health Informatics team from Flinders University in the MyHR third-party application development environment.
Results: The study presents a nuanced understanding of different data types and quality of data in MyHR and the complexities
associated with developing secondary-use applications. Regulatory requirements associated with utilization of MyHR data,
restrictions on visualizations of data, and processes of testing third-party applications were encountered during the development
of the application.
Conclusions: This study identified several processes, technical and regulatory barriers which, if addressed, can make MyHR a
thriving ecosystem of health applications. It clearly identifies opportunities and considerations for the Australian Digital Health
Agency and other national bodies wishing to encourage the development of new and innovative use cases for national EHRs.NB is supported by funding from Country Health SA. The study was supported by grants from Country Health SA and Flinders
ED IAPT service
A systematic review of interventions to support the careers of women in academic medicine and other disciplines
Get PDFNo commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/Objective To summarise quantitative evaluations of interventions designed to support the careers of women in academia of any discipline.
Method A systematic search of English entries in PubMed, CINAHL and Google Scholar was conducted in September 2017. Methodological quality of the studies was independently assessed by two authors using the Joanna Briggs Institute quality appraisal checklists. Meta-analysis was not possible due to heterogeneity in methods and outcomes; results were synthesised and displayed narratively.
Results Eighteen eligible studies were identified, mostly evaluating programmes in academic medicine departments. The most common interventions were mentoring, education, professional development and/or networking programmes. All programmes took a ‘bottom-up’ approach in that women were responsible for opting into and devoting time to participation. Study quality was low overall, but all studies reported positive outcomes on at least one indicator. Most often this included improvements in self-rated skills and capabilities, or satisfaction with the programme offered. Results regarding tangible outcomes were mixed; while some studies noted improvements in promotion, retention and remuneration, others did not.
Conclusions This review suggests that targeted programmes have the potential to improve some outcomes for women in academia. However, the studies provide limited high-quality evidence to provide information for academic institutions in terms of the best way to improve outcomes for women in academia. The success of an intervention appears to be undermined when it relies on the additional labour of those it is intending to support (ie, ‘bottom-up’ approaches). As such, academic institutions should consider and evaluate the efficacy of ‘top-down’ interventions that start with change in practice of higher management.This research received no specific grant from any funding agency in the
public, commercial or not-for-profit sectors
The link between domestic violence and abuse and animal cruelty in the intimate relationship of people of diverse genders and/or sexualities: a bi-national study
Get PDFThis manuscript version is made
available under the CC-BY-NC-ND 4.0 license http://
creativecommons.org/licenses/by-nc-nd/4.0/Over the past three decades, a growing body of research has focused on experiences of domestic violence and abuse (DVA) among people of diverse genders and/or sexualities. Missing, however, has been a focus on what is known as “the link” between DVA and animal cruelty with regard to people of diverse genders and/or sexualities. The present article reports on a study of 503 people living in either Australia or the United Kingdom, who reported on both their intimate human relationships and their relationships with animals, including relationships that were abusive. In terms of “the link,” a fifth of respondents who had experienced violence or abuse also reported that animal cruelty had been perpetuated by the violent or abusive partner. Statistical interactions were found between having witnessed animal cruelty perpetrated by a partner, gender and sexuality, and both psychological distress and social connectedness. Female participants who had witnessed animal cruelty reported greater psychological distress and lower levels of social support, and both lesbian and bisexual participants who had witnessed animal cruelty reported lower levels of social support. The article concludes by considering the implications of these findings for future research and service provision.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: No funding was received for the project reported in this article, although the first author was supported by an Australian Research Council Future Fellowship, FT130100087
Making matter matter: Meanings accorded to genetic material among Australian gay men
Get PDF© 2018 The Author. Published by Elsevier Inc.This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.As growing numbers of gay men enter into the reproductive realm, opportunities emerge for the rewriting or revision of kinship ties. Given the hegemonic status of genetic matter in the context of kinship, however, it is perhaps unsurprising that, amongst gay men, there are complex negotiations over how, and in what instances, genetic matter will be made to matter. This paper explores the question of genetic matter in the context of gay men's reproductive journeys by examining data from three studies: (i) an interview study with men who had donated sperm; (ii) an interview study with people who had entered into surrogacy arrangements; and (iii) a study of news media and blogs that document the experiences of people who have entered into surrogacy arrangements. Focusing solely on the gay men in these three studies, four thematic contexts were identified in which genetic matter was made salient with regard to kinship: (i) claiming kinship in the context of sperm donation; (ii) couples negotiating genetic matter in the context of surrogacy arrangements; (iii) minimizing the genetic contribution of women who act as egg donors; and (iv) controlling the flow of information about genetic matter to children. This paper concludes by suggesting the need for both the decentring of genetic matter in reproduction amongst gay men (e.g. exploring alternate routes to parenthood), and the recentring of genetic matter in instances where genetic relatedness is the basis of kinship (e.g. acknowledging the roles, needs and lifeworlds of all parties).The research reported in this paper was funded by a University of Adelaide Faculty of Health Sciences Research Grant, an Australian Research Council Discovery Project Grant (DP110101893) and an Australian Research Council Future Fellowship (FT130100087)
Inactivation of Serotonergic Neurons in the Rostral Medullary Raphé Attenuates Stress-Induced Tachypnea and Tachycardia in Mice
Get PDFNote: This article was submitted to
Integrative Physiology,
a section of the journal
Frontiers in Physiology.
This is an open-access article distributed under the terms of the Creative Commons
Attribution License (CC BY). The use, distribution or reproduction in other forums
is permitted, provided the original author(s) and the copyright owner(s) are credited
and that the original publication in this journal is cited, in accordance with accepted
academic practice. No use, distribution or reproduction is permitted which does not
comply with these terms.The medullary raphé nuclei are involved in controlling cardiovascular, respiratory, and thermoregulatory functions, as well as mediating stress-induced tachycardia and hyperthermia. Although the serotonergic system of the medullary raphé has been suggested as the responsible entity, specific evidence has been insufficient. In the present study, we tested this possibility by utilizing an optogenetic approach. We used genetically modified mice [tryptophan hydroxylase 2 (Tph2); archaerhodopsin-T (ArchT) mice] in which ArchT, a green light-driven neuronal silencer, was selectively expressed in serotonergic neurons under the regulation of Tph2 promoters. We first confirmed that an intruder stress selectively activated medullary, but not dorsal or median raphé serotonergic neurons. This activation was suppressed by photo-illumination via a pre-implanted optical fiber, as evidenced by the decrease of a cellular activation marker protein in the neurons. Next, we measured electro cardiogram (ECG), respiration, body temperature (BT), and locomotor activity in freely moving mice during intruder and cage-drop stress tests, with and without photo-illumination. In the intruder test, photo inactivation of the medullary serotonergic neurons significantly attenuated tachycardia (362 ± 58 vs. 564 ± 65 bpm.min, n = 19, p = 0.002) and tachypnea (94 ± 82 vs. 361 ± 138 cpm.min, n = 9, p = 0.026), but not hyperthermia (1.0 ± 0.1 vs. 1.0 ± 0.1∘C.min, n = 19, p = 0.926) or hyperlocomotion (17 ± 4 vs. 22 ± 4, arbitrary, n = 19, p = 0.089). Similar results were obtained from cage-drop stress testing. Finally, photo-illumination did not affect the basal parameters of the resting condition. We conclude that a subpopulation of serotonergic neurons in the medullary raphé specifically mediate stress-induced tachypnea and tachycardia, which have little involvement in the basal determination of respiratory frequency (Res) and heart rate (HR), specifically mediate stress-induced tachycardia and tachypnea.This work was supported by JSPS KAKENHI Grants (16H05130,
16K13112 to TK and 18K07353 to IK-Y), CREST JST
(JPMJCR1656 to AY), and Research Foundation for Opto-Science
and Technology (to IK-Y)
Dysregulation of neuronal iron homeostasis as an alternative unifying effect of mutations causing familial Alzheimer's dsease
Get PDFNote: This article was submitted to
Neurodegeneration,
a section of the journal
Frontiers in Neuroscience. This is an open-access article distributed under the terms of the
Creative Commons Attribution License (CC BY). The use, distribution or
reproduction in other forums is permitted, provided the original author(s)
and the copyright owner(s) are credited and that the original publication in
this journal is cited, in accordance with accepted academic practice. No use,
distribution or reproduction is permitted which does not comply with these
terms.The overwhelming majority of dominant mutations causing early onset familial
Alzheimer’s disease (EOfAD) occur in only three genes, PSEN1, PSEN2, and APP. An
effect-in-common of these mutations is alteration of production of the APP-derived
peptide, amyloid β (Aβ). It is this key fact that underlies the authority of the Amyloid
Hypothesis that has informed Alzheimer’s disease research for over two decades. Any
challenge to this authority must offer an alternative explanation for the relationship
between the PSEN genes and APP. In this paper, we explore one possible alternative
relationship – the dysregulation of cellular iron homeostasis as a common effect
of EOfAD mutations in these genes. This idea is attractive since it provides clear
connections between EOfAD mutations and major characteristics of Alzheimer’s disease
such as dysfunctional mitochondria, vascular risk factors/hypoxia, energy metabolism,
and inflammation. We combine our ideas with observations by others to describe a
“Stress Threshold Change of State” model of Alzheimer’s disease that may begin to
explain the existence of both EOfAD and late onset sporadic (LOsAD) forms of the
disease. Directing research to investigate the role of dysregulation of iron homeostasis
in EOfAD may be a profitable way forward in our struggle to understand this form of
dementia.JR was supported by grants from the Michael J. Fox Foundation
(Grant ID: 15468), the United States National Institutes
of Health (NIH 5R01MH102279-03, NIH 1R01AG056614-
01, and R21NS077079) and a Zenith Grant from the
Alzheimer’s Association. MN and ML are supported by a
grant from Australia’s National Health and Medical Research
Council (NHMRC), GNT1126422 and a donation from
the Carthew family. GS received support from a Sydney
Medical School Mid-career research Accelerator grant.
GV was supported by NHMRC grants GNT1045507 and
GNT1105698
How I became… and We and I Can't Attend and Ode to Sadness
No full textFour poems: How I became… and We and I Can't Attend and Ode to Sadnes
The Hunchback in the Park Watching Dylan Thomas
Get PDFPoem: The Hunchback in the Park Watching Dylan Thoma
