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Watson, R. G., P. W. Angus, M. Dewar, B. Goss, R. B. Sewell, and R. A. Smallwood. "Low prevalence of primary biliary cirrhosis in Victoria, Australia. Melbourne Liver Group." Gut 36, no. 6 (June 1, 1995): 927–30. http://dx.doi.org/10.1136/gut.36.6.927.
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Cheng, I.-Hao, Jacquie McBride, Miriam Decker, Therese Watson, Hannah Jakubenko, and Alana Russo. "The Asylum Seeker Integrated Healthcare Pathway: a collaborative approach to improving access to primary health care in South Eastern Melbourne, Victoria, Australia." Australian Journal of Primary Health 25, no. 1 (2019): 6. http://dx.doi.org/10.1071/py18028.
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It is important to address the health needs of asylum seekers within the early stages of their arrival in Australia, as this impacts all aspects of their resettlement. However, asylum seekers face a range of barriers to accessing timely and appropriate health care in the community. In 2012, the increasing number of asylum seekers in Australia placed additional demand on health and social services in high-settlement regions. Health providers experienced a substantial increase in Medicare ineligible clients and avoidable presentations to Emergency Departments, and the health needs of new asylum seeker arrivals were not being fully addressed. In response, South Eastern Melbourne Medicare Local, Monash Health, the Australian Red Cross and local settlement support agencies collaborated to develop an integrated healthcare pathway in South Eastern Melbourne to facilitate healthcare access for asylum seekers released from detention. From September 2012 to December 2014, a total of 951 asylum seekers transitioned through the pathway. Seventy-eight percent required primary healthcare assistance, and were provided with a service appointment within 3 weeks of their arrival in Melbourne. This initiative has demonstrated the value of partnership and collaboration when responding to emergent asylum seeker health needs.
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O’Brien, Patricia M. "Coming in From the Margin." Australasian Journal of Special Education 13, no. 2 (January 1990): 52–59. http://dx.doi.org/10.1017/s1030011200022223.
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Des English was a person of great charm, innovation, and inner strength. His early death at the age of 44 in 1977 came as a bitter blow not only for his family but for the many teachers and parents he had influenced and guided in respectively providing and in seeking educational opportunities for children with disabilities. Des grew up in a small town in Victoria called Donnybrook, north of Melbourne. He was educated by the Marist Brothers at Kilmore College, and in the 50’s trained as a primary teacher at Geelong Teachers College, from which he gained an extension of one year to study as a Special Teacher at Melbourne Teachers College. His first appointment was as an Opportunity Grade teacher at North Melbourne State School. His talent for leadership surfaced early and in his second appointment he became Principal of Footscray Special School for children and adolescents with intellectual disability. Throughout the rest of his career he gained one promotion after another to the Principal positions at Ormond, Travencore and St. Alban’s Special schools. I was fortunate to work as a deputy principal with him throughout his last two appointments.
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Eastwood, Kathryn, Dhanya Nambiar, Rosamond Dwyer, Judy A. Lowthian, Peter Cameron, and Karen Smith. "Ambulance dispatch of older patients following primary and secondary telephone triage in metropolitan Melbourne, Australia: a retrospective cohort study." BMJ Open 10, no. 11 (November 2020): e042351. http://dx.doi.org/10.1136/bmjopen-2020-042351.
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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.
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Whelan, Jillian, Joshua Hayward, Melanie Nichols, Andrew D. Brown, Liliana Orellana, Victoria Brown, Denise Becker, et al. "Reflexive Evidence and Systems interventions to Prevention Obesity and Non-communicable Disease (RESPOND): protocol and baseline outcomes for a stepped-wedge cluster-randomised prevention trial." BMJ Open 12, no. 9 (September 2022): e057187. http://dx.doi.org/10.1136/bmjopen-2021-057187.
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IntroductionSystems science methodologies have been used in attempts to address the complex and dynamic causes of childhood obesity with varied results. This paper presents a protocol for the Reflexive Evidence and Systems interventions to Prevention Obesity and Non-communicable Disease (RESPOND) trial. RESPOND represents a significant advance on previous approaches by identifying and operationalising a clear systems methodology and building skills and knowledge in the design and implementation of this approach among community stakeholders.Methods and analysisRESPOND is a 4-year cluster-randomised stepped-wedge trial in 10 local government areas in Victoria, Australia. The intervention comprises four stages: catalyse and set up, monitoring, community engagement and implementation. The trial will be evaluated for individuals, community settings and context, cost-effectiveness, and systems and implementation processes. Individual-level data including weight status, diet and activity behaviours will be collected every 2 years from school children in grades 2, 4 and 6 using an opt-out consent process. Community-level data will include knowledge and engagement, collaboration networks, economic costs and shifts in mental models aligned with systems training. Baseline prevalence data were collected between March and June 2019 among >3700 children from 91 primary schools.Ethics and disseminationEthics approval: Deakin University Human Research Ethics Committee (HREC 2018-381) or Deakin University’s Faculty of Health Ethics Advisory Committee (HEAG-H_2019-1; HEAG-H 37_2019; HEAG-H 173_2018; HEAG-H 12_2019); Victorian Government Department of Education and Training (2019_003943); Catholic Archdiocese of Melbourne (Catholic Education Melbourne, 2019-0872) and Diocese of Sandhurst (24 May 2019). The results of RESPOND, including primary and secondary outcomes, and emerging studies developed throughout the intervention, will be published in the academic literature, presented at national and international conferences, community newsletters, newspapers, infographics and relevant social media.Trial registration numberACTRN12618001986268p.
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Draper, Brian. "G Vernon Davies: unsung pioneer of old age psychiatry in Victoria." Australasian Psychiatry 30, no. 2 (November 8, 2021): 203–5. http://dx.doi.org/10.1177/10398562211045085.
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Objective: To provide a biography of G Vernon Davies who took up a career in old age psychiatry in 1955 at the age of 67 at Mont Park Hospital in an era when there few psychiatrists working in the field. Conclusion: In the 1950s and 1960s, Vernon Davies worked as an old age psychiatrist and published papers containing sensible practical advice informed by contemporary research and experience, broadly applicable to both primary and secondary care, presented in a compassionate and empathetic manner. His clinical research in old age psychiatry resulted in the first doctoral degree in psychiatry awarded at the University of Melbourne at the age of 79. Before commencing old age psychiatry, he served in the Australian Army Medical Corps as a Regimental Medical Officer and received the Distinguished Service Order. He spent 3 years as a medical missionary in the New Hebrides before settling at Wangaratta where he worked as a physician for over 30 years. He contributed to his local community in a broad range of activities. Vernon Davies is an Australian pioneer of old age psychiatry.
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Iwashita, Noriko, and Irene Liem. "Factors affecting second language achievement in primary school." Australian Review of Applied Linguistics 28, no. 1 (January 1, 2005): 36–51. http://dx.doi.org/10.1075/aral.28.1.03iwa.
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Abstract This study investigates achievement in second language learning (Chinese) in primary school in relation to learner variables such as amount and duration of instruction and home language background.1 Currently in the State of Victoria it is recommended that all students learn a second language from the beginning of primary school to the end of Year 10. As the majority of students in some LOTE (Languages Other Than English) classes such as Chinese are background speakers, some parents and teachers are concerned that non-background learners can be disadvantaged compared with classmates who have some exposure to the LOTE outside school. In order to examine whether home language use has any impact on achievement, we developed a test of four skills and administered it to Year 6 students in two primary schools in Melbourne. The results showed that Chinese background students scored much higher than non-Chinese background students in all four areas. However a close examination of the data revealed that other variables such as Chinese study outside school and the number of years of study at school also influenced the test scores. This research has strong implications for developing a LOTE curriculum for both background and non-background speakers.
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Kong, F., C. Kyle-Link, J. Hocking, and M. Hellard. "11. SEX AND SPORT: A COMMUNITY BASED PROJECT OF CHLAMYDIA TESTING AND TREATMENT IN RURAL AND REGIONAL VICTORIA." Sexual Health 4, no. 4 (2007): 288. http://dx.doi.org/10.1071/shv4n4ab11.
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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.
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Maher, Michelle, and Emer Campbell. "Demonstrating environmental water needs in a climate of change." Proceedings of the Royal Society of Victoria 122, no. 2 (2010): 70. http://dx.doi.org/10.1071/rs10016.
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Efficient and accountable management of water resources in Northern Victoria has become a critical issue for the future of irrigation, communities and the environment, both north and south of the Great Dividing Range. To increase efficiencies and enhance accountability for water resource use, the Victorian Government is investing $1 billion through the Northern Victoria Irrigation Renewal Project (NVIRP) to upgrade ageing irrigation infrastructure across the Goulburn-Murray Irrigation District. The upgrade is expected to generate an additional 225 GL of water that will be distributed equally between irrigators, the environment and Melbourne. Whilst there are significant potential benefits for the environment as a whole from the water savings initiatives, there may also be adverse impacts from altering the hydrology of the diverse array of wetlands and rivers which are directly linked to the irrigation delivery network. The NVIRP Environmental Referrals process has investigated these potential impacts and identified ten wetlands and four rivers of high environmental value that require the development of environmental watering plans. These plans are the primary means by which the NVIRP commitment to ‘no net environmental loss’ will be achieved and assets of high environmental value will be protected. Three Environmental Watering Plans (EWPs) were completed prior to the operation of NVIRP works in the 2009-2010 irrigation season. These are for Johnson Swamp, Lake Elizabeth and Lake Murphy. The paper will describe the development of the Lake Elizabeth EWPs by the North Central Catchment Management Authority (NCCMA), within the context of uncertain climatic conditions, the recent long drought and the need to demonstrate accountability and efficiency in the use of a scarce and finite resource.
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Thompson, Emma J., Miriam H. Beauchamp, Simone J. Darling, Stephen J. C. Hearps, Amy Brown, George Charalambous, Louise Crossley, et al. "Protocol for a prospective, school-based standardisation study of a digital social skills assessment tool for children: The Paediatric Evaluation of Emotions, Relationships, and Socialisation (PEERS) study." BMJ Open 8, no. 2 (February 2018): e016633. http://dx.doi.org/10.1136/bmjopen-2017-016633.
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BackgroundHumans are by nature a social species, with much of human experience spent in social interaction. Unsurprisingly, social functioning is crucial to well-being and quality of life across the lifespan. While early intervention for social problems appears promising, our ability to identify the specific impairments underlying their social problems (eg, social communication) is restricted by a dearth of accurate, ecologically valid and comprehensive child-direct assessment tools. Current tools are largely limited to parent and teacher ratings scales, which may identify social dysfunction, but not its underlying cause, or adult-based experimental tools, which lack age-appropriate norms. The present study describes the development and standardisation of Paediatric Evaluation of Emotions, Relationships, and Socialisation(PEERS®), an iPad-based social skills assessment tool.MethodsThe PEERS project is a cross-sectional study involving two groups: (1) a normative group, recruited from early childhood, primary and secondary schools across metropolitan and regional Victoria, Australia; and (2) a clinical group, ascertained from outpatient services at The Royal Children’s Hospital Melbourne (RCH). The project aims to establish normative data for PEERS®, a novel and comprehensive app-delivered child-direct measure of social skills for children and youth. The project involves recruiting and assessing 1000 children aged 4.0–17.11 years. Assessments consist of an intellectual screen, PEERS® subtests, and PEERS-Q, a self-report questionnaire of social skills. Parents and teachers also complete questionnaires relating to participants’ social skills. Main analyses will comprise regression-based continuous norming, factor analysis and psychometric analysis of PEERS® and PEERS-Q.Ethics and disseminationEthics approval has been obtained through the RCH Human Research Ethics Committee (34046), the Victorian Government Department of Education and Early Childhood Development (002318), and Catholic Education Melbourne (2166). Findings will be disseminated through international conferences and peer-reviewed journals. Following standardisation of PEERS®, the tool will be made commercially available.
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Young, Jesse T., Cheneal Puljević, Alexander D. Love, Emilia K. Janca, Catherine J. Segan, Donita Baird, Rachel Whiffen, Stan Pappos, Emma Bell, and Stuart A. Kinner. "Staying Quit After Release (SQuARe) trial protocol: a randomised controlled trial of a multicomponent intervention to maintain smoking abstinence after release from smoke-free prisons in Victoria, Australia." BMJ Open 9, no. 6 (June 2019): e027307. http://dx.doi.org/10.1136/bmjopen-2018-027307.
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IntroductionSmoke-free policies have been introduced in prisons internationally. However, high rates of relapse to smoking after release from prison indicate that these policies typically result in short-term smoking cessation only. These high rates of relapse, combined with a lack of investment in relapse prevention, highlight a missed opportunity to improve the health of a population who smoke tobacco at two to six times the rate of the general population. This paper describes the rationale and design of a randomised controlled trial, testing the effectiveness of a caseworker-delivered intervention promoting smoking cessation among former smokers released from smoke-free prisons in Victoria, Australia.Methods and analysisThe multicomponent, brief intervention consists of behavioural counselling, provision of nicotine spray and referral to Quitline and primary care to promote use of government-subsidised smoking cessation pharmacotherapy. The intervention is embedded in routine service delivery and is administered at three time points: one prerelease and two postrelease from prison. Control group participants will receive usual care. Smoking abstinence will be assessed at 1 and 3 months postrelease, and confirmed with carbon monoxide breath testing. Linkage of participant records to survey and routinely collected administrative data will provide further information on postrelease use of health services and prescribed medication.Ethics and disseminationEthical approval has been obtained from the Corrections Victoria Research Committee, the Victorian Department of Justice Human Research Ethics Committee, the Department of Human Services External Request Evaluation Committee and the University of Melbourne Human Research Ethics Committee. Results will be submitted to major international health-focused journals. In case of success, findings will assist policymakers to implement urgently needed interventions promoting the maintenance of prison-initiated smoking abstinence after release, to reduce the health disparities experienced by this marginalised population.Trial registration numberACTRN12618000072213; Pre-results.
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Clyne, Michael. "Bilingual Education—What can We Learn from the Past?" Australian Journal of Education 32, no. 1 (April 1988): 95–114. http://dx.doi.org/10.1177/000494418803200106.
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This paper shows that bilingual education has a long tradition in Australia. In the 19th century, primary and secondary schools operating German-English, French-English or Gaelic-English programs, or ones with a Hebrew component, existed in different parts of Australia. The most common bilingual schools were Lutheran rural day schools but there were also many private schools. They believed in the universal value of bilingualism, and some attracted children from English-speaking backgrounds. Bilingual education was for language maintenance, ethno-religious continuity or second language acquisition. The languages were usually divided according to subject and time of day or teacher. The programs were strongest in Melbourne, Adelaide and rural South Australia and Victoria. In Queensland, attitudes and settlement patterns led to the earlier demise of bilingual education. The education acts led to a decline in bilingual education except in elitist girls or rural primary schools and an increase in part-time language programs. Bilingual education was stopped by wartime legislation. It is intended that bilingualism can flourish unless monolingualism is given special preference.
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ALLSOPP, PETER G., and PETER J. HUDSON. "Novapus bifidus Carne, 1957, a primary homonym and synonym of Novapus bifidus Lea, 1910 (Coleoptera: Scarabaeidae: Dynastinae)." Zootaxa 4560, no. 3 (February 26, 2019): 576. http://dx.doi.org/10.11646/zootaxa.4560.3.9.
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In his landmark revision of the Australian Dynastinae (Coleoptera: Scarabaeidae) Phil Carne (1957) described Novapus bifidus Carne, 1957 from males and females collected at Cape York and Thursday Island. The type series is in the Australian National Insect Collection, Canberra, Australia (ANIC); the Natural History Museum, London, United Kingdom; the South Australian Museum, Adelaide, Australia (SAM); and the Museum of Victoria, Melbourne, Australia. He noted “In the collections of the South Australian Museum there are specimens designated as types of bifidus Lea. No description of this species has been published, and it is now described under the same specific name”. One of his paratypes is a female in SAM identified as “Lea’s unpublished ♀ type” and two other paratypes are males in SAM. Cassis & Weir (1992) noted that one of the SAM specimens has the registration number I4268, although they knew of only two paratypes (one male, one female) in that collection. The name has been attributed to Carne by most subsequent authors (Endrődi 1974, 1985; Carne & Allsopp 1987; Cassis & Weir 1992; Dechambre 2005; Atlas of Living Australia 2018.). Krajcik (2005, 2012) listed it in his scarab checklists but as “bifidus? Carne 1957”.
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Edge, M. K., and J. L. Barnett. "Development and integration of animal welfare standards into company quality assurance programs in the Australian livestock (meat) processing industry." Australian Journal of Experimental Agriculture 48, no. 7 (2008): 1009. http://dx.doi.org/10.1071/ea08024.
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A collaborative project between the Australian Meat Industry Council and the Animal Welfare Science Centre, a Centre partnered by the University of Melbourne, Department of Primary Industries (Victoria) and Monash University, that commenced in 2005, resulted in the development of a series of industry animal welfare standards designed to complement existing regulatory and commercial requirements. The project was the fourth in a series of similar projects conducted since 1998 for the poultry, pork and dairy industries, that was aimed at developing industry-wide animal welfare audit material. This concept was further developed to result in national industry animal welfare standards with accompanying audit material that could be integrated with existing industry, commercial and regulatory quality assurance documentation to demonstrate animal welfare practices. The resultant animal welfare standards were accompanied by additional implementation and reference information to enable integration and uptake within the industries and for the delivery of assurance on animal welfare to Governments, customers, trading partners and the consumer.
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Thompson, Sandra C., Gill E. Checkley, Jane S. Hocking, Nick Crofts, Anne M. Mijch, and Fiona K. Judd. "HIV Risk Behaviour and HIV Testing of Psychiatric Patients in Melbourne." Australian & New Zealand Journal of Psychiatry 31, no. 4 (August 1997): 566–76. http://dx.doi.org/10.3109/00048679709065079.
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Objectives: Patients with chronic mental illnesses constitute an important risk group for HIV infection overseas. This study aimed to determine the prevalence of risk behaviours associated with HIV transmission and factors associated with HIV testing in psychiatric patients in Melbourne. Methods: Inpatients and outpatients completed an interviewer-administered questionnaire which covered demographics, psychiatric diagnosis, risk behaviour, and HIV education and testing. Results: Of 145 participants, 60% were male and 55.2% had schizophrenia. Injecting drug use (IDU) was reported by 15.9%, a figure approximately 10 times that found in other population surveys. Most patients reported sex in the last decade and over 20% had multiple sexual partners in the last year. Of males, 12.6% reported sex with another male (9.2% anal sex); 19.0% of females reported sex with a bisexual male. Nearly half of the males reported sex with a prostitute, 2.5 times that in a population sample. Only 15.9% reported ever having someone talk to them specifically about HIV and its transmission, although one-third had been tested for HIV. In multivariate analysis, male-male sex, paying for sex, and IDU were associated with HIV testing, but those whose primary language was not English were less likely to be tested. Those who had received HIV education were more likely to have used a condom last time they had sex (OR 4.52, 95%C11.49–14.0). Conclusions: This study provides evidence that those with serious mental illness in Victoria have higher rates of participation in risk behaviour for HIV infection than those in the general community. Attention to HIV education and prevention in this group has been inappropriately scant; strategies to encourage safer behaviour are urgently needed.
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Carnegie, Garry D. "The accounting professional project and bank failures." Journal of Management History 22, no. 4 (September 12, 2016): 389–412. http://dx.doi.org/10.1108/jmh-04-2016-0018.
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Purpose The purpose of this paper is to examine the strategies and dynamics of the fledging accounting professional project in the context of boom, bust and reform in colonial Victoria. In doing so, the study provides evidence of the association of members of the Incorporated Institute of Accountants, Victoria (IIAV) (1886) and other auditors with banks that failed during the early 1890s Australian banking crisis, and addresses the implications for the professionalisation trajectory. Design/methodology/approach The study uses primary sources, including the surviving audited financial statements of a selection of 14 Melbourne-based failed banks, reports of relevant company meetings and other press reports and commentaries, along with relevant secondary sources, and applies theoretical analysis informed by the literature on the sociology of the professions. Findings IIAV members as bank auditors are shown to have been associated with most of the bank failures examined in this study, thereby not being immune from key problems in bank auditing and accounting of the period. The study shows how the IIAV, while part of the problem, ultimately became part of a solution that was regarded within the association’s leadership as less than optimal, essentially by means of 1896 legislative reforms in Victoria, and also addresses the associated implications. Practical implications The study reveals how a deeper understanding of economic and social problems in any context may be obtainable by examining surviving financial statements and related records sourced from archives of surviving business records. Originality/value The study elucidates accounting’s professionalisation trajectory in a colonial setting during respective periods of boom, bust and reform from the 1880s until around 1896 and provides insights into the development of financial auditing practices, which is still an important topic.
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Campbell, Susan. "So long as it's near water: variable roosting behaviour of the large-footed myotis (Myotis macropus)." Australian Journal of Zoology 57, no. 2 (2009): 89. http://dx.doi.org/10.1071/zo09006.
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The choice of day roosts by microbats influences energetics, social interactions and breeding success. In Australia, the large-footed myotis (Myotis macropus) is dependent on waterways for foraging. However, the extent to which the species relies upon, and selects roosts within, riparian habitat is unknown. I studied the roosting behaviour of this species around a water reservoir near Melbourne, Victoria, during the summers from October 2002 to April 2005. I radio-tracked 31 bats to 17 tree roosts; colony size averaged 6.0 ± 1.6 bats and individuals used 1.3 ± 0.1 roosts during the tracking period (average 6.2 ± 0.6 days). Two roosts were also located in crevices in an old aqueduct tunnel, housing colonies of 10.8 ± 0.6 bats. Colonies emerged earlier from tunnel crevices (25.0 ± 3.6 min after sunset, range 6–53 min), compared with conspecifics in tree roosts (45.6 ± 2.1 min after sunset, range 10–83 min). Roost trees and cavities differed from available habitat trees and cavities in terms of smaller entrance areas to used (182.2 ± 49.3 cm2) versus unused (328.0 ± 61.8 cm2) cavities. The primary force driving roost selection by M. macropus appears to be proximity of suitable waterways for foraging. Retention and maintenance of extensive riparian habitat, as well as the preservation of other structures used for roosting, are the most important conservation strategies for management of the day-roosting habitat of M. macropus.
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Zengin, Ayse, Cat Shore-Lorenti, Marc Sim, Louise Maple-Brown, Sharon Lee Brennan-Olsen, Joshua R. Lewis, Jennifer Ockwell, Troy Walker, David Scott, and Peter Ebeling. "Why Aboriginal and Torres Strait Islander Australians fall and fracture: the codesigned Study of Indigenous Muscle and Bone Ageing (SIMBA) protocol." BMJ Open 12, no. 4 (April 2022): e056589. http://dx.doi.org/10.1136/bmjopen-2021-056589.
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ObjectivesAboriginal and Torres Strait Islander Australians have a substantially greater fracture risk, where men are 50% and women are 26% more likely to experience a hip fracture compared with non-Indigenous Australians. Fall-related injuries in this population have also increased by 10%/year compared with 4.3%/year in non-Indigenous Australians. This study aims to determine why falls and fracture risk are higher in Aboriginal and Torres Strait Islander Australians.SettingAll clinical assessments will be performed at one centre in Melbourne, Australia. At baseline, participants will have clinical assessments, including questionnaires, anthropometry, bone structure, body composition and physical performance tests. These assessments will be repeated at follow-up 1 and follow-up 2, with an interval of 12 months between each clinical visit.ParticipantsThis codesigned prospective observational study aims to recruit a total of 298 adults who identify as Aboriginal and Torres Strait Islander and reside within Victoria, Australia. Stratified sampling by age and sex will be used to ensure equitable distribution of men and women across four age-bands (35–44, 45–54, 55–64 and 65+ years).Primary and secondary outcome measuresThe primary outcome is within-individual yearly change in areal bone mineral density at the total hip, femoral neck and lumbar spine assessed by dual energy X-ray absorptiometry. Within-individual change in cortical and trabecular volumetric bone mineral density at the radius and tibia using high-resolution peripheral quantitative computed tomography will be determined. Secondary outcomes include yearly differences in physical performance and body composition.Ethical approvalEthics approval for this study has been granted by the Monash Health Human Research Ethics Committee (project number: RES-19–0000374A).Trial registration numberACTRN12620000161921.
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Ruth, Denise, Rosalind Hurworth, and Nabil Sulaiman. "Moving towards meaningful local population health data: The service provider perspective." Australian Journal of Primary Health 11, no. 2 (2005): 113. http://dx.doi.org/10.1071/py05029.
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Increasingly, primary care services are required to use data to assess their local population's health needs and plan services. This paper reports focus group discussions of service providers' perceived current practice, issues and needs related to obtaining and using data for planning services in two local government areas of Melbourne. Six groups were conducted with nominees from two municipal councils, four divisions of general practice, three community health services, three hospital networks and eight community organizations. Two groups were conducted with planners and data providers from the Department of Human Services, Victoria. The 66 participants had a broad range of experience in using data to assess local population health needs. Participants reported that issues limiting the use of data related to: access to data (lack of awareness, contacting the right person, poor communication between data providers and users, resource constraints, lack of central access); gaps in data; quality of data (inconsistent definitions and collection, currency, ties to funding); applicability of data (unfriendly format, problems with aggregated versus small area data, non-matching data sets, lack of contextual information); and support for data use in local population health planning. If local population needs assessment is to lead to better health outcomes, service providers need access to high quality data presented in formats that are applicable to their communities. They also need practicable planning methods, skills training and support in using data for local population needs assessment and service planning.
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Hallinan, Christine M., and Kelsey L. Hegarty. "Advanced training for primary care and general practice nurses: enablers and outcomes of postgraduate education." Australian Journal of Primary Health 22, no. 2 (2016): 113. http://dx.doi.org/10.1071/py14072.
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The aims of the present study were to understand enablers to participation in postgraduate education for primary care nurses (PCNs), and to explore how postgraduate education has advanced their nursing practice. Cross-sectional questionnaires were mailed out in April 2012 to current and past students undertaking postgraduate studies in primary care nursing at The University of Melbourne, Victoria, Australia. Questionnaires were returned by 100 out of 243 nurses (response rate 41%). Ninety-one per cent (91/100) of the respondents were first registered as nurses in Australia. Fifty-seven per cent were hospital trained and 43% were university educated to attain their initial nurse qualification. The respondents reported opportunities to expand scope of practice (99%; 97/98), improve clinical practice (98%; 97/99), increase work satisfaction (93%; 91/98) and increase practice autonomy (92%; 89/97) as factors that most influenced participation in postgraduate education in primary care nursing. Major enablers for postgraduate studies were scholarship access (75%; 71/95) and access to distance education (74%; 72/98). Many respondents reported an increased scope of practice (98%; 95/97) and increased job satisfaction (71%; 70/98) as an education outcome. Only 29% (28/97) cited an increase in pay-rate as an outcome. Of the 73 PCNs currently working in general practice, many anticipated an increase in time spent on the preparation of chronic disease management plans (63%; 45/72), multidisciplinary care plans (56%; 40/72) and adult health checks (56%; 40/72) in the preceding 12 months. Recommendations emerging from findings include: (1) increased access to scholarships for nurses undertaking postgraduate education in primary care nursing is imperative; (2) alternative modes of course delivery need to be embedded in primary care nursing education; (3) the development of Australian primary care policy, including policy on funding models, needs to more accurately reflect the educational level of PCNs, PCN role expansion and the extent of interprofessional collaboration that is evident from research undertaken to date. Nurses with postgraduate education have the potential to increase their scope of practice, take on a greater teaching role and provide more preventive and chronic disease services in primary care. Policies aimed at increasing access to education for nurses working in primary care would strengthen the primary care nursing profession, and enhance the delivery of primary health care services in Australia.
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Dennett, Amy M., Katherine E. Harding, Casey L. Peiris, Nora Shields, Christian Barton, Lauren Lynch, Phillip Parente, David Lim, and Nicholas F. Taylor. "Efficacy of Group Exercise–Based Cancer Rehabilitation Delivered via Telehealth (TeleCaRe): Protocol for a Randomized Controlled Trial." JMIR Research Protocols 11, no. 7 (July 18, 2022): e38553. http://dx.doi.org/10.2196/38553.
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Background Access to rehabilitation to support cancer survivors to exercise is poor. Group exercise–based rehabilitation may be delivered remotely, but no trials have currently evaluated their efficacy. Objective We aimed to evaluate the efficacy of a group exercise–based cancer rehabilitation program delivered via telehealth compared to usual care for improving the quality of life of cancer survivors. Methods A parallel, assessor-blinded, pragmatic randomized controlled trial with embedded cost and qualitative analysis will be completed. In total, 116 cancer survivors will be recruited from a metropolitan health network in Melbourne, Victoria, Australia. The experimental group will attend an 8-week, twice-weekly, 60-minute exercise group session supervised via videoconferencing supplemented by a web-based home exercise program and information portal. The comparison group will receive usual care including standardized exercise advice and written information. Assessments will be completed at weeks 0 (baseline), 9 (post intervention), and 26 (follow-up). The primary outcome will be health-related quality of life measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire at week 9. Secondary measures include walking capacity (6-minute walk test), physical activity (activPAL accelerometer), self-efficacy (Health Action Process Approach Questionnaire), and adverse events. Health service data including hospital length of stay, hospital readmissions, and emergency department presentations will be recorded. Semistructured interviews will be completed within an interpretive description framework to explore the patient experience. The primary outcome will be analyzed using linear mixed effects models. A cost-effectiveness analysis will also be performed. Results The trial commenced in April 2022. As of June 2022, we enrolled 14 participants. Conclusions This trial will inform the future implementation of cancer rehabilitation by providing important data about efficacy, safety, cost, and patient experience. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12621001417875; https://tinyurl.com/yc5crwtr International Registered Report Identifier (IRRID) PRR1-10.2196/38553
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Chan, Jun Keat, Kah Hong Yep, Sarah Magarey, Zoe Keon-Cohen, and Matt Acheson. "Fit Testing Disposable P2/N95 Respirators during COVID-19 in Victoria, Australia: Fit Check Evaluation, Failure Rates, and a Survey of Healthcare Workers." COVID 1, no. 1 (July 6, 2021): 83–96. http://dx.doi.org/10.3390/covid1010007.
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Quantitative fit testing was utilised to evaluate the Department of Health and Human Services in Victoria (DHHS) recommended fit check and determine pass/fail rates for self-selected P2/N95 respirators. Survey experience and training related to P2/N95 respirators were also obtained. This was an observational study at a specialist tertiary referral centre, Melbourne, Australia, between 29 May 2020 and 5 June 2020. The primary outcome was quantitative fit test pass/fail results, with fit check reported against fit test as a 2 × 2 contingency table. The secondary outcomes were the number of adjustments needed to pass, as well as the pass rates for available sizes and types of self-selected respirators, survey data for attitudes, experience and training for P2/N95 respirators. The fit check predicts respirator seal poorly (PPV 34.1%, 95% CI 25.0–40.5). In total, 69% (40/58) of respirators failed quantitative fit testing after initial respirator application and is a clinically relevant finding (first-up failure rate for P2/N95 respirators). Only one person failed the fit test for all three respirator fit tests. There was significant variability between each of the seven types of self-selected P2/N95 respirators, although sample sizes were small. Few participants were trained in the use of P2/N95 respirators or the fit check prior to COVID-19, with a high number of participants confident in achieving a P2/95 respirator seal following a fit test. The fit check alone was not a validated method in confirming an adequate seal for P2/N95 respirators. Quantitative fit testing can facilitate education, improve the seal of P2/N95 respirators, and needs to be integrated into a comprehensive Respiratory Protection Program (RPP).
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Fisher, Jane, Tuan Tran, Stanley Luchters, Thach D. Tran, David B. Hipgrave, Sarah Hanieh, Ha Tran, et al. "Addressing multiple modifiable risks through structured community-based Learning Clubs to improve maternal and infant health and infant development in rural Vietnam: protocol for a parallel group cluster randomised controlled trial." BMJ Open 8, no. 7 (July 2018): e023539. http://dx.doi.org/10.1136/bmjopen-2018-023539.
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IntroductionOptimal early childhood development is an international priority. Risks during pregnancy and early childhood have lasting effects because growth is rapid. We will test whether a complex intervention addressing multiple modifiable risks: maternal nutrition, mental health, parenting capabilities, infant health and development and gender-based violence, is effective in reducing deficient cognitive development among children aged two in rural Vietnam.Methods and analysisThe Learning Clubs intervention is a structured programme combining perinatal stage-specific information, learning activities and social support. It comprises 20 modules, in 19 accessible, facilitated groups for women at a community centre and one home visit. Evidence-informed content is from interventions to address each risk tested in randomised controlled trials in other resource-constrained settings. Content has been translated and culturally adapted for Vietnam and acceptability and feasibility established in pilot testing.We will conduct a two-arm parallel-group cluster-randomised controlled trial, with the commune as clustering unit. An independent statistician will select 84/112 communes in Ha Nam Province and randomly assign 42 to the control arm providing usual care and 42 to the intervention arm. In total, 1008 pregnant women (12 per commune) from 84 clusters are needed to detect a difference in the primary outcome (Bayley Scales of Infant and Toddler Development Cognitive Score <1 SD below standardised norm for 2 years of age) of 15% in the control and 8% in the intervention arms, with 80% power, significance 0.05 and intracluster correlation coefficient 0.03.Ethics and disseminationMonash University Human Research Ethics Committee (Certificate Number 20160683), Melbourne, Victoria, Australia and the Institutional Review Board of the Hanoi School of Public Health (Certificate Number 017-377IDD- YTCC), Hanoi, Vietnam have approved the trial. Results will be disseminated through a comprehensive multistranded dissemination strategy including peer-reviewed publications, national and international conference presentations, seminars and technical and lay language reports.Trial registration numberACTRN12617000442303; Pre-results.
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Goller, Jane L., Jacqueline Coombe, Meredith Temple-Smith, Helen Bittleston, Lena Sanci, Rebecca Guy, Christopher Fairley, et al. "Management of Chlamydia Cases in Australia (MoCCA): protocol for a non-randomised implementation and feasibility trial." BMJ Open 12, no. 12 (December 2022): e067488. http://dx.doi.org/10.1136/bmjopen-2022-067488.
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IntroductionThe sexually transmitted infection chlamydia can cause significant complications, particularly among people with female reproductive organs. Optimal management includes timely and appropriate treatment, notifying and treating sexual partners, timely retesting for reinfection and detecting complications including pelvic inflammatory disease (PID). In Australia, mainstream primary care (general practice) is where most chlamydia infections are diagnosed, making it a key setting for optimising chlamydia management. High reinfection and low retesting rates suggest partner notification and retesting are not uniformly provided. The Management of Chlamydia Cases in Australia (MoCCA) study seeks to address gaps in chlamydia management in Australian general practice through implementing interventions shown to improve chlamydia management in specialist services. MoCCA will focus on improving retesting, partner management (including patient-delivered partner therapy) and PID diagnosis.Methods and analysisMoCCA is a non-randomised implementation and feasibility trial aiming to determine how best to implement interventions to support general practice in delivering best practice chlamydia management. Our method is guided by the Consolidated Framework for Implementation Research and the Normalisation Process Theory. MoCCA interventions include a website, flow charts, fact sheets, mailed specimen kits and autofills to streamline chlamydia consultation documentation. We aim to recruit 20 general practices across three Australian states (Victoria, New South Wales, Queensland) through which we will implement the interventions over 12–18 months. Mixed methods involving qualitative and quantitative data collection and analyses (observation, interviews, surveys) from staff and patients will be undertaken to explore our intervention implementation, acceptability and uptake. Deidentified general practice and laboratory data will be used to measure pre-post chlamydia testing, retesting, reinfection and PID rates, and to estimate MoCCA intervention costs. Our findings will guide scale-up plans for Australian general practice.Ethics and disseminationEthics approval was obtained from The University of Melbourne Human Research Ethics Committee (Ethics ID: 22665). Findings will be disseminated via conference presentations, peer-reviewed publications and study reports.
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Mitchell, Jenny. "1997 Awards for Innovation and Excellence in Primary Health Care Awards - Alliances and Collaboration: Refugee Health Program." Australian Journal of Primary Health 3, no. 3 (1997): 83. http://dx.doi.org/10.1071/py97026.
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Brief Description of the Program: This article describes the ways in which three agencies in the Western Region of Melbourne have joined forces to deliver a co-ordinated health service to newly arrived refugees. The three agencies are: ? the Victorian Foundation for Survivors of Torture ? the Western Region Health Centre ? the Western Melbourne Division of General Practice.
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McDonald, Paul. "From Streets to Sidewalks: Developments in Primary Care Services for Injecting Drug Users." Australian Journal of Primary Health 8, no. 1 (2002): 65. http://dx.doi.org/10.1071/py02010.
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Primary Health Care for the Injecting Drug User (IDU) has been established in Victoria in recognition of the serious health needs of IDUs, which require a relevant and effective response. Research shows the medical consequences that flow from drug abuse, ranging from the onset of blood borne viruses to cardiovascular conditions, and the propensity of drug users to access health services only through accident and emergency areas of hospitals. In 1999, the Victorian government announced the funding of five Local Drug Strategies in five of Melbourne's 'hotspot' street drug areas to address both the needs of users and communities in relation to substance abuse. This funding was an impetus to establish and trial the concept of primary health services, combining both a fixed site and a mobile outreach service. These services are designed to meet the primary health needs of street-based injecting drug users who are at high risk of experiencing overdose or other forms of drug-related harm.
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Rezania, Fatemeh, Christopher J. A. Neil, and Tissa Wijeratne. "Disparities in Care and Outcome of Stroke Patients from Culturally and Linguistically Diverse Communities in Metropolitan Australia." Journal of Clinical Medicine 10, no. 24 (December 14, 2021): 5870. http://dx.doi.org/10.3390/jcm10245870.
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Background: Acute stroke is a time-critical emergency where diagnosis and acute management are highly dependent upon the accuracy of the patient’s history. We hypothesised that the language barrier is associated with delayed onset time to thrombolysis and poor clinical outcomes. This study aims to evaluate the effect of language barriers on time to thrombolysis and clinical outcomes in acute ischemic stroke. Concerning the method, this is a retrospective study of all patients admitted to a metropolitan stroke unit (Melbourne, Victoria, Australia) with an acute ischemic stroke treated with tissue plasminogen activator between 1/2013 and 9/2017. Baseline characteristics, thrombolysis time intervals, length of stay, discharge destination, and in-hospital mortality were compared among patients with and without a language barrier using multivariate analysis after adjustment for age, sex, stroke severity, premorbid modified Rankin Scale (mRS), and Charlson Comorbidity Index (CCI). Language barriers were defined as a primary language other than English. A total of 374 patients were included. Our findings show that 76 patients (20.3%) had a language barrier. Mean age was five years older for patients with language barriers (76.7 vs. 71.8 years, p = 0.004). Less non-English speaking patients had premorbid mRS score of zero (p = 0.002), and more had premorbid mRS score of one or two (p = 0.04). There was no statistically significant difference between the two groups in terms of stroke severity on presentation (p = 0.06). The onset to needle time was significantly longer in patients with a language barrier (188 min vs. 173 min, p = 0.04). Onset to arrival and door to imaging times were reassuringly similar between the two groups. However, imaging to needle time was 9 min delayed in non-English speaking patients with a marginal p value (65 vs. 56 min, p = 0.06). Patients with language barriers stayed longer in the stroke unit (six vs. four days, p = 0.02) and had higher discharge rates than residential aged care facilities in those admitted from home (9.2% vs. 2.3%, p = 0.02). In-hospital mortality was not different between the two groups (p = 0.8). In conclusion, language barriers were associated with almost 14 min delay in thrombolysis. The delay was primarily attributable to imaging to needle time. Language barriers were also associated with poorer clinical outcomes.
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Dawson, Samantha L., Jeffrey M. Craig, Gerard Clarke, Mohammadreza Mohebbi, Phillip Dawson, Mimi LK Tang, and Felice N. Jacka. "Targeting the Infant Gut Microbiota Through a Perinatal Educational Dietary Intervention: Protocol for a Randomized Controlled Trial." JMIR Research Protocols 8, no. 10 (October 21, 2019): e14771. http://dx.doi.org/10.2196/14771.
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Background The early life gut microbiota are an important regulator of the biological pathways contributing toward the pathogenesis of noncommunicable disease. It is unclear whether improvements to perinatal diet quality could alter the infant gut microbiota. Objective The aim of this study is to assess the efficacy of a perinatal educational dietary intervention in influencing gut microbiota in mothers and infants 4 weeks after birth. Methods The Healthy Parents, Healthy Kids randomized controlled trial aimed to recruit 90 pregnant women from Melbourne, Victoria, Australia. At week 26 of gestation, women were randomized to receive dietary advice from their doctor (n=45), or additionally receive a dietary intervention (n=45). The intervention included an educational workshop and 2 support calls aiming to align participants’ diets with the Australian Dietary Guidelines and increase intakes of prebiotic and probiotic foods. The educational design focused on active learning and self-assessment. Behavior change techniques were used to support dietary adherence, and the target behavior was eating for the gut microbiota. Exclusion criteria were age under 18 years, diagnosed mental illnesses, obesity, diabetes mellitus, diagnosed bowel conditions, exclusion diets, illicit drug use, antibiotic use, prebiotic or probiotic supplementation, and those lacking dietary autonomy. The primary outcome measure is a between-group difference in alpha diversity in infant stool collected 4 weeks after birth. Secondary outcomes include evaluating the efficacy of the intervention in influencing infant and maternal stool microbial composition and short chain fatty acid concentrations, epigenetic profile, and markers of inflammation and stress, as well as changes in maternal dietary intake and well-being. The study and intervention feasibility and acceptance will also be evaluated as secondary outcomes. Results The study results are yet to be written. The first participant was enrolled on July 28, 2016, and the final follow-up assessment was completed on October 11, 2017. Conclusions Data from this study will provide new insights regarding the ability of interventions targeting the perinatal diet to alter the maternal and infant gut microbiota. If this intervention is proven, our findings will support larger studies aiming to guide the assembly of gut microbiota in early life. Trial Registration Australian Clinical Trials Registration Number ACTRN12616000936426; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370939 International Registered Report Identifier (IRRID) DERR1-10.2196/14771
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Hayes, Rick. "Primary Health and The Problem with Men?" Australian Journal of Primary Health 8, no. 1 (2002): 83. http://dx.doi.org/10.1071/py02013.
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It would be a brave health promotion coordinator who would suggest to Primary Care Partnership health promotion sub-committee members that just providing "information" to "people who are problems" is a "best-practice" approach (Legge et aI., 1996). One, and only one, of the many reasons for the change has been the creation and dissemination of the Men's Health Promotion Strategic Framework (Hayes, 1999). This framework was developed through a project funded by the Victorian Health Promotion Foundation and commissioned by the North East Health Promotion Centre (NEHPC), Melbourne.
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Cordwell, Lauren. "Advancing consumer participation in primary health: The case of a Victorian Primary Care Partnership." Australian Journal of Primary Health 11, no. 2 (2005): 38. http://dx.doi.org/10.1071/py05020.
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This paper presents an overview of the North Central Metro Primary Care Partnership (NCMPCP) process to strengthen consumer participation. The NCMPCP is a voluntary alliance of 60 health and community services in Melbourne's Northern metropolitan region that aims to make positive, sustainable improvements to services from the perspective of clients, their carers and their families. The population of the NCMPCP catchment includes significant cultural and linguistic diversity and social and economic disadvantage. In strengthening consumer participation, consumers and service providers from NCMPCP member agencies identified the need for a consumer participation training resource to be developed to support the ongoing engagement of consumers in participation opportunities in primary health services. The development of a consumer participation training resource involved consumers and service providers from 14 agencies. Consumers were involved in all stages of needs identification, design, implementation and evaluation. The process to develop the consumer participation training resources has contributed to a greater understanding of consumer participation for the NCMPCP member agencies and has increased the level of engagement and participation by consumers. The process has highlighted the need for consumers and service providers to be trained, resourced and supported to carry out consumer participation work.
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Lake, Marilyn. "The Chinese Empire Encounters the British Empire and Its “Colonial Dependencies”: Melbourne, 1887." Journal of Chinese Overseas 9, no. 2 (2013): 176–92. http://dx.doi.org/10.1163/17932548-12341258.
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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.
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Roussy, Véronique, and Charles Livingstone. "Service planning in the Victorian community health sector." Australian Journal of Primary Health 21, no. 3 (2015): 268. http://dx.doi.org/10.1071/py14076.
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Until now, comprehensive service planning has been uncommon in the Victorian community health sector. Where it has occurred, it has primarily been undertaken by community health services embedded within larger, hospital-based health services. Reflections on the utility and efficacy of community health service planning are largely absent from the Australian peer-reviewed literature. Using a case study focussed on a specific centre in Melbourne’s outer suburbs, this paper explores how community health service planning is shaped by the current policy context, the legal status of registered community health services, and the data and methodologies available to inform planning. It argues that regular and systematic service planning could support registered community health centres to better understand their unique position within the primary health-care landscape, having regard to their inherent opportunities and vulnerabilities. Furthermore, consistent and effective service planning is proposed to benefit agencies in establishing themselves as critical players in promoting local population health initiatives and driving improved health outcomes.
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Kamat, Ashish M. "Commentary on “Risks of primary extracolonic cancers following colorectal cancer in lynch syndrome.” Win AK, Lindor NM, Young JP, Macrae FA, Young GP, Williamson E, Parry S, Goldblatt J, Lipton L, Winship I, Leggett B, Tucker KM, Giles GG, Buchanan DD, Clendenning M, Rosty C, Arnold J, Levine AJ, Haile RW, Gallinger S, Le Marchand L, Newcomb PA, Hopper JL, Jenkins MA, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, Melbourne School of Population Health, The University of Melbourne, Victoria, Australia." Urologic Oncology: Seminars and Original Investigations 31, no. 5 (July 2013): 716. http://dx.doi.org/10.1016/j.urolonc.2013.03.013.
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Holmes, Rebecca Helena, Sunjuri Sun, Saniya Kazi, Sarath Ranganathan, Shidan Tosif, Stephen M. Graham, and Hamish R. Graham. "Management of tuberculosis infection in Victorian children: A retrospective clinical audit of factors affecting treatment completion." PLOS ONE 17, no. 10 (October 13, 2022): e0275789. http://dx.doi.org/10.1371/journal.pone.0275789.
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Background Tuberculosis preventive treatment (TPT) is strongly recommended for children following infection with Mycobacterium tuberculosis because of their high risk of progression to active tuberculosis, including severe disseminated disease. We describe the implementation of TPT for children and adolescents with evidence of tuberculosis infection (TBI) at Victoria’s largest children’s hospital and examine factors affecting treatment completion. Methods We conducted a retrospective clinical audit of all children and adolescents aged <18 years diagnosed with latent TBI at the Royal Children’s Hospital, Melbourne, between 2010 and 2016 inclusive. The primary outcome was treatment completion, defined as completing TPT to within one month of a target duration for the specified regimen (for instance, at least five months of a six-month isoniazid course), confirmed by the treating clinician. Factors associated with treatment adherence were evaluated by univariate and multivariate analysis. Results Of 402 participants with TBI, 296 (74%) met the criteria for treatment “complete”. The most common TPT regimen was six months of daily isoniazid (377, 94%). On multivariate logistic regression analysis, treatment completion was more likely among children and adolescents who had refugee health screening performed (OR 2.31, 95%CI 1.34–4.00) or who were also treated for other medical conditions (OR 1.67 95%CI 1.0–2.85), and less likely among those who experienced side-effects (OR 0.32, 95%CI 0.11–0.94). However, TPT was generally well tolerated with side-effects reported in 15 participants (3.7%). Conclusion Identification of factors associated with TPT completion and deficiencies in the existing care pathway have informed service provision changes to further improve outcomes for Victorian children and adolescents with TBI.
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Zeeuw, Diane. "Case Study: The Development and Evolution of the Creative Arts Practice-led PhD at the University of Melbourne, Victorian College of the Arts." Leonardo 50, no. 5 (October 2017): 526–27. http://dx.doi.org/10.1162/leon_a_01407.
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Many art academics within U.S. institutions have little understanding of the Creative Arts PhD. Moreover, this has lead to the proliferation of a great deal of misinformation as U.S. academics struggle to sift through a growing body of literature on the subject. The author, who believes there is a very real and demonstrated need for more critical “nuts and bolts” or basic information on how such programs have been developed, implemented, staffed and legitimated, created a case study that focuses upon the developmental path and outcomes of a practice-led Creative Arts PhD program. A primary goal of the study was to critically assess the viability of applying the gathered data/findings toward the development of an appropriately adjusted program within a specific U.S. institution. Access to the complete “Case Study: The Development and Evolution of the Creative Arts Practice-led PhD at the University of Melbourne, Victorian College of the Arts” is available on www.mitpressjournals.org/toc/leon/50/5 .
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Peate, Michelle, Sherine Sandhu, Sabine Braat, Roger Hart, Robert Norman, Anna Parle, Raelia Lew, and Martha Hickey. "Randomized control trial of a decision aid for women considering elective egg freezing: The Eggsurance study protocol." Women's Health 18 (January 2022): 174550572211396. http://dx.doi.org/10.1177/17455057221139673.
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Background: Uptake of elective egg freezing has increased globally. The decision to freeze eggs is complex, and detailed, unbiased information is needed. To address this, we developed an online Decision Aid for women considering elective egg freezing. Decision Aids are the standard of care to support complex health decisions. Objectives: This study will measure the impact of the Decision Aid on decision-making (e.g. decisional conflict, engagement in decision-making, distress, and decision delay) and decision quality (e.g. knowledge, level of informed choice, and regret). Methods and Analysis: A single-blinded two-arm parallel-group randomized controlled trial. Women considering elective egg freezing will be recruited using social media, newsletters, and fertility clinics. Data will be collected at baseline (recruitment), 6-month, and 12-month post-randomization. The primary hypothesis is that the intervention (Decision Aid plus Victorian Assisted Reproductive Technology Authority website) will reduce decisional conflict (measured using the Decisional Conflict Scale) at 12 months more than control (Victorian Assisted Reproductive Technology Authority website only). Secondary outcomes include engagement in decision-making (Perceived Involvement in Care Scale), distress (Depression, Anxiety, and Stress Scale), decision delay, knowledge, informed choice (Multi-dimensional Measure of Informed Choice), and decisional regret (Decisional Regret Scale). Ethics: The study was approved by the University of Melbourne Human Research Ethics Committee (Ethics ID: 2056457). Informed consent will be obtained from all participants prior to enrolment. Discussion: This is the first international randomized controlled trial that aims to investigate the effect of an elective egg freezing Decision Aid on decision-related outcomes (e.g. decisional conflict, informed choice, and regret). It is anticipated that participants who receive the Decision Aid will have better decision and health outcomes. Registration details: ACTRN12620001032943: Comparing different information resources on the process and quality of decision-making in women considering elective egg freezing.
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Cameron, Kate L., Jennifer L. McGinley, Kim Allison, Natalie A. Fini, Jeanie L. Y. Cheong, and Alicia J. Spittle. "Dance PREEMIE, a Dance PaRticipation intervention for Extremely prEterm children with Motor Impairment at prEschool age: an Australian feasibility trial protocol." BMJ Open 10, no. 1 (January 2020): e034256. http://dx.doi.org/10.1136/bmjopen-2019-034256.
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IntroductionChildren born extremely preterm (EP: <28 weeks gestation) and/or extremely low birth weight (ELBW: <1000 g) are at increased risk of motor impairment compared with children born at term. Children with motor impairment have lower rates of physical activity (PA) participation compared with their typically developing peers. PA participation is an important outcome for children with motor impairment, however, there is limited evidence available to support interventions that improve PA participation in this population. The aim of this study is to assess the feasibility, including the recruitment and retention, acceptability and fidelity, of a preschool dance participation intervention for children born EP/EBLW with motor impairment called Dance PaRticipation intervention for Extremely prEterm children with Motor Impairment at prEschool age.Methods and analysisThis feasibility case series trial will recruit EP/ELBW children with motor impairment (n=10) from the Victorian Infant Collaborative Study 2016/2017 cohort, a prospective longitudinal cohort study. Up to 10 community-based dance teachers will be recruited and provided with physiotherapy-led training and support to facilitate the participation of EP/ELBW children in community dance classes. A mixed-methods approach (quantitative and qualitative) will be used to analyse the primary aim, to determine the feasibility of the intervention from the perspectives of families and dance teachers.Ethics and disseminationThis study is approved by the Human Research Ethics Committees of The Royal Children’s Hospital and The Royal Women’s Hospital, Melbourne. Study outcomes will be disseminated through conference presentations, peer-reviewed publications and social media.Trial registration numberACTRN12619001266156
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Kinsella, Rita, Tom Collins, Bridget Shaw, James Sayer, Belinda Cary, Andrew Walby, and Sallie Cowan. "Management of patients brought in by ambulance to the emergency department: role of the Advanced Musculoskeletal Physiotherapist." Australian Health Review 42, no. 3 (2018): 309. http://dx.doi.org/10.1071/ah16094.
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Objective The aim of the present study was to evaluate the role of the Advanced Musculoskeletal Physiotherapist (AMP) in managing patients brought in by ambulance to the emergency department (ED). Methods This study was a dual-centre observational study. Patients brought in by ambulance to two Melbourne hospitals over a 12-month period and seen by an AMP were compared with a matched group seen by other ED staff. Primary outcome measures were wait time and length of stay (LOS) in the ED. Results Data from 1441 patients within the Australasian Triage Scale (ATS) Categories 3–5 with musculoskeletal complaints were included in the analysis. Subgroup analysis of 825 patients aged ≤65 years demonstrated that for Category 4 (semi-urgent) patients, the median wait time to see the AMP was 9.5 min (interquartile range (IQR) 3.25–18.00 min) compared with 25 min (IQR 10.00–56.00 min) to see other ED staff (P ≤ 0.05). LOS analysis was undertaken on patients discharged home and demonstrated that there was a 1.20 greater probability (95% confidence interval 1.07–1.35) that ATS Category 4 patients managed by the AMP were discharged within the 4-hour public hospital target compared with patients managed by other ED staff: 87.04% (94/108) of patients managed by the AMPs met this standard compared with 72.35% (123/170) of patients managed by other ED staff (P = 0.002). Conclusions Patients aged ≤65 years with musculoskeletal complaints brought in by ambulance to the ED and triaged to ATS Category 4 are likely to wait less time to be seen and are discharged home more quickly when managed by an AMP. This study has added to the evidence that AMPs improve patient flow in the ED, freeing up time for other ED staff to see higher-acuity, more complex patients. What is known about the topic? There is a growing body of evidence establishing that AMPs improve the flow of patients presenting with musculoskeletal conditions to the ED through reduced wait times and LOS and, at the same time, providing good-quality care and enhanced patient satisfaction. What does this paper add? Within their primary contact capacity, AMPs also manage patients who are brought in by ambulance presenting with musculoskeletal conditions. To the authors’ knowledge, there is currently no available literature documenting the performance of AMPs in the management of this cohort of patients. What are the implications for practitioners? This study has added to the body of evidence that AMPs improve patient flow in the ED and illustrates that AMPs, by seeing patients brought in by ambulance, are able to have a positive impact on the pressures increasingly facing the Victorian Ambulance Service and emergency hospital care.
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Layton, M., E. Johnson, S. Hall, H. Cross, J. Bishop, G. McArthur, and K. Lacey. "The VCCC Research & Education Lead Program: Collective Leadership in Cancer Across Multiple Organisations." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 156s. http://dx.doi.org/10.1200/jgo.18.60100.
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Background and context: The Victorian Comprehensive Cancer Centre (VCCC) is Australia´s first formally constituted comprehensive cancer center, based on NCI principles. It is an alliance of 10 organizations: 7 hospitals, 2 medical research institutes and a university, based in Melbourne, Australia. A key goal for the VCCC is to create meaningful collaborations across partner organizations. Aim: The VCCC established the Research & Education Lead (R & E Lead) Program to build leadership capability who can harness the critical mass of talent across the VCCC alliance to work toward optimal integration of cancer research and education into routine patient care. Strategy/Tactics: This VCCC Research & Education Lead Program manifests the foundational principles of the VCCC by systematising and normalizing collaborative activities across the VCCC alliance. The program is a vehicle that allows the VCCC to address its strategic priorities to enable: - better integration of research, education and clinical care - sharing of ideas and knowledge to improve patient outcomes - shared education and training across member organizations Program/Policy process: Clinicians-scientists were appointed to each tumor stream as VCCC R & E Leads (approx. 0.2 EFT). Their role is to build networks of expertise and to drive change that is evidence-based, strategic and agreed across the VCCC alliance, with a focus on the end goal of better outcomes for cancer patients. The program provides the basis for a model of distributed leadership, wherein champions invested in the VCCC concept are embedded in partner organizations. Outcomes: Three R & E Leads were initially appointed as a pilot for 2 years, with a further three leads appointed during this period. Following the pilot, the program has been expanded to encompass 10 tumor streams as well as leads in primary care integration and cancer nursing. Achievements to date have included the development of a Massive Online Open Course in Cancer Survivorship, conduct of numerous symposia and events that upskill the cancer workforce in niche areas identified by the leads as needs, and consensus on the clinical challenges and research priorities to be tackled collectively within each tumor stream. Overarching program benefits included increased engagement and collaboration across partner organizations, more sharing of knowledge, and more participation in collaborative efforts including VCCC strategy development and advocacy. What was learned: A key finding of an interim program evaluation identified that the appointment of clinician-scientists as the leads was an important factor in their ability to cross the boundaries between research and clinical practice and between organizations, and to work closely and cohesively with clinical service leads for the tumor streams.
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Felmingham, Claire, Gabrielle Byars, Simon Cumming, Jane Brack, Zongyuan Ge, Samantha MacNamara, Martin Haskett, Rory Wolfe, and Victoria Mar. "Testing Artificial Intelligence Algorithms in the Real World: Lessons From the SMARTI Trial." Iproceedings 8, no. 1 (March 1, 2022): e36902. http://dx.doi.org/10.2196/36902.
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Background A number of studies have shown promising performance of artificial intelligence (AI) algorithms for diagnosis of lesions in skin cancer. To date, none of these have assessed algorithm performance in the real-world setting. Objective The aim of this project is to evaluate practical issues of implementing a convolutional neural network developed by MoleMap Ltd and Monash University eResearch in the clinical setting. Methods Participants were recruited from the Alfred Hospital and Skin Health Institute, Melbourne, Australia, from November 1, 2019, to May 30, 2021. Any skin lesions of concern and at least two additional lesions were imaged using a proprietary dermoscopic camera. Images were uploaded directly to the study database by the research nurse via a custom interface installed on a clinic laptop. Doctors recorded their diagnosis and management plan for each lesion in real time. A pre-post study design was used. In the preintervention period, participating doctors were blinded to AI lesion assessment. An interim safety analysis for AI accuracy was then performed. In the postintervention period, the AI algorithm classified lesions as benign, malignant, or uncertain after the doctors’ initial assessment had been made. Doctors then had the opportunity to record an updated diagnosis and management plan. After discussing the AI diagnosis with the patient, a final management plan was agreed upon. Results Participants at both sites were high risk (for example, having a history of melanoma or being transplant recipients). 743 lesions were imaged in 214 participants. In total, 28 dermatology trainees and 17 consultant dermatologists provided diagnoses and management decisions, and 3 experienced teledermatologists provided remote assessments. A dedicated research nurse was essential to oversee study processes, maintain study documents, and assist with clinical workflow. In cases where AI algorithm and consultant dermatologist diagnoses were discordant, participant anxiety was an important factor in the final agreed management plan to biopsy or not. Conclusions Although AI algorithms are likely to be of most use in the primary care setting, higher event rates in specialist settings are important for the initial assessment of algorithm safety and accuracy. This study highlighted the importance of considering workflow issues and doctor-patient-AI interactions prior to larger-scale trials in community-based practices. Acknowledgments This research was supported by the Victorian Medical Research Acceleration Fund, with 1:1 contribution from MoleMap Ltd. VM is supported by the National Health and Medical Research Council Early Career Fellowship. CF is supported by the Monash University Research Training Program Scholarship. Conflicts of Interest SM is head of clinical research and regulatory affairs at Kahu.ai Ltd, a subsidiary of MoleMap Ltd. MH was the chief medical officer and a director of MoleMap Ltd, and holds shares in MoleMap Ltd. Trial Registration ClinicalTrials.gov NCT04040114; https://clinicaltrials.gov/ct2/show/NCT04040114
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Kauerhof, A. Christine, Nour Nicolas, Sudhanshu Bhushan, Eva Wahle, Kate A. Loveland, Daniela Fietz, Martin Bergmann, et al. "Investigation of activin A in inflammatory responses of the testis and its role in the development of testicular fibrosis." Human Reproduction 34, no. 8 (July 24, 2019): 1536–50. http://dx.doi.org/10.1093/humrep/dez109.
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Abstract STUDY QUESTION Does activin A contribute to testicular fibrosis under inflammatory conditions? SUMMARY ANSWER Our results show that activin A and key fibrotic proteins are increased in human testicular biopsies with leukocytic infiltrates and impaired spermatogenesis and in murine experimental autoimmune orchitis (EAO) and that activin A stimulates fibrotic responses in peritubular cells (PTCs) and NIH 3T3 fibroblasts. WHAT IS KNOWN ALREADY Fibrosis is a feature of EAO. Activin A, a regulator of fibrosis, was increased in testes of mice with EAO and its expression correlated with severity of the disease. STUDY DESIGN, SIZE, DURATION This is a cross-sectional and longitudinal study of adult mice immunized with testicular homogenate (TH) in adjuvant to induce EAO, collected at 30 (n = 6), 50 (n = 6) and 80 (n = 5) days after first immunization. Age-matched mice injected with adjuvant alone (n = 14) and untreated mice (n = 15) were included as controls. TH-immunized mice with elevated endogenous follistatin, injected with a non-replicative recombinant adeno-associated viral vector carrying a gene cassette of follistatin (rAAV-FST315; n = 3) or vector with an empty cassette (empty vector controls; n = 2) 30 days prior to the first immunization, as well as appropriate adjuvant (n = 2) and untreated (n = 2) controls, were also examined. Human testicular biopsies showing focal inflammatory lesions associated with impaired spermatogenesis (n = 7) were included. Biopsies showing intact spermatogenesis without inflammation, from obstructive azoospermia patients, served as controls (n = 7). Mouse primary PTC and NIH 3T3 fibroblasts were stimulated with activin A and follistatin 288 (FST288) to investigate the effect of activin A on the expression of fibrotic markers. Production of activin A by mouse primary Sertoli cells (SCs) was also investigated. PARTICIPANTS/MATERIALS, SETTING, METHODS Testicular RNA and protein extracts collected from mice at days 30, 50 and 80 after first immunization were used for analysis of fibrotic marker genes and proteins, respectively. Total collagen was assessed by hydroxyproline assay and fibronectin; collagen I, III and IV, α-smooth muscle actin (α-SMA) expression and phosphorylation of suppressor of mothers against decapentaplegic (SMAD) family member 2 were measured by western blot. Immunofluorescence was used to detect fibronectin. Fibronectin (Fn), αSMA (Acta2), collagen I (Col1a2), III (Col3a1) and IV (Col4a1) mRNA in PTC and NIH 3T3 cells treated with activin A and/or FST288 were measured by quantitative RT-PCR (qRT-PCR). Activin A in SC following tumour necrosis factor (TNF) or FST288 stimulation was measured by ELISA. Human testicular biopsies were analysed by qRT-PCR for PTPRC (CD45) and activin A (INHBA), hydroxyproline assay and immunofluorescence. MAIN RESULTS AND THE ROLE OF CHANCE Production of activin A by SC was stimulated by 25 and 50 ng/ml TNF (P < 0.01, P < 0.001, respectively) as compared to untreated cells. INHBA mRNA was increased in human testicular biopsies with leukocytic infiltrates and impaired spermatogenesis, compared with control biopsies (P < 0.05), accompanied by increased total collagen (P < 0.01) and fibronectin deposition. Total testicular collagen (P < 0.0001) and fibronectin protein expression (P < 0.05) were also increased in EAO, and fibronectin expression was correlated with the severity of the disease (r = 0.9028). In animals pre-treated with rAAV-FST315 prior to immunization with TH, protein expression of fibronectin was comparable to control. Stimulation of PTC and NIH 3T3 cells with activin A increased fibronectin mRNA (P < 0.05) and the production of collagen I (P < 0.001; P < 0.01) and fibronectin (P < 0.05). Moreover, activin A also increased collagen IV mRNA (P < 0.05) in PTC, while αSMA mRNA (P < 0.01) and protein (P < 0.0001) were significantly increased by activin A in NIH 3T3 cells. LARGE SCALE DATA N/A. LIMITATIONS, REASONS FOR CAUTION A limited number of human testicular specimens was available for the study. Part of the study was performed in vitro, including NIH 3T3 cells as a surrogate for testicular fibroblasts. WIDER IMPLICATIONS OF THE FINDINGS Resident fibroblasts and PTC may contribute to the progression of testicular fibrosis following inflammation, and activin A is implicated as a key mediator of this process. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the National Health and Medical Research Council of Australia, the Victorian Government’s Operational Infrastructure Support Program and the International Research Training Group between Justus Liebig University (Giessen) and Monash University (Melbourne) (GRK 1871/1–2) on `Molecular pathogenesis on male reproductive disorders’ funded by the Deutsche Forschungsgemeinschaft and Monash University. The authors declare no competing financial interests.
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"Leslie Harold Martin, 21 December 1900 - 1 February 1983." Biographical Memoirs of Fellows of the Royal Society 33 (December 1987): 387–409. http://dx.doi.org/10.1098/rsbm.1987.0015.
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Leslie Harold Martin was born on 21 December 1900 at Footscray, Melbourne, in the State of Victoria, Australia, the son of Henry Richard and Ettie Emily Martin ( née Tutty). His father came from Somerset and was superintendent of transport for the Victorian Railways, but died prematurely as the result of an accident. His mother was born midway between the cities of Sydney and Melbourne on a bullock train that her father operated for many years between the two cities [1]*. As a child he received his primary education in Melbourne at the Flemington State School from which he gained a scholarship to Essendon High School. He was only 11 years old when his father died and, as money was always scarce, he had to work as a grocer’s errand boy to help support him self at home and at school. He studied hard and managed to win a Junior State Scholarship that took him to the premier Melbourne High School for his final three years of secondary schooling. Here his natural gifts and interest in mathematics and science were soon recognized and encouraged by his mathematics teacher, Miss Julia Flynn, and this led to his winning a Victorian Education Department Senior Government Scholarship on the basis of his excellent performance in the school leaving examinations in December 1918. This scholarship enabled him to enter the University of Melbourne at the beginning of 1919. He was admitted to the course ‘B.Sc. for Education’ to train to become a teacher.
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Fernando, Himawan, Ziad Nehme, Diem Dinh, Emily Andrew, Angela Brennan, William Shi, Jason Bloom, et al. "Impact of prehospital opioid dose on angiographic and clinical outcomes in acute coronary syndromes." Emergency Medicine Journal, April 26, 2022, emermed-2021-211519. http://dx.doi.org/10.1136/emermed-2021-211519.
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BackgroundAn adverse interaction whereby opioids impair and delay the gastrointestinal absorption of oral P2Y12 inhibitors has been established, however the clinical significance of this in acute coronary syndrome (ACS) is uncertain. We sought to characterise the relationship between prehospital opioid dose and clinical outcomes in patients with ACS.MethodsPatients given opioid treatment by emergency medical services (EMS) with ACS who underwent percutaneous coronary intervention (PCI) between 1 January 2014 and 31 December 2018 were included in this retrospective cohort analysis using data linkage between the Ambulance Victoria, Victorian Cardiac Outcomes Registry and Melbourne Interventional Group databases. Patients with cardiogenic shock, out-of-hospital cardiac arrest and fibrinolysis were excluded. The primary end point was the risk-adjusted odds of 30-day major adverse cardiac events (MACE) between patients who received opioids and those that did not.Results10 531 patients were included in the primary analysis. There was no significant difference in 30-day MACE between patients receiving opioids and those who did not after adjusting for key patient and clinical factors. Among patients with ST-elevation myocardial infarction (STEMI), there were significantly more patients with thrombolysis in myocardial infarction (TIMI) 0 or 1 flow pre-PCI in a subset of patients with high opioid dose versus no opioids (56% vs 25%, p<0.001). This remained significant after adjusting for known confounders with a higher predicted probability of TIMI 0/1 flow in the high versus no opioid groups (33% vs 11%, p<0.001).ConclusionsOpioid use was not associated with 30-day MACE. There were higher rates of TIMI 0/1 flow pre-PCI in patients with STEMI prescribed opioids. Future prospective research is required to verify these findings and investigate alternative analgesia for ischaemic chest pain.
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Rabusin, Chantel L., Hylton B. Menz, Jodie A. McClelland, Angela M. Evans, Peter Malliaras, Sean I. Docking, Karl B. Landorf, James M. Gerrard, and Shannon E. Munteanu. "Efficacy of heel lifts versus calf muscle eccentric exercise for mid-portion Achilles tendinopathy (HEALTHY): a randomised trial." British Journal of Sports Medicine, September 28, 2020, bjsports—2019–101776. http://dx.doi.org/10.1136/bjsports-2019-101776.
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Objective(s)To compare the efficacy of in-shoe heel lifts to calf muscle eccentric exercise in reducing pain and improving function in mid-portion Achilles tendinopathy.MethodsThis was a parallel-group randomised superiority trial at a single centre (La Trobe University Health Sciences Clinic, Discipline of Podiatry, Melbourne, Victoria, Australia). One hundred participants (52 women and 48 men, mean age 45.9, SD 9.4 years) with clinically diagnosed and ultrasonographically confirmed mid-portion Achilles tendinopathy were randomly allocated to either a (1) heel lifts (n=50) or (2) eccentric exercise (n=50) group. The primary outcome measure was the Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire at 12 weeks. Differences between groups were analysed using intention to treat with analysis of covariance.ResultsThere was 80% follow-up of participants (n=40 per group) at 12 weeks. The mean VISA-A score improved by 26.0 points (95% CI 19.6 to 32.4) in the heel lifts group and by 17.4 points (95% CI 9.5 to 25.3) in the eccentric exercise group. On average, there was a between-group difference in favour of the heel lifts for the VISA-A (adjusted mean difference 9.6, 95% CI 1.8 to 17.4, p=0.016), which approximated, but did not meet our predetermined minimum important difference of 10 points.ConclusionIn adults with mid-portion Achilles tendinopathy, heel lifts were more effective than calf muscle eccentric exercise in reducing pain and improving function at 12 weeks. However, there is uncertainty in the estimate of effect for this outcome and patients may not experience a clinically worthwhile difference between interventions.Trial registration numberACTRN12617001225303.
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Nan Tie, E., H. Fernando, Z. Nehme, D. Dinh, E. Andrew, A. Brennan, S. Zaman, et al. "Sex differences in pre-hospital analgesia and outcomes in patients presenting with acute coronary syndromes." European Heart Journal 42, Supplement_1 (October 1, 2021). http://dx.doi.org/10.1093/eurheartj/ehab724.2778.
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Abstract Background Opioid analgesia remains the mainstay of pain management in acute coronary syndromes (ACS). Significant sex differences persist in ACS presentation, management and outcomes, but the impact of sex-differences on pre-hospital pain management of ACS with opioids is unknown. There is increasing awareness of the importance of pre-hospital factors in ACS, as well as emerging concerns with opioid use impairing the gastrointestinal absorption of oral P2Y12 inhibitors. Purpose This study examined if sex-differences in pre-hospital pain scores, opioid administration and clinical outcomes exist in ACS patients. Methods Patients presenting with ACS via ambulance (2014–2018) that underwent percutaneous coronary intervention (PCI) were prospectively collected via the Victorian Cardiac Outcomes Registry (VCOR), the Melbourne Interventional Group (MIG), and linked to the Ambulance Victoria database. The primary outcome was 30-day major adverse cardiac events (MACE). Secondary outcomes were descriptive analyses of pre-hospital pain score, intravenous morphine equivalent analgesic dosing, plus predictors of MACE and Thrombolysis In Myocardial Infarction (TIMI) 0–1 flow pre-PCI using logistic regression. Results 10,547 patients were included (female: 2,775 [26.3%]). Opioids were administered to 1,585 (57%) females and 5,068 (65%) males (p<0.001). Adjusted 30-day MACE was similar between opioid groups in both sexes (female: OR 1.21, CI 0.82–1.79, p=0.34; male: OR 0.89, 0.68–1.16, p=0.40). Median pain score at presentation was 6 (IQR 4,8) for both sexes. Median opioid dose was 2.5 mg (IQR 0,10) in females and 5 mg (IQR 0,10) in males (p<0.001), with similar pain relief achieved. Adjusted rates of TIMI 0–1 pre-PCI were higher in patients administered opioids (female: OR 2.83, CI 2.14–3.56, p<0.001; male: OR 2.95, CI 2.49–3.49, p<0.001). Conclusions Female patients undergoing PCI received less opioid analgesia, but no sex-differences in pre-hospital pain scores were seen. Opioid administration was associated with impaired antegrade flow in the culprit artery in both sexes, but not short-term MACE. Randomised trials evaluating the clinical implications of opioid administration in ACS with sex subgroup analyses are needed to guide clinical practice. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Melbourne Interventional GroupVictorian Cardiac Outcomes Registry
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McGuinness, Sarah L., Johnson Josphin, Owen Eades, Sharon Clifford, Jane Fisher, Maggie Kirkman, Grant Russell, et al. "Organizational responses to the COVID-19 pandemic in Victoria, Australia: A qualitative study across four healthcare settings." Frontiers in Public Health 10 (September 29, 2022). http://dx.doi.org/10.3389/fpubh.2022.965664.
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ObjectiveOrganizational responses that support healthcare workers (HCWs) and mitigate health risks are necessary to offset the impact of the COVID-19 pandemic. We aimed to understand how HCWs and key personnel working in healthcare settings in Melbourne, Australia perceived their employing organizations' responses to the COVID-19 pandemic.MethodIn this qualitative study, conducted May-July 2021 as part of the longitudinal Coronavirus in Victorian Healthcare and Aged Care Workers (COVIC-HA) study, we purposively sampled and interviewed HCWs and key personnel from healthcare organizations across hospital, ambulance, aged care and primary care (general practice) settings. We also examined HCWs' free-text responses to a question about organizational resources and/or supports from the COVIC-HA Study's baseline survey. We thematically analyzed data using an iterative process.ResultsWe analyzed data from interviews with 28 HCWs and 21 key personnel and free-text responses from 365 HCWs, yielding three major themes: navigating a changing and uncertain environment, maintaining service delivery during a pandemic, and meeting the safety and psychological needs of staff . HCWs valued organizational efforts to engage openly and honesty with staff, and proactive responses such as strategies to enhance workplace safety (e.g., personal protective equipment spotters). Suggestions for improvement identified in the themes included streamlined information processes, greater involvement of HCWs in decision-making, increased investment in staff wellbeing initiatives and sustainable approaches to strengthen the healthcare workforce.ConclusionsThis study provides in-depth insights into the challenges and successes of organizational responses across four healthcare settings in the uncertain environment of a pandemic. Future efforts to mitigate the impact of acute stressors on HCWs should include a strong focus on bidirectional communication, effective and realistic strategies to strengthen and sustain the healthcare workforce, and greater investment in flexible and meaningful psychological support and wellbeing initiatives for HCWs.
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Downing, Leanne. "Sensory Jam." M/C Journal 9, no. 6 (December 1, 2006). http://dx.doi.org/10.5204/mcj.2685.
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Sticky, messy and nauseatingly saccharine, the sensory properties of jam may be a long way from the stylized corporate polish of Australia’s multi-billion dollar film exhibition industry, yet the history of Australian cinema space will be forever indebted to the Victoria Preserving Company; one-time producer of the humblest of sweet treats. Through an analysis of Melbourne’s Jam Factory cinema complex, this article explores the unusual intersection of jam, sensory gratification and contemporary Australian cinema-going at the dawn of the 21st century. Encompassing the historic architecture of the former Victoria Preserving Company, South Yarra’s Jam Factory complex provides a gentrified gloss to an inner suburban precinct historically renowned for the manufacturing of jam and preserves. Nestled in the heart of Chapel Street, less than two blocks down from Toorak road and a stone’s throw from the nightclub precinct of Commercial road, the Jam Factory occupies an important part of Melbourne’s cultural heritage; functioning as a quintessential signifier of the city’s traversal from wholesale manufacturing during the early 1900s into the service vectors of digital media technologies and mixed-use retail entertainment destinations at the start of the new millennium. Established in 1876, the Victoria Preserving Company, AKA the ‘Jam Factory’, hosts an array of diverse retail and leisure outlets. Included amongst its tenants are Borders Books, Villa & Hut, TGI Fridays, The Pancake Parlour, a Virgin Music Mega-store, an elaborate Village Cinema megaplex, and a range of ancillary restaurants, fashion stores and cafes. According to the venue’s promotional material, “The Jam Factory of today is, in short, ‘jam packed’ with entertainment” (Chapel St Precinct, n.pag.). With the original building’s façade and cooling store still intact, the architectural remnants of the Victoria Preserving Factory provide a culturally significant backdrop for what is ostensibly Australia’s most noteworthy cinema venture; Village Roadshow’s megaplex cinema flagship. Replete with fifteen large format screens, including two Gold Class cinemas, a Cinema Europa enclave and an interactive games alcove, The Village Jam Factory signifies Australia’s first foray into cinema-based retail entertainment destinations. In commenting on the opening of the Jam Factory megaplex in 1998, Village Roadshow’s general manager Mr. David Herman said, “The objective was to create Australia’s first non-gambling cinema and lifestyle complex” (Catalano 6). More than any other cinema venue, the Village Jam Factory played a key role in pushing Australian film exhibition standards into the new millennium. In an era marked by competing home theatre technologies and diversified sites of media consumption, the Jam Factory’s shift from suburban cinema to lifestyle complex dramatically altered both the business and social practice of movie-going in Australia. Central to this shift was a tripartite marketing strategy which sought to capitalize on: protracted movie-going experiences; sensory stimulation; and, venue promotion. Experiential Jam The promotion of a protracted movie-going experience has been essential to the continued success of the Village Jam Factory. As I have argued elsewhere, the Australian cinema industry of the mid 1990s faced a number of significant incentives for extending the movie going experience beyond the auditorium; not the least being the steady decline of box office takings that occurred during the late 1980s (Downing). In the face of new media technologies such as the internet, DVD and Pay TV, many cinema operators were forced to look beyond the box office as a primary source of profits. To this end Village Roadshow effectively used the Jam Factory as a testing ground for the generation of ancillary leisure and retail income streams. During the mid 1990s Village actively promoted the Jam Factory as a space in which audiences could not only see a film, but also engage in a series of expanded retail activities such as shopping, dining and video-game playing. Discussing the development of multi-use cinema venues during the 1990s, Charles Acland has commented that such spaces “…do not situate conditions of spectatorship alone; they also construct relations between public and cinematic practices” (Acland 119). Sensory Jam Far from being a traditional site of film consumption, the Jam Factory set an industry precedent by becoming the nation’s first cinema venue in which audiences were encouraged to engage in an entertainment experience that was, above all, aimed at stimulating the senses. In keeping with the ‘lifestyle destination’ mantra, the Village Jam Factory provided a new generation of Australians with a multi-sensory entertainment experience that could not be emulated by home theatre technologies. Wide sweeping foyers and elaborate ticket and merchandising counters greet the eye; ‘luxury’ stadium seating with wide aisles and broad armrests offer the ‘ultimate’ in tactile comfort; digital surround sound facilities pleasure the ears and a plethora of food and beverage novelties work to gratify the senses of taste and smell. More than any other Village cinema outlet, the Jam Factory venue smacks of sugar-coated commerce. With a revenue contribution of over 18%, the Village Roadshow candy bar is the undisputed cash-cow of the enterprise (Australian Film Commission 143). Colloquially known as ‘Lollywood’, the Village confectionary counter is an over-priced explosion of colour and candy that sustains industry revenue through a deliberate appeal to the audience’s sense of taste. This sugar dependency synchronistically mirrors the former success of Henry Jones, the entrepreneur behind Australia’s IXL jam brand, who operated his famous preserving company on the site between 1895 and 1926 (Chapel St Precinct, n.pag.). Venue Jam Village Roadshow’s promotion of the Jam Factory venue over the actual films being screened is indicative of Australia’s primary shift towards retail entertainment based cinema complexes. Unlike the homogenous multiplex venues of the 1970s and 1980s, the Village Jam Factory Complex has been aggressively marketed as a Melbourne icon, capable of offering a unique entertainment experience. This agenda is clearly documented in the 1999 Village Roadshow annual report which, pointing towards a perceived threat of home theatre technologies, proclaimed: [In] broadening the cinema going experience … [Village] aims to create an environment of quality entertainment theming and ancillary lifestyle retailing, thus providing a consistently high level of incentive for people to leave their homes for cinema anchored destinations. (Village Roadshow 19) To this end, the Jam Factory became the physical embodiment of Village Cinemas’ corporate tagline “Where Movies Live” (Village Cinemas, n.pag.). Throughout the late 1990s, a number of similar sites proliferated across Europe, the United States and Canada. Two noteworthy examples of this trend are the Manchester Times building in the UK (initially managed by a short lived Village-Warner synergy) and the Sony Centre at Potsdamer Platz, Berlin; previous home to the Third Reich and later, the Berlin Wall. In both of these examples a similar venue-promotion agenda is clearly at work. In reflecting the cultural specificities of their host cities, each of these venues pays a semiotic homage to the previous occupants of their space. The Manchester Times building, for example, retains much of its former architecture and reflects the nocturnal vibrancy of 19th century printing plant. Similarly, the Sony Centre offers an architectural reflection on the complexities of Berlin history and German cinema. In Melbourne, the Jam Factory’s history of jam and jam making are equally preserved. Drawing heavily on postmodern architectural styles, the Jam Factory’s interior uses South Yarra’s local history as a backdrop for a schizophrenic collage of seemingly incommensurate time/place references. From the distinctive red-brick cooling tower (located in the centre of the building) one encounters a hybrid fusion of Mediterranean pasta courts, European coffee lounges, Romanesque artwork and columns (complete with weathered-look paint and ‘crumbling’ tops), statues of Hollywood stars, as well as a dazzling gaming alcove and a series of subdued ‘luxury’ (Gold Class) cinemas. Such eclectic displays of visual hyperbole have been prefigured by Umberto Eco, whose discussion on hyperreality addresses an imagination which “… demands the real thing, and in order to attain it, must fabricate the absolute fake” (Eco 8). As a relatively recent contributor to Australian cinema history, the Village Jam Factory has achieved little sustained academic attention, yet its significance must not be undervalued. As Australia’s first cinema-oriented retail entertainment destination, the Village Jam Factory has been crucial in placing Australia into the global film exhibition arena. While the pungent aromas of ripened fruit, vinegar and boiling sugar have long since been replaced by the scent of popcorn and recycled air, the legacy and architecture of jam-making has played a key role in propelling Australian film exhibition into the new millennium. References Acland, Charles. Screen Traffic: Movies, Multiplexes and Global Culture. Durham: Duke UP, 2003. Australian Film Commission. Get the Picture. Sydney: Australian Film Commission, 2001. Catalano, Anthony. “Village to Extend Jam Factory to 14 Cinemas.” The Age 5 Aug. 1998. Chapel St Precinct. General History of Chapel Street & Surrounds. 2006. 30 Dec. 2006 http://www.chapelstreet.com.au/default.asp?mode=history>. Downing, Leanne. “More than Meets the Eye: The Suburban Cinema Megaplex as Sensory Heterotopia.” Refractory: Journal of Media and Culture 8 (2005). http://www.refractory.unimelb.edu.au/journalissues/vol8/downing.html>. Eco, Umberto. Travels in Hyper Reality. Orlando Florida: Harcourt Brace Jovanovich, 1986. Village Cinemas. 2006. 30 Dec. 2006. http://www.villagecinemas.com.au/>. Village Roadshow. Annual Report. Melbourne: Village Roadshow, 1999.
Citation reference for this article
MLA Style
Downing, Leanne. "Sensory Jam: How the Victoria Preserving Company Pushed Australian Cinema Space into the New Millennium." M/C Journal 9.6 (2006). echo date('d M. Y'); ?> <http://journal.media-culture.org.au/0612/05-downing.php>. APA Style
Downing, L. (Dec. 2006) "Sensory Jam: How the Victoria Preserving Company Pushed Australian Cinema Space into the New Millennium," M/C Journal, 9(6). Retrieved echo date('d M. Y'); ?> from <http://journal.media-culture.org.au/0612/05-downing.php>.
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Douglas, Ned, Sophie Demeduik, Kate Conlan, Priscilla Salmon, Brian Chee, Taylor Sullivan, David Heelan, John Ozcan, Gareth Symons, and Candida Marane. "Surgical caps displaying team members' names and roles improve effective communication in the operating room: a pilot study." Patient Safety in Surgery 15, no. 1 (July 28, 2021). http://dx.doi.org/10.1186/s13037-021-00301-w.
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Abstract Background Teamwork in the operating theatre is a complex emergent phenomenon and is driven by cooperative relationships between staff. A foundational requirement for teamwork is the ability to communicate effectively, and in particular, knowing each other’s name. Many operating theatre staff do not know each other’s name, even after formal team introductions. The use of theatre caps to display a staff member’s name and role has been suggested to improve communication and teamwork. Methods We hypothesized that the implementation of scrub hats with individual team members' names and roles would improve the perceived quality and effectiveness of communication in the operating theatre. A pilot project was designed as a pre-/post-implementation questionnaire sent to 236 operating room staff members at a general hospital in suburban Melbourne, Victoria, Australia, between November 6 to December 18, 2018. Participants included medical practitioners (anaesthetists, surgeons, obstetricians and gynaecologists), nurses (anaesthetic, scrub/scout and paediatric nurses), midwives and theatre technicians. The primary outcome was a change in perceived teamwork score, measured using a five position Likert scale. Results Of 236 enrolled participants, 107 (45%) completed both the pre and post intervention surveys. The median perceived teamwork response of four did not change after the intervention, though the number of low scores was reduced (p = 0.015). In a pre-planned subgroup analysis, the median perceived teamwork score rose for midwives from three to four (p < 0.001), while for other craft groups remained similar. The median number of staff members in theatre that a participant did not know the name of reduced from three to two (p < 0.001). Participants reported knowing the names of all staff members present in the theatre more frequently after the intervention (31% vs 15%, p < 0.001). The reported rate of formal team introductions was not significantly different after the intervention (34.7% vs 47.7% p = 0.058). Conclusions In this study, we found that wearing caps displaying name and role appeared to improve perceived teamwork and improve communication between staff members working in the operating theatre.
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"Guest Editorial: Development of the Five Year Victorian Women's Health Plan." Australian Journal of Primary Health 4, no. 3 (1998): 6. http://dx.doi.org/10.1071/py98026.
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This issue of the Australian Journal of Primary Health-Interchange is a special issue for the publication of papers presented at the Victorian Women's Health Conference held in Melbourne between 9-10th June, 1998. For many of us involved in the organisation of the conference, we were overwhelmed by the interest in it. My involvement was as chairperson of u�f Victorian Women's Health Plan Consultation and Communication Committee.
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Burnham, S. C., P. M. Coloma, Q. X. Li, S. Collins, G. Savage, S. Laws, J. Doecke, et al. "APPLICATION OF THE NIA-AA RESEARCH FRAMEWORK: TOWARDS A BIOLOGICAL DEFINITION OF ALZHEIMER’S DISEASE USING CEREBROSPINAL FLUID BIOMARKERS IN THE AIBL STUDY." Journal of Prevention of Alzheimer's Disease, 2019, 1–8. http://dx.doi.org/10.14283/jpad.2019.25.
Full textAbstract:
BACKGROUND: The National Institute on Aging and Alzheimer’s Association (NIA-AA) have proposed a new Research Framework: Towards a biological definition of Alzheimer’s disease, which uses a three-biomarker construct: Aß-amyloid, tau and neurodegeneration AT(N), to generate a biomarker based definition of Alzheimer’s disease. OBJECTIVES: To stratify AIBL participants using the new NIA-AA Research Framework using cerebrospinal fluid (CSF) biomarkers. To evaluate the clinical and cognitive profiles of the different groups resultant from the AT(N) stratification. To compare the findings to those that result from stratification using two-biomarker construct criteria (AT and/or A(N)). DESIGN: Individuals were classified as being positive or negative for each of the A, T, and (N) categories and then assigned to the appropriate AT(N) combinatorial group: A-T-(N)-; A+T-(N)-; A+T+(N)-; A+T-(N)+; A+T+(N)+; A-T+(N)-; A-T-(N)+; A-T+(N)+. In line with the NIA-AA research framework, these eight AT(N) groups were then collapsed into four main groups of interest (normal AD biomarkers, AD pathologic change, AD and non-AD pathologic change) and the respective clinical and cognitive trajectories over 4.5 years for each group were assessed. In two sensitivity analyses the methods were replicated after assigning individuals to four groups based on being positive or negative for AT biomarkers as well as A(N) biomarkers. SETTING: Two study centers in Melbourne (Victoria) and Perth (Western Australia), Australia recruited MCI individuals and individuals with AD from primary care physicians or tertiary memory disorder clinics. Cognitively healthy, elderly NCs were recruited through advertisement or via spouses of participants in the study. PARTICIPANTS: One-hundred and forty NC, 33 MCI participants, and 27 participants with AD from the AIBL study who had undergone CSF evaluation using Elecsys® assays. INTERVENTION (if any): Not applicable. MEASUREMENTS: Three CSF biomarkers, namely amyloid β1-42, phosphorylated tau181, and total tau, were measured to provide the AT(N) classifications. Clinical and cognitive trajectories were evaluated using the AIBL Preclinical Alzheimer Cognitive Composite (AIBL-PACC), a verbal episodic memory composite, an executive function composite, California Verbal Learning Test – Second Edition; Long-Delay Free Recall, Mini-Mental State Examination, and Clinical Dementia Rating Sum of Boxes scores. RESULTS: Thirty-eight percent of the elderly NCs had no evidence of abnormal AD biomarkers, whereas 33% had biomarker levels consistent with AD or AD pathologic change, and 29% had evidence of non-AD biomarker change. Among NC participants, those with biomarker evidence of AD pathology tended to perform worse on cognitive outcome assessments than other biomarker groups. Approximately three in four participants with MCI or AD had biomarker levels consistent with the research framework’s definition of AD or AD pathologic change. For MCI participants, a decrease in AIBL-PACC scores was observed with increasing abnormal biomarkers; and increased abnormal biomarkers were also associated with increased rates of decline across some cognitive measures. CONCLUSIONS: Increasing biomarker abnormality appears to be associated with worse cognitive trajectories. The implementation of biomarker classifications could help better characterize prognosis in clinical practice and identify those at-risk individuals more likely to clinically progress, for their inclusion in future therapeutic trials.