8 research outputs found
Cost savings from a telemedicine model of care in northern Queensland, Australia
No full textOBJECTIVE: To conduct a cost analysis of a telemedicine model for cancer care (teleoncology) in northern Queensland, Australia, compared with the usual model of care from the perspective of the Townsville and other participating hospital and health services. DESIGN: Retrospective cost–savings analysis; and a one-way sensitivity analysis performed to test the robustness of findings in net savings. PARTICIPANTS AND SETTING: Records of all patients managed by means of teleoncology at the Townsville Cancer Centre (TCC) and its six rural satellite centres in northern Queensland, Australia between 1 March 2007 and 30 November 2011. MAIN OUTCOME MEASURES: Costs for set-up and staffing to manage the service, and savings from avoidance of travel expenses for specialist oncologists, patients and their escorts, and for aeromedical retrievals. RESULTS: There were 605 teleoncology consultations with 147 patients over 56 months, at a total cost of 36 000, equipment/maintenance was 261 520. The estimated travel expense avoided was 658 760, aeromedical retrievals of 47 634, as well as an estimate of accommodation costs for a proportion of patients of 320 118. Costs would have to increase by 72% to negate the savings. CONCLUSION: The teleoncology model of care at the TCC resulted in net savings, mainly due to avoidance of travel costs. Such savings could be redirected to enhancing rural resources and service capabilities. This teleoncology model is applicable to geographically distant areas requiring lengthy travel.Darshit A Thaker, Richard Monypenny, Ian Olver, Sabe Sabesa
Attitudes, knowledge and barriers to participation in cancer clinical trials among rural and remote patients
No full textAim: To assess the knowledge of randomized clinical trials and willingness and barriers to participation among rural, remote and regional cancer patients of North Queensland.
Methods: A survey was conducted in medical oncology outpatient clinics at the Townsville and Mt Isa hospitals on patients, following their informed consent, using questionnaires. Rurality was defined according to the rural remote and metropolitan area classification.
Results: Of the 180 patients approached, 178 participated. The median distance to the regional trial center for rural participants was 180 km (range 80–1300 km). 45.4% lived in rural or remote areas and the rest lived in Townsville, a regional metropolitan center. Their overall knowledge was low, with a median knowledge score of 3 (inter-quartile ranges n = 2.5). For randomized controlled trials there were no significant relationships between willingness to participate and rurality or education level (P = 0.981). Cost of travel (41.1% rural or remote; 23.5% regional; P < 0.001) and the need for family or friends to accompany them (38.9% rural or remote; 24.1% regional, P = 0.021) were more important for rural/remote than regional patients as factors affecting participation.
Conclusion: Rural and remote patients are as interested in participating in randomized clinical trials as regional patients. Their knowledge of trials is poor and education earlier in the consultations is needed. Since cost of travel and the need for family members to accompany them are important for rural patients trial budgets should include the cost of travel to encourage participation
The nuts and bolts of pills and potions: the functions of a drug safety working group
No full textHospitalised patients commonly experience adverse drug events (ADEs) and medication errors. Runciman reported that ADEs in hospitals account for 20% of reported adverse events and contribute to 27% of deaths where death followed an adverse event. Hughes recommends multidisciplinary hospital drug committees to assess performance and raise standards. The new Code of Conduct of the Medical Board of Australia recommends participation in systems for surveillance and monitoring of adverse events, and to improve patient safety.Wedescribe the functions and role of a Drug Safety Working Group (DSWG) in a suburban hospital, which aims to audit and promote a culture of prescribing and medication administration that is prudent and cautious to minimise the risk of harm to patients. We believe that regular prescription monitoring and feedback to Resident Medical Officers (RMOs) improves medication management in our hospital
Implementing a highly accessible model of screening and assessment in geriatric oncology: Our experience
No full textEvaluation of a virtual meeting platform for state-wide oncology education during the COVID-19 pandemic
No full textIntroduction: Due to COVID-19 restrictions, face-to-face educational meetings and conferences have either been delayed or cancelled. Continuing oncology professional education is vital and virtual platforms are increasingly being used to facilitate delivery.
Methods: We organised a virtual meeting for Queensland oncologists, trainees and pharmaceutical representatives to share updates from the American Society of Clinical Oncology 2020 virtual meeting. The meeting was conducted on the Microsoft Teams™ platform on a Saturday as a single-day event, organised in eight separate 45-minute tumour-streamed presentations. An online feedback survey was sent to all attendees following the meeting.
Results: A total of 96 participants attended the live meeting, which comprised report-back presenters, formal discussants, and concurrent sidebar chat interaction. Median number of active participants via chat feature per session was 13 (range, 8–18). Our survey had respondents, of whom 84% attended the live session.
For future meetings, virtual delivery was the most favoured meeting format (by 45% responders), followed by face-to-face weekend event (31%) and dinner meeting (23%).
The main perceived advantages reported of virtual delivery included: facilitation of remote attendance including from regional centres; the sidebar chat format which allowed concurrent, non-interruptive discussion by attendees; and the convenience of selective attendance of sessions of interest.
The most common suggestions for improvement were related to meeting logistics: restructuring content delivery in the interests of time efficiency, and to enable recording for on-demand viewing.
Conclusion: A virtual meeting platform proved to be convenient method for online oncology education. Based on the satisfaction rates and feedback, it will likely have an ongoing role in future meetings even after the COVID-19 pandemic.No Full Tex
AGITG MONARCC: A Randomized Phase 2 Study of Panitumumab Monotherapy and Panitumumab Plus 5-Fluorouracil as First-Line Therapy for Older Patients With RAS and BRAF Wild Type Metastatic Colorectal Cancer. A Study by the Australasian Gastro-Intestinal Trials Group (AGITG)
No full textBackground
Panitumumab (pan) plus chemotherapy is a preferred first-line therapy for unresectable RAS and BRAF wild type metastatic colorectal cancer (mCRC). Older patients may not be suitable for combination regimens. We investigated 2 lower intensity pan-containing regimens.
Methods
Prospective, noncomparative, randomized (1:1) phase 2 study of pan alone (Arm A) or pan plus FU (Arm B). Previously untreated mCRC were ≥70 years; RAS/BRAF wild type. Primary endpoint: 6-month progression-free survival (PFS). Secondary endpoints included: overall survival (OS), response rate (RR), feasibility of geriatric assessments and overall treatment utility (OTU)—a composite measure based on radiological response, clinical progress, toxicity and patient-reported treatment worth. Planned sample size was 40 patients per arm.
Results
36 patients (Arm A n = 19, Arm B n = 17) were randomized between June 2018 and June 2021. Median age was 79 and 80 years respectively. 6-month PFS 63% (95% CI 38%-80%) arm A 82% (95%CI 55%-94%) Arm B. Median OS 21 months Arm A (95%CI 13-31) 28 (95%CI 14-39) months Arm B. RR 47% and 65% Arms A and B respectively. Baseline comprehensive geriatric assessments were completed in >80% of patients. At week 16, OTU was categorized as good in 92% (Arm A) and 90% (Arm B). No unexpected adverse events were seen.
Conclusions
Six-month PFS in both arms was consistent with that achieved with FU/bev, whilst the rate was numerically higher for Arm B. Baseline comprehensive geriatric assessments were feasible and OTU was high. Both treatment arms might be suitable in appropriately selected patients.No Full Tex
Design, construction, and control of a 3d printed Diwheel prototype
No full textThis project extends beyond the successful realization of a 3D-printed Diwheel prototype by meticulously guiding the process from concept to completion. The initial
stages involved a thorough review of existing Diwheel designs and the application of
modular 3D printing techniques, culminating in the creation of a fully functional prototype. By employing advanced system identification methods, a dynamic model was developed to accurately represent the behavior of the Diwheel. This model enabled the implementation of control strategies, ensuring stable and responsive operation across various conditions, demonstrating the effectiveness of the design and
control techniques.1 Introduction 2
1.1 Problem Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
1.2 Justification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
1.3 Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
1.3.1 General objective . . . . . . . . . . . . . . . . . . . . . . . . . 6
1.3.2 Specific objectives . . . . . . . . . . . . . . . . . . . . . . . . . 6
1.4 State of the art . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
1.5 Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
2 Design and construction of a 3D printed Diwheel 10
2.1 Preliminary design of the 3D printed Diwheel . . . . . . . . . . . . . 10
2.2 GearBox preliminary design . . . . . . . . . . . . . . . . . . . . . . . 12
2.3 Optimization of 3D printing parameters . . . . . . . . . . . . . . . . 14
3 System Identification of a 3D Printed Diwheel 17
3.1 Least Squares Algorithm . . . . . . . . . . . . . . . . . . . . . . . . . 17
3.2 Least Squares Algorithm Implementation . . . . . . . . . . . . . . . . 18
3.2.1 Chassis Angle Behavior . . . . . . . . . . . . . . . . . . . . . . 18
3.2.2 Wheel Translation Behavior . . . . . . . . . . . . . . . . . . . 20
4 Analysis and Control of a 3D Printed Diwheel 22
4.1 Basic control actions . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
4.1.1 Proportional, Integral and Derivative (PID) Control Action . . 22
4.2 Control System Implementation . . . . . . . . . . . . . . . . . . . . . 23
4.2.1 Chassis Angle Control . . . . . . . . . . . . . . . . . . . . . . 23
4.2.2 Wheel Translation Control . . . . . . . . . . . . . . . . . . . . 24
5 Conclusions and Final Remarks 26
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vii Contents
A Explanation of the Arduino Code for Diwheel Control 27
A.1 Input and Output Pin Definitions . . . . . . . . . . . . . . . . . . . . 27
A.2 Global Variables for Encoder and Motor Control . . . . . . . . . . . . 27
A.3 Motor Initialization . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
A.4 Gyroscope Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
A.5 PID Control for Gyroscope and Motors . . . . . . . . . . . . . . . . . 28
A.6 Encoder Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
A.7 Bluetooth Communication . . . . . . . . . . . . . . . . . . . . . . . . 29
A.8 Basic Movement Control . . . . . . . . . . . . . . . . . . . . . . . . . 31
A.9 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
B Arduino Connection 32PregradoIngeniero(a) Electricist
