Academic literature on the topic 'Alcoholism Treatment Victoria Melbourne'

Melbourne Pathology, a subsidiary of Sonic Health Care, provided a comprehensive range of pathology services as an aid in the diagnosis and treatment of patients in Melbourne and Central Victoria. In a capped funding and highly regulated market such as the pathology service market in Australia, the only way in which the sales of a provider could grow was usually at the expense of another provider. To combat this situation, Melbourne Pathology opted to compete by providing higher quality service and faster turnaround time. The recent results of Melbourne Pathology, however, indicated that although the average turnaround time was within the promised targets, significant percentage of jobs in routine category and over 10% of jobs in the urgent category failed to meet the established targets. The case is primarily intended to illustrate the impact of demand distortions in a service setting that arise due to lack of coordination among various entities in the service value chain and a failure to have an integrated perspective that aligns all departments towards a common goal. This phenomenon is similar to the bullwhip effect in supply chains of manufactured products which has received considerable attention during the past decade. The case provides opportunities for students to develop corrective actions to mitigate this problem.

Objective: The aim of the study was to compare the efficacy of atypical and typical anti-psychotics in treating behavioural disturbance in people with psychotic disorders, in a naturalistic setting. Method: This was a prospective naturalistic study of 303 incidents of behavioural disturbance at Royal Melbourne Hospital, Melbourne, Victoria, Australia. Results: There was no significant difference between atypicals and typicals on two efficacy measures and some evidence on a third measure, that typicals are more effective. Conclusions: In the pharmacological treatment of behavioural disturbance in psychosis, typical and atypical anti-psychotics have largely comparable efficacy.

Abstract In September 2018, the Federal Court of Australia found that a Victorian woman did not need her estranged husband’s consent to undergo in vitro fertilisation treatment (IVF) using donor sperm. The woman, who was 45 years of age, made an urgent application to the Court for permission to undergo IVF using donor sperm. In a single judge ruling, Griffiths J held that the requirement in the Assisted Reproductive Treatment Act 2008 (Vic) (‘ART Act’) for a married woman to obtain the consent of her husband discriminated against the woman in question on the basis of her marital status in contravention of the Commonwealth Sex Discrimination Act 1984 (Cth) (‘SD Act’). His Honour declared the Victorian law in this instance ‘invalid and inoperable’ by operation of section 109 of the Commonwealth Constitution to the extent it was inconsistent with the Commonwealth law. Although the declarations by the Federal Court were limited in their terms to the circumstances of the case, the judgment raises broader issues about equity of access to assisted reproductive treatment (ART) in Victoria. The issue of partner consent as a barrier to access to ART was specifically raised by an independent review of the ART Act in Victoria. The Victorian Government released an interim report late last year as a first stage of the review, which canvasses some options for reform. This raises a broader question as to whether prescriptive legislation imposing detailed access requirements for ART is necessary or even helpful.

The advent of fasciotomy by intralesional collagenase injection has been a significant step forward in the treatment of Dupuytren’s contracture. While the therapeutic benefit of collagenase injection in the treatment of Dupuytren’s contracture has been established, seeking its value relative to the surgery has stimulated an interesting debate about the management of the condition, causing us to examine the results of surgery in more detail. Dupuytren’s disease and its treatment has become topical and will be the subject of the hand surgery symposium at this year’s Plastic Surgery Congress from 30 May – 1 June 2019 at the Melbourne Convention and Exhibition Centre, Victoria, Australia.

IntroductionThe ambulance clinical triage-for acute stroke treatment (ACT-FAST) algorithm is a severity based 3-step paramedic triage tool for pre-hospital recognition of large vessel occlusion (LVO), designed to improve specificity and paramedic assessment reliability compared to existing triage scales. ACT-FAST sequentially assesses 1. Unilateral arm fall to stretcher <10 s; 2a. Severe language disturbance (right arm weak), or 2b. Severe gaze deviation/hemi-neglect assessed by shoulder tap (left arm weak); 3. Clinical eligibility questions. We present the results of the ongoing Ambulance Victoria paramedic validation study.MethodsAmbulance Victoria paramedics assessed ACT-FAST in all suspected stroke patients pre-hospital in metropolitan Melbourne, Australia, and in the Royal Melbourne Hospital Emergency Department since July 2017. Algorithm results were validated against a comparator of ICA/M1 occlusion on CT-angiography with NIHSS ≥6 (Class 1 indications for endovascular thrombectomy).ResultsData were available from n=119 assessments (ED n=68, pre-hospital n=51). Patient diagnoses were LVO n=20 (15.6%), non-LVO infarcts n=45 (38.5%), ICH n=10 (8.3%) and no stroke on imaging n=44 (37.6%). ACT-FAST showed 85% sensitivity, 88.9% specificity, 60.7% (72% excluding ICH) positive predictive value and 96.7% negative predictive value for LVO. Of 10 false-positives, 4 received thrombectomy for non-Class 1 indications (basilar/M2 occlusions/cervical dissection), 3 were ICH, and 1 was tumour. Three false-negatives were LVO with milder syndromes.DiscussionThe ongoing ACT-FAST algorithm validation study shows high accuracy for clinical recognition of LVO. The streamlined algorithmic approach with just two examination items provides a more practical option for implementation in large emergency service networks. Accurate pre-hospital recognition of LVO will allow bypass to endovascular centres and early activation of neuro-intervention services to expedite endovascular thrombectomy.

BackgroundMost calls to ambulance result in emergency ambulance dispatch (direct dispatch) following primary telephone triage. Ambulance Victoria uses clinician-led secondary telephone triage for patients identified as low-acuity during primary triage to refer them to alternative care pathways; however, some are returned for ambulance dispatch (secondary dispatch). Older adult patients are frequent users of ambulance services; however, little is known about the appropriateness of subsequent secondary dispatches.ObjectivesTo examine the appropriateness of secondary dispatch through a comparison of the characteristics and ambulance outcomes of older patients dispatched an emergency ambulance via direct or secondary dispatch.DesignA retrospective cohort study of ambulance patient data between September 2009 and June 2012 was conducted.SettingThe secondary telephone triage service operated in metropolitan Melbourne, Victoria, Australia during the study period.ParticipantsThere were 90 086 patients included aged 65 years and over who had an emergency ambulance dispatch via direct or secondary dispatch with one of the five most common secondary dispatch paramedic diagnoses.Main outcome measuresDescriptive analyses compared characteristics, treatment and transportation rates between direct and secondary dispatch patients.ResultsThe dispatch groups were similar in demographics, vital signs and hospital transportation rates. However, secondary dispatch patients were half as likely to be treated by paramedics (OR 0.51; CI 0.48 to 0.55; p<0.001). Increasing age was associated with decreasing treatment (p<0.005) and increasing transportation rates (p<0.005).ConclusionSecondary triage could identify patients who would ultimately be transported to an emergency department. However, the lower paramedic treatment rates suggest many secondary dispatch patients may have been suitable for referral to alternative low-acuity transport or referral options.

AbstractIn 1887 Qing Imperial Commissioners General Wong Yung Ho and U Tsing visited Melbourne as part of an investigative mission to enquire into the treatment of Chinese imperial subjects in Southeast Asia and the Australian colonies. In this article I suggest that the political ramifications of their visit should be understood in the context of the larger imperial and national contestations occurring in the colony of Victoria in the 1880s. White colonial assertions of the rights of self-government — argued in defiance of imperial power both British and Chinese — and Chinese appeals to international law were antagonistic, but mutually constitutive claims. The more Chinese community leaders and the Imperial Commissioners appealed to the primacy of international law, the more strident were white colonial invocations of a newly defined national interest couched in a republican discourse on national sovereignty defined as border protection.

Since April 1997, in Melbourne, Australia, speech pathologists have collaborated to establish a prospective database of functional outcomes of speech, swallowing and voice for patients undergoing head and neck cancer treatments.Staff at eight acute care hospitals, all of which offer speech pathology for head and neck cancer services in Victoria, are contributing data, collated centrally, in an agreed pro forma.Early results are given (after 12 months’ data collection). The implications for clinically-based research, and the future potential for benchmarking outcomes – by expansion of the rehabilitation database beyond the current participating sites – is discussed.This paper outlines the rationale of establishing the database is multicentred, and explores some of the complexities involved, including the challenges inherent in long-term accurate data collection in the head and neck cancer patient population. This work represents the development of an appropriate, usable tool for data collection on functional outcomes.

Urban drainage systems historically were developed on principles of hydraulic capacity for the transport of storm water to reduce the risk of flooding. However, with urbanization the percent of impervious surfaces increases dramatically resulting in increased flood volumes, peak discharge rates, velocities and duration, and a significant increase in pollutant loads. Storm water and urban runoff are the leading causes of the impairment of receiving waters and their beneficial uses in Australia and the United States today. Strict environmental and technology controls on wastewater treatment facilities and industry for more than three decades have ensured that these sources are less significant today as the cause of impairment of receiving waters. This paper compares the approach undertaken by the Environmental Protection Authority Victoria for the Melbourne metropolitan area with the approach implemented by the California Environmental Protection Agency for the Los Angeles area to control storm water pollution. Both these communities are largely similar in population size and the extent of urbanization. The authors present an analysis of the different approaches contrasting Australia with the USA, comment on their comparative success, and discuss the relevance of the two experiences for developed and developing nations in the context of environmental policy making to control storm water and urban runoff pollution.

Chlamydia is the most common notifiable infectious disease in Australia with the number of notifications increasing 92% over the past 5 years. The "Sex and Sport" Project is piloting a community based chlamydia testing and treatment program reaching young people in a specific community setting, sporting clubs. This multifaceted approach utilises health education, population screening and collection of data on risk taking behaviour as the first steps in enhancing health and shaping future service provisions. The project's primary aim is to assess the feasibility of an outreach testing and treatment program. Secondary aims are to measure the prevalence of chlamydia and assess sexual risk behaviour in this population. Strong community collaborations and integration into local health services through the Primary Care Partnerships is important in the project's sustainability; in particular key community members respected by sporting clubs needed to be identified, capacity developed to deliver effective health promotion messages and improve young people's access to sexual health services. Additionally, local knowledge has guided overall program implementation and provides opportunities for capacity building to regionally based services. For example, poor access to sexual health services is being addressed by the participants being able to access services via telephone consultation with Melbourne Sexual Health Centre. Approximately 1000 Victorians aged 16-25 years from the Loddon Mallee region of Victoria will be tested between June and September 2007. This paper will report on the feasibility, challenges and possible solutions in establishing a community based outreach testing and treatment program.

Throughout this guide, we have tried to explain all parts of a first episode of psychosis in a detailed way. But what happens if you know someone who may be experiencing an episode of psychosis and you have to act fast or help them get into treatment? This last chapter includes advice on how to provide mental health “first aid” to those who may be experiencing an episode of psychosis. These guidelines were developed by and reprinted here with permission from Professor Anthony Jorm and Ms. Betty Kitchener from the University of Melbourne and ORYGEN Research Centre in Melbourne, Victoria, Australia. As a result of an extensive process, they are based on the agreement of a panel of patients, family members, and mental health professionals from Australia, Canada, New Zealand, the United Kingdom, and the United States. For more information on their Mental Health First Aid program, please visit www.mhfa.com.au. The remainder of this chapter is organized around nine questions that are addressed to help people who may need to provide “first aid” to someone experiencing psychosis. The purpose of these guidelines is to help members of the public to provide first aid to someone who may be experiencing psychosis. The role of the first aider is to assist the person until he or she receives appropriate professional help or the crisis resolves. These guidelines are a general set of recommendations about how you can help someone who may be experiencing psychosis. Each individual is unique, and it is important to tailor your support to that person’s needs. So, these recommendations will not be appropriate for every person who may have psychosis. It is important to learn about the early warning signs of psychosis and the symptoms of psychosis so that you can recognize when someone may be developing psychosis. Although some of these signs may not be very dramatic on their own, when you consider them together, they may suggest that something is not quite right. It is important not to ignore or dismiss such warning signs or symptoms, even if they appear gradually and are unclear.

Most of the time, people of all different ages and with all sorts of mental illnesses go to the same place to see a doctor, get medicines, or participate in counseling. That is, they go to mental health clinics or the office of a mental health professional that provides treatments for a number of different illnesses. Most young people who have psychosis get their medical care and treatment in a hospital, clinic, or doctor’s office. In these places, the doctors and other mental health professionals may have taken special classes about how to help young people with psychosis, but that may not be their only focus. They may see people with other illnesses too. However, in some places around the world, there are special clinics that are for people in the early stages of psychosis. These types of specialized programs have been developed recently, since the 1990s. These programs have a number of different types of mental health professionals, including psychiatrists, psychologists, nurses, social workers, counselors, and others. In some programs, mental health professionals and doctors in training may rotate through the clinic spending several months at a time training in the clinic. Some programs, like the Early Psychosis Prevention and Intervention Centre (EPPIC) in Melbourne, Victoria, Australia, operate within the framework of a youth health service. Such youth services treat all sorts of mental health issues in young people. Other programs are located primarily in adult mental health facilities. Such programs may offer classes or group meetings just for people who recently developed psychosis and other classes or group meetings especially for the families of these young people. Typically, these programs provide someone with 2–3 years of treatment. They usually do a full evaluation of the patient every few months and keep track of how he or she is doing. If the patient needs more care afterwards, they help him or her find another program for longer-term care. In this chapter, we list some of these clinics located in various parts of the world and describe what these specialized early psychosis programs provide.

EXPERIMENTAL STUDY OF MICROWAVE SLOW WAVE COMB AND CERAMIC APPLICATORS FOR SOIL TREATMENT AT FREQUENCY 2.45 GHZ. G. Brodie and G. Torgovnikov University of Melbourne, 4 Water St, Creswick, Victoria 3363, Australia; e-mail: grigori@unimelb.edu.au Keywords: ceramic applicator, comb applicator, microwave, slow wave, soil microwave treatment In many cases in industry it is required to heat or treat surface layers of different material (soil, timber, concrete, plastics and so on) with microwaves (MW). Traditional MW irradiators (antennas) cannot provide heating only in the surface areas and energy penetrates deep into the material, where it decays exponentially due to normal attenuation. Therefore, energy losses, if a heating depth of 20 - 40 mm (for example to heat soil for killing weed seeds) is all that is required, are very significant. Therefore, it is required to develop special MW applicators for surface treatment to increase process efficiency. To address this problem, a slow wave (which is sometimes called a "surface wave" applicator) comb and ceramic structures, was studied. The main property of slow waves is that the energy concentration is very near impedance electrode – comb or ceramic plate surface. Previously, slow wave structures were used mostly as delay lines and as interaction circuits in MW vacuum devices, and their properties were explored only for these specific applications. The work objectives of this study were: design slow wave, ceramic and comb structure applicators for soil treatment at frequency 2.45 GHz;experimentally study the energy distribution from slow wave applicators in the soil;study of opportunities to use slow wave structures for surface soil layer heating; andrecommendations for practical use of new slow wave applicators. Comb and ceramic slab applicators for frequency 2.45 GHz operation were designed for the soil treatment on the bases of theoretical studies and computer modelling. The comb applicator was made from aluminium and the ceramic slab applicator was made from alumina (DC=9.8, loss tangent=0.0002). A 30 kW (2.45 GHz) microwave generator was used for experiments. Containers with soil were placed on the applicator surface. An auto tuner was used in MW system to provided good impedance matching of the generator and applicators (with soil on top). This resulted in practically no power reflection. The soil “Potting Mix Hortico”, with moisture content range 32-174% and density range 590-1070 kg/m3, was used for the experiments. Energy distribution in the soil was determined by temperature measuring in the soil using thermocouples, after MW heating. Distribution of temperature measuring points covered the whole volume of the soil along and across the applicator. Results of the experiments showed that the comb applicator provides maximum energy release in soil in the central vertical plane. The ceramic alumina applicator forms two temperature maximums in two vertical planes at a distance of about 40 mm from the central applicator plane and a minimum in the applicator central plane. The ceramic applicator provides better uniformity of energy distribution across the width of the applicator due to the two temperature maximums. It reduces overheating of the soil surface and energy losses. The depth of energy penetration provided by ceramic applicator is lower compared with the comb applicator. It means that the ceramic applicator provides better energy localization and more energy absorption in the soil surface layers compared with the comb applicator. To provide better uniformity of energy distribution across the ceramic applicator it is recommended to use ceramics with higher dielectric constants, such as in the range of 15-25, which will allow more energy to be released closer to the applicator surface. It will increase efficiency of MW energy use. The ceramic applicator is more effective for MW treatment of the soil surface areas and is recommended for practical use in machines for thermal treatment and sterilization of surface layers of the soil and other materials.