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1

Mansfield, Sarah J., Frances Quirk, Kathryn von Treuer, and Gerard Gill. "On the right path? Exploring the experiences and opinions of clinicians involved in developing and implementing HealthPathways Barwon." Australian Health Review 40, no. 2 (2016): 129. http://dx.doi.org/10.1071/ah15009.

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The aims of this paper are to present the findings of a process evaluation exploring the experiences and opinions of clinicians who have been involved in the HealthPathways Barwon clinical workgroups and discuss implications for further development of the program, as well as regional health service initiatives more broadly. HealthPathways Barwon is a web-based program comprising locally agreed-upon evidence-based clinical pathways that assist with assessment, management and region-specific referral for various clinical conditions. Clinical workgroup members participated in focus groups. Coding and thematic analysis were performed and findings were compared with similar evaluations of HealthPathways in other jurisdictions. Five broad themes emerged from the focus group, each with several subthemes: (1) purpose of HealthPathways; (2) workgroup process; (3) barriers and facilitators to HealthPathways use; (4) impact of HealthPathways on clinical practice; and (5) measuring performance. Findings of particular interest were that the perceived drivers for implementation of HealthPathways Barwon are broad, HealthPathways Barwon is viewed positively by clinicians, the workgroup process itself has a positive impact on relationships between primary and secondary care clinicians, existing habits of clinicians are a major barrier to adoption of HealthPathways Barwon, the sustainability of HealthPathways Barwon is a concern and it is difficult to measure the outcomes of HealthPathways. Although HealthPathways Barwon is viewed positively by clinicians and is seen to have the potential to address many issues at the primary–secondary care interface, successful implementation and uptake will depend on buy-in from clinicians, as well as continuous evaluation to inform improved development and implementation. More broadly, health service initiatives like HealthPathways Barwon require longer-term certainty of funding and administration to become established and produce meaningful outcomes. What is known about this topic? HealthPathways is a program that has been implemented in Canterbury, New Zealand, and several regions in Australia. Early evaluations in these jurisdictions have found that measuring the impact of the program is challenging, and there is little evidence of the program’s influence on health system performance indicators such as waiting times. However they have found some evidence of improved collaboration between primary and secondary care clinicians and improved clinician experience in providing patient care. What does the paper add? This case study outlines a potential method of evaluation of HealthPathways, as well as some early evidence regarding the experiences of those developing, implementing and using the program in the Barwon region in South-West Victoria. What are the implications for practitioners? HealthPathways Barwon may impact positively on clinician-clinician relationships and confidence, however getting more clinicians to use the program may require identification of ways to better incorporate HealthPathways use into their existing clinical information sourcing and referral routines. Additionally, HealthPathways Barwon’s future depends on recruitment of more clinicians to develop and update pathways.
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Fitzsimons, J., T. Lambert, S. Dodd, C. Pantelis, T. Callaly, B. Kuluris, and M. Berk. "Clozapine and cardiotoxicity: echocardiography findings from Barwon Health." Acta Neuropsychiatrica 18, no. 6 (December 2006): 249–50. http://dx.doi.org/10.1017/s0924270800030246.

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Ritchie, Ann, and Helen Skoglund. "Ebooks at Barwon Health Library: a case study." Australian Library Journal 64, no. 3 (July 3, 2015): 180–93. http://dx.doi.org/10.1080/00049670.2015.1048042.

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4

Mann, J. "ACP at Barwon health - a community program in a Victorian regional health service." BMJ Supportive & Palliative Care 1, no. 1 (June 1, 2011): 77. http://dx.doi.org/10.1136/bmjspcare-2011-000053.39.

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5

Williams, Lana J., Amanda L. Stuart, Michael Berk, Sharon L. Brennan-Olsen, Jason M. Hodge, Stephanie Cowdery, Vinoomika Chandrasekaran, and Julie A. Pasco. "Bone health in bipolar disorder: a study protocol for a case–control study in Australia." BMJ Open 10, no. 2 (February 2020): e032821. http://dx.doi.org/10.1136/bmjopen-2019-032821.

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IntroductionLittle is known about the bone health of adults with bipolar disorder, aside from evidence purporting bone deficits among individuals with other mental illnesses, or those taking medications commonly used in bipolar disorder. In this paper, we present the methodology of a case–control study which aims to examine the role of bipolar disorder as a risk factor for bone fragility.Methods and analysisMen and women with bipolar disorder (~200 cases) will be recruited and compared with participants with no history of bipolar disorder (~1500 controls) from the Geelong Osteoporosis Study. Both cases and controls will be drawn from the Barwon Statistical Division, south-eastern Australia. The Structured Clinical Interview for DSM-IV-TR Research Version, Non-patient edition is the primary diagnostic instrument, and psychiatric symptomatology will be assessed using validated rating scales. Demographic information and detailed lifestyle data and medical history will be collected via comprehensive questionnaires. Participants will undergo dual energy X-ray absorptiometry scans and other clinical measures to determine bone and body composition. Blood samples will be provided after an overnight fast and stored for batch analysis.Ethics and disseminationEthics approval has been granted from Barwon Health Research Ethics Committee. Participation in the study is voluntary. The study findings will be disseminated via peer-reviewed publications, conference presentations and reports to the funding body.
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Austin, Sandy, Rob Kennedy, and Paul Napper. "The value of local area planning." Australian Health Review 28, no. 3 (2004): 317. http://dx.doi.org/10.1071/ah040317.

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The following case study describes the Barwon Primary Care Forum (BPCF) model for local area planning and the value this model has brought to the member agencies. The model was developed from a locally identified need for social planning which historically had resulted in numerous community consultations and needs assessments, often duplicative and potentially burdensome to the community. The process for this local area planning model is described in detail.
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Gill, Stephen D., Sarah Mansfield, Margie McLeod, Kathryn von Treuer, Matthew Dunn, and Frances Quirk. "HealthPathways improving access to care." Australian Health Review 43, no. 2 (2019): 207. http://dx.doi.org/10.1071/ah17090.

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Objective HealthPathways (HPW) is an international web-based information portal that provides health practitioners with guidelines and referral pathways to specialists and services. The present study explored usage of HPW by general practitioners (GPs) in the Barwon region, south-west Victoria, and any benefits and barriers to its use. Methods Approximately 421 GPs provide services in 86 clinics across the Barwon region, south-west Victoria and Barwon Health is the public health service providing acute, subacute, residential aged care and community health services to approximately 350000 people. The present study was a mixed-methods analysis of all GPs in the region, who were invited to complete a survey in two waves (2014 and 2016) and participate in focus groups. Data were survey/questionnaire (fixed response and free text options, analysed with descriptive statistics and content analysis), and focus groups (interview and facilitated group discussion, analysed using the principles of thematic analysis). Results Most GPs surveyed used HPW and usage increased over time from 2014 to 2016 (67% vs 77% respectively). Junior GPs used HPW more often than the more experienced practitioners. GPs reported that HPW was easy to access and navigate, improved their knowledge of local services, improved their confidence, changed their clinical management and saved them time. Main barriers to use of HPW were: GPs did not think to look at HPW, or simply did not know about it. Conclusions HPW has the potential to improve patient management and health outcomes, and use of HPW is increasing over time. What is known about the topic? Initiatives such as HPW are viewed positively by clinicians and have the potential to address challenges at the primary–secondary care interface, specifically, referral to secondary specialists. What does this paper add? Proof of concept that the ongoing availability of localised HPW for common clinical conditions improves GP usage of HPW and has increased access to HPW as the first source of clinical information. Benefits and barriers to use have been identified. What are the implications for practitioners? HPW improves knowledge of local services and provides GPs with easy access to referral pathways.
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Icasiano, F., P. Hewson, P. Machet, C. Cooper, and A. Marshall. "Childhood autism spectrum disorder in the Barwon region: A community based study." Journal of Paediatrics and Child Health 40, no. 12 (December 2004): 696–701. http://dx.doi.org/10.1111/j.1440-1754.2004.00513.x.

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Farrell, Elizabeth, and Sara Knight. "Rural Women's Health Education: A Model of Best Practice." Australian Journal of Primary Health 4, no. 3 (1998): 135. http://dx.doi.org/10.1071/py98040.

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The Jean Hailes Foundation has a distinct approach to the health care of women. The integration of a team of clinicians, educators and researchers enables the Foundation to give women access to relevant, timely and clear information about their health and health care issues to assist them in making informed health choices. The Rural Women's Education Program has been developed to meet the increasing demand for more information by rural Australians. The isolation of rural women, their difficulties in service access and transport availability are some of the problems addressed in the planning process for each respective area. To date each program has consisted of large public seminars, interactive information sessions and professional training. The response to each program has been overwhelming. Local ownership of the event has been part of its success. The 'Regional Women's Health Plan, 1998 - 2000' for the Barwon-South Western Region outlined certain health needs in the area. The Foundation responded to this need and, in collaboration with local network leaders, devised a program to meet the specific needs of that community. The planning process, delivery and evaluation of this successful program are discussed.
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Hyde, Natalie K., Sharon L. Brennan-Olsen, John D. Wark, Sarah M. Hosking, Peter J. Vuillermin, Lana J. Williams, and Julie A. Pasco. "The Vitamin D in Pregnancy Study: a prospective prebirth cohort in southern Australia." BMJ Open 10, no. 8 (August 2020): e036003. http://dx.doi.org/10.1136/bmjopen-2019-036003.

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PurposeThe Vitamin D in Pregnancy Study is a long-term ongoing cohort study. It was conceived to explore relationships between maternal vitamin D status in pregnancy and offspring growth and development, and has since diversified to include a wide range of physical and mental health exposures and outcomes.ParticipantsRecruitment was from the University Hospital Geelong (Barwon Health) antenatal clinic, Geelong, Victoria, Australia, between 2002 and 2004. 475 women were initially recruited, which resulted in 400 eligible mother–child pairs at birth.Findings to dateThe cohort has been followed up twice in pregnancy, at birth, and 1 year, 6 years and 11 years post birth. The study has reported an association between vitamin D in pregnancy and musculoskeletal health and body composition in the children.Future plansSubject to funding, there will be a prospective young adult follow-up. This profile aims to foster both cross-national and international collaborations with both existing and future data collection.
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Maidment, Jane, Ronnie Egan, and Jane Wexler. "Social work with older people from culturally and linguistically diverse backgrounds: Using research to inform practice." Aotearoa New Zealand Social Work 23, no. 3 (July 8, 2016): 3–15. http://dx.doi.org/10.11157/anzswj-vol23iss3id156.

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This research investigated the views of older culturally and linguistically diverse (CALD) people, their families and paid workers about experiences of giving and receiving care services in the Barwon region of Victoria, Australia. The project was conducted in collaboration with Diversitat, Geelong. While the research process incorporated a range of qualitative techniques this article is confined to reporting selected findings from the individual interviews and a focus group discussion. These findings demonstrated that particular caregiver personal attributes strengthened the relationship between older people and caregivers; differing interpretations were offered up about the use of time; multiple barriers for older CALD people using health and social services were identified; and that experiences of ageism within the health services were reported along with infrequent use of interpreter services. The article concludes with a discussion about the implications for social work practice and education with older CALD people.
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Vaughan, Vanessa C., Meg Harrison, Anna Dowd, Peter Eastman, and Peter Martin. "Evaluation of a Multidisciplinary Cachexia and Nutrition Support Service— The Patient and Carers Perspective." Journal of Patient Experience 8 (January 1, 2021): 237437352098147. http://dx.doi.org/10.1177/2374373520981476.

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The Barwon Health Cachexia & Nutrition Support Service (CNSS) is an outpatient service focused on improving clinical outcomes and quality of life for patients with or at high risk of cancer cachexia. Patients see a multidisciplinary team, comprising a palliative medicine physician, physiotherapist, dietitian, and nurse practitioner. This study evaluated the service from patient and carer perspectives. In 2016/17, semistructured interviews were conducted with 12 patients and 9 carers attending the service, focusing on: (1) reflection on experience of the CNSS, and (2) describing how a cachexia-specific service can meet their needs and concerns. Analysis generated 4 superordinate themes: evolving perception of service value, empowerment through person-centered care, communication to patients and carers regarding health/disease information, and the importance of the multidisciplinary team-based approach. Generally, patients and carers reported overall positive experiences with the service, particularly with regard to improved communication and management of the patient. Findings confirmed the patient-centered and individualized approaches were particularly valued. These insights are a critical step in the development of recommendations for future clinical management of cancer cachexia.
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Callaly, Thomas, Carmel A. Ackerly, Mary E. Hyland, Seetal Dodd, Melissa O'Shea, and Michael Berk. "A qualitative evaluation of a regional Early Psychosis Service 3 years after its commencement." Australian Health Review 34, no. 4 (2010): 382. http://dx.doi.org/10.1071/ah08731.

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Objective. To outline the major findings of a qualitative evaluation of an Early Psychosis Service 3 years after its establishment. Design. Data to evaluate the service were collected from team meetings, focus groups, individual interviews and questionnaires administered to clinicians, school staff, patients, carers and families. Setting. Barwon Health; Mental Health, Drug and Alcohol Services provide public mental health care to the Geelong, Victoria, region (population 270 000), which is a mixed urban and rural setting. The Early Psychosis Service model implemented involved the placement of two early psychosis workers into each of five adult geographically based Area Mental Health Teams rather than the establishment of a single Early Psychosis Team. Results. The service was found not to adhere to its original design in several key respects. Caseloads and periods of case management were found to be lower and shorter respectively than was originally planned for, caseworkers often experienced isolation and resentment from their adult service coworkers, the service was perceived to be difficult to access and premises not to be youth friendly and communication and engagement with external agencies and service providers was perceived to be poor. Conclusions. The choice of service model, inadequate consultation with stakeholders and inadequate promotion of the service contributed to its failure to reach early expectations. Because of these and other issues, including difficulties distinguishing between early psychosis and non-psychosis, a decision was made to restructure youth services and a separate youth mental health service, which incorporated the Early Psychosis Service function, was established.
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Mansell, Toby, Peter Vuillermin, Anne-Louise Ponsonby, Fiona Collier, Richard Saffery, and Joanne Ryan. "Maternal mental well-being during pregnancy and glucocorticoid receptor gene promoter methylation in the neonate." Development and Psychopathology 28, no. 4pt2 (April 4, 2016): 1421–30. http://dx.doi.org/10.1017/s0954579416000183.

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AbstractMaternal mental health during pregnancy has been linked to health outcomes in progeny. Mounting evidence implicates fetal “programming” in this process, possibly via epigenetic disruption. Maternal mental health has been associated with glucocorticoid receptor methylation (nuclear receptor subfamily 3, group C, member 1 [NR3C1]) in the neonate; however, most studies have been small (n < 100) and have failed to control for multiple testing in the statistical analysis. The Barwon Infant Study is a population-derived birth cohort with antenatal recruitment. Maternal depression and anxiety were assessed using the Edinburgh Postnatal Depression Scale and psychological distress using the Perceived Stress Scale. NR3C1 cord blood methylation levels were determined using Sequenom MassArray for 481 participants. Maternal psychological distress and anxiety were associated with a small increase in neonate NR3C1 methylation at specific CpG sites, thus replicating some previous findings. However, associations were only nominally significant and did not remain after correction for the number of CpG sites and exposures investigated. As the largest study to explore the relationship between maternal well-being and offspring NR3C1 cord blood methylation, our results highlight the need for caution when interpreting previous findings in this area. Future studies must ensure they are adequately powered to detect the likely small effect sizes while controlling for multiple testing.
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Gray, Lawrence EK, Tiffany Lin, Martin O'Hely, Peter Vuillermin, and the BIS Investigator Group. "ASCIA-P37: FAMILY HISTORY OF ALLERGIC DISEASE IS ASSOCIATED WITH ADVERSE INFANT RESPIRATORY HEALTH AND INCREASED HEALTHCARE UTILISATION: FINDINGS FROM THE BARWON INFANT STUDY." Internal Medicine Journal 46 (September 2016): 16. http://dx.doi.org/10.1111/imj.37_13197.

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Fox, Aaron, Jason Bonacci, Stephen D. Gill, and Richard S. Page. "Evaluating the effects of arthroscopic Bankart repair and open Latarjet shoulder stabilisation procedures on shoulder joint neuromechanics and function: a single-centre, parallel-arm trial protocol." BMJ Open Sport & Exercise Medicine 7, no. 1 (February 2021): e000956. http://dx.doi.org/10.1136/bmjsem-2020-000956.

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IntroductionShoulder instability injuries are common in sports involving collisions and overhead movements. Arthroscopic Bankart repair and the open Latarjet are two commonly used surgical stabilisation procedures. There is a lack of knowledge surrounding movement strategies, joint loading and muscle strength after each of these procedures. This study will compare: (1) shoulder joint neuromechanics during activities of daily living and an overhead sporting task; (2) shoulder range of motion; (3) shoulder strength; and (4) self-reported shoulder function and health status, between individuals who have undergone an arthroscopic Bankart repair versus open Latarjet.Methods and analysisThis is a prospective cohort, single-centre, non-randomised parallel arm study of surgical interventions for athletic shoulder instability injuries. Thirty participants will be recruited. Of these, 20 will have experienced one or more traumatic shoulder instability injuries requiring surgical stabilisation—and will undergo an arthroscopic Bankart repair or open Latarjet procedure. The remaining 10 participants will have no history of shoulder instability injury and act as controls. Participants will undergo baseline testing and be followed up at 3, 6 and 12 months. A two-way (group×time) analysis of variance with repeated measures on one factor (ie, time) will compare each outcome measure between groups across time points.Ethics and disseminationThis study was approved by the Barwon Health and Deakin University Human Research Ethics Committees. Outcomes will be disseminated through publications in peer-reviewed journals and presentations at relevant scientific conferences.Trial registration numberAustralian and New Zealand Clinical Trials Registry (ACTRN12620000016932).
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Stewart, Lesley. "Influenza vaccination among health care workers – A time to get serious. Moving responsibility from the individual clinician to the entire health care facility. A regional approach across the Barwon Southwest Region in Victoria." Infection, Disease & Health 23 (November 2018): S6. http://dx.doi.org/10.1016/j.idh.2018.09.022.

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18

Sanigorski, Andrea M., A. Colin Bell, and Boyd A. Swinburn. "Association of key foods and beverages with obesity in Australian schoolchildren." Public Health Nutrition 10, no. 2 (February 2007): 152–57. http://dx.doi.org/10.1017/s1368980007246634.

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AbstractObjectiveTo examine the pattern of intake of key foods and beverages of children aged 4–12 years and the association with weight status.Design and settingA computer-assisted telephone interview was used to determine the intake of fruit, vegetables, packaged snacks, fast foods and sweetened drinks ‘yesterday’ and ‘usually’ as reported by parents/guardians of a representative sample of 2184 children from the Barwon South-Western region of Victoria, Australia.ResultsChildren who consumed >2–3, >3–4 and >4 servings of fruit juice/drinks ‘yesterday’ were, respectively, 1.7 (95% confidence interval (CI) 1.2–2.2), 1.7 (95% CI 1.2–2.5) and 2.1 (95% CI 1.5–2.9) times more likely to be overweight/obese compared with those who had no servings of fruit juice/drink ‘yesterday’, adjusted for age, gender and socio-economic status (SES). Further, children who had ≥ 3 servings of soft drink ‘yesterday’ were 2.2 (95% CI 1.3–3.9) times more likely to be overweight/obese compared with those who had no servings of soft drink ‘yesterday’, adjusted for age, gender and SES. In addition, children who ‘usually’ drank fruit juice/drinks twice or more per day were 1.7 (95% CI 1.2–2.4) times more likely to be overweight/obese compared with those who drank these beverages once or less per week, adjusted for age, gender and SES. Although fast foods and packaged snacks were regularly eaten, there were no associations between weight status and consumption of these foods.ConclusionsIntake of sweetened beverages was associated with overweight and obesity in this population of Australian schoolchildren and should be a target for intervention programmes aimed at preventing unhealthy weight gain in children.
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O’Brien, Daniel P., N. Deborah Friedman, Raquel Cowan, Aaron Walton, and Eugene Athan. "Six vs Eight Weeks of Antibiotics for Small Mycobacterium ulcerans Lesions in Australian Patients." Clinical Infectious Diseases 70, no. 9 (June 20, 2019): 1993–97. http://dx.doi.org/10.1093/cid/ciz532.

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Abstract Background Antibiotics are highly effective in curing Mycobacterium ulcerans lesions, but are associated with significant toxicity. In those not undergoing surgery, we compared 6 weeks with the currently recommended 8 weeks of combination antibiotic therapy for small M. ulcerans lesions. Methods Mycobacterium ulcerans cases from an observational cohort at Barwon Health, Victoria, treated with antibiotics alone from 1 October 2010 to 31 March 2018 were included. The 6-week antibiotic group received ≥28 days and ≤42 days and the 8-week antibiotic group received ≥56 days of antibiotic therapy, respectively. Only World Health Organization category 1 lesions were included. Results 207 patients were included; 53 (25.6%) in the 6-week group and 154 (74.4%) in the 8-week group. The median age of patients was 53 years (interquartile range [IQR], 33–69 years) and 100 (48.3%) were female. Lesions were ≤900 mm2 in size in 79.7% of patients and 93.2% were ulcerative. Fifty-three patients (100%) achieved treatment cure in the 6-week group compared with 153 (99.4%) in the 8-week group (P = .56). No patients died or were lost to follow-up during the study. Median time to heal was 70 days (IQR, 60–96 days) in the 6-week group and 128 days (IQR, 95–173 days) in the 8-week group (P &lt; .001). Two (3.8%) patients in the 6-week group experienced a paradoxical reaction compared with 39 (25.3%) patients in the 8-week group (P = .001). Conclusions For selected small M. ulcerans lesions, 6 weeks may be as effective as 8 weeks of combined antibiotic therapy in curing lesions without surgery.
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Friedman, N. Deborah, Eugene Athan, Aaron L. Walton, and Daniel P. O'Brien. "Increasing Experience with Primary Oral Medical Therapy for Mycobacterium ulcerans Disease in an Australian Cohort." Antimicrobial Agents and Chemotherapy 60, no. 5 (February 16, 2016): 2692–95. http://dx.doi.org/10.1128/aac.02853-15.

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ABSTRACTBuruli ulcer (BU) is a necrotizing infection of subcutaneous tissue that is caused byMycobacterium ulceransand is responsible for disfiguring skin lesions. The disease is endemic to specific geographic regions in the state of Victoria in southeastern Australia. Growing evidence of the effectiveness of antibiotic therapy forM. ulceransdisease has evolved our practice to the use of primarily oral medical therapy. An observational cohort study was performed on all confirmedM. ulceranscases treated with primary rifampin-based medical therapy at Barwon Health between October 2010 and December 2014 and receiving 12 months of follow-up. One hundred thirty-two patients were managed with primary medical therapy. The median age of patients was 49 years, and nearly 10% had diabetes mellitus. Lesions were ulcerative in 83.3% of patients and at WHO stage 1 in 78.8% of patients. The median duration of therapy was 56 days, with 22 patients (16.7%) completing fewer than 56 days of antimicrobial treatment. Antibiotic-associated complications requiring cessation of one or more antibiotics occurred in 21 (15.9%) patients. Limited surgical debridement was performed on 30 of these medically managed patients (22.7%). Cure was achieved, with healing within 12 months, in 131 of 132 patients (99.2%), and cosmetic outcomes were excellent. Primary rifampin-based oral medical therapy forM. ulceransdisease, combined with either clarithromycin or a fluoroquinolone, has an excellent rate of cure and an acceptable toxicity profile in Australian patients. We advocate for further research to determine the optimal and safest minimum duration of medical therapy for BU.
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Wong, Shu Fen, Richard Norman, Trisha L. Dunning, David M. Ashley, and Paula K. Lorgelly. "A protocol for a discrete choice experiment: understanding preferences of patients with cancer towards their cancer care across metropolitan and rural regions in Australia." BMJ Open 4, no. 10 (October 2014): e006661. http://dx.doi.org/10.1136/bmjopen-2014-006661.

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IntroductionMedical decision-making in oncology is a complicated process and to date there are few studies examining how patients with cancer make choices with respect to different features of their care. It is also unknown whether patient choices vary by geographical location and how location could account for observed rural and metropolitan cancer differences. This paper describes an ongoing study that aims to (1) examine patient and healthcare-related factors that influence choices of patients with cancer; (2) measure and quantify preferences of patients with cancer towards cancer care using a discrete choice experiment (DCE) and (3) explore preference heterogeneity between metropolitan and rural locations.Methods and analysisA DCE is being conducted to understand how patients with cancer choose between two clinical scenarios accounting for different patient and healthcare-related factors (and levels). Preliminary qualitative research was undertaken to guide the development of an appropriate DCE design including characteristics that are important and relevant to patients with cancer. A fractional factorial design using the D-efficiency criteria was used to estimate interactions among attributes. Multinomial logistic regression will be used for the primary DCE analysis and to control for sociodemographic and clinical characteristics.Ethics and disseminationThe Barwon Health Human Research Ethics Committee approved the study. Findings from the study will be presented in national/international conferences and peer-reviewed journals. Our results will form the basis of a feasibility study to inform the development of a larger scale study into preferences of patients with cancer and their association with cancer outcomes.
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Gray, Lawrence, Kyoko Hasebe, Martin O’Hely, Anne-Louise Ponsonby, Peter Vuillermin, and Fiona Collier. "Rapid PCR identification of Prevotella copri in an Australian cohort of pregnant women." Journal of Developmental Origins of Health and Disease 11, no. 3 (December 17, 2019): 228–34. http://dx.doi.org/10.1017/s2040174419000849.

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AbstractGut bacteria from the genus Prevotella are found in high abundance in faeces of non-industrialised communities but low abundance in industrialised, Westernised communities. Prevotella copri is one of the principal Prevotella species within the human gut. As it has been associated with developmental health and disease states, we sought to (i) develop a real-time polymerase chain reaction (PCR) to rapidly determine P. copri abundance and (ii) investigate its abundance in a large group of Australian pregnant mothers.The Barwon Infant Study is a pre-birth cohort study (n = 1074). Faecal samples were collected from mothers at 36 weeks gestation. Primers with a probe specific to the V3 region of P. copri 16S rRNA gene were designed and optimised for real-time PCR. Universal 16S rRNA gene primers amplified pan-bacterial DNA in parallel. Relative abundance of P. copri was calculated using a 2-ΔCt method.Relative abundance of P. copri by PCR was observed in 165/605 (27.3%) women. The distribution was distinctly bimodal, defining women with substantial (n = 115/165, 69.7%) versus very low P. copri expression (n = 50/165, 30.3%). In addition, abundance of P. copri by PCR correlated with 16S rRNA gene MiSeq sequencing data (r2 = 0.67, P < 0.0001, n = 61).We have developed a rapid and cost-effective technique for identifying the relative abundance of P. copri using real-time PCR. The expression of P. copri was evident in only a quarter of the mothers, and either at substantial or very low levels. PCR detection of P. copri may facilitate assessment of this species in large, longitudinal studies across multiple populations and in various clinical settings.
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Schoch, Peter A., and Lisa Adair. "Successfully reforming orthopaedic outpatients." Australian Health Review 36, no. 2 (2012): 233. http://dx.doi.org/10.1071/ah11040.

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Since 2005, Barwon Health has successfully reformed its orthopaedic outpatient service to address the following issues: increasing number of referrals, inefficient referral management and triage, long waiting times for non-urgent appointments, high ‘Did Not Attend’ (DNA) rates and poor utilisation of conservative therapies before referral to surgeon. Numerous strategies have been implemented including: waiting list audits, triage guidelines, physiotherapy-led clinics, a DNA policy, an orthopaedic lead nurse role and a patient-focussed booking system. There has been a 66% reduction in the number of patients waiting for their first appointment; an 87% reduction in the waiting time from referral to first appointment; a 10% reduction in new patient DNAs; and more efficient referral management and communication processes. Patients are now seen in clinically appropriate time frames and offered earlier access to a wider range of conservative treatments. What is known about the topic? Demand for public outpatient services continues to increase. New resource and budget availability is limited, so organisations must continually look for ways to utilise existing resources as efficiently and effectively as possible to deliver timely and appropriately patient care. What does this paper add? Further evidence that redesign work that addresses both the administrative and clinical aspects of outpatient services can achieve positive and sustainable outcomes. Alternative models of care such as physiotherapy-led screening clinics, which utilise the skills of a range of health professionals, can supplement traditional medical-led clinics to provide high quality patient care and reduce the workload on consultants. Administrative changes such as patient focussed bookings can be implemented without compromising patient care and may simultaneously reduce the administrative load for the organisation and encourage patients to become more active and responsible participants in their own care. What are the implications for practitioners? Redesign work needs to consider both the clinical and administrative aspects of outpatient care, in order to implement sustainable change that positively affects the patient journey. The effects of change on upstream and downstream providers needs to be considered before changes are made. Transparency of the change of management process is vital, no matter how confronting this may be for stakeholders, to ensure decisions are based on fact, rather than hearsay or historical practice.
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Pereira, Robert B., Timothy L. Brown, Alison Guida, Nerida Hyett, Mary Nolan, Lidia Oppedisano, Kayla Riley, and Grace Walker. "Consumer experiences of care coordination for people living with chronic conditions and other complex needs: an inclusive and co-produced research study." Australian Health Review 45, no. 4 (2021): 472. http://dx.doi.org/10.1071/ah20108.

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ObjectiveThe aim of this study was to explore consumer experiences of care coordination within Barwon Health’s Hospital Admission Risk Program (HARP) located in Geelong, Victoria. MethodsThe study design was qualitative description informed by phenomenology and inclusive and co-production methodology. Semi-structured interviews were conducted with a purposive sample of six consumers living with chronic conditions and other complex needs. Participants were asked about their lived experience related to accessing the service, communication, and health and supports before and after accessing the service using an interview guide. Interviews were audio-recorded and transcribed verbatim for thematic analysis. ResultsFive themes were identified: (1) experiencing authentic, values-based care; (2) collaborative care and working together; (3) gaining independence; (4) improved health and quality of life; and (5) limited understanding of HARP at the start. Overall, participants’ experiences were positive, which related to improved health, quality of life, and sustainable supports. Although gains were experienced, most of the participants identified that their knowledge of HARP was limited when services commenced, which is an area for service improvement. ConclusionThis research begins to address the knowledge gap related to consumer experiences of care coordination. Findings highlight the importance of providing person-centred, authentic and values-based care, listening authentically, and promoting consumer voice within services. The study demonstrates that inclusive, co-design research is feasible in this service context, and further research is recommended into how stakeholders understand the function of care coordination services to promote health and prevent hospital readmissions, and improve consumer participation. What is known about the topic?Care coordination is multifaceted, with the primary purpose of facilitating person-centred care through appropriate and timely delivery of healthcare services. Despite the effectiveness of care coordination programs in preventing avoidable hospital admissions and reducing hospital length of stay, there is a paucity of research that has investigated consumer perspectives. There is also limited research that has adopted an inclusive research design of knowledge co-production where clinicians and consumers are included as equal members of the research team. What does this paper add?The study findings provide evidence into the value of care coordination from the perspective of consumers living with chronic conditions and other complex health and psychosocial issues. The findings also extend evidence into person- and consumer-centred care through understanding the qualities of care coordination practice that promote authenticity, integrity and positive health outcomes. Listening is identified as a critical element of authentic, values-based care, and as a care coordination intervention. Finally, the study demonstrates that inclusive, co-design research is feasible in this service context, and a larger-scale Experience-Based Co-Design study is recommended to investigate how stakeholders understand the function of care coordination services to promote health and prevent hospital readmissions and improve consumer participation. What are the implications for practitioners?The study informs practitioners of consumer lived experience of care coordination. Practitioners are recommended to apply the findings to practice by adopting an authentic, values-based and person-centred care approach described in the study findings. Service improvement initiatives are recommended to focus on increasing awareness of care coordination services through consumer participation and the meaningful inclusion of consumer voice, which could focus on education for referring health and social care professionals.
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PHILIPS, DEBORAH. "Healthy Heroines: Sue Barton, Lillian Wald, Lavinia Lloyd Dock and the Henry Street Settlement." Journal of American Studies 33, no. 1 (April 1999): 65–82. http://dx.doi.org/10.1017/s0021875898006070.

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Sue Barton is the fictional redhaired nursing heroine of a series of novels written for young women. Recalled by several generations of women readers with affection, Sue Barton has remained in print ever since the publication of the first novel in the series: Sue Barton, Student Nurse, written by Helen Dore Boylston, was published in America in 1936. Neither the covers of her four novels now in paperback, nor the publisher's catalogue entry, however, acknowledge Sue Barton's age: “Sue Barton Series – The everyday stories of redheaded Sue Barton and hospital life as she progresses from being a student nurse through her varied nursing career.”The catalogue entry for the series and the novels' paperback covers now claim Sue Barton as a contemporary young woman, poised for romance. Sue is, however, a pre-war heroine, and very much located within an American history and tradition of nursing. With her close contemporary, Cherry Ames, Sue Barton is one of the nursing heroines who were to establish a genre in popular fiction for young women, the career novel, and, more particularly, the nursing career novel.
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Heyrman, Mark. "Ethics and Law in Mental Health Administration. Walter E. Barton , Gail M. Barton." Social Service Review 59, no. 3 (September 1985): 530–31. http://dx.doi.org/10.1086/644322.

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Barton, Gail M. "Walter E. Barton." Psychiatric Bulletin 24, no. 2 (February 2000): 76. http://dx.doi.org/10.1192/pb.24.2.76.

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Jolley, David. "Remembering Russell Barton." Psychiatric Bulletin 27, no. 6 (December 2003): 233–34. http://dx.doi.org/10.1192/pb.27.6.233-b.

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Kristl Davison, H., and Mark N. Bing. "Obesity: Disability or Public Health Crisis?" Industrial and Organizational Psychology 6, no. 1 (March 2013): 96–99. http://dx.doi.org/10.1111/iops.12016.

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In their article, Ruggs, Law, Cox, Roehling, Wiener, Hebl, and Barron (2013) address a number of underresearched groups that are subject to discrimination. We applaud the authors for calling attention to the neglected groups in the study of discrimination. However, it is likely that researchers have neglected some of these groups for practical reasons as the discrimination against these groups is either less intense or less widespread. For example, religious discrimination has accounted for between 2% and 4% of Equal Employment Opportunity Commission (EEOC) charges, whereas race and sex discrimination together have accounted for approximately 65% of discrimination charges (EEOC, 2012a).
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30

Anonymous. "Interview: Angela Barron McBride." Journal of Psychosocial Nursing and Mental Health Services 28, no. 9 (September 1990): 34–35. http://dx.doi.org/10.3928/0279-3695-19900901-10.

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Cawthra, R., G. O'Brien, and F. Hassanyeh. "‘Imposed Psychosis’." British Journal of Psychiatry 150, no. 4 (April 1987): 553–56. http://dx.doi.org/10.1192/bjp.150.4.553.

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In 1969 Barton & Whithead described the Gaslight Phenomenon. In this condition a presentation of mental illness is found, on further enquiry, to a hospital. Previous reports have highlighted the malicious intent of the exploiter (Barton & Whitehead, 1969; Smith & Sinanan, 1972; Tyndal, 1973; Lund & Gardiner, 1977).
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McSeán, Tony. "Obituary - Jane Rowlands (nee Barton)." Health Information and Libraries Journal 24, no. 2 (June 2007): 150–52. http://dx.doi.org/10.1111/j.1471-1842.2007.00711.x.

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33

Biddiss, Michael. "Baron Coubertin (1863–1937) and the Olympic cult of health." Journal of Medical Biography 20, no. 3 (August 2012): 95–100. http://dx.doi.org/10.1258/jmb.2012.012032.

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34

Rollin, Henry. "Russell William Andrew Charles Barton." Psychiatric Bulletin 27, no. 1 (January 2003): 35–36. http://dx.doi.org/10.1192/pb.27.1.35.

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Ristich, Miodrag. "Obituary of Dr Russell Barton." Psychiatric Bulletin 27, no. 05 (May 2003): 196. http://dx.doi.org/10.1192/pb.27.5.196.

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Rank, Roger. "Almen L. Barron: 1926???2003." Sexually Transmitted Diseases 31, no. 4 (April 2004): 257–58. http://dx.doi.org/10.1097/01.olq.0000118427.17206.af.

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37

O'Hara, Jean. "Learning disabilities services: primary care or mental health trust?" Psychiatric Bulletin 24, no. 10 (October 2000): 368–69. http://dx.doi.org/10.1192/pb.24.10.368.

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In the next few months the London Region is expected to publish its strategy for learning disability services in the capital. This will inform the National Service Framework due in the autumn. At the same time, many trusts and health authorities are at various stages of reorganisation and reconfiguration. With the dawning of primary care trusts, single speciality mental health trusts and joint commissioning between health and social services, the debate over where learning disability services are best placed and their interface with mental health services has re-emerged (Barron et al, 2000).
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Frantz, Ann. "Clara Barton Not Forgotten." Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 15, no. 8 (August 1997): 529. http://dx.doi.org/10.1097/00004045-199708000-00002.

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KERR, J. "Drs Kerr, Barson, and Burnie respond." Archives of Disease in Childhood 84, no. 6 (June 1, 2001): 525h—525. http://dx.doi.org/10.1136/adc.84.6.525h.

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40

Scriver, Charles R. "Howland Award Presentation to Barton Childs." Pediatric Research 26, no. 4 (October 1989): 388–89. http://dx.doi.org/10.1203/00006450-198910000-00022.

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KERR, JR, JP BURNIE, and AJ BARSON. "Drs Kerr, Barson, and Burnie respond." Archives of Disease in Childhood 84, no. 6 (June 1, 2001): 525.9–525. http://dx.doi.org/10.1136/adc.84.6.525-h.

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42

Gershon, Samuel. "In Memoriam—Dr. Baron Avery Shopsin." Neuropsychopharmacology 43, no. 9 (May 17, 2018): 1980. http://dx.doi.org/10.1038/s41386-018-0060-6.

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43

Jeong, Eunha, and SooCheong (Shawn) Jang. "Heuristic evaluation of healthy menus: examining the effect of brand image congruity." International Journal of Contemporary Hospitality Management 29, no. 10 (October 9, 2017): 2514–34. http://dx.doi.org/10.1108/ijchm-11-2015-0633.

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Purpose This study aims to investigate how restaurant customers’ heuristic judgment, originating from their perceived level of congruity between restaurant brand image regarding healthfulness and healthy menu products, can affect their information processing in terms of their perceived nutritional information credibility and, furthermore, how these effects influence customers’ attitude toward the menu in terms of healthiness. Design/methodology/approach A Web-based survey was developed and distributed to randomly selected respondents in the USA, and in total, 320 responses were used for the data analyses. Structural equation modeling (SEM) was used to examine the relationship among three constructs: perceived brand–product congruity, perceived nutritional information credibility and nutrition attitude toward the healthy menu item being promoted. To assess the mediating role of perceived information credibility, an analytical procedure proposed by (Baron and Kenny 1986) was used. Finally, to investigate the moderating effect of the health involvement, multiple group analyses were executed. Findings The study results suggested that the synchronization between healthful brand image of the restaurant and the promoted menu item is important for ensuring customers’ perceptions of information credibility regarding the menu item healthiness and for eliciting customers’ positive nutrition attitudes toward the menu item. Also, positive nutrition attitudes toward a menu item can be increased by improving perceived information credibility. Depending on an individual’s level of health involvement, the relationships between the three proposed constructs vary. Originality/value This paper includes a theoretical model that explains customers’ heuristic evaluation of a healthy menu product by assessing the influence of brand image congruity in terms of healthy menu promotion.
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Berrettini, Wade. "Response to Baron and Knowles." Psychiatric Genetics 9, no. 4 (December 1999): 205–6. http://dx.doi.org/10.1097/00041444-199912000-00008.

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AL. Agele, Ahmed Talib Mahdi, Muntadher Kadhim Shamram, and Dhafir Ubed Faraj. "Service Quality Evaluation in the Internal Supervision Department and the Level of Customer Satisfaction “Applied Study on Baron Hotel”." International Journal of Psychosocial Rehabilitation 24, no. 03 (February 18, 2020): 1151–64. http://dx.doi.org/10.37200/ijpr/v24i3/pr200867.

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Pearce, J. M. "Baron Constantin von Economo and encephalitis lethargica." Journal of Neurology, Neurosurgery & Psychiatry 60, no. 2 (February 1, 1996): 167. http://dx.doi.org/10.1136/jnnp.60.2.167.

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Bhat, Shyam K. "A Psychiatrist's Diary: The Baron and the Medical Student." Journal of Clinical Psychiatry 67, no. 07 (July 15, 2006): 1154–55. http://dx.doi.org/10.4088/jcp.v67n0720.

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Cha, Soo Min, and Hyun Dae Shin. "Buttress plating for volar Barton fractures in children." Journal of Pediatric Orthopaedics B 28, no. 1 (January 2019): 73–78. http://dx.doi.org/10.1097/bpb.0000000000000534.

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Schwartz, Harold I. "Ethics and Law in Mental Health Administration—by Walter E. Barton, M.D., and Gail M. Barton, M.D., M.P.H.; International Universities Press, New York, 1984, 378 pages, $35." Psychiatric Services 36, no. 3 (March 1985): 304. http://dx.doi.org/10.1176/ps.36.3.304.

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S. Momonoki, Yoshie, and Motoyuki Nakaya. "Baron-Cohen's Cognitive Styles as a Mediator between Gender Role and Mental Health among Undergraduates." Japanese Journal of Personality 25, no. 2 (2016): 101–11. http://dx.doi.org/10.2132/personality.25.101.

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