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Добірка наукової літератури з теми "Alfred Hospital (Melbourne, Vic )"

Автор: Grafiati
Опубліковано: 10 грудня 2022
Оновлено: 28 січня 2023

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Статті в журналах з теми "Alfred Hospital (Melbourne, Vic )"

1

O’Keefe, Daniel, J. Gunn, Kathleen Ryan, Filip Djordjevic, Phoebe Kerr, Judy Gold, Imogen Elsum, et al. "Exploring hepatitis C virus testing and treatment engagement over time in Melbourne, Australia: a study protocol for a longitudinal cohort study (EC-Experience Cohort study)." BMJ Open 12, no. 1 (January 2022): e057618. http://dx.doi.org/10.1136/bmjopen-2021-057618.

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IntroductionThe advent of direct acting antiviral therapy for hepatitis C virus (HCV) means the elimination of HCV is possible but requires sustained effort to achieve. Between 2016 and 2019, 44% of those living with HCV were treated in Australia. However, treatment uptake has declined significantly. In Australia, people who inject drugs (PWID) are the population most at risk of HCV acquisition. Eliminating HCV in Australia will require nuanced understanding of the barriers to HCV treatment experienced by PWID and tailored interventions to address these barriers. The EC-Experience Cohort study aims to explore the barriers and enablers reported by PWID to engagement in HCV care.Methods and analysisThe EC-Experience Cohort study is a prospective cohort of PWID, established in Melbourne, Australia in 2018. Participants are assigned into three study groups: (1) those not currently engaged in HCV testing; (2) those diagnosed with HCV but not currently engaged in treatment and (3) those completed treatment. Participants complete a total of four interviews every 6 months across an 18-month study period. Predictors of experience of key outcome events along the HCV care cascade will be explored over time.Ethics and disseminationEthical approval for the EC-Experience Cohort study was obtained by the Alfred Hospital Ethics Committee in Melbourne, Australia (Project Number: HREC/16/Alfred/164). All eligible participants are assessed for capacity to consent and partake in a thorough informed consent process. Results from the EC-Experience Cohort study will be disseminated via national and international scientific and public health conferences and peer-reviewed journal publications. Data from the EC-Experience Cohort study will improve the current understanding of the barriers to HCV care for PWID and guide the tailoring of service provision for specific subgroups. Understanding the barriers and how to increase engagement in care of PWID is critical to achieve HCV elimination goals.
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2

WOODS, MAREE. "Occupational Therapy at Alfred Hospital Melbourne." Australian Occupational Therapy Journal 9, no. 2 (August 27, 2010): 12–15. http://dx.doi.org/10.1111/j.1440-1630.1962.tb00929.x.

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Scarff, Christopher W., John Lippmann, and Andrew W. Fock. "A review of diving practices and outcomes following the diagnosis of a persistent (patent) foramen ovale in compressed air divers with a documented episode of decompression sickness." Diving and Hyperbaric Medicine Journal 50, no. 4 (December 20, 2020): 363–69. http://dx.doi.org/10.28920/dhm50.4.363-369.

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(Scarff CW, Lippmann J, Fock AW. A review of diving practices and outcomes following the diagnosis of a persistent (patent) foramen ovale in compressed air divers with a documented episode of decompression sickness. Diving and Hyperbaric Medicine. 2020 December 20;50(4):363–369. doi: 10.28920/dhm50.4.363-369. PMID: 33325017.) Introduction: The presence of a persistent (patent) foramen ovale (PFO) increases the risk of decompression sickness (DCS) whilst diving with pressurised air. After the diagnosis of a PFO, divers will be offered a number of options for risk mitigation. The aim of this study was to review the management choices and modifications to diving practices following PFO diagnosis in the era preceding the 2015 joint position statement (JPS) on PFO and diving. Methods: A retrospective study was conducted of divers sourced from both the Alfred Hospital, Melbourne and the Divers Alert Network Asia-Pacific during the period 2005–2015. Divers were contacted via a combination of phone, text, mail and email. Data collected included: diving habits (years, style and depths); DCS symptoms, signs and treatment; return to diving and modifications of dive practices; history of migraine and echocardiography (ECHO) pre- and post-intervention; ECHO technique(s) used, and success or failure of PFO closure (PFOC). Analyses were performed to compare the incidence of DCS pre- and post-PFO diagnosis. Results: Seventy-three divers were interviewed. Sixty-eight of these returned to diving following the diagnosis of PFO. Thirty-eight underwent PFOC and chose to adopt conservative diving practices (CDPs); 15 chose PFOC with no modification to practices; 15 adopted CDPs alone; and five have discontinued diving. The incidence of DCS decreased significantly following PFOC and/or adoption of conservative diving practices. Of interest, migraine with aura resolved in almost all those who underwent PFOC. Conclusions: Many divers had already adopted practices consistent with the 2015 JPS permitting the resumption of scuba diving with a lowering of the incidence of DCS to that of the general diving population. These results support the recommendations of the JPS.
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Barnett, A. J. "Studies of scleroderma at The Alfred Hospital, Melbourne." Internal Medicine Journal 36, no. 8 (August 2006): 513–18. http://dx.doi.org/10.1111/j.1445-5994.2006.01133.x.

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McDermott, Francis T. "Mortality from bleeding peptic ulcer: Alfred Hospital, Melbourne, 1976‐1980." Medical Journal of Australia 142, no. 1 (January 1985): 11–14. http://dx.doi.org/10.5694/j.1326-5377.1985.tb113274.x.

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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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Roberts, S. A., J. C. Franklin, A. Mijch, and D. Spelman. "NocardiaInfection in Heart‐Lung Transplant Recipients at Alfred Hospital, Melbourne, Australia, 1989–1998." Clinical Infectious Diseases 31, no. 4 (October 2000): 968–72. http://dx.doi.org/10.1086/318150.

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8

Robinson, Maureen, and Janet Campton. "Using partner hospitals in collaborative benchmarking." Australian Health Review 20, no. 1 (1997): 122. http://dx.doi.org/10.1071/ah970122.

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In May 1994 the Physiotherapy Department at John Hunter Hospital received a Commonwealth Best Practice in the Health Sector grant to design a critical pathway for the treatment of stroke.The implementation of the pathway at John Hunter Hospital and the introduction of the methodology to secondary sites (The Alfred Healthcare Group, Melbourne, and Royal Hobart & Repatriation General Hospitals, Hobart) resulted in the development of a Benchmarking Consortium.This paper will discuss the importance of benchmarking in understanding clinical processes, and the methodology employed to ensure that meaningful benchmarks wereachieved.
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9

Nair, Anish Puliyayil, Cindy Lee, Anna Kalff, Patricia A. Walker, Krystal Bergin, Jay Hocking, Sue Morgan, et al. "High Risk Multiple Myeloma: Better Outcomes with Upfront Tandem Autologous- Non-Myelo Ablative Allogeneic Stem Cell Transplantation Compared to Upfront Autologous Stem Cell Transplantation." Blood 128, no. 22 (December 2, 2016): 4684. http://dx.doi.org/10.1182/blood.v128.22.4684.4684.

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Abstract Aim/Background: The outcomes of high risk multiple myeloma (HR-MM) remain poor. As per the revised international staging system (R-ISS), high risk patients, defined by International Staging System (ISS) stage 3 plus high risk chromosomal abnormality and/or high Lactate Dehydrogenase (LDH), have particularly poor outcomes with 5 year progression free survival (PFS) and overall survival (OS) of 24% and 40% respectively.1 Tandem autologous - non-myeloablative allogeneic stem cell transplantation (ASCT-NMA AlloSCT), when used as upfront consolidation may improve the outcome via a graft versus myeloma effect. We performed a retrospective analysis comparing patients who had upfront tandem ASCT-NMA allo SCT for HR-MM with a HR-MM control group who were conventionally treated with upfront ASCT alone. Method: From May 2008 to June 2015, 29 HR-MM patients were treated at the Alfred Hospital Melbourne, with upfront tandem ASCT-NMA alloSCT. HR-MM was defined by the presence of at least 2 of 5 high risk features including International Staging System (ISS) score III, adverse cytogenetics [t(4;14 and/or 17p- identified on FISH and/or complex karyotype on metaphase analysis], elevated lactate dehydrogenase (LDH), plasma cell leukemia (all at diagnosis) or induction failure (less than partial remission (PR)) with proteosome inhibitor (PI) or immunomodulator (IMID) based combination chemotherapy. Outcomes for these patients were compared with 12 HR-MM patients contemporaneously treated at the Royal Adelaide hospital, Adelaide with upfront ASCT alone. All ASCT were conditioned with melphalan 200mg/m2; NMA were conditioned with oral fludarabine 48mg/m2 on days -4 to -2 and 2Gy TBI on day 0. All tandem ASCT-NMA allo SCT patients received cyclosporine and mycophenylate mofetil for graft versus host disease prophylaxis. Results: Median age of the tandem cohort was 52 years (range: 22-66 years) whereas the ASCT cohort was older with a median age of 59 years (range: 51-72 years; p=0.01). 44.8% of the tandem group and 50% of the ASCT group were male (p=0.77). 18 patients (62.1%) of the tandem cohort were transplanted from unrelated donors. Within the tandem cohort 24.1% developed grade II-IV acute graft versus host disease (GVHD) and 44.8% had extensive chronic GVHD. After a median follow up of 48.9 months, progression free survival (PFS) was significantly superior for tandem group compared to ASCT group (median PFS=1166 days versus 399 days; p=0.001) (Fig:1). The 3-year cumulative incidence of relapse was 31.9% for tandem group against 79.8% for ASCT group (p=0.005). The 5-year overall survival of tandem and ASCT groups were 59.84% and 44.56%, respectively (p=0.38). Transplant related mortality was not significantly different between the groups (20.7% for tandem group and 8.3% for ASCT group; p=0.32). To avoid any age bias, we then compared the ASCT cohort with an older subgroup of the tandem cohort (17 patients with a median age of 58 years, range: 51-66 years, p=0.61 when compared with ASCT cohort) and demonstrated that the PFS was still significantly superior for the tandem approach (median PFS=1179 days for tandem cohort versus 399 days for ASCT cohort; p=0.009). Minimal residual disease (MRD) analysis by 8-colour Euroflow (sensitivity at 10-5) was negative in 12 of 17 tandem patients tested. Conclusion: Upfront tandem ASCT-NMA AlloSCT for HR-MM results in superior PFS and an emerging OS benefit with acceptable toxicity when compared to conventional ASCT. High-resolution MRD negativity in a significant proportion of tandem patients predicts for extended disease free survival. Ref: 1. Palumbo A, Avet-Loiseau H, Oliva S, et al. Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group. J Clin Oncol. 2015 Sep 10;33(26):2863-69. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.
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10

Pauling, M., and C. M. Ball. "Delivery of Anoxic Gas Mixtures in Anaesthesia: Case Report and Review of the Struggle towards Safer Standards of Care." Anaesthesia and Intensive Care 45, no. 1_suppl (July 2017): 21–28. http://dx.doi.org/10.1177/0310057x170450s104.

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In 1983 a patient at The Alfred Hospital, Melbourne died during general anaesthesia for emergency surgery, in the weeks following maintenance to the operating theatre gas supply. In the ensuing investigation, it was revealed that he had been given 100% nitrous oxide throughout the anaesthetic due to the inadvertent crossing of the nitrous oxide and oxygen pipelines during the repair work. In this article we review the published literature on the delivery of hypoxic and anoxic gas mixtures, and the associated morbidity and mortality. We explore the developments that took place in the delivery of anaesthetic gases, and the unforeseen dangers associated with these advances. We consider the risks to patient safety when technological advances outpaced the implementation of essential safety standards. We investigate the events that pushed the development of safer standards of anaesthetic practice and patient monitoring, which have contributed to modern day theatre practice. Finally, we consider the risks that still exist in the hospital environment, and the need for on-going vigilance.
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Книги з теми "Alfred Hospital (Melbourne, Vic )"

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Russell, Emma. Bricks or spirit: The Queen Victoria Hospital, Melbourne. Melbourne: Australian Scholarly Publishing, 1997.

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2

Skewes, Edna M. Mother Mary Berchmans Daly, foundress of St. Vincent's Hospital, Melbourne. Melbourne: Spectrum Publications, 1989.

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3

Paterson, Helen. 5.30, nurse!: The story of the Alfred nurses. Kew, Vic., Australia: History Books, 1996.

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4

McCalman, Janet. Sex and suffering: Women's health and a women's hospital : the Royal Women's Hospital, Melbourne 1856-1996. Melbourne: Melbourne University Press, 1998.

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5

Auditor-General, Victoria Office of the. The new Royal Women's Hospital: A public private partnership. Melbourne, Vic: Victorian Government Printer, 2008.

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6

Tyquin, Michael B. A place on the hill: The history of St. Vincent's private hospitals in Melbourne, 1906-93. Hargreen Pub. Co, 1997.

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7

Merinda, Epstein, Wadsworth Yoland, Victorian Health Promotion Foundation, and Victorian Mental Health Awareness Council., eds. Understanding and involvement (U&I): Consumer evaluation of acute psychiatric hospital practice : "A project's beginnings-". Melbourne: Victorian Mental Illness Awareness Council, 1994.

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8

Sex and Suffering: Women's Health and a Women's Hospital. The Johns Hopkins University Press, 1999.

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Частини книг з теми "Alfred Hospital (Melbourne, Vic )"

1

Nhu, Duong, Mubeen Janmohamed, Lubna Shakhatreh, Ofer Gonen, Patrick Kwan, Amanda Gilligan, Chang Wei Tan, and Levin Kuhlmann. "Automated Inter-Ictal Epileptiform Discharge Detection from Routine EEG." In Healthier Lives, Digitally Enabled. IOS Press, 2021. http://dx.doi.org/10.3233/shti210012.

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Epilepsy is the most common neurological disorder. The diagnosis commonly requires manual visual electroencephalogram (EEG) analysis which is time-consuming. Deep learning has shown promising performance in detecting interictal epileptiform discharges (IED) and may improve the quality of epilepsy monitoring. However, most of the datasets in the literature are small (n≤100) and collected from single clinical centre, limiting the generalization across different devices and settings. To better automate IED detection, we cross-evaluated a Resnet architecture on 2 sets of routine EEG recordings from patients with idiopathic generalized epilepsy collected at the Alfred Health Hospital and Royal Melbourne Hospital (RMH). We split these EEG recordings into 2s windows with or without IED and evaluated different model variants in terms of how well they classified these windows. The results from our experiment showed that the architecture generalized well across different datasets with an AUC score of 0.894 (95% CI, 0.881–0.907) when trained on Alfred’s dataset and tested on RMH’s dataset, and 0.857 (95% CI, 0.847–0.867) vice versa. In addition, we compared our best model variant with Persyst and observed that the model was comparable.
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