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  1. Multiple sclerosis susceptibility-associated SNPs do not influence disease severity measures in a cohort of Australian MS patients.

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    Cathy J Jensen

    Full Text Available Recent association studies in multiple sclerosis (MS have identified and replicated several single nucleotide polymorphism (SNP susceptibility loci including CLEC16A, IL2RA, IL7R, RPL5, CD58, CD40 and chromosome 12q13-14 in addition to the well established allele HLA-DR15. There is potential that these genetic susceptibility factors could also modulate MS disease severity, as demonstrated previously for the MS risk allele HLA-DR15. We investigated this hypothesis in a cohort of 1006 well characterised MS patients from South-Eastern Australia. We tested the MS-associated SNPs for association with five measures of disease severity incorporating disability, age of onset, cognition and brain atrophy. We observed trends towards association between the RPL5 risk SNP and time between first demyelinating event and relapse, and between the CD40 risk SNP and symbol digit test score. No associations were significant after correction for multiple testing. We found no evidence for the hypothesis that these new MS disease risk-associated SNPs influence disease severity.

  2. Biological activity and LC-MS/MS profiling of extracts from the Australian medicinal plant Acacia ligulata (Fabaceae)

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    Knudsen, Diana Jæger; Simpson, Bradley S.; Ndi, Chi P.

    2018-01-01

    Acacia ligulata A.Cunn. ex Benth. (Fabaceae: Mimosoideae) is a native Australian plant used traditionally by Australian Aboriginal groups. This study was undertaken to investigate the bioactivity of A. ligulata extracts and to evaluate their chemical composition. Potential antibacterial, cytotoxic...

  3. Factors Associated with Neurologists' Provision of MS Patient Care

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    Halpern, Michael T.; Teixeira-Poit, Stephanie M.; Kane, Heather; Frost, Corey; Keating, Michael; Olmsted, Murrey

    2014-01-01

    Neurologists are central to providing quality care for individuals with MS. However, neurologist shortages may restrict access to care for MS patients. To examine factors influencing neurologists' provision of MS care, we surveyed 1,700 US neurologists to assess demographic/practice characteristics, training, and attitudes toward MS care. The study population consisted of 573 respondents: 87 (15.2%) MS subspecialists and 486 (84.8%) “other neurologists,” including subspecialists in other neurology areas (i.e., non-MS) and general neurologists. MS subspecialists indicating they “enjoy interacting with MS patients” had a significantly greater rate of MS patients seen per week. In separate analyses of the “other neurologists” group, the rate of MS patients seen was lower among neurologists in university-based groups or those practicing in major cities; female neurologists; and neurologists who indicated lack of sufficient knowledge regarding MS patient care. Rates of MS patients seen were significantly greater for other neurologists who agreed that MS care involved “ability to improve patient outcomes and quality of life”; “dynamic area with evolving treatment options”; and “enjoy interacting with MS patients.” Understanding factors influencing MS patient care by neurologists and developing policies for appropriate access to care is critical for optimal outcomes among this population. PMID:24949203

  4. Factors Associated with Neurologists’ Provision of MS Patient Care

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    Michael T. Halpern

    2014-01-01

    Full Text Available Neurologists are central to providing quality care for individuals with MS. However, neurologist shortages may restrict access to care for MS patients. To examine factors influencing neurologists’ provision of MS care, we surveyed 1,700 US neurologists to assess demographic/practice characteristics, training, and attitudes toward MS care. The study population consisted of 573 respondents: 87 (15.2% MS subspecialists and 486 (84.8% “other neurologists,” including subspecialists in other neurology areas (i.e., non-MS and general neurologists. MS subspecialists indicating they “enjoy interacting with MS patients” had a significantly greater rate of MS patients seen per week. In separate analyses of the “other neurologists” group, the rate of MS patients seen was lower among neurologists in university-based groups or those practicing in major cities; female neurologists; and neurologists who indicated lack of sufficient knowledge regarding MS patient care. Rates of MS patients seen were significantly greater for other neurologists who agreed that MS care involved “ability to improve patient outcomes and quality of life”; “dynamic area with evolving treatment options”; and “enjoy interacting with MS patients.” Understanding factors influencing MS patient care by neurologists and developing policies for appropriate access to care is critical for optimal outcomes among this population.

  5. Exploring Positive Survivorship Experiences of Indigenous Australian Cancer Patients

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    Tam, Laura; Garvey, Gail; Meiklejohn, Judith; Martin, Jennifer; Adams, Jon; Walpole, Euan; Fay, Michael; Valery, Patricia

    2018-01-01

    Amongst Indigenous Australians, “cancer” has negative connotations that detrimentally impact upon access to cancer care services. Barriers to accessing cancer services amongst Indigenous Australians are widely reported. In contrast, factors that facilitate this cohort to successfully navigate cancer care services (“enablers”) are scarcely reported in the literature. Through qualitative interviews, this article examines factors that assist Indigenous Australians to have positive cancer experiences. Semi-structured interviews were conducted with twelve adult Indigenous oncology patients recruited from a tertiary hospital in Queensland, Australia during 2012–2014. Data generated from the interviews were independently reviewed by two researchers via inductive thematic analytical processes. Discussions followed by consensus on the major categories allowed conclusions to be drawn on potential enablers. Two major categories of enablers were identified by the researchers: resilience and communication. Individual’s intrinsic strength, their coping strategies, and receipt of support improved participant’s resilience and consequently supported a positive experience. Communication methods and an effective patient-provider relationship facilitated positive experiences for participants. Despite potential barriers to access of care for Indigenous cancer patients, participants in the study demonstrated that it was still possible to focus on the positive aspects of their cancer experiences. Many participants explained how cancer changed their outlook on life, often for the better, with many feeling empowered as they progressed through their cancer diagnosis and treatment processes. PMID:29342934

  6. Demographic characteristics of MS patients in Poland's upper Silesia region.

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    Pierzchala, Krystyna; Adamczyk-Sowa, Monika; Dobrakowski, Pawel; Kubicka-Baczyk, Katarzyna; Niedziela, Natalia; Sowa, Pawel

    2015-05-01

    In Poland, no national registry of MS patients has yet been introduced. So far, no demographic studies have been conducted in patients with MS in Upper Silesia. The aim of the present study was to evaluate, for the first time, a selected demographic and clinical parameters in MS patients from the Upper Silesia region and compare these characteristics with previously published data from other regions of Poland. 640 patients with clinically defined MS, were prospectively and randomly selected for the study. Social, socio-economic, and demographic data were obtained through a questionnaire study. All subjects performed a self-assessment of their health condition using EQ-5D and EQ-VAS version questionnaires. The ratio of women to men was 2.18. The average age of onset was 29.6 ± 11.1 years; the disease duration was 7.9 ± 4.5 years. The relapsing-remitting form of MS was diagnosed in 73.12%. In 71.25% the onset was monofocal and in 28.75% multifocal disease onset was observed. Among the studied population 339 (52.97%) patients were still employed. A mean EQ-VAS score of 66.11 ± 20.12 was calculated. Results from our study identify for the first time the demographic and clinical characteristics of the Upper Silesia MS population.

  7. Teaching Gender: Australian First-Year University Student Views of "Ms."

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    Burns, Edgar; Tulloch, Ian; Shamsullah, Ardel

    2016-01-01

    Negative "push-back" from a group of first-year undergraduate sociology students during a class discussion of gender and feminism included rejecting personal use of the title Ms. Teaching team members asked themselves: how general is this response among other student groups in the same one-semester subject? A short in-class survey…

  8. Development of an Efficient Protein Extraction Method Compatible with LC-MS/MS for Proteome Mapping in Two Australian Seagrasses Zostera muelleri and Posidonia australis

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    Zhijian Jiang

    2017-08-01

    Full Text Available The availability of the first complete genome sequence of the marine flowering plant Zostera marina (commonly known as seagrass in early 2016, is expected to significantly raise the impact of seagrass proteomics. Seagrasses are marine ecosystem engineers that are currently declining worldwide at an alarming rate due to both natural and anthropogenic disturbances. Seagrasses (especially species of the genus Zostera are compromised for proteomic studies primarily due to the lack of efficient protein extraction methods because of their recalcitrant cell wall which is rich in complex polysaccharides and a high abundance of secondary metabolites in their cells. In the present study, three protein extraction methods that are commonly used in plant proteomics i.e., phenol (P; trichloroacetic acid/acetone/SDS/phenol (TASP; and borax/polyvinyl-polypyrrolidone/phenol (BPP extraction, were evaluated quantitatively and qualitatively based on two dimensional isoelectric focusing (2D-IEF maps and LC-MS/MS analysis using the two most abundant Australian seagrass species, namely Zostera muelleri and Posidonia australis. All three tested methods produced high quality protein extracts with excellent 2D-IEF maps in P. australis. However, the BPP method produces better results in Z. muelleri compared to TASP and P. Therefore, we further modified the BPP method (M-BPP by homogenizing the tissue in a modified protein extraction buffer containing both ionic and non-ionic detergents (0.5% SDS; 1.5% Triton X-100, 2% PVPP and protease inhibitors. Further, the extracted proteins were solubilized in 0.5% of zwitterionic detergent (C7BzO instead of 4% CHAPS. This slight modification to the BPP method resulted in a higher protein yield, and good quality 2-DE maps with a higher number of protein spots in both the tested seagrasses. Further, the M-BPP method was successfully utilized in western-blot analysis of phosphoenolpyruvate carboxylase (PEPC—a key enzyme for carbon

  9. Development of a fast isocratic LC-MS/MS method for the high-throughput analysis of pyrrolizidine alkaloids in Australian honey.

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    Griffin, Caroline T; Mitrovic, Simon M; Danaher, Martin; Furey, Ambrose

    2015-01-01

    Honey samples originating from Australia were purchased and analysed for targeted pyrrolizidine alkaloids (PAs) using a new and rapid isocratic LC-MS/MS method. This isocratic method was developed from, and is comparable with, a gradient elution method and resulted in no loss of sensitivity or reduction in chromatographic peak shape. Isocratic elution allows for significantly shorter run times (6 min), eliminates the requirement for column equilibration periods and, thus, has the advantage of facilitating a high-throughput analysis which is particularly important for regulatory testing laboratories. In excess of two hundred injections are possible, with this new isocratic methodology, within a 24-h period which is more than 50% improvement on all previously published methodologies. Good linear calibrations were obtained for all 10 PAs and four PA N-oxides (PANOs) in spiked honey samples (3.57-357.14 µg l(-1); R(2) ≥ 0.9987). Acceptable inter-day repeatability was achieved for the target analytes in honey with % RSD values (n = 4) less than 7.4%. Limits of detection (LOD) and limits of quantitation (LOQ) were achieved with spiked PAs and PANOs samples; giving an average LOD of 1.6 µg kg(-1) and LOQ of 5.4 µg kg(-1). This method was successfully applied to Australian and New Zealand honey samples sourced from supermarkets in Australia. Analysis showed that 41 of the 59 honey samples were contaminated by PAs with the mean total sum of PAs being 153 µg kg(-1). Echimidine and lycopsamine were predominant and found in 76% and 88%, respectively, of the positive samples. The average daily exposure, based on the results presented in this study, were 0.051 µg kg(-1) bw day(-1) for adults and 0.204 µg kg(-1) bw day(-1) for children. These results are a cause for concern when compared with the proposed European Food Safety Authority (EFSA), Committee on Toxicity (COT) and Bundesinstitut für Risikobewertung (BfR - Federal Institute of Risk Assessment Germany) maximum

  10. Measurement of methionine level with the LC-ESI-MS/MS method in schizophrenic patients.

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    Kulaksizoglu, S; Kulaksizoglu, B; Ellidag, H Y; Eren, E; Yilmaz, N; Baykal, A

    2016-01-01

    The purpose of this study was to evaluate plasma methionine levels by using liquid chromatography electrospray ionization-tandem mass spectroscopy (LC-ESI-MS/MS) in schizophrenic patients. A twelve-point standard graph was drawn, and the recovery rate, the intra-day and inter-day coefficients of variation (CV), the limit of detection (LOD), and the limit of quantification (LOQ) were evaluated. The y and R2 values of the standard graph equation were determined as 0.011x + 0.0179 and 0.9989, respectively, and the graph remained linear until the 200 µmol/l level. The intra-day coefficients of variation of the samples (n = 10) containing 8, 28, and 58 µmol/l methionine were determined as 2.68, 3.10, and 3.79%, respectively; while their inter-day coefficients of variation were determined as 2.98, 3.19, and 3.84%. The LOD and LOQ values were determined as 0.04 and 0.1 µmol/l, respectively, while the mean recovery rates were determined as 101.7 and 99.3%. Plasma methionine values were measured as 21.5 (19.5-24,6) µmol/l for the patient group, 17.8 (16.3-20.1) µmol/l for the control group, and the difference between the two groups was statistically significant (p = 0.03). LC-ESI-MS/MS method represents a fairly sensitive, economic, and rapid analysis that requires very little sample and is suitable for measuring methionine levels in schizophrenic patients.

  11. Pandoraea pnomenusa Isolated from an Australian Patient with Cystic Fibrosis.

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    Ambrose, Mark; Malley, Roslyn C; Warren, Sanchia J C; Beggs, Sean A; Swallow, Oliver F E; McEwan, Belinda; Stock, David; Roddam, Louise F

    2016-01-01

    Pandoraea species are considered as emerging pathogens in people with cystic fibrosis (CF). The contribution of these organisms to disease progression in CF patients is not fully understood owing in large measure to the scant reports in clinical and research literature describing their colonization of CF patients and their associated virulence determinants. In an effort to increase awareness and evidence for Pandoraea spp. infection in people with CF, and to stimulate research aimed at unraveling the pathogenic properties of Pandoraea, we report a case of a 26-year-old Australian (Tasmanian) man with CF who was chronically infected with Pandoraea pnomenusa for at least one year prior to his death from respiratory failure. In addition, we describe for the first time evidence suggesting that this bacterium is a facultative anaerobe and report on the availability of a whole genome sequence for this organism. To the best of our knowledge, this report represents only the second clinical case study of P. pnomenusa infection in the world, and the first in an Australian CF patient.

  12. MRI criteria for MS in patients with clinically isolated syndromes

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    Montalban, X.; Tintore, M.; Swanton, J.

    2010-01-01

    neurologists and neuroradiologists. In some circumstances, several MRI examinations are needed to achieve an accurate and prompt diagnosis. This provides an incentive for continued efforts to refine the incorporation of MRI-derived information into the diagnostic workup of patients presenting with a clinically...... isolated syndrome. Within the European multicenter collaborative research network that studies MRI in MS (MAGNIMS), a workshop was held in London in November 2007 to review information that may simplify the existing MS diagnostic criteria, while maintaining a high specificity that is essential to minimize...... false positive diagnoses. New data that are now published were reviewed and discussed and together with a new proposal are integrated in this position paper. Neurology(R) 2010;74:427-434...

  13. Organizational change, patient-focused care: an Australian perspective.

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    Braithwaite, J

    1995-08-01

    Hospitals throughout the world are attempting to improve organizational performance through a variety of means. The focus in this paper is on a leading teaching hospital in Australia for a review of current management strategy. In a time of shrinking resources, management adopted a multi-faceted change management program including restructuring the organization, becoming more patient-focused via a product-line management approach and emphasising efficiency and cost-reduction measures. The next stage in management thinking is to place greater emphasis on patient-focused care. It is concluded this has the propensity to yield substantial further benefits, including improved financial and quality of care outcomes, in the Australian as well as the British and wider Organization for Economic Co-operation and Development (OECD) context. 'Professionally, we have committed ourselves to creating caring environments that promote healing. We cannot meet this goal until we make a commitment to be patient-focused and give up being nurse-focused or facility-focused' (Kerfort and LeClair, 1991). 'In a customer-driven [organization], the distribution of roles is different. The organization is decentralized, with responsibility delegated to those who until now have comprised the order-obeying bottom level of the pyramid. The traditional, hierarchical corporate structure, in other words, is beginning to give way to a flattened, more horizontal structure' (Carlzon, 1987).

  14. Deletion Mutations in an Australian Series of HNPCC Patients

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    McPhillips Mary

    2005-11-01

    Full Text Available Abstract Hereditary non polyposis colorectal cancer (HNPCC is characterized by the presence of early onset colorectal cancer and other epithelial malignancies. The genetic basis of HNPCC is a deficiency in DNA mismatch repair, which manifests itself as DNA microsatellite instability in tumours. There are four genes involved in DNA mismatch repair that have been linked to HNPCC; these include hMSH2, hMLH1, hMSH6 and hPMS2. Of these four genes hMLH1 and hMSH2 account for the majority of families diagnosed with the disease. Notwithstanding, up to 40 percent of families do not appear to harbour a change in either hMSH2 or hMLH1 that can be detected using standard screening procedures such as direct DNA sequencing or a variety of methods all based on a heteroduplex analysis. In this report we have screened a series of 118 probands that all have the clinical diagnosis of HNPCC for medium to large deletions by the Multiplex Ligation-Dependent Probe Amplification assay (MLPA to determine the frequency of this type of mutation. The results indicate that a significant proportion of Australian HNPCC patients harbour deletion or duplication mutations primarily in hMSH2 but also in hMLH1.

  15. Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective: part 2 new and emerging therapies and their efficacy. MS Neurology Group of the Australian and New Zealand Association of Neurologists.

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    Broadley, Simon A; Barnett, Michael H; Boggild, Mike; Brew, Bruce J; Butzkueven, Helmut; Heard, Robert; Hodgkinson, Suzanne; Kermode, Allan G; Lechner-Scott, Jeannette; Macdonell, Richard A L; Marriott, Mark; Mason, Deborah F; Parratt, John; Reddel, Stephen W; Shaw, Cameron P; Slee, Mark; Spies, Judith; Taylor, Bruce V; Carroll, William M; Kilpatrick, Trevor J; King, John; McCombe, Pamela A; Pollard, John D; Willoughby, Ernest

    2014-11-01

    In Part 2 of this three part review of multiple sclerosis (MS) treatment with a particular focus on the Australian and New Zealand perspective, we review the newer therapies that have recently become available and emerging therapies that have now completed phase III clinical trial programs. We go on to compare the relative efficacies of these newer and emerging therapies alongside the existing therapies. The effectiveness of β-interferon in the treatment of different stages and the different disease courses of MS is critically reviewed with the conclusion that the absolute level of response in term of annualised relapse rates (where relapses occur) and MRI activity are similar, but are disappointing in terms of sustained disability progression for progressive forms of the disease. Finally we review the controversial area of combination therapy for MS. Whilst it remains the case that we have no cure or means of preventing MS, we do have a range of effective therapies that when used appropriately and early in the disease course can have a significant impact on short term and longer term outcomes. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  16. Natalizumab Discontinuation and Treatment Strategies in Patients with Multiple Sclerosis (MS): A Retrospective Study from Two Italian MS Centers.

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    Lo Re, Marianna; Capobianco, Marco; Ragonese, Paolo; Realmuto, Sabrina; Malucchi, Simona; Berchialla, Paola; Salemi, Giuseppe; Bertolotto, Antonio

    2015-12-01

    Natalizumab (NTZ) discontinuation can be followed by multiple sclerosis (MS) disease reactivation. Currently no disease-modifying drug (DMD) has been shown to be able to abolish disease reactivation. The aims of the current study were: (1) to determine the frequency of MS reactivation after NTZ discontinuation; (2) to evaluate predictors of reactivation risk, and (3) to compare the effect of different treatments in reducing this risk. Data from 132 patients with MS followed-up for 2 years before NTZ treatment and 1 year after interruption were collected from two Italian MS centers and retrospectively evaluated. Overall, 72 of 132 patients (54.5%) had relapses after NTZ discontinuation and 60 of 125 patients (48%), who had magnetic resonance imaging, had radiological reactivation. Rebound was observed in 28 of 132 patients (21.2%). A higher number of relapses in the 2 years before NTZ treatment, a longer washout period, and a lower number NTZ infusions correlated with reactivation and rebound. Untreated patients (n = 37) had higher clinical and radiological activity and rebound in comparison to patients receiving DMDs. Moreover, a lower risk of relapses was found in patients treated with second-line therapies (NTZ and fingolimod) than in those treated with first-line therapies (interferon beta, glatiramer acetate, teriflunomide, azathioprine). Interestingly, no disease reactivation in off-label treatment (rituximab, autologous hematopoietic stem cell transplantation) was observed. NTZ discontinuation is a risk for MS reactivation and rebound. An alternative treatment should be promptly resumed mainly in patients with a previous very active disease course and with a shorter NTZ therapy. Second-line therapies demonstrate superiority in preventing relapses after NTZ discontinuation.

  17. Reduced Dual-Task Performance in MS Patients Is Further Decreased by Muscle Fatigue.

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    Wolkorte, Ria; Heersema, Dorothea J; Zijdewind, Inge

    2015-06-01

    Multiple sclerosis (MS) can be accompanied by motor, cognitive, and sensory impairments. Additionally, MS patients often report fatigue as one of their most debilitating symptoms. It is, therefore, expected that MS patients will have difficulties in performing cognitive-motor dual tasks (DTs), especially in a fatiguing condition. To determine whether MS patients are more challenged by a DT than controls in a fatiguing and less-fatiguing condition and whether DT performance is associated with perceived fatigue. A group of 19 MS patients and 19 age-, sex-, and education-matched controls performed a cognitive task (2-choice reaction time task) separately or concurrent with a low-force or a high-force motor task (index finger abduction at 10% or 30% maximal voluntary contraction). MS patients performed less well on a cognitive task than controls. Cognitive task performance under DT conditions decreased more for MS patients. Moreover, under high-force DT conditions, cognitive performance declined in both groups but to a larger degree for MS patients. Besides a decline in cognitive task performance, MS patients also showed a stronger decrease in motor performance under high-force DT conditions. DT costs were positively related to perceived fatigue as measured by questionnaires. Compared with controls, MS patients performed less well on DTs as demonstrated by a reduction in both cognitive and motor performances. This performance decrease was stronger under fatiguing conditions and was related to the sense of fatigue of MS patients. These data illustrate problems that MS patients may encounter in daily life because of their fatigue. © The Author(s) 2014.

  18. Survey of Australian schools of nursing use of human patient (mannequin) simulation.

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    McGarry, Denise Elizabeth; Cashin, Andrew; Fowler, Cathrine

    2014-11-01

    Rapid adoption of high-fidelity human patient (mannequin) simulation has occurred in Australian Schools of Nursing in recent years, as it has internationally. This paper reports findings from a 2012 online survey of Australian Schools of Nursing and builds on findings of earlier studies. The survey design allowed direct comparison with a previous study from the USA but limited its scope to the pre-registration (pre-service Bachelor of Nursing) curriculum. It also included extra mental health specific questions. Australian patterns of adoption and application of high-fidelity human patient (mannequin) simulation in the pre-registration nursing curriculum share features with experiences reported in previous US and Australian surveys. A finding of interest in this survey was a small number of Schools of Nursing that reported no current use of high-fidelity human patient (mannequin) simulation and no plans to adopt it, in spite of a governmental capital funding support programme. In-line with prior surveys, mental health applications were meagre. There is an absence of clearly articulated learning theory underpinnings in the use of high-fidelity human patient (mannequin) simulation generally. It appears the first stage of implementation of high-fidelity human patient (mannequin) simulation into the pre-registration nursing curriculum has occurred and the adoption of this pedagogy is entering a new phase.

  19. A new cognitive rehabilitation programme for patients with multiple sclerosis: the 'MS-line! Project'.

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    Gich, Jordi; Freixenet, Jordi; Garcia, Rafael; Vilanova, Joan Carles; Genís, David; Silva, Yolanda; Montalban, Xavier; Ramió-Torrentà, Lluís

    2015-09-01

    Cognitive rehabilitation is often delayed in multiple sclerosis (MS). To develop a free and specific cognitive rehabilitation programme for MS patients to be used from early stages that does not interfere with daily living activities. MS-line!, cognitive rehabilitation materials consisting of written, manipulative and computer-based materials with difficulty levels developed by a multidisciplinary team. Mathematical, problem-solving and word-based exercises were designed. Physical materials included spatial, coordination and reasoning games. Computer-based material included logic and reasoning, working memory and processing speed games. Cognitive rehabilitation exercises that are specific for MS patients have been successfully developed. © The Author(s), 2014.

  20. Australian Nurses' Perception of the Impact of Their Postgraduate Studies on Their Patient Care Activities.

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    Pelletier, Dianne; Donoghue, Judith; Duffield, Christine

    2003-01-01

    A longitudinal study of 403 Australian nurses who undertook postgraduate studies received 236 responses. Respondents indicated that postgraduate education had an impact on a number of professional behaviors but little or no effect on others, such as autonomy, time management, use of computers, and communication with patients. (Contains 25…

  1. The detection of THC, CBD and CBN in the oral fluid of Sativex® patients using two on-site screening tests and LC-MS/MS.

    Science.gov (United States)

    Molnar, Anna; Fu, Shanlin; Lewis, John; Allsop, David J; Copeland, Jan

    2014-05-01

    Sativex(®) is an oromucosal spray used to treat spasticity in multiple sclerosis sufferers in some European countries, the United Kingdom, Canada and New Zealand. The drug has also recently been registered by the Therapeutic Goods Administration (TGA) in Australia for treatment of multiple sclerosis. Sativex(®) contains high concentrations of Δ(9)-tetrahydrocannabinol (THC) and cannabidiol (CBD), with the former being the subject of random roadside drug tests across Australia to detect cannabis use. This pilot study aims to determine whether or not patients taking Sativex(®) will test positive to THC using these roadside screening tests. Detectable levels of THC, CBD and cannabinol (CBN) in their oral fluid were also confirmed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The study was a double-blind, placebo controlled design. Oral fluid was tested prior to and immediately after dosing with either Sativex(®) or placebo at intervals up to 2h after the dose. Two Sativex(®) doses were studied. The low dose contained 5.4mg THC, the high dose 21.6mg THC. Results indicate that the primary screening test used in Australian roadside drug testing, the DrugWipe(®) II Twin, often gave a false negative response for THC, even with high concentrations present. However, secondary screening test, Cozart(®) DDS (used by police after a DrugWipe test gives a positive result), gave true positive results in all cases where patients were being treated with Sativex(®). Confirmatory testing showed high concentrations of THC and CBD (>5356ng/mL THC and >3826ng/mL CBD) in the oral fluid shortly after dosing and also elevated concentrations of CBN. Levels dropped quickly but remained at detectable concentrations (>67.6ng/mL) two hours after drug administration. The average concentration ratio of THC/CBD across all positive samples was 1.10 (%RSD 19.9) reflecting the composition of the Sativex(®) spray. In conclusion, Sativex(®) users may test positive for THC by

  2. APOE epsilon4 is associated with impaired verbal learning in patients with MS.

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    Koutsis, G; Panas, M; Giogkaraki, E; Potagas, C; Karadima, G; Sfagos, C; Vassilopoulos, D

    2007-02-20

    To investigate the effect of APOE epsilon4 on different cognitive domains in a population of Greek patients with multiple sclerosis (MS). A total of 125 patients with MS and 43 controls were included in this study and underwent neuropsychological assessment with Rao's Brief Repeatable Battery. All patients with MS were genotyped for APOE. The effect of APOE epsilon4 on different cognitive domains was investigated. Fifty-one percent of patients with MS were cognitively impaired. E4 carriers had a sixfold increase in the relative risk of impairment in verbal learning vs noncarriers (OR 6.28, 95% CI 1.74 to 22.69). This effect was domain-specific and was not observed in other cognitive domains assessed by the battery. We found an association of APOE epsilon4 with impaired verbal learning in patients with multiple sclerosis.

  3. The role of KIR2DS1 in multiple sclerosis--KIR in Portuguese MS patients.

    Science.gov (United States)

    Bettencourt, Andreia; Silva, Ana Martins; Carvalho, Cláudia; Leal, Bárbara; Santos, Ernestina; Costa, Paulo P; Silva, Berta M

    2014-04-15

    Killer Immunoglobulin-like Receptor (KIR) genes may influence both resistance and susceptibility to different autoimmune diseases, but their role in the pathogenesis of Multiple Sclerosis (MS) is still unclear. We investigated the influence of KIR genes on MS susceptibility in 447 MS Portuguese patients, and also whether genetic interactions between specific KIR genes and their HLA class I ligands could contribute to the pathogenesis of MS. We observed a negative association between the activating KIR2DS1 gene and MS (adjusted OR=0.450, p=0.030) independently from the presence of HLA-DRB1*15 allele. The activating KIR2DS1 receptor seems to confer protection against MS most probably through modulation of autoreactive T cells by Natural Killer cells. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Atrophy of reward-related striatal structures in fatigued MS patients is independent of physical disability.

    Science.gov (United States)

    Damasceno, Alfredo; Damasceno, Benito Pereira; Cendes, Fernando

    2016-05-01

    MRI studies have shown gray-matter abnormalities in fatigued multiple sclerosis (MS) patients. However, given that physical disability is highly correlated to MS fatigue, it is often difficult to disentangle its effect in these MRI findings. The objective of this research paper is to investigate gray-matter damage in mildly disabled MS patients, addressing which variables were better related to fatigue while controlling for physical disability and depression. Forty-nine relapsing-remitting MS (RRMS) patients and 30 controls underwent MRI (3T). Fatigue was assessed using the Fatigue Severity Scale (FSS). Multivariate logistic regression was performed to assess the contribution of clinical and MRI metrics to fatigue. Statistical analyses were performed controlling for disability and depression. Fatigue was present in 22 (44.9%) patients. FSS score was highly correlated with EDSS (p = 0.00001). Patients with fatigue had lower brain cortical and subcortical gray-matter volumes. However, after controlling for EDSS, only the caudate and the accumbens volumes remained statistically significant. Fatigued MS patients have a global cortical and subcortical gray-matter atrophy that seems largely related to higher physical disability. However, striatal structures involved in effort-reward functions exhibited smaller volumes in fatigued patients, independently of physical disability and depressive symptoms, supporting the theory of cortico-striatal network impairment in MS fatigue. © The Author(s), 2015.

  5. Folk concepts of mental disorders among Chinese-Australian patients and their caregivers.

    Science.gov (United States)

    Hsiao, Fei-Hsiu; Klimidis, Steven; Minas, Harry I; Tan, Eng S

    2006-07-01

    This paper reports a study of (a) popular conceptions of mental illness throughout history, (b) how current social and cultural knowledge about mental illness influences Chinese-Australian patients' and caregivers' understanding of mental illness and the consequences of this for explaining and labelling patients' problems. According to traditional Chinese cultural knowledge about health and illness, Chinese people believe that psychotic illness is the only type of mental illness, and that non-psychotic illness is a physical illness. Regarding patients' problems as not being due to mental illness may result in delaying use of Western mental health services. Data collection took place in 2001. Twenty-eight Chinese-Australian patients with mental illness and their caregivers were interviewed at home, drawing on Kleinman's explanatory model and studies of cultural transmission. Interviews were tape-recorded and transcribed, and analysed for plots and themes. Chinese-Australians combined traditional knowledge with Western medical knowledge to develop their own labels for various kinds of mental disorders, including 'mental illness', 'physical illness', 'normal problems of living' and 'psychological problems'. As they learnt more about Western conceptions of psychology and psychiatry, their understanding of some disorders changed. What was previously ascribed to non-mental disorders was often re-labelled as 'mental illness' or 'psychological problems'. Educational programmes aimed at introducing Chinese immigrants to counselling and other psychiatric services could be made more effective if designers gave greater consideration to Chinese understanding of mental illness.

  6. Memory rehabilitation for the working memory of patients with multiple sclerosis (MS).

    Science.gov (United States)

    Mousavi, Shokoufeh; Zare, Hossein; Etemadifar, Masoud; Taher Neshatdoost, Hamid

    2018-05-01

    The main cognitive impairments in multiple sclerosis (MS) affect the working memory, processing speed, and performances that are in close interaction with one another. Cognitive problems in MS are influenced to a lesser degree by disease recovery medications or treatments,but cognitive rehabilitation is considered one of the promising methods for cure. There is evidence regarding the effectiveness of cognitive rehabilitation for MS patients in various stages of the disease. Since the impairment in working memory is one of the main MS deficits, a particular training that affects this cognitive domain can be of a great value. This study aims to determine the effectiveness of memory rehabilitation on the working memory performance of MS patients. Sixty MS patients with cognitive impairment and similar in terms of demographic characteristics, duration of disease, neurological problems, and mental health were randomly assigned to three groups: namely, experimental, placebo, and control. Patients' cognitive evaluation incorporated baseline assessments immediately post-intervention and 5 weeks post-intervention. The experimental group received a cognitive rehabilitation program in one-hour sessions on a weekly basis for 8 weeks. The placebo group received relaxation techniques on a weekly basis; the control group received no intervention. The results of this study showed that the cognitive rehabilitation program had a positive effect on the working memory performance of patients with MS in the experimental group. These results were achieved in immediate evaluation (post-test) and follow-up 5 weeks after intervention. There was no significant difference in working memory performance between the placebo group and the control group. According to the study, there is evidence for the effectiveness of a memory rehabilitation program for the working memory of patients with MS. Cognitive rehabilitation can improve working memory disorders and have a positive effect on the

  7. Visualization of Chronic Myocardial Infarction Using the Intravascular Contrast Agent MS-325 (Gadofosveset in Patients

    Directory of Open Access Journals (Sweden)

    Thomas Thouet

    2012-01-01

    Full Text Available Aims. The aim of this study was to evaluate the potential of visualizing chronic myocardial infarction in patients using the intravascular CA MS-325 (gadofosveset, EPIX Pharmaceuticals, Mass, USA. Methods. Nine patients were enrolled in a clinical phase II multicenter trial for MRCA and perfusion imaging using MS-325. They had objective evidence of chronic myocardial infarction as visualized by previously performed late gadolinium (Gd enhancement imaging (LGE with a conventional extracellular Gd-DTPA CA (Magnevist, Bayer Healthcare, Germany, 0.2 mmol/kg/body weight serving as reference standard. A prepulse-optimized LGE study was performed immediately and at several time points after injection of MS-325 (0.05 mmol/kg/body weight. The number and localization of segments demonstrating LGE with MS-325 as well as signal intensities were compared with the reference standard (Gd-DTPA. Results. Using MS-325, LGE could be detected at every time point in all 9 patients. The accuracy of LGE with MS-325 as compared to LGE with Gd-DTPA was highest 54±4 minutes after contrast injection, resulting in a sensitivity of 84% with a specificity of 98%. Conclusion. The intravascular CA MS-325 has the potential to visualize chronic myocardial infarction. However, in comparison with Gd-DTPA, the transmural extent and the number of segments are smaller.

  8. Anticoagulation knowledge in patients with atrial fibrillation: An Australian survey.

    Science.gov (United States)

    Obamiro, Kehinde O; Chalmers, Leanne; Lee, Kenneth; Bereznicki, Bonnie J; Bereznicki, Luke R E

    2018-03-01

    Atrial fibrillation (AF) is the most commonly diagnosed arrhythmia in clinical practice, and is associated with a significant medical and economic burden. Anticoagulants reduce the risk of stroke and systemic embolism by approximately two-thirds compared with no therapy. Knowledge regarding anticoagulant therapy can influence treatment outcomes in patients with AF. To measure the level of anticoagulation knowledge in patients with AF taking oral anticoagulants (OACs), investigate the association between patient-related factors and anticoagulation knowledge, and compare these results in patients taking warfarin and direct-acting oral anticoagulant (DOACs). Participants were recruited for an online survey via Facebook. Survey components included the Anticoagulation Knowledge Tool, the Perception of Anticoagulant Treatment Questionnaires (assessing treatment expectations, convenience and satisfaction), a modified Cancer Information Overload scale and the Morisky Medication Adherence Scale. Treatment groups were compared and predictors of OAC knowledge were identified. Participants taking warfarin had a higher knowledge score compared with those taking DOACs (n = 386, 73% ± 13% vs 66% ± 14%, Pcounselling sessions to help identify and resolve knowledge deficits. © 2018 John Wiley & Sons Ltd.

  9. Conditional survival of cancer patients: an Australian perspective

    Directory of Open Access Journals (Sweden)

    Yu Xue

    2012-10-01

    Full Text Available Abstract Background Estimated conditional survival for cancer patients diagnosed at different ages and disease stage provides important information for cancer patients and clinicians in planning follow-up, surveillance and ongoing management. Methods Using population-based cancer registry data for New South Wales Australia, we estimated conditional 5-year relative survival for 11 major cancers diagnosed 1972–2006 by time since diagnosis and age and stage at diagnosis. Results 193,182 cases were included, with the most common cancers being prostate (39,851, female breast (36,585 and colorectal (35,455. Five-year relative survival tended to increase with increasing years already survived and improvement was greatest for cancers with poor prognosis at diagnosis (lung or pancreas and for those with advanced stage or older age at diagnosis. After surviving 10 years, conditional 5-year survival was over 95% for 6 localised, 6 regional, 3 distant and 3 unknown stage cancers. For the remaining patient groups, conditional 5-year survival ranged from 74% (for distant stage bladder cancer to 94% (for 4 cancers at different stages, indicating that they continue to have excess mortality 10–15 years after diagnosis. Conclusion These data provide important information for cancer patients, based on age and stage at diagnosis, as they continue on their cancer journey. This information may also be used by clinicians as a tool to make more evidence-based decisions regarding follow-up, surveillance, or ongoing management according to patients' changing survival expectations over time.

  10. Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective: part 3 treatment practicalities and recommendations. MS Neurology Group of the Australian and New Zealand Association of Neurologists.

    Science.gov (United States)

    Broadley, Simon A; Barnett, Michael H; Boggild, Mike; Brew, Bruce J; Butzkueven, Helmut; Heard, Robert; Hodgkinson, Suzanne; Kermode, Allan G; Lechner-Scott, Jeannette; Macdonell, Richard A L; Marriott, Mark; Mason, Deborah F; Parratt, John; Reddel, Stephen W; Shaw, Cameron P; Slee, Mark; Spies, Judith; Taylor, Bruce V; Carroll, William M; Kilpatrick, Trevor J; King, John; McCombe, Pamela A; Pollard, John D; Willoughby, Ernest

    2014-11-01

    In this third and final part of our review of multiple sclerosis (MS) treatment we look at the practical day-to-day management issues that are likely to influence individual treatment decisions. Whilst efficacy is clearly of considerable importance, tolerability and the potential for adverse effects often play a significant role in informing individual patient decisions. Here we review the issues surrounding switching between therapies, and the evidence to assist guiding the choice of therapy to change to and when to change. We review the current level of evidence with regards to the management of women in their child-bearing years with regards to recommendations about treatment during pregnancy and whilst breast feeding. We provide a summary of recommended pre- and post-treatment monitoring for the available therapies and review the evidence with regards to the value of testing for antibodies which are known to be neutralising for some therapies. We review the occurrence of adverse events, both the more common and troublesome effects and those that are less common but have potentially much more serious outcomes. Ways of mitigating these risks and managing the more troublesome adverse effects are also reviewed. Finally, we make specific recommendations with regards to the treatment of MS. It is an exciting time in the world of MS neurology and the prospects for further advances in coming years are high. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  11. Psychopathy, Antisocial Personality Disorder, and Reconviction in an Australian Sample of Forensic Patients.

    Science.gov (United States)

    Shepherd, Stephane M; Campbell, Rachel E; Ogloff, James R P

    2018-02-01

    This study identified the presence of psychopathy (as measured by the PCL-R/PCL:SV instruments) and antisocial personality disorder (APD) and their relationship with future reconviction in an Australian forensic sample ( N = 136) of patients with a mental disorder. Patients were tracked for over 4 years postrelease to determine associations between a diagnosis of APD/psychopathy and reoffense. Patients with higher psychopathy scores were found to have an increased likelihood of reincarceration, a higher rate of reconviction, and were reconvicted earlier compared with patients with lower psychopathy scores. Patients with APD were more likely to be reconvicted and reincarcerated during the follow-up period than patients without an APD diagnosis. Despite demonstrating associations with general reconviction, the PCL instruments did not exhibit statistically significant relationships with violence. Implications for the clinical identification of personality disordered patients in forensic settings are discussed.

  12. An audit of the pharmacological management of ischaemic stroke patients in a metropolitan Australian hospital.

    Science.gov (United States)

    Khalil, Viviane; Li, Matthew; Hua, Qiantong Amanda

    2015-02-01

    According to the Australian Bureau of Statistics, stroke is the second leading cause of death in Australia. The clinical Guidelines for stroke management published by the National Stroke Foundation provide a series of evidence based recommendations to assist clinicians in the management of stroke patients. Appropriate management of patients admitted to stroke units reduces death and disability by 20 %. Moreover, a multidisciplinary team approach also improves patient outcomes. To retrospectively review the pharmacological management of ischaemic stroke patients in a metropolitan Australian hospital, and to compare adherence with the guidelines for stroke management with the national stroke foundation data with and without pharmacist intervention. A retrospective audit of medical records was undertaken of all patients admitted to a large teaching hospital with the diagnosis of stroke or cerebral infarction from January 2013 to May 2013. A total of 124 patients were included in the study. Most patients were discharged on appropriate pharmacological intervention for the prevention of secondary stroke: antihypertensive agents (71 %), lipid lowering agents (67 %) and antithrombotic (85 %) medications. The majority of the cohort was discharged on the appropriate evidence based medications for the management of secondary stroke. Further improvement may be achieved by pharmacist intervening as part of a multidisciplinary team.

  13. Molecular diagnosis of bloodstream infections in onco-haematology patients with PCR/ESI-MS technology.

    Science.gov (United States)

    Jordana-Lluch, Elena; Rivaya, Belén; Marcó, Clara; Giménez, Montserrat; Quesada, Mª Dolores; Escobedo, Agustín; Batlle, Montserrat; Martró, Elisa; Ausina, Vicente

    2017-02-01

    Onco-haematological patients are prone to develop infections, and antibiotic prophylaxis may lead to negative blood cultures. Thus, the microbiological diagnosis and subsequent administration of a targeted antimicrobial therapy is often difficult. The goal of this study was to evaluate the usefulness of IRIDICA (PCR/ESI-MS technology) for the molecular diagnosis of bloodstream infections in this patient group. A total of 463 whole blood specimens from different sepsis episodes in 429 patients were analysed using the PCR/ESI-MS platform, comparing the results with those of blood culture and other clinically relevant information. The sensitivity of PCR/ESI-MS by specimen (excluding polymicrobial infections, n = 25) in comparison with blood culture was 64.3% overall, 69.0% in oncological patients, and 59.3% in haematological patients. When comparing with a clinical infection criterion, overall sensitivity rose to 74.7%, being higher in oncological patients (80.0%) than in haematological patients (67.7%). Thirty-one microorganisms isolated by culture were not detected by IRIDICA, whereas 42 clinically relevant pathogens not isolated by culture were detected moleculary. PCR/ESI-MS offers a reliable identification of pathogens directly from whole blood. While additional studies are needed to confirm our findings, the system showed a lower sensitivity in onco-haematological patients in comparison with previously reported results in patients from the Intensive Care Unit. Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  14. Combined evaluation of personality, risk and coping in MS patients: A step towards individualized treatment choice - The PeRiCoMS-Study I.

    Science.gov (United States)

    Bsteh, G; Monz, E; Zamarian, L; Hagspiel, S; Hegen, H; Auer, M; Wurth, S; Di Pauli, F; Deisenhammer, F; Berger, T

    2017-05-15

    Multiple sclerosis (MS) is a chronic inflammatory neurological disease requiring disease-modifying treatment (DMT). To provide patients with the optimal individual therapeutic option, treatment recommendations should be based not only on individual disease course and DMT specific benefit-risk estimates, but also on patient's individual characteristics such as personality, risk attitude and coping strategies. However, these characteristics are difficult to objectify in clinical routine practice without the support of appropriate evaluation instruments. To identify and to assemble an objective test battery measuring personality, risk attitude and coping strategies in MS patients. A comprehensive literature search was performed to obtain all questionnaires assessing personality, risk attitude and coping strategies. Availability in German language, validation in a published normative collective and a reliability of >0.70 were required for our purposes. Based on these criteria, we chose the Big-Five-Personality Test, UPPS Impulsive Behaviour Scale, Domain-Specific Risk-Taking scale (DOSPERT), Brief-COPE and Stress & Coping Inventory (SCI). Results were compared to published normative controls of the respective questionnaires. Out of 22 MS patients (7 males, 15 females) participating in this study, 19 (86.4%) completed all questionnaires. The median completion time was 45min (min-max range: 25-60min). The median scores of the MS group were within the average range of published control samples in all questionnaires. We report that traits of personality, risk attitude and coping strategies can be effectively and feasibly tested in MS patients by the instruments used in our exploratory study. There were no differences between MS patients and healthy controls, thus enabling assessment without being influenced by the diagnosis of MS. After validation in a larger cohort the "PeRiCoMS"-battery will be useful as another step towards a more individualized shared

  15. A specific and sensitive HPLC-MS/MS micromethod for milrinone plasma levels determination after inhalation in cardiac patients.

    Science.gov (United States)

    Gavra, Paul; Nguyen, Anne Q-N; Theoret, Yves; Litalien, Catherine; Denault, André Y; Varin, France

    2014-10-01

    Milrinone administered through inhalation is an emerging method aimed at specifically reducing pulmonary hypertension without affecting systemic pressures. Its administration has been shown to be useful both in patients undergoing cardiac surgery and for persistent pulmonary hypertension of the newborn. These populations are prone to receive many concomitant medications and/or blood sampling may require a low volume quantification method. To address these issues in view of pharmacokinetic studies, this article aims to develop and validate a specific and sensitive analytical assay using high performance liquid chromatography (HPLC) and tandem mass spectrometry (MS/MS) detection for the quantification of milrinone plasma concentrations after inhalation in patients undergoing cardiac surgery. Plasma samples (50 μL) were extracted using ethyl acetate. Milrinone was separated on a C18 analytical column at 50°C. The mobile phase consisted of methanol and 10 mM ammonium acetate (45:55 vol/vol). The electrospray was operated in the negative ionization mode and monitored the following mass transitions: m/z 212.1 → 140.0 at 36 eV for milrinone and m/z 252.1 → 156.1 at 32 eV for olprinone. Calibration curves followed a quadratic regression in the concentration range of 0.3125-640 ng/mL. The lower limit of quantification is 0.3125 ng/mL and is based on a low plasma volume of 50 μL. Mean drug recovery and accuracy were ≥72.3% and 96.0%, respectively. Intraday and interday precision coefficient of variation (%) was ≤7.4% and ≤11.5%, respectively. The specificity allowed milrinone quantification in the multidrug administration conditions of cardiopulmonary bypass. This validated micromethod proved to be highly sensitive and specific while using a low volume of plasma. Its low volume and its lower limit of quantification indicate that this approach is suitable for further characterization of milrinone pharmacokinetics in both adults (inhalation) and neonates.

  16. Individualized robot-assisted training for MS- and stroke patients in I-TRAVLE

    OpenAIRE

    Notelaers, Sofie; De Weyer, Tom; Octavia, Johanna; Coninx, Karin; Bastiaens, Hanne; Feys, Peter

    2011-01-01

    Persons with central nervous deficits, such as MS and stroke patients, can benefit a lot from suitable training approaches that enhance their ability to perform activities in daily life. Personalized training, in accordance with the individual capabilities of the patient is a key issue in this context. We propose several techniques for individualization, including adaptive training games. Evaluations with patients and therapists reveal appreciation for the resulting ...

  17. A 30-month study of patient complaints at a major Australian hospital.

    Science.gov (United States)

    Anderson, K; Allan, D; Finucane, P

    2001-12-01

    Health practitioners often regard complaints about the quality of patient care in a negative light. However, complaints can indicate strategies to improve care. Therefore, an audit was undertaken of all formal complaints about patient care at a major Australian hospital over a 30-month period. The profile of complainants, the reasons for complaints, and the outcome were analysed. A total of 1308 complaints, concerning the care of 1267 patients, were received. The complaint rate was 1.12 per 1000 occasions of service. In all, 57% of complaints were lodged by advocates and 71% of complaints related to poor communication or to the treatment provided. In 97% of occasions, an explanation and/or an apology resulted. To date, no complaint has proceeded to litigation. Complaints are potentially useful quality assurance tools and can identify remediable system flaws. Health professionals and employers should understand why patients complain and be able to respond appropriately.

  18. Serum IFN neutralizing antibodies and neopterin levels in a cross-section of MS patients.

    Science.gov (United States)

    Cook, S D; Quinless, J R; Jotkowitz, A; Beaton, P

    2001-09-25

    To determine levels of serum interferon beta (IFNbeta) neutralizing antibody (NAb) and neopterin-an IFN biologic response marker-in patients with MS treated with Betaseron or Avonex. Controversy exists over the relative immunogenicity of IFNbeta-1a and IFNbeta-1b and the reasons for any such difference. To determine the role of patient profile and test methodology in IFNbeta, NAb levels need to be measured blindly and simultaneously in a predefined closely matched MS patient cohort. Serum NAb and neopterin levels were measured in closely matched patients on Avonex (n = 98) or Betaseron (n = 64). NAb were determined by Athena Diagnostics and serum neopterin levels by Covance Laboratories using a competitive binding radioimmunoassay. More patients taking Betaseron (22%) than Avonex (7%) had elevated titers of NAb (p = 0.008). Mean serum neopterin levels were lower in patients with high as compared to low NAb titers (p = 0.0002). No difference in mean neopterin levels was found comparing the total Betaseron group to the Avonex group; however, in the subset of patients with low NAb titers, mean neopterin levels were higher in the Betaseron than in the Avonex group (p = 0.027). A random cross-sectional sampling of patients on Avonex showed a decrease in neopterin levels over time between weekly doses. NAb are more commonly found with Betaseron than Avonex. More studies are needed to determine the correlation among serum neopterin levels, other biologic response markers, NAb, and disease activity in patients with MS being treated with IFNbeta.

  19. Localized atrophy of the thalamus and slowed cognitive processing speed in MS patients.

    Science.gov (United States)

    Bergsland, Niels; Zivadinov, Robert; Dwyer, Michael G; Weinstock-Guttman, Bianca; Benedict, Ralph Hb

    2016-09-01

    Deep gray matter (DGM) atrophy is common in multiple sclerosis (MS), but no studies have investigated surface-based structure changes over time with respect to healthy controls (HCs). Moreover, the relationship between cognition and the spatio-temporal evolution of DGM atrophy is poorly understood. To explore DGM structural differences between MS and HCs over time in relation to neuropsychological (NP) outcomes. The participants were 44 relapsing-remitting and 20 secondary progressive MS patients and 22 HCs. All were scanned using 3T magnetic resonance imaging (MRI) at baseline and 3-year follow-up. NP examination emphasized consensus standard tests of processing speed and memory. We performed both volumetric and shape analysis of DGM structures and assessed their relationships with cognition. Compared to HCs, MS patients presented with significantly smaller DGM volumes. For the thalamus and caudate, differences in shape were mostly localized along the lateral ventricles. NP outcomes were related to both volume and shape of the DGM structures. Over 3 years, decreased cognitive processing speed was related to localized atrophy on the anterior and superior surface of the left thalamus. These findings highlight the role of atrophy in the anterior nucleus of the thalamus and its relation to cognitive decline in MS. © The Author(s), 2015.

  20. Application of serum natalizumab levels during plasma exchange in MS patients with progressive multifocal leukoencephalopathy

    NARCIS (Netherlands)

    Vennegoor, A.; Rispens, T.; van Oosten, B.W.; Wattjes, M.P.; Wondergem, M.J.; Teunissen, C.E.; van der Kleij, D.; Uitdehaag, B.M.J.; Polman, C.H.; Killestein, J.

    2015-01-01

    Progressive multifocal leukoencephalopathy (PML) is a severe complication of natalizumab treatment. Restoring immune function by plasmapheresis/immunoadsorption (PLEX/IA) is important for the outcome of PML. We report on four multiple sclerosis (MS) patients whom developed PML during natalizumab

  1. A longitudinal study of cerebral glucose metabolism, MRI, and disability in patients with MS

    DEFF Research Database (Denmark)

    Blinkenberg, M; Jensen, C.V.; Holm, S

    1999-01-01

    OBJECTIVE: To study the time-related changes in cerebral metabolic rate of glucose (CMRglc) in MS patients and to correlate these with changes in MRI lesion load and disability. BACKGROUND: Measurements of MRI lesion load and neurologic disability are used widely to monitor disease progression...... and parietal cortical areas. There was a statistically significant increase of disability (pmetabolism in MS is decreased significantly during a 2......-year observation period, suggesting a deterioration of cortical activity with disease progression. The time-related changes of cortical CMRglc are statistically stronger than changes in TLA measurements and neurologic disability, and might be a useful secondary measure of treatment efficacy...

  2. Epidemiological characteristics of chronic fatigue- syndrome/myalgic encephalomyelitis in Australian patients

    Directory of Open Access Journals (Sweden)

    Johnston SC

    2016-05-01

    Full Text Available Samantha C Johnston1,2 Donald R Staines1 Sonya M Marshall-Gradisnik1,2 1National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, 2School of Medical Sciences, Griffith University, Parklands, QLD, Australia Background: No epidemiological investigations have previously been conducted in Australia according to the current clinical definitions of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME. The aim of this study was to describe sociodemographic and illness characteristics of Australian patients with CFS/ME.Methods: A cross-sectional survey on the medical history of patients enrolled in an Australian CFS/ME research database between April 2013 and April 2015. Participants were classified according to Fukuda criteria and International Consensus Criteria.Results: A total of 535 patients diagnosed with CFS/ME by a primary care physician were identified. The mean age of all patients was 46.4 years (standard deviation 12.0; the majority were female (78.61%, Caucasian, and highly educated. Of these, 30.28% met Fukuda criteria. A further 31.96% met both Fukuda criteria and International Consensus Criteria. There were 14.58% reporting chronic fatigue but did not meet criteria for CFS/ME and 23.18% were considered noncases due to exclusionary conditions. Within those meeting CFS/ME criteria, the most common events prior to illness included cold or flu, gastrointestinal illness, and periods of undue stress. Of the 60 symptoms surveyed, fatigue, cognitive, and short-term memory symptoms, headaches, muscle and joint pain, unrefreshed sleep, sensory disturbances, muscle weakness, and intolerance to extremes of temperature were the most commonly occurring symptoms (reported by more than two-thirds of patients. Significant differences in symptom occurrence between Fukuda- and International Consensus Criteria-defined cases were also identified.Conclusion: This is the first study to summarize sociodemographic and

  3. Balance and gait improved in patients with MS after physiotherapy based on the Bobath concept.

    Science.gov (United States)

    Smedal, Tori; Lygren, Hildegunn; Myhr, Kjell-Morten; Moe-Nilssen, Rolf; Gjelsvik, Bente; Gjelsvik, Olav; Strand, Liv Inger; Inger, Liv

    2006-06-01

    Patients with multiple sclerosis (MS) tend to have movement difficulties, and the effect of physiotherapy for this group of patients has been subjected to limited systematic research. In the present study physiotherapy based on the Bobath concept, applied to MS patients with balance and gait problems, was evaluated. The ability of different functional tests to demonstrate change was evaluated. A single-subject experimental study design with ABAA phases was used, and two patients with relapsing-remitting MS in stable phase were treated. Tests were performed 12 times, three at each phase: A (at baseline); B (during treatment); A (immediately after treatment); and A (after two months). The key feature of treatment was facilitation of postural activity and selective control of movement. Several performance and self report measures and interviews were used. After intervention, improved balance was shown by the Berg Balance Scale (BBS) in both patients, and improved quality of gait was indicated by the Rivermead Visual Gait Assessment (RVGA). The patients also reported improved balance and gait function in the interviews and scored their condition as 'much improved'. Gait parameters, recorded by an electronic walkway, changed, but differently in the two patients. Among the physical performance tests the BBS and the RVGA demonstrated the highest change, while no or minimal change was demonstrated by the Rivermead Mobility Index (RMI) and Ratings of Perceived Exertion (RPE). The findings indicate that balance and gait can be improved after physiotherapy based on the Bobath concept, but this should be further evaluated in larger controlled trials of patients with MS.

  4. Elevated urinary levels of carcinogenic N-nitrosamines in patients with urinary tract infections measured by isotope dilution online SPE LC–MS/MS

    International Nuclear Information System (INIS)

    Hu, Chiung-Wen; Shih, Ying-Ming; Liu, Hung-Hsin; Chiang, Yi-Chen; Chen, Chih-Ming; Chao, Mu-Rong

    2016-01-01

    Highlights: • Nine N-nitrosamines in urine were quantified by LC–MS/MS. • N-nitrosodiphenylamine was firstly identified in human urine. • UTI patients had much higher N-nitrosamines concentrations than healthy subjects. • N-nitrosamines were dramatically decreased after antibiotic treatment. • NDMA was correlated with the pH, WBC esterase activity or nitrite in UTI patients. - Abstract: N-nitrosamines (NAms) are well-documented for their carcinogenic potential. Human exposure to NAms may arise from the daily environment and endogenous formation via the reaction of secondary amines with nitrites or from bacteria infection. We describe the use of isotope dilution online solid-phase extraction (SPE) LC–MS/MS to quantify nine NAms in human urine. This method was validated and further applied to healthy subjects and patients with urinary tract infection (UTI). N-nitrosodimethylamine (NDMA), N-nitrosomethylethylamine (NMEA), N-nitrosopyrrolidine (NPYR) and N-nitrosomorpholine (NMOR) were analyzed with an APCI source, while N-nitrosodiethylamine (NDEA), N-nitrosopiperidine (NPIP), N-nitrosodi-n-propylamine (NDPA), N-nitrosodibutylamine (NDBA) and N-nitrosodiphenylamine (NDPhA) were quantified with an ESI source, due to their effect on the sensitivity and chromatography. NDMA was the most abundant N-nitrosamine, while NDPhA was firstly identified in human. UTI patients had three to twelve-fold higher concentrations for NDMA, NPIP, NDEA, NMOR and NDBA in urine than healthy subjects, and the NAms were significantly decreased after antibiotics treatment. NDMA concentrations were also significantly correlated with the pH value, leukocyte esterase activity or nitrite in urines of UTI patients. Our findings by online SPE LC–MS/MS method evidenced that UTI patients experienced various NAms exposures, especially the potent carcinogen NDMA, which was likely induced by bacteria infection.

  5. Elevated urinary levels of carcinogenic N-nitrosamines in patients with urinary tract infections measured by isotope dilution online SPE LC–MS/MS

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Chiung-Wen [Department of Public Health, Chung Shan Medical University, Taichung 402, Taiwan (China); Shih, Ying-Ming [Department of Public Health, Chung Shan Medical University, Taichung 402, Taiwan (China); Division of Chest Medicine, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan (China); Liu, Hung-Hsin [Department of Occupational Safety and Health, Chung Shan Medical University, Taichung 402, Taiwan (China); Chiang, Yi-Chen [Department of Public Health, Chung Shan Medical University, Taichung 402, Taiwan (China); School of Public Health, Xiamen University, Xiamen 361102, Fujian (China); Chen, Chih-Ming [Department of Occupational Safety and Health, Chung Shan Medical University, Taichung 402, Taiwan (China); Chao, Mu-Rong, E-mail: chaomurong@gmail.com [Department of Occupational Safety and Health, Chung Shan Medical University, Taichung 402, Taiwan (China); Department of Occupational Medicine, Chung Shan Medical University Hospital, Taichung 402, Taiwan (China)

    2016-06-05

    Highlights: • Nine N-nitrosamines in urine were quantified by LC–MS/MS. • N-nitrosodiphenylamine was firstly identified in human urine. • UTI patients had much higher N-nitrosamines concentrations than healthy subjects. • N-nitrosamines were dramatically decreased after antibiotic treatment. • NDMA was correlated with the pH, WBC esterase activity or nitrite in UTI patients. - Abstract: N-nitrosamines (NAms) are well-documented for their carcinogenic potential. Human exposure to NAms may arise from the daily environment and endogenous formation via the reaction of secondary amines with nitrites or from bacteria infection. We describe the use of isotope dilution online solid-phase extraction (SPE) LC–MS/MS to quantify nine NAms in human urine. This method was validated and further applied to healthy subjects and patients with urinary tract infection (UTI). N-nitrosodimethylamine (NDMA), N-nitrosomethylethylamine (NMEA), N-nitrosopyrrolidine (NPYR) and N-nitrosomorpholine (NMOR) were analyzed with an APCI source, while N-nitrosodiethylamine (NDEA), N-nitrosopiperidine (NPIP), N-nitrosodi-n-propylamine (NDPA), N-nitrosodibutylamine (NDBA) and N-nitrosodiphenylamine (NDPhA) were quantified with an ESI source, due to their effect on the sensitivity and chromatography. NDMA was the most abundant N-nitrosamine, while NDPhA was firstly identified in human. UTI patients had three to twelve-fold higher concentrations for NDMA, NPIP, NDEA, NMOR and NDBA in urine than healthy subjects, and the NAms were significantly decreased after antibiotics treatment. NDMA concentrations were also significantly correlated with the pH value, leukocyte esterase activity or nitrite in urines of UTI patients. Our findings by online SPE LC–MS/MS method evidenced that UTI patients experienced various NAms exposures, especially the potent carcinogen NDMA, which was likely induced by bacteria infection.

  6. Multiple sclerosis documentation system (MSDS): moving from documentation to management of MS patients.

    Science.gov (United States)

    Ziemssen, Tjalf; Kempcke, Raimar; Eulitz, Marco; Großmann, Lars; Suhrbier, Alexander; Thomas, Katja; Schultheiss, Thorsten

    2013-09-01

    The long disease duration of multiple sclerosis and the increasing therapeutic options require a individualized therapeutic approach which should be carefully documented over years of observation. To switch from MS documentation to an innovative MS management, new computer- and internet-based tools could be implemented as we could demonstrate with the novel computer-based patient management system "multiple sclerosis management system 3D" (MSDS 3D). MSDS 3D allows documentation and management of visit schedules and mandatory examinations via defined study modules by integration of data input from various sources (patients, attending physicians and MS nurses). It provides forms for the documentation of patient visits as well as clinical and diagnostic findings. Information can be collected via interactive touch screens. Specific modules allow the management of highly efficacious treatments as natalizumab or fingolimod. MSDS can be used to transfer the documented data to databases as, e.g. the registry of the German MS society or REGIMS. MSDS has already been implemented successfully in clinical practice and is currently being evaluated in a multicenter setting. High-quality management and documentation are crucial for improvements in clinical practice and research work.

  7. Genetic burden of MS risk variants distinguish patients from healthy individuals but are not associated with disease activity

    DEFF Research Database (Denmark)

    Søndergaard, Helle Bach; Petersen, Eva Rosa; Magyari, Melinda

    2017-01-01

    Weighted genetic risk score (wGRS) was analysed for association with disease activity in more than 500 MS patients before and during interferon-beta treatment. The wGRS was higher in MS patients than in healthy controls when analysing eight HLA - and 109 non-HLA MS risk gene variants....... No significant associations were observed between number of relapses prior to or during treatment with interferon-beta, both with and without HLA risk alleles included in the wGRS. In conclusion, among Danes the wGRS was higher in MS patients than controls but was not associated with the overall disease activity...

  8. The efficacy of cladribine tablets in CIS patients retrospectively assigned the diagnosis of MS using modern criteria: Results from the ORACLE-MS study.

    Science.gov (United States)

    Freedman, Mark S; Leist, Thomas P; Comi, Giancarlo; Cree, Bruce Ac; Coyle, Patricia K; Hartung, Hans-Peter; Vermersch, Patrick; Damian, Doris; Dangond, Fernando

    2017-01-01

    Multiple sclerosis (MS) diagnostic criteria have changed since the ORACLE-MS study was conducted; 223 of 616 patients (36.2%) would have met the diagnosis of MS vs clinically isolated syndrome (CIS) using the newer criteria. The objective of this paper is to assess the effect of cladribine tablets in patients with a first clinical demyelinating attack fulfilling newer criteria (McDonald 2010) for MS vs CIS. A post hoc analysis for subgroups of patients retrospectively classified as fulfilling or not fulfilling newer criteria at the first clinical demyelinating attack was conducted. Cladribine tablets 3.5 mg/kg ( n  = 68) reduced the risk of next attack or three-month confirmed Expanded Disability Status Scale (EDSS) worsening by 74% vs placebo ( n  = 72); p  = 0.0009 in patients meeting newer criteria for MS at baseline. Cladribine tablets 5.25 mg/kg ( n  = 83) reduced the risk of next attack or three-month confirmed EDSS worsening by 37%, but nominal significance was not reached ( p  = 0.14). In patients who were still CIS after applying newer criteria, cladribine tablets 3.5 mg/kg ( n  = 138) reduced the risk of conversion to clinically definite multiple sclerosis (CDMS) by 63% vs placebo ( n  = 134); p  = 0.0003. Cladribine tablets 5.25 mg/kg ( n  = 121) reduced the risk of conversion by 75% vs placebo ( n  = 134); p  ORACLE-MS study (NCT00725985).

  9. Neuro-ophthalmologic evaluation, quality of life, and functional disability in patients with MS.

    Science.gov (United States)

    Garcia-Martin, Elena; Rodriguez-Mena, Diego; Herrero, Raquel; Almarcegui, Carmen; Dolz, Isabel; Martin, Jesus; Ara, Jose R; Larrosa, Jose M; Polo, Vicente; Fernández, Javier; Pablo, Luis E

    2013-07-02

    To evaluate correlations between longitudinal changes in neuro-ophthalmologic measures and quality of life (QOL) and disability in patients with multiple sclerosis (MS), using optical coherence tomography (OCT), visual evoked potentials (VEP), and visual field examination. Fifty-four patients with relapsing-remitting MS were enrolled in this study and underwent Multiple Sclerosis Quality of Life questionnaire (54 items) (MSQOL-54) and Expanded Disability Status Scale (EDSS) evaluation, as well as complete neuro-ophthalmologic examination including visual field testing and retinal nerve fiber layer (RNFL) measurements using Cirrus and Spectralis OCT and VEP. All patients were re-evaluated at 12, 24, and 36 months. Logistical regression was performed to analyze which measures, if any, could predict QOL. Overall, RNFL thickness results at the baseline evaluation were significantly different from those at 3 years (p ≤ 0.05), but there were no differences in functional measures (visual acuity, contrast sensitivity, color vision, visual field, and VEP). A reduced MSQOL-54 score was associated with an increase in EDSS score and a decrease in both functional and structural parameters. Patients with longer MS duration presented with a lower MSQOL-54 score (reduction in QOL). Patients with progressive axonal loss as seen in RNFL results had a lower QOL and more functional disability.

  10. Identification of Australian Aboriginal and Torres Strait Islander Cancer Patients in the Primary Health Care Setting

    Directory of Open Access Journals (Sweden)

    Audra de Witt

    2017-08-01

    Full Text Available BackgroundAboriginal and Torres Strait Islander Australians have poorer cancer outcomes and experience 30% higher mortality rates compared to non-Indigenous Australians. Primary health care (PHC services are increasingly being recognized as pivotal in improving Indigenous cancer patient outcomes. It is currently unknown whether patient information systems and practices in PHC settings accurately record Indigenous and cancer status. Being able to identify Indigenous cancer patients accessing services in PHC settings is the first step in improving outcomes.MethodsAboriginal Medical Centres, mainstream (non-Indigenous specific, and government-operated centers in Queensland were contacted and data were collected by telephone during the period from 2014 to 2016. Participants were asked to (i identify the number of patients diagnosed with cancer attending the service in the previous year; (ii identify the Indigenous status of these patients and if this information was available; and (iii advise how this information was obtained.ResultsTen primary health care centers (PHCCs across Queensland participated in this study. Four centers were located in regional areas, three in remote areas and three in major cities. All participating centers reported ability to identify Indigenous cancer patients attending their service and utilizing electronic Patient Care Information Systems (PCIS to manage their records; however, not all centers were able to identify Indigenous cancer patients in this way. Indigenous cancer patients were identified by PHCCs using PCIS (n = 8, searching paper records (n = 1, and combination of PCIS and staff recall (n = 1. Six different types of PCIS were being utilized by participating centers. There was no standardized way to identify Indigenous cancer patients across centers. Health service information systems, search functions and capacities of systems, and staff skill in extracting data using PCIS varied between centers

  11. Determination of rivaroxaban in patient's plasma samples by anti-Xa chromogenic test associated to High Performance Liquid Chromatography tandem Mass Spectrometry (HPLC-MS/MS).

    Science.gov (United States)

    Derogis, Priscilla Bento Matos; Sanches, Livia Rentas; de Aranda, Valdir Fernandes; Colombini, Marjorie Paris; Mangueira, Cristóvão Luis Pitangueira; Katz, Marcelo; Faulhaber, Adriana Caschera Leme; Mendes, Claudio Ernesto Albers; Ferreira, Carlos Eduardo Dos Santos; França, Carolina Nunes; Guerra, João Carlos de Campos

    2017-01-01

    Rivaroxaban is an oral direct factor Xa inhibitor, therapeutically indicated in the treatment of thromboembolic diseases. As other new oral anticoagulants, routine monitoring of rivaroxaban is not necessary, but important in some clinical circumstances. In our study a high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method was validated to measure rivaroxaban plasmatic concentration. Our method used a simple sample preparation, protein precipitation, and a fast chromatographic run. It was developed a precise and accurate method, with a linear range from 2 to 500 ng/mL, and a lower limit of quantification of 4 pg on column. The new method was compared to a reference method (anti-factor Xa activity) and both presented a good correlation (r = 0.98, p plasma samples for rivaroxaban measurement by HPLC-MS/MS without interferences. The chromogenic and HPLC-MS/MS methods were highly correlated and should be used as clinical tools for drug monitoring. The method was applied successfully in a group of 49 real-life patients, which allowed an accurate determination of rivaroxaban in peak and trough levels.

  12. Hippotherapy for patients with multiple sclerosis: A multicenter randomized controlled trial (MS-HIPPO).

    Science.gov (United States)

    Vermöhlen, Vanessa; Schiller, Petra; Schickendantz, Sabine; Drache, Marion; Hussack, Sabine; Gerber-Grote, Andreas; Pöhlau, Dieter

    2017-08-01

    Evidence-based complementary treatment options for multiple sclerosis (MS) are limited. To investigate the effect of hippotherapy plus standard care versus standard care alone in MS patients. A total of 70 adults with MS were recruited in five German centers and randomly allocated to the intervention group (12 weeks of hippotherapy) or the control group. Primary outcome was the change in the Berg Balance Scale (BBS) after 12 weeks, and further outcome measures included fatigue, pain, quality of life, and spasticity. Covariance analysis of the primary endpoint resulted in a mean difference in BBS change of 2.33 (95% confidence interval (CI): 0.03-4.63, p = 0.047) between intervention ( n = 32) and control ( n = 38) groups. Benefit on BBS was largest for the subgroup with an Expanded Disability Status Scale (EDSS) ⩾ 5 (5.1, p = 0.001). Fatigue (-6.8, p = 0.02) and spasticity (-0.9, p = 0.03) improved in the intervention group. The mean difference in change between groups was 12.0 ( p Hippotherapy plus standard care, while below the threshold of a minimal clinically important difference, significantly improved balance and also fatigue, spasticity, and quality of life in MS patients.

  13. Economic evaluation of an extended nutritional intervention in older Australian hospitalized patients: a randomized controlled trial.

    Science.gov (United States)

    Sharma, Yogesh; Thompson, Campbell; Miller, Michelle; Shahi, Rashmi; Hakendorf, Paul; Horwood, Chris; Kaambwa, Billingsley

    2018-02-05

    Prevalence of malnutrition in older hospitalized patients is 30%. Malnutrition is associated with poor clinical outcomes in terms of high morbidity and mortality and is costly for hospitals. Extended nutrition interventions improve clinical outcomes but limited studies have investigated whether these interventions are cost-effective. In this randomized controlled trial, 148 malnourished general medical patients ≥60 years were recruited and randomized to receive either an extended nutritional intervention or usual care. Nutrition intervention was individualized and started with 24 h of admission and was continued for 3 months post-discharge with a monthly telephone call whereas control patients received usual care. Nutrition status was confirmed by Patient generated subjective global assessment (PG-SGA) and health-related quality of life (HRQoL) was measured using EuroQoL 5D (EQ-5D-5 L) questionnaire at admission and at 3-months follow-up. A cost-effectiveness analysis was conducted for the primary outcome (incremental costs per unit improvement in PG-SGA) while a cost-utility analysis (CUA) was undertaken for the secondary outcome (incremental costs per quality adjusted life year (QALY) gained). Nutrition status and HRQoL improved in intervention patients. Mean per included patient Australian Medicare costs were lower in intervention group compared to control arm (by $907) but these differences were not statistically significant (95% CI: -$2956 to $4854). The main drivers of higher costs in the control group were higher inpatient ($13,882 versus $13,134) and drug ($838 versus $601) costs. After adjusting outcomes for baseline differences and repeated measures, the intervention was more effective than the control with patients in this arm reporting QALYs gained that were higher by 0.0050 QALYs gained per patient (95% CI: -0.0079 to 0.0199). The probability of the intervention being cost-effective at willingness to pay values as low as $1000 per unit

  14. Individualized robot-assisted training for MS- and stroke patients in I-TRAVLE

    Directory of Open Access Journals (Sweden)

    Bastiaens Hanne

    2011-12-01

    Full Text Available Persons with central nervous deficits, such as MS and stroke patients, can benefit a lot from suitable training approaches that enhance their ability to perform activities in daily life. Personalized training, in accordance with the individual capabilities of the patient is a key issue in this context. We propose several techniques for individualization, including adaptive training games. Evaluations with patients and therapists reveal appreciation for the resulting Individualized, Technology-supported and RobotAssisted Virtual Learning Environments (I-TRAVLE system.

  15. Mnesic performance and executive functions in patients with multiple sclerosis (MS

    Directory of Open Access Journals (Sweden)

    Isabel Introzzi

    2009-10-01

    Full Text Available The Episodic Memory (EM and the Executive Functions (EF are cognitive areas that are affected in patients with diagnosis of Multiple Sclerosis (MS. Nowadays there exists scarce works destined to explore the infl uence of the EF on measures of mnesic performance in MS. For this reason, we analyze the effect of the EF on the performance in a set of memory measures. We worked with a clinical group (n=36 and with a control group (n=36 compared by age and educational level. The results show that the clinical group obtained significantly low average values in all the mnesic indexes (with exception of recognition and in all the executive measures. All the executive indexes showed significant associations with some of the indexes of mnesic performance. These findings suggest that the problems in the episodic memory in EM patients could be analyzed as the manifestation of a global disorder that could be similar to the one that involves the EF.

  16. Evidence that the ancestral haplotype in Australian hemochromatosis patients may be associated with a common mutation in the gene.

    OpenAIRE

    Crawford, D H; Powell, L W; Leggett, B A; Francis, J S; Fletcher, L M; Webb, S I; Halliday, J W; Jazwinska, E C

    1995-01-01

    Hemochromatosis (HC) is a common inherited disorder of iron metabolism for which neither the gene nor biochemical defect have yet been identified. The aim of this study was to look for clinical evidence that the predominant ancestral haplotype in Australian patients is associated with a common mutation in the gene. We compared indices of iron metabolism and storage in three groups of HC patients categorized according to the presence of the ancestral haplotype (i.e., patients with two copies, ...

  17. The Australian National Sub-Acute and Non-Acute Patient casemix classification.

    Science.gov (United States)

    Eagar, K

    1999-01-01

    The Australian National Sub-Acute and Non-Acute Patient (AN-SNAP) Version 1 casemix classification was completed in 1997. AN-SNAP is designed for the classification of sub-acute and non-acute care provided in both inpatient and ambulatory settings and is intended to be useful for both funding and clinical management purposes. The National Sub-Acute and Non-Acute Casemix Classification study has produced the first version of a national classification of sub-acute and non-acute care. Ongoing refinement (leading to Version 2) will be possible through further analysis of the existing data set in combination with analysis of the results of a carefully planned and phased implementation.

  18. Australian rural radiographers' perspectives on disclosure of their radiographic opinion to patients

    International Nuclear Information System (INIS)

    Squibb, Kathryn; Bull, Rosalind M.; Smith, Anthony; Dalton, Lisa

    2015-01-01

    The role of Australian rural radiographers in radiographic interpretation, communication and disclosure of their radiographic opinion with a specific focus on plain film radiography was examined in a two phase, exploratory interpretive study. Data were collected using questionnaires and interviews and analysed thematically. This reports one of the key themes identified in the thematic data analysis. ‘Disclosure of Radiographic Opinion to Patients’ comprises the three interrelated sub-themes Acting Ethically, Selective Disclosure and Filtered Truth. It is wholly concerned with the ways in which rural radiographers choose to disclose their radiographic opinion to patients. Without a clear picture of where they stand medico-legally, rural radiographers draw on experience and a strong ethical framework as the basis for these complex decisions. Rural radiographers frame their disclosures to patients in a manner that is governed by the diagnostic, therapeutic and emotional impact the information disclosed may have on the patient. Disclosure to patients was found to be selective, often diagnostically vague and ethically filtered

  19. Streptococcal peritonitis in Australian peritoneal dialysis patients: predictors, treatment and outcomes in 287 cases

    Directory of Open Access Journals (Sweden)

    McDonald Stephen P

    2009-07-01

    Full Text Available Abstract Background There has not been a comprehensive, multi-centre study of streptococcal peritonitis in patients on peritoneal dialysis (PD to date. Methods The predictors, treatment and clinical outcomes of streptococcal peritonitis were examined by binary logistic regression and multilevel, multivariate poisson regression in all Australian PD patients involving 66 centres between 2003 and 2006. Results Two hundred and eighty-seven episodes of streptococcal peritonitis (4.6% of all peritonitis episodes occurred in 256 individuals. Its occurrence was independently predicted by Aboriginal or Torres Strait Islander racial origin. Compared with other organisms, streptococcal peritonitis was associated with significantly lower risks of relapse (3% vs 15%, catheter removal (10% vs 23% and permanent haemodialysis transfer (9% vs 18%, as well as a shorter duration of hospitalisation (5 vs 6 days. Overall, 249 (87% patients were successfully treated with antibiotics without experiencing relapse, catheter removal or death. The majority of streptococcal peritonitis episodes were treated with either intraperitoneal vancomycin (most common or first-generation cephalosporins for a median period of 13 days (interquartile range 8–18 days. Initial empiric antibiotic choice did not influence outcomes. Conclusion Streptococcal peritonitis is a not infrequent complication of PD, which is more common in indigenous patients. When treated with either first-generation cephalosporins or vancomycin for a period of 2 weeks, streptococcal peritonitis is associated with lower risks of relapse, catheter removal and permanent haemodialysis transfer than other forms of PD-associated peritonitis.

  20. Antibiotic complications during the treatment of Mycobacterium ulcerans disease in Australian patients.

    Science.gov (United States)

    O'Brien, Daniel P; Friedman, Deborah; Hughes, Andrew; Walton, Aaron; Athan, Eugene

    2017-09-01

    Antibiotics are the recommended first-line treatment for Mycobacterium ulcerans disease. Antibiotic toxicity is common in Australian patients, yet antibiotic complication rates and their risk factors have not been determined. To determine the incidence rate and risk factors for antibiotic toxicity in Australian patients treated for M. ulcerans disease. An analysis of severe antibiotic complications was performed using data from a prospective cohort of M. ulcerans cases managed at Barwon Health from 1 January 1998 to 30 June 2016. A severe antibiotic complication was defined as an antibiotic adverse event that required its cessation. Antibiotic complication rates and their associations were assessed using a Poisson regression model. A total of 337 patients was included; 184 (54.6%) males and median age 57 years (interquartile range (IQR) 36-73 years). Median antibiotic treatment duration was 56 days (IQR 49-76 days). Seventy-five (22.2%) patients experienced severe antibiotic complications after a median 28 days (IQR 17-45 days) at a rate of 141.53 per 100 person-years (95% confidence interval (CI) 112.86-177.47). Eleven (14.7%) patients required hospitalisation. Compared with rifampicin/clarithromycin combinations, severe complication rates were not increased for rifampicin/ciprofloxacin (rate ratio (RR) 1.49, 95% CI 0.89-2.50, P = 0.13) or rifampicin/moxifloxacin (RR 2.54, 95% CI 0.76-8.50, P = 0.13) combinations, but were significantly increased for 'other' combinations (RR 2.53, 95% CI 1.13-5.68, P = 0.03). In a multivariable analysis, severe complication rates were significantly increased with reduced estimated glomerular filtration rates (EGFR) (adjusted rate ratio (aRR) 2.65, 95% CI 1.24-5.65 for EGFR 60-89 mL/min and aRR 1.31, 95% CI 0.49-3.53 for EGFR 0-59 mL/min compared with EGFR ≥90 mL/min, P antibiotic complications during M. ulcerans treatment are high with increased rates independently associated with reduced renal function and female

  1. Non-prescription treatment of NSAID induced GORD by Australian pharmacies: a national simulated patient study.

    Science.gov (United States)

    MacFarlane, Brett; Matthews, Andrew; Bergin, Jenny

    2015-10-01

    Patients regularly present to community pharmacies for advice about and treatment for reflux symptoms and NSAIDs are a common cause of these symptoms. There is no published literature detailing the approach that pharmacies take to these enquiries, the pharmacotherapy they recommend or whether they contribute to the safe and effective use of reflux medicines. To assess in an observational study design the clinical history gathering, recommendations for GORD management and counselling provided by community pharmacies in a simulated patient scenario involving suspected NSAID induced reflux symptoms. Setting Australian community pharmacies. Simulated patients visited 223 community pharmacies to request treatment for reflux symptoms. The interaction was audiotaped and assessed against guidelines for the treatment of reflux symptoms. Alignment of community pharmacies with international expert gastroenterologist guidance and national professional practice guidelines for the treatment of reflux symptoms by pharmacists including: consultation with a pharmacist; confirmation of reflux diagnosis based on symptoms; recommendation of short courses proton pump inhibitor (PPI) therapy; advice on the safe and effective use of reflux medicines and referral to a doctor for further assessment. Pharmacists consulted with the simulated patient in 77% of cases. Symptoms were enquired about in 95% of cases and a medicines history taken in 69% of cases. Recommendations for treatment included: PPIs (18%), histamine H2 antagonists (57%) and antacids (19%). Advice on product use was given in 83% of cases. Referral to a doctor to discuss reflux symptoms was made in 63% of cases. When assessing patients for the symptoms of GORD, Australian pharmacists and non-pharmacist support staff take a comprehensive history including symptomatology, duration of symptoms, concomitant medicines and medical conditions and any GORD treatments previously trialled. They provide comprehensive counselling on the

  2. AToMS: A Ubiquitous Teleconsultation System for Supporting AMI Patients with Prehospital Thrombolysis

    Directory of Open Access Journals (Sweden)

    Bruno S. P. M. Correa

    2011-01-01

    Full Text Available The latest population-based studies in the medical literature worldwide indicate that acute myocardial infarction (AMI patients still experience prolonged delay to be rescued, which often results in morbidity and mortality. This paper reports from a technological standpoint a teleconsultation and monitoring system named AToMS. This system addresses the problem of prehospital delivery of thrombolysis to AMI patients by enabling the remote interaction of the paramedics and a cardiologist available at a Coronary Care Unit (CCU. Such interaction allows the diagnosis of the patient eligibility to the immediate application of thrombolysis, which is meant to reduce the delay between the onset of symptoms and the eventual application of proper treatment. Such delay reduction is meant to increase the AMI patient's chances of survival and decrease the risks of postinfarction sequels. The teleconsultation is held with the support of wireless and mobile technologies, which also allows the cardiologist to monitor the patient while he/she is being taken to the nearest CCU. All exchanged messages among paramedics and cardiologists are recorded to render an auditable system. AToMS has been deployed in a first stage in the city of Rio de Janeiro, where the medical team involved in the project has conducted commissioned tests.

  3. Catalytic properties of IgMs with amylolytic activity isolated from patients with multiple sclerosis.

    Science.gov (United States)

    Ivanen, Dina R; Kulminskaya, Anna A; Shabalin, Konstantin A; Isaeva-Ivanova, Luydmila V; Ershova, Nadezhda A; Saveliev, Andrew N; Nevinsky, Gregory A; Neustroev, Kirill N

    2004-08-01

    Recently, amylolytic activity was detected in IgMs isolated from the sera of the patients with multiple sclerosis. All purified samples of IgM were electrophoretically homogenous and did not contain any co-purified a-amylase and a-glucosidase activities, in accordance with a set of criteria developed for abzymes. The amylolytic activity of abzymes was studied in the hydrolysis of p-nitrophenyl a-D-maltooligosaccharides with different degrees of polymerization from 1 to 8 by TLC and reverse-phase HPLC techniques. All IgM samples isolated from 54 patients with clinically definite multiple sclerosis demonstrated hydrolytic activity towards the above artificial substrates. The Michaelis constant values (Km) in the hydrolysis of p-nitrophenyl a-D-maltoheptaoside were in the range of 10 p-nitrophenyl or p-nitrophenyl a-D-glucosides, thus indicating the presence of an a-D-glucosidase activity. For a number of the investigated samples, specific amylolytic activity increased depending on the length of substrates (from p-nitrophenyl maltopentaoside to p-nitrophenyl maltohexaoside); for other IgMs, the opposite dependence was observed. All IgMs studied did not exhibit any other glycoside hydrolase activities toward p-nitrophenyl glycoside substrates. Abzyme fractions from different donors demonstrated catalytic heterogeneity in Michaelis-Menten parameters and different modes of action in the hydrolysis of p-nitrophenyl maltooligosaccharides. Enzymatic properties of the IgMs tested varied from human a-amylases. All investigated abzyme samples did not show transglycosylating ability.

  4. Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective: part 1 historical and established therapies. MS Neurology Group of the Australian and New Zealand Association of Neurologists.

    Science.gov (United States)

    Broadley, Simon A; Barnett, Michael H; Boggild, Mike; Brew, Bruce J; Butzkueven, Helmut; Heard, Robert; Hodgkinson, Suzanne; Kermode, Allan G; Lechner-Scott, Jeannette; Macdonell, Richard A L; Marriott, Mark; Mason, Deborah F; Parratt, John; Reddel, Stephen W; Shaw, Cameron P; Slee, Mark; Spies, Judith; Taylor, Bruce V; Carroll, William M; Kilpatrick, Trevor J; King, John; McCombe, Pamela A; Pollard, John D; Willoughby, Ernest

    2014-11-01

    Multiple sclerosis (MS) is a potentially life-changing immune mediated disease of the central nervous system. Until recently, treatment has been largely confined to acute treatment of relapses, symptomatic therapies and rehabilitation. Through persistent efforts of dedicated physicians and scientists around the globe for 160 years, a number of therapies that have an impact on the long term outcome of the disease have emerged over the past 20 years. In this three part series we review the practicalities, benefits and potential hazards of each of the currently available and emerging treatment options for MS. We pay particular attention to ways of abrogating the risks of these therapies and provide advice on the most appropriate indications for using individual therapies. In Part 1 we review the history of the development of MS therapies and its connection with the underlying immunobiology of the disease. The established therapies for MS are reviewed in detail and their current availability and indications in Australia and New Zealand are summarised. We examine the evidence to support their use in the treatment of MS. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  5. An Australian government dental scheme: Doctor-dentist-patient tensions in the triangle.

    Science.gov (United States)

    Weerakoon, Arosha; Fitzgerald, Lisa; Porter, Suzette

    2014-11-30

    Autonomy of participants is challenged when legislation to provide a public health service is weakly designed and implemented. Australia's Chronic Disease Dental Scheme was instigated to provide a government subsidy for private dental treatment for people suffering chronic illness impacting their oral health or vice versa. They were allocated AUD$4250 towards comprehensive treatment over 2 years with their eligibility determined by their general medical doctor. A qualitative research study was conducted to explore the experiences from the perspectives of the patient, medical and dental practitioner. One of the research outcomes identified a frequently reported level of discomfort in the patient/doctor/dentist triangle. Doctors and dentists reported feeling forced by patients into positions that compromised their autonomy in obeying the intent (if not the law) of the scheme. Additionally, dentists felt under pressure from doctors and patients to provide subsidized treatment to those eligible. In turn, the patients reported difficulties in gaining access to the scheme and in some cases, experiencing full or partially unmet oral health needs. REASON FOR CONFLICT: Poor inter-professional communication and lack of understanding about profession-unique patient-driven pressures, ultimately contributed to dissonance. Ill-defined eligibility guidelines rendered the doctor's ability to gate-keep challenging. OUTCOME OF CONFLICT: Inefficient gate-keeping led to exponential increase in referrals, resulting in unprecedented cost blow-outs. Ensuing government-led audits caused political tensions and contributed to the media-induced vilification of dentists. In December 2013, government financing of dental treatment through Chronic Disease Dental Scheme was discontinued, leaving many Australians without a viable alternative. There is a need for qualitative research methods to help identify social issues that affect public health policy process. In order to succeed, new health

  6. Surgical strategies in polytraumatized patients with femoral shaft fractures - comparing a German and an Australian level I trauma centre.

    Science.gov (United States)

    Andruszkow, Hagen; Dowrick, Adam S; Frink, Michael; Zeckey, Christian; Krettek, Christian; Hildebrand, Frank; Edwards, Elton R; Mommsen, Philipp

    2013-08-01

    Femoral shaft fractures are one of the most common injuries in multiple trauma patients. Due to their prognostic relevance, there is an ongoing controversial discussion as to the optimal treatment strategy in terms of Damage Control Orthopaedics (DCO) and Early Total Care (ETC). We aimed to describe the differences in fracture management and clinical outcome of multiple trauma patients with concomitant femoral shaft fractures treated at a German and an Australian level I trauma centre using the same inclusion criteria. Polytraumatized patients (ISS ≥ 16) with a femoral shaft fracture aged ≥ 16 years treated at a German and an Australian trauma centre between 2003 and 2007 were included. According to ETC and DCO management principles, we evaluated demographic parameters as well as posttraumatic complications and clinical outcome. Seventy-three patients were treated at the German and 134 patients at the Australian trauma centre. DCO was performed in case of increased injury severity in both hospitals. Prolonged mechanical ventilation time, and length of ICU and hospital stay were demonstrated in DCO treatment regardless of the trauma centre. No differences concerning posttraumatic complications and survival were found between both centres. Survival of patients after DCO was similar to those managed using ETC despite a greater severity of injury and lower probability of survival. There was no difference in the incidence of ARDS. DCO was, however, associated with a greatly increased length of time on mechanical ventilation and length of stay in the ICU. We found no differences concerning patient demographics or clinical outcomes in terms of incidence of ARDS, MODS, or mortality. As such, we propose that comparability between German and Australian trauma populations is justified. Despite a higher ISS in the DCO group, there were no differences in posttraumatic complications and survival depending on ETC or DCO treatment. Further research is required to confirm

  7. Use of hypofractionated post-mastectomy radiotherapy reduces health costs by over $2000 per patient: An Australian perspective.

    Science.gov (United States)

    Mortimer, Joshua W; McLachlan, Craig S; Hansen, Carmen J; Assareh, Hassan; Last, Andrew; McKay, Michael J; Shakespeare, Thomas P

    2016-02-01

    The most recent clinical practice guidelines released by Cancer Australia draw attention to unanswered questions concerning the health economic considerations associated with hypofractionated radiotherapy. This study aimed to quantify and compare the healthcare costs at a regional Australian radiotherapy institute with respect to conventionally fractionated post-mastectomy radiotherapy (Cf-PMRT) versus hypofractionated post-mastectomy radiotherapy (Hf-PMRT) administration. Medical records of 196 patients treated with post-mastectomy radiotherapy at the NSW North Coast Cancer Institute from February 2008 to June 2014 were retrospectively reviewed. Australian Medicare item numbers billed for patients receiving either Cf-PMRT of 50 Gy in 25 daily fractions or Hf-PMRT of 40.05 Gy in 15 daily fractions were calculated. Decision tree analysis was used to model costs. Independent-samples t-tests and Mann-Whitney U-tests were used to compare crude average costs for Cf-PMRT and Hf-PMRT and determine which treatment components accounted for any differences. Hf-PMRT, with or without irradiation to the regional lymph nodes, was associated with significantly reduced Medicare costs ($5613 AUD per patient for Hf-PMRT vs $8272 AUD per patient for Cf-PMRT; P < 0.001). Savings associated with Hf-PMRT ranged from $1353 (22.1%) for patients receiving no regional irradiation to $2898 (32.0%) for patients receiving both axillary and supraclavicular therapy. Hf-PMRT results in a significant reduction in the financial costs associated with treating breast cancer patients in a regional Australian setting when compared with Cf-PMRT. © 2015 The Royal Australian and New Zealand College of Radiologists.

  8. A more in-depth interpretation of MMPI-2 in MS patients by using Harris and Lingoes subscales.

    Science.gov (United States)

    Incerti, Chiara C; Argento, Ornella; Pisani, Valerio; Magistrale, Giuseppe; Sabatello, Ugo; Caltagirone, Carlo; Nocentini, Ugo

    2017-01-01

    Multiple Sclerosis (MS) is frequently associated with neuropsychiatric abnormalities. The aim of our study was to discriminate between psychosomatic disturbances and MS physically-related symptoms using the Harris-Lingoes subscales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Forty-six MS out-patients (35 females; mean age = 44.5); and 82 healthy volunteers (62 females; mean age = 46.5) were evaluated with MMPI-2 questionnaire. The frequency distribution of MMPI-2 clinical scales with high scores (> = 65) and the related Harris-Lingoes subscales were analyzed for both MS patients and healthy control subjects. Data analysis showed elevated scores in 47.8% of the patients mainly on MMPI-2 clinical scales 1, 2, and 3. The Harris-Lingoes subscales analysis allowed us to isolate and identify physical symptoms contributing to elevation of MMPI-2 clinical scales, reduce the occurrence of false positives (MMPI-2 clinical scales elevations mainly due to MS physical disability) and provide a more detailed description of psycho-emotional symptoms of MS patients. In conclusion, our study shows the utility of Harris-Lingoes subscales analysis when MMPI-2 is used for psychological assessment of MS patients.

  9. LC-MS/MS method for simultaneous determination of thalidomide, lenalidomide, cyclophosphamide, bortezomib, dexamethasone and adriamycin in serum of multiple myeloma patients.

    Science.gov (United States)

    Shu, Chang; Zeng, Tianmei; Gao, Shouhong; Xia, Tianyi; Huang, Lifeng; Zhang, Feng; Chen, Wansheng

    2016-08-15

    Multiple myeloma (MM), a malignant neoplastic serum-cell disorder, has been a serious threat to human health. The determination of 6 commonly used drug concentrations, including thalidomide, lenalidomide, cyclophosphamide, bortezomib, dexamethasone and adriamycin, in MM patients was of great clinical interest. Herein, we reported a method for the rapid and simultaneous measurement of the above therapeutics by liquid chromatography-tandem mass spectroscopy (LC-MS/MS) method with solid phase extraction. Analysis was performed on a Waters XBridge(®) BEH C18 column (2.5μm, 2.1 mm×50mm), with formic acid aqueous solution and acetonitrile as the mobile phase at flow rate 0.3mL/min. All analytes showed good correlation coefficients (r>0.996), and LLOQ of thalidomide, lenalidomide, cyclophosphamide, bortezomib, dexamethasone and adriamycin were 4, 2, 2, 2, 2 and 2ng/mL, respectively. The inter- and intra-day precisions and stability were expressed as variation coefficients within 15% and relative error less than 15%. Dilution effect, carryover and incurred sample reanalysis were investigated according to the 2015 edition Chinese Pharmacopoeia guidelines, as US FDA (2013, revision 1) required. The LC-MS/MS based assay described in this article may improve future clinical studies evaluating common therapeutics for MM treatment. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Exploring the predictive value of the evoked potentials score in MS within an appropriate patient population: a hint for an early identification of benign MS?

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    Margaritella Nicolò

    2012-08-01

    Full Text Available Abstract Background The prognostic value of evoked potentials (EPs in multiple sclerosis (MS has not been fully established. The correlations between the Expanded Disability Status Scale (EDSS at First Neurological Evaluation (FNE and the duration of the disease, as well as between EDSS and EPs, have influenced the outcome of most previous studies. To overcome this confounding relations, we propose to test the prognostic value of EPs within an appropriate patient population which should be based on patients with low EDSS at FNE and short disease duration. Methods We retrospectively selected a sample of 143 early relapsing remitting MS (RRMS patients with an EDSS Results The Evoked Potentials score (EP score and the Time to EDSS 2.0 (TT2 were the best predictors of worsening in our sample (Odds Ratio 1.10 and 0.82 respectively, p=0.001. Low EP score (below 15–20 points, short TT2 (lower than 3–5 years and their interaction resulted to be the most useful for the identification of worsening patterns. Moreover, in patients with an EP score at FNE below 6 points and a TT2 greater than 3 years the probability of worsening was 10% after 4–5 years and rapidly decreased thereafter. Conclusions In an appropriate population of early RRMS patients, the EP score at FNE is a good predictor of disability at low values as well as in combination with a rapid buildup of disability. Interestingly, an EP score at FNE under the median together with a clinical stability lasting more than 3 years turned out to be a protective pattern. This finding may contribute to an early identification of benign patients, well before the term required to diagnose Benign MS (BMS.

  11. Management of over-the-counter insomnia complaints in Australian community pharmacies: a standardized patient study.

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    Kashyap, Krishneeta C; Nissen, Lisa M; Smith, Simon S; Kyle, Greg

    2014-04-01

    To evaluate the current management of over-the-counter (OTC) insomnia complaints in Australian community pharmacies using standardized patient methodology. Trained standardized patients visited a sample of 100 randomly selected South East Queensland community pharmacies in June 2011. The standardized patients enacted two OTC insomnia scenarios: a direct product request (DPR) (n = 50) and a symptom-based request (SBR) (n = 50). Results of the interactions were documented immediately after each visit and evaluated using the Pharmaceutical Society of Australia's WHAT STOP GO protocol as a standard comparison. Of all DPRs, 30% were handled entirely by the pharmacist, 70% of staff enquired about specific symptoms and 28% investigated the cause of insomnia. No staff investigated the frequency of product use. The DPR scenario resulted in a 92% supply of the requested doxylamine product (Restavit). In the SBR scenario, 18% of requests were handled entirely by the pharmacist, 58% of staff enquired about specific symptoms and 44% investigated the cause of insomnia. Staff recommended medicated products (38%), or herbal (78%) or non-drug techniques (18%). Investigation into smoking and alcohol intake was not undertaken in DPR or SBR interactions, while questioning on caffeine intake was undertaken in 2 and 14% of cases respectively. There were no significant differences found in the handling of sleep requests by pharmacists compared to pharmacy assistants. The standardized patient methodology was a successful way to assess the community pharmacy counselling provided with OTC sleep requests and suboptimal staff responses were found when compared with recommended practice standards. © 2013 Royal Pharmaceutical Society.

  12. Pediatric MS

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    ... Pediatric MS Share this page Facebook Twitter Email Pediatric MS Pediatric MS Pediatric MS Support Pediatric Providers ... system through the Pediatric MS Support Group . Treating pediatric MS In 2018 the U.S. Food and Drug ...

  13. "Cure" for multiple sclerosis (MS)-Evolving views of therapy goals in patients on different stages of the disease: A pilot study in a cohort of Polish MS patients.

    Science.gov (United States)

    Chacińska, Weronika; Brzostowska, Marta; Nojszewska, Monika; Podlecka-Piętowska, Aleksandra; Jędrzejczak, Wiesław W; Snarski, Emilian

    2017-06-01

    New aggressive treatments promise improvement of results in the treatment of multiple sclerosis (MS), however, with high risk of serious complications. In this study, we analyzed patients' acceptance for risks connected with the MS treatment. The study was designed as a prospective nonanonymous online questionnaire. Responders were asked about the definition of the "cure" for MS and crucial goals in the treatment. One hundred and eighty patients filled in the questionnaire (129 women and 51 men), and the mean age was 33 years ( SD  = 10.29). The MS forms were as follows: relapsing-remitting (65%), secondary progressive (14%), primary progressive (10%), and other (11%), with mean EDSS score of 3 points ( SD  = 2.6). For 50% of the patients, relief of symptoms such as fatigue (72%), paresis (66%), and balance disorders (65%) was synonymous with "cure." The patients with faster progression of the disease were likely to accept risky "curative" treatments-with average 68% accepted mortality risk ( p  = .003). Over 81% of patients accepted mortality rates over 1% for the treatment that achieves self-defined cure. The study shows that the MS patients are likely to accept even very risky treatments as long as they promise patient-defined "cure."

  14. Ensuring cultural sensitivity for Muslim patients in the Australian ICU: considerations for care.

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    Bloomer, Melissa J; Al-Mutair, Abbas

    2013-11-01

    Australia is a diverse and multicultural nation, made up of a population with a predominant Christian faith. Islam, the second largest religion in the world, has demonstrated significant growth in Australia in the last decade. Coming from various countries of origin and cultural backgrounds, Muslim beliefs can range from what is considered 'traditional' to very 'liberal'. It is neither possible nor practical for every intensive care clinician to have an intimate understanding of Islam and Muslim practices, and cultural variations amongst Muslims will mean that not all beliefs/practices will be applicable to all Muslims. However, being open and flexible in the way that care is provided and respectful of the needs of Muslim patients and their families is essential to providing culturally sensitive care. This discussion paper aims to describe the Islamic faith in terms of Islamic teachings, beliefs and common practices, considering how this impacts upon the perception of illness, the family unit and how it functions, decision-making and care preferences, particularly at the end of life in the intensive care unit. Copyright © 2013 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  15. Quantification of hydroxyurea in human plasma by HPLC-MS/MS and its application to pharmacokinetics in patients with chronic myeloid leukaemia.

    Science.gov (United States)

    Hai, Xin; Guo, Meihua; Gao, Chunlu; Zhou, Jin

    2017-04-15

    Hydroxyurea (HU) has been used in the treatment of chronic myeloid leukaemia (CML) and other myeloproliferative malignancies. Considering patient's wide variation in clinical response to HU, a new and simple liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated to monitor patients' compliance to treatment and investigate the pharmacokinetics of HU in patients with CML. Stable isotope labeled HU- 13 C 1 , 15 N 2 was used as internal standard. Plasma samples were treated with acetonitrile to precipitate protein. The supernatant was injected directly without derivatization and separated on a hydrophilic interaction liquid chromatography column. HU was quantitatively analyzed with a mobile phase of acetonitrile-1.5mM ammonium formate (90:10, V:V) within 3min. The proposed method provided a linearity range of 1-200μg/mL. The coefficients of variation for intra- and inter-day precision were less than 2.07% and 4.28%, respectively, while the accuracy (bias) was in the range of -3.77 to 2.96%. This method was satisfactorily applied to the determination of HU in two patients with CML. It is suitable for supporting pharmacokinetic studies and clinical therapeutic monitoring. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Genotypic Diversity within a Single Pseudomonas aeruginosa Strain Commonly Shared by Australian Patients with Cystic Fibrosis.

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    Anna Sze Tai

    Full Text Available In cystic fibrosis (CF, Pseudomonas aeruginosa undergoes intra-strain genotypic and phenotypic diversification while establishing and maintaining chronic lung infections. As the clinical significance of these changes is uncertain, we investigated intra-strain diversity in commonly shared strains from CF patients to determine if specific gene mutations were associated with increased antibiotic resistance and worse clinical outcomes. Two-hundred-and-one P. aeruginosa isolates (163 represented a dominant Australian shared strain, AUST-02 from two Queensland CF centres over two distinct time-periods (2001-2002 and 2007-2009 underwent mexZ and lasR sequencing. Broth microdilution antibiotic susceptibility testing in a subset of isolates was also performed. We identified a novel AUST-02 subtype (M3L7 in adults attending a single Queensland CF centre. This M3L7 subtype was multi-drug resistant and had significantly higher antibiotic minimum inhibitory concentrations than other AUST-02 subtypes. Prospective molecular surveillance using polymerase chain reaction assays determined the prevalence of the 'M3L7' subtype at this centre during 2007-2009 (170 patients and 2011 (173 patients. Three-year clinical outcomes of patients harbouring different strains and subtypes were compared. MexZ and LasR sequences from AUST-02 isolates were more likely in 2007-2009 than 2001-2002 to exhibit mutations (mexZ: odds ratio (OR = 3.8; 95% confidence interval (CI: 1.1-13.5 and LasR: OR = 2.5; 95%CI: 1.3-5.0. Surveillance at the adult centre in 2007-2009 identified M3L7 in 28/509 (5.5% P. aeruginosa isolates from 13/170 (7.6% patients. A repeat survey in 2011 identified M3L7 in 21/519 (4.0% P. aeruginosa isolates from 11/173 (6.4% patients. The M3L7 subtype was associated with greater intravenous antibiotic and hospitalisation requirements, and a higher 3-year risk of death/lung transplantation, than other AUST-02 subtypes (adjusted hazard ratio [HR] = 9.4; 95%CI: 2

  17. Communication challenges experienced by migrants with cancer: A comparison of migrant and English-speaking Australian-born cancer patients.

    Science.gov (United States)

    Hyatt, Amelia; Lipson-Smith, Ruby; Schofield, Penelope; Gough, Karla; Sze, Ming; Aldridge, Lynley; Goldstein, David; Jefford, Michael; Bell, Melanie L; Butow, Phyllis

    2017-10-01

    Understanding the difficulties faced by different migrant groups is vital to address disparities and inform targeted health-care service delivery. Migrant oncology patients experience increased morbidity, mortality and psychological distress, with this tentatively linked to language and communication difficulties. The objective of this exploratory study was to investigate the communication barriers and challenges experienced by Arabic, Greek and Chinese (Mandarin and Cantonese) speaking oncology patients in Australia. This study employed a cross-sectional design using patient-reported outcome survey data from migrant and English-speaking Australian-born patients with cancer. Patients were recruited through oncology clinics and Australian state cancer registries. Data were collected regarding patient clinical and demographic characteristics and health-care and communication experiences. Data from the clinics and registries were combined for analysis. Significant differences were found between migrant groups in demographic characteristics, communication and health-care experiences, and information and care preferences. Chinese patients cited problems with understanding medical information, the Australian health-care system, and communicating with their health-care team. Conversely, Arabic- and Greek-speaking patients reported higher understanding of the health-care system, and less communication difficulties. Our study findings suggest that migrant groups differ from each other in their health communication expectations and requirements. Lower education and health literacy of some groups may play a role in poorer health outcomes. Public health interventions and assistance provided to migrants should be tailored to the specific needs and characteristics of that language or cultural group. Future research directions are discussed. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  18. Clinical and laboratory characteristics of 19 patients with Churg-Strauss syndrome from a single South Australian centre.

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    Whyte, A F; Smith, W B; Sinkar, S N; Kette, F E; Hissaria, P

    2013-07-01

    Churg-Strauss syndrome (CSS) is a rare, idiopathic systemic vasculitis. There is emerging evidence of an association between the presence or absence of antineutrophil cytoplasmic antibodies (ANCA) and clinical phenotype. Thromboembolism is an increasingly recognised complication of the disease. Given the paucity of Australian data, the aim of this study was to examine the clinical and laboratory features of CSS in a single Australian centre. We performed a retrospective review of all patients who fulfilled the American College of Rheumatology classification criteria for CSS managed at the Department of Immunology, Royal Adelaide Hospital between 2002 and 2008. Nineteen patients were included. All patients had asthma and most had upper airway involvement. Peripheral nerve, musculoskeletal, gastrointestinal and cutaneous involvement was common. Renal and cardiac involvement was uncommon in this series. Histological confirmation was obtained in 15 patients (78.9%). Ten patients (52.6%) were ANCA+, and these were more likely to have musculoskeletal involvement, such as arthralgia or myalgia (odds ratio 57, P = 0.005). Thrombosis was a feature at diagnosis in six patients (31.6%); two of these recurred with relapse. Sixteen patients (84.2%) were followed up; five died, and mean survival was 8.9 years. This is the first Australian study to focus on CSS. Our results demonstrate similar presentation and prognosis of CSS to previous descriptions; however, we noted that musculoskeletal involvement was more common in ANCA+ patients. In our series, thrombosis was a significant complication and we suggest that thromboprophylaxis may be warranted. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

  19. Socio-Economic Status and Peritonitis in Australian Non-Indigenous Peritoneal Dialysis Patients

    Science.gov (United States)

    Tang, Wen; Grace, Blair; McDonald, Stephen P.; Hawley, Carmel M.; Badve, Sunil V.; Boudville, Neil C.; Brown, Fiona G.; Clayton, Philip A.; Johnson, David W.

    2015-01-01

    ♦ Background: The aim of the present study was to investigate the relationship between socio-economic status (SES) and peritoneal dialysis (PD)-related peritonitis. ♦ Methods: Associations between area SES and peritonitis risk and outcomes were examined in all non-indigenous patients who received PD in Australia between 1 October 2003 and 31 December 2010 (peritonitis outcomes). SES was assessed by deciles of postcode-based Australian Socio-Economic Indexes for Areas (SEIFA), including Index of Relative Socio-economic Disadvantage (IRSD), Index of Relative Socio-economic Advantage and Disadvantage (IRSAD), Index of Economic Resources (IER) and Index of Education and Occupation (IEO). ♦ Results: 7,417 patients were included in the present study. Mixed-effects Poisson regression demonstrated that incident rate ratios for peritonitis were generally lower in the higher SEIFA-based deciles compared with the reference (decile 1), although the reductions were only statistically significant in some deciles (IRSAD deciles 2 and 4 – 9; IRSD deciles 4 – 6; IER deciles 4 and 6; IEO deciles 3 and 6). Mixed-effects logistic regression showed that lower probabilities of hospitalization were predicted by relatively higher SES, and lower probabilities of peritonitis-associated death were predicted by less SES disadvantage status and greater access to economic resources. No association was observed between SES and the risks of peritonitis cure, catheter removal and permanent hemodialysis (HD) transfer. ♦ Conclusions: In Australia, where there is universal free healthcare, higher SES was associated with lower risks of peritonitis-associated hospitalization and death, and a lower risk of peritonitis in some categories. PMID:24497587

  20. Family functioning and perceived support from nurses during cancer treatment among Danish and Australian patients and their families.

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    Dieperink, Karin B; Coyne, Elisabeth; Creedy, Debra K; Østergaard, Birte

    2018-01-01

    This study aimed to compare family functioning and perceptions of support from nurses among Danish and Australian adult oncology patients and family members. Family can have a strong influence on the health of individuals, providing support during a health crisis such as cancer. However, family functioning and supportive care from nurses may vary across cultures and settings. A descriptive, cross-sectional comparative design with patients and family members from Denmark and Australia. Participants were asked to fill in translated versions of the Iceland-Expressive Family Functioning Questionnaire (ICE-EFFQ) and Iceland-Expressive Family Perceived Support Questionnaire (ICE-FPSQ). In total, 232 participants were recruited. The Danish cohort consisted of 56 patients and 54 family members. The Australian cohort consisted of 83 patients and 39 family members. Mean age was 59 years. No significant differences were found between Danish and Australian families. However, compared to patients, family members reported significantly lower overall family functioning, expressive emotions and communication, as well as less emotional support from nurses. Family functioning was comparable between Denmark and Australia. Family members reported less emotional support than patients. Nurses need to consider the patient and the family as a unit with complex needs that require monitoring and attention during oncology treatment. Families supporting a member with cancer have significant and often unmet needs. Assessment, information-sharing and health education need to include the family. Supportive care information may be shared between Denmark and Australia and inspires the development of common guidelines for optimal family nursing practice. © 2017 John Wiley & Sons Ltd.

  1. An LC-MS/MS-Based Method for the Quantification of Pyridox(am)ine 5'-Phosphate Oxidase Activity in Dried Blood Spots from Patients with Epilepsy.

    Science.gov (United States)

    Wilson, Matthew P; Footitt, Emma J; Papandreou, Apostolos; Uudelepp, Mari-Liis; Pressler, Ronit; Stevenson, Danielle C; Gabriel, Camila; McSweeney, Mel; Baggot, Matthew; Burke, Derek; Stödberg, Tommy; Riney, Kate; Schiff, Manuel; Heales, Simon J R; Mills, Kevin A; Gissen, Paul; Clayton, Peter T; Mills, Philippa B

    2017-09-05

    We report the development of a rapid, simple, and robust LC-MS/MS-based enzyme assay using dried blood spots (DBS) for the diagnosis of pyridox(am)ine 5'-phosphate oxidase (PNPO) deficiency (OMIM 610090). PNPO deficiency leads to potentially fatal early infantile epileptic encephalopathy, severe developmental delay, and other features of neurological dysfunction. However, upon prompt treatment with high doses of vitamin B 6 , affected patients can have a normal developmental outcome. Prognosis of these patients is therefore reliant upon a rapid diagnosis. PNPO activity was quantified by measuring pyridoxal 5'-phosphate (PLP) concentrations in a DBS before and after a 30 min incubation with pyridoxine 5'-phosphate (PNP). Samples from 18 PNPO deficient patients (1 day-25 years), 13 children with other seizure disorders receiving B 6 supplementation (1 month-16 years), and 37 child hospital controls (5 days-15 years) were analyzed. DBS from the PNPO-deficient samples showed enzyme activity levels lower than all samples from these two other groups as well as seven adult controls; no false positives or negatives were identified. The method was fully validated and is suitable for translation into the clinical diagnostic arena.

  2. A quantitative analysis of the polyamine in lung cancer patient fingernails by LC-ESI-MS/MS.

    Science.gov (United States)

    Min, Jun Zhe; Matsumoto, Akihito; Li, Gao; Jiang, Ying-Zi; Yu, Hai-Fu; Todoroki, Kenichiro; Inoue, Koichi; Toyo'oka, Toshimasa

    2014-04-01

    A quantitative analysis of polyamines in lung cancer patient fingernails by the combination of 4-(N,N-dimethylaminosulfonyl)-7-fluoro-2,1,3-benzoxadiazole derivatives and liquid chromatography-electrospray ionization tandem mass spectrometry is described. The reaction of the reagent with eight kinds of polyamines, that is, N(1) -acetylputrescine (N(1) -actPUT), N(8) -acetylspermidine, N(1) -acetylspermine, 1,3-diaminopropane, putrescine (PUT), cadaverine, spermidine and spermine (SPM) effectively occurs at 60 °C for 30 min. The detection limits (signal-to-noise ratio 5) were 5-100 fmol. A good linearity was achieved from the calibration curves, which was obtained by plotting the peak area ratios of the analytes relative to the internal standard (IS), that is, 1,6-diaminohexane, vs the injected amounts of polyamines (r(2)  > 0.996), and the intra-day and inter-day assay precisions were group, as compared with the healthy volunteers, the concentrations of SPM had a statistically significant (p < 0.05) correlation. Therefore, because the proposed method provides a good mass accuracy and the trace detection of the polyamines in human fingernails, this analytical technique could be a noninvasive technique to assist in the diagnosis and assessment of disease activity in lung cancer patients. Copyright © 2013 John Wiley & Sons, Ltd.

  3. Antibody production in response to staphylococcal MS-1 phage cocktail in patients undergoing phage therapy

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    Maciej Żaczek

    2016-10-01

    Full Text Available In this study, we investigated the humoral immune response (through the release of IgG, IgA, and IgM antiphage antibodies to a staphylococcal phage cocktail in patients undergoing experimental phage therapy at the Phage Therapy Unit, Medical Center of the Ludwik Hirszfeld Institute of Immunology and Experimental Therapy in Wrocław, Poland. We also evaluated whether occurring antiphage antibodies had neutralizing properties towards applied phages (K rate. Among 20 examined patients receiving the MS-1 phage cocktail orally and/or locally, the majority did not show a noticeably higher level of antiphage antibodies in their sera during phage administration. Even in those individual cases with an increased immune response, mostly by induction of IgG and IgM, the presence of antiphage antibodies did not translate into unsatisfactory clinical results of phage therapy. On the other hand, a negative outcome of the treatment occurred in some patients who showed relatively weak production of antiphage antibodies before and during treatment. This may imply that possible induction of antiphage antibodies is not an obstacle to the implementation of phage therapy and support our assumption that the outcome of the phage treatment does not primarily depend on the appearance of antiphage antibodies in sera of patients during therapy. These conclusions are in line with our previous findings. The confirmation of this thesis is of great interest as regards the efficacy of phage therapy in humans.

  4. Antibody Production in Response to Staphylococcal MS-1 Phage Cocktail in Patients Undergoing Phage Therapy.

    Science.gov (United States)

    Żaczek, Maciej; Łusiak-Szelachowska, Marzanna; Jończyk-Matysiak, Ewa; Weber-Dąbrowska, Beata; Międzybrodzki, Ryszard; Owczarek, Barbara; Kopciuch, Agnieszka; Fortuna, Wojciech; Rogóż, Paweł; Górski, Andrzej

    2016-01-01

    In this study, we investigated the humoral immune response (through the release of IgG, IgA, and IgM antiphage antibodies) to a staphylococcal phage cocktail in patients undergoing experimental phage therapy at the Phage Therapy Unit, Medical Center of the Ludwik Hirszfeld Institute of Immunology and Experimental Therapy in Wrocław, Poland. We also evaluated whether occurring antiphage antibodies had neutralizing properties toward applied phages (K rate). Among 20 examined patients receiving the MS-1 phage cocktail orally and/or locally, the majority did not show a noticeably higher level of antiphage antibodies in their sera during phage administration. Even in those individual cases with an increased immune response, mostly by induction of IgG and IgM, the presence of antiphage antibodies did not translate into unsatisfactory clinical results of phage therapy. On the other hand, a negative outcome of the treatment occurred in some patients who showed relatively weak production of antiphage antibodies before and during treatment. This may imply that possible induction of antiphage antibodies is not an obstacle to the implementation of phage therapy and support our assumption that the outcome of the phage treatment does not primarily depend on the appearance of antiphage antibodies in sera of patients during therapy. These conclusions are in line with our previous findings. The confirmation of this thesis is of great interest as regards the efficacy of phage therapy in humans.

  5. A descriptive model of patient readiness, motivators, and hepatitis C treatment uptake among Australian prisoners.

    Directory of Open Access Journals (Sweden)

    Lorraine Yap

    Full Text Available BACKGROUND: Hepatitis C virus infection (HCV has a significant global health burden with an estimated 2%-3% of the world's population infected, and more than 350,000 dying annually from HCV-related conditions including liver failure and liver cancer. Prisons potentially offer a relatively stable environment in which to commence treatment as they usually provide good access to health care providers, and are organised around routine and structure. Uptake of treatment of HCV, however, remains low in the community and in prisons. In this study, we explored factors affecting treatment uptake inside prisons and hypothesised that prisoners have unique issues influencing HCV treatment uptake as a consequence of their incarceration which are not experienced in other populations. METHOD AND FINDINGS: We undertook a qualitative study exploring prisoners' accounts of why they refused, deferred, delayed or discontinued HCV treatment in prison. Between 2010 and 2013, 116 Australian inmates were interviewed from prisons in New South Wales, Queensland, and Western Australia. Prisoners experienced many factors similar to those which influence treatment uptake of those living with HCV infection in the community. Incarceration, however, provides different circumstances of how these factors are experienced which need to be better understood if the number of prisoners receiving treatment is to be increased. We developed a descriptive model of patient readiness and motivators for HCV treatment inside prisons and discussed how we can improve treatment uptake among prisoners. CONCLUSION: This study identified a broad and unique range of challenges to treatment of HCV in prison. Some of these are likely to be diminished by improving treatment options and improved models of health care delivery. Other barriers relate to inmate understanding of their illness and stigmatisation by other inmates and custodial staff and generally appear less amenable to change although there

  6. A Descriptive Model of Patient Readiness, Motivators, and Hepatitis C Treatment Uptake among Australian Prisoners

    Science.gov (United States)

    Yap, Lorraine; Carruthers, Susan; Thompson, Sandra; Cheng, Wendy; Jones, Jocelyn; Simpson, Paul; Richards, Alun; Thein, Hla-Hla; Haber, Paul; Lloyd, Andrew; Butler, Tony

    2014-01-01

    Background Hepatitis C virus infection (HCV) has a significant global health burden with an estimated 2%–3% of the world's population infected, and more than 350,000 dying annually from HCV-related conditions including liver failure and liver cancer. Prisons potentially offer a relatively stable environment in which to commence treatment as they usually provide good access to health care providers, and are organised around routine and structure. Uptake of treatment of HCV, however, remains low in the community and in prisons. In this study, we explored factors affecting treatment uptake inside prisons and hypothesised that prisoners have unique issues influencing HCV treatment uptake as a consequence of their incarceration which are not experienced in other populations. Method and Findings We undertook a qualitative study exploring prisoners' accounts of why they refused, deferred, delayed or discontinued HCV treatment in prison. Between 2010 and 2013, 116 Australian inmates were interviewed from prisons in New South Wales, Queensland, and Western Australia. Prisoners experienced many factors similar to those which influence treatment uptake of those living with HCV infection in the community. Incarceration, however, provides different circumstances of how these factors are experienced which need to be better understood if the number of prisoners receiving treatment is to be increased. We developed a descriptive model of patient readiness and motivators for HCV treatment inside prisons and discussed how we can improve treatment uptake among prisoners. Conclusion This study identified a broad and unique range of challenges to treatment of HCV in prison. Some of these are likely to be diminished by improving treatment options and improved models of health care delivery. Other barriers relate to inmate understanding of their illness and stigmatisation by other inmates and custodial staff and generally appear less amenable to change although there is potential for

  7. Potential serum biomarkers and metabonomic profiling of serum in ischemic stroke patients using UPLC/Q-TOF MS/MS.

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    Hongxue Sun

    Full Text Available Stroke still has a high incidence with a tremendous public health burden and it is a leading cause of mortality and disability. However, biomarkers for early diagnosis are absent and the metabolic alterations associated with ischemic stroke are not clearly understood. The objectives of this case-control study are to identify serum biomarkers and explore the metabolic alterations of ischemic stroke.Metabonomic analysis was performed using ultra-performance liquid chromatography quadrupole time-of-flight tandem mass spectrometry and multivariate statistical analysis was employed to study 60 patients with or without ischemic stroke (30 cases and 30 controls.Serum metabolic profiling identified a series of 12 metabolites with significant alterations, and the related metabolic pathways involved glycerophospholipid, sphingolipid, phospholipid, fat acid, acylcarnitine, heme, and purine metabolism. Subsequently, multiple logistic regression analyses of these metabolites showed uric acid, sphinganine and adrenoyl ethanolamide were potential biomarkers of ischemic stroke with an area under the receiver operating characteristic curve of 0.941.These findings provide insights into the early diagnosis and potential pathophysiology of ischemic stroke.

  8. [The influence of age and illness duration on cognitive impairment in aging patients with relapsing-remitting multiple sclerosis (RR-MS)].

    Science.gov (United States)

    Leclercq, Eugénie; Cabaret, Maryline; Guilbert, Alma; Jougleux, Caroline; Vermersch, Patrick; Moroni, Christine

    2014-09-01

    The aim of this study was to dissociate age and duration of illness effects on cognitive impairment of patients with relapsing-remitting multiple sclerosis. Cognitive impairment among patients with multiple sclerosis (MS) is well known. However, few studies were devoted to assess the respective role of disease duration and age on cognitive functions in MS patients. Therefore, two studies were carried out on relapsing-remitting MS (RR-MS) patients using some tests of the BCcogSEP--a French test battery evaluating cognitive functions in MS. The cognitive deficits of RR-MS patients aged 50 years and over and whose symptoms had been present for more than 20 years were more severe than those of MS patients with a shorter illness duration (less than 10 years) or matched-age control participants. The more impaired cognitive functions were information-processing speed, episodic memory, verbal fluency and attention. On the other hand, cognitive performances of young RR-MS patients were similar to those of older RR-MS patients when all patients had the same illness duration (8 years in this study). Older patients even achieved better performance than younger ones on verbal fluency. This can be partly explained by the theory of cognitive reserve, as reported in previous cognitive aging studies. In RR-MS patients, the influence of illness duration seems to be a predominant factor in the development of cognitive impairment.

  9. Development of a patient reported outcome scale for fatigue in multiple sclerosis: The Neurological Fatigue Index (NFI-MS

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    Tennant Alan

    2010-02-01

    Full Text Available Abstract Background Fatigue is a common and debilitating symptom in multiple sclerosis (MS. Best-practice guidelines suggest that health services should repeatedly assess fatigue in persons with MS. Several fatigue scales are available but concern has been expressed about their validity. The objective of this study was to examine the reliability and validity of a new scale for MS fatigue, the Neurological Fatigue Index (NFI-MS. Methods Qualitative analysis of 40 MS patient interviews had previously contributed to a coherent definition of fatigue, and a potential 52 item set representing the salient themes. A draft questionnaire was mailed out to 1223 people with MS, and the resulting data subjected to both factor and Rasch analysis. Results Data from 635 (51.9% response respondents were split randomly into an 'evaluation' and 'validation' sample. Exploratory factor analysis identified four potential subscales: 'physical', 'cognitive', 'relief by diurnal sleep or rest' and 'abnormal nocturnal sleep and sleepiness'. Rasch analysis led to further item reduction and the generation of a Summary scale comprising items from the Physical and Cognitive subscales. The scales were shown to fit Rasch model expectations, across both the evaluation and validation samples. Conclusion A simple 10-item Summary scale, together with scales measuring the physical and cognitive components of fatigue, were validated for MS fatigue.

  10. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... for You and Your Practice Publications for Clinicians Publications for Your Patients MS Navigator Program Programs and Services for Your Patients ... Relapsing-remitting MS (RRMS) Relapsing-remitting MS ( ...

  11. A New Method to Quantify Ifosfamide Blood Levels Using Dried Blood Spots and UPLC-MS/MS in Paediatric Patients with Embryonic Solid Tumours.

    Directory of Open Access Journals (Sweden)

    Luz-María Torres

    Full Text Available Ifosfamide blood concentrations are necessary to monitor its therapeutic response, avoiding any adverse effect. We developed and validated an analytical method by UPLC-MS/MS to quantify ifosfamide in dried blood spots (DBS. Blood samples were collected on Whatman 903® filter paper cards. Five 3 mm disks were punched out from each dried blood spot. Acetonitrile and ethyl acetate were used for drug extraction. Chromatographic separation was carried out in an Acquity UPLC equipment with a BEH-C18 column, 2.1 x 100 mm, 1.7 μm (Waters®. The mobile phase consisted in 5 mM ammonium formate and methanol:acetonitrile (40:48:12 v/v/v at 0.2 mL/min. LC-MS/MS detection was done by ESI+ and multiple reaction mode monitoring, ionic transitions were m/z1+ 260.99 > 91.63 for ifosfamide and 261.00 > 139.90 for cyclophosphamide (internal standard. This method was linear within a 100-10000 ng/mL range and it was accurate, precise and selective. Ifosfamide samples in DBS were stable for up to 52 days at -80°C. The procedure was tested in 14 patients, ages 1 month to 17 years (9 males and 5 females, with embryonic tumours treated with ifosfamide, alone or combined, at a public tertiary referral hospital. Ifosfamide blood levels ranged from 11.1 to 39.7 μmol/L at 12 hours after the last infusion, while 24-hour levels ranged from 0.7-19.7 μmol/L. The median at 12 hours was 19.5 μmol/L (Q25 14.4-Q75 29.0 and 3.8 μmol/L (Q25 1.5-Q75 9.9 at 24 hours, p<0.001. This method is feasible to determine ifosfamide plasma levels in paediatric patients.

  12. Characterization of lymphopenia in patients with MS treated with dimethyl fumarate and fingolimod.

    Science.gov (United States)

    Nakhaei-Nejad, Maryam; Barilla, David; Lee, Chieh-Hsin; Blevins, Gregg; Giuliani, Fabrizio

    2018-03-01

    Lymphopenia is a common occurrence of disease-modifying therapies (DMTs) for relapsing-remitting MS (RRMS). The aim of this study was to dissect the prevalence of various lymphocyte subsets in patients with RRMS treated with 2 DMTs commonly associated with lymphopenia, dimethyl fumarate (DMF), and fingolimod (FTY). Multicolor flow cytometry and multiplex assays were used to identify up to 50 lymphocyte subpopulations and to examine the expression of multiple cytokines in selected patients. We compared patients untreated (NT) or treated with FTY or DMF who did (DMF-L) or did not (DMF-N) develop lymphopenia. All FTY patients developed lymphopenia in both T-cell and B-cell compartments. CD41 T cells were more affected by this treatment than CD81 cells. In the B-cell compartment, the CD271IgD2 subpopulation was reduced. T cells but not B cells were significantly reduced in DMF-L. However, within the B cells, CD271 cells were significantly lower. Both CD41 and CD81 subpopulations were reduced in DMF-L. Within the remaining CD41 and CD81 compartments, there was an expansion of the naive subpopulation and a reduction of the effector memory subpopulation. Unactivated lymphocyte from DMF-L patients had significantly higher levels of interferon-γ, interleukin (IL)-12, IL-2, IL-4, IL-6, and IL-1β compared with DMF-N. In plasma, TNFβ was significantly higher in DMF-N and DMF-L compared with NT, whereas CCL17 was significantly higher in DMF-L compared with NT and DMF-N. This study shows that different treatments can target different lymphocyte compartments and suggests that lymphopenia can induce compensatory mechanisms to maintain immune homeostasis.

  13. Group-based education for patients with type 2 diabetes: a survey of Australian dietitians.

    Science.gov (United States)

    Odgers-Jewell, Kate; Isenring, Elisabeth A; Thomas, Rae; Reidlinger, Dianne P

    2017-09-01

    Group-based education has the potential to substantially improve the outcomes of individuals with type 2 diabetes mellitus (T2DM) and reduce the enormous burden that chronic diseases place on healthcare systems worldwide. Despite this proven effectiveness, the utilisation of group services for the management of T2DM by Australian dietitians is surprisingly low. This study surveyed a sample of 263 Australian dietitians to explore the utilisation of group-based education for T2DM, as well as dietitians' preferences for practice and training. The results of this study indicate that Australian dietitians are currently under-utilising group-based education programs for the management of T2DM, with the primary reasons identified as a lack of training provided to dietitians in the area, limited access to facilities suitable for conducting group education, the perceived poor cost-effectiveness of these programs, and the lack of evidence-based practice guidelines for the group-based management of persons with T2DM. Additionally, the majority of preferences for further training were for either face-to-face or web-based formal training conducted over 3-6h. Clear, evidence-based practice guidelines and training resources for group education for the management of T2DM are needed in order to encourage better utilisation of group-based education by Australian dietitians.

  14. Effectiveness of Mindfulness-Based Stress Reduction (MBSR In Stress and Fatigue in Patients with Multiple Sclerosis (MS

    Directory of Open Access Journals (Sweden)

    Ebrahimi Alisaleh

    2016-07-01

    Full Text Available Multiple sclerosis (MS disease can lead to creation of mental and behavioral disorders such as stress and fatigue. Controlling the problems in patients is essential. Hence, this study has considered effectiveness of mindfulnessbased stress reduction in stress and fatigue symptoms in patients with multiple sclerosis (MS.this study is in kind of semi-experimental research in form of pretest posttest pattern with control group. Statistical population of the study consists of all patients with multiple sclerosis referred to Iran MS Association by 2016. Sampling method in this study is available sampling and based on having inclusion criteria. among patients who gained point higher than 21.8 in stress inventory and point higher than 5.1 in fatigue inventory, 30 people are selected as sample randomly and are placed in 2 groups with 15 people in each group. The experimental group was placed under mindfulnessbased stress reduction (MBSR training course including 8 sessions with 2hrs per session. k\\however, no intervention was done in control group. All patients in experimental and control groups fulfilled stress and fatigue inventories before and after intervention. obtained data was analyzed using MANCOVA and in SPSS22 software. obtained results show that there is significant difference between the two groups in terms of stress and fatigue after intervention (p<0.001.according to obtained results, it could be found that treatment method of mindfulness-based stress reduction can help reduction of symptoms of stress and fatigue in patients with MS.

  15. A Novel Rapid MALDI-TOF-MS-Based Method for Measuring Urinary Globotriaosylceramide in Fabry Patients

    Science.gov (United States)

    Alharbi, Fahad J.; Geberhiwot, Tarekegn; Hughes, Derralynn A.; Ward, Douglas G.

    2016-04-01

    Fabry disease is an X-linked lysosomal storage disorder caused by deficiency of α-galactosidase A, resulting in the accumulation of glycosphingolipids in various organs. Globotriaosylceramide (Gb3) and its isoforms and analogues have been identified and quantified as biomarkers of disease severity and treatment efficacy. The current study aimed to establish rapid methods for urinary Gb3 extraction and quantitation. Urine samples from 15 Fabry patients and 21 healthy control subjects were processed to extract Gb3 by mixing equal volumes of urine, methanol containing an internal standard, and chloroform followed by sonication and centrifugation. Thereafter, the lower phase was analyzed by MALDI-TOF MS and the relative peak areas of the internal standard and four major species of Gb3 determined. The results showed high reproducibility with intra- and inter-assay coefficients variation of 9.9% and 13.7%, respectively. The limit of detection was 0.15 ng/μL and the limit of quantitation was 0.30 ng/μL. Total urinary Gb3 levels in both genders of classic Fabry patients were significantly higher than in healthy controls (p < 0.0001). Gb3 levels in Fabry males were higher than in Fabry females (p = 0.08). We have established a novel assay for urinary total Gb3 that takes less than 15 min from start to finish.

  16. Pathological Assessment of Brain White Matter in Relapsing-Remitting MS Patients using Quantitative Magnetization Transfer Imaging

    Directory of Open Access Journals (Sweden)

    Khodarahm Pahlevan

    2011-09-01

    Full Text Available Introduction: Multiple sclerosis (MS is characterized by lesions in the white matter (WM of the central nervous system. Magnetic resonance imaging is the most specific and sensitive method for diagnosis of multiple sclerosis. However, the ability of conventional MRI to show histopathologic heterogeneity of MS lesions is insufficient. Quantitative magnetization transfer imaging (qMTI is a relatively new method to investigate pathologic processes of the brain tissue occurring in MS patients. Material and Methods: Voxel-based analyses allow regional comparisons between groups to be made for the whole brain in a single analysis. This is done by coregistering data from all individual subjects to a reference brain, generally referred to as the "standard space", and then comparing them on a voxel-by-voxel basis. This study aimed to analyze whole-brain quantitative T1 maps, not to find global changes or changes in selected regions, but specifically to investigate the spatial distribution throughout the brain of T1 increases in MS WM with respect to control WM. In this study, 11 healthy controls, 10 relapsing-remitting (RR MS patients and 13 CIS patients were studied using MT-MRI imaging. MT parameters, including magnetization transfer ratio (MTR, magnetization transfer rate between free protons and restricted macromolecular protons, Ksat and longitudinal relaxation times (with and without MT saturation pulse, T1sat and T1free values were evaluated. Results: The results showed that, at a group level, there is widespread involvement of WM throughout the brain in CIS MS and especially in RRMS, where a significant T1 increase was found in 15.58% of WM voxels (normals < RR. Discussion and Conclusion: This study demonstrates that WM in large parts of the brain is susceptible to disease processes in RR and CIS MS

  17. Australian Government Information Resources

    OpenAIRE

    Chapman, Bert

    2017-01-01

    Provides an overview of Australian Government information resources. Features content from Australian Government agency websites such as the Department of Environment and Energy, Department of Defence, Australian National Maritime Museum, ANZAC Memorial in Sydney, Department of Immigration & Border Protection, Australian Bureau of Statistics, Australian Dept. of Agriculture and Water Resources, Australian Parliament, Australian Treasury, Australian Transport Safety Board, and Australian Parl...

  18. UPLC-MS/MS assay of riluzole in human plasma and cerebrospinal fluid (CSF): Application in samples from spinal cord injured patients.

    Science.gov (United States)

    Sarkar, Mahua; Grossman, Robert G; Toups, Elizabeth G; Chow, Diana S-L

    2017-11-30

    In the present study, a sensitive and robust LC-MS/MS method has been developed and validated for the quantification of riluzole in human plasma and cerebrospinal fluid (CSF) in clinical samples from patients with spinal cord injury (SCI). Riluzole and its labeled internal standard (IS) were isolated from plasma and CSF by liquid-liquid extraction using ethyl acetate. Riluzole (m/z 235→166) and IS (m/z 238→169) were detected by electrospray ionization (ESI) using multiple reaction monitoring (MRM) in a positive mode. The assay was linear in the concentration range of 0.5 (LLOQ, signal/noise ratio>10)-800ng/ml in plasma, and 1.0 (LLOQ)-800ng/ml in CSF samples. The intra- and inter-day accuracy in plasma were 94.2-110.0% and 97.8-102.0%, respectively, and those in CSF were 87.6-105.1% and 91.9-98.8%, respectively. The intra- and inter-day precision were 2.2-7.2% and 4.0-9.1%, respectively, in plasma, and 1.4-14.1% and 2.6-11.5%, respectively in CSF. Matrix effect was negligible from both matrices with signal percentages of 97.6-100.6% in plasma and 99.4-106.4% in CSF. The recoveries were >75% in plasma, >84% in CSF with low protein (53.9mg/dl), and >68% in CSF with high protein (348.2mg/dl). This method was successfully applied to quantify riluzole concentrations in plasma and CSF from patients with SCI. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Psychosocial Functioning of Adult Epileptic and MS Patients and Adult Normal Controls on the WPSI.

    Science.gov (United States)

    Tan, Siang-Yang

    1986-01-01

    Psychosocial functioning of adult epileptic outpatients as assessed by the Washington Psychosocial Seizure Inventory (WPSI) was compared to that of adult multiple sclerosis (MS) outpatients and normal subjects. When only valid WPSI profiles were considered, the only significant finding was that the epilepsy group and the MS group had more…

  20. Pharmacokinetics of taurolidine following repeated intravenous infusions measured by HPLC-ESI-MS/MS of the derivatives taurultame and taurinamide in glioblastoma patients.

    Science.gov (United States)

    Stendel, Ruediger; Scheurer, Louis; Schlatterer, Kathrin; Stalder, Urs; Pfirrmann, Rolf W; Fiss, Ingo; Möhler, Hanns; Bigler, Laurent

    2007-01-01

    Taurolidine is known to have antimicrobial activity. Furthermore, at lower concentrations, it has been found to exert a selective antineoplastic effect in vitro and in vivo. The aim of this study was to investigate the pharmacokinetics of taurolidine in vivo following repeated intravenous infusion in a schedule used for the treatment of glioblastoma. As a prerequisite, the pharmacokinetics of taurolidine in human blood plasma and whole blood in vitro was investigated. The pharmacokinetics of taurolidine and its derivatives taurultame and taurinamide were investigated in human blood plasma and in whole blood in vitro using blood from a healthy male volunteer. During repeated intravenous infusion therapy with taurolidine, plasma samples were taken every hour for a period of 13 hours per day in seven patients (three male, four female; mean age 48.4 +/- 12.8 years, range 27-66 years) with a glioblastoma. Following dansyl derivatisation, the concentrations of taurultame and taurinamide were determined using a new method based on high-performance liquid chromatography (HPLC) online coupled to electrospray ionisation tandem mass spectrometry (ESI-MS/MS) in the multiple reaction monitoring mode. Under the experimental conditions used, taurolidine could not be determined directly and was back-calculated from the taurultame and taurinamide values. The new HPLC-ESI-MS/MS method demonstrated high accuracy and reproducibility. In vitro plasma concentrations of taurultame and taurinamide remained constant over the incubation period. In whole blood in vitro, a time-dependent formation of taurinamide was observed. At the start of the incubation, the taurultame-taurinamide ratio (TTR) was 0.95 at an initial taurolidine concentration of 50 microg/mL, and 1.69 at 100 microg/mL. The concentration of taurultame decreased at the same rate as the taurinamide concentration increased, showing logarithmic kinetics. The calculated taurolidine concentration remained largely constant over the

  1. Absence of MxA induction by interferon beta in patients with MS reflects complete loss of bioactivity

    DEFF Research Database (Denmark)

    Hesse, D.; Sellebjerg, F.; Sorensen, P.S.

    2009-01-01

    BACKGROUND: In patients with multiple sclerosis (MS), neutralizing antibodies (NAbs) appearing during treatment with interferon (IFN) beta reduce or in high concentrations abolish bioactivity and therapeutic efficacy. In vivo MxA induction by IFNbeta is used as a marker of biologic response....... Lack of MxA in vivo response in patients with multiple sclerosis with NAbs is a reliable marker of a completely blocked biologic response to IFNbeta, with no indication of residual bioactivity Udgivelsesdato: 2009/8/4...

  2. Preliminary study of urine metabolism in type two diabetic patients based on GC-MS

    OpenAIRE

    Zhang, Ning; Geng, Fang; Hu, Zhong-Hua; Liu, Bin; Wang, Ye-Qiu; Liu, Jun-Cen; Qi, Yong-Hua; Li, Li-Jing

    2016-01-01

    Objective: Comparative study of type 2 diabetes and healthy controls by metabolomics methods to explore the pathogenesis of Type II diabetes. Methods: Gas chromatography - mass spectrometry (GC-MS) with a variety of multivariate statistical analysis methods to the healthy control group 58 cases, 68 cases of Type II diabetes group were analyzed. Chromatographic conditions: DB-5MS column; the carrier gas He; flow rate of 1 mL·min-1, the injection volume 1 uL; split ratio is 100: 1. MS condition...

  3. New activity-based funding model for Australian private sector overnight rehabilitation cases: the rehabilitation Australian National Sub-Acute and Non-Acute Patient (AN-SNAP) model.

    Science.gov (United States)

    Hanning, Brian; Predl, Nicolle

    2015-09-01

    Traditional overnight rehabilitation payment models in the private sector are not based on a rigorous classification system and vary greatly between contracts with no consideration of patient complexity. The payment rates are not based on relative cost and the length-of-stay (LOS) point at which a reduced rate applies (step downs) varies markedly. The rehabilitation Australian National Sub-Acute and Non-Acute Patient (AN-SNAP) model (RAM), which has been in place for over 2 years in some private hospitals, bases payment on a rigorous classification system, relative cost and industry LOS. RAM is in the process of being rolled out more widely. This paper compares and contrasts RAM with traditional overnight rehabilitation payment models. It considers the advantages of RAM for hospitals and Australian Health Service Alliance. It also considers payment model changes in the context of maintaining industry consistency with Electronic Claims Lodgement and Information Processing System Environment (ECLIPSE) and health reform generally.

  4. Self-reported quality of life in multiple sclerosis patients: preliminary results based on the Polish MS Registry.

    Science.gov (United States)

    Brola, Waldemar; Sobolewski, Piotr; Fudala, Małgorzata; Flaga, Stanisław; Jantarski, Konrad; Ryglewicz, Danuta; Potemkowski, Andrzej

    2016-01-01

    The aim of the study was to analyze selected clinical and sociodemographic factors and their effects on the quality of life (QoL) of multiple sclerosis (MS) patients registered in the Polish MS Registry. This was a cross-sectional observational study performed in Poland. Data on personal and disease-specific factors were collected between January 1, 2011, and December 31, 2015, via the web portal of the Polish MS Registry. All patients were assessed by a physician and asked to complete the Polish language versions of the following self-evaluation questionnaires: EuroQol 5-Dimensions, EuroQoL Visual Analog Scale, and Multiple Sclerosis Impact Scale. Univariate analysis and logistic regression were performed to determine the factors associated with QoL. The study included 2,385 patients (female/male ratio 2.3:1) with clinically confirmed MS (mean age 37.8±9.2 years). Average EuroQol 5-Dimensions index was 0.72±0.24, and the mean EuroQoL Visual Analog Scale score was 64.2±22.8. The average Multiple Sclerosis Impact Scale score was 84.6±11.2 (62.2±18.4 for physical condition and 23.8±7.2 for mental condition). Lower QoL scores were significantly associated with higher level of disability (odds ratio [OR], 0.932; 95% confidence interval [CI], 0.876-0.984; P=0.001), age >40 years (OR, 1.042; 95% CI, 0.924-1.158; P=0.012), longer disease duration (OR, 0.482; 95% CI, 0.224-0.998; P=0.042), and lack of disease modifying therapies (OR, 0.024; 95% CI, 0.160-0.835; P=0.024). No significant associations were found between QoL, sex, type of MS course, patient's education, and marital status. The Polish MS Registry is the first national registry for long-term observation that allows for self-evaluation of the QoL. QoL of Polish patients with MS is significantly lower compared with the rest of the population. The parameter is mainly affected by the level of disability, duration of the disease, and limited access to immunomodulatory therapy.

  5. Australian diagnostic radiographers' attitudes and perceptions of imaging obese patients: A study of self, peers and students

    International Nuclear Information System (INIS)

    Aweidah, L.; Robinson, J.; Cumming, S.; Lewis, S.

    2016-01-01

    Introduction and Objective: Imaging obese patients poses a number of challenges for diagnostic radiographers through positioning, radiation exposure, communication and care. Furthermore, the increasing prevalence of obesity in Australian society ensures these imaging challenges are more frequent however little is known about this area. This study aims to explore the attitudes and perceptions of diagnostic radiographers toward imaging obese patients through a mixed methods study. Methods: Ethics approval was granted to interview and survey diagnostic radiographers about their attitudes and perceptions of imaging obese patients. Twelve diagnostic radiographers who are designated clinical educators (DR CEs) took part in a 30–45 min semi-structured interview as well as a 20 min computer-based Weight Implicit Association Test (Weight-IAT) and self-report questionnaire of explicit attitudes. An additional 25 experienced Diagnostic Radiographers who were associate supervisors completed the Weight-IAT/explicit questionnaire only. Results: Thematic analysis of the interviews revealed that DR CEs adopted an image-focussed or patient-focussed approach to obese patients. Key themes with a negative bias included blame, tolerance and insecurity of skill. Positively associated key themes were empathy and experience in radiography. The sample overall showed a significant negative implicit weight bias (P = 0.016) as measured by the Weight-IAT and there was no evidence of negative explicit attitudes. Conclusion: Australian diagnostic radiographers in this study exhibited significant negative implicit weight bias, with interview results highlighting attitudes of blame and frustration towards obese patients. DR CEs were more likely to be focussed on image acquisition rather than patient considerations, with fewer responses related to empathy and equity. - Highlights: • Mixed-methods study combining qualitative interviews and implicit–explicit bias towards imaging obese

  6. Circulating dendritic cells of multiple sclerosis patients are proinflammatory and their frequency is correlated with MS-associated genetic risk factors.

    Science.gov (United States)

    Thewissen, Kristof; Nuyts, Amber H; Deckx, Nathalie; Van Wijmeersch, Bart; Nagels, Guy; D'hooghe, Marie; Willekens, Barbara; Cras, Patrick; Eijnde, Bert O; Goossens, Herman; Van Tendeloo, Viggo F I; Stinissen, Piet; Berneman, Zwi N; Hellings, Niels; Cools, Nathalie

    2014-04-01

    The role of the adaptive immune system and more specifically T cells in the pathogenesis of multiple sclerosis (MS) has been studied extensively. Emerging evidence suggests that dendritic cells (DCs), which are innate immune cells, also contribute to MS. This study aimed to characterize circulating DC populations in MS and to investigate the contribution of MS-associated genetic risk factors to DCs. Ex vivo analysis of conventional (cDCs) and plasmacytoid DCs (pDCs) was carried out on peripheral blood of MS patients (n = 110) and age- and gender-matched healthy controls (n = 112). Circulating pDCs were significantly decreased in patients with chronic progressive MS compared to relapsing-remitting MS and healthy controls. While no differences in cDCs frequency were found between the different study groups, HLA-DRB1*1501(+) MS patients and patients not carrying the protective IL-7Rα haplotype 2 have reduced frequencies of circulating cDCs and pDCs, respectively. MS-derived DCs showed enhanced IL-12p70 production upon TLR ligation and had an increased expression of the migratory molecules CCR5 and CCR7 as well as an enhanced in vitro chemotaxis. DCs in MS are in a pro-inflammatory state, have a migratory phenotype and are affected by genetic risk factors, thereby contributing to pathogenic responses.

  7. Hydroxycholesterol Levels in the Serum and Cerebrospinal Fluid of Patients with Neuromyelitis Optica Revealed by LC-Ag+CIS/MS/MS and LC-ESI/MS/MS with Picolinic Derivatization: Increased Levels and Association with Disability during Acute Attack.

    Directory of Open Access Journals (Sweden)

    Eunju Cha

    Full Text Available Neuromyelitis optica (NMO is an inflammatory demyelinating disease of the central nervous system (CNS. Hydroxycholesterols (OHCs, metabolites of CNS cholesterol, are involved in diverse cellular responses to inflammation and demyelination, and may also be involved in the pathogenesis of NMO. We aimed to develop a sensitive and reliable method for the quantitative analysis of three major OHCs (24S-, 25-, and 27-OHCs, and to evaluate their concentration in the cerebrospinal fluid (CSF and serum of patients with NMO. The levels of the three OHCs in the serum and CSF were measured using liquid chromatography-silver ion coordination ionspray tandem mass spectrometry and liquid chromatography-electrospray ionization tandem mass spectrometry with picolinyl ester derivatization, respectively. The linear range was 5-250 ng/mL for 24S- and 27-OHC, and 0.5-25 ng/mL for 25-OHC in serum, and was 0.1-5 ng/mL for 24S- and 27-OHC, and 0.03-1 ng/mL for 25-OHC in CSF. Precision and accuracy were 0.5%-14.7% and 92.5%-109.7%, respectively, in serum, and were 0.8%-7.7% and 94.5%-119.2%, respectively, in CSF. Extraction recovery was 82.7%-90.7% in serum and 68.4%-105.0% in CSF. When analyzed in 26 NMO patients and 23 control patients, the 25-OHC (0.54 ± 0.96 ng/mL vs. 0.09 ± 0.04 ng/mL, p = 0.032 and 27-OHC (2.68 ± 3.18 ng/mL vs. 0.68 ± 0.25 ng/mL, p = 0.005 were increased in the CSF from NMO patients. When we measured the OHCCSF index that controls the effects of blood-brain barrier disruption on the level of OHC in the CSF, the 27-OHCCSF index was associated with disability (0.723; 95% confidence interval (CI- 0.181, 0.620; p = 0.002, while the 24-OHCCSF index (0.518; 95% CI- 1.070, 38.121; p = 0.040 and 25-OHCCSF index (0.677; 95% CI- 4.313, 18.532; p = 0.004 were associated with the number of white blood cells in the CSF of NMO patients. Our results imply that OHCs in the CNS could play a role in the pathogenesis of NMO.

  8. Hydroxycholesterol Levels in the Serum and Cerebrospinal Fluid of Patients with Neuromyelitis Optica Revealed by LC-Ag+CIS/MS/MS and LC-ESI/MS/MS with Picolinic Derivatization: Increased Levels and Association with Disability during Acute Attack

    Science.gov (United States)

    Park, Ki Duk; Park, Kyung Seok; Lee, Kwang-Woo; Kim, Sung-Min; Lee, Jaeick

    2016-01-01

    Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of the central nervous system (CNS). Hydroxycholesterols (OHCs), metabolites of CNS cholesterol, are involved in diverse cellular responses to inflammation and demyelination, and may also be involved in the pathogenesis of NMO. We aimed to develop a sensitive and reliable method for the quantitative analysis of three major OHCs (24S-, 25-, and 27-OHCs), and to evaluate their concentration in the cerebrospinal fluid (CSF) and serum of patients with NMO. The levels of the three OHCs in the serum and CSF were measured using liquid chromatography-silver ion coordination ionspray tandem mass spectrometry and liquid chromatography-electrospray ionization tandem mass spectrometry with picolinyl ester derivatization, respectively. The linear range was 5–250 ng/mL for 24S- and 27-OHC, and 0.5–25 ng/mL for 25-OHC in serum, and was 0.1–5 ng/mL for 24S- and 27-OHC, and 0.03–1 ng/mL for 25-OHC in CSF. Precision and accuracy were 0.5%–14.7% and 92.5%–109.7%, respectively, in serum, and were 0.8%–7.7% and 94.5%–119.2%, respectively, in CSF. Extraction recovery was 82.7%–90.7% in serum and 68.4%–105.0% in CSF. When analyzed in 26 NMO patients and 23 control patients, the 25-OHC (0.54 ± 0.96 ng/mL vs. 0.09 ± 0.04 ng/mL, p = 0.032) and 27-OHC (2.68 ± 3.18 ng/mL vs. 0.68 ± 0.25 ng/mL, p = 0.005) were increased in the CSF from NMO patients. When we measured the OHCCSF index that controls the effects of blood–brain barrier disruption on the level of OHC in the CSF, the 27-OHCCSF index was associated with disability (0.723; 95% confidence interval (CI)– 0.181, 0.620; p = 0.002), while the 24-OHCCSF index (0.518; 95% CI– 1.070, 38.121; p = 0.040) and 25-OHCCSF index (0.677; 95% CI– 4.313, 18.532; p = 0.004) were associated with the number of white blood cells in the CSF of NMO patients. Our results imply that OHCs in the CNS could play a role in the pathogenesis of NMO. PMID:27942009

  9. Length of stay, discharge destination, and functional improvement: utility of the Australian National Subacute and Nonacute Patient Casemix Classification.

    Science.gov (United States)

    Tooth, Leigh; McKenna, Kryss; Goh, Kong; Varghese, Paul

    2005-07-01

    Although implemented in 1998, no research has examined how well the Australian National Subacute and Nonacute Patient (AN-SNAP) Casemix Classification predicts length of stay (LOS), discharge destination, and functional improvement in public hospital stroke rehabilitation units in Australia. 406 consecutive admissions to 3 stroke rehabilitation units in Queensland, Australia were studied. Sociodemographic, clinical, and functional data were collected. General linear modeling and logistic regression were used to assess the ability of AN-SNAP to predict outcomes. AN-SNAP significantly predicted each outcome. There were clear relationships between the outcomes of longer LOS, poorer functional improvement and discharge into care, and the AN-SNAP classes that reflected poorer functional ability and older age. Other predictors included living situation, acute LOS, comorbidity, and stroke type. AN-SNAP is a consistent predictor of LOS, functional change and discharge destination, and has utility in assisting clinicians to set rehabilitation goals and plan discharge.

  10. Distress associated with patients' symptoms and depression in a sample of Mexican caregivers of individuals with MS.

    Science.gov (United States)

    Lehan, Tara; Arango-Lasprilla, Juan Carlos; Macias, Miguel Ángel; Aguayo, Adriana; Villaseñor, Teresita

    2012-11-01

    The objectives of this quantitative correlational study were to: (a) determine the frequency and level of distress associated with patients' symptoms as reported by caregivers of individuals with multiple sclerosis (MS), (b) determine the prevalence of depression in these caregivers, and (c) examine the relationship between these caregivers' total symptom distress and depression after controlling for patient, caregiver, and illness characteristics. In this quantitative correlational study, data from 79 caregivers of individuals with MS in Mexico were analyzed. The patient symptoms with the highest average level of distress for caregivers were depression, difficulty talking, difficulty hearing, becoming upset easily, and upsetting other people. Patient symptoms with the lowest average level of distress for caregivers included difficulty learning, seizures, trouble reading, difficulty eating, and difficulty writing. Forty percent of the caregivers met the criteria for probable major depressive disorder. Results of a multivariate regression analysis showed that caregiver total symptom distress was significantly related to caregiver depression, after controlling for patient marital status, caregiver gender, caregiver relationship to patient, caregiver current employment, and months spent caregiving. These findings have implications for MS patients and caregivers as well as larger society, as depression in caregivers often results in the institutionalization of individuals with chronic illnesses and disabilities, which is costly for both individuals and society. In addition, there might be increased expenditures associated with the caregivers' own declining health. For these reasons, it is important to develop a better understanding of its risk factors to identify caregivers who might benefit from intervention. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  11. Better than nothing? Patient-delivered partner therapy and partner notification for chlamydia: the views of Australian general practitioners

    Directory of Open Access Journals (Sweden)

    Bowden Francis J

    2010-09-01

    Full Text Available Abstract Background Genital chlamydia is the most commonly notified sexually transmissible infection (STI in Australia and worldwide and can have serious reproductive health outcomes. Partner notification, testing and treatment are important facets of chlamydia control. Traditional methods of partner notification are not reaching enough partners to effectively control transmission of chlamydia. Patient-delivered partner therapy (PDPT has been shown to improve the treatment of sexual partners. In Australia, General Practitioners (GPs are responsible for the bulk of chlamydia testing, diagnosis, treatment and follow up. This study aimed to determine the views and practices of Australian general practitioners (GPs in relation to partner notification and PDPT for chlamydia and explored GPs' perceptions of their patients' barriers to notifying partners of a chlamydia diagnosis. Methods In-depth, semi-structured telephone interviews were conducted with 40 general practitioners (GPs from rural, regional and urban Australia from November 2006 to March 2007. Topics covered: GPs' current practice and views about partner notification, perceived barriers and useful supports, previous use of and views regarding PDPT. Transcripts were imported into NVivo7 and subjected to thematic analysis. Data saturation was reached after 32 interviews had been completed. Results Perceived barriers to patients telling partners (patient referral included: stigma; age and cultural background; casual or long-term relationship, ongoing relationship or not. Barriers to GPs undertaking partner notification (provider referral included: lack of time and staff; lack of contact details; uncertainty about the legality of contacting partners and whether this constitutes breach of patient confidentiality; and feeling both personally uncomfortable and inadequately trained to contact someone who is not their patient. GPs were divided on the use of PDPT - many felt concerned that it is not

  12. Recurrence or rebound of clinical relapses after discontinuation of natalizumab therapy in highly active MS patients

    DEFF Research Database (Denmark)

    Sorensen, P. S.; Koch-Henriksen, N.; Petersen, T.

    2014-01-01

    A number of studies have reported flare-up of multiple sclerosis (MS) disease activity after cessation of natalizumab, increasing to a level beyond the pre-natalizumab treatment level. Our aim was to describe the development in clinical disease activity following cessation of natalizumab therapy...

  13. Long acting risperidone in Australian patients with chronic schizophrenia: 24-month data from the e-STAR database

    Directory of Open Access Journals (Sweden)

    Lambert Tim

    2012-03-01

    Full Text Available Abstract Background This observational study was designed to collect treatment outcomes data in patients using the electronic Schizophrenia Treatment Adherence Registry (e-STAR. Methods Patients with schizophrenia or schizoaffective disorder in Australia who were prescribed risperidone long-acting injection (RLAI between 2003 and 2007 were assessed 12-months retrospectively, at baseline and 24-months prospectively at 3-monthly intervals. The intent-to-treat population, defined as all patients who received at least one dose of RLAI at baseline, was used for the efficacy and safety analyses. Results At total of 784 patients (74% with schizophrenia, 69.8% male with a mean age of 37.1 ± 12.5 years and 10.6 ± 9.5 years since diagnosis were included in this Australian cohort. A significant improvement in mean Clinical Global Impression - severity score was observed at 24-months (4.52 ± 1.04 at baseline, 3.56 ± 1.10 at 24-months. Most of this improvement was seen by 3-months and was also reflected in mean Global Assessment of Functioning score, which improved significantly at 24-months (42.9 ± 14.5 at baseline, 59 ± 15.4 at 24-months. For patients still receiving RLAI at 24-months there was an increase from a mean baseline RLAI dose of 26.4 ± 5 mg to 43.4 ± 15.7 mg. Sixty-six percent of patients discontinued RLAI before the 24-month period--this decreased to 46% once patients lost to follow-up were excluded. Conclusion Over the 24-month period, initiation of RLAI was associated with improved patient functioning and illness severity in patients with schizophrenia or schizoaffective disorder. Improved outcomes were observed early and sustained throughout the study. Trial Registration Clinical Trials Registration Number, NCT00283517.

  14. The MS@Work study: a 3-year prospective observational study on factors involved with work participation in patients with relapsing-remitting Multiple Sclerosis.

    Science.gov (United States)

    van der Hiele, Karin; van Gorp, Dennis A M; Heerings, Marco A P; van Lieshout, Irma; Jongen, Peter J; Reneman, Michiel F; van der Klink, Jac J L; Vosman, Frans; Middelkoop, Huub A M; Visser, Leo H

    2015-08-12

    Multiple Sclerosis (MS) is the most common cause of neurological disability in young and middle-aged adults. At this stage in life most people are in the midst of their working career. The majority of MS patients are unable to retain employment within 10 years from disease onset. Leading up to unemployment, many may experience a reduction in hours or work responsibilities and increased time missed from work. The MS@Work study examines various factors that may influence work participation in relapsing-remitting MS patients, including disease-related factors, the working environment and personal factors. The MS@Work study is a multicenter, 3-year prospective observational study on work participation in patients with relapsing-remitting MS. We aim to include 350 patients through 15-18 MS outpatient clinics in the Netherlands. Eligible participants are 18 years and older, and either currently employed or within three years since their last employment. At baseline and after 1, 2 and 3 years, the participants are asked to complete online questionnaires (including questions on work participation, work problems and accommodations, cognitive and physical ability, anxiety, depression, psychosocial stress, quality of life, fatigue, empathy, personality traits and coping strategies) and undergo cognitive and neurological examinations. After six months, patients are requested to only complete online questionnaires. Patient perspectives on maintaining and improving work participation and reasons to stop working are gathered through semi-structured interviews in a sub-group of patients. Prospective studies with long-term follow-up on work participation in MS are rare, or take into account a limited number of factors. The MS@Work study provides a 3-year follow-up on various factors that may influence work participation in patients with relapsing-remitting MS. We aim to identify factors that relate to job loss and to provide information about preventative measures for physicians

  15. Effects of MTHFR and MS gene polymorphisms on baseline blood pressure and Benazepril effectiveness in Chinese hypertensive patients.

    Science.gov (United States)

    Jiang, S; Yu, Y; Venners, S A; Zhang, Y; Xing, H; Wang, X; Xu, X

    2011-03-01

    The development of essential hypertension (EH) and inter-individual differences in response to antihypertensive treatment may partly result from genetic heterogeneity. In this study, we conducted an investigation of the combined effects of 5, 10-methylenetetrahydrofolate reductase (MTHFR) C677T and methionine synthase (MS) A2756G polymorphisms on baseline blood pressure (BP) and BP response to antihypertensive Benazepril treatment in 823 Chinese hypertensive patients with a fixed daily dosage of 10 mg for 15 consecutive days. When MTHFR C677T and MS A2756G polymorphisms were modelled together with adjustment for important covariates, only MTHFR C677T was associated with baseline systolic BP (SBP) (β (s.e.)=2.84 (1.10), P=0.0096) or baseline diastolic BP (DBP) (β (s.e.)=2.19 (0.65), P=0.0008). Modelled together with adjustment for important covariates, MTHFR C677T and MS A2756G polymorphisms were both independently associated with increased DBP response (baseline minus post-treatment) to Benazepril treatment (C677T: β (s.e.)=1.58 (0.76), P=0.038; A2756G: β (s.e.)=2.14 (0.89), P=0.016). Neither polymorphism was associated with SBP response to Benazepril treatment. There were no significant interactions or effect modification between MTHFR C677T and MS A2756G gene polymorphisms in models of baseline SBP, baseline DBP or DBP response to Benazepril treatment. Our results suggest that the effects of MTHFR C677T and MS A2756G gene polymorphisms may have pivotal roles in the aetiology of EH and BP response to Benazepril treatment.

  16. Evidence that the ancestral haplotype in Australian hemochromatosis patients may be associated with a common mutation in the gene

    Energy Technology Data Exchange (ETDEWEB)

    Crawford, D.H.G.; Powell, L.W.; Leggett, B.A. [Univ. of Queensland (Australia)] [and others

    1995-08-01

    Hemochromatosis (HC) is a common inherited disorder of iron metabolism for which neither the gene nor biochemical defect have yet been identified. The aim of this study was to look for clinical evidence that the predominant ancestral haplotype in Australian patients is associated with a common mutation in the gene. We compared indices of iron metabolism and storage in three groups of HC patients categorized according to the presence of the ancestral haplotype (i.e., patients with two copies, one copy, and no copies of the ancestral haplotype). We also examined iron indices in two groups of HC heterozygotes (those with the ancestral haplotype and those without) and in age-matched controls. These analyses indicate that (i) HC patients with two copies of the ancestral haplotype show significantly more severe expression of the disorder than those with one copy or those without, (ii) HC heterozygotes have partial clinical expression, which may be influenced by the presence of the ancestral haplotype in females but not in males, and (iii) the high population frequency of the HC gene may be the result of the selective advantage conferred by protecting heterozygotes against iron deficiency. 18 refs., 3 tabs.

  17. Australian coal

    Energy Technology Data Exchange (ETDEWEB)

    1985-11-01

    Total export shipments of coal in Australia in the year ending June 30 1985 reached a record of 83.8 Mt. The export trade is expected to bring in an income of 4 billion Australian dollars in the current year making coal Australia's biggest revenue-earning export commodity. This article presents a brief overview of the Australian coal industry with production and export statistics and information on major open pit and underground mines.

  18. Safety and cost benefit of an ambulatory program for patients with low-risk neutropenic fever at an Australian centre.

    Science.gov (United States)

    Teh, Benjamin W; Brown, Christine; Joyce, Trish; Worth, Leon J; Slavin, Monica A; Thursky, Karin A

    2018-03-01

    Neutropenic fever (NF) is a common complication of cancer chemotherapy. Patients at low risk of medical complications from NF can be identified using a validated risk assessment and managed in an outpatient setting. This is a new model of care for Australia. This study described the implementation of a sustainable ambulatory program for NF at a tertiary cancer centre over a 12-month period. Peter MacCallum Cancer Centre introduced an ambulatory care program in 2014, which identified low-risk NF patients, promoted early de-escalation to oral antibiotics, and early discharge to a nurse-led ambulatory program. Patients prospectively enrolled in the ambulatory program were compared with a historical-matched cohort of patients from 2011 for analysis. Patient demographics, clinical variables (cancer type, recent chemotherapy, treatment intent, site of presentation) and outcomes were collected and compared. Total cost of inpatient admissions was determined from diagnosis-related group (DRG) codes and applied to both the prospective and historical cohorts to allow comparisons. Twenty-five patients were managed in the first year of this program with a reduction in hospital median length of stay from 4.0 to 1.1 days and admission cost from Australian dollars ($AUD) 8580 to $AUD2360 compared to the historical cohort. Offsetting salary costs, the ambulatory program had a net cost benefit of $AUD 71895. Readmission for fever was infrequent (8.0%), and no deaths were reported. Of relevance to hospitals providing cancer care, feasibility, safety, and cost benefits of an ambulatory program for low-risk NF patients have been demonstrated.

  19. The MS@Work study : a 3-year prospective observational study on factors involved with work participation in patients with relapsing-remitting Multiple Sclerosis

    NARCIS (Netherlands)

    van der Hiele, Karin; van Gorp, Dennis A. M.; Heerings, Marco A. P.; van Lieshout, Irma; Jongen, Peter J.; Reneman, Michiel F.; van der Klink, Jac J. L.; Vosman, Frans; Middelkoop, Huub A. M.; Visser, Leo H.

    2015-01-01

    Background: Multiple Sclerosis (MS) is the most common cause of neurological disability in young and middle-aged adults. At this stage in life most people are in the midst of their working career. The majority of MS patients are unable to retain employment within 10 years from disease onset. Leading

  20. The MS@Work study : A 3-year prospective observational study on factors involved with work participation in patients with relapsing-remitting Multiple Sclerosis

    NARCIS (Netherlands)

    van der Hiele, K.; van Gorp, D.A.; Heerings, M.A.; van Lieshout, I.; Jongen, P.J.; Reneman, M.F.; van der Klink, J.J.L.; Vosman, F.; Middelkoop, H.A.; Visser, L.H.

    2015-01-01

    Background Multiple Sclerosis (MS) is the most common cause of neurological disability in young and middle-aged adults. At this stage in life most people are in the midst of their working career. The majority of MS patients are unable to retain employment within 10 years from disease onset. Leading

  1. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Clinicians Publications for Your Patients MS Navigator Program Programs and Services for Your Patients Contact Us Clinical Fellows ... Relapsing-remitting MS (RRMS) Relapsing-remitting ...

  2. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Your Practice Publications for Clinicians Publications for Your Patients MS Navigator Program Programs and Services for Your Patients Contact Us Clinical Fellows d Careers in MS ...

  3. The Italian validation of the minimal assessment of cognitive function in multiple sclerosis (MACFIMS) and the application of the Cognitive Impairment Index scoring procedure in MS patients.

    Science.gov (United States)

    Argento, Ornella; Incerti, Chiara C; Quartuccio, Maria E; Magistrale, Giuseppe; Francia, Ada; Caltagirone, Carlo; Pisani, Valerio; Nocentini, Ugo

    2018-04-27

    Cognitive dysfunction occurs in almost 50-60% of patients with multiple sclerosis (MS) even in early stages of the disease and affects different aspects of patient's life. Aims of the present study were (1) to introduce and validate an Italian version of the minimal assessment of cognitive functions in MS (MACFIMS) battery and (2) to propose the use of the Cognitive Impairment Index (CII) as a scoring procedure to define the degree of impairment in relapsing-remitting (RRMS) and secondary-progressive (SPMS) patients. A total of 240 HC and 123 MS patients performed the Italian version of the MACFIMS composed by the same tests as the original except for the Paced Auditory Serial Addition Test. The CII was derived for each score of the 11 scales for participants of both groups. The results of the study show that cognitive impairment affects around 50% of our sample of MS patients. In RRMS group, only the 15.7% of patients reported a severe impairment, while in the group of SPMS, the 51.4% of patients felt in the "severely impaired" group. Results are in line with previously reported percentages of impairment in MS patients, showing that the calculation of the CII applied to the Italian version of the MACFIMS is sensitive and reliable in detecting different degrees of impairment in MS patients.

  4. Egg donation for stem cell research: ideas of surplus and deficit in Australian IVF patients' and reproductive donors' accounts.

    Science.gov (United States)

    Waldby, Catherine; Carroll, Katherine

    2012-05-01

    We report on a study undertaken with an Australian in vitro fertilisation (IVF) clinic to understand IVF patients' and reproductive donors' perceptions of oocyte (egg) donation for stem cell research. Such perspectives are particularly valuable because IVF patients form a major recruitment group for oocyte donation for research, and because patients and donors have direct experience of the medical procedures involved. Similar studies of oocyte donation have been carried out elsewhere in the world, but to date very little social science research has been published that reports on donation for research, as distinct from donation for reproduction. Our respondents expressed a distinct unwillingness to donate viable oocytes for stem cell research. In our analysis we consider a number of factors that explain this unwillingness. These include the labour of oocyte production, the inscrutability of oocytes (the lack of a test to identify degrees of fertility) and the extent to which the oocytes' fertility sets the parameters for all downstream reproductive possibilities. We draw on the science studies literature on affordances to make sense of the social intractability of oocytes, and compare them with the respondents' much greater willingness to donate frozen embryos for human embryonic stem cells research. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  5. Ankylosing Spondylitis Patients Commencing Biologic Therapy Have High Baseline Levels of Comorbidity: A Report from the Australian Rheumatology Association Database

    Directory of Open Access Journals (Sweden)

    John Oldroyd

    2009-01-01

    Full Text Available Aims. To compare the baseline characteristics of a population-based cohort of patients with ankylosing spondylitis (AS commencing biological therapy to the reported characteristics of bDMARD randomised controlled trials (RCTs participants. Methods. Descriptive analysis of AS participants in the Australian Rheumatology Association Database (ARAD who were commencing bDMARD therapy. Results. Up to December 2008, 389 patients with AS were enrolled in ARAD. 354 (91.0% had taken bDMARDs at some time, and 198 (55.9% completed their entry questionnaire prior to or within 6 months of commencing bDMARDs. 131 (66.1% had at least one comorbid condition, and 24 (6.8% had a previous malignancy (15 nonmelanoma skin, 4 melanoma, 2 prostate, 1 breast, cervix, and bowel. Compared with RCT participants, ARAD participants were older, had longer disease duration and higher baseline disease activity. Conclusions. AS patients commencing bDMARDs in routine care are significantly different to RCT participants and have significant baseline comorbidities.

  6. Contemporary utilization of antithrombotic therapy for stroke prevention in patients with atrial fibrillation: an audit in an Australian hospital setting.

    Science.gov (United States)

    Pandya, Ekta Yogeshkumar; Anderson, Elizabeth; Chow, Clara; Wang, Yishen; Bajorek, Beata

    2018-02-01

    To document antithrombotic utilization in patients with nonvalvular atrial fibrillation (NVAF), particularly, recently approved NOACs (nonvitamin K antagonist oral anticoagulants) and warfarin; and identify factors predicting the use of NOACs versus warfarin. A retrospective audit was conducted in an Australian hospital. Data pertaining to inpatients diagnosed with atrial fibrillation (AF) admitted between January and December 2014 were extracted. This included patient demographics, risk factors (stroke, bleeding), social history, medical conditions, medication history, medication safety issues, medication adherence, and antithrombotic prescribed at admission and discharge. Among 199 patients reviewed, 84.0% were discharged on antithrombotics. Anticoagulants (± antiplatelets) were most frequently (52.0%) prescribed (two-thirds were prescribed warfarin, the remainder NOACs), followed by antiplatelets (33.0%). Among 41 patients receiving NOACs, 59.0% were prescribed rivaroxaban, 24.0% dabigatran, and 17.0% apixaban. Among patients aged 75 years and over, antiplatelets were most frequently used (37.0%), followed by warfarin (33.0%), then NOACs (14.0%). Compared with their younger counterparts, patients aged 75 years and over were significantly less likely to receive NOACs (14.0% versus 28.0%, p = 0.01). Among the 'most eligible' patients (Congestive Cardiac Failure, Hypertension (, Age ⩾ 75 years, Age= 65-74 years, Diabetes Mellitus, Stroke/ Transient Ischaemic Attack/ Thromboembolism, Vascular disease, Sex female[CHA 2 DS 2 -VASc] score ⩾2 and no bleeding risk factors), 46.0% were not anticoagulated on discharge. Patients with anaemia (68.0% versus 86.0%, p = 0.04) or a history of bleeding (65.0% versus 87.0%, p = 0.01) were less likely to receive antithrombotics compared with those without these risk factors. Warfarin therapy was less frequently prescribed among patients with cognitive impairment compared with patients with no cognitive issues (12.0% versus 23

  7. Neutralizing antibodies hamper IFNbeta bioactivity and treatment effect on MRI in patients with MS

    DEFF Research Database (Denmark)

    Sorensen, P Soelberg; Petersen, Thomas Tscherning; Kahr Mathiesen, Henrik

    2006-01-01

    We measured neutralizing antibodies (NABs) and the in vivo biologic response to interferon-beta on neopterin and beta(2)-microglobulin blood levels. All NAB-negative patients had an in vivo biologic response (full or partial), whereas all high-level positive patients had no response. High-level NAB...... patients had more MRI activity than NAB-negative patients (p = 0.031). Patients with a full response had less MRI activity than patients without biologic response (p = 0.032)....

  8. Quinine Treatment Selects the pfnhe–1 ms4760–1 Polymorphism in Malian Patients with Falciparum Malaria

    Science.gov (United States)

    Kone, Aminatou; Mu, Jianbing; Maiga, Hamma; Beavogui, Abdoul H.; Yattara, Omar; Sagara, Issaka; Tekete, Mamadou M.; Traore, Oumar B.; Dara, Antoine; Dama, Souleymane; Diallo, Nouhoum; Kodio, Aly; Traoré, Aliou; Björkman, Anders; Gil, Jose P.; Doumbo, Ogobara K.; Wellems, Thomas E.; Djimde, Abdoulaye A.

    2013-01-01

    Background. The mechanism of Plasmodium falciparum resistance to quinine is not known. In vitro quantitative trait loci mapping suggests involvement of a predicted P. falciparum sodium–hydrogen exchanger (pfnhe–1) on chromosome 13. Methods. We conducted prospective quinine efficacy studies in 2 villages, Kollé and Faladié, Mali. Cases of clinical malaria requiring intravenous therapy were treated with standard doses of quinine and followed for 28 days. Treatment outcomes were classified using modified World Health Organization protocols. Molecular markers of parasite polymorphisms were used to distinguish recrudescent parasites from new infections. The prevalence of pfnhe–1 ms4760–1 among parasites before versus after quinine treatment was determined by direct sequencing. Results. Overall, 163 patients were enrolled and successfully followed. Without molecular correction, the mean adequate clinical and parasitological response (ACPR) was 50.3% (n = 163). After polymerase chain reaction correction to account for new infections, the corrected ACPR was 100%. The prevalence of ms4760–1 increased significantly, from 26.2% (n = 107) before quinine treatment to 46.3% (n = 54) after therapy (P = .01). In a control sulfadoxine–pyrimethamine study, the prevalence of ms4760–1 was similar before and after treatment. Conclusions. This study supports a role for pfnhe–1 in decreased susceptibility of P. falciparum to quinine in the field. PMID:23162138

  9. Is bronchial wall imaging affected by temporal resolution? Comparative evaluation at 140 and 75 ms in 90 patients

    Energy Technology Data Exchange (ETDEWEB)

    Hutt, Antoine; Tacelli, Nunzia; Faivre, Jean-Baptiste; Remy, Jacques; Remy-Jardin, Martine [CHRU et Universite de Lille, Department of Thoracic Imaging, Hospital Calmette (EA 2694), Lille (France); Flohr, Thomas [Computed Tomography, Siemens Healthcare, Forchheim (Germany); Duhamel, Alain [CHRU et Universite de Lille, Department of Biostatistics (EA 2694), Lille (France)

    2016-02-15

    To evaluate the influence of temporal resolution (TR) on cardiogenic artefacts at the level of bronchial walls. Ninety patients underwent a dual-source, single-energy chest CT examination enabling reconstruction of images with a TR of 75 ms (i.e., optimized TR) (Group 1) and 140 ms (i.e., standard TR) (Group 2). Cardiogenic artefacts were analyzed at the level of eight target bronchi, i.e., right (R) and left (L) B1, B5, B7, and B10 (total number of bronchi examined: n = 720). Cardiogenic artefacts were significantly less frequent and less severe in Group 1 than in Group 2 (p < 0.0001) with the highest scores of discordant ratings for bronchi in close contact with cardiac cavities: RB5 (61/90; 68 %); LB5 (66/90; 73 %); LB7 (63/90; 70 %). In Group 1, 78 % (560/720) of bronchi showed no cardiac motion artefacts, whereas 22 % of bronchi (160/720) showed artefacts rated as mild (152/160; 95 %), moderate (7/160; 4 %), and severe (1/160; 1 %). In Group 2, 70 % of bronchi (503/720) showed artefacts rated as mild (410/503; 82 %), moderate (82/503; 16 %), and severe (11/503; 2 %). At 75 ms, most bronchi can be depicted without cardiogenic artefacts. (orig.)

  10. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... the Challenges of MS You CAN! Webcasts DVDs Books For Kids: Keep S'myelin Información en Español Brochures ... MS Managing MS Resources for You and Your Practice Publications for Clinicians Publications for Your Patients MS ...

  11. Unmet needs, burden of treatment, and patient engagement in multiple sclerosis: A combined perspective from the MS in the 21st Century Steering Group.

    Science.gov (United States)

    Rieckmann, Peter; Centonze, Diego; Elovaara, Irina; Giovannoni, Gavin; Havrdová, Eva; Kesselring, Jurg; Kobelt, Gisela; Langdon, Dawn; Morrow, Sarah A; Oreja-Guevara, Celia; Schippling, Sven; Thalheim, Christoph; Thompson, Heidi; Vermersch, Patrick; Aston, Karen; Bauer, Birgit; Demory, Christy; Giambastiani, Maria Paz; Hlavacova, Jana; Nouvet-Gire, Jocelyne; Pepper, George; Pontaga, Maija; Rogan, Emma; Rogalski, Chrystal; van Galen, Pieter; Ben-Amor, Ali-Frédéric

    2018-01-01

    Patient engagement is vital in multiple sclerosis (MS) in order to optimise outcomes for patients, society and healthcare systems. It is essential to involve all stakeholders in potential solutions, working in a multidisciplinary way to ensure that people with MS (PwMS) are included in shared decision-making and disease management. To start this process, a collaborative, open environment between PwMS and healthcare professionals (HCPs) is required so that similarities and disparities in the perception of key areas in patient care and unmet needs can be identified. With this patient-centred approach in mind, in 2016 the MS in the 21st Century Steering Group formed a unique collaboration to include PwMS in the Steering Group to provide a platform for the patient voice. The MS in the 21st Century initiative set out to foster engagement through a series of open-forum joint workshops. The aims of these workshops were: to identify similarities and disparities in the perception and prioritisation in three key areas (unmet needs, the treatment burden in MS, and factors that impact patient engagement), and to provide practical advice on how the gaps in perception and understanding in these key areas could be bridged. Combined practical advice and direction are provided here as eight actions: 1. Improve communication to raise the quality of HCP-patient interaction and optimise the limited time available for consultations. 2. Heighten the awareness of 'hidden' disease symptoms and how these can be managed. 3. Improve the dialogue surrounding the benefit versus risk issues of therapies to help patients become fully informed and active participants in their healthcare decisions. 4. Provide accurate, lucid information in an easily accessible format from reliable sources. 5. Encourage HCPs and multidisciplinary teams to acquire and share new knowledge and information among their teams and with PwMS. 6. Foster greater understanding and awareness of challenges faced by PwMS and

  12. Telephone-administered psychotherapy for depression in MS patients: moderating role of social support.

    Science.gov (United States)

    Beckner, Victoria; Howard, Isa; Vella, Lea; Mohr, David C

    2010-02-01

    Depression is common in individuals with multiple sclerosis (MS). While psychotherapy is an effective treatment for depression, not all individuals benefit. We examined whether baseline social support might differentially affect treatment outcome in 127 participants with MS and depression randomized to either Telephone-administered Cognitive-Behavioral Therapy (T-CBT) or Telephone-administered Emotion-Focused Therapy (T-EFT). We predicted that those with low social support would improve more in T-EFT, since this approach emphasizes the therapeutic relationship, while participants with strong social networks and presumably more emotional resources might fare better in the more structured and demanding T-CBT. We found that both level of received support and satisfaction with that support at baseline did moderate treatment outcome. Individuals with high social support showed a greater reduction in depressive symptoms in the T-CBT as predicted, but participants with low social support showed a similar reduction in both treatments. This suggests that for participants with high social support, CBT may be a more beneficial treatment for depression compared with EFT.

  13. Missing Value Imputation Improves Mortality Risk Prediction Following Cardiac Surgery: An Investigation of an Australian Patient Cohort.

    Science.gov (United States)

    Karim, Md Nazmul; Reid, Christopher M; Tran, Lavinia; Cochrane, Andrew; Billah, Baki

    2017-03-01

    The aim of this study was to evaluate the impact of missing values on the prediction performance of the model predicting 30-day mortality following cardiac surgery as an example. Information from 83,309 eligible patients, who underwent cardiac surgery, recorded in the Australia and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) database registry between 2001 and 2014, was used. An existing 30-day mortality risk prediction model developed from ANZSCTS database was re-estimated using the complete cases (CC) analysis and using multiple imputation (MI) analysis. Agreement between the risks generated by the CC and MI analysis approaches was assessed by the Bland-Altman method. Performances of the two models were compared. One or more missing predictor variables were present in 15.8% of the patients in the dataset. The Bland-Altman plot demonstrated significant disagreement between the risk scores (prisk of mortality. Compared to CC analysis, MI analysis resulted in an average of 8.5% decrease in standard error, a measure of uncertainty. The MI model provided better prediction of mortality risk (observed: 2.69%; MI: 2.63% versus CC: 2.37%, Pvalues improved the 30-day mortality risk prediction following cardiac surgery. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  14. Multiple Sclerosis (M.S.: Epidemiologic Research in 187 Patients Who Admitted in University Cnters of Tehran in 1998

    Directory of Open Access Journals (Sweden)

    Homeira Sajjadi

    2001-01-01

    Full Text Available Objective: Multiple Sclerosis (M.S. is a chronic disease which most commonly involves females. Prevalence of disease begins from adolescent, gradually increases until 35 years old and then decreases. Its geographical distribution is non homogen and prevalence changes from 5/100000 to 250/100000. Iran is a low incident region with prevalence of 5/100000 or at least 3000 patients. Materials & Methods: This research has been done on 187 patients who admitted in Tehran university centers in 1998. Results: Results show that 63.3% of patients were female and most of them were married. The average age at beginning was 28y. Conclusion: Manifestation of disease were: Extremity weakness (44.2%, vision cloudiness and diplopia (33.7% and sensory disturbances (32.2%.

  15. Disclosure of adverse events: a data linkage study reporting patient experiences among Australian adults aged ≥ 45 years.

    Science.gov (United States)

    Walton, Merrilyn; Harrison, Reema; Smith-Merry, Jennifer; Kelly, Patrick; Manias, Elizabeth; Jorm, Christine; Iedema, Rick

    2018-04-26

    Objective Since Australia initiated national open disclosure standards in 2002, open disclosure policies have been adopted in all Australian states and territories. Yet, research evidence regarding their adoption is limited. The aim of the present study was to determine the frequency with which patients who report an adverse event had information disclosed to them about the incident, including whether they participated in a formal open disclosure process, their experiences of the process and the extent to which these align with the current New South Wales (NSW) policy. Methods A cross-sectional survey about patient experiences of disclosure associated with an adverse event was administered to a random sample of 20000 participants in the 45 and Up Study who were hospitalised in NSW, Australia, between January and June 2014. Results Of the 18993 eligible potential participants, completed surveys were obtained from 7661 (40% response rate), with 474 (7%) patients reporting an adverse event. Of those who reported an adverse event, a significant majority reported an informal or bedside disclosure (91%; 430/474). Only 79 patients (17%) participated in a formal open disclosure meeting. Most informal disclosures were provided by nurses, with only 25% provided by medical practitioners. Conclusions Experiences of open disclosure may be enhanced by informing patients of their right to full disclosure in advance of or upon admission to hospital, and recognition of and support for informal or bedside disclosure for appropriate types of incidents. A review of the open disclosure guidelines in relation to the types of adverse events that require formal open disclosure and those more suitable to informal bedside disclosure is indicated. Guidelines for bedside disclosure should be drafted to assist medical practitioners and other health professionals facilitate and improve their communications about adverse events. Alignment of formal disclosure with policy requirements may also be

  16. Knowledge of and willingness to try acupuncture for postoperative nausea and vomiting: an Australian survey of surgical patients.

    Science.gov (United States)

    Weeks, Evan M; Trinca, Jane; Zheng, Zhen

    2017-10-01

    Level 1 evidence supports the use of acupuncture as a safe and effective treatment for postoperative nausea and vomiting (PONV). However, to date, very few hospitals in Western countries have incorporated this technique into their management strategies. To conduct a survey to establish patients' knowledge and opinions of acupuncture as a treatment option for the management of PONV in a large Western teaching hospital that did not offer acupuncture. Over a 4-week period, a self-completed, anonymous questionnaire survey was distributed to 171 consecutive patients attending the preadmission clinic pending surgery. Overall, 161 participants met the selection criteria and completed the survey (100%). The majority of them had a European background (88.8%) and were over 40 years old (87.6%). Seventy-eight participants (48%) had a history of nausea and vomiting and 39 (24%) had suffered from PONV. One hundred and four (65%) and 110 (68%) patients, respectively, stated that they would be willing to try acupuncture in hospital or at home following surgery to prevent or reduce PONV. Only 25 (15.5%) participants knew that acupuncture could be used to treat nausea and vomiting; however, 140 (87%) indicated that they would be willing to try the therapy after being informed of the potential benefit of acupuncture for PONV prevention/reduction. Those with previous experience of acupuncture were ~3.9 times more likely to be willing to use acupuncture for PONV than those without. Patients attending an Australian tertiary hospital showed an overwhelming interest in acupuncture to manage PONV. This provides strong support for the potential implementation of acupuncture in an acute hospital setting. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Management of hypertension in an Australian community pharmacy setting - patients' beliefs and perspectives.

    Science.gov (United States)

    Bajorek, Beata V; LeMay, Kate S; Magin, Parker J; Roberts, Christopher; Krass, Ines; Armour, Carol L

    2017-08-01

    To explore patients' perspectives and experiences following a trial of a pharmacist-led service in hypertension management. A qualitative study comprising individual interviews was conducted. Patients of a community pharmacy, where a pharmacist-led hypertension management service had been trialled in selected metropolitan regions in Sydney (Australia), were recruited to the study. Emergent themes describing patients' experiences and perspectives on the service were elicited via thematic analysis (using manual inductive coding). Patients' (N = 18) experiences of the service were extremely positive, especially around pharmacists' monitoring of blood pressure and provision of advice about medication adherence. Patients' participation in the service was based on their trust in, and relationship with, their pharmacist. The perception of working in a 'team' was conveyed through the pharmacist's caring style of communication and the relaxed atmosphere of the community pharmacy. Patients felt that the community pharmacy was an obvious place for such a service because of their regular contact with the pharmacist, but was limited because the pharmacists were not able to prescribe medication. Patients were extremely positive about the role of, and their experience of, the pharmacy-based hypertension management service. Factors contributing to the patients' positive experiences provide important insights for community pharmacy practice. Good rapport with the pharmacist and a long-term relationship underpin patient engagement in such services. Restrictions on the pharmacists' scope of practice prevent their expertise, and the benefits of their accessibility as a primary point of contact, from being fully realised. © 2016 Royal Pharmaceutical Society.

  18. Patients' value of asthma services in Australian pharmacies: the way ahead for asthma care.

    Science.gov (United States)

    Naik-Panvelkar, Pradnya; Armour, Carol; Rose, John; Saini, Bandana

    2012-04-01

    Long-term sustainability of health services requires an understanding of patients' values and preferences. The aim of this study was to evaluate patients' preferences as well as their willingness-to-pay (WTP) for a community pharmacy-delivered specialized asthma service using a discrete choice experiment (DCE). Patients with asthma in New South Wales, Australia, who had recently experienced a specialized asthma management service at their pharmacy were mailed DCE questionnaires. Patients were asked to choose between two hypothetical service models with varying attributes. Multinomial logit models estimated patients' marginal WTP. The study had a response rate of 47%. Patients greatly valued various aspects of the pharmacy-based specialized service and had marginal WTP values of AUD$18.00 for a private area, AUD$44.50 for lung function testing, AUD$9.18 for appointments with pharmacists, and AUD$22.80 for provision of comprehensive advice on asthma and its medications. The marginal WTP for the overall service was AUD$94.86. The findings of the study indicate that patients greatly value and are willing to pay for asthma services in pharmacies. The study results will help pharmacists and policy advisors in the development of individualized asthma services that patients will use, are willing to pay for, and thus are economically viable in the future.

  19. BioSunMS: a plug-in-based software for the management of patients information and the analysis of peptide profiles from mass spectrometry

    Directory of Open Access Journals (Sweden)

    Zhang Xuemin

    2009-02-01

    Full Text Available Abstract Background With wide applications of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS and surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS, statistical comparison of serum peptide profiles and management of patients information play an important role in clinical studies, such as early diagnosis, personalized medicine and biomarker discovery. However, current available software tools mainly focused on data analysis rather than providing a flexible platform for both the management of patients information and mass spectrometry (MS data analysis. Results Here we presented a plug-in-based software, BioSunMS, for both the management of patients information and serum peptide profiles-based statistical analysis. By integrating all functions into a user-friendly desktop application, BioSunMS provided a comprehensive solution for clinical researchers without any knowledge in programming, as well as a plug-in architecture platform with the possibility for developers to add or modify functions without need to recompile the entire application. Conclusion BioSunMS provides a plug-in-based solution for managing, analyzing, and sharing high volumes of MALDI-TOF or SELDI-TOF MS data. The software is freely distributed under GNU General Public License (GPL and can be downloaded from http://sourceforge.net/projects/biosunms/.

  20. Asthma disease management-Australian pharmacists' interventions improve patients' asthma knowledge and this is sustained.

    Science.gov (United States)

    Saini, Bandana; LeMay, Kate; Emmerton, Lynne; Krass, Ines; Smith, Lorraine; Bosnic-Anticevich, Sinthia; Stewart, Kay; Burton, Deborah; Armour, Carol

    2011-06-01

    To assess any improvements in knowledge of asthma patients after a tailored education program delivered by pharmacists and measure the sustainability of any improvements. To ascertain patients' perceptions about any changes in their knowledge. Ninety-six specially trained pharmacists recruited patients based on their risk of poor asthma control. A tailored intervention was delivered to patients based on individual needs and goals, and was conducted at three or four time points over six months. Asthma knowledge was assessed at the beginning and end of the service, and six and 12 months after it had ended. Patients' perceptions of the impact of the service on their knowledge were explored qualitatively in interviews. The 96 pharmacists recruited 570 patients, 398 (70%) finished. Asthma knowledge significantly improved as a result of the service (7.65 ± 2.36, n=561, to 8.78 ± 2.14, n=393). This improvement was retained for at least 12 months after the service. Patients reported how the knowledge and skills gained had led to a change in the way they managed their asthma. Improvements in knowledge are achievable and sustainable if pharmacists used targeted educational interventions. Pharmacist educational interventions are an efficient way to improve asthma knowledge in the community. Crown Copyright © 2011. Published by Elsevier Ireland Ltd. All rights reserved.

  1. Quality of life of head and neck cancer patients in urban and regional areas: An Australian perspective.

    Science.gov (United States)

    Pateman, Kelsey A; Cockburn, Nicole L; Batstone, Martin D; Ford, Pauline J

    2018-06-01

    Head and neck cancer treatment affects quality of life. There are differences in quality of life outcomes and perceived supportive care needs between cancer patients living in metropolitan and regional-remote areas. This study investigated quality of life over the first 6 months following head and neck cancer diagnosis and observed differences in quality of life by geographical location. Prospective observational study. Tertiary hospital in Brisbane, Australia. Newly diagnosed patients who were referred for the diagnosis, and/or treatment of head and neck cancer. Quality of life was measured by the University of Washington Quality of Life Survey, version 4 (UW-QoL). Participants completed the UW-QoL questionnaire prior to starting treatment, 1 month and 6 months post treatment. Metropolitan and regional or remote status was classified according to the Australian Standard Geographic Classification-Remoteness Area system. Ninety-five participants were included at baseline; 49 and 41 participants completed the 1-month and 6-month follow-ups, respectively. Scores in most UW-QoL domains decreased between baseline and 1 month post treatment and increased towards pre-treatment scores at the 6-month follow-up (except for anxiety and saliva). Pain at baseline was significantly worse in the regional-remote participants compared with metropolitan participants. No other statistically significant differences in UW-QoL score by geographical location were observed. The findings generally did not support significant differences in quality of life outcome between metropolitan and regional-remote head and neck cancer patients. The difference in pain experience between metropolitan and regional-remote groups requires further investigation. © 2018 National Rural Health Alliance Ltd.

  2. Reduced NAA-levels in the NAWM of patients with MS is a feature of progression. A study with quantitative magnetic resonance spectroscopy at 3 Tesla.

    Science.gov (United States)

    Aboul-Enein, Fahmy; Krssák, Martin; Höftberger, Romana; Prayer, Daniela; Kristoferitsch, Wolfgang

    2010-07-20

    Reduced N-acetyl-aspartate (NAA) levels in magnetic resonance spectroscopy (MRS) may visualize axonal damage even in the normal appearing white matter (NAWM). Demyelination and axonal degeneration are a hallmark in multiple sclerosis (MS). To define the extent of axonal degeneration in the NAWM in the remote from focal lesions in patients with relapsing-remitting (RRMS) and secondary progressive MS (SPMS). 37 patients with clinical definite MS (27 with RRMS, 10 with SPMS) and 8 controls were included. We used 2D (1)H-MR-chemical shift imaging (TR = 1500ms, TE = 135ms, nominal resolution 1ccm) operating at 3Tesla to assess the metabolic pattern in the fronto-parietal NAWM. Ratios of NAA to creatine (Cr) and choline (Cho) and absolute concentrations of the metabolites in the NAWM were measured in each voxel matching exclusively white matter on the anatomical T2 weighted MR images. No significant difference of absolute concentrations for NAA, Cr and Cho or metabolite ratios were found between RRMS and controls. In SPMS, the NAA/Cr ratio and absolute concentrations for NAA and Cr were significantly reduced compared to RRMS and to controls. In our study SPMS patients, but not RRMS patients were characterized by low NAA levels. Reduced NAA-levels in the NAWM of patients with MS is a feature of progression.

  3. The computer-based Symbol Digit Modalities Test: establishing age-expected performance in healthy controls and evaluation of pediatric MS patients.

    Science.gov (United States)

    Bigi, Sandra; Marrie, R A; Till, C; Yeh, E A; Akbar, N; Feinstein, A; Banwell, B L

    2017-04-01

    Decreased information processing speed (IPS) is frequently reported in pediatric multiple sclerosis (MS) patients. The computerized version of the Symbol Digit Modalities Test (c-SDMT) measures IPS over eight consecutive trials per session and additionally captures changes in performance within the session. Here, we establish normative c-SDMT performance and test-retest reliability in healthy children (HC) and explore differences in the overall c-SDMT-performance between HC and MS patients. This cross-sectional study included 478 HC (237 female, 49.5%) divided into five age groups (2 years each), and 27 MS patients (22 female, 81.5%) aged 8-18 years. The average time to complete the c-SDMT increased with age (|r| 0.70, 95% CI -0.74, -0.64). Test-retest reliability was high (ICC = 0.91) in HC. The total time to complete the c-SDMT did not differ between children with MS and sex- and age- matched HC (p = 0.23). However, MS patients were less likely to show faster performance across all the successive eight trials compared to HC (p = 0.0001). Healthy children demonstrate faster IPS with increasing age, as well as during successive trials of the c-SDMT. The inability of pediatric MS patients to maintain the increase in processing speed over successive trials suggests a reduced capacity for procedural learning, possibly resulting from cognitive fatigue.

  4. Fatigue, mood and quality of life improve in MS patients after progressive resistance training

    DEFF Research Database (Denmark)

    Dalgas, U; Stenager, E; Jakobsen, J

    2010-01-01

    Fatigue occurs in the majority of multiple sclerosis patients and therapeutic possibilities are few. Fatigue, mood and quality of life were studied in patients with multiple sclerosis following progressive resistance training leading to improvement of muscular strength and functional capacity...... disabled (Expanded Disability Status Scale, EDSS: 3-5.5) multiple sclerosis patients including a Control group (n = 15) and an Exercise group (n = 16). Fatigue (FSS > 4) was present in all patients. Scores of FSS, MDI, PCS-SF36 and MCS-SF36 were comparable at start of study in the two groups. Fatigue...

  5. Performance of the Modified Mini-Mental State Examination (3MS) in Assessing Specific Cognitive Function in Patients Undergoing Peritoneal Dialysis

    Science.gov (United States)

    Li, Yi; Tian, Xue; Xiong, Zu-Ying; Liao, Jin-Lan; Hao, Li; Liu, Gui-Ling; Ren, Ye-Ping; Wang, Qin; Duan, Li-Ping; Zheng, Zhao-Xia; Quan, Wen-Xiang; Dong, Jie

    2016-01-01

    Purpose While Cognitive impairment (CI) has been identified as an independent risk factors for mortality in patients undergoing peritoneal dialysis (PD), it is inadequately assessed. We evaluated the applicability of the Modified Mini-Mental State Examination (3MS) in assessing specific cognitive function and compared it to a detailed neuropsychological test battery as the reference standard. Methods In this multicentric cross-sectional study, we enrolled 445 clinically stable patients from five PD units, who were undergoing PD for at least 3 months. The 3MS was evaluated for general cognitive function. A detailed neuropsychological battery including domains of immediate memory, delayed memory, executive function, language, and visuospatial ability were evaluated as reference standards. Sensitivity and specificity of the 3MS was determined by using receiver operating characteristic (ROC) analysis. Results The CI prevalence evaluated by 3MS was 23.6%. PD patients with CI performed worse in all cognitive domains. The 3MS correlated well with specific cognitive domains. However, 18.5%, 57.4%, 12.6%, 8.8%, and 41.2% of patients whom were idendified as normal by 3MS still showed executive dysfunction, immediate memory impairment, delayed memory impairment, and language-ability and visuospatial-ability impairment, respectively. The 3MS identified patients having specific cognitive dysfunction with varied extent of diagnostic value, with 0.50, 0.42, 0.35, 0.34, and 0.26 of Youden index in executive function, delayed memory, language ability, immediate memory, and visuospatial ability, respectively. Conclusions The 3MS is not a comprehensive instrument for major cognitive domains in PD patients. It could, however, be used for executive dysfunction and delayed memory impairment screening. PMID:27911914

  6. CCR5Δ32 Polymorphism Associated with a Slower Rate Disease Progression in a Cohort of RR-MS Sicilian Patients

    Directory of Open Access Journals (Sweden)

    Rosalia D'Angelo

    2011-01-01

    Full Text Available Multiple sclerosis (MS disease is carried through inflammatory and degenerative stages. Based on clinical feaures, it can be subdivided into three groups: relapsing-remitting MS, secondary progressive MS, and primary progressive MS. Multiple sclerosis has a multifactorial etiology with an interplay of genetic predisposition, environmental factors, and autoimmune inflammatory mechanism in which play a key role CC-chemokines and its receptors. In this paper, we studied the frequency of CCR5 gene Δ32 allele in a cohort of Sicilian RR-MS patients comparing with general Sicilian population. Also, we evaluate the association between this commonly polymorphism and disability development and age of disease onset in the same cohort. Our results show that presence of CCR5Δ32 is significantly associated with expanded disability status scale score (EDSS but not with age of disease onset.

  7. The self-perceived knowledge, skills and attitudes of Australian practice nurses in providing nutrition care to patients with chronic disease.

    Science.gov (United States)

    Martin, Louise; Leveritt, Michael D; Desbrow, Ben; Ball, Lauren E

    2014-04-01

    Nutrition is important for the management of chronic diseases. While practice nurses have numerous roles in primary care, the expectations on practice nurses to provide nutrition care for chronic disease management are increasing. The self-perceived knowledge, skills and attitudes of practice nurses in providing nutrition care has not been widely investigated. The aim of the present study was to investigate the perceptions of Australian practice nurses on the provision of nutrition care for chronic disease management, including specific nutrition-related activities. A cross-sectional online survey was completed by 181 Australian practice nurses in 2013. Descriptive analyses were conducted on each survey item. The survey sample was tested for representation of the Australian practice nurse workforce, and associations between respondents' demographic characteristics and responses to survey items were explored. Almost all practice nurses (89%) felt it was important to address diet whenever they cared for a patient. Over half of practice nurses (61%) were unsure if their practices were effective in increasing patients' compliance with nutritional recommendations. Nearly all practice nurses (98%) perceived further education on nutrition would assist them in their role. Practice nurses perceive they have an important role and favourable attitudes towards providing nutrition care; however, further training and education to enhance their self-perceived effectiveness is warranted. Future research should clarify whether an increase in nutrition-focused training results in improved effectiveness of nutrition care provided by practice nurses in terms of patient health outcomes.

  8. Adherence to Therapeutic Guidelines for Patients with Community-Acquired Pneumonia in Australian Hospitals

    Directory of Open Access Journals (Sweden)

    N.R. Adler

    2014-01-01

    Full Text Available Community-acquired pneumonia (CAP is a significant cause of morbidity and mortality, particularly in elderly patients, and is associated with a considerable economic burden on the healthcare system. The combination of high incidence and substantial financial costs necessitate accurate diagnosis and appropriate management of patients admitted with CAP. This article will discuss the rates of adherence to clinical guidelines, the use of severity scoring tools and the appropriateness of antimicrobial prescribing for patients diagnosed with CAP. The authors maintain that awareness of national and hospital guidelines is imperative to complement the physicians’ clinical judgment with evidence-based recommendations. Increased use of pneumonia severity assessment tools and greater adherence to therapeutic guidelines will enhance concordant antimicrobial prescribing for patients with CAP. A robust and multifaceted educational intervention, in combination with antimicrobial stewardship programs, may enhance compliance of CAP guidelines in clinical practice in Australia.

  9. Economic costs of chemotherapy-induced febrile neutropenia among patients with non-Hodgkin’s lymphoma in European and Australian clinical practice

    Directory of Open Access Journals (Sweden)

    Weycker Derek

    2012-08-01

    Full Text Available Abstract Background Economic implications of chemotherapy-induced febrile neutropenia (FN in European and Australian clinical practice are largely unknown. Methods Data were obtained from a European (97% and Australian (3% observational study of patients with non-Hodgkin’s lymphoma (NHL receiving CHOP (±rituximab chemotherapy. For each patient, each cycle of chemotherapy within the course, and each occurrence of FN within cycles, was identified. Patients developing FN in a given cycle (“FN patients”, starting with the first, were matched to those who did not develop FN in that cycle (“comparison patients”, irrespective of subsequent FN events. FN-related healthcare costs (£2010 were tallied for the initial FN event as well as follow-on care and FN events in subsequent cycles. Results Mean total cost was £5776 (95%CI £4928-£6713 higher for FN patients (n = 295 versus comparison patients, comprising £4051 (£3633-£4485 for the initial event and a difference of £1725 (£978-£2498 in subsequent cycles. Among FN patients requiring inpatient care (76% of all FN patients, mean total cost was higher by £7259 (£6327-£8205, comprising £5281 (£4810-£5774 for the initial hospitalization and a difference of £1978 (£1262-£2801 in subsequent cycles. Conclusions Cost of chemotherapy-induced FN among NHL patients in European and Australian clinical practice is substantial; a sizable percentage is attributable to follow-on care and subsequent FN events.

  10. HPLC-MS-Based Metabonomics Reveals Disordered Lipid Metabolism in Patients with Metabolic Syndrome

    Directory of Open Access Journals (Sweden)

    Xinjie Zhao

    2011-12-01

    Full Text Available Ultra-high performance liquid chromatography/ quadrupole time of flight mass spectrometry-based metabonomics platform was employed to profile the plasma metabolites of patients with metabolic syndrome and the healthy controls. Data analysis revealed lots of differential metabolites between the two groups, and most of them were identified as lipids. Several fatty acids and lysophosphatidylcholines were of higher plasma levels in the patient group, indicating the occurrence of insulin resistance and inflammation. The identified ether phospholipids were decreased in the patient group, reflecting the oxidative stress and some metabolic disorders. These identified metabolites can also be used to aid diagnosis of patients with metabolic syndrome. These results showed that metabonomics was a promising and powerful method to study metabolic syndrome.

  11. Comparison of preferences of healthcare professionals and MS patients for attributes of disease-modifying drugs: A best-worst scaling.

    Science.gov (United States)

    Kremer, Ingrid E H; Evers, Silvia M A A; Jongen, Peter J; Hiligsmann, Mickaël

    2018-02-01

    The choice between disease-modifying drugs (DMDs) for the treatment of multiple sclerosis (MS) becomes more often a shared decision between the patient and the neurologist and MS nurse. This study aimed to assess which DMD attributes are most important for the healthcare professionals in selecting a DMD for a patient. Subsequently, within this perspective, the neurologists' and nurses' perspectives were compared. Lastly, the healthcare professionals' perspective was compared with the patients' perspective to detect any differences that may need attention in the communication about DMDs. A best-worst scaling (BWS) was conducted among 27 neurologists and 33 MS nurses treating patients with MS to determine the importance of 27 DMD attributes. These attributes were identified through three focus groups with MS patients in a previous study (N=19). Relative importance scores (RISs) were estimated for each attribute. Multivariable linear regression analyses were used to compare the different perspectives. According to the neurologists and nurses, safety of the DMD was the most important DMD attribute in the treatment decision, closely followed by effect on disability progression, quality of life and relapse rate. Patients with MS agreed with the importance of the last three attributes, but valued safety significantly lower (b=-2.59, P<.001). This study suggests that, overall, neurologists and nurses regard the same DMD attributes as important as MS patients with the notable exception of safety. This study provides valuable information for the development of interventions to support shared decision making and highlights which attributes of DMDs may need additional attention. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  12. Patients' perceptions and experiences of using a mobile phone-based advanced symptom management system (ASyMS) to monitor and manage chemotherapy related toxicity.

    Science.gov (United States)

    McCann, L; Maguire, R; Miller, M; Kearney, N

    2009-03-01

    Chemotherapy forms a core component of treatment for the majority patients with cancer. Recent changes in cancer services mean patients frequently receive such treatment as outpatients and are often required to manage side effects at home without direct support from oncology health professionals. Information technology continues to develop to support patients in the community; this study evaluated the impact of a mobile phone-based advanced symptom management system (ASyMS) on chemotherapy related toxicity in patients with lung, breast or colorectal cancer. One hundred and twelve patients were randomized from seven clinical sites across the UK; 56 patients used the mobile phone to record their symptoms, sending their reports directly to the nurses at their clinical site; 56 control group patients received standard care. Health professionals were alerted about any severe or life-threatening symptoms through the development of a chemotherapy symptom risk model. Patients' perceptions of ASyMS were evaluated pre and post participation. Patients reported many benefits of using ASyMS including improved communication with health professionals, improvements in the management of their symptoms, and feeling reassured their symptoms were being monitored while at home. ASyMS has the potential to positively impact on the management of symptoms in patients receiving chemotherapy treatment.

  13. Referring patients to specialists: A structured vignette survey of Australian and British GPs

    Directory of Open Access Journals (Sweden)

    Ee Hooi

    2008-01-01

    Full Text Available Abstract Background In Australia and in the United Kingdom (UK access to specialists is sanctioned by General Practitioners (GPs. It is important to understand how practitioners determine which patients warrant referral. Methods A self-administered structured vignette postal survey of General Practitioners in Western Australia and the United Kingdom. Sixty-four vignettes describing patients with colorectal symptoms were constructed encompassing six clinical details. Nine vignettes, chosen at random, were presented to each individual. Respondents were asked if they would refer the patient to a specialist and how urgently. Logistic regression and parametric tests were used to analyse the data Results We received 260 completed questionnaires. 58% of 'cancer vignettes' were selected for 'urgent' referral. 1632/2367 or 69% of all vignettes were selected for referral. After adjusting for clustering the model suggests that 38.4% of the variability is explained by all the clinical variables as well as the age and experience of the respondents. 1012 or 42.8 % of vignettes were referred 'urgently'. After adjusting for clustering the data suggests that 31.3 % of the variability is explained by the model. The age of the respondents, the location of the practice and all the clinical variables were significant in the decision to refer urgently. Conclusion GPs' referral decisions for patients with lower bowel symptoms are similar in the two countries. We question the wisdom of streaming referrals from primary care without a strong evidence base and an effective intervention for implementing guidelines. We conclude that implementation must take into account the profile of patients but also the characteristics of GPs and referral policies.

  14. A qualitative study assessing patient perspectives in the process of decision-making on disease modifying therapies (DMT's) in multiple sclerosis (MS).

    Science.gov (United States)

    Ceuninck van Capelle, Archibald de; Meide, Hanneke van der; Vosman, Frans J H; Visser, Leo H

    2017-01-01

    Physicians commonly advise patients to begin disease modifying therapies (DMT's) shortly after the establishment of a diagnosis of Multiple Sclerosis (MS) to prevent further relapses and disease progression. However, little is known about the meaning for patients going through the process of the diagnosis of MS and of making decisions on DMT's in early MS. To explore the patient perspective on using DMT's for MS. Methods: Ten participants with a recent (approach. The analysis revealed the following themes: (1) Constant confrontation with the disease, (2) Managing inevitable decline, (3) Hope of delaying the progression of the disease, and, (4) The importance of social support. The themes show that patients associate the recommendation to begin DMT's (especially injectable DMT's) with views about their bodies as well as their hopes about the future. Both considering and adhering to treatment are experienced by patients as not only matters of individual and rational deliberation, but also as activities that are lived within a web of relationships with relatives and friends. From the patient perspective, the use of DMT's is not a purely rational and individual experience. More attention to the use of DMT's as relational and lived phenomena will improve the understanding of the process of decision-making for DMT's in MS.

  15. Does one workshop on respecting cultural differences increase health professionals' confidence to improve the care of Australian Aboriginal patients with cancer? An evaluation.

    Science.gov (United States)

    Durey, Angela; Halkett, Georgia; Berg, Melissa; Lester, Leanne; Kickett, Marion

    2017-09-15

    Aboriginal Australians have worse cancer survival rates than other Australians. Reasons include fear of a cancer diagnosis, reluctance to attend mainstream health services and discrimination from health professionals. Offering health professionals education in care focusing on Aboriginal patients' needs is important. The aim of this paper was to evaluate whether participating in a workshop improved the confidence of radiation oncology health professionals in their knowledge, communication and ability to offer culturally safe healthcare to Aboriginal Australians with cancer. Mixed methods using pre and post workshop online surveys, and one delivered 2 months later, were evaluated. Statistical analysis determined the relative proportion of participants who changed from not at all/a little confident at baseline to fairly/extremely confident immediately and 2 months after the workshop. Factor analysis identified underlying dimensions in the items and nonparametric tests recorded changes in mean dimension scores over and between times. Qualitative data was analysed for emerging themes. Fifty-nine participants attended the workshops, 39 (66% response rate) completed pre-workshop surveys, 32 (82% of study participants) completed post-workshop surveys and 25 (64% of study participants) completed surveys 2 months later. A significant increase in the proportion of attendees who reported fair/extreme confidence within 2 days of the workshop was found in nine of 14 items, which was sustained for all but one item 2 months later. Two additional items had a significant increase in the proportion of fair/extremely confident attendees 2 months post workshop compared to baseline. An exploratory factor analysis identified three dimensions: communication; relationships; and awareness. All dimensions' mean scores significantly improved within 2 days (p Aboriginal Australians that in some cases resulted in improved care. Single workshops co-delivered by an Aboriginal and non

  16. Alemtuzumab improves preexisting disability in active relapsing-remitting MS patients

    DEFF Research Database (Denmark)

    Giovannoni, Gavin; Cohen, Jeffrey A; Coles, Alasdair J

    2016-01-01

    .0300); improvement in MSFC scores with alemtuzumab was primarily driven by the upper limb coordination and dexterity domain. Alemtuzumab-treated patients had more favorable changes from baseline in SLCLA (2.5% contrast) scores (p = 0.0014) and MSFC + SLCLA composite scores (p = 0.0097) than SC IFN-β-1a...

  17. Untargeted metabolomic profiling plasma samples of patients with lung cancer for searching significant metabolites by HPLC-MS method

    Science.gov (United States)

    Dementeva, N.; Ivanova, K.; Kokova, D.; Kurzina, I.; Ponomaryova, A.; Kzhyshkowska, J.

    2017-09-01

    Lung cancer is one of the most common types of cancer leading to death. Consequently, the search and the identification of the metabolites associated with the risk of developing cancer are very valuable. For the purpose, untargeted metabolic profiling of the plasma samples collected from the patients with lung cancer (n = 100) and the control group (n = 100) was conducted. After sample preparation, the plasma samples were analyzed using LC-MS method. Biostatistics methods were applied to pre-process the data for elicitation of dominating metabolites which responded to the difference between the case and the control groups. At least seven significant metabolites were evaluated and annotated. The most part of identified metabolites are connected with lipid metabolism and their combination could be useful for follow-up studies of lung cancer pathogenesis.

  18. Quantifying the hidden healthcare cost of diabetes mellitus in Australian hospital patients.

    Science.gov (United States)

    Karahalios, Amalia; Somarajah, Gowri; Hamblin, Peter S; Karunajeewa, Harin; Janus, Edward D

    2018-03-01

    Diabetes mellitus in hospital inpatients is most commonly present as a comorbidity rather than as the primary diagnosis. In some hospitals, the prevalence of comorbid diabetes mellitus across all inpatients exceeds 30%, which could add to complexity of care and resource utilisation. However, whether and to what extent comorbid diabetes mellitus contributes indirectly to greater hospitalisation costs is ill-defined. To determine the attributable effect of comorbid diabetes mellitus on hospital resource utilisation in a General Internal Medical service in Melbourne, Australia. We extracted data from a database of all General Internal Medical discharge episodes from July 2012 to June 2013. We fitted multivariable regression models to compare patients with diabetes mellitus to those without diabetes mellitus with respect to hospitalisation cost, length of stay, admissions per year and inpatient mortality. Of 4657 patients 1519 (33%) had diabetes mellitus, for whom average hospitalisation cost (AUD9910) was higher than those without diabetes mellitus (AUD7805). In multivariable analysis, this corresponded to a 1.22-fold (95% confidence interval (CI) 1.12-1.33, P diabetes was 8.2 days versus 6.8 days for those without diabetes, with an adjusted 1.19-fold greater odds (95% CI 1.06-1.33, P = 0.001) of staying an additional day. Number of admissions and mortality were similar. Comorbid diabetes mellitus adds significantly to hospitalisation duration and costs in medical inpatients. Moreover, diabetes mellitus patients with chronic complications had a greater-still cost and hospitalisation duration compared to those without diabetes mellitus. © 2017 Royal Australasian College of Physicians.

  19. A randomized, controlled, single-blind, 6-month pilot study to evaluate the efficacy of MS-Line!: a cognitive rehabilitation programme for patients with multiple sclerosis.

    Science.gov (United States)

    Gich, Jordi; Freixanet, Jordi; García, Rafael; Vilanova, Joan Carles; Genís, David; Silva, Yolanda; Montalban, Xavier; Ramió-Torrentà, Lluís

    2015-09-01

    MS-Line! was created to provide an effective treatment for cognitive impairment in multiple sclerosis (MS) patients. To assess the efficacy of MS-Line!. A randomized, controlled, single-blind, 6-month pilot study. Patients were randomly assigned to an experimental group (cognitive rehabilitation with the programme) or to a control group (no cognitive rehabilitation). Randomization was stratified by cognitive impairment level. Cognitive assessment included: selective reminding test, 10/36 spatial recall test (10/36 SPART), symbol digit modalities test, paced auditory serial addition test, word list generation (WLG), FAS test, subtests of WAIS-III, Boston naming test (BNT), and trail making test (TMT). Forty-three patients (22 in the experimental group, 21 in the control group) were analyzed. Covariance analysis showed significant differences in 10/36 SPART (P=0.0002), 10/36 SPART delayed recall (P=0.0021), WLG (P=0.0123), LNS (P=0.0413), BNT (P=0.0007) and TMT-A (P=0.010) scores between groups. The study showed a significant improvement related to learning and visual memory, executive functions, attention and information processing speed, and naming ability in those patients who received cognitive rehabilitation. The results suggest that MS-Line! is effective in improving cognitive impairment in MS patients. © The Author(s), 2015.

  20. Determination of morphine, codeine and 6-monoacetylmorphine in saliva of substance-abuse patients using HPLC/MS methods

    Directory of Open Access Journals (Sweden)

    Milovanović Vesna

    2012-01-01

    Full Text Available Background/Aim. Saliva represents an alternative specimen for substances abuse determination in toxicology. Hence, the aim of this study was to optimize a method for saliva specimen preparation for heroin metabolites, morphine and 6-monoacetylmorphine (6-mam, and codeine determination by liquid chromatography-mass spectrometry (LC/MS, and to apply this method on saliva samples taken from the patients. Methods. Saliva specimen was prepared using liqiud/liquid extraction of morphine, codeine and 6- mam by mixture of chloroform and isopropanol (9 : 1; v/v. Extracts were analysed by HPLC/MS technique: separation column Waters Spherisorb® 5 μm, ODS2, 4.6 × 100 mm; mobile phase: ammonium acetate : acetonitile (80 : 20; v/v, mobile phase flow rate 0.3 mL/min; mass detection range: 100-400 m/z. Regression and correlation analyses were performed with the probalility level of 0.05. Concentrations of morphine, codeine and 6-mam were determined in saliva samples of the patients with “opiates” in urine identified by the test strips. Results. Calibration for each analysed substance was done in the concentration range from 0.1 to 1 mg/L and the coefficient of correlation was R2 > 0.99. We obtained following calibration curves: y = 385531x + 14584; y = 398036x + 31542; and y = 524162x - 27105, for morphine, codeine and 6-mam, respectively. Recovery for morphine and codeine determination was 99%, while for 6- mam it was 94%. Limits of detection and quantification of a proposed method were 0.01 mg/L and 0.05 mg/L, respectively. Concentration of morphine in the saliva of the heroin users ranged between 0.54 and 5.82 mg/L, concentration of codeine between 0.05 and 5.33, and 6-mam between 0.01 and 0.68 mg/L. A statistically significant correlation between codeine and 6-mam concentrations was obtained. Conclusion. A proposed HPLC/MS method for morphine, codeine and 6-mam determination in saliva is accurate, simple, cheap and suitable for routine analysis and

  1. The Effect of Group Mindfulness-based Stress Reduction and Consciousness Yoga Program on Quality of Life and Fatigue Severity in Patients with MS

    Directory of Open Access Journals (Sweden)

    Somayeh Nejati

    2016-12-01

    Full Text Available Introduction: The chronic nature of Multiple Sclerosis (MS, have can leave devastating effects on quality of life and fatigue. The present research aimed to study the effect of group Mindfulness-based Stress Reduction (MBSR and conscious yoga program on the quality of life and fatigue severity among patients with MS. Methods: This study was quasi-experimental with intervention and control groups. The statistical population included all members to MS Society of Tehran Province, 24 of whom diagnosed with MS were selected as the sample based on the inclusion criteria. The subjects were randomly assigned into the test group (12 patients and the control group (12 patients. MS Quality of Life-54 (MSQOL-54 and Fatigue Severity Scale (FSS were used for data collection. Subjects in the test group underwent a MBSR and conscious yoga program in 8 two-hour sessions. The data were analyzed using the SPSS ver.13 software. Results: The study findings showed that there was a significant difference between subjects in the experimental and control groups in terms of mean score of some subscales of quality of life including physical health, role limitations due to physical and emotional problems, energy, emotional well-being, health distress, health perception, and satisfaction with sexual function, overall quality of life, and fatigue severity. Conclusion: The results show that the program is effective in reduction of fatigue severity and improving some subscales of quality of life in MS patients. Hence, this supportive method can be used as an effective way for improving quality of life and relieving fatigue in MS patients.

  2. Physical activity coaching by Australian Exercise Physiologists is cost effective for patients referred from general practice.

    Science.gov (United States)

    Ewald, Ben; Stacey, Fiona; Johnson, Natalie; Plotnikoff, Ronald C; Holliday, Elizabeth; Brown, Wendy; James, Erica L

    2018-02-01

    Interventions to promote physical activity for sedentary patients seen in general practice may be a way to reduce the burden of chronic disease. Coaching by an exercise physiologist is publicly funded in Australia, but cost effectiveness has not been documented. In a three-arm randomised controlled trial, face-to-face coaching and telephone coaching over 12 weeks were compared with a control group using the outcome of step count for one week at baseline, three months and twelve months. Program costs and time-based costs were considered. Quality of life was measured as a secondary outcome. At 12 months, the intervention groups were more active than controls by 1,002 steps per day (95%CI 244, 1,759). This was achieved at a cost of AUD$245 per person. There was no change in reported quality of life or utility values. Coaching achieved a modest increase in activity equivalent to 10 minutes walking per day, at a cost of AUD$245 per person. Face-to-face and telephone counselling were both effective. Implication for public health: Persistence of increases nine months after the end of coaching suggests it creates long-term change and is a good value health intervention. © 2017 The Authors.

  3. "Ms. B changes doctors": using a comic and patient transition packet to engineer patient-oriented clinic handoffs (EPOCH).

    Science.gov (United States)

    Pincavage, Amber T; Lee, Wei Wei; Venable, Laura Ruth; Prochaska, Megan; Staisiunas, Daina D; Beiting, Kimberly J; Czerweic, M K; Oyler, Julie; Vinci, Lisa M; Arora, Vineet M

    2015-02-01

    Few patient-centered interventions exist to improve year-end residency clinic handoffs. Our purpose was to assess the impact of a patient-centered transition packet and comic on clinic handoff outcomes. The study was conducted at an academic medicine residency clinic. Participants were patients undergoing resident clinic handoff 2011-2013 PROGRAM DESCRIPTION: Two months before the 2012 handoff, patients received a "transition packet" incorporating patient-identified solutions (i.e., a new primary care provider (PCP) welcome letter with photo, certificate of recognition, and visit preparation tool). In 2013, a comic was incorporated to stress the importance of follow-up. Patients were interviewed by phone with response rates of 32 % in 2011, 43 % in 2012 and 36 % in 2013. Most patients who were interviewed were aware of the handoff post-packet (95 %). With the comic, more patients recalled receiving the packet (44 % 2012 vs. 64 % 2013, pcomic was associated with increased packet recall and improved follow-up rates.

  4. The Role of Radiotherapy Alone in Patients With Merkel Cell Carcinoma: Reporting the Australian Experience of 43 Patients

    International Nuclear Information System (INIS)

    Veness, Michael; Foote, Matthew; Gebski, Val; Poulsen, Michael

    2010-01-01

    Purpose: To review the role of radiotherapy (RTx) alone in patients with Merkel cell carcinoma (MCC). Methods and Materials: The records of 43 patients with MCC treated with RTx alone between 1993 and 2007 at the Westmead and Royal Brisbane/Mater Hospitals, Australia, were reviewed. Multivariate analysis was performed by use of Cox regression analysis. Results: The median age was 79 years (range, 48-91 years) in 19 women (44%) and 24 men (56%). All patients were white, and 5 (12%) had immunosuppression. A majority (56%) underwent irradiation at initial diagnosis, with the remainder (44%) treated in the relapse setting. The median duration of follow-up was 39 months. The head and neck comprised the most frequently treated site (47%). The median maximum lesion size was 30 mm (range, 5-130 mm). Relapse developed in 60% of patients, with most being out-of-field relapses. The in-field control rate was 75%. Most out-of-field relapses were to visceral organs. Relapse developed outside the irradiated field in 53% of patients. On multivariate analysis, only nodal status (negative nodes vs. nodes present) was significantly associated with relapse-free survival, with p = 0.005 (hazard ratio, 0.25; 95% confidence interval, 0.96-0.663). Overall survival at 2 and 5 years was 58% and 37%, respectively. Conclusions: Patients with MCC treated with RTx have a high likelihood of obtaining in-field control. Doses of 50 to 55 Gy in 20 to 25 fractions are recommended. A minority of patients are cured, with many dying of systemic relapse. Lower dose fractionation schedules (e.g., 25 Gy in 5 fractions) may be considered in patients with a very poor performance status.

  5. Proteomic biomarkers predicting lymph node involvement in serum of cervical cancer patients. Limitations of SELDI-TOF MS

    Directory of Open Access Journals (Sweden)

    Van Gorp Toon

    2012-06-01

    Full Text Available Abstract Background Lymph node status is not part of the staging system for cervical cancer, but provides important information for prognosis and treatment. We investigated whether lymph node status can be predicted with proteomic profiling. Material & methods Serum samples of 60 cervical cancer patients (FIGO I/II were obtained before primary treatment. Samples were run through a HPLC depletion column, eliminating the 14 most abundant proteins ubiquitously present in serum. Unbound fractions were concentrated with spin filters. Fractions were spotted onto CM10 and IMAC30 surfaces and analyzed with surface-enhanced laser desorption time of flight (SELDI-TOF mass spectrometry (MS. Unsupervised peak detection and peak clustering was performed using MASDA software. Leave-one-out (LOO validation for weighted Least Squares Support Vector Machines (LSSVM was used for prediction of lymph node involvement. Other outcomes were histological type, lymphvascular space involvement (LVSI and recurrent disease. Results LSSVM models were able to determine LN status with a LOO area under the receiver operating characteristics curve (AUC of 0.95, based on peaks with m/z values 2,698.9, 3,953.2, and 15,254.8. Furthermore, we were able to predict LVSI (AUC 0.81, to predict recurrence (AUC 0.92, and to differentiate between squamous carcinomas and adenocarcinomas (AUC 0.88, between squamous and adenosquamous carcinomas (AUC 0.85, and between adenocarcinomas and adenosquamous carcinomas (AUC 0.94. Conclusions Potential markers related with lymph node involvement were detected, and protein/peptide profiling support differentiation between various subtypes of cervical cancer. However, identification of the potential biomarkers was hampered by the technical limitations of SELDI-TOF MS.

  6. Reliable volumetry of the cervical spinal cord in MS patient follow-up data with cord image analyzer (Cordial).

    Science.gov (United States)

    Amann, Michael; Pezold, Simon; Naegelin, Yvonne; Fundana, Ketut; Andělová, Michaela; Weier, Katrin; Stippich, Christoph; Kappos, Ludwig; Radue, Ernst-Wilhelm; Cattin, Philippe; Sprenger, Till

    2016-07-01

    Spinal cord (SC) atrophy is an important contributor to the development of disability in many neurological disorders including multiple sclerosis (MS). To assess the spinal cord atrophy in clinical trials and clinical practice, largely automated methods are needed due to the sheer amount of data. Moreover, using these methods in longitudinal trials requires them to deliver highly reliable measurements, enabling comparisons of multiple data sets of the same subject over time. We present a method for SC volumetry using 3D MRI data providing volume measurements for SC sections of fixed length and location. The segmentation combines a continuous max flow approach with SC surface reconstruction that locates the SC boundary based on image voxel intensities. Two cutting planes perpendicular to the SC centerline are determined based on predefined distances to an anatomical landmark, and the cervical SC volume (CSCV) is then calculated in-between these boundaries. The development of the method focused on its application in MRI follow-up studies; the method provides a high scan-rescan reliability, which was tested on healthy subject data. Scan-rescan reliability coefficients of variation (COV) were below 1 %, intra- and interrater COV were even lower (0.1-0.2 %). To show the applicability in longitudinal trials, 3-year follow-up data of 48 patients with a progressive course of MS were assessed. In this cohort, CSCV loss was the only significant predictor of disability progression (p = 0.02). We are, therefore, confident that our method provides a reliable tool for SC volumetry in longitudinal clinical trials.

  7. Cost-effectiveness analysis of entecavir versus lamivudine in the first-line treatment of Australian patients with chronic hepatitis B.

    Science.gov (United States)

    Arnold, Elizabeth; Yuan, Yong; Iloeje, Uchenna; Cook, Greg

    2008-01-01

    Chronic hepatitis B (CHB) virus infection is a major global healthcare problem. The recent introduction of entecavir in Australia for the treatment of CHB patients in the naive treatment setting has triggered significant optimism with regards to improved clinical outcomes for CHB patients. To estimate, from an Australian healthcare perspective, the cost effectiveness of entecavir 0.5 mg/day versus lamivudine 100 mg/day in the treatment of CHB patients naive to nucleos(t)ide therapy. A cost-utility analysis to project the clinical and economic outcomes associated with CHB disease and treatment was conducted by developing two decision-tree models specific to hepatitis B e antigen-positive (HBeAg+ve) and HBeAg-ve CHB patient subsets. This analysis was constructed using the Australian payer perspective of direct costs and outcomes, with indirect medical costs and lost productivity not being included. The study population comprised a hypothetical cohort of 1000 antiviral treatment-naive CHB patients who received either entecavir 0.5 mg/day or lamivudine 100 mg/day at model entry. The population of patients used in this analysis was representative of those patients likely to receive initial antiviral therapy in clinical practice in Australia. The long-term cost effectiveness of entecavir compared with lamivudine in the first-line treatment of CHB patients was expressed as an incremental cost per life-year gained (LYG) or QALY gained. Results revealed that the availability of entecavir 0.5 mg/day as part of the Australian hepatologist's treatment armamentarium should result in significantly lower future rates of compensated cirrhosis (CC), decompensated cirrhosis (DC), and hepatocellular carcinoma (HCC) events (i.e. 54 fewer cases of CC, seven fewer cases of DC, and 20 fewer cases of HCC over the model's timeframe for HBeAg+ve CHB patients, and 69 fewer cases of CC, eight fewer cases of DC and 25 fewer cases of HCC over the model's timeframe for HBeAg-ve CHB patients

  8. Fast and Highly Selective LC-MS/MS Screening for THC and 16 Other Abused Drugs and Metabolites in Human Hair to Monitor Patients for Drug Abuse

    NARCIS (Netherlands)

    Koster, Remco A.; Alffenaar, Jan-Willem C.; Greijdanus, Ben; VanDerNagel, Joanneke E. L.; Uges, Donald R. A.

    Background:To facilitate the monitoring of drug abuse by patients, a method was developed and validated for the analysis of amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine, methylenedioxyamphetamine, methylenedioxyethylamphetamine, methylphenidate, cocaine, benzoylecgonine, morphine,

  9. Decrease of blood anti-α1,3 Galactose Abs levels in multiple sclerosis (MS) and clinically isolated syndrome (CIS) patients.

    Science.gov (United States)

    Le Berre, L; Rousse, J; Gourraud, P-A; Imbert-Marcille, B-M; Salama, A; Evanno, G; Semana, G; Nicot, A; Dugast, E; Guérif, P; Adjaoud, C; Freour, T; Brouard, S; Agbalika, F; Marignier, R; Brassat, D; Laplaud, D-A; Drouet, E; Van Pesch, V; Soulillou, J-P

    2017-07-01

    The etiology of multiple sclerosis (MS) remains elusive. Among the possible causes, the increase of anti-Neu5Gc antibodies during EBV primo-infection of Infectious mononucleosis (IMN) may damage the integrity of the blood-brain barrier facilitating the transfer of EBV-infected B cells and anti-EBV T cell clones in the brain. We investigated the change in titers of anti-Neu5Gc and anti-α1,3 Galactose antibodies in 49 IMN, in 76 MS, and 73 clinically isolated syndrome (CIS) patients, as well as age/gender-matched healthy individuals. Anti-Gal and anti-Neu5Gc are significantly increased during IMN (p=0.02 and pMS/CIS, the two populations exhibit a significant decrease in anti-Gal (combined p=2.7.10 -3 ), in contrast with patients with non-MS/CIS central nervous system pathologies. Since anti-Gal result from an immunization against α1,3 Gal, lacking in humans but produced in the gut, our data suggest that CIS and MS patients have an altered microbiota or an altered response to this microbiotic epitope. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  10. Effect of oral cladribine on time to conversion to clinically definite multiple sclerosis in patients with a first demyelinating event (ORACLE MS): a phase 3 randomised trial.

    Science.gov (United States)

    Leist, Thomas P; Comi, Giancarlo; Cree, Bruce A C; Coyle, Patricia K; Freedman, Mark S; Hartung, Hans-Peter; Vermersch, Patrick; Casset-Semanaz, Florence; Scaramozza, Matthew

    2014-03-01

    Patients who develop relapsing-remitting multiple sclerosis (MS) present with a first clinical demyelinating event. In this double-blind, multicentre, randomised, phase 3 study we investigated the effect of oral cladribine on conversion to clinically definite MS in patients with a first clinical demyelinating event, when given at the same doses shown to be effective in relapsing-remitting MS. Between Oct 21, 2008, and Oct 11, 2010, we recruited patients aged 18-55 years, inclusive, from 160 hospitals, private clinics, or treatment centres in 34 countries. Eligible patients had a first clinical demyelinating event within 75 days before screening, at least two clinically silent lesions of at least 3 mm on a T2-weighted brain MRI scan, and an Expanded Disability Status Scale score of 5.0 or lower. Patients with a first clinical demyelinating event ≤75 days before screening were randomly assigned (1:1:1) to receive cladribine tablets at cumulative doses of 5.25 mg/kg or 3.5 mg/kg or placebo. Randomisation was done with a central web-based randomisation system and was stratified by geographic region. Masking was maintained using a two-physician model. The primary endpoint of this 96-week study was time to conversion to clinically definite MS according to the Poser criteria. This study is registered with ClinicalTrials.gov, number NCT00725985. Of 903 participants assessed for eligibility, 616 patients received cladribine 5.25 mg/kg (n=204), cladribine 3.5 mg/kg (n=206), or placebo (n=206). At trial termination on Oct 25, 2011, cladribine was associated with a risk reduction versus placebo for time to conversion to clinically definite MS (hazard ratio [HR] for 5.25 mg/kg=0.38, 95% CI 0.25-0.58, pMS diagnosis compared with placebo. The safety profile of cladribine was similar to that noted in a trial in patients with relapsing-remitting MS. Further research could clarify the potential effects of oral cladribine treatment in the early stages of MS. Merck Serono SA Geneva

  11. Self-reported confidence in patient safety knowledge among Australian undergraduate nursing students: A multi-site cross-sectional survey study.

    Science.gov (United States)

    Usher, Kim; Woods, Cindy; Parmenter, Glenda; Hutchinson, Marie; Mannix, Judy; Power, Tamara; Chaboyer, Wendy; Latimer, Sharon; Mills, Jane; Siegloff, Lesley; Jackson, Debra

    2017-06-01

    Patient safety is critical to the provision of quality health care and thus is an essential component of nurse education. To describe first, second and third year Australian undergraduate nursing students' confidence in patient safety knowledge acquired in the classroom and clinical settings across the three years of the undergraduate nursing program. A cross-sectional online survey conducted in 2015. Seven Australian universities with campuses across three states (Queensland, New South Wales, South Australia). A total of 1319 Australian undergraduate nursing students. Participants were surveyed using the 31-item Health Professional Education in Patient Safety Survey (H-PEPSS). Descriptive statistics summarised the sample and survey responses. Paired t-tests, ANOVA and generalized-estimating-equations models were used to compare responses across learning settings (classroom and clinical), and year of nursing course. Participants were most confident in their learning of clinical safety skills and least confident in learning about the sociocultural dimensions of working in teams with other health professionals, managing safety risks and understanding human and environmental factors. Only 59% of students felt confident they could approach someone engaging in unsafe practice, 75% of students agreed it was difficult to question the decisions or actions of those with more authority, and 78% were concerned they would face disciplinary action if they made a serious error. One patient safety subscale, Recognising and responding to remove immediate safety risks, was rated significantly higher by third year nursing students than by first and second year students. Two broader aspects of patient safety scales, Consistency in how patient safety issues are dealt with by different preceptors, and System aspects of patient safety are well covered in our program, were rated significantly higher by first year nursing students than by second and third year students. One scale

  12. Study Protocol: establishing good relationships between patients and health care providers while providing cardiac care. Exploring how patient-clinician engagement contributes to health disparities between indigenous and non-indigenous Australians in South Australia

    Directory of Open Access Journals (Sweden)

    Roe Yvette L

    2012-11-01

    Full Text Available Abstract Background Studies that compare Indigenous Australian and non-Indigenous patients who experience a cardiac event or chest pain are inconclusive about the reasons for the differences in-hospital and survival rates. The advances in diagnostic accuracy, medication and specialised workforce has contributed to a lower case fatality and lengthen survival rates however this is not evident in the Indigenous Australian population. A possible driver contributing to this disparity may be the impact of patient-clinician interface during key interactions during the health care process. Methods/Design This study will apply an Indigenous framework to describe the interaction between Indigenous patients and clinicians during the continuum of cardiac health care, i.e. from acute admission, secondary and rehabilitative care. Adopting an Indigenous framework is more aligned with Indigenous realities, knowledge, intellects, histories and experiences. A triple layered designed focus group will be employed to discuss patient-clinician engagement. Focus groups will be arranged by geographic clusters i.e. metropolitan and a regional centre. Patient informants will be identified by Indigenous status (i.e. Indigenous and non-Indigenous and the focus groups will be convened separately. The health care provider focus groups will be convened on an organisational basis i.e. state health providers and Aboriginal Community Controlled Health Services. Yarning will be used as a research method to facilitate discussion. Yarning is in congruence with the oral traditions that are still a reality in day-to-day Indigenous lives. Discussion This study is nestled in a larger research program that explores the drivers to the disparity of care and health outcomes for Indigenous and non-Indigenous Australians who experience an acute cardiac admission. A focus on health status, risk factors and clinical interventions may camouflage critical issues within a patient

  13. Australian energy statistics - Australian energy update 2005

    Energy Technology Data Exchange (ETDEWEB)

    Donaldson, K.

    2005-06-15

    ABARE's energy statistics include comprehensive coverage of Australian energy consumption, by state, by industry and by fuel. Australian Energy Update 2005 provides an overview of recent trends and description of the full coverage of the dataset. There are 14 Australian energy statistical tables available as free downloads (product codes 13172 to 13185).

  14. Patient-reported questionnaires in MS rehabilitation: responsiveness and minimal important difference of the multiple sclerosis questionnaire for physiotherapists (MSQPT).

    Science.gov (United States)

    van der Maas, Nico Arie

    2017-03-16

    The Multiple Sclerosis Questionnaire for Physical Therapists (MSQPT) is a patient-rated outcome questionnaire for evaluating the rehabilitation of persons with multiple sclerosis (MS). Responsiveness was evaluated, and minimal important difference (MID) estimates were calculated to provide thresholds for clinical change for four items, three sections and the total score of the MSQPT. This multicentre study used a combined distribution- and anchor-based approach with multiple anchors and multiple rating of change questions. Responsiveness was evaluated using effect size, standardized response mean (SRM), modified SRM and relative efficiency. For distribution-based MID estimates, 0.2 and 0.33 standard deviations (SD), standard error of measurement (SEM) and minimal detectable change were used . Triangulation of anchor- and distribution-based MID estimates provided a range of MID values for each of the four items, the three sections and the total score of the MSQPT. The MID values were tested for their sensitivity and specificity for amelioration and deterioration for each of the four items, the three sections and the total score of the MSQPT. The MID values of each item and section and of the total score with the best sensitivity and specificity were selected as thresholds for clinical change. The outcome measures were the MSQPT, Hamburg Quality of Life Questionnaire for Multiple Sclerosis (HAQUAMS), rating of change questionnaires, Expanded Disability Status Scale, 6-metre timed walking test, Berg Balance Scale and 6-minute walking test. The effect size ranged from 0.46 to 1.49. The SRM data showed comparable results. The modified SRM ranged from 0.00 to 0.60. Anchor-based MID estimates were very low and were comparable with SD- and SEM-based estimates. The MSQPT was more responsive than the HAQUAMS in detecting improvement but less responsive in finding deterioration. The best MID estimates of the items, sections and total score, expressed in percentage of their

  15. Proteomic analysis of plasma proteins in diabetic retinopathy patients by two dimensional electrophoresis and MALDI-Tof-MS.

    Science.gov (United States)

    Gopalakrishnan, Vidhya; Purushothaman, Parthiban; Bhaskar, Anusha

    2015-01-01

    Diabetic retinopathy is a highly specific vascular complication of diabetes mellitus and progresses from mild non-proliferative abnormalities characterized by increased vascular permeability to moderate and severe proliferative diabetic retinopathy characterized by the growth of blood vessels on the retina. The aim of the study was to identify the differentially expressed proteins in diabetic retinopathy using two-dimensional electrophoresis. Blood sample was drawn from subjects with diabetes mellitus (without retinopathy) who served as controls and patients with diabetic retinopathy in tubes containing EDTA as anticoagulant. Albumin and immunoglobulin IgG collectively removed to enrich proteins of lower abundance. 2de was carried out to see if there are any differentially expressed proteins. Approximately 48 and 61 spots were identified in control and diabetic retinopathy respectively, of which three protein spots RBP1 (retinol-binding protein 1), NUD10 (Diphosphoinositol polyphosphohydrolase 3 alpha), NGB (neuroglobin) were down regulated and HBG2 (hemoglobin) and BY55 (CD 160 antigen) were upregulated in diabetic retinopathy. These five protein spots were excised and were subjected to in-gel tryptic digestion, and their identities were determined by ultraflex MALDI-TOF-MS. We report a comprehensive patient-based plasma proteomic approach to the identification of potential biomarkers for diabetic retinopathy screening and detection. We identified 5 different proteins that were differentially expressed in the plasma of control diabetic patients (without retinopathy). Among these five proteins the expression of neuroglobin (NGB) protein varied significantly and may be a potential biomarker in diabetic retinopathy. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Longitudinal proxy measurements in multiple sclerosis: patient-proxy agreement on the impact of MS on daily life over a period of two years

    NARCIS (Netherlands)

    van der Linden, F.A.H.; Kragt, J.J.; van Bon, M.; Klein, M.; Thompson, A.J.; van der Ploeg, H.M.; Polman, C.H.; Uitdehaag, B.M.J.

    2008-01-01

    Background: The use of self-report measurements in clinical settings is increasing. However, in patients with limitations that interfere with reliable self-assessment such as cognitive impairment or mood disturbances, as may be the case in multiple sclerosis (MS), data collection might be

  17. An LC–MS/MS-Based Method for the Quantification of Pyridox(am)ine 5′-Phosphate Oxidase Activity in Dried Blood Spots from Patients with Epilepsy

    Science.gov (United States)

    2017-01-01

    We report the development of a rapid, simple, and robust LC–MS/MS-based enzyme assay using dried blood spots (DBS) for the diagnosis of pyridox(am)ine 5′-phosphate oxidase (PNPO) deficiency (OMIM 610090). PNPO deficiency leads to potentially fatal early infantile epileptic encephalopathy, severe developmental delay, and other features of neurological dysfunction. However, upon prompt treatment with high doses of vitamin B6, affected patients can have a normal developmental outcome. Prognosis of these patients is therefore reliant upon a rapid diagnosis. PNPO activity was quantified by measuring pyridoxal 5′-phosphate (PLP) concentrations in a DBS before and after a 30 min incubation with pyridoxine 5′-phosphate (PNP). Samples from 18 PNPO deficient patients (1 day–25 years), 13 children with other seizure disorders receiving B6 supplementation (1 month–16 years), and 37 child hospital controls (5 days–15 years) were analyzed. DBS from the PNPO-deficient samples showed enzyme activity levels lower than all samples from these two other groups as well as seven adult controls; no false positives or negatives were identified. The method was fully validated and is suitable for translation into the clinical diagnostic arena. PMID:28782931

  18. "Cross-Cultural Adaptation Of The Multiple Sclerosis Impact Scale (MSIS-29 For Iranian MS Patients, Evaluation Of Reliability And Validity "

    Directory of Open Access Journals (Sweden)

    P. Ayatollahi

    2006-05-01

    Full Text Available Background and Aim: Measuring the outcome of chronic diseases such as multiple sclerosis is an important factor in assessment of disease impact on different dimensions of quality of life and in evaluation of therapeutic interventions. The aim of this study was to perform the cross-cultural adaptation of the MSIS-29 which is a MS-specific outcome measure for Iranian patients. Materials and Methods: The Iranian adaptation process of the MSIS-29 included 5 steps. To evaluate psychometric properties of the translated version, the questionnaire was administered to a consecutive sample of 96 patients with clinically definite MS referred to our out-patient clinic. Test-retest reliability was assessed in a sub-sample consisted of 30 patients. These patients completed the questionnaire on two occasions separated by a 7-day interval. The Iranian version of the SF-36 was also administered to this sub-sample in order to evaluate the validity of translated MSIS-29. Results: Statistical analysis indicated that the Persian version of the MSIS-29 had high internal consistency (cronbach’s alpha coefficients > 0.70 and test-retest reliability (intra-class correlation coefficients >0.70 and a good validity. Conclusion: The Persian version of the MSIS-29 is a reliable and valid instrument for measuring MS outcome in Iranian patients. It can be used in clinical trials and cross-sectional studies.

  19. Clinical verification of the superiority of the current International Union Against Cancer staging criteria in an Australian population of patients with nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Corry, J.; Porceddu, S.; Peters, L.J.; Fisher, R.; Rischin, D.

    2004-01-01

    The purpose of this study is to assess the prognostic abilities of the fourth and fifth edition International Union Against Cancer (UICC) staging systems for nasopharyngeal carcinoma (NPC) in Australian patients. All patients planned for curative treatment at the Peter MacCallum Cancer Centre from April 1985 to December 1999 were included in this study. There were 181 patients eligible for this study. The median follow up was 7.6 years. Histological subgroups were World Health Organization (WHO) 1 (23), WHO 2 (12), and WHO 3 (146). Presentation with stage IV disease was 83% by UICC fourth edition staging and 34% by UICC fifth edition staging. The 5 years failure-free survival (FFS) rates for stage 1, 2, 3 and 4 disease by the fourth edition was 77, 100, 93, and 49% respectively,and by the fifth edition was 85, 76. 57 and 36%, respectively. The 5 years overall survival (OS) for stage 1, 2, 3, and 4 disease by the fourth edition was 77. 100, 100 and 61%; respectively.and by the fifth edition was 85, 82, 67 and 53%, respectively. Stage 4 patients by the fourth edition were reclassified as stages 2, 3 and 4 by the fifth edition with hazard ratios of 0.77, 1.01 and 1.79, respectively. In multifactor analysis, the fifth edition staging system was significantly related to FFS and OS after allowing for the fourth edition (FFS: P= 0.002; OS: P = 0.005), but the fourth edition was not significantly related to FFS or OS after allowing for the fifth edition (FFS: P = 0.96; OS: P = 0.96). This study confirms the prognostic superiority of the fifth edition UICC staging system over the fourth edition staging system in an Australian NPC population. Copyright (2004) Blackwell Science Pty Ltd

  20. Absence of Mycoplasma-specific DNA sequence in brain, blood and CSF of patients with multiple sclerosis (MS): a study by PCR and real-time PCR.

    Science.gov (United States)

    Casserly, Georgina; Barry, Thomas; Tourtellotte, Wallace W; Hogan, Edward L

    2007-02-15

    Mycoplasmas are the smallest of the known self-replicating organisms. They lack cell walls and are associated with numerous diseases in humans and animals. We are exploring the possibility that infection by Mycoplasma may induce the inflammatory demyelinating disease of the central nervous system (CNS) that is MS. The presence of specific Mycoplasma species DNA was sought in brain, serum and cerebrospinal fluid (CSF) of patients diagnosed with multiple sclerosis (MS) and other neurological diseases (OND) including inflammatory disorders. The MS samples from patients with active and progressive MS, as well as in remission, a variety of other neurological disease controls, including inflammatory CNS diseases such as meningitis, cryptococcal meningitis and encephalitis and other neurological disorders such as migraine were also examined. Clinical samples were provided by the National Neurological Research Specimen Bank and the Human Brain and Spinal Fluid Resource Centre, Los Angeles. Analysis was carried out by conventional PCR using Mycoplasma-specific primers (McAuliffe et al., 2005) that target the 16S rDNA gene in Mycoplasma species. The Mycoplasma-specific primers could detect 102 Mycoplasma species. In this study, 30 samples of human brain and 57 pairs of serum and CSF and were examined. No Mycoplasma-specific nucleic acid sequence was detected, and the consistent observation of an endogenous gene, human serum albumin (HSA), as a positive control documented the adequacy of the method. Real-time PCR analysis of serum and CSF was done also targeting utilizing the Mycoplasma 16S rDNA gene, and this also demonstrated the lack of Mycoplasma in these samples. The presence of Mycoplasma at extraneural sites in MS patients is now being explored.

  1. Optimized LC-MS/MS Method for the High-throughput Analysis of Clinical Samples of Ivacaftor, Its Major Metabolites, and Lumacaftor in Biological Fluids of Cystic Fibrosis Patients.

    Science.gov (United States)

    Schneider, Elena K; Reyes-Ortega, Felisa; Li, Jian; Velkov, Tony

    2017-10-15

    Defects in the cystic fibrosis trans-membrane conductance regulator (CFTR) are the cause of cystic fibrosis (CF), a disease with life-threatening pulmonary manifestations. Ivacaftor (IVA) and ivacaftor-lumacaftor (LUMA) combination are two new breakthrough CF drugs that directly modulate the activity and trafficking of the defective CFTR-protein. However, there is still a dearth of understanding on pharmacokinetic/pharmacodynamic parameters and the pharmacology of ivacaftor and lumacaftor. The HPLC-MS technique for the simultaneous analysis of the concentrations of ivacaftor, hydroxymethyl-ivacaftor, ivacaftor-carboxylate, and lumacaftor in biological fluids in patients receiving standard ivacaftor or ivacaftor-lumacaftor combination therapy has previously been developed by our group and partially validated to FDA standards. However, to allow the high-throughput analysis of a larger number of patient samples, our group has optimized the reported method through the use of a smaller pore size reverse-phase chromatography column (2.6 µm, C8 100 Å; 50 x 2.1 mm) and a gradient solvent system (0-1 min: 40% B; 1-2 min: 40-70% B; 2-2.7 min: held at 70% B; 2.7-2.8 min: 70-90% B; 2.8-4.0 min: 90% B washing; 4.0-4.1 min: 90-40% B; 4.1-6.0 min: held at 40% B) instead of an isocratic elution. The goal of this study was to reduce the HPLC-MS analysis time per sample dramatically from ~15 min to only 6 min per sample, which is essential for the analysis of a large amount of patient samples. This expedient method will be of considerable utility for studies into the exposure-response relationships of these breakthrough CF drugs.

  2. A new assessment tool for patients with multiple sclerosis from Spanish-speaking countries: validation of the Brief International Cognitive Assessment for MS (BICAMS) in Argentina.

    Science.gov (United States)

    Vanotti, Sandra; Smerbeck, Audrey; Benedict, Ralph H B; Caceres, Fernando

    2016-10-01

    The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) is an international assessment tool for monitoring cognitive function in multiple sclerosis (MS) patients. BICAMS comprises the Symbol Digit Modalities Test (SDMT), the California Verbal Learning Test - Second Edition (CVLT II) and the Brief Visuospatial Memory Test - Revised (BVMT-R). Our objective was to validate and assess the reliability of BICAMS as applied in Argentina and to obtain normative data in Spanish for this population. The sample composed of 50 MS patients and 100 healthy controls (HC). In order to test its reliability, BICAMS was re-administered in a subset of 25 patients. The sample's average age was 43.42 ± 10.17 years old, and average years of schooling were 14.86 ± 2.78. About 74% of the participants were women. The groups did not differ in age, years of schooling, or gender. The MS group performed significantly worse than the HC group across the three neuropsychological tests, yielding the following Cohen's d values: SDMT: .85; CVLT I: .87; and BVMT-R: .40. The mean raw scores for Argentina normative data were as follows: SDMT: 56.71 ± 10.85; CVLT I: 60.88 ± 10.46; and BVMT-R: 23.44 ± 5.84. Finally, test-retest reliability coefficients for each test were as follows: SDMT: r = .95; CVLT I: r = .87; and BVMT-R: r = .82. This BICAMS version is reliable and useful as a monitoring tool for identifying MS patients with cognitive impairment.

  3. Cost-effectiveness of the Australian Medical Sheepskin for the prevention of pressure ulcers in somatic nursing home patients: study protocol for a prospective multi-centre randomised controlled trial (ISRCTN17553857).

    NARCIS (Netherlands)

    Mistiaen, P.; Achterberg, W.P.; Ament, A.; Halfen, R.; Huizinga, J.; Montgomery, K.; Post, H.; Francke, A.

    2008-01-01

    BACKGROUND: Pressure ulcers are a major problem, especially in nursing home patients, although they are regarded as preventable and there are many pressure relieving methods and materials. One such pressure relieving material is the recently developed Australian Medical Sheepskin, which has been

  4. "I have nine specialists. They need to swap notes!" Australian patients' perspectives of medication-related problems following discharge from hospital.

    Science.gov (United States)

    Eassey, Daniela; McLachlan, Andrew J; Brien, Jo-Anne; Krass, Ines; Smith, Lorraine

    2017-10-01

    Research has shown that patients are most susceptible to medication-related problems (MRPs) when transitioning from hospital to home. Currently, the literature in this area focuses on interventions, which are mainly orientated around the perspective of the health-care professional and do not take into account patient perspectives and experiences. To capture the experiences and perceptions of Australian patients regarding MRPs following discharge from hospital. A cross-sectional study was conducted using a questionnaire collecting quantitative and qualitative data. Thematic analysis was conducted of the qualitative data. Survey participants were recruited through The Digital Edge, an online market research company. Five hundred and six participants completed the survey. A total of 174 participants self-reported MRPs. Two concepts and seven subthemes emerged from the analysis. The first concept was types of MRPs and patient experiences. Three themes were identified: unwanted effects from medicines, confusion about medicines and unrecognized medicines. The second concept was patient engagement in medication management, of which four themes emerged: informing patients, patient engagement, communication amongst health-care professionals and conflicting advice. This study provides an important insight into patients' experiences and perceptions of MRPs following discharge from hospital. Future direction for practice and research should look into implementing patient-centred care at the time of hospital discharge to ensure the provision of clear and consistent information, and developing ways to support and empower patients to ensure a smooth transition post-discharge from hospital. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  5. Burden of cardiovascular risk factors and disease among patients with type 1 diabetes: results of the Australian National Diabetes Audit (ANDA).

    Science.gov (United States)

    Pease, Anthony; Earnest, Arul; Ranasinha, Sanjeeva; Nanayakkara, Natalie; Liew, Danny; Wischer, Natalie; Andrikopoulos, Sofianos; Zoungas, Sophia

    2018-06-02

    Cardiovascular risk stratification is complex in type 1 diabetes. We hypothesised that traditional and diabetes-specific cardiovascular risk factors were prevalent and strongly associated with cardiovascular disease (CVD) among adults with type 1 diabetes attending Australian diabetes centres. De-identified, prospectively collected data from patients with type 1 diabetes aged ≥ 18 years in the 2015 Australian National Diabetes Audit were analysed. The burden of cardiovascular risk factors [age, sex, diabetes duration, glycated haemoglobin (HbA1c), blood pressure, lipid profile, body mass index, smoking status, retinopathy, renal function and albuminuria] and associations with CVD inclusive of stroke, myocardial infarction, coronary artery bypass graft surgery/angioplasty and peripheral vascular disease were assessed. Restricted cubic splines assessed for non-linearity of diabetes duration and likelihood ratio test assessed for interactions between age, diabetes duration, centre type and cardiovascular outcomes of interest. Discriminatory ability of multivariable models were assessed with area under the receiver operating characteristic (ROC) curves. Data from 1169 patients were analysed. Mean (± SD) age and median diabetes duration was 40.0 (± 16.7) and 16.0 (8.0-27.0) years respectively. Cardiovascular risk factors were prevalent including hypertension (21.9%), dyslipidaemia (89.4%), overweight/obesity (56.4%), ever smoking (38.5%), albuminuria (31.1%), estimated glomerular filtration rate  7.0% (53 mmol/mol) (81.0%). Older age, longer diabetes duration, smoking and antihypertensive therapy use were positively associated with CVD, while high density lipoprotein-cholesterol and diastolic blood pressure were negatively associated (p < 0.05). Association with CVD and diabetes duration remained constant until 20 years when a linear increase was noted. Longer diabetes duration also had the highest population attributable risk of 6.5% (95% CI 1

  6. AUSTRALIAN COMPETITION AND CONSUMER COMMISSION v ACN 117 372 915: SHOULD CONSUMER LAW REGULATE DOCTOR-PATIENT RELATIONS IN A CORPORATISED HEALTH CARE SYSTEM?

    Science.gov (United States)

    Wallace, Jessica; Pyman, Ella; Faunce, Thomas

    2015-09-01

    In April 2015, North J of the Federal Court of Australia made a finding of unconscionable conduct against Advanced Medical Institute, a promoter and provider of erectile dysfunction treatment, in a case concerning unfair contract terms (Australian Competition and Consumer Commission vACN 117 372 915 Pty Ltd (in liq) (formerly Advanced Medical Institute Pty Ltd) [2015] FCA 368). The contract required a minimum 12-month commitment, with costs exceeding treatments available from general practitioners, and made refunds available only after all possible treatment plans were exhausted which included penile injections. This column analyses that case, particularly in respect to the consumer law standards of practice under which it was litigated. Those standards refer to patients as "consumers" yet North J made extensive reference to the Good Medical Practice: A Code of Conduct for Doctors in Australia, a text which refers to "patients", as evidence of what constitutes appropriate professional conduct or practice for the health profession. This column considers whether legislative and judicial categorisation of patients (a class of people presumptively suffering, sick and vulnerable) as "consumers" undermines the formal and informal protections accorded to patients under normative systems of medical ethics such as those represented by the Code. The case, it is argued, also illuminates the contemporary tensions between the ethical, legal and human rights standards required of doctors in their treatment of patients and the commercial interests of businesses.

  7. Motor training programs of arm and hand in patients with MS according to different levels of the ICF: a systematic review

    Directory of Open Access Journals (Sweden)

    Spooren Annemie IF

    2012-07-01

    Full Text Available Abstract Background The upper extremity plays an important role in daily functioning of patients with Multiple Sclerosis (MS and strongly influences their quality of life. However, an explicit overview of arm-hand training programs is lacking. The present review aims to investigate the training components and the outcome of motor training programs for arm and hand in MS. Methods A computerized systematic literature search in 5 databases (PubMed, CINAHL, EMBASE, PEDro and Cochrane was performed using the following Mesh terms: Multiple Sclerosis, Rehabilitation, Physical Education and Training, Exercise, Patient-Centered Care, Upper Extremity, Activities of Daily Living, Motor Skills, Motor Activity, Intervention Studies and Clinical Trial. The methodological quality of the selected articles was scored with the Van Tulder Checklist. A descriptive analyses was performed using the PICO principle, including scoring of training components with the calculation of Hedges’g effect sizes. Results Eleven studies were eligible (mean Van Tulder-score = 10.82(SD2.96. Most studies reported a specific improvement in arm hand performance at the ICF level that was trained at. The mean number of training components was 5.5(SD2.8 and a significant correlation (r = 0.67; p  Conclusion Motor training programs (both at the ICF body function and activity level have shown to improve arm and hand performance in MS in which the value of the training specificity was emphasized. To optimize upper extremity training in MS the component ‘client-centred’ and ‘exercise progression’ may be important. Furthermore, given the importance attributed to the components ‘distribution based practice’, ‘feedback’ and ‘random practice’ in previous research in stroke patients, the use of these components in arm hand training should be explored in future research.

  8. The Australian National Sub-acute and Non-acute Patient Casemix Classification (AN-SNAP): its application and value in a stroke rehabilitation programme.

    Science.gov (United States)

    Lowthian, P; Disler, P; Ma, S; Eagar, K; Green, J; de Graaff, S

    2000-10-01

    To investigate whether the Australian National Sub-acute and Non-acute Patient Casemix Classification (SNAP) and Functional Independence Measure and Functional Related Group (Version 2) (FIM-FRG2) casemix systems can be used to predict functional outcome, and reduce the variance of length of stay (LOS) of patients undergoing rehabilitation after strokes. The study comprised a retrospective analysis of the records of patients admitted to the Cedar Court Healthsouth Rehabilitation Hospital for rehabilitation after stroke. The sample included 547 patients (83.3% of those admitted with stroke during this period). Patient data were stratified for analysis into the five SNAP or nine FIM-FRG2 groups, on the basis of the admission FIM scores and age. The AN-SNAP classification accounted for a 30.7% reduction of the variance of LOS, and 44.2% of motor FIM, and the FIM-FRG2 accounts for 33.5% and 56.4% reduction respectively. Comparison of the Cedar Court with the national AN-SNAP data showed differences in the LOS and functional outcomes of older, severely disabled patients. Intensive rehabilitation in selected patients of this type appears to have positive effects, albeit with a slightly longer period of inpatient rehabilitation. Casemix classifications can be powerful management tools. Although FIM-FRG2 accounts for more reduction in variance than SNAP, division into nine groups meant that some contained few subjects. This paper supports the introduction of AN-SNAP as the standard casemix tool for rehabilitation in Australia, which will hopefully lead to rational, adequate funding of the rehabilitation phase of care.

  9. Cost-effectiveness of the Australian Medical Sheepskin for the prevention of pressure ulcers in somatic nursing home patients: study protocol for a prospective multi-centre randomised controlled trial (ISRCTN17553857

    Directory of Open Access Journals (Sweden)

    Montgomery Ken

    2008-01-01

    Full Text Available Abstract Background Pressure ulcers are a major problem, especially in nursing home patients, although they are regarded as preventable and there are many pressure relieving methods and materials. One such pressure relieving material is the recently developed Australian Medical Sheepskin, which has been shown in two randomized controlled trials 12 to be an effective intervention in the prevention of sacral pressure ulcers in hospital patients. However, the use of sheepskins has been debated and in general discouraged by most pressure ulcer working groups and pressure ulcer guidelines, but these debates were based on old forms of sheepskins. Furthermore, nothing is yet known about the (cost-effectiveness of the Australian Medical sheepskin in nursing home patients. The objective of this study is to assess the effects and costs of the use of the Australian Medical Sheepskin combined with usual care with regard to the prevention of sacral pressure ulcers in somatic nursing home patients, versus usual care only. Methods/Design In a multi-centre randomised controlled trial 750 patients admitted for a primarily somatic reason to one of the five participating nursing homes, and not having pressure ulcers on the sacrum at admission, will be randomized to either usual care only or usual care plus the use of the Australian Medical Sheepskin as an overlay on the mattress. Outcome measures are: incidence of sacral pressure ulcers in the first month after admission; sacrum pressure ulcer free days; costs; patient comfort; and ease of use. The skin of all the patients will be observed once a day from admission on for 30 days. Patient characteristics and pressure risk scores are assessed at admission and at day 30 after it. Additional to the empirical phase, systematic reviews will be performed in order to obtain data for economic weighting and modelling. The protocol is registered in the Controlled Trial Register as ISRCTN17553857.

  10. Cost-effectiveness of the Australian Medical Sheepskin for the prevention of pressure ulcers in somatic nursing home patients: study protocol for a prospective multi-centre randomised controlled trial (ISRCTN17553857).

    Science.gov (United States)

    Mistiaen, Patriek; Achterberg, Wilco; Ament, Andre; Halfens, Ruud; Huizinga, Janneke; Montgomery, Ken; Post, Henri; Francke, Anneke L

    2008-01-07

    Pressure ulcers are a major problem, especially in nursing home patients, although they are regarded as preventable and there are many pressure relieving methods and materials. One such pressure relieving material is the recently developed Australian Medical Sheepskin, which has been shown in two randomized controlled trials 12 to be an effective intervention in the prevention of sacral pressure ulcers in hospital patients. However, the use of sheepskins has been debated and in general discouraged by most pressure ulcer working groups and pressure ulcer guidelines, but these debates were based on old forms of sheepskins. Furthermore, nothing is yet known about the (cost-)effectiveness of the Australian Medical sheepskin in nursing home patients. The objective of this study is to assess the effects and costs of the use of the Australian Medical Sheepskin combined with usual care with regard to the prevention of sacral pressure ulcers in somatic nursing home patients, versus usual care only. In a multi-centre randomised controlled trial 750 patients admitted for a primarily somatic reason to one of the five participating nursing homes, and not having pressure ulcers on the sacrum at admission, will be randomized to either usual care only or usual care plus the use of the Australian Medical Sheepskin as an overlay on the mattress. Outcome measures are: incidence of sacral pressure ulcers in the first month after admission; sacrum pressure ulcer free days; costs; patient comfort; and ease of use. The skin of all the patients will be observed once a day from admission on for 30 days. Patient characteristics and pressure risk scores are assessed at admission and at day 30 after it. Additional to the empirical phase, systematic reviews will be performed in order to obtain data for economic weighting and modelling. The protocol is registered in the Controlled Trial Register as ISRCTN17553857.

  11. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Employer Matching Gifts d Gifts of Stock or Securities d Giving Circles Golden Circle Circle of Distinction ... Your Practice Publications for Clinicians Publications for Your Patients MS Navigator Program Programs and Services for Your ...

  12. Metaphyseal osteopathy in three Australian Kelpie siblings.

    Science.gov (United States)

    Greenwell, C M; Brain, P H; Dunn, A L

    2014-04-01

    Metaphyseal osteopathy (MO) was diagnosed in three Australian Kelpie puppies that were presented for veterinary assessment of lameness. The three puppies were siblings. Each was from a different litter by the same breeding pair. The puppy in case one was seen by the authors, and the puppies in cases two and three were patients at other veterinary hospitals. However, the medical records and radiographs were examined and reviewed for this report. Radiographic investigation of the lameness revealed pathognomonic appearance of MO affecting the metaphyseal region of the long bones in all three puppies. The diagnosis was confirmed on histopathology in one patient. MO is considered a disease of large and giant-breed dogs, being rarely reported in non-large-breed dogs, and has not been reported in the Australian Kelpie, which is considered a medium-breed dog. This case series suggests a previously unreported breed predisposition to MO in the Australian Kelpie. © 2014 Australian Veterinary Association.

  13. [Detection of serum proteins in the patients of lung adenocarcinoma by the method of magnetic bead based sample fractionation and MALDI-TOF-MS].

    Science.gov (United States)

    Liu, Dan; Liu, Lun-Xu; Yuan, Quan; Li, Xiao-Liang; Huang, Na; Yang, Xiao-Dong

    2010-05-01

    To screen the serum proteins related to human lung adenocarcinoma using matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) technology. The blood samples were collected from 10 patients of lung adenocarcinoma before and one week after the surgery, while 10 healthy subjects were used as control. The differential protein expression between the two groups and the change of those proteins after surgery were studied by ClinProt magnetic bead enrichment and MALDI-TOF-MS. Six protein peaks were identified, 2 of them were highly expressed protein biomarkers with relative molecular weights of 2661, 2991, and increased after the surgery, 4 of them were lowly expressed protein biomarkers with relative molecular weights of 4091, 4210, 4644, 5336, which continuously decreased after the surgery. ClinProt magnetic bead enrichment and MALDI-TOF-MS is a quick, easy and sensitive method of proteomics. The differential expressed proteins may be the latent tumor marker of lung adenocarcinoma. The alteration of those proteins after surgery might be helpful to assess the therapeutic effect and prognosis.

  14. Longitudinal proxy measurements in multiple sclerosis: patient-proxy agreement on the impact of MS on daily life over a period of two years

    Directory of Open Access Journals (Sweden)

    Thompson Alan J

    2008-02-01

    Full Text Available Abstract Background The use of self-report measurements in clinical settings is increasing. However, in patients with limitations that interfere with reliable self-assessment such as cognitive impairment or mood disturbances, as may be the case in multiple sclerosis (MS, data collection might be problematic. In these situations, information obtained from proxy respondents (e.g. partners may replace self-ratings. The aim of this study was to examine the value of proxy ratings at separate points in time and to assess patient-proxy agreement on possible changes in disease impact of MS. Methods Fifty-six MS patients and their partners completed the Multiple Sclerosis Impact Scale (MSIS-29 at baseline and follow-up, two years later. Patient-proxy agreement was assessed at both time points by calculating intraclass correlation coefficients (ICCs, exact and global agreement and the mean directional differences between groups. Agreement of change over time was assessed by calculating ICCs between change scores. In parallel, global ratings of both patients and proxy respondents of the extent to which the patient had improved or deteriorated over the past two years were collected to validate possible changes on the MSIS-29. Results At both time points, agreement on the physical scale was higher than agreement on the psychological scale (ICCs at baseline were 0.81 for the physical scale and 0.72 for the psychological scale; at follow-up, the ICC values were 0.86 and 0.65 respectively. At follow-up, statistically significant mean differences between patients and proxies were noted for the physical scale (-4.8 ± 12.7, p = 0.006 and the psychological scale (-8.9 ± 18.8, p = 0.001. Agreement between change scores on the MSIS-29 was fair (ICC Conclusion Proxy respondents could act as a reliable source of information in cross-sectional studies. Moreover, results suggested that agreement on change over time might be better for proxy respondents compared to

  15. Television and Popular Culture: Reflections on British and Australian Critical Practice.

    Science.gov (United States)

    Fiske, John

    1986-01-01

    Traces the development of British and Australian television criticism from the mid-seventies. Suggests a conscious study of the characteristics of television as a cultural agent and as a text within a sociocultural context. (MS)

  16. Assessing the Association between Serum Ferritin, Transferrin Saturation, and C-Reactive Protein in Northern Territory Indigenous Australian Patients with High Serum Ferritin on Maintenance Haemodialysis

    Directory of Open Access Journals (Sweden)

    Sandawana William Majoni

    2017-01-01

    Full Text Available Objective. To determine the significance of high serum ferritin observed in Indigenous Australian patients on maintenance haemodialysis in the Northern Territory, we assessed the relationship between ferritin and transferrin saturation (TSAT as measures of iron status and ferritin and C-reactive protein (CRP as markers of inflammation. Methods. We performed a retrospective cohort analysis of data from adult patients (≥18 years on maintenance haemodialysis (>3 months from 2004 to 2011. Results. There were 1568 patients. The mean age was 53.9 (11.9 years. 1244 (79.3% were Indigenous. 44.2% (n=693 were male. Indigenous patients were younger (mean age [52.3 (11.1 versus 57.4 (15.2, p<0.001] and had higher CRP [14.7 mg/l (7–35 versus 5.9 mg/l (1.9–17.5, p<0.001], higher median serum ferritin [1069 µg/l (668–1522 versus 794.9 µg/l (558.5–1252.0, p<0.001], but similar transferrin saturation [26% (19–37 versus 28% (20–38, p=0.516]. We observed a small positive correlation between ferritin and TSAT (r2=0.11, p<0.001, no correlation between ferritin and CRP (r2 = 0.001, p<0.001, and positive association between high serum ferritin and TSAT (p<0.001, Indigenous ethnicity (p<0.001, urea reduction ratio (p=0.001, and gender (p<0.001 after adjustment in mixed regression analysis. Conclusion. Serum ferritin and TSAT may inadequately reflect iron status in this population. The high ferritin was poorly explained by inflammation.

  17. Australian uranium mining policy

    International Nuclear Information System (INIS)

    Fisk, B.

    1985-01-01

    Australian government policy is explained in terms of adherence to the Non-Proliferation Treaty. Two alleged uncertainties are discussed: the future of Australian mining industry as a whole -on which it is said that Australian uranium mines will continue to be developed; and detailed commercial policy of the Australian government - on which it is suggested that the three-mines policy of limited expansion of the industry would continue. Various aspects of policy, applying the principles of the NPT, are listed. (U.K.)

  18. Metabolomic Profiling of Plasma from Melioidosis Patients Using UHPLC-QTOF MS Reveals Novel Biomarkers for Diagnosis

    Directory of Open Access Journals (Sweden)

    Susanna K. P. Lau

    2016-02-01

    Full Text Available To identify potential biomarkers for improving diagnosis of melioidosis, we compared plasma metabolome profiles of melioidosis patients compared to patients with other bacteremia and controls without active infection, using ultra-high-performance liquid chromatography-electrospray ionization-quadruple time-of-flight mass spectrometry. Principal component analysis (PCA showed that the metabolomic profiles of melioidosis patients are distinguishable from bacteremia patients and controls. Using multivariate and univariate analysis, 12 significant metabolites from four lipid classes, acylcarnitine (n = 6, lysophosphatidylethanolamine (LysoPE (n = 3, sphingomyelins (SM (n = 2 and phosphatidylcholine (PC (n = 1, with significantly higher levels in melioidosis patients than bacteremia patients and controls, were identified. Ten of the 12 metabolites showed area-under-receiver operating characteristic curve (AUC >0.80 when compared both between melioidosis and bacteremia patients, and between melioidosis patients and controls. SM(d18:2/16:0 possessed the largest AUC when compared, both between melioidosis and bacteremia patients (AUC 0.998, sensitivity 100% and specificity 91.7%, and between melioidosis patients and controls (AUC 1.000, sensitivity 96.7% and specificity 100%. Our results indicate that metabolome profiling might serve as a promising approach for diagnosis of melioidosis using patient plasma, with SM(d18:2/16:0 representing a potential biomarker. Since the 12 metabolites were related to various pathways for energy and lipid metabolism, further studies may reveal their possible role in the pathogenesis and host response in melioidosis.

  19. Metabolomic Profiling of Plasma from Melioidosis Patients Using UHPLC-QTOF MS Reveals Novel Biomarkers for Diagnosis.

    Science.gov (United States)

    Lau, Susanna K P; Lee, Kim-Chung; Lo, George C S; Ding, Vanessa S Y; Chow, Wang-Ngai; Ke, Tony Y H; Curreem, Shirly O T; To, Kelvin K W; Ho, Deborah T Y; Sridhar, Siddharth; Wong, Sally C Y; Chan, Jasper F W; Hung, Ivan F N; Sze, Kong-Hung; Lam, Ching-Wan; Yuen, Kwok-Yung; Woo, Patrick C Y

    2016-02-27

    To identify potential biomarkers for improving diagnosis of melioidosis, we compared plasma metabolome profiles of melioidosis patients compared to patients with other bacteremia and controls without active infection, using ultra-high-performance liquid chromatography-electrospray ionization-quadruple time-of-flight mass spectrometry. Principal component analysis (PCA) showed that the metabolomic profiles of melioidosis patients are distinguishable from bacteremia patients and controls. Using multivariate and univariate analysis, 12 significant metabolites from four lipid classes, acylcarnitine (n = 6), lysophosphatidylethanolamine (LysoPE) (n = 3), sphingomyelins (SM) (n = 2) and phosphatidylcholine (PC) (n = 1), with significantly higher levels in melioidosis patients than bacteremia patients and controls, were identified. Ten of the 12 metabolites showed area-under-receiver operating characteristic curve (AUC) >0.80 when compared both between melioidosis and bacteremia patients, and between melioidosis patients and controls. SM(d18:2/16:0) possessed the largest AUC when compared, both between melioidosis and bacteremia patients (AUC 0.998, sensitivity 100% and specificity 91.7%), and between melioidosis patients and controls (AUC 1.000, sensitivity 96.7% and specificity 100%). Our results indicate that metabolome profiling might serve as a promising approach for diagnosis of melioidosis using patient plasma, with SM(d18:2/16:0) representing a potential biomarker. Since the 12 metabolites were related to various pathways for energy and lipid metabolism, further studies may reveal their possible role in the pathogenesis and host response in melioidosis.

  20. The risks, needs and stages of recovery of a complete forensic patient cohort in an Australian state.

    Science.gov (United States)

    Adams, Jonathon; Thomas, Stuart D M; Mackinnon, Tobias; Eggleton, Damien

    2018-02-07

    Routine outcome measures are increasingly being mandated across mental health services in Australia and overseas. This requirement includes forensic mental health services, but their utility in such specialist services and the inter-relationships between the measures remain unclear. This study sought to characterise the risks, needs and stages of recovery of an entire cohort of forensic patients in one jurisdiction in Australia. Local expert groups, comprising of members of the forensic patient treating teams, were formed to gather information about the status and needs of all forensic patients in the State of New South Wales, Australia. The expert groups provided demographic information and completed three assessment tools concerning the risks, needs and stages of recovery of each forensic patient. The cohort of 327 forensic patients in NSW appears to be typical of forensic mental health service populations internationally when considering factors such as gender, diagnosis, and index offence. A number of important differences across the three structured tools for forensic patients in different levels of secure service provision are presented. The DUNDRUM Quartet demonstrated interesting findings, particularly in terms of the therapeutic security needs, the treatment completion, and the stages of recovery for the forensic patients in the community. The CANFOR highlighted the level of needs across the forensic patient population, whilst the HCR-20 data showed there was no significant difference in the mean clinical and risk management scores between male forensic patients across levels of security. To the authors' knowledge this is the first study of its kind in New South Wales, Australia. We have demonstrated the utility of using a suite of measures to evaluate the risks, needs, and stages of recovery for an entire cohort of forensic patients. The data set helps inform service planning and development, together with providing various avenues for future research.

  1. Improving outcomes for hospital patients with critical bleeding requiring massive transfusion: the Australian and New Zealand Massive Transfusion Registry study methodology.

    Science.gov (United States)

    Oldroyd, J C; Venardos, K M; Aoki, N J; Zatta, A J; McQuilten, Z K; Phillips, L E; Andrianopoulos, N; Cooper, D J; Cameron, P A; Isbister, J P; Wood, E M

    2016-10-06

    The Australian and New Zealand (ANZ) Massive Transfusion (MT) Registry (MTR) has been established to improve the quality of care of patients with critical bleeding (CB) requiring MT (≥ 5 units red blood cells (RBC) over 4 h). The MTR is providing data to: (1) improve the evidence base for transfusion practice by systematically collecting data on transfusion practice and clinical outcomes; (2) monitor variations in practice and provide an opportunity for benchmarking, and feedback on practice/blood product use; (3) inform blood supply planning, inventory management and development of future clinical trials; and (4) measure and enhance translation of evidence into policy and patient blood management guidelines. The MTR commenced in 2011. At each participating site, all eligible patients aged ≥18 years with CB from any clinical context receiving MT are included using a waived consent model. Patient information and clinical coding, transfusion history, and laboratory test results are extracted for each patient's hospital admission at the episode level. Thirty-two hospitals have enrolled and 3566 MT patients have been identified across Australia and New Zealand between 2011 and 2015. The majority of CB contexts are surgical, followed by trauma and gastrointestinal haemorrhage. Validation studies have verified that the definition of MT used in the registry correctly identifies 94 % of CB events, and that the median time of transfusion for the majority of fresh products is the 'product event issue time' from the hospital blood bank plus 20 min. Data linkage between the MTR and mortality databases in Australia and New Zealand will allow comparisons of risk-adjusted mortality estimates across different bleeding contexts, and between countries. Data extracts will be examined to determine if there are differences in patient outcomes according to transfusion practice. The ratios of blood components (e.g. FFP:RBC) used in different types of critical bleeding will also

  2. Patients' Attitudes and Approaches to the Self-Management of Hypertension: Perspectives from an Australian Qualitative Study in Community Pharmacy.

    Science.gov (United States)

    Bajorek, Beata; Lemay, Kate; Magin, Parker; Roberts, Christopher; Krass, Ines; Armour, Carol

    2017-06-01

    In the management of hypertension, blood pressure (BP) monitoring and medication use are key strategies, but they are dependent on patients' motivation to practice self-care. To gauge patients' approaches to monitoring their blood pressure, as well as explore their attitudes toward, and actions relating to, high blood pressure readings, as the key components of their self-management of hypertension. This qualitative study, comprising individual telephone interviews, involved patients attending community pharmacies in Sydney (Australia). Patients' perspectives were elicited using a purpose-designed, semi-structured interview guide. The verbal responses were audio-recorded, transcribed verbatim, and thematically analysed. Three key themes arose: (1) approaches to monitoring blood pressure, (2) attitudes to variability in BP, (3) responses to high BP readings. Many patients self-regulated the frequency of monitoring based on perceived need and/or opportunity. Most were indifferent toward their readings, regarding BP fluctuations as 'normal'. When a high BP was detected, the action taken was highly variable, with no clear action plans in place. Several patients recognised a high BP to be a consequence of not taking their antihypertensive medication, triggering the resumption of short-term adherence to their preferred management strategy, i.e., self-medication with antihypertensives (i.e., restarting their medication) and/or self-management via lifestyle strategies. This study highlights patients' inappropriate self-management of hypertension. Misperceptions about hypertension, e.g., accepting BP fluctuations as normal, can produce indifferent attitudes as well as influence patients' self-management actions. This lack of insight undermines long-term adherence to antihypertensive therapy.

  3. Australian Asian Options

    OpenAIRE

    Manuel Moreno; Javier F. Navas

    2003-01-01

    We study European options on the ratio of the stock price to its average and viceversa. Some of these options are traded in the Australian Stock Exchange since 1992, thus we call them Australian Asian options. For geometric averages, we obtain closed-form expressions for option prices. For arithmetic means, we use different approximations that produce very similar results.

  4. A snapshot of patients' awareness of radiation dose and risks associated with medical imaging examinations at an Australian radiology clinic.

    Science.gov (United States)

    Singh, N; Mohacsy, A; Connell, D A; Schneider, M E

    2017-05-01

    Cumulative radiation exposure is linked to increasing the lifetime attributable risk of cancer. To avoid unnecessary radiation exposure and facilitate shared decision making, patients should be aware of these issues. This paper examines patients' awareness of radiation dose and risks associated with medical imaging examinations. Consecutive patients attending a private radiology clinic over a nine week period in 2014 in Metropolitan Melbourne were surveyed while waiting to undergo an imaging examination. Patients who were under 18 years of age, did not speak English and/or were referred for interventional imaging procedures were excluded from participation. Survey questions addressed patients' awareness of radiation dose associated with various imaging modalities' and patients' experience and preferences regarding communication of information about radiation. Data was analysed using SPSS (Ver 20.1). A total of 242 surveys were completed. Most participants were male (143/239, 59.8%) and aged between 33 and 52 years (109/242, 45%). Over half of participants were not concerned about radiation from medical imaging (130/238, 54.6%). Only a third of participants (80/234, 34.2%) correctly reported that CT has a higher radiation dose than X-ray. Very few participants correctly identified mammography, DEXA, PET and PET/CT as radiation emitting examinations. The majority of participants (202/236, 85.6%) indicated that they were not informed about radiation dose and risks by their referring doctor in advance. This paper provides information relevant to a single private radiology clinic in Australia. Nevertheless, our results have shown that patients presenting for medical imaging have little awareness of radiation dose and risks associated with these examinations and received little information by their referring physicians or staff at the radiology clinic. Copyright © 2016 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

  5. Changes in case-mix and outcomes of critically ill patients in an Australian tertiary intensive care unit.

    Science.gov (United States)

    Williams, T A; Ho, K M; Dobb, G J; Finn, J C; Knuiman, M W; Webb, S A R

    2010-07-01

    Critical care service is expensive and the demand for such service is increasing in many developed countries. This study aimed to assess the changes in characteristics of critically ill patients and their effect on long-term outcome. This cohort study utilised linked data between the intensive care unit database and state-wide morbidity and mortality databases. Logistic and Cox regression was used to examine hospital survival and five-year survival of 22,298 intensive care unit patients, respectively. There was a significant increase in age, severity of illness and Charlson Comorbidity Index of the patients over a 16-year study period. Although hospital mortality and median length of intensive care unit and hospital stay remained unchanged, one- and five-year survival had significantly improved with time, after adjusting for age, gender; severity of illness, organ failure, comorbidity, 'new' cancer and diagnostic group. Stratified analyses showed that the improvement in five-year survival was particularly strong among patients admitted after cardiac surgery (P = 0.001). In conclusion, although critical care service is increasingly being provided to patients with a higher severity of acute and chronic illnesses, long-term survival outcome has improved with time suggesting that critical care service may still be cost-effectiveness despite the changes in case-mix.

  6. Strengths and resources used by Australian and Danish adult patients and their family caregivers during treatment for cancer

    DEFF Research Database (Denmark)

    Coyne, Elisabeth; Dieperink, K. B.; Østergaard, Birte

    2017-01-01

    Purpose Family plays an essential role in supporting the patient with cancer, however, relatively little attention has been given to understanding the strengths and resources of the family unit across different settings and countries. This study aims to investigate the strengths and resources...... of patients and family members in Australia and Denmark. Methods Using a descriptive, cross-sectional design, 232 patient and family participants from inpatient and outpatient oncology services in Australia and Denmark completed paper based surveys that included the Family Hardiness Index (FHI) and Family...... Crisis Orientated Personal Evaluation Scales (F-COPES), together with demographic and health information. Results The family's appraisal of the cancer and ways the family worked together predicted the level of external resources used to manage their circumstances. Conclusion After a cancer diagnosis...

  7. Detection of Serum Peptides in Patients with Lung Squamous Cell Carcinoma by MALDI-TOF-MS and Analysis of Their Correlation with Chemotherapy Efficacy

    Directory of Open Access Journals (Sweden)

    Guanhua ZHAO

    2017-05-01

    Full Text Available Background and objective Treatment options for patients with squamous cell carcinoma of the lung (SCC are limited in chemotherapy. However, not all patients could benefit form standard platinum regimen. Considering the dismal prognosis of patients with advanced SCC, a greater focus on selecting sensitive chemotherapy regimens remains of upmost importance to improve outcomes in this disease. In this study, we used matrix-assisted laser desorption/ionization time-of-flight mass spectrometry to detect pre-chemotherapy serum peptides in advanced lung squamous cell carcinoma patients accepting paclitaxel combined with platinum chemotherapy and to analyze the correlation between serum peptides and chemotherapy efficacy. Methods Patients with advanced lung squamous cell carcinoma received paclitaxel combining with platinum chemotherapy and evaluated the efficacy every two cycles. Evaluation of complete response (CR or partial response (PR patients defined as sensitive group, progressive disease (PD patients defined as resistant group. Serum samples were collected from patients with lung squamous cell carcinoma. Eighty-one patients were randomly divided into training group (sensitive group I and resistant group I and validation group (sensitive group II and resistant group II according to the ratio of 3:1. Serum samples were pretreated and Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS was used to detect serum peptide fingerprints. ClinProTools software was used to analyze the differences between the sensitive group I and the resistant group I. Three kinds of biological algorithms (SNN, GA, QC built in CPT software were used to establish the curative effect prediction model respectively and the optimal algorithm was selected. The validation group was used for blind verification. Results Thirty sensitive patients and 31 resistant patients were enrolled in the training group. Ten sensitive patients and 10

  8. Family functioning and perceived support from nurses during cancer treatment among Danish and Australian patients and their families

    DEFF Research Database (Denmark)

    Dieperink, Karin B; Coyne, Elisabeth; Creedy, Debra K

    2018-01-01

    such as cancer. However, family functioning and supportive care from nurses may vary across cultures and settings. DESIGN AND METHODS: A descriptive, cross sectional comparative design with patients and family members from Denmark and Australia. Participants were asked to fill in translated versions...

  9. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Area Donate Donate Search v What Is MS? Definition of MS What Causes MS? Who Gets MS? ... Support Personal Stories d What Is MS? d Definition of MS Myelin Immune-Mediated Disease T Cells ...

  10. Undergraduate nursing students' performance in recognising and responding to sudden patient deterioration in high psychological fidelity simulated environments: an Australian multi-centre study.

    Science.gov (United States)

    Bogossian, Fiona; Cooper, Simon; Cant, Robyn; Beauchamp, Alison; Porter, Joanne; Kain, Victoria; Bucknall, Tracey; Phillips, Nicole M

    2014-05-01

    Early recognition and situation awareness of sudden patient deterioration, a timely appropriate clinical response, and teamwork are critical to patient outcomes. High fidelity simulated environments provide the opportunity for undergraduate nursing students to develop and refine recognition and response skills. This paper reports the quantitative findings of the first phase of a larger program of ongoing research: Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACTTM). It specifically aims to identify the characteristics that may predict primary outcome measures of clinical performance, teamwork and situation awareness in the management of deteriorating patients. Mixed-method multi-centre study. High fidelity simulated acute clinical environment in three Australian universities. A convenience sample of 97 final year nursing students enrolled in an undergraduate Bachelor of Nursing or combined Bachelor of Nursing degree were included in the study. In groups of three, participants proceeded through three phases: (i) pre-briefing and completion of a multi-choice question test, (ii) three video-recorded simulated clinical scenarios where actors substituted real patients with deteriorating conditions, and (iii) post-scenario debriefing. Clinical performance, teamwork and situation awareness were evaluated, using a validated standard checklist (OSCE), Team Emergency Assessment Measure (TEAM) score sheet and Situation Awareness Global Assessment Technique (SAGAT). A Modified Angoff technique was used to establish cut points for clinical performance. Student teams engaged in 97 simulation experiences across the three scenarios and achieved a level of clinical performance consistent with the experts' identified pass level point in only 9 (1%) of the simulation experiences. Knowledge was significantly associated with overall teamwork (p=.034), overall situation awareness (p=.05) and clinical performance in two of the three scenarios

  11. Quantitative assessment of metal dysregulation in β-thalassemia patients in comparison with healthy controls by ICP-MS and chemometric analyses.

    Science.gov (United States)

    Farooq, Sabiha; Mazhar, Wardah; Siddiqui, Amna Jabbar; Ansari, Saqib Hussain; Musharraf, Syed Ghulam

    2018-01-31

    β-Thalassemia is one of the most common inherited disorders and is widely distributed throughout the world. Owing to severe deficiencies in red blood cell production, blood transfusion is required to correct anemia for normal growth and development but causes additional complications owing to iron overload. The aim of this study is to quantify the biometal dysregulations in β-thalassemia patients as compared with healthy controls. A total of 17 elements were analyzed in serum samples of β-thalassemia patients and healthy controls using ICP-MS followed by chemometric analyses. Out of these analyzed elements, 14 showed a significant difference between healthy and disease groups at p 3. A PLS-DA model revealed an excellent separation with 89.8% sensitivity and 97.2% specificity and the overall accuracy of the model was 92.2%. This metallomic study revealed that there is major difference in metallomic profiling of β-thalassemia patients specifically in Co, Mn, Ni, V and Ba, whereas the fold changes in Co, Mn, V and Ba were found to be greater than that in Fe, providing evidence that, in addition to Fe, other metals are also altered significantly and therefore chelation therapy for other metals may also needed in β-thalassemia patients. Copyright © 2018 John Wiley & Sons, Ltd.

  12. Walking speed, rather than Expanded Disability Status Scale, relates to long-term patient-reported impact in progressive MS

    NARCIS (Netherlands)

    Bosma, L.V.A.E.; Kragt, J.J.; Polman, C.H.; Uitdehaag, B.M.J.

    2013-01-01

    Objective: To study the relationships between 1-2 year changes in well-known physician-rated measurements (Expanded Disability Status Scale (EDSS), Timed 25-Foot Walk (T25FW), 9-Hole Peg Test (9HPT)) and the long-term (= 5 years) outcome in patient-reported outcome (PRO) measures (Multiple Sclerosis

  13. Clinical and social characteristics associated with reduced visual acuity at presentation in Australian patients with neovascular age-related macular degeneration: a prospective study from a long-term observational data set. The Fight Retinal Blindness! Project.

    Science.gov (United States)

    Nguyen, Vuong; Daien, Vincent; Guymer, Robyn H; McAllister, Ian L; Morlet, Nigel; Barthelmes, Daniel; Gillies, Mark C

    2018-04-01

    Identifying variables that influence presenting visual acuity (VA) in patients with neovascular age-related macular degeneration (nAMD) is important because it is a strong predictor of long-term outcomes. To assess the clinical and social characteristics associated with low presenting VA in nAMD patients. The present study is a cross-sectional analysis from a prospective, observational database. We identified 3242 treatment-naïve patients from 54 Australian practices in the Fight Retinal Blindness! registry. Age, gender, ethnicity and VA were recorded at the baseline visit. Socio-economic status was determined using the Australian Bureau of Statistics socio-economic indexes for areas. Association between clinical and socio-economic characteristics with presenting VA was identified. Poor VA (≤35 letters) in the presenting eye was associated with older age (adjusted odds ratio [AOR]: 1.33 for patients aged ≥80 years vs. <80 years [95% confidence interval, CI: 1.04, 1.71]), treatment at a public practice (AOR: 1.91 for public vs. private practices [95% CI: 1.46, 2.50]) and intermediate (36-69 letters) VA in the fellow eye (AOR: 0.67 [95% CI: 0.47, 0.95] and 0.64 [95% CI: 0.48, 0.85] for poor [≤35 letters] and good [≥70 letters] VA vs. intermediate VA in the fellow eye). Gender, ethnicity and socio-economic status were not independently associated with VA at presentation. Poor presenting vision is detrimental to the long-term outcomes of nAMD. Poor presentation of nAMD in Australia may not be related to socio-economic circumstances, but due to systems of care. Further research is warranted to determine why patients at public practices present with worse vision compared with private practices in Australia. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

  14. Australian national proton facility

    International Nuclear Information System (INIS)

    Jackson, M.

    2000-01-01

    important in children and other long-term survivors. When used with chemotherapy, the lower dose to normal tissue will reduce acute toxicity and the risk of second malignancies. It may also be possible to use a smaller number of radiotherapy fractions and thus reduce the total cost of treatment. With the development of more compact and reliable accelerators it is now possible to realistically plan for proton therapy in an Australian hospital. The Australian National Proton Project has been formed to look at the feasibility of such a facility, which would be primarily for patient treatment but would also be suitable for research and commercial applications. A detailed report will be produced early next year. This presentation will outline the planned facility that would have a combination of fixed and rotating beams with an energy range of 70-250 MeV. Such a centre would enable the conduct of randomised trials and a comparison with other radiotherapy techniques such as Intensity Modulated Radiation Therapy. The beam would be available for physics, engineering and biological research

  15. The Australian synchrotron

    International Nuclear Information System (INIS)

    Farhi, R.

    2005-06-01

    This document recalls the historical aspects of the Australian Synchrotron which will be implemented in 2007. It presents then the objectives of this program, the specifications of the ring and the light lines. (A.L.B.)

  16. Australian road rules

    Science.gov (United States)

    2009-02-01

    *These are national-level rules. Australian Road Rules - 2009 Version, Part 18, Division 1, Rule 300 "Use of Mobile Phones" describes restrictions of mobile phone use while driving. The rule basically states that drivers cannot make or receive calls ...

  17. Washability of Australian coals

    Energy Technology Data Exchange (ETDEWEB)

    Whitmore, R L

    1979-06-01

    Australian coals tend to be young in geological age and high in ash by world standards; preparation of the coal before marketing is almost universal. On the basis of float and sink data from 39 locations in the eastern Australian coalfields, the coals are place in four categories representing increasing difficulty in their washability characteristics. These seem to be related neither to the geological age nor the geographical position of the deposit and Hunter Valley coals, for example, span all categories. The influence of crushing on the washability of Australian coals is briefly considered and from limited data it is concluded to be appreciably smaller than for British or North American coals. A strategy for the float and sink analysis of Australian coals is proposed and the influence of washability characteristics on current trends in the selection of separating processes for coking and steaming products is discussed.

  18. Progression in familial and nonfamilial MS

    NARCIS (Netherlands)

    Koch, Marcus; Uyttenboogaart, Maarten; Heerings, Marco; Heersema, Dorothea; Mostert, Jop; De Keyser, Jacques

    Objective To investigate whether the timing of secondary or primary progression is different between patients with familial and nonfamilial multiple sclerosis (MS). Methods Information on the family history of 313 patients with MS was taken from our prospective hospital-based database. We used

  19. Australianness as fairness

    DEFF Research Database (Denmark)

    Plage, Stefanie; Willing, Indigo; Skrbis, Zlatko

    2017-01-01

    This article provides an account of interwoven and often competing repertoires of cosmopolitanism and nationalism on which Australians draw when encountering diversity. Using interview and focus group data the article first explores how the notion of Australianness grounded in civic virtues such ......-go’ principle at times conceptually overlaps with cosmopolitan ethics. However, it also bears the potential to hinder cosmopolitan practices. Ultimately national and cosmopolitan ethical frameworks have to be interrogated simultaneously when applied to micro-level interactions....

  20. Australian Aboriginal Astronomy: Overview

    OpenAIRE

    Norris, Ray P.; Hamacher, Duane W.

    2013-01-01

    The traditional cultures of Aboriginal Australians include a significant astronomical component, perpetuated through oral tradition, ceremony, and art. This astronomical component includes a deep understanding of the motion of objects in the sky, and this knowledge was used for practical purposes, such as constructing calendars. There is also evidence that traditional Aboriginal Australians made careful records and measurements of cyclical phenomena, paid careful attention to unexpected pheno...

  1. The salivary proteome profile in patients affected by SAPHO syndrome characterized by a top-down RP-HPLC-ESI-MS platform.

    Science.gov (United States)

    Sanna, Monica; Firinu, Davide; Manconi, Paolo Emilio; Pisanu, Maria; Murgia, Giuseppe; Piras, Valentina; Castagnola, Massimo; Messana, Irene; del Giacco, Stefano Renato; Cabras, Tiziana

    2015-06-01

    SAPHO syndrome is a rare and often unrecognized disease with prominent inflammatory cutaneous and articular symptoms characterized by musculoskeletal manifestations (synovitis, hyperostosis, osteomyelitis) associated with dermatological conditions (severe acne and pustulosis). The acidic soluble fraction of whole saliva from 10 adult women affected by SAPHO syndrome and from a group of 28 healthy women was analysed by RP-HPLC-ESI-MS with the aim of discovering salivary biomarkers of the disorder. The levels of the oral proteins and peptides were correlated with clinical data. The following proteins showed a significant decreased concentration in saliva of SAPHO subjects with respect to controls: cystatin S1 and SN, histatins, the major acidic PRPs, P-C and P-B peptides. The cystatin SN abundance lowered according to the disease duration and histatins showed positive correlations with the C reactive protein. Statistical analysis performed excluding one patient with a different pattern of salivary proteins/peptides highlighted a positive relationship between cystatin S1, histatins 3, histatin 5, and the neutrophil count. Moreover, histatin 3 correlated positively with the total white cell count and negatively with the erythrocyte sedimentation rate. Levels and frequency of S100A12 protein showed a trend to increase in SAPHO patients. The high expression of this pro-inflammatory protein is probably related to the inflammatory response and to the altered neutrophil responses to functional stimuli that characterize SAPHO syndrome suggesting a possible application as a salivary biomarker.

  2. MS in Your Relationships

    Science.gov (United States)

    ... MS Relationships Share this page Facebook Twitter Email Relationships MS poses additional challenges, but it also enriches ... when it is not. Keeping balance in your relationship When one person in a couple is affected ...

  3. Progression and CSF Inflammation after Eradication of Oligoclonal Bands in an MS Patient Treated with Allogeneic Hematopoietic Cell Transplantation for Follicular Lymphoma

    DEFF Research Database (Denmark)

    Braendstrup, P; Langkilde, Annika; Schreiber, K

    2012-01-01

    Allogeneic hematopoietic cell transplantation (allo-HCT) has been proposed as treatment for multiple sclerosis (MS) and other autoimmune diseases.......Allogeneic hematopoietic cell transplantation (allo-HCT) has been proposed as treatment for multiple sclerosis (MS) and other autoimmune diseases....

  4. Feasibility of asymmetric flow field-flow fractionation coupled to ICP-MS for the characterization of wear metal particles and metalloproteins in biofluids from hip replacement patients

    DEFF Research Database (Denmark)

    Löschner, Katrin; Harrington, Chris F.; Kearney, Jacque-Lucca

    2015-01-01

    or other elements, but the current analytical methods used to investigate the processes involved do not provide sufficient information to understand the size or composition of the wear particles generated in vivo. In this qualitative feasibility study, asymmetric flow field-flow fractionation (AF4) coupled...... to ICP-MS was used to confirm the metal–protein associations in the serum samples. Off-line single particle ICP-MS (spICP-MS) analysis was used to confirm the approximate size distribution indicated by AF4 of the wear particles in hip aspirates. In the serum samples, AF4–ICP-MS suggested that Cr...... unidentified compounds; AEC analysis confirmed the Cr results and the association of Co with Alb and a second compound. Enzymatic digestion of the hip aspirate sample, followed by separation using AF4 with detection by UV absorption (280 nm), multi-angle light scattering and ICP-MS, suggested that the sizes...

  5. Promoting lifestyle changes for Chinese Australians with Type 2 diabetes

    OpenAIRE

    SUET TING CHOI

    2017-01-01

    Providing translated diabetes education from English to Chinese is not enough to promote healthy lifestyle changes among Chinese Australians with type 2 diabetes. This thesis explored the behaviour patterns of Chinese patients during diabetes education and identified the most successful education approaches. The research involved a review of literature and an exploratory qualitative study across three countries. The findings suggest health professionals working with Chinese Australian patient...

  6. Clinical predictive value of the ABCD2 score for early risk of stroke in patients who have had transient ischaemic attack and who present to an Australian tertiary hospital.

    Science.gov (United States)

    Sanders, Lauren M; Srikanth, Velandai K; Psihogios, Helen; Wong, Kitty K; Ramsay, David; Phan, Thanh G

    2011-02-07

    To determine the predictive value of the ABCD(2) score for early risk of stroke in Australian patients who have had transient ischaemic attack (TIA). Cohort study of 512 consecutive patients with suspected TIA referred by the emergency department to the acute stroke unit (in accordance with the TIA pathway) of an urban tertiary hospital in Melbourne, Victoria, between 1 June 2004 and 30 November 2007. Overall accuracy, estimated by the area under the curve (AUC) of receiver operating characteristic plots (of true positive rate v false positive rate), and sensitivity, specificity, predictive values and likelihood ratios at prespecified cut-off ABCD(2) scores for stroke within 2, 7 and 90 days. 24 patients were excluded because their symptoms lasted more than 24 hours. All included patients were reviewed by a stroke physician; TIA was confirmed in 301/488 (61.7%). Most (289/301; 96.0%) had complete follow-up. Stroke occurred in 4/292 patients (1.37%; 95% CI, 0.37%-3.47%) within 2 days and 7/289 (2.42%; 95% CI, 0.98%-4.93%) within 90 days; no patient had a stroke between 2 and 7 days. The AUCs for stroke in patients with confirmed TIA were 0.80 (95% CI, 0.68-0.91) and 0.62 (95% CI, 0.40-0.83) for stroke within 2 days and 90 days, respectively. At a cut-off of ≥ 5, the ABCD(2) score had modest specificity for stroke within 2 days (0.58) and 90 days (0.58), but positive predictive values (2 days, 0.03; 90 days, 0.04) and positive likelihood ratios (2 days, 2.40; 90 days, 1.71) were both poor. The score performed similarly poorly at other prespecified cut-off scores. Given its poor predictive value, the use of the ABCD(2) score alone may not be dependable for guiding clinical treatment decisions or service organisation in an Australian tertiary setting. Validation in other Australian settings is recommended before it can be applied with confidence.

  7. Current status of cannabis treatment of multiple sclerosis with an illustrative case presentation of a patient with MS, complex vocal tics, paroxysmal dystonia, and marijuana dependence treated with dronabinol.

    Science.gov (United States)

    Deutsch, Stephen I; Rosse, Richard B; Connor, Julie M; Burket, Jessica A; Murphy, Mary E; Fox, Fiona J

    2008-05-01

    Pain, spasticity, tremor, spasms, poor sleep quality, and bladder and bowel dysfunction, among other symptoms, contribute significantly to the disability and impaired quality of life of many patients with multiple sclerosis (MS). Motor symptoms referable to the basal ganglia, especially paroxysmal dystonia, occur rarely and contribute to the experience of distress. A substantial percentage of patients with MS report subjective benefit from what is often illicit abuse of extracts of the Cannabis sativa plant; the main cannabinoids include delta-9-tetrahydrocannabinol (delta9-THC) and cannabidiol. Clinical trials of cannabis plant extracts and synthetic delta9-THC provide support for therapeutic benefit on at least some patient self-report measures. An illustrative case is presented of a 52-year-old woman with MS, paroxysmal dystonia, complex vocal tics, and marijuana dependence. The patient was started on an empirical trial of dronabinol, an encapsulated form of synthetic delta9-THC that is usually prescribed as an adjunctive medication for patients undergoing cancer chemotherapy. The patient reported a dramatic reduction of craving and illicit use; she did not experience the "high" on the prescribed medication. She also reported an improvement in the quality of her sleep with diminished awakenings during the night, decreased vocalizations, and the tension associated with their emission, decreased anxiety and a decreased frequency of paroxysmal dystonia.

  8. The role of EBV in MS pathogenesis

    DEFF Research Database (Denmark)

    Christensen, Tove

    2006-01-01

    Environmental factors operate on a background of genetic susceptibility in the pathogenesis of MS. Human herpesviruses, notably Epstein-Barr virus (EBV), and human endogenous retroviruses are factors associated with MS. EBV association is found in epidemiological surveys where late EBV infection...... confers a higher risk of MS, and EBV reactivation also appears to be linked to disease activity in early MS. MS patients have elevated anti-EBV antibody responses, both in serum and cerebrospinal fluid. Molecular mimicry is found between certain EBV and myelin epitopes in the cell-mediated immune response....... EBV cannot stand alone as a causal factor of MS, but is likely to play an indirect role as an activator of the underlying disease process....

  9. Australian Hackers and Ethics

    OpenAIRE

    M.J. Warren; W. Hutchinson

    2003-01-01

    The aim of the paper is to look at the way hackers act and ways in which society can protect itself. The paper will show the current views and attitudes of hackers in an Australian context. The paper will also include a case study to show how a hacking incident can develop and how technology can be used to protect against hacking.

  10. Australian uranium industry

    Energy Technology Data Exchange (ETDEWEB)

    Warner, R K

    1976-04-01

    Various aspects of the Australian uranium industry are discussed including the prospecting, exploration and mining of uranium ores, world supply and demand, the price of uranium and the nuclear fuel cycle. The market for uranium and the future development of the industry are described.

  11. Australian uranium today

    International Nuclear Information System (INIS)

    Fisk, B.

    1978-01-01

    The subject is covered in sections, entitled: Australia's resources; Northern Territory uranium in perspective; the government's decision [on August 25, 1977, that there should be further development of uranium under strictly controlled conditions]; Government legislation; outlook [for the Australian uranium mining industry]. (U.K.)

  12. Australian Film Studies.

    Science.gov (United States)

    Breen, Myles P.

    Although Australia had a vigorous film industry in the silent film era, it was stifled in the 1930s when United States and British interests bought up the Australian distribution channels and closed down the indigenous industry. However, the industry and film study have undergone a renaissance since the advent of the Labor government in 1972,…

  13. Quantification by SIFT-MS of volatile compounds emitted by in vitro cultures of S. aureus, S. pneumoniae and H. influenzae isolated from patients with respiratory diseases

    Czech Academy of Sciences Publication Activity Database

    Chippendale, T. W. E.; Gilchrist, F. J.; Španěl, Patrik; Alcock, A.; Lenney, W.; Smith, D.

    2014-01-01

    Roč. 6, č. 8 (2014), s. 2460-2472 ISSN 1759-9660 Institutional support: RVO:61388955 Keywords : SIFT-MS * breath analysis * analytical methods Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 1.821, year: 2014

  14. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... d Living Well with MS d Diet, Exercise & Healthy Behaviors Diet & Nutrition Exercise Heat & Temperature Sensitivity Sleep Vaccinations Women's Health Unhealthy Habits Managing MS and Another Condition Aging with MS Anesthesia and Surgery Managing Your MS ...

  15. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Definition of MS Myelin Immune-Mediated Disease T Cells d What Causes MS? Disproved Theories Viruses Clusters ... d Research News & Progress Research News MSPARIS2017 Stem Cells in MS Progressive MS Research Clinical Trials in ...

  16. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... to navigation Skip to content Menu Navigation National Multiple Sclerosis Society Sign In In Your Area Donate Donate ... of MS What Causes MS? Who Gets MS? Multiple Sclerosis FAQs Types of MS Related Conditions Symptoms & Diagnosis ...

  17. Sensitivity of GC-EI/MS, GC-EI/MS/MS, LC-ESI/MS/MS, LC-Ag(+) CIS/MS/MS, and GC-ESI/MS/MS for analysis of anabolic steroids in doping control.

    Science.gov (United States)

    Cha, Eunju; Kim, Sohee; Kim, Ho Jun; Lee, Kang Mi; Kim, Ki Hun; Kwon, Oh-Seung; Lee, Jaeick

    2015-01-01

    This study compared the sensitivity of various separation and ionization methods, including gas chromatography with an electron ionization source (GC-EI), liquid chromatography with an electrospray ionization source (LC-ESI), and liquid chromatography with a silver ion coordination ion spray source (LC-Ag(+) CIS), coupled to a mass spectrometer (MS) for steroid analysis. Chromatographic conditions, mass spectrometric transitions, and ion source parameters were optimized. The majority of steroids in GC-EI/MS/MS and LC-Ag(+) CIS/MS/MS analysis showed higher sensitivities than those obtained with other analytical methods. The limits of detection (LODs) of 65 steroids by GC-EI/MS/MS, 68 steroids by LC-Ag(+) CIS/MS/MS, 56 steroids by GC-EI/MS, 54 steroids by LC-ESI/MS/MS, and 27 steroids by GC-ESI/MS/MS were below cut-off value of 2.0 ng/mL. LODs of steroids that formed protonated ions in LC-ESI/MS/MS analysis were all lower than the cut-off value. Several steroids such as unconjugated C3-hydroxyl with C17-hydroxyl structure showed higher sensitivities in GC-EI/MS/MS analysis relative to those obtained using the LC-based methods. The steroids containing 4, 9, 11-triene structures showed relatively poor sensitivities in GC-EI/MS and GC-ESI/MS/MS analysis. The results of this study provide information that may be useful for selecting suitable analytical methods for confirmatory analysis of steroids. Copyright © 2015 John Wiley & Sons, Ltd.

  18. Significance of MRI Perivascular Spaces in MS

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2008-10-01

    Full Text Available The role of perivascular Virchow-Robin spaces was investigated in 45 multiple sclerosis (MS patients and 30 healthy controls, in a study at Charite-Universitaetsmedizin Berlin, and Goethe University, Frankfurt.

  19. Survey of a community-based infusion program for Australian patients with rheumatoid arthritis requiring treatment with tocilizumab: patient characteristics and drivers of patient satisfaction and patient-perceived benefits and concerns

    Directory of Open Access Journals (Sweden)

    Voight L

    2012-04-01

    Full Text Available Louisa VoightCoast Joint Care, Maroochydore, Queensland, AustraliaBackground: Tocilizumab is an effective therapy for patients with moderate to severe rheumatoid arthritis that is administered by infusion over one hour every 4 weeks. The community-based infusion (ACTiv program was introduced to Australia in August 2010 to provide accessible and convenient treatment for patients with rheumatoid arthritis who require tocilizumab. The primary objectives of this study were to determine the characteristics of patients in the ACTiv program, patient satisfaction, and patient-perceived benefits and concerns with the ACTiv program, and drivers of patient satisfaction and patient-perceived benefits and concerns.Methods: A voluntary self-administered survey was given to all 608 patients in the ACTiv program between January 27, 2011 and March 31, 2011.Results: A total of 351 surveys were returned completed, giving a response rate of 58% (351/608. Most patients in the ACTiv program were women aged 40–64 years, with a mean disease duration of 13.7 years and moderate disability, who had been in the ACTiv program for ≥5 months. Most patients (88%, 302/342 were either very satisfied or satisfied with the ACTiv program and believed that they were very unlikely or somewhat unlikely to switch from the ACTiv program (64%, 214/335. The most important benefit was the reassurance of receiving treatment from a trained nurse in a professional medical environment (33%, 102/309. The most important concern was the fear of side effects (48%, 134/280. The main drivers of patient satisfaction and patient-perceived benefits and concerns of patients were health profile, previous medication experience, and length of treatment time in the program.Conclusion: The ACTiv program is used by patients of various ages, family life situations, and locations. Patient satisfaction with the program is high, which enables patients to benefit from long-term use of tocilizumab

  20. Ms. Mentor Unmasked

    Science.gov (United States)

    Krebs, Paula

    2008-01-01

    This article presents an interview with Emily Toth, who writes the monthly "Ms. Mentor" academic advice column in the "Chronicle of Higher Education" and teaches in the English department at Louisiana State University, in Baton Rouge. She is the author of "Ms. Mentor's Impeccable Advice for Women in Academia" (1997), "Inside Peyton Place: The Life…

  1. Exploring the professional values of Australian physiotherapists.

    Science.gov (United States)

    Aguilar, Alejandra; Stupans, Ieva; Scutter, Sheila; King, Sharron

    2013-03-01

    A profession's values guide daily practice and professional behaviours. They clarify what professionalism means to a profession, by providing insight into the values that members of the profession aim to uphold and profess. There has been limited research into the values of the Australian physiotherapy profession, and as such, the values that guide practice and constitute professionalism are not explicit. This study aimed to make a preliminary identification of the values of the profession, by exploring the shared professional values of 14 Australian physiotherapists. This study was guided by a qualitative approach and constructivist paradigm. Purposive sampling was employed to identify physiotherapists who could contribute rich information to the study. Semi-structured interviews were conducted and analysed using an inductive data analysis method. The emerging professional values formed three main themes. The first theme, 'the patient and the patient-therapist partnership', incorporated values such as having patient trust and working collaboratively with patients. The theme labelled 'physiotherapy knowledge, skills and practice' included the values of having an evidence base and respecting professional boundaries. The last theme, 'altruistic values', was inclusive of values such as honesty, empathy and caring. The values that emerged went beyond philanthropic values, to values that guided every day practice, professional relationships and the responsibilities of being a professional. The results contribute to research orientated towards identifying the values of the profession and in doing so, clarifying what professionalism means to the Australian physiotherapy profession. Differences between the values identified by the American Physical Therapy Association and the study reported in this paper highlight the importance of identifying the values of the profession within the Australian context. In terms of practice implications, physiotherapists may be prompted to

  2. Survey of diagnostic and treatment practices for multiple sclerosis (MS) in Europe. Part 2: Progressive MS, paediatric MS, pregnancy and general management.

    Science.gov (United States)

    Fernández, O; Delvecchio, M; Edan, G; Fredrikson, S; Giovannoni, G; Hartung, H-P; Havrdova, E; Kappos, L; Pozzilli, C; Soerensen, P S; Tackenberg, B; Vermersch, P; Comi, G

    2018-05-01

    The European Charcot Foundation supported the development of a set of surveys to understand current practice patterns for the diagnosis and management of multiple sclerosis (MS) in Europe. Part 2 of the report summarizes survey results related to secondary progressive MS (SPMS), primary progressive MS (PPMS), pregnancy, paediatric MS and overall patient management. A steering committee of MS neurologists developed case- and practice-based questions for two sequential surveys distributed to MS neurologists throughout Europe. Respondents generally favoured changing rather than stopping disease-modifying treatment (DMT) in patients transitioning from relapsing-remitting MS to SPMS, particularly with active disease. Respondents would not initiate DMT in patients with typical PPMS symptoms, although the presence of ≥1 spinal cord or brain gadolinium-enhancing lesion might affect that decision. For patients considering pregnancy, respondents were equally divided on whether to stop treatment before or after conception. Respondents strongly favoured starting DMT in paediatric MS with active disease; recommended treatments included interferon, glatiramer acetate and, in John Cunningham virus negative patients, natalizumab. Additional results regarding practice-based questions and management are summarized. Results of part 2 of the survey of diagnostic and treatment practices for MS in Europe largely mirror results for part 1, with neurologists in general agreement about the treatment and management of SPMS, PPMS, pregnancy and paediatric MS as well as the general management of MS. However, there are also many areas of disagreement, indicating the need for evidence-based recommendations and/or guidelines. © 2018 EAN.

  3. Australian Hackers and Ethics

    Directory of Open Access Journals (Sweden)

    M.J. Warren

    2003-05-01

    Full Text Available The aim of the paper is to look at the way hackers act and ways in which society can protect itself. The paper will show the current views and attitudes of hackers in an Australian context. The paper will also include a case study to show how a hacking incident can develop and how technology can be used to protect against hacking.

  4. Australian synchrotron radiation science

    International Nuclear Information System (INIS)

    White, J.W.

    1996-01-01

    Full text: The Australian Synchrotron Radiation Program, ASRP, has been set up as a major national research facility to provide facilities for scientists and technologists in physics, chemistry, biology and materials science who need access to synchrotron radiation. Australia has a strong tradition in crystallography and structure determination covering small molecule crystallography, biological and protein crystallography, diffraction science and materials science and several strong groups are working in x-ray optics, soft x-ray and vacuum ultra-violet physics. A number of groups whose primary interest is in the structure and dynamics of surfaces, catalysts, polymer and surfactant science and colloid science are hoping to use scattering methods and, if experience in Europe, Japan and USA can be taken as a guide, many of these groups will need third generation synchrotron access. To provide for this growing community, the Australian National Beamline at the Photon Factory, Tsukuba, Japan, has been established since 1990 through a generous collaboration with Japanese colleagues, the beamline equipment being largely produced in Australia. This will be supplemented in 1997 with access to the world's most powerful synchrotron x-ray source at the Advanced Photon Source, Argonne National Laboratory, USA. Some recent experiments in surface science using neutrons as well as x-rays from the Australian National Beamline will be used to illustrate one of the challenges that synchrotron x-rays may meet

  5. Development of a label-free LC-MS/MS strategy to approach the identification of candidate protein biomarkers of disease recurrence in prostate cancer patients in a clinical trial of combined hormone and radiation therapy.

    LENUS (Irish Health Repository)

    Morrissey, Brian

    2013-06-01

    Combined hormone and radiation therapy (CHRT) is one of the principle curative regimes for localised prostate cancer (PCa). Following treatment, many patients subsequently experience disease recurrence however; current diagnostics tests fail to predict the onset of disease recurrence. Biomarkers that address this issue would be of significant advantage.

  6. Medium-chain acyl-CoA dehydrogenase (MCAD) mutations identified by MS/MS-based prospective screening of newborns differ from those observed in patients with clinical symptoms

    DEFF Research Database (Denmark)

    Andresen, B S; Dobrowolski, S F; O'Reilly, L

    2001-01-01

    Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency is the most frequently diagnosed mitochondrial beta-oxidation defect, and it is potentially fatal. Eighty percent of patients are homozygous for a common mutation, 985A-->G, and a further 18% have this mutation in only one disease allele. In a...

  7. Examination using LC-MS/MS determination of grayanotoxin levels in blood, urine, and honey consumed by patients presenting to the emergency department with mad honey intoxication and relations with clinical data: a preliminary study.

    Science.gov (United States)

    Aygun, Ali; Gunduz, Abdulkadir; Turedi, Suleyman; Turkmen, Suha; Karaca, Yunus; Ayaz, Faik Ahmet; Ahn, Su Youn; Kim, Suncheun

    2015-01-01

    Intoxications related to "mad honey" are frequently encountered in the Black Sea region of Turkey. Intoxication is established on the basis of whether honey was consumed when history was taken at presentation. The search for a simple and reliable method for showing the grayanotoxins (GTXs) in mad honey in body fluids and in honey consumed by patients is still at the research stage. The purpose of this preliminary study was to investigate GTX levels in blood, urine, and honey consumed by patients with mad honey intoxication and to determine whether there is an association with clinical status. This descrptive study was conducted at the department of Emergency Medicine of Karadeniz Technical University Medical Faculty in Turkey. Mad honey, blood, and urine samples were obtained from patients between September 2013 and October 2014. Four cases presenting the Department of Emergency Medicine and diagnosed with mad honey intoxication were included in the study. GTX levels in blood, urine, and honey consumed by patients were determined using liquid chromatography-tandem mass spectrometry. Patients' mean blood GTX I level was 30.62 ng/mL, GTX III level 4.917 ng/mL, urine GTX I level 0.447 mg/mL, and GTX III level 1.998 mg/mL. The mean GTX I level in the honey samples consumed was 4.683 mg/g and GTX III level 8.423 mg/g. The present study is unique in representing the first time that GTXs have been determined in human body fluids. There is now an urgent need for a large series of studies to provide statistical evidence whether there is a relationship between levels of toxins in human body fluids and clinical picture.

  8. Human herpesviruses and MS

    DEFF Research Database (Denmark)

    Christensen, Tove

    2007-01-01

    and they are capable of reactivation. Epstein Barr virus (EBV), HHV-6A and varicella zoster virus (VZV) are consistently linked with MS, particularly with respect to epidemiology, antibody responses in serum (EBV) and cerebrospinal fluid (EBV and HHV-6A), and with MS exacerbations that are associated with viral...... reactivation (VZV, HHV-6A and EBV). HHV have the potential for a causal role in MS--they may be key players in the disease process--and this role could be mediated through several direct or indirect mechanisms....

  9. Physical Exercise and MS Recommendations

    DEFF Research Database (Denmark)

    Dalgas, U; Ingemann-Hansen, T; Stenager, E

    2009-01-01

    in a number of physiological functions, which ultimately can lead to functional improvements that have a positive effect on a patients daily life. The purpose of this review is, based on the existing research, to provide clinicians with some easily administrable recommendations for the application of exercise......The use of physical exercise programmes in the rehabilitation of patients with multiple sclerosis (MS) has been a controversial issue for many years. During the last decade, however, evidence from a number of studies has suggested that exercise is a safe and efficient way to induce improvements...

  10. Conditions for Australian consent to reprocessing

    International Nuclear Information System (INIS)

    Anon.

    1980-01-01

    This article contains the text of the statement by the Australian Minister for Foreign Affairs to the House of Representatives, Noember 1980, on conditions for Australian consent to the reprocessing of nuclear material of Australian origin

  11. Living with Advanced MS

    Science.gov (United States)

    ... Diet, Exercise & Healthy Behaviors Diet & Nutrition Exercise Heat & Temperature Sensitivity Sleep Vaccinations Women's Health Unhealthy Habits Managing ... as well as other resources in your area. Learning to redefine control and independence Sometimes MS symptoms ...

  12. MS Based Metabonomics

    Energy Technology Data Exchange (ETDEWEB)

    Want, Elizabeth J.; Metz, Thomas O.

    2010-03-01

    Metabonomics is the latest and least mature of the systems biology triad, which also includes genomics and proteomics, and has its origins in the early orthomolecular medicine work pioneered by Linus Pauling and Arthur Robinson. It was defined by Nicholson and colleagues in 1999 as the quantitative measurement of perturbations in the metabolite complement of an integrated biological system in response to internal or external stimuli, and is often used today to describe many non-global types of metabolite analyses. Applications of metabonomics are extensive and include toxicology, nutrition, pharmaceutical research and development, physiological monitoring and disease diagnosis. For example, blood samples from millions of neonates are tested routinely by mass spectrometry (MS) as a diagnostic tool for inborn errors of metabolism. The metabonome encompasses a wide range of structurally diverse metabolites; therefore, no single analytical platform will be sufficient. Specialized sample preparation and detection techniques are required, and advances in NMR and MS technologies have led to enhanced metabonome coverage, which in turn demands improved data analysis approaches. The role of MS in metabonomics is still evolving as instrumentation and software becomes more sophisticated and as researchers realize the strengths and limitations of current technology. MS offers a wide dynamic range, high sensitivity, and reproducible, quantitative analysis. These attributes are essential for addressing the challenges of metabonomics, as the range of metabolite concentrations easily exceeds nine orders of magnitude in biofluids, and the diversity of molecular species ranges from simple amino and organic acids to lipids and complex carbohydrates. Additional challenges arise in generating a comprehensive metabolite profile, downstream data processing and analysis, and structural characterization of important metabolites. A typical workflow of MS-based metabonomics is shown in Figure

  13. Review of Australian Higher Education: An Australian Policy Perspective

    Science.gov (United States)

    Montague, Alan

    2013-01-01

    Higher education is one of the key foundations that economic prosperity is founded upon. Government policies, funding and strategic planning require a fine balance to stimulate growth, prosperity health and well-being. The key Australian government policies influenced by a Review of Australian Higher Education report include attracting many more…

  14. Analysis of RET promoter CpG island methylation using methylation-specific PCR (MSP), pyrosequencing, and methylation-sensitive high-resolution melting (MS-HRM): impact on stage II colon cancer patient outcome.

    Science.gov (United States)

    Draht, Muriel X G; Smits, Kim M; Jooste, Valérie; Tournier, Benjamin; Vervoort, Martijn; Ramaekers, Chantal; Chapusot, Caroline; Weijenberg, Matty P; van Engeland, Manon; Melotte, Veerle

    2016-01-01

    Already since the 1990s, promoter CpG island methylation markers have been considered promising diagnostic, prognostic, and predictive cancer biomarkers. However, so far, only a limited number of DNA methylation markers have been introduced into clinical practice. One reason why the vast majority of methylation markers do not translate into clinical applications is lack of independent validation of methylation markers, often caused by differences in methylation analysis techniques. We recently described RET promoter CpG island methylation as a potential prognostic marker in stage II colorectal cancer (CRC) patients of two independent series. In the current study, we analyzed the RET promoter CpG island methylation of 241 stage II colon cancer patients by direct methylation-specific PCR (MSP), nested-MSP, pyrosequencing, and methylation-sensitive high-resolution melting (MS-HRM). All primers were designed as close as possible to the same genomic region. In order to investigate the effect of different DNA methylation assays on patient outcome, we assessed the clinical sensitivity and specificity as well as the association of RET methylation with overall survival for three and five years of follow-up. Using direct-MSP and nested-MSP, 12.0 % (25/209) and 29.6 % (71/240) of the patients showed RET promoter CpG island methylation. Methylation frequencies detected by pyrosequencing were related to the threshold for positivity that defined RET methylation. Methylation frequencies obtained by pyrosequencing (threshold for positivity at 20 %) and MS-HRM were 13.3 % (32/240) and 13.8 % (33/239), respectively. The pyrosequencing threshold for positivity of 20 % showed the best correlation with MS-HRM and direct-MSP results. Nested-MSP detected RET promoter CpG island methylation in deceased patients with a higher sensitivity (33.1 %) compared to direct-MSP (10.7 %), pyrosequencing (14.4 %), and MS-HRM (15.4 %). While RET methylation frequencies detected by nested

  15. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Disease T Cells d What Causes MS? Disproved Theories Viruses Clusters d Who Gets MS? Pediatric MS ... of Distinction Lawry Circle Circle of Influence d Planned Giving d Other Ways to Give Donate by ...

  16. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Disease T Cells d What Causes MS? Disproved Theories Viruses Clusters d Who Gets MS? Pediatric MS ... Review of Society's Research Programs d Careers d Leadership Board of Directors Senior Leadership Team Founder Sylvia ...

  17. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Disease T Cells d What Causes MS? Disproved Theories Viruses Clusters d Who Gets MS? Pediatric MS ... times as often as men; in PPMS, the number of women and men are approximately equal. RRMS ...

  18. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Disease T Cells d What Causes MS? Disproved Theories Viruses Clusters d Who Gets MS? Pediatric MS ... Community at MSconnection.org Join a Local Support Group Peer Connections: One-on-One Edward M. Dowd ...

  19. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Trials in MS Wellness and Lifestyle Research Diet Vitamin D How and Why Do Scientists Share Results ... The National MS Society is Here to Help Need More Information? We Are Here Our MS Navigators ...

  20. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... working effectively. How does RRMS differ from progressive types of MS? While RRMS is defined by attacks ... Pinterest MS Connection About the Society Vision Careers Leadership Cultural Values Financials News Press Room MS Prevalence ...

  1. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Viruses Clusters d Who Gets MS? Pediatric MS African Americans Hispanics & Latino/as d Multiple Sclerosis FAQs d ... Diet & Nutrition Exercise Heat & Temperature Sensitivity Sleep Vaccinations Women's Health Unhealthy Habits Managing MS and Another Condition ...

  2. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Disproved Theories Viruses Clusters d Who Gets MS? Pediatric MS African Americans Hispanics & Latino/as d Multiple ... Questions to Ask d Resources for Specific Populations Pediatric MS Support Veterans with Multiple Sclerosis d Find ...

  3. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Room Events at a Glance MS the Disease Public Service Announcements In the News Archives d MS ... For Professionals Researchers Physicians Nurses Rehabilitation Professionals Mental Health Professionals Health and Wellness Professionals What Is MS? ...

  4. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Conditions to Rule Out For Clinicians Treating MS Comprehensive Care Find an MS Care Provider Medications Managing ... ADEM) d For Clinicians d Treating MS d Comprehensive Care Developing a Healthcare Team Make the Most ...

  5. Australian research reactor studies

    International Nuclear Information System (INIS)

    McCulloch, D.B.

    1978-01-01

    The Australian AEC has two research reactors at the Lucas Heights Research Establishment, a 10 HW DIDO class materials testing reactor, HIFAR, and a smaller 100kW reactor MOATA, which was recently upgraded from 10kW power level. Because of the HIFAR being some 20 years old, major renewal and repair programmes are necessary to keep it operational. To enable meeting projected increases in demand for radioisotopes, plans for a new reactor to replace the HIFAR have been made and the design criteria are described in the paper. (author)

  6. Western Australian natural gas

    International Nuclear Information System (INIS)

    Harman, Frank

    1994-01-01

    Western Australia has 80% of Australia's natural gas resources. These are currently exploited to supply the Western Australian market and LNG to Japan. Growth in the market is dependent on limited prospects for power generation and mineral resource processing. Future exploitation of gas resources will require new export LNG markets and/or the installations of a transcontinental pipeline to eastern Australia. The transcontinental option should only be considered after other options for energy supply in eastern Australia are eliminated. Competition to meet market growth in North-east Asia will be considerable and Australia lacks the policies to underpin future LNG capacity. (author)

  7. Australian nuclear safeguards

    International Nuclear Information System (INIS)

    Kerin, J.C.

    1988-01-01

    The Australian Government considers that allegations made by the West German magazine - Der Spiegel in its January and February 1988 editions, flow from a lack of understanding of the complexities of international trade in nuclear materials, confusion between internal and international flag swaps and failure to comprehend the equivalence principle used in nuclear materials accounting. The Ministerial statement briefly outlines these issues and concludes that there is no evidence that any material subject to Australia's bilateral safeguards agreement has been diverted from peaceful uses or that Australia's safeguard requirements have been breached

  8. Australian methane fluxes

    International Nuclear Information System (INIS)

    Williams, D.J.

    1990-01-01

    Estimates are provided for the amount of methane emitted annually into the atmosphere in Australia for a variety of sources. The sources considered are coal mining, landfill, motor vehicles, natural gas suply system, rice paddies, bushfires, termites, wetland and animals. This assessment indicates that the major sources of methane are natural or agricultural in nature and therefore offer little scope for reduction. Nevertheless the remainder are not trival and reduction of these fluxes could play a significant part in any Australian action on the greenhouse problem. 19 refs., 7 tabs., 1 fig

  9. Australian University International Student Finances

    Science.gov (United States)

    Forbes-Mewett, Helen; Marginson, Simon; Nyland, Chris; Ramia, Gaby; Sawir, Erlenawati

    2009-01-01

    The omission of international students from the Australian Vice-Chancellor's Committee (AVCC) 2007 national study on student finances is indicative of a pattern of exclusion. The exclusion is unacceptable from a humane perspective and feeds the belief that Australians perceive international students primarily as "cash cows". This study…

  10. Australian health professionals' health website recommendation trends.

    Science.gov (United States)

    Usher, Wayne T

    2011-08-01

    This study was concerned with indentifying motivations and trends associated with a health website recommendation from eight of Australia's major health professions to the health consumer. Health professions included in this study are: psychiatrists, general practitioners, social workers, dietitians, chiropractors, physiotherapists, optometrists and pharmacists. An online survey (www.limesurvey.org) was developed from a common set of questions negotiated between all eight health professions. Survey questions were constructed in an attempt to identify participants' reasons for or against recommending a health website to a patient. A 5-point scale (not, slightly, neutral, moderately, strongly) to measure influence was used throughout the question set. This study indicates that Australian general practitioners (GPs) were the highest Australian health professionals to undertake a health website recommendation (86%), followed by psychiatrists (80%), with the lowest being physiotherapists (42%) and optometrists (33%). A profile of the Australian health professional who recommends a health website is identified as male, aged above 50 years, has had more than 10 years experience, works in a major city, is in private practice and has patient numbers exceeding 500 in a 12-month period (2009). Recommendations from this study include the need to develop mechanisms that identify high-quality online medical information and the development and implementation of Continuing Professional Development (CPD) courses which up-skill health professionals concerning the recommendation of health websites for health care delivery.

  11. Australian bat lyssavirus: implications for public health.

    Science.gov (United States)

    Francis, Joshua R; McCall, Bradley J; Hutchinson, Penny; Powell, Jodie; Vaska, Vikram L; Nourse, Clare

    2014-12-11

    Australian bat lyssavirus (ABLV) infection in humans is rare but fatal, with no proven effective therapy. ABLV infection can be prevented by administration of a post-exposure prophylaxis regimen of human rabies immunoglobulin and rabies vaccine. All Australian bats (flying foxes and microbats) should be considered to be carrying ABLV unless proven otherwise. Any bat-related injury (bite, scratch or mucosal exposure to bat saliva or neural tissue) should be notified immediately to the relevant public health unit - no matter how small the injury or how long ago it occurred. Human-to-human transmission of ABLV has not been reported but is theoretically possible. Standard infection control precautions should be employed when managing patients with suspected or confirmed ABLV infection.

  12. Long-term effects of childbirth in MS

    NARCIS (Netherlands)

    D'hooghe, M.B.; Nagels, G.; Uitdehaag, B.M.J.

    2010-01-01

    Background: The uncertainty about long-term effects of childbirth presents MS patients with dilemmas. Methods: Based on clinical data of 330 female MS patients, the long-term effects of childbirth were analysed, using a cross-sectional study design. Four groups of patients were distinguished: (1)

  13. Australians' use of surrogacy.

    Science.gov (United States)

    Everingham, Sam G; Stafford-Bell, Martyn A; Hammarberg, Karin

    2014-09-01

    To investigate the characteristics of parents and intended parents and their current and planned behaviour in relation to surrogacy arrangements. Members of two Australian parenting support forums who were considering surrogacy or were currently or previously in a surrogacy arrangement were invited to complete an online survey during July 2013. Sociodemographic characteristics; proportions engaging in domestic uncompensated and overseas compensated arrangements; countries used; costs incurred; and impact on behaviour of state laws criminalising compensated surrogacy. Of 1135 potential participants, 312 (27%) commenced the survey. Of these, 24 did not fulfil inclusion criteria and 29 did not complete the survey. Eighty-nine respondents were considering surrogacy and 170 had commenced or completed surrogacy. Many respondents (53%) considered both overseas and domestic surrogacy. Among those who only considered one option, overseas surrogacy was considered significantly more often than domestic surrogacy (92% v 8%; P surrogacy were India and the United States, and average total estimated costs were $69 212 for India and $172 347 for the US. Barriers discouraging domestic surrogacy included concern that the surrogate might keep the child (75%), belief that it was too long and complicated a process (68%) and having no one of the right age or life stage to ask (61%). Few intended parents (9%) were deterred by state laws criminalising compensated surrogacy. Most Australian intended parents via surrogacy consider or use overseas compensated arrangements. Laws banning compensated surrogacy do not appear to deter those seeking surrogacy arrangements.

  14. Serum amyloid beta peptides in patients with dementia and age-matched non-demented controls as detected by surface-enhanced laser desorption ionisation-time of flight mass spectrometry (SELDI-TOF MS).

    Science.gov (United States)

    Frankfort, Suzanne V; van Campen, Jos P C M; Tulner, Linda R; Beijnen, Jos H

    2008-09-01

    By using surface enhanced laser desorption/ionisation- time of flight mass spectrometry (SELDI-TOF MS) an amyloid beta (Abeta) profile was shown in cerebrospinal fluid (CSF) of patients with dementia. To investigate the Abeta-profile in serum with SELDI-TOF MS, to evaluate if this profile resembles CSF profiles and to investigate the correlation between intensity of Abeta-peptide-peaks in serum and clinical, demographical and genetic variables. Duplicate profiling of Abeta by an SELDI-TOF MS immunocapture assay was performed in 106 patients, suffering from Alzheimer's Disease or Vascular Dementia and age-matched non-demented control patients. Linear regression analyses were performed to investigate the intensities of four selected Abeta peaks as dependent variables in relation to the independent clinical, demographic or genetic variables. Abeta37, Abeta38 and Abeta40 were found among additional unidentified Abeta peptides, with the most pronounced Abeta peak at a molecular mass of 7752. This profile partly resembled the CSF profile. The clinical diagnosis was not a predictive independent variable, however ABCB1 genotypes C1236T, G2677T/A, age and creatinine level showed to be related to Abeta peak intensities in multivariate analyses. We found an Abeta profile in serum that partly resembled the CSF profile in demented patients. Age, creatinine levels, presence of the APOE epsilon4 allele and ABCB1 genotypes (C1236T and G2677T/A) were correlated with the Abeta serum profile. The role of P-gp as an Abeta transporter and the role of ABCB1 genotypes deserves further research. The investigated serum Abeta profile is probably not useful in the diagnosis of dementia.

  15. An Australian tuberous sclerosis cohort: are surveillance guidelines being met?

    NARCIS (Netherlands)

    Chopra, M.; Lawson, J.A.; Wilson, M.; Kennedy, S.E.; Taylor, P.; Buckley, M.F.; Wargon, O.; Parasivam, G.; Camphausen, C.; Yates, D.; Mowat, D.

    2011-01-01

    AIM: This study aims to describe the phenotypic and genotypic characteristics of 45 Australian patients with tuberous sclerosis complex (TSC), to assess risk factors for intellectual disability, to compare patients with TSC1 and TSC2 mutations and to assess adherence to surveillance recommendations.

  16. The Australian synchrotron research program

    International Nuclear Information System (INIS)

    Garrett, R.F.

    1998-01-01

    Full text: The Australian Synchrotron Research Program (ASRP) was established in 1996 under a 5 year grant from the Australian Government, and is managed by ANSTO on behalf of a consortium of Australian universities and research organisations. It has taken over the operation of the Australian National Beamline Facility (ANBF) at the Photon Factory, and has joined two CATS at the Advanced Photon Source: the Synchrotron Radiation Instrumentation CAT (SRI-CAT) and the Consortium for Advanced Radiation Sources (CARS). The ASRP thus manages a comprehensive range of synchrotron radiation research facilities for Australian science. The ANBF is a general purpose hard X-ray beamline which has been in operation at the Photon Factory since 1993. It currently caters for about 35 Australian research teams per year. The facilities available at the ANBF will be presented and the research program will be summarised. The ASRP facilities at the APS comprise the 5 sectors operated by SRI-CAT, BioCARS and ChemMatCARS. A brief description will be given of the ASRP research programs at the APS, which will considerably broaden the scope of Australian synchrotron science

  17. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... the Challenges of MS You CAN! Webcasts DVDs Books For Kids: Keep S'myelin Información en Español Brochures ... Managing MS and Another Condition Aging with MS Anesthesia and Surgery Managing Your MS d Emotional Well- ...

  18. Determination of Glyphosate Levels in Breast Milk Samples from Germany by LC-MS/MS and GC-MS/MS

    NARCIS (Netherlands)

    Steinborn, Angelika; Alder, Lutz; Michalski, Britta; Zomer, Paul; Bendig, Paul; Martinez, Sandra Aleson; Mol, Hans G.J.; Class, Thomas J.; Costa Pinheiro, Nathalie

    2016-01-01

    This study describes the validation and application of two independent analytical methods for the determination of glyphosate in breast milk. They are based on liquid chromatography-tandem mass spectrometry (LC-MS/MS) and gas chromatography-tandem mass spectrometry (GC-MS/MS), respectively. For

  19. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... MS Relapsing-remitting MS (RRMS) Share this page Facebook Twitter Email Relapsing-remitting MS (RRMS) Relapsing-remitting ... Here Start Here Colophon Stay Informed Join Us Facebook Twitter LinkedIn YouTube Pinterest MS Connection About the ...

  20. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Relapsing-remitting MS (RRMS) Share this page Facebook Twitter Email Relapsing-remitting MS (RRMS) Relapsing-remitting MS ( ... Start Here Colophon Stay Informed Join Us Facebook Twitter LinkedIn YouTube Pinterest MS Connection About the Society ...

  1. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Become an MS Activist Take Action Current Advocacy Issues Advocacy Results Advocacy News d Raise Awareness d ... MS are more likely to experience gradually worsening problems with walking and mobility, along with whatever other symptoms they may have. Diagnosing relapsing-remitting MS (RRMS) Learn More Learn More ... Room MS Prevalence ...

  2. ICP-MS Workshop

    Energy Technology Data Exchange (ETDEWEB)

    Carman, April J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Eiden, Gregory C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2014-11-01

    This is a short document that explains the materials that will be transmitted to LLNL and DNN HQ regarding the ICP-MS Workshop held at PNNL June 17-19th. The goal of the information is to pass on to LLNL information regarding the planning and preparations for the Workshop at PNNL in preparation of the SIMS workshop at LLNL.

  3. siMS Score: Simple Method for Quantifying Metabolic Syndrome.

    Science.gov (United States)

    Soldatovic, Ivan; Vukovic, Rade; Culafic, Djordje; Gajic, Milan; Dimitrijevic-Sreckovic, Vesna

    2016-01-01

    To evaluate siMS score and siMS risk score, novel continuous metabolic syndrome scores as methods for quantification of metabolic status and risk. Developed siMS score was calculated using formula: siMS score = 2*Waist/Height + Gly/5.6 + Tg/1.7 + TAsystolic/130-HDL/1.02 or 1.28 (for male or female subjects, respectively). siMS risk score was calculated using formula: siMS risk score = siMS score * age/45 or 50 (for male or female subjects, respectively) * family history of cardio/cerebro-vascular events (event = 1.2, no event = 1). A sample of 528 obese and non-obese participants was used to validate siMS score and siMS risk score. Scores calculated as sum of z-scores (each component of metabolic syndrome regressed with age and gender) and sum of scores derived from principal component analysis (PCA) were used for evaluation of siMS score. Variants were made by replacing glucose with HOMA in calculations. Framingham score was used for evaluation of siMS risk score. Correlation between siMS score with sum of z-scores and weighted sum of factors of PCA was high (r = 0.866 and r = 0.822, respectively). Correlation between siMS risk score and log transformed Framingham score was medium to high for age groups 18+,30+ and 35+ (0.835, 0.707 and 0.667, respectively). siMS score and siMS risk score showed high correlation with more complex scores. Demonstrated accuracy together with superior simplicity and the ability to evaluate and follow-up individual patients makes siMS and siMS risk scores very convenient for use in clinical practice and research as well.

  4. The prevalence of dental anomalies in an Australian population.

    Science.gov (United States)

    Dang, H Q; Constantine, S; Anderson, P J

    2017-06-01

    The aim of this study was to determine the prevalence of dental anomalies within an Australian paediatric population using panoramic radiographs. This was a prospective review of 1050 panoramic radiographs obtained as part of a school dental screening program in suburban and rural New South Wales, Australia. Fifty-four (5.14%) patients had a dental anomaly present. Agenesis was noted to have occurred 69 times across 45 patients (4.28%), along with seven cases of impaction (0.6%) and three cases of supernumerary teeth (0.28%). Dental anomalies rarely occur in the Australian population, which possesses a wide-ranging multiethnic cohort. Despite their rarity, they can be incidentally discovered so identification and management by dental practitioners are important. © 2016 Australian Dental Association.

  5. Development and Validation of an LC-MS/MS Method and Comparison with a GC-MS Method to Measure Phenytoin in Human Brain Dialysate, Blood, and Saliva

    Directory of Open Access Journals (Sweden)

    Raphael Hösli

    2018-01-01

    Full Text Available Phenytoin (PHT is one of the most often used critical dose drugs, where insufficient or excessive dosing can have severe consequences such as seizures or toxicity. Thus, the monitoring and precise measuring of PHT concentrations in patients is crucial. This study develops and validates an LC-MS/MS method for the measurement of phenytoin concentrations in different body compartments (i.e., human brain dialysate, blood, and saliva and compares it with a formerly developed GC-MS method that measures PHT in the same biological matrices. The two methods are evaluated and compared based on their analytical performance, appropriateness to analyze human biological samples, including corresponding extraction and cleanup procedures, and their validation according to ISO 17025/FDA Guidance for Industry. The LC-MS/MS method showed a higher performance compared with the GC-MS method. The LC-MS/MS was more sensitive, needed a smaller sample volume (25 µL and less chemicals, was less time consuming (cleaning up, sample preparation, and analysis, and resulted in a better LOD ( 0.995 for all tested matrices (blood, saliva, and dialysate. For larger sample numbers as in pharmacokinetic/pharmacodynamic studies and for bedside as well as routine analyses, the LC-MS/MS method offers significant advantages over the GC-MS method.

  6. The Australian National Proton Facility

    International Nuclear Information System (INIS)

    Jackson, M.; Rozenfeld, A.; Bishop, J.

    2002-01-01

    Full text: Protons have been used in the treatment of cancer since 1954 and over 30,000 patients have been treated around the world. Their precise dose distribution allows the treatment of small tumours in critical locations such as the base of skull and orbit and is an alternative to stereotactic radiotherapy in other sites. With the development of hospital-based systems in the 1990's, common tumours such as prostate, breast and lung cancer can now also be treated using simple techniques. The therapeutic ratio is improved as the dose to the tumour can be increased while sparing normal tissues. The well defined high dose region and low integral dose compared with photon treatments is a particular advantage in children and other situations where long-term survival is expected and when used in combination with chemotherapy. In January 2002, the NSW Health Department initiated a Feasibility Study for an Australian National Proton Facility. This Study will address the complex medical, scientific, engineering, commercial and legal issues required to design and build a proton facility in Australia. The Facility will be mainly designed for patient treatment but will also provide facilities for biological, physical and engineering research. The proposed facility will have a combination of fixed and rotating beams with an energy range of 70-250 MeV. Such a centre will enable the conduct of randomised clinical trials and a comparison with other radiotherapy techniques such as Intensity Modulated Radiation Therapy. Cost-utility comparisons with other medical treatments will also be made and further facilities developed if the expected benefit is confirmed. When patients are not being treated, the beam will be available for commercial and research purposes. This presentation will summarize the progress of the Study and discuss the important issues that need to be resolved before the Facility is approved and constructed

  7. Australian coal year book 1986

    Energy Technology Data Exchange (ETDEWEB)

    1986-01-01

    This yearbook presents a review of the Australian coal industry during the 1984-85 financial year. Included are details on mines, future prospects, coal export facilities and ports, annual cost statistics and a index of coal mine owners.

  8. 1982 Australian coal conference papers

    Energy Technology Data Exchange (ETDEWEB)

    1982-01-01

    This third Australian coal conference included papers discussing the market for coal, finance and investment, use of computers, mining, coal research, coal preparation and waste disposal, marketing and trade, and the transport of coal. All papers have been individually abstracted.

  9. A review of the Australian healthcare system: A policy perspective

    Science.gov (United States)

    Sambasivan, Murali

    2018-01-01

    This article seeks to review the Australian healthcare system and compare it to similar systems in other countries to highlight the main issues and problems. A literature search for articles relating to the Australian and other developed countries’ healthcare systems was conducted by using Google and the library of Victoria University, Melbourne. Data from the websites of the Commonwealth of Australia, the Australian Institute of Health and Welfare, the Australian Productivity Commission, the Organisation for Economic Co-operation and Development and the World Bank have also been used. Although care within the Australian healthcare system is among the best in the world, there is a need to change the paradigm currently being used to measure the outcomes and allocate resources. The Australian healthcare system is potentially dealing with two main problems: (a) resource allocation, and (b) performance and patient outcomes improvements. An interdisciplinary research approach in the areas of performance measurement, quality and patient outcomes improvement could be adopted to discover new insights, by using the policy implementation error/efficiency and bureaucratic capacity. Hospital managers, executives and healthcare management practitioners could use an interdisciplinary approach to design new performance measurement models, in which financial performance, quality, healthcare and patient outcomes are blended in, for resource allocation and performance improvement. This article recommends that public policy implementation error and the bureaucratic capacity models be applied to healthcare to optimise the outcomes for the healthcare system in Australia. In addition, it highlights the need for evaluation of the current reimbursement method, freedom of choice to patients and a regular scrutiny of the appropriateness of care. PMID:29686869

  10. Foundations of Australian Agricultural Economics

    OpenAIRE

    Myers, Laurel

    2007-01-01

    In the early years of the twentieth century, Australia's leading economists were well versed in the nature of Australian agriculture but it was not until the 1930s and 1940s that scientists and economists alike realised there was an obvious need for trained agricultural economists. In this paper it is argued that the foundations of Australian agricultural economics were laid in the period immediately following the economic upheaval of the Great Depression and the Second World War. The formali...

  11. Australian black coal statistics 1991

    Energy Technology Data Exchange (ETDEWEB)

    1992-01-01

    This third edition of Australian black coal statistics covers anthracite, bituminous and subbituminous coals. It includes maps and figures on resources and coal fields and statistics (mainly based on the calendar year 1991) on coal demand and supply, production, employment and productivity in Australian coal mines, exports, prices and ports, and domestic consumption. A listing of coal producers by state is included. A final section presents key statistics on international world trade in 1991. 54 tabs.

  12. Development of an UPLC-MS/MS method for quantification of Avitinib (AC0010) and its five metabolites in human cerebrospinal fluid: Application to a study of the blood-brain barrier penetration rate of non-small cell lung cancer patients.

    Science.gov (United States)

    Wang, Weicong; Zheng, Xin; Wang, Hanping; Wang, Lu; Jiang, Ji; Hu, Pei

    2017-05-30

    Avitinib (AC0010) is a mutant-selective epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI), designed to be a targeted therapeutic agent for non-small cell lung cancer (NSCLC) patients harboring EGFR active and T790M resistant mutations. A rapid and sensitive ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was developed and validated for the determination of Avitinib and its five metabolites (M1, M2, M4, M7, MII-6) in human cerebrospinal fluid (CSF). The samples were purified by protein precipitation and separated on a BEH C 18 column (2.1×50mm, 1.7μm). Electrospray ionization (ESI) in positive ion mode and multiple reaction monitoring (MRM) were used to monitor the ion transitions at m/z 488/257, 474/403, 504/487, 434/377, 490/405, 476/391. The results indicated that the method had excellent sensitivity and specificity. The linear range covered from 0.05 to 50ng/mL for Avitinib, M1, M4, M7, and MII-6, and from 0.01 to 10ng/mL for M2. Intra-day and inter-day precisions (in terms of% RSD) were all <15% and the accuracies (in terms of% RE) were within the range of ±15%. The lower limit of quantification (LLOQ), matrix effect, extraction recovery, stability and dilution integrity were also validated and satisfied with the criteria of validation. Finally, the method was successfully applied to a blood-brain barrier (BBB) penetration rate research of NSCLC patients after an oral administration of Avitinib. Copyright © 2017. Published by Elsevier B.V.

  13. Building the Clinical Bridge: An Australian Success

    Directory of Open Access Journals (Sweden)

    Marianne Wallis

    2012-01-01

    Full Text Available Nursing effectiveness science includes primary, secondary, and translational, clinically focused research activities which aim to improve patient or client outcomes. It is imperative, for the successful conduct of a program of nursing effectiveness science, that a clinical bridge is established between academic and healthcare service facilities. An Australian example of the development of a robust clinical bridge through the use of jointly funded positions at the professorial level is outlined. In addition, an analysis of the practical application of Lewin’s model of change management and the contribution of both servant and transformational leadership styles to the bridge building process is provided.

  14. A description of 'Australian Lyme disease' epidemiology and impact: an analysis of submissions to an Australian senate inquiry.

    Science.gov (United States)

    Brown, Jeremy D

    2018-04-01

    Many Australian patients are diagnosed and treated for the scientifically and politically controversial diagnosis of an endemic form of 'Australian Lyme Disease'. Patient advocacy led Senator John Madigan to propose an Australian Senate Inquiry into this illness. To describe the symptomology and outcomes of patients diagnosed and treated with Lyme disease in Australia. All public, first-person submissions (n = 698) to the inquiry were reviewed and responses analysed for epidemiology, symptoms and impact against structured criteria. The most common symptoms described were fatigue (62.6%), disordered thinking (51.9%) and sensory disturbance (46.1%). Respondents reported experiencing symptoms for a median of 10 years and spent a median of $30 000 on diagnosis and treatment. Almost 10% of respondents self-diagnosed after being exposed to a media report of Australian Lyme disease. Patients diagnosed with Lyme disease in Australia display a symptomology similar to 'medically unexplained physical symptoms' syndromes, experience social and financial harms, and are at risk of nosocomial harms. Negative medical interactions and the media may contribute to patients seeking alternative and potentially non-evidence-based diagnoses and treatments. © 2018 Royal Australasian College of Physicians.

  15. Playing With Antidepressants: Perspectives From Indian Australians and Anglo-Australians Living With Depression.

    Science.gov (United States)

    Brijnath, Bianca; Antoniades, Josefine

    2017-11-01

    Patient perspectives were explored on the meaning and experience of antidepressant use by applying Johan Huizinga's theory of play to interviews from Indian Australians and Anglo-Australians diagnosed with depression. Through the analysis, the centrality of Huizinga's "magic circle" emerged, that is, defining the boundaries within which one could safely play. Consumption of antidepressants involved learning, breaking, and modulating rules of the game of adherence, then forging a new "magic circle." In these games, there were playful elements including experimentation, improvisation, absorption, and experiential learning. This application of Huizinga's theory in relation to antidepressant use is a novel approach in the literature on medication non/adherence. This application not only opens a new theoretical line of inquiry but also shows that antidepressant non/adherence is not a static practice but dynamic and changing, revealing critical insights around participant's agency, capabilities, desires, and notions of selfhood with regard to managing their depression and conceptualizing their recovery.

  16. MALDI-TOF MS/MS measurements of PMMA

    NARCIS (Netherlands)

    Becer, C.R.; Baumgaertel, A.; Gottschaldt, M.; Schubert, U.S.

    2008-01-01

    The polymer poly(Me methacrylate) (PMMA) was analyzed using the matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) technique. The MALDI-TOF MS app. was coupled with a collision-induced dissocn. (CID) unit. The performance of the MALDI-TOF/TOF MS method in

  17. Diabetes Education Needs of Chinese Australians: A Qualitative Study

    Science.gov (United States)

    Choi, Tammie S. T.; Walker, Karen Z.; Ralston, Robin A.; Palermo, Claire

    2015-01-01

    Objective: The aim of this study was to evaluate a type 2 diabetes education programme for Chinese Australians, based on the experience of participants and by exploring the unique needs of Chinese patients, their health beliefs and their cultural behaviours. Design and setting: A qualitative ethnographic study was undertaken in a community health…

  18. A snapshot of patients' awareness of radiation dose and risks associated with medical imaging examinations at an Australian radiology clinic

    International Nuclear Information System (INIS)

    Singh, N.; Mohacsy, A.; Connell, D.A.; Schneider, M.E.

    2017-01-01

    Background: Cumulative radiation exposure is linked to increasing the lifetime attributable risk of cancer. To avoid unnecessary radiation exposure and facilitate shared decision making, patients should be aware of these issues. This paper examines patients' awareness of radiation dose and risks associated with medical imaging examinations. Methods: Consecutive patients attending a private radiology clinic over a nine week period in 2014 in Metropolitan Melbourne were surveyed while waiting to undergo an imaging examination. Patients who were under 18 years of age, did not speak English and/or were referred for interventional imaging procedures were excluded from participation. Survey questions addressed patients' awareness of radiation dose associated with various imaging modalities' and patients' experience and preferences regarding communication of information about radiation. Data was analysed using SPSS (Ver 20.1). Results: A total of 242 surveys were completed. Most participants were male (143/239, 59.8%) and aged between 33 and 52 years (109/242, 45%). Over half of participants were not concerned about radiation from medical imaging (130/238, 54.6%). Only a third of participants (80/234, 34.2%) correctly reported that CT has a higher radiation dose than X-ray. Very few participants correctly identified mammography, DEXA, PET and PET/CT as radiation emitting examinations. The majority of participants (202/236, 85.6%) indicated that they were not informed about radiation dose and risks by their referring doctor in advance. Conclusion: This paper provides information relevant to a single private radiology clinic in Australia. Nevertheless, our results have shown that patients presenting for medical imaging have little awareness of radiation dose and risks associated with these examinations and received little information by their referring physicians or staff at the radiology clinic. - Highlights: • Patients' awareness regarding

  19. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Contact Us Newly Diagnosed If you or somone close to you has recently been diagnosed, access our MS information and resources. Start ... Room MS Prevalence Charitable Ratings Corporate Support Helpful Links ...

  20. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Events Living Well with MS Diet, Exercise & Healthy Behaviors Emotional Well-Being Spiritual Well-Being Cognitive Health ... Living Well with MS d Diet, Exercise & Healthy Behaviors Diet & Nutrition Exercise Heat & Temperature Sensitivity Sleep Vaccinations ...

  1. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Programs and Events Living Well with MS Diet, Exercise & Healthy Behaviors Emotional Well-Being Spiritual Well-Being ... Events d Living Well with MS d Diet, Exercise & Healthy Behaviors Diet & Nutrition Exercise Heat & Temperature Sensitivity ...

  2. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Treating MS Comprehensive Care Find an MS Care Provider Medications Managing Relapses Rehabilitation Complementary & Alternative Medicines For Clinicians Resources & Support Library & Education Programs Find Support Advanced Care ...

  3. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... working effectively. How does RRMS differ from progressive types of MS? While RRMS is defined by attacks ... forms of MS involve much less of this type of inflammation. People with RRMS tend to have ...

  4. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... of Programs and Events Living Well with MS Diet, Exercise & Healthy Behaviors Emotional Well-Being Spiritual Well- ... and Events d Living Well with MS d Diet, Exercise & Healthy Behaviors Diet & Nutrition Exercise Heat & Temperature ...

  5. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Rule Out For Clinicians Treating MS Comprehensive Care Find an MS Care Provider Medications Managing Relapses Rehabilitation ... Medicines For Clinicians Resources & Support Library & Education Programs Find Support Advanced Care Needs Resources for Specific Populations ...

  6. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... bowel and bladder problems, and problems with cognition (learning and memory or information processing). People with progressive ... More The National MS Society is Here to Help Need More Information? We Are Here Our MS ...

  7. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Brochure Working with MS (.pdf) Download Brochure Taming Stress (.pdf) Download Brochure Multiple Sclerosis and Your Emotions (. ... For Professionals Researchers Physicians Nurses Rehabilitation Professionals Mental Health Professionals Health and Wellness Professionals What Is MS? ...

  8. Progressive-Relapsing MS (PRMS)

    Science.gov (United States)

    ... Is MS? Types of MS Share this page Facebook Twitter Email ... multiple sclerosis (PRMS) was described in the 1996 disease-course definitions as — steadily worsening neurologic function from the beginning ...

  9. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... d Spiritual Well-Being Building Spirituality into Your Life d Cognitive Health d Work, Home & Leisure Employment ... Partnership Opportunities d Personal Stories Ambassadors & Familiar Faces Life with MS Givers Shakers Families with MS Seekers ...

  10. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Life d Cognitive Health d Work, Home & Leisure Employment Insurance & Financial Information Staying Mobile Reclaiming Control Accessibility ... Living with MS (.pdf) Download Brochure Focus on Employment (.pdf) Download Brochure Working with MS (.pdf) Download ...

  11. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Online d Give in Honor or Memory d Workplace Giving d Employer Matching Gifts d Gifts of ... Living with MS (.pdf) Download Brochure Focus on Employment (.pdf) Download Brochure Working with MS (.pdf) Download ...

  12. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Associated Myelopathy (HAM) Neuromyelitis Optica (NMO) Schilder's Disease Transverse Myelitis d Symptoms & Diagnosis d Diagnosing MS d ... Overview (.pdf) Download Document Pediatric MS Learn More Transverse Myelitis Learn More Neuromyelitis Optica (NMO) Learn More ...

  13. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... attacks of inflammation (relapses) in the CNS, progressive forms of MS involve much less of this type ... and memory or information processing). People with progressive forms of MS are more likely to experience gradually ...

  14. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... working effectively. How does RRMS differ from progressive types of MS? While RRMS is defined by attacks of ... forms of MS involve much less of this type of inflammation. People with RRMS tend to have more ...

  15. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Directors Senior Leadership Team Founder Sylvia Lawry d Cultural Values d Financials Annual Reports Sources of Support ... MS Connection About the Society Vision Careers Leadership Cultural Values Financials News Press Room MS Prevalence Charitable ...

  16. Using patients' experiences of adverse events to improve health service delivery and practice: protocol of a data linkage study of Australian adults age 45 and above.

    Science.gov (United States)

    Walton, Merrilyn; Jorm, Christine; Smith-Merry, Jennifer; Harrison, Reema; Manias, Elizabeth; Iedema, Rick; Kelly, Patrick

    2014-10-13

    Evidence of patients' experiences is fundamental to creating effective health policy and service responses, yet is missing from our knowledge of adverse events. This protocol describes explorative research redressing this significant deficit; investigating the experiences of a large cohort of recently hospitalised patients aged 45 years and above in hospitals in New South Wales (NSW), Australia. The 45 and Up Study is a cohort of 265,000 adults aged 45 years and above in NSW. Patients who were hospitalised between 1 January and 30 June 2014 will be identified from this cohort using data linkage and a random sample of 20,000 invited to participate. A cross-sectional survey (including qualitative and quantitative components) will capture patients' experiences in hospital and specifically of adverse events. Approximately 25% of respondents are likely to report experiencing an adverse event. Quantitative components will capture the nature and type of events as well as common features of patients' experiences. Qualitative data provide contextual knowledge of their condition and care and the impact of the event on individuals. Respondents who do not report an adverse event will report their experience in hospital and be the control group. Statistical and thematic analysis will be used to present a patient perspective of their experiences in hospital; the characteristics of patients experiencing an adverse event; experiences of information sharing after an event (open disclosure) and the other avenues of redress pursued. Interviews with key policymakers and a document analysis will be used to create a map of the current practice. Dissemination via a one-day workshop, peer-reviewed publications and conference presentations will enable effective clinical responses and service provision and policy responses to adverse events to be developed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... and problems with cognition (learning and memory or information processing). People with progressive forms of MS are more likely to experience gradually worsening problems with walking and mobility, along with whatever other symptoms they may have. Diagnosing ... MS Society is Here to Help Need More Information? We Are Here Our MS Navigators help identify ...

  18. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Living Well with MS Diet, Exercise & Healthy Behaviors Emotional Well-Being Spiritual Well-Being Cognitive Health Work, ... MS Anesthesia and Surgery Managing Your MS d Emotional Well-Being Mood Changes d Spiritual Well-Being ...

  19. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Treating MS d Comprehensive Care Developing a Healthcare Team Make the Most of Your Doctor Visits Advance Medical Directives d Find an MS Care Provider Partners in MS Care d Managing Relapses Plasmapheresis d Rehabilitation Functional Electrical Stimulation (FES) ...

  20. COPD Diagnostic Questionnaire (CDQ) for selecting at-risk patients for spirometry: a cross-sectional study in Australian general practice.

    Science.gov (United States)

    Stanley, Anthony J; Hasan, Iqbal; Crockett, Alan J; van Schayck, Onno C P; Zwar, Nicholas A

    2014-07-10

    Using the COPD Diagnostic Questionnaire (CDQ) as a selection tool for spirometry could potentially improve the efficiency and accuracy of chronic obstructive pulmonary disease (COPD) diagnosis in at-risk patients. To identify an optimal single cut point for the CDQ that divides primary care patients into low or high likelihood of COPD, with the latter group undergoing spirometry. Former or current smokers aged 40-85 years with no prior COPD diagnosis were invited to a case-finding appointment with the practice nurse at various general practices in Sydney, Australia. The CDQ was collected and pre- and post-bronchodilator spirometry was performed. Cases with complete CDQ data and spirometry meeting quality standards were analysed (1,054 out of 1,631 patients). CDQ cut points were selected from a receiver operating characteristic (ROC) curve. The area under the ROC curve was 0.713. A cut point of 19.5 had the optimal combination of sensitivity (63%) and specificity (70%) with two-thirds below this cut point. A cut point of 14.5 corresponded to a sensitivity of 91%, specificity of 35% and negative predictive value of 96%, and 31% of patients below this cut point. The CDQ can be used to select patients at risk of COPD for spirometry using one cut point. We consider two possible cut points. The 19.5 cut point excludes a higher proportion of patients from undergoing spirometry with the trade-off of more false negatives. The 14.5 cut point has a high sensitivity and negative predictive value, includes more potential COPD cases but has a higher rate of false positives.

  1. State of the ART: Characteristics of HIV infected patients receiving care in Mississippi (MS), USA from the Medical Monitoring Project, 2009-2010.

    Science.gov (United States)

    Barnes, Arti; Nunn, Amy; Karakala, Sudharshanam; Sunesara, Imran; Johnson, Kendra; Parham, Jason; Mena, Leandro

    2015-12-01

    Mississippi, the poorest state in the US, has a very high prevalence of HIV and among the highest HIV infection rates and AIDS-adjusted mortality rates in the country. African Americans, who suffer the worst health care disparities in the US, account for 76% of people with HIV in MS. The purpose of this study is to describe those in care for HIV and determine the factors associated with anti-retroviral treatment (ART) and viral suppression. The CDC's Medical Monitoring Project collects surveillance data from 23 project areas in the US, including Mississippi, using annual probability sampling of persons in care for HIV. Data were collected from in-person interviews and medical record abstraction in 2009. The surveillance period was the 12 months prior to the interview date. 212 randomly selected participants represented a nationally representative weighted sample of 3190.4. Participants had a mean of 3.71 provider visits during the surveillance period. Geometric mean for CD4 count = 438.91 (95% CI 402.25-475.56). Overall 80.80% (95% CI 75.30%- 86.29%) were on ART, and 68.12% (95% CI 62.69%-73-56%) had undetectable viral load. Males (65.15%) were less likely to achieve undetectable viral load compared to females (78.30%) after controlling for individuals who were on ART (p = 0.01). Viral suppression was not associated with age, race or sexual risk factors. Although Mississippi has a high proportion of individuals out of HIV care, the majority in care is on ART and has suppressed viral loads. However, men are less likely to achieve virological suppression than females.

  2. Concomitant medication polypharmacy, interactions and imperfect adherence are common in Australian adults on suppressive antiretroviral therapy

    NARCIS (Netherlands)

    Siefried, Krista J; Mao, Limin; Cysique, Lucette A; Rule, John; Giles, Michelle L; Smith, Don E; McMahon, James E.; Read, Tim R; Ooi, Catriona; Tee, Ban K; Bloch, Mark; de Wit, John; Carr, Andrew

    2018-01-01

    OBJECTIVES: We quantified concomitant medication polypharmacy, pharmacokinetic and pharmacodynamic interactions, adverse effects and adherence in Australian adults on effective antiretroviral therapy. DESIGN: Cross-sectional. METHODS: Patients recruited into a nationwide cohort and assessed for

  3. Dopamine, T cells and multiple sclerosis (MS).

    Science.gov (United States)

    Levite, Mia; Marino, Franca; Cosentino, Marco

    2017-05-01

    Dopamine is a key neurotransmitter that induces critical effects in the nervous system and in many peripheral organs, via 5 dopamine receptors (DRs): D1R-D5R. Dopamine also induces many direct and very potent effects on many DR-expressing immune cells, primarily T cells and dendritic cells. In this review, we focus only on dopamine receptors, effects and production in T cells. Dopamine by itself (at an optimal concentration of~0.1 nM) induces multiple function of resting normal human T cells, among them: T cell adhesion, chemotactic migration, homing, cytokine secretion and others. Interestingly, dopamine activates resting effector T cells (Teffs), but suppresses regulatory T cells (Tregs), and both effects lead eventually to Teff activation. Dopamine-induced effects on T cells are dynamic, context-sensitive and determined by the: T cell activation state, T cell type, DR type, and dopamine concentration. Dopamine itself, and also few dopaminergic molecules/ drugs that are in clinical use for cardiac, neurological and other non-immune indications, have direct effects on human T cells (summarized in this review). These dopaminergic drugs include: dopamine = intropin, L-DOPA, bromocriptine, pramipexole, pergolide, haloperidol, pimozide, and amantadine. Other dopaminergic drugs were not yet tested for their direct effects on T cells. Extensive evidence in multiple sclerosis (MS) and experimental autoimmune encephalomyelitis (EAE) show dopaminergic dysregulations in T cells in these diseases: D1-like DRs are decreased in Teffs of MS patients, and dopamine does not affect these cells. In contrast, D1-like DRs are increased in Tregs of MS patients, possibly causing functional Treg impairment in MS. Treatment of MS patients with interferon β (IFN-β) increases D1-like DRs and decreases D2-like DRs in Teffs, decreases D1-like DRs in Tregs, and most important: restores responsiveness of patient's Teffs to dopamine. DR agonists and antagonists confer some benefits in

  4. The management of diabetes in indigenous Australians from primary care

    Directory of Open Access Journals (Sweden)

    Thomas Merlin C

    2007-10-01

    Full Text Available Abstract Background Indigenous Australians have high rates of diabetes and its complications. This study examines ethnic differences in the management of patients with type 2 diabetes in Australian primary care. Methods Diabetes management and outcomes in Indigenous patients enrolled in the NEFRON study (n = 144 was systematically compared with that in non-Indigenous patients presenting consecutively to the same practitioner (n = 449, and the NEFRON cohort as a whole (n = 3893. Results Indigenous Australians with diabetes had high rates of micro- and macrovascular disease. 60% of Indigenous patients had an abnormal albumin to creatinine ratio compared to 33% of non-Indigenous patients (p 1c ≥ 8.0%, observed in 55% of all Indigenous patients, despite the similar frequency use of oral antidiabetic agents and insulin. Smoking was also more common in Indigenous patients (38%vs 10%, p Conclusion Although seeing the same doctors and receiving the same medications, glycaemic and smoking cessation targets remain unfulfilled in Indigenous patients. This cross-sectional study confirms Aboriginal ethnicity as a powerful risk factor for microvascular and macrovascular disease, which practitioners should use to identify candidates for intensive multifactorial intervention.

  5. A UPLC-MS/MS method for analysis of vancomycin in human cerebrospinal fluid and comparison with the chemiluminescence immunoassay.

    Science.gov (United States)

    Mei, Shenghui; Wang, Jiaqing; Zhu, Leting; Chen, Ruiling; Li, Xingang; Chen, Kai; Chen, Guangqiang; Zhou, Jianxin; Wang, Qiang; Zhao, Zhigang

    2017-08-01

    Vancomycin (VCM) is clinically used in treating patients with postoperative intracranial infections. The cerebrospinal fluid (CSF) concentration of VCM varies greatly among patients. To guide the dosage regimens, monitoring of VCM in CSF is needed. However a method for analysis of VCM in human CSF is lacking. An ultraperformance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) was developed and validated for analysis of VCM in human CSF, and the agreement of UPLC-MS/MS and chemiluminescence immunoassay (CLIA) in the analysis of CSF VCM was evaluated. The ion transitions were m/z 725.5 > 144.1 for VCM and m/z 455.2 > 308.2 for methotrexate (internal standard). The agreement between UPLC-MS/MS and CLIA was evaluated by Bland-Altman plot in 179 samples. The calibration range of the UPLC-MS/MS method was 1-400 mg/L. The inaccuracy and imprecision were -0.69-10.80% and  0.98). The 95% limit of agreement of the ratio of CLIA to UPLC-MS/MS was 61.66-107.40%. Further studies are warranted to confirm the results. Copyright © 2017 John Wiley & Sons, Ltd.

  6. Testing a new form to document 'Goals-of-Care' discussions regarding plans for end-of-life care for patients in an Australian emergency department.

    Science.gov (United States)

    Mills, Amber C; Levinson, Michele; Dunlop, William A; Cheong, Edward; Cowan, Timothy; Hanning, Jennifer; O'Callaghan, Erin; Walker, Katherine J

    2018-04-16

    There is limited literature to inform the content and format of Goals-of-Care forms, for use by doctors when they are undertaking these important conversations. This was a prospective, qualitative and quantitative study evaluating the utility of a new 'Goals-of-Care' form to doctors in a private, tertiary ED, used from December 2016 to February 2017 at Cabrini, Melbourne. A Goals-of-Care form was designed, incorporating medical aims of therapy and patient values and preferences. Doctors wishing to complete a Not-for-CPR form were also supplied with the trial Goals-of-Care form. Form use, content and patient progress were followed. Doctors completing a form were invited to interview. Forms were used in 3% of attendances, 120 forms were taken for use and 108 were analysed. The median patient age was 91, 81% were Supportive and Palliative Care Indicators Tool (SPICT) positive and patients had a 48% 6-month mortality. A total of 34 doctors completed the forms, 16 were interviewed (two ED trainees, 11 senior ED doctors and three others). Theme saturation was only achieved for the senior doctors interviewed. Having a Goals-of-Care form was valued by 88% of doctors. The frequency of section use was: Aims-of-Care 91%; Quality-of-Life 75% (the term was polarising); Functional Impairments 35%; and Outcomes of Value 29%. Opinions regarding the ideal content and format varied. Some doctors liked free-text space and others tick-boxes. The median duration of the conversation and documentation was 10 min (interquartile range 6-20 min). Having a Goals-of-Care form in emergency medicine is supported; the ideal contents of the form was not determined. © 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  7. BOOMERANG - the Australian light source

    International Nuclear Information System (INIS)

    Boldeman, J.W.; Garrett, R.L.

    1999-01-01

    A proposal has been prepared for the installation in Australia of a national high performance synchrotron light facility called Boomerang. The Boomerang proposal had its origin in the establishment of the Australian Synchrotron Research Program (ASRP) which was one of the seven Major National Research Facilities announced by the Federal Government in December 1995. The ASRP provides the opportunity and funding for Australian researchers to access international synchrotron facilities, specifically two consortia at the Advanced Photon Source (APS) at the Argonne National Laboratory, USA and continued interaction with the Photon Factory at the KEK Laboratory in Japan. The ASRP was the successor to the Australian National Beamline Facility project (ANBF) which began in 1991 following the ASTEC inquiry titled 'Small Country - Big Science'. The Federal Government also provided funding for a Feasibility Study to determine the value of establishing an Australian-based synchrotron radiation facility. The Feasibility Study was completed in August 1998 and endorsed by the institutional members of the ASRP and the research community in general. The study concluded that, on the data available in Australia, there was a strong case for the installation of an Australian-based facility. The study considered several options for an Australian-based facility and recommended that these options and the data supporting the general conclusions receive further investigation. A mission was arranged to a select group of overseas laboratories to explore these questions in detail. The review team included a mix of scientific and industrial experience and also represented the interests of the ASRP and an Industrial Synchrotron Consortium based in Victoria. Based on the conclusions of the overseas mission and incorporating the advice of all international specialists in the design and use of synchrotron facilities consulted during the mission, the most cost-effective option was an extended

  8. Australian Journalists' Professional and Ethical Values.

    Science.gov (United States)

    Henningham, John

    1996-01-01

    Reports on the first comprehensive national study of Australian journalists. Finds that Australian journalists are similar to their United States colleagues in distributions of age, sex, and socioeconomic background, but have less formal education. Shows that Australians have mixed professional and ethical values and are committed both to…

  9. Should there be an Australian Army Association?

    Science.gov (United States)

    2006-12-15

    subscriptions, private donations , and the commercial sales of specialized merchandise. It also determined that a lifetime individual membership would be...following potential sources of income: individual subscriptions, corporate subscriptions, private donations , and the commercial sales of... Armoured Corps RAAF Royal Australian Air Force RAMSI Regional Assistance Mission to Solomon Islands RAN Royal Australian Navy RAR Royal Australian

  10. An Australian view of the uranium market

    International Nuclear Information System (INIS)

    Lloyd, B.

    1978-01-01

    The subject is covered in sections, entitled as shown. Numerical data are indicated in parenthesis. Introduction (principal Australian uranium deposits, possible Australian production, estimates of world-wide uranium resources and production, estimates of world-wide uranium requirements); Australian marketing policy; commercial considerations; uncertainties affecting the industry, including unnecessary and undesirable government involvement, and supply and demand. (U.K.)

  11. Closing the gap: Longitudinal changes in employment for Australians with multiple sclerosis.

    Science.gov (United States)

    Van Dijk, Pieter A; Kirk-Brown, Andrea K; Taylor, Bruce; van der Mei, Ingrid

    2017-09-01

    Previous studies have documented far lower employment participation rates for people with multiple sclerosis (PwMS) compared to the general population. In a large national sample of PwMS, we examined employment status, longitudinal changes in employment and the provision of modifications to work role/environment from 2010 to 2013. Employment data were collected through the Australian MS Longitudinal Study from 2010 to 2013, with 1260 people responding to all four surveys. Employment rates were compared with the Australian general population. The survey included questions on the provision of modifications to employees' work role and work environment. Employment (full- and part-time) increased from 48.8% in 2010 to 57.8% in 2013, mainly due to increases in male full-time employment. The employment gap between PwMS and the general population fell from 14.3% in 2010 to 3.5% in 2013. Male employment rates, however, remain significantly lower than the general population. The majority of PwMS who required adjustments to either their work role or environment received them. The gap in employment between PwMS and the general population has substantially reduced from 2010 to 2013, with organisations responding positively to requests for work role/environment adjustments.

  12. Australian Aboriginal Astronomy - An Overview

    Science.gov (United States)

    Norris, Ray P.; Hamacher, Duane W.

    The traditional cultures of Aboriginal Australians include a significant astronomical component, perpetuated through oral tradition, ceremony, and art. This astronomical component includes a deep understanding of the motion of objects in the sky, and this knowledge was used for practical purposes such as constructing calendars. There is also evidence that traditional Aboriginal Australians made careful records and measurements of cyclical phenomena, paid careful attention to unexpected phenomena such as eclipses and meteorite impacts, and could determine the cardinal points to an accuracy of a few degrees.

  13. The Australian solar scene

    Energy Technology Data Exchange (ETDEWEB)

    Cowley, Paul [IT Power Australia (Australia)

    2007-06-15

    This presentation mainly talks about the actions taken by the Australian country concerning the use of renewable energy and the reduction of the peak load in some areas. In the first part, there are found both the geographical aspects as well as the major political, e.g. Asia-Pacific Partnership on Clean development and Climate. There are also explained the issues related to peak load growth and it is shown a comparison graphic having information about the most used photovoltaic systems. Then, there are mentioned the communities that are testing one of the model photovoltaic systems in order to: reduce the peak load, use the energy in a properly way, reduce the energy cost, among others. Finally, it is succinctly explained the photovoltaic rebate program as well as the use of the off-grid systems, besides, it is given relevant information about those remote communities of Australia and the benefits of the implementation of Bushlight. [Spanish] Esta presentacion trata primordialmente de las acciones, referentes al uso de energia renovable, tomadas por Australia y creadas con el fin de reducir la maxima demanda en algunas regiones de este pais. En la primera parte, se encuentran tanto los aspectos geograficos como los principales aspectos politicos; por ejemplo, la Sociedad Asia-Pacifico para el Desarrollo no Contaminante y el Clima. Asimismo, se da una explicacion acerca de las cuestiones relacionadas al crecimiento de la maxima demanda; ademas, se muestra un cuadro comparativo, que contiene informacion relacionada con los sistemas fotovoltaicos mas utilizados. Despues, se mencionan aquellas comunidades que tienen en periodo de prueba alguno de los modelos fotovoltaicos con el fin de: reducir la maxima demanda, utilizar eficientemente la energia, reducir el costo de la misma, entre otros aspectos mas. Finalmente, se explica escuetamente el programa de reembolso centrado en el uso de sistemas fotovoltaicos, asi como el uso de sistemas asilados de la red; ademas, se

  14. LC-MS (/MS) in clinical toxicology screening methods.

    Science.gov (United States)

    Viette, Véronique; Hochstrasser, Denis; Fathi, Marc

    2012-01-01

    Toxicological screening is the analysis of biological samples to detect and identify unknown compounds. The high selectivity and sensitivity of liquid chromatography (LC) coupled to mass spectrometry (MS) or tandem mass spectrometry (MS/MS) technology provide an attractive alternative to the current methods (LC-UV, GC/MS, etc.). For these reasons, an increasing number of applications are being published. This paper is a brief overview of LC-MS(/MS) screening methods developed for clinical toxicology in recent years. Various sample treatments, chromatographic separations and detection by mass spectrometry can be combined to obtain screening methods adapted to the constraints and needs of clinical toxicology laboratories. Currently the techniques are in the hands of specialists, mainly in academic institutions. However, the evolution in technology should allow application of these techniques as a tool in toxicology laboratories, thus allowing a more widespread exploitation of their potential.

  15. The case of Ms B: suicide's slippery slope?

    Science.gov (United States)

    Keown, J

    2002-08-01

    In the case of Ms B, the High Court ruled that as Ms B was a competent adult patient, her doctors acted unlawfully in overriding her refusal of life-preserving ventilation. This commentary considers whether this case supports the proposition that in English law the right to refuse treatment extends even to refusals which are clearly suicidal.

  16. Survival and mortality rates among Danes with MS

    DEFF Research Database (Denmark)

    Brønnum-Hansen, H; Stenager, Egon; Hansen, Thomas

    2006-01-01

    Long-term survival and trends in overall and cause-specific excess mortality among people with MS have been studied using the Danish Multiple Sclerosis Registry, which contains information about all Danish MS patients since the mid-20th Century. A total of 4254 deaths among approximately 10......,000 people with MS, representing more than 200,000 person-years of observation, have been analysed. Overall, mortality was almost three times higher and life expectancy 10 years less among people with MS than for the general population. However, excess mortality has declined significantly since 1950....

  17. Identification of a new genetic marker in Mycoplasma synoviae vaccine strain MS-H and development of a strategy using polymerase chain reaction and high-resolution melting curve analysis for differentiating MS-H from field strains.

    Science.gov (United States)

    Zhu, Ling; Konsak, Barbara M; Olaogun, Olusola M; Agnew-Crumptona, Rebecca; Kanci, Anna; Marenda, Marc S; Browning, Glenn F; Noormohammadi, Amir H

    2017-10-01

    Mycoplasma synoviae (MS) is an economically important avian pathogen worldwide, causing subclinical respiratory tract infection and infectious synovitis in chickens and turkeys. A temperature-sensitive (ts + ) live attenuated vaccine MS-H, derived from the Australian field strain 86079/7NS, is now widely used in many countries to control the disease induced by MS. Differentiation of MS-H vaccine from field strains is crucial for monitoring vaccination programs in commercial poultry. Comparison of genomic sequences of MS-H and its parent strain revealed an adenine deletion at nucleotide position 468 of the MS-H oppF-1 gene. This mutation was shown to be unique to MS-H in further comparative analyses of oppF-1 genes of MS-H re-isolates and field strains from Australia and other countries. Based on this single nucleotide, a combination of nested PCR and high-resolution melting (HRM) curve analysis was used to evaluate its potential for use in differentiation of MS-H from field strains. The mean genotype confidence percentages of 99.27 and 48.20 for MS-H and field strains, respectively, demonstrated the high discriminative power of the newly developed assay (oppF PCR-HRM). A set of 13 tracheal swab samples collected from MS-H vaccinated specific pathogen free birds and commercial chicken flocks infected with MS were tested using the oppF PCR-HRM test and results were totally consistent with those obtained using vlhA genotyping. The nested-PCR HRM method established in this study proved to be a rapid, simple and cost effective tool for discriminating the MS-H vaccine strain from Australian and international strains in pure cultures and on tracheal swabs. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Measures of Rheumatoid Arthritis Disease Activity in Australian Clinical Practice

    OpenAIRE

    Taylor, Andrew; Bagga, Hanish

    2011-01-01

    Objectives. To investigate which rheumatoid arthritis (RA) disease activity measures are being collected in patients receiving glucocorticoids, non-biologic or biologic disease-modifying antirheumatic drugs (DMARDs) in Australian rheumatology practice. Methods. A retrospective audit of medical records was conducted from eight rheumatology practices around Australia. Each rheumatologist recruited 30 consecutive eligible patients into the review, 10 of whom must have been receiving a biological...

  19. A review of statistical estimators for risk-adjusted length of stay: analysis of the Australian and new Zealand Intensive Care Adult Patient Data-Base, 2008-2009.

    Science.gov (United States)

    Moran, John L; Solomon, Patricia J

    2012-05-16

    For the analysis of length-of-stay (LOS) data, which is characteristically right-skewed, a number of statistical estimators have been proposed as alternatives to the traditional ordinary least squares (OLS) regression with log dependent variable. Using a cohort of patients identified in the Australian and New Zealand Intensive Care Society Adult Patient Database, 2008-2009, 12 different methods were used for estimation of intensive care (ICU) length of stay. These encompassed risk-adjusted regression analysis of firstly: log LOS using OLS, linear mixed model [LMM], treatment effects, skew-normal and skew-t models; and secondly: unmodified (raw) LOS via OLS, generalised linear models [GLMs] with log-link and 4 different distributions [Poisson, gamma, negative binomial and inverse-Gaussian], extended estimating equations [EEE] and a finite mixture model including a gamma distribution. A fixed covariate list and ICU-site clustering with robust variance were utilised for model fitting with split-sample determination (80%) and validation (20%) data sets, and model simulation was undertaken to establish over-fitting (Copas test). Indices of model specification using Bayesian information criterion [BIC: lower values preferred] and residual analysis as well as predictive performance (R2, concordance correlation coefficient (CCC), mean absolute error [MAE]) were established for each estimator. The data-set consisted of 111663 patients from 131 ICUs; with mean(SD) age 60.6(18.8) years, 43.0% were female, 40.7% were mechanically ventilated and ICU mortality was 7.8%. ICU length-of-stay was 3.4(5.1) (median 1.8, range (0.17-60)) days and demonstrated marked kurtosis and right skew (29.4 and 4.4 respectively). BIC showed considerable spread, from a maximum of 509801 (OLS-raw scale) to a minimum of 210286 (LMM). R2 ranged from 0.22 (LMM) to 0.17 and the CCC from 0.334 (LMM) to 0.149, with MAE 2.2-2.4. Superior residual behaviour was established for the log-scale estimators

  20. Australian black coal statistics 1990

    Energy Technology Data Exchange (ETDEWEB)

    1991-01-01

    This second edition of Australian black coal statistics replaces the Joint Coal Board's publication 'Black coal in Australia'. It includes an expanded international coal trade supplement. Sections cover resources of black coal, coal supply and demand, coal production, employment and productivity of mines, export data, coal consumption and a directory of producers.

  1. Australian Queer Science Fiction Fans.

    Science.gov (United States)

    Kerry, Stephen Craig

    2017-10-23

    Science fiction (sf) does more than provide a fleeting moment of entertainment; it has many personal and social functions. In addition to offering audiences "romantic escapism" (Gerrold, 1996, pp. 5-6), sf also enables the "postulation of an alternative reality from which to contemplate this one" (Gerrold, 1996, pp. 5-6); as such, it is especially important "for groups which have had limited stakes in the status quo" (Jenkins, 1995, p. 242). To date, no research has been undertaken on the relationship between Australian queers and sf fandom. This article reports the findings of an online survey and explores the psycho-social features of Australian queer sf fans and why they like the genre. While the characteristics of this sample mirror those of Australian queers generally, they also have slightly higher rates of mental illness and are far more likely to state they have "no religion." Furthermore, while enjoying the "sciency" (P10, bisexual woman) aspects of sf, Australian queers also like the "poignant metaphors for our own civilization" (P45, asexual man).

  2. Australian Naturalism and Its Critics.

    Science.gov (United States)

    Hyung, Park Sun

    1997-01-01

    Details the ongoing debate between Australian naturalists and their critics since the publication of C.W. Evers and G. Lakomski's seminal book "Knowing Educational Administration." Examines critics' views in several categories: the coherence concept, coherentism criteria, the naturalistic fallacy, and questions concerning foundations and…

  3. Differential diagnoses to MS

    DEFF Research Database (Denmark)

    Horwitz, Henrik; Friis, Tina; Modvig, Signe

    2014-01-01

    ), giant cell arteritis (n = 4), sarcoidosis (n = 3), thyrotoxicosis (n = 2), and hereditary or toxic neuropathies (n = 2). Nine percent of patients referred to the Clinic of Optic Neuritis had symptoms caused by medical, neurosurgical or ophthalmic disorders, and 0.9 % of our patients had NMO. Though most...... of these conditions are rare, it is of importance to keep them in mind upon encountering patients with symptoms of ON....

  4. Boomerang - the Australian light source

    International Nuclear Information System (INIS)

    Boldeman, J.W.; Garrett, R.F.

    2000-01-01

    Full text: The Australian Synchrotron Research Program (ASRP) was one of seven major national research facilities funded by the Federal Government in December 1995. The program provides guaranteed access and travel funds for Australian scientists to conduct synchrotron radiation-based research at two overseas facilities - the Photon Factory at Tsukuba in Japan and the Advanced Photon Source at the Argonne National Laboratory in the US. The Federal Government also provided funding of $100K to carry out a Feasibility Study for an Australian-based facility. This has been completed and included a mission to a number of laboratories overseas that were or had recently constructed a facility that could be considered for Australia. Following the mission, consensus was achieved within the community for the specifications of a proposed Australian facility. The proposed facility, Boomerang, has an energy of 3 GeV, an emittance of 16 nm rad and will be equipped in the first phase with 9 instrument stations. Boomerang will be competitive in performance with other facilities currently under construction overseas. A detailed proposal has been submitted to the Federal Government for funding. No site has been specified in the proposal. The proposal was prepared within the Australian Synchrotron Research Program (ASRP) following extensive consultation with industrial and scientific groups in all Australian states. Valuable contributions have been made by members of all the committees of the ASRP, the Australian synchrotron research community that works through the ASRP and the National Synchrotron Steering Committee. Important contributions have also been made by many industrial groups including consortia in Victoria, Queensland and New South Wales. The input from the ANKA staff at Forschungszentrum Karlsruhe and, in particular. Professor Einfeld has been a critical component. The estimated capital cost of a no frills laboratory has been estimated to be $100M in 1999 dollars. The

  5. A comparative study of the economic and social functioning of Vietnamese-Australians with low English proficiency living with psychotic illness.

    Science.gov (United States)

    Stolk, Yvonne; Sevar, Katherine; Tran, Nga; Mancuso, Serafino G; Chopra, Prem; Castle, David

    2015-06-01

    Because national surveys of people living with psychotic disorders tend to exclude people with low English proficiency (LEP), little is known of their economic and social functioning. Culturally influenced explanatory models may result in delayed presentation and poorer functioning. The study aimed to compare the functioning of LEP Vietnamese-Australian and Australian-born patients with psychosis and to investigate the Vietnamese-Australians' pathways to care. In all, 19 LEP Vietnamese-Australians, previously excluded from the Australian Survey of High Impact Psychosis (SHIP), were matched with 15 Australian-born controls, and interviewed by a Vietnamese bilingual mental health professional using the SHIP Interview Schedule. The Vietnamese-Australian patients were significantly more likely to live with family, rate spirituality as important and participate in community rehabilitation programs. Their work, social and independent functioning, was better than the controls. The groups did not differ in mental health services received and satisfaction with services. Although half of Vietnamese-Australians attributed mental illness to supernatural, among other causes, none had consulted traditional healers. Despite LEP, Vietnamese-Australians with psychosis showed comparable or better functioning than Australian-born patients. Further investigation is recommended into LEP patients' clinical and social recovery and the role of language communities' support networks. © The Author(s) 2014.

  6. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Brochure Working with MS (.pdf) Download Brochure Taming Stress (.pdf) Download Brochure Multiple Sclerosis and Your Emotions (.pdf) Download Brochure Disease Modifying Therapies Overview (.pdf) ...

  7. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Privacy Policy Site Map Site Tour Contact Us For Professionals Researchers Physicians Nurses Rehabilitation Professionals Mental Health Professionals Health and Wellness Professionals What Is MS? ...

  8. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... About the Society Vision Careers Leadership Cultural Values Financials News Press Room MS Prevalence Charitable Ratings Corporate Support Helpful Links Donate Society Store MSConnection Blog ...

  9. Diagnosis and heterogeneity of MS in MRI

    International Nuclear Information System (INIS)

    Holst, B.; Fiehler, J.; Schippling, S.

    2008-01-01

    An efficient therapy of MS requires a quick and reliable diagnosis of the disease. MRI is the most leading paraclinical examination for MS diagnosis. Even though there is no pathognomic finding in MRI, there are MS characteristics with respect to morphology and localization. To exclude other neurological disorders and distinguish between different characteristics within MS, the use of contrast agent is advantageous. Postulated MRI criteria have been increasingly adjusted to the clinical routine and have become clearer, more sensitive, and more specific. Different imaging criteria will be introduced. In addition to the McDonald criteria of 2001 and 2005, new criteria will be presented in which the use of contrast agent is replaced by a second MRI and the dissemination in time and space is simplified. Different pathomechanisms which help to separate MS patients into subgroups are postulated. The diverse pathomechanisms also enable the development of new pharmaceuticals to manipulate the immunologic course in different stages. For varying therapy approaches, it is increasingly important to differentiate the heterogeneous appearance forms into subtypes. The two visible main components of the disorder in MRI are inflammation and neurodegeneration and are responsible for different clinical courses. Both are interdependent and independent of each other. We introduce a stratification which uses both components as a function of their different outcomes to compose subgroups. The previous challenge with respect to MRI was to support the diagnosis of MS via MRI criteria. A future problem will be the heterogeneity and classification of subgroups. This article gives an overview of both problems. (orig.)

  10. Rootkit pro MS Windows

    OpenAIRE

    Trutman, Michal

    2012-01-01

    Tato bakalářská práce se zabývá metodami útoků na operační systém MS Windows a přibližuje techniky skrývání výpočetních prostředků používané existujícími rootkity. Práce je rozdělena na teoretickou a praktickou část. První část pojednává o klasifikaci rootkitů, představuje strukturu jádra systému a následně popisuje jednotlivé techniky napadení operačního systému. V praktické části je prezentována implementace a testování vlastního rootkitu. This bachelor's thesis deals with methods of att...

  11. Statistical process control of mortality series in the Australian and New Zealand Intensive Care Society (ANZICS) adult patient database: implications of the data generating process.

    Science.gov (United States)

    Moran, John L; Solomon, Patricia J

    2013-05-24

    Statistical process control (SPC), an industrial sphere initiative, has recently been applied in health care and public health surveillance. SPC methods assume independent observations and process autocorrelation has been associated with increase in false alarm frequency. Monthly mean raw mortality (at hospital discharge) time series, 1995-2009, at the individual Intensive Care unit (ICU) level, were generated from the Australia and New Zealand Intensive Care Society adult patient database. Evidence for series (i) autocorrelation and seasonality was demonstrated using (partial)-autocorrelation ((P)ACF) function displays and classical series decomposition and (ii) "in-control" status was sought using risk-adjusted (RA) exponentially weighted moving average (EWMA) control limits (3 sigma). Risk adjustment was achieved using a random coefficient (intercept as ICU site and slope as APACHE III score) logistic regression model, generating an expected mortality series. Application of time-series to an exemplar complete ICU series (1995-(end)2009) was via Box-Jenkins methodology: autoregressive moving average (ARMA) and (G)ARCH ((Generalised) Autoregressive Conditional Heteroscedasticity) models, the latter addressing volatility of the series variance. The overall data set, 1995-2009, consisted of 491324 records from 137 ICU sites; average raw mortality was 14.07%; average(SD) raw and expected mortalities ranged from 0.012(0.113) and 0.013(0.045) to 0.296(0.457) and 0.278(0.247) respectively. For the raw mortality series: 71 sites had continuous data for assessment up to or beyond lag40 and 35% had autocorrelation through to lag40; and of 36 sites with continuous data for ≥ 72 months, all demonstrated marked seasonality. Similar numbers and percentages were seen with the expected series. Out-of-control signalling was evident for the raw mortality series with respect to RA-EWMA control limits; a seasonal ARMA model, with GARCH effects, displayed white-noise residuals

  12. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Another Condition Aging with MS Anesthesia and Surgery Managing Your MS d Emotional Well-Being Mood Changes d Spiritual Well-Being Building Spirituality into Your Life d Cognitive Health d Work, Home & Leisure Employment Insurance & Financial Information Staying Mobile ...

  13. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Review of Society's Research Programs d Careers d Leadership Board of Directors Senior Leadership Team Founder Sylvia Lawry d Cultural Values d ... Pinterest MS Connection About the Society Vision Careers Leadership Cultural Values Financials News Press Room MS Prevalence ...

  14. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Text Print Discover More Here are a few related topics that may interest you Living with MS (.pdf) Download Brochure Focus on Employment (.pdf) Download Brochure Working with MS (.pdf) Download Brochure Taming Stress (.pdf) Download Brochure Multiple Sclerosis and Your Emotions (. ...

  15. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... More Schilder's Disease Learn More The National MS Society is Here to Help Need More Information? We ... Twitter LinkedIn YouTube Pinterest MS Connection About the Society Vision Careers Leadership Cultural Values Financials News Press ...

  16. Economic costs associated with an MS relapse

    LENUS (Irish Health Repository)

    O'Connell, K.

    2014-09-01

    This was an prospective audit composed of medical chart review and patient questionnaire. Relapses were stratified into 3 groups: low, moderate and high intensity. Age, gender, MS subtype, disease duration, expanded disability status scale (EDSS) score, disease modifying therapy (DMT) use and employment status were recorded. Direct costs included GP visits, investigations, clinic visit, consultations with medical staff, medication and admission costs. Indirect costs assessed loss of earnings, partner\\'s loss of earnings, childcare, meals and travel costs.

  17. Cataract surgery audit at an Australian urban teaching hospital.

    Science.gov (United States)

    Kahawita, Shyalle K; Goggin, Michael

    2015-08-01

    To provide local data on visual acuity and surgical outcomes for cataract surgery performed in an Australian teaching hospital. Continuous audit over 7 years in a public teaching hospital. A total of 3740 eyes had cataract surgery performed at The Queen Elizabeth Hospital, South Australia, from May 2006 to September 2013. Visual acuity and complication rates were recorded for cataract surgery cases operated on between May 2006 and September 2013 on a digital database with data entry contemporaneous with final follow-up. Visual acuity and surgical complications. Of the patients, 91.4% achieved postoperative best-measured vision better than preoperative best-measured vision. The rate of posterior capsular tear was 2.59%, endophthalmitis was 0.11% and the overall complication rate was 11.7%. This audit is the first to document modern cataract surgery, overwhelmingly dominated by phacoemulsification in an Australian population and can be used to benchmark cataract surgery outcome in an urban Australian population. © 2015 Royal Australian and New Zealand College of Ophthalmologists.

  18. Australian survey on current practices for breast radiotherapy.

    Science.gov (United States)

    Dundas, Kylie L; Pogson, Elise M; Batumalai, Vikneswary; Boxer, Miriam M; Yap, Mei Ling; Delaney, Geoff P; Metcalfe, Peter; Holloway, Lois

    2015-12-01

    Detailed, published surveys specific to Australian breast radiotherapy practice were last conducted in 2002. More recent international surveys specific to breast radiotherapy practice include a European survey conducted in 2008/2009 and a Spanish survey conducted in 2009. Radiotherapy techniques continue to evolve, and the utilisation of new techniques, such as intensity-modulated radiation therapy (IMRT), is increasing. This survey aimed to determine current breast radiotherapy practices across Australia. An online survey was completed by 50 of the 69 Australian radiation therapy treatment centres. Supine tangential beam whole breast irradiation remains the standard of care for breast radiotherapy in Australia. A growing number of institutions are exploring prone positioning and IMRT utilisation. This survey demonstrated a wide variation in the benchmarks used to limit and report organ at risk doses, prescribed dose regimen, and post-mastectomy bolus practices. This survey also indicated, when compared with international literature, that there may be less interest in or uptake of external beam partial breast irradiation, prone positioning, simultaneous integrated boost and breath hold techniques. These are areas where further review and research may be warranted to ensure Australian patients are receiving the best care possible based on the best evidence available. This survey provides insight into the current radiotherapy practice for breast cancer in Australia. © 2015 The Royal Australian and New Zealand College of Radiologists.

  19. Are we there yet? Travel vaccinations for Australian children.

    Science.gov (United States)

    Slonim, Marnie; Starr, Mike; Blashki, Grant

    2014-06-01

    Australians travel overseas frequently and general practitioners (GPs) are often asked to provide detailed advice on travel vaccinations for children. Planning a safe and effective vaccination schedule is dependent on the context: where and when the family is travelling, the individual child's medical needs and past vaccination history, and if they are visiting family and friends. In this paper we provide an overview of the issues to consider when vaccinating Australian children for overseas travel. We also list the suite of common travel vaccinations and discuss some clinical scenarios that are likely to present in Australian general practice. Australians love to travel overseas and, increasingly, GPs are asked by patients to provide detailed advice on travel vaccinations for their children. Decisions regarding vaccinations for travelling children can be complex and the advice often differs from that provided for adults. Children differ from adults in their vulnerability to illnesses and side effects of medications. These differences, as well as their status regarding routine childhood vaccinations, all need to be taken into account. As with adults, it is important to consider the location and duration of travel and time until departure. The age of the child is also important and there may be a case for accelerating the routine childhood vaccinations in some children. The aim of this paper is to provide a clear and simple outline of the vaccination recommendations for children travelling overseas from Australia.

  20. Isolation and structural characterization of echinocystic acid triterpenoid saponins from the Australian medicinal and food plant Acacia ligulata

    DEFF Research Database (Denmark)

    Knudsen, Diana Jæger; Ndi, Chi P.; Crocoll, Christoph

    2017-01-01

    The Australian plant Acacia ligulata has a number of traditional food and medicinal uses by Australian Aboriginal people, although no bioactive compounds have previously been isolated from this species. Bioassay-guided fractionation of an ethanolic extract of the mature pods of A. ligulata led...... to the isolation of the two new echinocystic acid triterpenoid saponins, ligulatasides A (1) and B (2), which differ in the fine structure of their glycan substituents. Their structures were elucidated on the basis of 1D and 2D NMR, GC-MS, LC-MS/MS, and saccharide linkage analysis. These are the first isolated...... compounds from A. ligulata and the first fully elucidated structures of triterpenoid saponins from Acacia sensu stricto having echinocystic acid reported as the aglycone. Compounds 1 and 2 were evaluated for cytotoxic activity against a human melanoma cancer cell line (SK-MEL28) and a diploid fibroblast...

  1. Uranium: a notable Australian decision

    Energy Technology Data Exchange (ETDEWEB)

    Willheim, E

    1978-07-01

    Australia, with 20% of the world's known reserves, has legislated strict controls for the mining, milling, and export of its uranium deposits. Background information on the environmental inquiry preceding this legislation is reviewed, including a description of the Australian Environmental Protection Act and the Ranger Uranium Environmental Inquiry. A package of six bills implemented the Australian government's decisions on: (1) nuclear proliferation and safeguards, (2) mining in the Kakadu National Park wilderness area, (3) economic and social protection of the Aboriginal people, (4) nuclear waste disposal, (5) security from nuclear terrorism, and (6) environmental controls. The author concludes that the decision and implementing legislation were improved as a result of the public environmental inquiry technique.

  2. Australian synchrotron light source - (boomerang)

    International Nuclear Information System (INIS)

    Boldeman, J.

    2001-01-01

    The Australian National Synchrotron Light Source - (Boomerang) is to be installed at the Monash University in Victoria. This report provides some background to the proposed facility and discusses aspects of a prospective design. Recently, significant effort was devoted to refining the in principle design and a lattice providing an emittance od 18 nm rad was obtained with a distributed dispersion in the straight section of 0.29m. Exhaustive studies have been made of the economic benefits that would accrue to Australia to Australia following the installation of this facility. This design is a refinement of the design concept presented to the SRI -2000, Berlin (Boldeman, Einfeld et al), to the meeting of the 4th Asian Forum and the Preliminary Design Study presented to the Australian Synchrotron Research Program

  3. Funding emergency care: Australian style.

    Science.gov (United States)

    Bell, Anthony; Crilly, Julia; Williams, Ged; Wylie, Kate; Toloo, Ghasem Sam; Burke, John; FitzGerald, Gerry

    2014-08-01

    The ongoing challenge for ED leaders is to remain abreast of system-wide changes that impact on the day-to-day management of their departments. Changes to the funding model creates another layer of complexity and this introductory paper serves as the beginning of a discussion about the way in which EDs are funded and how this can and will impact on business decisions, models of care and resource allocation within Australian EDs. Furthermore it is evident that any funding model today will mature and change with time, and moves are afoot to refine and contextualise ED funding over the medium term. This perspective seeks to provide a basis of understanding for our current and future funding arrangements in Australian EDs. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  4. Found: The Original 1945 Records of Australian Radio Astronomy

    Science.gov (United States)

    Goss, Miller; Ekers, Ron; Sim, Helen

    2015-08-01

    In July 2014, we found the original records of the first published Australian radio astronomy observations. These were obtained by Joseph L. Pawsey and Ruby Payne-Scott in early October 1945. The observations gave strong evidence of a million degree corona as well as frequent radio bursts.These observations followed earlier detections of the radio sun by Stanley Hey, George Southworth, Grote Reber and Elizabeth Alexander. The latter observations (the "Norfolk Island Effect" of March 1945) were the immediate motivation for the campaign carried out by Pawsey and Payne-Scott.These observations formed the basis for a number of pioneering publications: the 9 February 1946 Nature paper of Pawsey, Payne-Scott and McCready which was submitted on the last date on which data was obtained on 23 October 1945, the major publication of the initial Australian radio solar publication in the Proceedings of the Royal Society of London in August 1947 and Pawsey's presentation of the radio properties of the million degree corona in the Nature of 2 November 1946. Contemporaneously with these publications, D. F.Martyn was involved in an independent theoretical study of the properties of the solar corona.(Ginzburg and Shklovsky were also involved in this era in a study of the properties of the corona.) The back-to-back Martyn and Pawsey Nature papers were the first that described the radio properties of the hot corona, due to free-free emission. The division of the observed emission into "bursting" and "quiet" modes was challenging for the novice radio astronomers.These historical records had been recognized by Paul Wild in 1968, who instructed the CSIRO Division of Radiophysics secretary to E.("Taffy") G. Bowen, Ms. Sally Atkinson, to submit these to the Australian Academy of Science. Wild characterized these documents as "of considerable historical interest". Apparently the transmission of the documents was not done; a thorough search of the Australian Academy Library in August 2014

  5. Australian Government Balance Sheet Management

    OpenAIRE

    Wilson Au-Yeung; Jason McDonald; Amanda Sayegh

    2006-01-01

    Since almost eliminating net debt, the Australian Government%u2019s attention has turned to the financing of broader balance sheet liabilities, such as public sector superannuation. Australia will be developing a significant financial asset portfolio in the %u2018Future Fund%u2019 to smooth the financing of expenses through time. This raises the significant policy question of how best to manage the government balance sheet to reduce risk. This paper provides a framework for optimal balance sh...

  6. Meteors in Australian Aboriginal Dreamings

    Science.gov (United States)

    Hamacher, Duane W.; Norris, Ray P.

    2010-06-01

    We present a comprehensive analysis of Australian Aboriginal accounts of meteors. The data used were taken from anthropological and ethnographic literature describing oral traditions, ceremonies, and Dreamings of 97 Aboriginal groups representing all states of modern Australia. This revealed common themes in the way meteors were viewed between Aboriginal groups, focusing on supernatural events, death, omens, and war. The presence of such themes around Australia was probably due to the unpredictable nature of meteors in an otherwise well-ordered cosmos.

  7. Clinical laboratory verification of thyroglobulin concentrations in the presence of autoantibodies to thyroglobulin: comparison of EIA, radioimmunoassay and LC MS/MS measurements in an Urban Hospital.

    Science.gov (United States)

    Wheeler, Sarah E; Liu, Li; Blair, Harry C; Sivak, Richard; Longo, Nancy; Tischler, Jeffery; Mulvey, Kathryn; Palmer, Octavia M Peck

    2017-12-08

    Thyroglobulin (Tg) measurements assess recurrence in post-thyroidectomy thyroid cancer patients. Tg measurements by enzyme immunoassays (EIA) can be falsely elevated by interference from Tg autoantibodies (TgAb). Radioimmunoassay (RIA) is less susceptible to TgAb interference and has been the standard-of-care test for TgAb positive patients. Recently developed liquid chromatography tandem mass spectrometry (LC-MS/MS) methods may eliminate TgAb interference. We assessed the performance of Tg measurements by EIA, RIA and LC-MS/MS to evaluate TgAb interference differences. We measured TgAb and Tg in 50 plasma samples from 40 patients in whom Tg measurement was part of their routine follow-up and 10 healthy volunteers. Discrepancy between EIA and both LC-MS/MS and RIA was observed at low Tg concentrations (≤ 7.55 ng/mL) in TgAb positive specimens (LC-MS/MS = 1.9 * EIA - 0.03, r = 0.68). RIA and LC-MS/MS Tg measurements in TgAb positive specimens with low Tg concentrations had improved correlation but demonstrated bias (LC MS/MS = 0.6 * RIA - 1.4, r = 0.90). Disagreement between methods may be attributed to LC-MS/MS reported Tg concentrations as undetectable compared to RIA. It seems likely that most discrepant cases are falsely elevated in RIA due to TgAb interference, however, some cases appear below the detection limit of LC-MS/MS; implementation of LC-MS/MS by clinicians will require lower detection limits.

  8. Natalizumab in progressive MS

    DEFF Research Database (Denmark)

    Romme Christensen, Jeppe; Ratzer, Rikke; Börnsen, Lars

    2014-01-01

    that systemic inflammation contributes to the pathogenesis. Moreover, the study establishes the feasibility of using CSF biomarkers in proof-of-concept trials, allowing a low number of participants and short study duration. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that in patients...

  9. Compliance with Corporate Governance Principles: Australian Evidence

    OpenAIRE

    Maryam Safari; Soheila Mirshekary; Victoria Wise

    2015-01-01

    This study investigates the association between the level of compliance of Australian listed companies with Australian corporate governance principles, in aggregate, and the level of discretionary accruals using the modified Jones model. It is hypothesised that higher levels of compliance would be associated with lower levels of discretionary accruals. Data from a random sample of 214 Australian listed companies for the years 2009 and 2010 were used to test the hypothesis. The results demonst...

  10. Changing activity in MS lesions

    International Nuclear Information System (INIS)

    Kermode, A.G.; Tofts, P.S.; Thompson, A.J.; Rudge, P.; MacManus, D.G.; Kendall, B.E.; Moseley, I.F.; Kingsley, D.P.E.; McDonald, W.I.

    1989-01-01

    Gd-DTPA enhanced T1 weighted MRI is a discriminating test for a defective blood-brain barrier, with MS lesions showing considerable variation in the pattern of enhancement. Since little is known of the changes in the blood-brain barrier in the active plaque over time, the natural history of blood-brain barrier disturbance in the MS lesion was examined to confirm earlier reports that Gd-DTPA enhancement is a consistent early event in new lesions of relapsing/remitting MS. This knowledge is essential for the use of MRI in monitoring treatment. (author). 9 refs

  11. Adherence to MRI protocol consensus guidelines in multiple sclerosis: an Australian multi-centre study

    International Nuclear Information System (INIS)

    Curley, Michael; Josey, Lawrence; Lucas, Robyn; Dear, Keith; Taylor, Bruce V.; Coulthard, Alan; Ausimmune Investigator Group

    2012-01-01

    Multiple sclerosis (MS) is a debilitating disease that causes significant morbidity within a young demographic. Diagnostic guidelines for MS have evolved, and imaging has played an increasingly important role in diagnosis over the last two decades. For imaging to contribute to diagnosis in a meaningful way, it must be reproducible. Consensus guidelines for MRI in MS exist to define correct sequence type and imaging technique, but it is not clear to what extent they are followed. This study reviewed MRI studies performed on Australian individuals presenting with a first clinical diagnosis of central nervous system demyelination (FCD) for adherence to published guidelines and discussed practical implementation of MS guidelines in light of recent updates. The Ausimmune study was a prospective case control study of Australian participants presenting with FCD from 2003 to 2006. Baseline cranial and spinal cord MRI studies of 226 case participants from four separate Australian regions were reviewed. MRI sequences were classified according to anatomical location, slice plane, tissue weighting and use of gadolinium-containing contrast media. Results were compared with the 2003 Consortium of Multiple Sclerosis Centres MRI protocol for the diagnosis of MS. The composition of core cranial MRI sequences performed varied across the 226 scans. Of the studies, 91% included sagittal fluid attenuated inversion recovery (FLAIR) sequences. Cranial axial T2-weighted, axial FLAIR and axial proton density-weighted sequences were performed in 88%, 60% and 16% (respectively) of scans. Only 25% of the studies included a T1-weighted contrast-enhanced sequence. Concordance with the guidelines in all sequences was very low (2). Only a small number of MRI investigations performed included all of the sequences stipulated by consensus guidelines. This is likely due to poor awareness in the imaging community of the guidelines and the rationale behind certain sequences. Radiologists with a sub

  12. Growth charts for Australian children with achondroplasia.

    Science.gov (United States)

    Tofts, Louise; Das, Sandeep; Collins, Felicity; Burton, Karen L O

    2017-08-01

    Achondroplasia is an autosomal dominant disorder, the most common genetic cause of short stature in humans. Reference curves for head circumference, weight, height, and BMI are needed in clinical practice but none exist for the Australian population. This study aimed to produce head circumference, height, weight, and BMI reference percentile curves for Australian children and adolescents with achondroplasia. Measurements of head circumference, height and weight taken at clinical visits were retrospectively extracted from the electronic medical record. Age was corrected for prematurity. Patients were excluded from head circumference analysis if they had significant neurosurgical complications and from the weight and BMI analysis when they had a clinical diagnosis of overweight. Measurements were available on 138 individuals (69 males and 69 females) taken between 1970 and 2015, with over 50% collected since 2005. A total of 3,352 data points were available. The LMS method was used to produce growth charts with estimated centiles (10, 25, 50, 75, and 90th) separately for males and females. For females birth weight was 3 kg (2.5-3.5 kg), birth length 48 cm (44-50 cm) and head circumference 37.5 cm (36-39 cm), adult height was 125 cm (116-132 cm), weight 42 kg (34-54 kg), and head circumference 58 cm (55.5-60.5 cm) all 50th centile (10-90th). For males birth weight was 3.5 kg (3-4 kg), length 49 cm (46-52 cm) and head circumference 38.5 cm (36-41 cm), adult height was 134 cm (125-141 cm), weight 41 kg (24.5-57 kg) and head circumference 61 cm (58-64 cm). The curves are similar to previously published reference data from the USA and have expected population wide variation from curves from an Argentinian population. Despite limitations of our curves for adolescents (12 years and older) due to data paucity, these Australian growth charts for children and adolescents with achondroplasia will be a useful reference in clinical

  13. Substantial Early, But Nonprogressive Neuronal Loss in Multiple Sclerosis (MS) Spinal Cord

    NARCIS (Netherlands)

    Schirmer, Lucas; Albert, Monika; Buss, Armin; Schulz-Schaeffer, Walter J.; Antel, Jack P.; Brueck, Wolfgang; Stadelmann, Christine

    2009-01-01

    Research in multiple sclerosis (MS) has recently been focusing on the extent of neuroaxonal damage and its contribution to disease outcome. In the present Study, we examined spinal cord tissue from 30 clinically well-characterized MS patients. MS, amyotrophic lateral sclerosis (ALS), and control

  14. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Behaviors Emotional Well-Being Spiritual Well-Being Cognitive Health Work, Home & Leisure Relationships Research Participate in Research ... Nutrition Exercise Heat & Temperature Sensitivity Sleep Vaccinations Women's Health Unhealthy Habits Managing MS and Another Condition Aging ...

  15. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... you and your MS care provider discuss your treatment options and expected outcomes. For example: If you ... will likely want to consider a more aggressive treatment approach than if there were no evidence of ...

  16. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Research Diet Vitamin D How and Why Do Scientists Share Results d Research We Fund Stopping MS ... Share Smaller Text Larger Text Print In this article Overview RRMS – the most common disease course – is ...

  17. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... membranes surrounding nerve fibers in the central nervous system (CNS)), as well as the nerve fibers themselves. ... and problems with cognition (learning and memory or information processing). People with progressive forms of MS are ...

  18. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... discuss your treatment options and expected outcomes. For example: If you have RRMS that is active and worsening, you and your MS care provider will likely want to consider a more aggressive treatment approach than if there ...

  19. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Electrical Stimulation (FES) d Complementary & Alternative Medicines Chiropractic Therapy Marijuana Massage and Bodywork Acupuncture d For Clinicians ... you and your MS care provider discuss your treatment options and expected outcomes. For example: If you ...

  20. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Webinar Series Momentum Magazine Educational Videos Knowledge Is Power Live Fully, Live Well Everyday Matters Resilience: Addressing ... d Living Well with MS d Diet, Exercise & Healthy Behaviors Diet & Nutrition Exercise Heat & Temperature Sensitivity Sleep ...

  1. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Webinar Series Momentum Magazine Educational Videos Knowledge Is Power Live Fully, Live Well Everyday Matters Resilience: Addressing the Challenges of MS You CAN! Webcasts DVDs Books ...

  2. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Find Support Advanced Care Needs Resources for Specific Populations Find Programs & Services in Your Area Calendar of ... Services: Questions to Ask d Resources for Specific Populations Pediatric MS Support Veterans with Multiple Sclerosis d ...

  3. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... in RRMS; however, each person's experience with RRMS will be unique. Following a relapse, the new symptoms ... and worsening, you and your MS care provider will likely want to consider a more aggressive treatment ...

  4. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Senior Leadership Team Founder Sylvia Lawry d Cultural Values d Financials Annual Reports Sources of Support d ... Connection About the Society Vision Careers Leadership Cultural Values Financials News Press Room MS Prevalence Charitable Ratings ...

  5. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Diet & Nutrition Exercise Heat & Temperature Sensitivity Sleep Vaccinations Women's Health Unhealthy Habits Managing MS and Another Condition ... lesions, which contain fewer inflammatory cells. In RRMS, women are affected two to three times as often ...

  6. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... CIS) Newly Diagnosed Diagnosing Tools Other Conditions to Rule Out For Clinicians Treating MS Comprehensive Care Find ... CSF) Evoked Potentials (EP) d Other Conditions to Rule Out Lyme Disease Lupus Neuromyelitis Optica Acute Disseminated ...

  7. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Become an MS Activist Take Action Current Advocacy Issues Advocacy Results Advocacy News ... d Give in Honor or Memory d Workplace Giving d Employer Matching Gifts d Gifts of ...

  8. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... without symptoms of which the person is aware. What happens in RRMS? Relapsing-remitting MS is defined ... a different mechanism of action in order to control the disease activity more effectively and help prevent ...

  9. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Behaviors Diet & Nutrition Exercise Heat & Temperature Sensitivity Sleep Vaccinations Women's Health Unhealthy Habits Managing MS and Another ... or worsening. Together, you can weigh the potential risks and benefits of other treatment options. If your ...

  10. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... An increase in disability is confirmed when the person exhibits the same level of disability at the ... to 12 months later. Approximately 85 percent of people with MS are initially diagnosed with RRMS. This ...

  11. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Support d Library & Education Programs Email newsletter Mood Changes Webinar Series Momentum Magazine Educational Videos Knowledge Is Power Live Fully, Live Well Everyday Matters Resilience: Addressing the Challenges of MS You CAN! Webcasts DVDs Books For ...

  12. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... 344-4867 or contact us online. Contact Us Contact Us Newly Diagnosed If you or somone close to you has recently been diagnosed, access our MS information ... Connection About the Society Vision ...

  13. Relapsing-Remitting MS (RRMS)

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  14. Relapsing-Remitting MS (RRMS)

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  16. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Employer Matching Gifts d Gifts of Stock or Securities d Giving Circles Golden Circle Circle of Distinction ... and problems with cognition (learning and memory or information processing). People with progressive forms of MS are ...

  17. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Fully, Live Well Everyday Matters Resilience: Addressing the Challenges of MS You CAN! Webcasts DVDs Books For ... Review of Society's Research Programs d Careers d Leadership Board of Directors Senior Leadership Team Founder Sylvia ...

  18. Relapsing-Remitting MS (RRMS)

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  19. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Online d Give in Honor or Memory d Workplace Giving d Employer Matching Gifts d Gifts of ... Brochure Working with MS (.pdf) Download Brochure Taming Stress (.pdf) Download Brochure Multiple Sclerosis and Your Emotions (. ...

  20. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... Team Make the Most of Your Doctor Visits Advance Medical Directives d Find an MS Care Provider ... in RRMS; however, each person's experience with RRMS will be unique. Following a relapse, the new symptoms ...

  1. Relapsing-Remitting MS (RRMS)

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    Full Text Available ... as shown by the arrows, often occur as part of a relapse. However, new MRI lesions indicating ... course of your disease at different points in time helps you and your MS care provider discuss ...

  2. Feasibility of establishing an Australian ACL registry: a pilot study by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR).

    Science.gov (United States)

    Lekkas, Christina; Clarnette, Richard; Graves, Stephen E; Rainbird, Sophia; Parker, David; Lorimer, Michelle; Paterson, Roger; Roe, Justin; Morris, Hayden; Feller, Julian A; Annear, Peter; Forster, Ben; Hayes, David

    2017-05-01

    Rupture of the anterior cruciate ligament (ACL) is a common and debilitating injury that impacts significantly on knee function and risks the development of degenerative arthritis. The outcome of ACL surgery is not monitored in Australia. The optimal treatment is unknown. Consequently, the identification of best practice in treating ACL is crucial to the development of improved outcomes. The Australian Knee Society (AKS) asked the Australian Orthopaedic Association (AOA) to consider establishing a national ACL registry. As a first step, a pilot study was undertaken by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) to test the hypothesis that collecting the required information in the Australian setting was possible. Surgeons completed an operative form which provided comprehensive information on the surgery undertaken. Patients provided pre- and post-operative questionnaires including the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Marx Activity Scale (MA Scale). The number of ACL procedures undertaken at each hospital during the recruitment period was compared against State Government Health Department separation data. A total of 802 patients were recruited from October 2011 to January 2013. The overall capture rate for surgeon-derived data was 99%, and the capture rate for the pre-operative patient questionnaire was 97.9%. At 6 months, patient-reported outcomes were obtained from 55% of patients, and 58.5% of patients at 12 months. When checked against State Government Health Department separation data, 31.3% of procedures undertaken at each study hospital were captured in the study. It is possible to collect surgeon-derived and pre-operative patient-reported data, following ACL reconstruction in Australia. The need to gain patient consent was a limiting factor to participation. When patients did consent to participate in the study, we were able to capture nearly 100% of surgical procedures. Patient consent

  3. MRI atlas of MS lesions

    Energy Technology Data Exchange (ETDEWEB)

    Sahraian, Mohammad Ali [Tehran Univ. of Medical Sciences Sina Hospital (Iran). Dept. of Neurology; Radue, Ernst-Wilhelm [Univ. Hospital Basel (Switzerland). Dept. of Neuroradiology

    2008-07-01

    MRI has become the main paraclinical test in the diagnosis and management of multiple sclerosis. We have demonstrated more than 400 pictures of different typical and atypical MS lesions in this atlas. Each image has a teaching point. New diagnostic criteria and differential diagnosis are discussed and the book is supported by a teaching DVD where the reader can see MS lesions in different slices and sequences. (orig.)

  4. Diabetes management in an Australian primary care population.

    Science.gov (United States)

    Krass, I; Hebing, R; Mitchell, B; Hughes, J; Peterson, G; Song, Y J C; Stewart, K; Armour, C L

    2011-12-01

    Worldwide studies have shown that significant proportions of patients with type 2 diabetes (T2DM) do not meet targets for glycaemic control, blood pressure (BP) and lipids, putting them at higher risk of developing complications. However, little is known about medicines management in Australian primary care populations with T2DM. The aim of this study was to (i) describe the management of a large group of patients in primary care, (ii) identify areas for improvement in management and (iii) determine any relationship between adherence and glycaemic, BP and lipid control. This was a retrospective, epidemiological study of primary care patients with T2DM diabetes, with HbA(1c) of >7%, recruited in 90 Australian community pharmacies. Data collected included demographic details, diabetes history, current medication regimen, height, weight, BP, physical activity and smoking status. Of the 430 patients, 98% used antidiabetics, 80% antihypertensives, 73% lipid lowering drugs and 38% aspirin. BP and all lipid targets were met by only 21% and 14% of the treated patients and 21% and 12% of the untreated patients respectively. Medication adherence was related to better glycaemic control (P = 0.04). An evidence-base prescribing practice gap was seen in this Australian primary care population of T2DM patients. Patients were undertreated with antihypertensive and lipid lowering medication, and several subgroups with co-morbidities were not receiving the recommended pharmacotherapy. Interventions are required to redress the current evidence-base prescribing practice gap in disease management in primary care. © 2011 Blackwell Publishing Ltd.

  5. Finding of pesticides in fashionable fruit juices by LC-MS/MS and GC-MS/MS.

    Science.gov (United States)

    Tran, Kevin; Eide, David; Nickols, Susan M; Cromer, Michele R; Sabaa-Srur, Armando; Smith, Robert E

    2012-10-15

    Products labelled as containing extracts from two mushrooms (cordyceps plus reishi) and the juices from açaí, goji, mangosteen, noni, pomegranate, and sea buckthorn have been analysed for 174 different pesticides, using the validated QuEChERS method for sample preparation and electrospray LC-MS/MS in the positive ion mode for analysis. Pesticides were found in 10 of the 21 samples analysed. Most pesticides found were below the tolerance levels (1-6 μg/g, depending on the pesticide), but some were not. This included boscalid, dimethomorph, iprovalicarb, pyridaben, pyrimethanil, and imazalil, for which there is no tolerance reported or zero tolerance in any fruit. However, genuine açaí that was harvested in the state of Pará and lyophilised in Rio de Janeiro had no detectable pesticides, when analysed by both LC-MS/MS and GC-MS/MS, which can detect 213 more pesticides and industrial chemicals. Likewise no pesticides were found in one sample each of cordyceps plus reishi, sea buckthorn and noni. Published by Elsevier Ltd.

  6. Costing the Australian National Hand Hygiene Initiative.

    Science.gov (United States)

    Page, K; Barnett, A G; Campbell, M; Brain, D; Martin, E; Fulop, N; Graves, N

    2014-11-01

    The Australian National Hand Hygiene Initiative (NHHI) is a major patient safety programme co-ordinated by Hand Hygiene Australia (HHA) and funded by the Australian Commission for Safety and Quality in Health Care. The annual costs of running this programme need to be understood to know the cost-effectiveness of a decision to sustain it as part of health services. To estimate the annual health services cost of running the NHHI; the set-up costs are excluded. A health services perspective was adopted for the costing and collected data from the 50 largest public hospitals in Australia that implemented the initiative, covering all states and territories. The costs of HHA, the costs to the state-level infection-prevention groups, the costs incurred by each acute hospital, and the costs for additional alcohol-based hand rub are all included. The programme cost AU$5.56 million each year (US$5.76, £3.63 million). Most of the cost is incurred at the hospital level (65%) and arose from the extra time taken for auditing hand hygiene compliance and doing education and training. On average, each infection control practitioner spent 5h per week on the NHHI, and the running cost per annum to their hospital was approximately AU$120,000 in 2012 (US$124,000, £78,000). Good estimates of the total costs of this programme are fundamental to understanding the cost-effectiveness of implementing the NHHI. This paper reports transparent costing methods, and the results include their uncertainty. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  7. LSN MS guidelines for the management of multiple sclerosis.

    Science.gov (United States)

    Shatila, A R; Koussa, S; Jabbour, R; Mourad, A; Aouad, A; Sabbagh, G; Kallab, K; Hilal, R; Khalifeh, R; Gebeily, S; Tourbah, A

    2013-12-01

    The prevalence of multiple sclerosis (MS) in Lebanon is unknown, as there are no available or reliable epidemiological studies to date. The circumstances of Middle East countries are different from those of Europe and North America in terms of differential diagnoses and disease management. The aim of the conference is to establish guidelines for diagnosis, treatment, follow-up and management of patients with MS in Lebanon. Another objective is to discuss and participate in research projects based on epidemiology, clinical trials and more fundamental aspects of the disease in the future. Under the authority of the Lebanese Society of Neurology (LSN), a group of neurologists took the initiative to participate in this LSN MS committee with the purpose of establishing a consensus for the management of patients with MS, and under the supervision of a Coordinator (A.T.) designed by the LSN board. Diagnostic and therapeutic, follow-up and research recommendations were proposed with special emphasis on the specific needs and circumstances of Lebanon. The experts highlighted the importance of considering particular needs, the identification of patients at high risk of developing MS in order to maximize therapeutic opportunities, and cost-effective control of treatment efficacy, as well as global assessment of disability. The experts established guidelines concerning diagnosis, treatment, and follow-up of patients with MS in Lebanon. Furthermore, they recommended some clinical and fundamental research projects. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  8. Simultaneous Determination of Cyclosporine A, Tacrolimus, Sirolimus, and Everolimus in Whole-Blood Samples by LC-MS/MS

    Directory of Open Access Journals (Sweden)

    Mustafa Karapirli

    2012-01-01

    Full Text Available Objectives. Cyclosporine A (CyA, tacrolimus (TRL, sirolimus (SIR, and everolimus (RAD are immunosuppressive drugs frequently used in organ transplantation. Our aim was to confirm a robust sensitive and selective liquid chromatography-tandem mass spectrometry (LC-MS/MS method for determination of CyA, TRL, SIR, and RAD in whole-blood samples. Materials and Methods. We used an integrated online solid-phase extraction-LC-MS/MS system and atmospheric pressure ionization tandem mass spectrometry (API-MS/MS in the multiple reaction monitoring (MRM detection mode. CyA, TRL, SIR, and RAD were simultaneously analyzed in whole blood treated with precipitation reagent taken from transplant patients. Results. System performance parameters were suitable for using this method as a high-throughput technique in clinical practice. The high concentration of one analyte in the sample did not affect the concentration of other analytes. Total analytical time was 2.5 min, and retention times of all analytes were shorter than 2 minutes. Conclusion. This LC-MS/MS method can be preferable for therapeutic drug monitoring of these immunosuppressive drugs (CyA, TRL, SRL, and RAD in whole blood. Sample preparation was too short and simple in this method, and it permits robust, rapid, sensitive, selective, and simultaneous determination of these drugs.

  9. Testing the Australian Megatsunami Hypothesis

    Science.gov (United States)

    Courtney, Claire; Strotz, Luke; Chague-Goff, Catherine; Goff, James; Dominey-Howes, Dale

    2010-05-01

    In the wake of the 2004 Indian Ocean Tsunami, many countries have been forced to reassess the risk of tsunamis to their coasts. Australia, with relative tectonic stability, has previously been considered at low risk of tsunami inundation. Within written history, only small tsunamis have struck the Australian coast, causing little damage. However, a body of work has arisen that sheds doubt on this apparent low risk, with researchers suggesting that megatsunamis have affected the east Australian coast, in particular southern New South Wales. With proposed run-ups in excess of 100m, recurrence of such megatsunamis in the now densely populated New South Wales coastal region would be catastrophic. The disjunct between historical and geological records demands a thorough re-evaluation of New South Wales sites purported to contain evidence of megatsunamis. In addition, the unique set of diagnostic criteria previously used to identify Australian palaeotsunami deposits is distinctly different to criteria applied to paleotsunamis globally. To address these issues, four coastal lagoonal sites in southern New South Wales were identified for further investigation. In addition to paleotsunami investigation, these sites were selected to provide a geological record of significant events during the Holocene. Site selection was based on small accommodation space and a high preservation potential with back barrier depressions closed to the sea. A suite of diagnostic criteria developed over the past two decades to identify palaeotsunamis have been applied to cores extracted from these sites. Methods used include sedimentary description, grain size analysis, micropalaeontology, geochemistry and a variety of dating techniques such as radiocarbon and lead 210. Preliminary analysis of these results will be presented, with particular focus on sites where there is evidence that could indicate catastrophic saltwater inundation.

  10. Succession Planning in Australian Farming

    Directory of Open Access Journals (Sweden)

    John Hicks

    2012-11-01

    Full Text Available The theme of this paper is that succession planning in Australian farming is under-developed.It may be linked to economic and social change which suggests that farmers need to adapt togenerational change but this is being resisted or ignored. The implications of this are the slowdecline of family farming, a poor transfer of skills and knowledge to subsequent generationsof farmers in some parts of the agricultural sector and the potential for an extension of thefinancial services industry to develop a more effective raft of succession planning measuresto mitigate the effects of a traditional approach to succession in agriculture.

  11. Comets in Australian Aboriginal Astronomy

    Science.gov (United States)

    Hamacher, Duane W.; Norris, Ray P.

    2011-03-01

    We present 25 accounts of comets from 40 Australian Aboriginal communities, citing both supernatural perceptions of comets and historical accounts of historically bright comets. Historical and ethnographic descriptions include the Great Comets of 1843, 1861, 1901, 1910, and 1927. We describe the perceptions of comets in Aboriginal societies and show that they are typically associated with fear, death, omens, malevolent spirits, and evil magic, consistent with many cultures around the world. We also provide a list of words for comets in 16 different Aboriginal languages.

  12. Aurorae in Australian Aboriginal Traditions

    Science.gov (United States)

    Hamacher, Duane W.

    2013-07-01

    Transient celestial phenomena feature prominently in the astronomical knowledge and traditions of Aboriginal Australians. In this paper, I collect accounts of the Aurora Australis from the literature regarding Aboriginal culture. Using previous studies of meteors, eclipses, and comets in Aboriginal traditions, I anticipate that the physical properties of aurora, such as their generally red colour as seen from southern Australia, will be associated with fire, death, blood, and evil spirits. The survey reveals this to be the case and also explores historical auroral events in Aboriginal cultures, aurorae in rock art, and briefly compares Aboriginal auroral traditions with other global indigenous groups, including the Maori of New Zealand.

  13. Asian and Australian power policy

    International Nuclear Information System (INIS)

    Hammons, T.J.

    1996-01-01

    This article is a 1995 Summer Meeting panel session summary on infrastructure, interconnections, and electricity exchanges in Asia and Australia. Panelists focused on the present and future state of the electric power sector, future expansion of Asian and Australian power systems, interconnections and power exchanges, cooperation, new capacity, direction of reforming the industry, interstate relations in the fuel and energy complex, and the impact of privatization on electric supply. They addressed electricity and energy issues in both developing and developed Asian countries and in Australia as seen by the United Nations (UN), the World Energy Council (WEC), The World Bank, Japan, Australia, India, China, East Russia, Vietnam, and Malaysia

  14. Career Intentions of Australian Physical Education Teachers

    Science.gov (United States)

    Mäkelä, Kasper; Whipp, Peter R.

    2015-01-01

    The purpose of this study was to investigate Australian physical education (PE) teachers' career intentions and factors influencing their intentions. A sample (N = 234) of Western Australian PE teachers responded to a questionnaire determining PE teachers' work and the primary motivators for intention to leave the profession. Half (51.3%) of the…

  15. The Australian Skills Agenda: Productivity versus Credentialism?

    Science.gov (United States)

    Ashenden, Dean

    1992-01-01

    Discusses the rise of the concept of improved skills recognition in Australian industry. Highlights include the role of industrial relations; the Australian vocational education and training system; recognition, industrial relations, and workplace change; career and training paths; credentials; and future prospects. (10 references) (LRW)

  16. Australian International Food Security Research Centre | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Australian International Food Security Research Centre. Australian International Food Security Research Centre. http://aciar.gov.au/AIFSC. Cultivate Africa's Future. The Cultivate Africa's Future research partnership is designed to support applied research to combat hunger in sub-Saharan Africa by harnessing the potential ...

  17. The sociology of the Australian agricultural environment

    NARCIS (Netherlands)

    Vanclay, F.

    1994-01-01

    Australian agriculture is in crisis, the terms of trade for agriculture are falling, many farmers have negative incomes, and there is massive structural adjustment with government policy assisting the exit of marginal farmers out of agriculture. Australian governments are gripped with the

  18. Understanding Culture and Diversity: Australian Aboriginal Art

    Science.gov (United States)

    Vize, Anne

    2009-01-01

    Australian Aboriginal culture is rich, complex and fascinating. The art of Aboriginal Australians shows a great understanding of the earth and its creatures. This article presents an activity which has been designed as a multi-age project. The learning outcomes have been written to suit both younger and older students. Aspects of the project could…

  19. Four Management Agendas for Australian Universities

    Science.gov (United States)

    Sharrock, Geoff

    2012-01-01

    In a new mixed economy of higher learning, Australian universities require more strategic management to compete and collaborate sustainably. However, many scholars argue that new modes of university management are at odds with scholarly aims and values. This article examines how Australian universities frame their missions and communicate their…

  20. Analysis of acrylamide by LC-MS/MS and GC-MS in processed Japanese foods.

    Science.gov (United States)

    Ono, H; Chuda, Y; Ohnishi-Kameyama, M; Yada, H; Ishizaka, M; Kobayashi, H; Yoshida, M

    2003-03-01

    Acrylamide concentrations in processed foods (63 samples covering 31 product types) from Japan were analysed by LC-MS/MS and GC-MS methods. The limit of detection and limit of quantification of acrylamide were 0.2 ng x ml(-1) (6 fmol) and 0.8 ng x ml(-1) (22 fmol), respectively, by LC-MS/MS, and those of 2,3-dibromopropionamide derived from acrylamide were 12 ng x ml(-1) (52 fmol) and 40 ng x ml(-1) (170 fmol), respectively, by GC-MS. Repeatability given as RSD was 1000 microg x kg(-1). The concentrations in non-whole potato-based snacks, rice crackers processed by grilling or frying, and candied sweet potatoes were lower compared with those in the potato crisps and the whole potato-based fried snacks. One of the whole potato-based fried snacks, however, showed low acrylamide concentration (instant precooked noodles and won-tons were <100 microg x kg(-1) with only one exception. Roasted barley grains for 'Mugi-cha' tea contained 200-600 microg x kg(-1) acrylamide.

  1. Psychiatric advance directives in Australian mental-health legislation.

    Science.gov (United States)

    Ouliaris, Calina; Kealy-Bateman, Warren

    2017-12-01

    Following the recent widespread reform of mental-health legislation in Australia, psychiatric advance directives (PADs) have now been incorporated in four jurisdictions. We contextualise the potential role for PADs within the Australian legal framework and note their varying introduction across jurisdictions, with a focus on progressive legislation in the Australian Capital Territory (ACT). The formal recognition of PADs effectively shifts the trajectory of mental-health law towards a stronger recognition of consumer autonomy, albeit to varying degrees across jurisdictions. The most inspiring of these changes may be seen in the ACT Act, where an innovative framing of PAD provisions creates a safe space for clinicians and patients to engage, build therapeutic alliances and develop appropriate frameworks for further change.

  2. Measures of rheumatoid arthritis disease activity in Australian clinical practice.

    Science.gov (United States)

    Taylor, Andrew; Bagga, Hanish

    2011-01-01

    Objectives. To investigate which rheumatoid arthritis (RA) disease activity measures are being collected in patients receiving glucocorticoids, non-biologic or biologic disease-modifying antirheumatic drugs (DMARDs) in Australian rheumatology practice. Methods. A retrospective audit of medical records was conducted from eight rheumatology practices around Australia. Each rheumatologist recruited 30 consecutive eligible patients into the review, 10 of whom must have been receiving a biological agent for rheumatoid arthritis. Disease activity measures and radiographic assessments were collected from each patient's last consultation. For biologic patients, disease activity measures were also collected from when the patient was first initiated on the biological agent. Results. At last consultation, the disease measures that were recorded most often were ESR (89.2%), haemoglobin (87.5%), and CRP (84.2%). DAS28 was infrequently recorded (16.3%). The rate of recording disease activity measures for patients receiving biologic DMARDs decreased over time (mean 27 months). Conclusion. This review has shown inconsistency of RA activity measures being recorded in Australian rheumatology clinical practice. An accurate assessment of the disease process is necessary to effectively target rheumatoid arthritis patients to treat in order to achieve optimal outcomes.

  3. Improving forensic mental health care for Aboriginal Australians: challenges and opportunities.

    Science.gov (United States)

    Durey, Angela; Wynaden, Dianne; Barr, Lesley; Ali, Mohammed

    2014-06-01

    Mental illnesses constitute a major burden of disease in Aboriginal Australians and Torres Strait Islanders (hereafter Aboriginal Australians), who are also overrepresented in the prison system. A legacy of colonization compounds such prevalence, and is further exacerbated by the persistence of racial discrimination and insensitivity across many sectors, including health. This research completed in a Western Australian forensic mental health setting identifies non-Aboriginal health professionals' support needs to deliver high-quality, culturally-safe care to Aboriginal patients. Data were collected from health professionals using an online survey and 10 semistructured interviews. Survey and interview results found that ongoing education was needed for staff to provide culturally-safe care, where Aboriginal knowledge, beliefs, and values were respected. The findings also support previous research linking Aboriginal health providers to improved health outcomes for Aboriginal patients. In a colonized country, such as Australia, education programmes that critically reflect on power relations privileging white Anglo-Australian cultural dominance and subjugating Aboriginal knowledge, beliefs, and values are important to identify factors promoting or compromising the care of Aboriginal patients and developing a deeper understanding of 'cultural safety' and its clinical application. Organizational commitment is needed to translate the findings to support non-Aboriginal health professionals deliver high-quality care to Aboriginal patients that is respectful of cultural differences. © 2013 Australian College of Mental Health Nurses Inc.

  4. Australian manufacture of QuadrametTM (Samarium-153 EDTMP)

    International Nuclear Information System (INIS)

    Wood, N.R.; Whitwell, J.

    1997-01-01

    Quadramet T (Samarium-153 EDTMP) has been shown overseas to be potentially useful in the palliation of painful osteoblastic skeletal metastases and has been approved this year for general marketing in the USA. Australian Radioisotopes (ARI) has licensed this product from the Australian patent holders, Dow Chemical. Within the facilities of ARI, a hot cell has been dedicated to this product and fitted out to manufacture it weekly on a cycle related to the operating cycle of the Australian reactor HIFAR. Due to neutron flux limitations of HIFAR, the local formulation has an elemental Samarium content up to 200μg/mL whereas the overseas formulation has a level of 20-46μg/mL. All other specifications of the two products are essentially the same. In 1995 and 1996 a small clinical trial with 19 patients was held which demonstrated that the pharmacokinetic behaviour was also essentially the same by measuring blood clearance rates and skeletal uptake dynamics. Soft tissue uptake was also qualitatively determined. The ARI version is now the subject of an application for general marketing within Australia. Some useful characteristics of this agent are: almost complete excretion or fixation in the skeleton within 6 hours, rapid onset of clinical effect, applicability in most cases where an abnormal diagnostic bone scan correlates with painful sites, dosage can be tailored to individual patient uptake due to easy dose measurement and retreatment is quite possible. The use of this class of agents in pain palliation continues to increase. Australian manufacture of Quadramet TM provides a further option in the management of these difficult cases

  5. Methylation-Sensitive High Resolution Melting (MS-HRM).

    Science.gov (United States)

    Hussmann, Dianna; Hansen, Lise Lotte

    2018-01-01

    Methylation-Sensitive High Resolution Melting (MS-HRM) is an in-tube, PCR-based method to detect methylation levels at specific loci of interest. A unique primer design facilitates a high sensitivity of the assays enabling detection of down to 0.1-1% methylated alleles in an unmethylated background.Primers for MS-HRM assays are designed to be complementary to the methylated allele, and a specific annealing temperature enables these primers to anneal both to the methylated and the unmethylated alleles thereby increasing the sensitivity of the assays. Bisulfite treatment of the DNA prior to performing MS-HRM ensures a different base composition between methylated and unmethylated DNA, which is used to separate the resulting amplicons by high resolution melting.The high sensitivity of MS-HRM has proven useful for detecting cancer biomarkers in a noninvasive manner in urine from bladder cancer patients, in stool from colorectal cancer patients, and in buccal mucosa from breast cancer patients. MS-HRM is a fast method to diagnose imprinted diseases and to clinically validate results from whole-epigenome studies. The ability to detect few copies of methylated DNA makes MS-HRM a key player in the quest for establishing links between environmental exposure, epigenetic changes, and disease.

  6. Hydrodynamic chromatography coupled to single-particle ICP-MS for the simultaneous characterization of AgNPs and determination of dissolved Ag in plasma and blood of burn patients.

    Science.gov (United States)

    Roman, Marco; Rigo, Chiara; Castillo-Michel, Hiram; Munivrana, Ivan; Vindigni, Vincenzo; Mičetić, Ivan; Benetti, Federico; Manodori, Laura; Cairns, Warren R L

    2016-07-01

    Silver nanoparticles (AgNPs) are increasingly used in medical devices as innovative antibacterial agents, but no data are currently available on their chemical transformations and fate in vivo in the human body, particularly on their potential to reach the circulatory system. To study the processes involving AgNPs in human plasma and blood, we developed an analytical method based on hydrodynamic chromatography (HDC) coupled to inductively coupled plasma mass spectrometry (ICP-MS) in single-particle detection mode. An innovative algorithm was implemented to deconvolute the signals of dissolved Ag and AgNPs and to extrapolate a multiparametric characterization of the particles in the same chromatogram. From a single injection, the method provides the concentration of dissolved Ag and the distribution of AgNPs in terms of hydrodynamic diameter, mass-derived diameter, number and mass concentration. This analytical approach is robust and suitable to study quantitatively the dynamics and kinetics of AgNPs in complex biological fluids, including processes such as agglomeration, dissolution and formation of protein coronas. The method was applied to study the transformations of AgNP standards and an AgNP-coated dressing in human plasma, supported by micro X-ray fluorescence (μXRF) and micro X-ray absorption near-edge spectroscopy (μXANES) speciation analysis and imaging, and to investigate, for the first time, the possible presence of AgNPs in the blood of three burn patients treated with the same dressing. Together with our previous studies, the results strongly support the hypothesis that the systemic mobilization of the metal after topical administration of AgNPs is driven by their dissolution in situ. Graphical Abstract Simplified scheme of the combined analytical approach adopted for studying the chemical dynamics of AgNPs in human plasma/blood.

  7. CCSVI and MS: no meaning, no fact.

    Science.gov (United States)

    Baracchini, Claudio; Atzori, Matteo; Gallo, Paolo

    2013-03-01

    A condition called "chronic cerebrospinal venous insufficiency" (CCSVI) has been postulated to play a role in the pathogenesis of multiple sclerosis (MS). This hypothesis implies that a complex pattern of extracranial venous stenosis determines a venous reflux into the brain of MS patients, followed by increased intravenous pressure, blood-brain barrier breakdown and iron deposition into the brain parenchyma, thus triggering a local inflammatory response. In this review, we critically analyze the scientific basis of CCSVI, the current literature on the relationship between CCSVI and MS, as well as the ultrasound methodology that has been claimed to provide evidence of impaired cerebral venous drainage. We show that no piece of the CCSVI theory has a solid supportive scientific evidence. The CCSVI appears to be a rather alien condition and its existence should be definitely questioned. Finally, no proven (i.e., based on strict scientific methodology and on the rules of evidence-based medicine) therapeutic effect of the "liberation" procedure (unblocking the extracranial venous obstruction using angioplasty) has been shown up to date.

  8. Learner discipline: An Australian perspective

    Directory of Open Access Journals (Sweden)

    D. Stewart

    2004-07-01

    Full Text Available Australian schools by and large are safe schools. Nonetheless discipline problems do exist – including bullying behaviour. For this kind of problem schools should have management policies in place. As traditional behaviour-management practices – including corporal punishment – are largely prohibited in Australian schools, contemporary practices centre on management through supportive school programmes, including appropriate curricula and school-support structures. This article supports the belief that measures such as the exclusion of misbehaving learners should be treated with caution. Measures such as this might not reflect accepted international principles and practices and should only be exercised in the most extreme circumstances. The article also supports the view that it is part of the school’s role to ensure that all learners are aware of the reality that while they have rights, they also have corresponding responsibilities. This awareness is more likely to be achieved in a supportive school culture where each learner is recognised as having unique qualities that can mature and grow in an appropriate learning environment.

  9. Somatic embryogenesis from leaf explants of Australian fan flower, Scaevola aemula R. Br.

    Science.gov (United States)

    Wang, Y-H; Bhalla, P L

    2004-01-01

    Somatic embryogenesis from leaf explants of Scaevola aemula R. Br. was achieved. Somatic embryos were induced from explants cultured on MS medium supplemented with 0.2 mg/ 2,4-dichlorophenoxyacetic acid and 0.2-0.5 mg/l 6-benzylaminopurine (BAP). Various developmental stages of somatic embryos were found on this medium-from globular embryos to germinated embryos. The transfer of globular embryos to MS medium containing 0.5 mg/l BAP resulted in a high frequency of shoot regeneration. Leaf explants cultured on MS medium containing different combinations of BAP and alpha-naphthaleneacetic acid formed adventitious shoots and roots. Histological examination confirmed the process of somatic embryogenesis. Induction of somatic embryogenesis in Scaevola provides a system for studying embryogenesis in Australian native plants and will facilitate the improvement of these plants using genetic transformation techniques.

  10. Motor Neurone Disease: Disability Profile and Service Needs in an Australian Cohort

    Science.gov (United States)

    Ng, Louisa; Talman, Paul; Khan, Fary

    2011-01-01

    Motor neurone disease (MND) places considerable burden upon patients and caregivers. This is the first study, which describes the disability profile and healthcare needs for persons with MND (pwMND) in an Australian sample from the perspective of the patients and caregivers to identify current gaps in the knowledge and service provision. A…

  11. Neuroimaging (NMR) in the assessment of multiple sclerosis (MS)

    International Nuclear Information System (INIS)

    Gambi, D.; Uncini, A.

    1990-01-01

    Clinical well defined patients with MS have been submitted to series of controls of NMR investigations after an attack of the disease and during 12 months in order to organize a methodology useful to analyze patients in different periods or stages of the disease, when new lesions can develop. (author). 11 refs.; 2 figs.; 5 tabs

  12. Malignant otitis externa: An Australian case series.

    LENUS (Irish Health Repository)

    2012-02-01

    OBJECTIVES: To establish a clinicopathological profile of malignant otitis externa (MOE) in an Australian tertiary referral institution. STUDY DESIGN: Retrospective cohort outcomes study. METHODS: 24 patients were identified with MOE between January 1998 and July 2007. Patients were classified into Radiological Grades I-IV. Laboratory investigations Including C-reactive protein (CRP), white cell count (WCC), glycosylated haemoglobin (HBA1c) and average glucose level over admission were recorded. RESULTS: Radiological Grade was significantly associated with duration of therapy (rank correlation 0.57, p = 0.004). CRP was a useful indicator confirming disease resolution. Diabetics with MOE had elevated average blood sugar levels during their Hospital admission (p < 0.001) and had poor overall glycaemic control represented by Elevated HBA1c scores (p < 0.001). CONCLUSIONS: Malignant otitis externa is a rare disease, which is best managed in a multidisciplinary team setting. This practical grading system can be used to predict the duration of therapy at time of diagnosis, which enables the efficient utilisation of Hospital resources. Poorly controlled diabetics are more susceptible to developing. MOE than diabetics with satisfactory glycaemic control and may represent a subgroup of more brittle diabetics. CRP combined with appropriate clinical and radiological investigations is useful in assessing disease resolution.

  13. Social cognition in pediatric-onset multiple sclerosis (MS).

    Science.gov (United States)

    Charvet, L E; Cleary, R E; Vazquez, K; Belman, A L; Krupp, L B

    2014-10-01

    Pediatric-onset multiple sclerosis (MS) patients represent a subpopulation who are diagnosed during the course of development. Social cognitive deficits have recently been recognized in adults with MS. It is critical to identify whether these youngest patients with the disorder are also at risk. To determine whether pediatric-onset MS is associated with social cognitive deficits. Consecutively-recruited participants with pediatric-onset MS were compared to a group of age- and gender-matched healthy controls on Theory of Mind (ToM) task performance. Tasks measured facial affect recognition (Reading the Mind in the Eyes Test), detecting social faux pas (Faux Pas Test), and understanding the perspective of another (False Beliefs Task). Twenty-eight (28) pediatric-onset MS participants (median age 17 years) and 32 healthy controls (median age 16 years) completed the study. The MS participants performed worse than controls on all three ToM tasks: Reading the Mind in the Eyes Test (p = 0.008), the Faux Pas Test (p = 0.009), and the False Beliefs Task (p = 0.06). While more MS than control participants were impaired on a measure of information processing speed (the Symbol Digit Modalities Test; 38% versus 6%), it did not account for the differences in ToM performance. Social cognition may represent an area of cognitive functioning affected by MS in the pediatric-onset population. These processes are especially important to study in younger patients as they may have long range implications for social adjustment, employment, and well-being. © The Author(s) 2014.

  14. The multiple sclerosis visual pathway cohort: understanding neurodegeneration in MS.

    Science.gov (United States)

    Martínez-Lapiscina, Elena H; Fraga-Pumar, Elena; Gabilondo, Iñigo; Martínez-Heras, Eloy; Torres-Torres, Ruben; Ortiz-Pérez, Santiago; Llufriu, Sara; Tercero, Ana; Andorra, Magi; Roca, Marc Figueras; Lampert, Erika; Zubizarreta, Irati; Saiz, Albert; Sanchez-Dalmau, Bernardo; Villoslada, Pablo

    2014-12-15

    Multiple Sclerosis (MS) is an immune-mediated disease of the Central Nervous System with two major underlying etiopathogenic processes: inflammation and neurodegeneration. The latter determines the prognosis of this disease. MS is the main cause of non-traumatic disability in middle-aged populations. The MS-VisualPath Cohort was set up to study the neurodegenerative component of MS using advanced imaging techniques by focusing on analysis of the visual pathway in a middle-aged MS population in Barcelona, Spain. We started the recruitment of patients in the early phase of MS in 2010 and it remains permanently open. All patients undergo a complete neurological and ophthalmological examination including measurements of physical and disability (Expanded Disability Status Scale; Multiple Sclerosis Functional Composite and neuropsychological tests), disease activity (relapses) and visual function testing (visual acuity, color vision and visual field). The MS-VisualPath protocol also assesses the presence of anxiety and depressive symptoms (Hospital Anxiety and Depression Scale), general quality of life (SF-36) and visual quality of life (25-Item National Eye Institute Visual Function Questionnaire with the 10-Item Neuro-Ophthalmic Supplement). In addition, the imaging protocol includes both retinal (Optical Coherence Tomography and Wide-Field Fundus Imaging) and brain imaging (Magnetic Resonance Imaging). Finally, multifocal Visual Evoked Potentials are used to perform neurophysiological assessment of the visual pathway. The analysis of the visual pathway with advance imaging and electrophysilogical tools in parallel with clinical information will provide significant and new knowledge regarding neurodegeneration in MS and provide new clinical and imaging biomarkers to help monitor disease progression in these patients.

  15. Russell Brains Review of MS.

    Science.gov (United States)

    Murray, Tj

    2011-05-01

    In 1930 there were many conflicting views on the cause, incidence, precipitating factors, inheritance and treatment of multiple sclerosis (MS). A young, London neurologist summarized the state of understanding of the disease with his personal view of many of the uncertain areas, and clarified the thinking for the neurological community at that time. Although his later career was influential in many fields of medicine, and his personal influence was extraordinary in many areas as an author, educator, administrator, opinion leader and historian, his review was an important milestone in the history of MS.

  16. Increased cerebrospinal fluid concentrations of the chemokine CXCL13 in active MS

    DEFF Research Database (Denmark)

    Sellebjerg, F; Börnsen, L; Khademi, M

    2009-01-01

    BACKGROUND: Accumulating evidence supports a major role of B cells in multiple sclerosis (MS) pathogenesis. How B cells are recruited to the CNS is incompletely understood. Our objective was to study B-cell chemokine concentrations in MS, their relationship with disease activity, and how treatment...... the chemokine receptor CXCR5 to the CNS in multiple sclerosis (MS), and may be a useful biomarker for treatment effects in MS. Furthermore, CXCL13 or its receptor CXCR5 should be considered as therapeutic targets in MS....... with methylprednisolone and natalizumab affected the concentration in CSF. METHODS: Using a cross-sectional design, CSF and blood samples were obtained from cohorts of patients with clinically isolated syndromes (CIS), relapsing-remitting MS (RRMS), primary progressive MS (PPMS), or secondary progressive MS (SPMS...

  17. Patterns and trends of potentially inappropriate high-density lipoprotein cholesterol testing in Australian adults at high risk of cardiovascular disease from 2008 to 2014: analysis of linked individual patient data from the Australian Medicare Benefits Schedule and Pharmaceutical Benefits Scheme.

    Science.gov (United States)

    Hajati, Farshid; Atlantis, Evan; Bell, Katy J L; Girosi, Federico

    2018-03-08

    We examine the extent to which the adult Australian population on lipid-lowering medications receives the level of high-density lipoprotein cholesterol (HDL-C) testing recommended by national guidelines. We analysed records from 7 years (2008-2014) of the 10% publicly available sample of deidentified, individual level, linked Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) electronic databases of Australia. The PBS data were used to identify individuals on stable prescriptions of lipid-lowering treatment. The MBS data were used to estimate the annual frequency of HDL-C testing. We developed a methodology to address the issue of 'episode coning' in the MBS data, which causes an undercounting of pathology tests. We used a published figure on the proportion of unreported HDL-C tests to correct for the undercounting and estimate the probability that an HDL-C test was performed. We judged appropriateness of testing frequency by comparing the HDL-C testing rate to guidelines' recommendations of annual testing for people at high risk for cardiovascular disease. We estimated that approximately 49% of the population on stable lipid-lowering treatment did not receive any HDL-C test in a given year. We also found that approximately 19% of the same population received two or more HDL-C tests within the year. These levels of underutilisation and overutilisation have been changing at an average rate of 2% and -4% a year, respectively, since 2009. The yearly expenditure associated with test overutilisation was approximately $A4.3 million during the study period, while the cost averted because of test underutilisation was approximately $A11.3 million a year. We found that approximately half of Australians on stable lipid-lowering treatment may be having fewer HDL-C testing than recommended by national guidelines, while nearly one-fifth are having more tests than recommended. © Article author(s) (or their employer(s) unless otherwise stated in the text

  18. Australian natural gas market outlook

    International Nuclear Information System (INIS)

    Anon.

    2004-01-01

    A new study of the Australian natural gas industry by leading Australian economics and policy consultancy ACIL Tasman highlights the significant supply and demand side uncertainties currently facing the industry. The ACIL Tasman 'Australian Gas Market Review and Outlook 2004' study presents modelling results for three supply/demand scenarios in Eastern Australia and two in Western Australia. The results show that, even under moderate assumptions about future levels of gas demand growth, major supply-side investment is likely to be needed over the next ten to fifteen years. The base supply/demand scenario for Eastern Australia and Northern Territory, illustrated in Figure 1, shows that even allowing for substantial new discoveries in existing production basins and major expansion of coal seam methane production, in the absence of a northern gas connection to the eastern states (Timor Sea or PNG Highlands) a significant supply gap will begin to emerge from around 2013. The study identifies several supply-side options for Eastern Australia - new discoveries in the established production provinces in Bass Strait and Central Australia; greenfield developments such as the Otway Basin offshore from Victoria and South Australia; continuing expansion of coal seam methane production in Queensland and New South Wales; and gas from Papua New Guinea, Timor Sea or from the North West Shelf region delivered via a trans-continental pipeline. The study concludes that it is unlikely that any single option will suffice to meet future demand. Almost inevitably, a combination of these sources will be needed if anticipated growth opportunities are to be met. With regard to prices, the study shows that in the short to medium term the outlook is for some real reductions in wholesale prices in most regional markets. This reflects increasing levels of upstream competition and declining real costs of pipeline transportation. However in the longer term, supply-side constraints will tend to

  19. Emerging tropical diseases in Australia. Part 3. Australian bat lyssavirus.

    Science.gov (United States)

    Moore, P R; Jansen, C C; Graham, G C; Smith, I L; Craig, S B

    2010-12-01

    Since its discovery in a juvenile black flying fox (Pteropus alecto) in 1996, Australian bat lyssavirus (ABLV) has become the cause of a potentially important emerging disease for health authorities in Australia, with two human deaths (one in 1996 and one in 1998) attributed to the virus in the north-eastern state of Queensland. In Australia, the virus has been isolated from all four species of flying fox found on the mainland (i.e. P. alecto, P. scapulatus, P. poliocephalus and P. conspicillatus) as well as a single species of insectivorous bat (Saccolaimus flaviventris). Australian bat lyssavirus belongs to the Lyssavirus genus and is closely related, genetically, to the type strain of Rabies virus (RABV). Clinically, patients infected with ABLV have displayed the 'classical' symptoms of rabies and a similar disease course. This similarity has led to the belief that the infection and dissemination of ABLV in the body follows the same pathways as those followed by RABV. Following the two ABLV-related deaths in Queensland, protocols based on the World Health Organization's guidelines for RABV prophylaxis were implemented and, presumably in consequence, no human infection with ABLV has been recorded since 1998. ABLV will, however, probably always have an important part to play in the health of Australians as the density of the human population in Australia and, consequently, the level of interaction between humans and flying foxes increase.

  20. Perspectives on the working hours of Australian junior doctors.

    Science.gov (United States)

    Glasgow, Nicholas J; Bonning, Michael; Mitchell, Rob

    2014-01-01

    The working hours of junior doctors have been a focus of discussion in Australia since the mid-1990s. Several national organizations, including the Australian Medical Association (AMA), have been prominent in advancing this agenda and have collected data (most of which is self-reported) on the working hours of junior doctors over the last 15 years. Overall, the available data indicate that working hours have fallen in a step-wise fashion, and AMA data suggest that the proportion of doctors at high risk of fatigue may be declining. It is likely that these changes reflect significant growth in the number of medical graduates, more detailed specifications regarding working hours in industrial agreements, and a greater focus on achieving a healthy work-life balance. It is notable that reductions in junior doctors' working hours have occurred despite the absence of a national regulatory framework for working hours. Informed by a growing international literature on working hours and their relation to patient and practitioner safety, accreditation bodies such as the Australian Commission on Safety and Quality in Health Care (ACSQHC) and the Australian Medical Council (AMC) are adjusting their standards to encourage improved work and training practices.

  1. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... the Challenges of MS You CAN! Webcasts DVDs Books For Kids: Keep S'myelin Información en Español Brochures ... RRMS Treating RRMS Research in RRMS Share Smaller Text Larger Text Print In this article Overview RRMS – ...

  2. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Multiple Sclerosis and Your Emotions (.pdf) Download Brochure Disease Modifying Therapies Overview (.pdf) Download Document Pediatric MS Learn More Transverse Myelitis Learn More Neuromyelitis Optica (NMO) Learn More HTLV-I ... Learn More Acute Disseminated Encephalomyelitis (ADEM) Learn More ...

  3. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... for Specific Populations Find Programs & Services in Your Area Calendar of Programs and Events Living Well with MS Diet, Exercise & Healthy Behaviors Emotional Well-Being Spiritual Well-Being Cognitive Health Work, Home & Leisure Relationships Research Participate in ...

  4. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... bowel and bladder problems, and problems with cognition (learning and memory or information processing). People with progressive ... Colophon Stay Informed Join Us Facebook Twitter LinkedIn YouTube Pinterest MS Connection About the Society Vision Careers ...

  5. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Información en Español d Site Map d Site Tour d Contact Us d For Professionals d Researchers Society Funding Deadlines Apply Online Funding Policies and Procedures Scientific Peer Reviewers Resources for Researchers d Professional Resource Center About MS ...

  6. Compliance with Corporate Governance Principles: Australian Evidence

    Directory of Open Access Journals (Sweden)

    Maryam Safari

    2015-12-01

    Full Text Available This study investigates the association between the level of compliance of Australian listed companies with Australian corporate governance principles, in aggregate, and the level of discretionary accruals using the modified Jones model. It is hypothesised that higher levels of compliance would be associated with lower levels of discretionary accruals. Data from a random sample of 214 Australian listed companies for the years 2009 and 2010 were used to test the hypothesis. The results demonstrate a significant negative relationship indicating that companies with higher levels of compliance engage in lower levels of earnings management via discretionary accruals.

  7. A new opportunity for Australian uranium

    International Nuclear Information System (INIS)

    1994-07-01

    This study analyses the outlook for the world uranium industry and includes projections of uranium demand, supply and prices over the next decade and a comparison with other forecasts. The potential increases in Australian output are quantified, under both continuation of the three mine policy and an open mine policy, as well as the potential impact on the world uranium market, using the well known ORANI model of the Australian economy. It is estimated that Australian output could almost double by 2004 if the three mine policy were abolished. 53 refs., 20 tabs., 6 figs

  8. A new opportunity for Australian uranium

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-07-01

    This study analyses the outlook for the world uranium industry and includes projections of uranium demand, supply and prices over the next decade and a comparison with other forecasts. The potential increases in Australian output are quantified, under both continuation of the three mine policy and an open mine policy, as well as the potential impact on the world uranium market, using the well known ORANI model of the Australian economy. It is estimated that Australian output could almost double by 2004 if the three mine policy were abolished. 53 refs., 20 tabs., 6 figs.

  9. Preventing proliferation : the role of Australian uranium

    International Nuclear Information System (INIS)

    Falk, J.

    1987-01-01

    The uranium debate has polarised Australian society for almost a decade. From 1977 until just before it achieved office in 1983 the Australia Labor Party took a position of strong opposition to uranium exports. The Australian Council of Trade Unions, the Australian Democrats, the Nuclear Disarmament Party, and many other organisations and sections of the community continue to oppose uranium mining and exports. Australia's uranium is currently exported for use in the commercial nuclear fuel cycle. But as the nuclear plants which are part of this cycle spread across the world, the risk rises that they will provide the cover and facilities for increasing numbers of countries to move towards nuclear weapons capability

  10. Australians' attitudes to nuclear disarmament

    International Nuclear Information System (INIS)

    Clark, A.W.; Trahair, R.C.S.; Powell, R.J.; Walker, R.M.

    1985-08-01

    The results of a series of surveys of 2900 Australians show that some 80 per cent favour nuclear disarmament. The nuclear disarmament view is broad-based, for example it cuts across differences in age, sex and education. However the view is more common among people towards the left of the political spectrum who view the world as benign rather than hostile and who consider stockpiles can be reduced by small, reciprocated and supervised reductions. Between 2.5 per cent and 5.5 per cent of respondents act to bring about nuclear disarmament. The findings support and extend results from studies outside Australia showing that attitudes favouring nuclear disarmament are distributing themselves widely

  11. Method-MS. Final report

    International Nuclear Information System (INIS)

    Skipperud, L.; Popic, J.M.; Roos, P.; Salminen, S.; Nygren, U.; Sigmarsson, O.; Palsson, S.E.

    2011-05-01

    Radiometric determination methods, such as alpha spectrometry require long counting times when low activities are to be determined. Mass spectrometric techniques as Inductively Coupled Plasma Mass Spectrometry (ICP-MS), Thermal Ionisation Mass Spectrometry (TIMS) and Accelerator Mass Spectrometry (AMS) have shown several advantages compared to traditional methods when measuring long-lived radionuclides. Mass spectrometric methods for determination of very low concentrations of elemental isotopes, and thereby isotopic ratios, have been developed using a variety of ion sources. Although primarily applied to the determination of the lighter stable element isotopes and radioactive isotopes in geological studies, the techniques can equally well be applied to the measurement of activity concentrations of long-lived low-level radionuclides in various samples using 'isotope dilution' methods such as those applied in inductively coupled plasma mass spectrometry (ICP-MS). Due to the low specific activity of long-lived radionuclides, many of these are more conveniently detected using mass spectrometric techniques. Mass spectrometry also enables the individual determination of Pu-239 and Pu-240, which cannot be obtained by alpha spectrometry. Inductively Coupled Plasma Mass Spectrometry (ICP-MS) are rapidly growing techniques for the ultra-trace analytical determination of stable and long-lived isotopes and have a wide potential within environmental science, including ecosystem tracers and radio ecological studies. Such instrumentation, of course needs good radiochemical separation, to give best performance. The objectives of the project is to identify current needs and problems within low-level determination of long-lived radioisotopes by ICP-MS, to perform intercalibration and development and improvement of ICP-MS methods for the measurement of radionuclides and isotope ratios and to develop new methods based on modified separation chemistry applied to new auxiliary

  12. Method-MS. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Skipperud, L.; Popic, J.M. (Norwegian Univ. of Life Science (UMB), Isotope Lab. (Norway)); Roos, P. (Technical Univ. of Denmark, Risoe National Lab. for Sustainable Energy, Roskilde (Denmark)); Salminen, S. (Univ. of Helsinki (UH) (Finland)); Nygren, U. (Swedish Defence Research Agency (FOI) (Sweden)); Sigmarsson, O.; Palsson, S.E. (Univ. of Iceland/Icelandic Radiation Protection Institute (Iceland))

    2011-05-15

    Radiometric determination methods, such as alpha spectrometry require long counting times when low activities are to be determined. Mass spectrometric techniques as Inductively Coupled Plasma Mass Spectrometry (ICP-MS), Thermal Ionisation Mass Spectrometry (TIMS) and Accelerator Mass Spectrometry (AMS) have shown several advantages compared to traditional methods when measuring long-lived radionuclides. Mass spectrometric methods for determination of very low concentrations of elemental isotopes, and thereby isotopic ratios, have been developed using a variety of ion sources. Although primarily applied to the determination of the lighter stable element isotopes and radioactive isotopes in geological studies, the techniques can equally well be applied to the measurement of activity concentrations of long-lived low-level radionuclides in various samples using 'isotope dilution' methods such as those applied in inductively coupled plasma mass spectrometry (ICP-MS). Due to the low specific activity of long-lived radionuclides, many of these are more conveniently detected using mass spectrometric techniques. Mass spectrometry also enables the individual determination of Pu-239 and Pu-240, which cannot be obtained by alpha spectrometry. Inductively Coupled Plasma Mass Spectrometry (ICP-MS) are rapidly growing techniques for the ultra-trace analytical determination of stable and long-lived isotopes and have a wide potential within environmental science, including ecosystem tracers and radio ecological studies. Such instrumentation, of course needs good radiochemical separation, to give best performance. The objectives of the project is to identify current needs and problems within low-level determination of long-lived radioisotopes by ICP-MS, to perform intercalibration and development and improvement of ICP-MS methods for the measurement of radionuclides and isotope ratios and to develop new methods based on modified separation chemistry applied to new

  13. Development and Validation of a Novel LC-MS/MS Opioid Confirmation Assay: Evaluation of β-glucuronidase Enzymes and Sample Cleanup Methods.

    Science.gov (United States)

    Yang, He S; Wu, Alan H B; Lynch, Kara L

    2016-06-01

    With the rise in the use and misuse of prescription opioids, there is an increasing need for the confirmed identification of opioid analgesics in toxicology laboratories. The goals of this study were to (i) systematically evaluate the hydrolysis efficiency of four β-glucuronidase enzymes under optimized condition; (ii) evaluate compound recovery, matrix effects and precision of three protein precipitation plates and (iii) develop and validate a qualitative liquid-chromatography mass spectrometry (LC-MS/MS) assay to identify 13 opioids in urine. A recombinant β-glucuronidase exhibited the best overall hydrolysis efficiency for seven opioid glucuronide conjugates compared with β-glucuronidase from red abalone, Escherichia coli and Patella vulgata One of the protein precipitation plates tested exhibited overall better recovery of the opioids and lower ion suppression compared with the other two plates. An ESI positive mode LC-MS/MS assay for qualitative opioid analysis was developed and validated. Linearity, LOD, precision, matrix effect, recovery, carryover and interference of the method were evaluated. Sixty-two patient samples were analyzed by both a legacy GC-MS opioid method and the LC-MS/MS method, and 22 samples were analyzed by the LC-MS/MS and an LC-MS/MS reference method. The results of the comparisons showed good concordance. Overall, we described an efficient sample preparation procedure for a sensitive qualitative opioid confirmation assay in urine. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Population and Australian development assistance.

    Science.gov (United States)

    Jones, R

    1992-07-01

    Australia's position on international population issues is consistent with the major international statements on population: the World Population Plan of Action (1974), the Mexico City Declaration (1984), and the Amsterdam Declaration (1989). Australia's policy emphasizes the importance of population policies as an integral part of social, economic, and cultural development aimed at improving the quality of life of the people. Factors that would promote smaller families include improving economic opportunities, old-age security, education and health (particularly for women), as well as improving the accessibility and quality of family planning services. The quality of care approach is directly complementary to the Australian International Development Assistance Bureau (AIDAB)'s Women-In-Development Policy and its Health Policy, which stresses the theme of Women And Their Children's Health (WATCH). Australia's support for population programs and activities has increased considerably over the last few years. Total assistance for the year 1990/91 was around $7 million out of a total aid program of $1216 million. In recent years AIDAB has funded family planning activities or health projects with family planning components in a number of countries in the Asia-Pacific region. In the South Pacific region AIDAB has funded a reproductive health video project taking into consideration the cultural sensitivities and customs of the peoples of the region. AIDAB has supported a UN Population Fund project in Thailand that aims to strengthen the capacity of the National Statistical Office to collect population data. The US currently accounts for around 40% of all population-related development assistance to improve the health of women and children through family planning. The other major donors are Japan, the Scandinavian countries, and the Netherlands. Funding for population has been a relatively low percentage of overall development assistance budgets in OECD countries. In the

  15. Characterisation of Bone Beneficial Components from Australian Wallaby Bone

    Science.gov (United States)

    Lao, Weiguo; Jin, Xingliang; Tan, Yi; Xiao, Linda; Padula, Matthew P.; Bishop, David P.; Reedy, Brian; Ong, Madeleine; Kamal, Mohammad A.; Qu, Xianqin

    2016-01-01

    Background: Osteoporosis is a condition in which the bones become brittle, increasing the risk of fractures. Complementary medicines have traditionally used animal bones for managing bone disorders, such as osteoporosis. This study aimed to discover new natural products for these types of conditions by determining mineral and protein content of bone extracts derived from the Australian wallaby. Methods: Inductively coupled plasma-mass spectrometry and Fourier transform infrared spectroscopic analysis were used for mineral tests, proteome analysis was using LC/MS/MS and the effects of wallaby bone extracts (WBE)s on calcium deposition and alkaline phosphatase activity were evaluated in osteogenic cells derived from adipose tissue-derived stem cells (ADSCs). Results: Concentrations of calcium and phosphorus were 26.21% and 14.72% in WBE respectively. Additionally, minerals found were wide in variety and high in concentration, while heavy metal concentrations of aluminium, iron, zinc and other elements were at safe levels for human consumption. Proteome analysis showed that extracts contained high amounts of bone remodelling proteins, such as osteomodulin, osteopontin and osteoglycin. Furthermore, in vitro evaluation of WBEs showed increased deposition of calcium in osteoblasts with enhanced alkaline phosphatase activity in differentiated adipose-derived stem cells. Conclusion: Our results demonstrate that wallaby bone extracts possess proteins and minerals beneficial for bone metabolism. WBEs may therefore be used for developing natural products for conditions such as osteoporosis and further investigation to understand biomolecular mechanism by which WBEs prevent osteoporosis is warranted. PMID:28930133

  16. Association of Visual Impairment and All-Cause 10-Year Mortality Among Indigenous Australian Individuals Within Central Australia: The Central Australian Ocular Health Study.

    Science.gov (United States)

    Ng, Soo Khai; Kahawita, Shyalle; Andrew, Nicholas Howard; Henderson, Tim; Craig, Jamie Evan; Landers, John

    2018-05-01

    It is well established from different population-based studies that visual impairment is associated with increased mortality rate. However, to our knowledge, the association of visual impairment with increased mortality rate has not been reported among indigenous Australian individuals. To assess the association between visual impairment and 10-year mortality risk among the remote indigenous Australian population. Prospective cohort study recruiting indigenous Australian individuals from 30 remote communities located within the central Australian statistical local area over a 36-month period between July 2005 and June 2008. The data were analyzed in January 2017. Visual acuity, slitlamp biomicroscopy, and fundus examination were performed on all patients at recruitment. Visual impairment was defined as a visual acuity of less than 6/12 in the better eye. Mortality rate and mortality cause were obtained at 10 years, and statistical analyses were performed. Hazard ratios for 10-year mortality with 95% confidence intervals are presented. One thousand three hundred forty-seven patients were recruited from a total target population number of 2014. The mean (SD) age was 56 (11) years, and 62% were women. The total all-cause mortality was found to be 29.3% at 10 years. This varied from 21.1% among those without visual impairment to 48.5% among those with visual impairment. After adjustment for age, sex, and the presence of diabetes and hypertension, those with visual impairment were 40% more likely to die (hazard ratio, 1.40; 95% CI, 1.16-1.70; P = .001) during the 10-year follow-up period compared with those with normal vision. Bilateral visual impairment among remote indigenous Australian individuals was associated with 40% higher 10-year mortality risk compared with those who were not visually impaired. Resource allocation toward improving visual acuity may therefore aid in closing the gap in mortality outcomes between indigenous and nonindigenous Australian

  17. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders.

    Science.gov (United States)

    Hay, Phillipa; Chinn, David; Forbes, David; Madden, Sloane; Newton, Richard; Sugenor, Lois; Touyz, Stephen; Ward, Warren

    2014-11-01

    This clinical practice guideline for treatment of DSM-5 feeding and eating disorders was conducted as part of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Clinical Practice Guidelines (CPG) Project 2013-2014. The CPG was developed in accordance with best practice according to the National Health and Medical Research Council of Australia. Literature of evidence for treatments of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), other specified and unspecified eating disorders and avoidant restrictive food intake disorder (ARFID) was sourced from the previous RANZCP CPG reviews (dated to 2009) and updated with a systematic review (dated 2008-2013). A multidisciplinary working group wrote the draft CPG, which then underwent expert, community and stakeholder consultation, during which process additional evidence was identified. In AN the CPG recommends treatment as an outpatient or day patient in most instances (i.e. in the least restrictive environment), with hospital admission for those at risk of medical and/or psychological compromise. A multi-axial and collaborative approach is recommended, including consideration of nutritional, medical and psychological aspects, the use of family based therapies in younger people and specialist therapist-led manualised based psychological therapies in all age groups and that include longer-term follow-up. A harm minimisation approach is recommended in chronic AN. In BN and BED the CPG recommends an individual psychological therapy for which the best evidence is for therapist-led cognitive behavioural therapy (CBT). There is also a role for CBT adapted for internet delivery, or CBT in a non-specialist guided self-help form. Medications that may be helpful either as an adjunctive or alternative treatment option include an antidepressant, topiramate, or orlistat (the last for people with comorbid obesity). No specific treatment is recommended for ARFID as there are no trials to

  18. Divine service, music, sport, and recreation as medicinal in Australian asylums 1860s-1945.

    Science.gov (United States)

    MacKinnon, Dolly

    2009-01-01

    Australian asylum records (circa 1860 to circa 1945) demonstrate that medical staff went to great lengths to provide recreation to suitable patients. This article examines how the demarcation of Australian institutional spaces along gender divisions was also mirrored by the gender-specific recreational activities provided in purpose-built facilities. Using Australian examples I demonstrate how the main forms of recreation-that is divine service, music and dance, and sport-were justified to governments on medical grounds. Some designated recreational spaces even offered select female and male patients the opportunity to mix under medical supervision. Recreation was therapeutic because of its psychological, physical, social, and moral benefits, and government authorities funded the construction of costly chapels, recreation halls, and sports grounds expressly for this medical purpose.

  19. Australian Mining's product register 1990-91

    Energy Technology Data Exchange (ETDEWEB)

    1990-01-01

    The Australian Minings' Product Register 1990-91 contains an industry review, resource assessment, mineral industry statistics, directory of exploration and mining companies, buyers guide and directory of consultants.

  20. Comparative growth performance of different Australian ...

    African Journals Online (AJOL)

    Comparative growth performance of different Australian provenances and local land ... and Ubiri in the West Usambara Mountains (WUM), North East Tanzania. ... with local land races for subsequent management as seed production stands.

  1. Responding to Indigenous Australian Sexual Assault

    Directory of Open Access Journals (Sweden)

    Janya McCalman

    2014-01-01

    Full Text Available Indigenous Australians experience a high prevalence of sexual assault, yet a regional sexual assault service found few Indigenous Australians accessed their services. This prompted exploration of how its services might be improved. A resultant systematic search of the literature is reported in this article. Seven electronic databases and seven websites were systematically searched for peer reviewed and gray literature documenting responses to the sexual assault of Indigenous Australians. These publications were then classified by response type and study type. Twenty-three publications met the inclusion criteria. They included studies of legal justice, media, and community-based and mainstream service responses for Indigenous survivors and perpetrators. We located program descriptions, measurement, and descriptive research, but no intervention studies. There is currently insufficient evidence to confidently prescribe what works to effectively respond to Indigenous Australian sexual assault. The study revealed an urgent need for researchers, Indigenous communities, and services to work together to develop the evidence base.

  2. 1980 Australian coal conference. Conference papers

    Energy Technology Data Exchange (ETDEWEB)

    1980-01-01

    Papers were presented under the following headings: supply and demand for coal; government policies - coal development; mining finance and taxation; Australian coal mining practices; research and development; infrastructure and transportation; legislation and safe working practices; and industrial relations.

  3. Workloads in Australian emergency departments a descriptive study.

    Science.gov (United States)

    Lyneham, Joy; Cloughessy, Liz; Martin, Valmai

    2008-07-01

    This study aimed to identify the current workload of clinical nurses, managers and educators in Australian Emergency Departments according to the classification of the department Additionally the relationship of experienced to inexperienced clinical staff was examined. A descriptive research method utilising a survey distributed to 394 Australian Emergency departments with a 21% response rate. Nursing workloads were calculated and a ratio of nurse to patient was established. The ratios included nurse to patient, management and educators to clinical staff. Additionally the percentage of junior to senior clinical staff was also calculated. Across all categories of emergency departments the mean nurse:patient ratios were 1:15 (am shift), 1:7 (pm shift) and 1:4 (night shift). During this period an average of 17.1% of attendances were admitted to hospital. There were 27 staff members for each manager and 23.3 clinical staff for each educator. The percentage of junior staff rostered ranged from 10% to 38%. Emergency nurses cannot work under such pressure as it may compromise the care given to patients and consequently have a negative effect on the nurse personally. However, emergency nurses are dynamically adjusting to the workload. Such conditions as described in this study could give rise to burnout and attrition of experienced emergency nurses as they cannot resolve the conflict between workload and providing quality nursing care.

  4. Career intentions of Australian physical education teachers

    OpenAIRE

    Mäkelä, Kasper; Whipp, Peter R

    2015-01-01

    The purpose of this study was to investigate Australian physical education (PE) teachers’ career intentions and factors influencing their intentions. A sample (N = 234) of Western Australian PE teachers responded to a questionnaire determining PE teachers’ work and the primary motivators for intention to leave the profession. Half (51.3%) of the respondents wanted a change from their current PE teacher job and 39.8% were intending to leave PE teaching. The most frequent reasons for wanting to...

  5. ANSTO: Australian Nuclear Science and Technology Organization

    International Nuclear Information System (INIS)

    1989-01-01

    The Australian Nuclear Science and Technology Organization conducts or is engaged in collaborative research and development in the application of nuclear science and associated technology. Through its Australian radio-isotopes unit, it markets radioisotopes, their products and other services for nuclear medicine industry and research. It also operates national nuclear facilities ( HIFAR and Moata research reactors), promote training, provide advice and disseminates information on nuclear science and technology. The booklet briefly outlines these activities. ills

  6. Analysis of phytochemical variations in dioecious Tinospora cordifolia stems using HPLC/QTOF MS/MS and UPLC/QqQLIT -MS/MS.

    Science.gov (United States)

    Bajpai, Vikas; Singh, Awantika; Chandra, Preeti; Negi, M P S; Kumar, Nikhil; Kumar, Brijesh

    2016-01-01

    The stem of dioecious Tinospora cordifolia (Menispermaceae) is a commonly used traditional Ayurvedic medicine in India having several therapeutic properties. To develop and validate LC-MS methods for the identification and simultaneous quantitation of various secondary metabolites and to study metabolomic variations in the stem of male and female plants. Ethanolic extract of stems were analysed by HPLC/ESI-QTOF-MS/MS for rapid screening of bioactive phytochemicals. High resolution MS and MS/MS in positive ESI mode were used for structural investigation of secondary metabolites. An UPLC/ESI-QqQ(LIT) -MS/MS method in MRM mode was developed and validated for the simultaneous quantitation of five bioactive alkaloids. Identification and characterisation of 36 metabolites including alkaloids, sesquiterpenes and phytoecdysteroids were performed using LC-MS and MS/MS techniques. The bioactive alkaloids such as jatrorrhizine, magnoflorine, isocorydine, palmatine and tetrahydropalmatine were successfully quantified in male and female plants. The mean abundances of magnoflorine jatrorrhizine, and oblongine were significantly (P Phytochemicals in the stem of male and female Tinospora cordifolia showed significant qualitative and quantitative variations. LC-MS and MS/MS methods can be used to differentiate between male and female plants based on their chemical profiles and quantities of the marker bioactive alkaloids. This chemical composition difference was also evident during vegetative stage when there were no male and female flowers. Copyright © 2015 John Wiley & Sons, Ltd.

  7. LC-MS based Metabolomics

    DEFF Research Database (Denmark)

    Magdenoska, Olivera

    . The analytical tools applied for analysis of intracellular metabolites should be capable to cope with the large number of metabolites to be analyzed and the complex matrix in the samples. Therefore the combination of separation and detection techniques is commonly applied for analysis of intracellular........ In the studies conducted during this Ph.D. the developed method was used to understand how the genetic manipulations in various organisms, influence the levels of their intracellular metabolites. The method development was divided into three steps: i) optimization of the MS detection, ii) establishment...... of the MS detection aimed to determine multiple reaction monitoring (MRM) transitions of the analytes and to increase the sensitivity by testing different ion-source parameters and collision energies. This resulted in optimized detection of more than 50 intracellular metabolites. During the optimization...

  8. Publishing and Australian literature : crisis, decline or transformation?

    Directory of Open Access Journals (Sweden)

    Bode, Katherine

    2010-01-01

    Full Text Available The globalisation and consolidation of book publishing is widely seen as having negative consequences for Australian literature. Some commentators argue that this shift is detrimental to Australian literature as a whole; others identify the growth of multinational publishing conglomerates with a specific decline in Australian literary fiction. This article explores both positions, first identifying and investigating trends in Australian novel publication and comparing these to trends in the publication of novels from other countries as well as other Australian-originated literature (specifically, poetry and auto/biography. It then considers the specific case of Australian literary fiction, before looking in detail at the output of large publishers of Australian novels. This analysis reveals a recent decline in Australian novel and poetry titles, but offers a more complex picture of this trend than dominant expressions of nostalgia and alarm about the fate of Australian literature and publishing would suggest.

  9. Publishing and Australian Literature: Crisis, Decline or Transformation?

    Directory of Open Access Journals (Sweden)

    Katherine Bode

    2010-09-01

    Full Text Available The globalisation and consolidation of book publishing is widely seen as having negative consequences for Australian literature. Some commentators argue that this shift is detrimental to Australian literature as a whole; others identify the growth of multinational publishing conglomerates with a specific decline in Australian literary fiction. This article explores both positions, first identifying and investigating trends in Australian novel publication and comparing these to trends in the publication of novels from other countries as well as other Australian-originated literature (specifically, poetry and auto/biography. It then considers the specific case of Australian literary fiction, before looking in detail at the output of large publishers of Australian novels. This analysis reveals a recent decline in Australian novel and poetry titles, but offers a more complex picture of this trend than dominant expressions of nostalgia and alarm about the fate of Australian literature and publishing would suggest.

  10. The National Medical Cyclotron - An Australian experience in technology

    Energy Technology Data Exchange (ETDEWEB)

    Barnes, R K [Australian Nuclear Science and Technology Organisation (ANSTO), Lucas Heights, NSW (Australia). National Medical Cyclotron

    1998-12-31

    The establishment of the National Medical Cyclotron (NMC) in the early 1990`s was the practical outcome of a vision, held by nuclear medicine professionals, to complement the available neutron-rich radionuclides produced in Australia, with neutron-deficient radionuclides. The NMC is operated by the Australian Nuclear Science and Technology Organisation (ANSTO) in collaboration with the Royal Prince Alfred Hospital (RPAH) in Sydney where the PET department is able to use the short-lived radiotracers to good advantage. Neutron-deficient radionuclides, are also produced by the NMC laboratories. The cyclotron-generated radionuclides are used in over 70,000 patient studies per year. 7 refs., 1 tab.

  11. The National Medical Cyclotron - An Australian experience in technology

    International Nuclear Information System (INIS)

    Barnes, R. K.

    1997-01-01

    The establishment of the National Medical Cyclotron (NMC) in the early 1990's was the practical outcome of a vision, held by nuclear medicine professionals, to complement the available neutron-rich radionuclides produced in Australia, with neutron-deficient radionuclides. The NMC is operated by the Australian Nuclear Science and Technology Organisation (ANSTO) in collaboration with the Royal Prince Alfred Hospital (RPAH) in Sydney where the PET department is able to use the short-lived radiotracers to good advantage. Neutron-deficient radionuclides, are also produced by the NMC laboratories. The cyclotron-generated radionuclides are used in over 70,000 patient studies per year

  12. The Australian terrestrial carbon budget

    Directory of Open Access Journals (Sweden)

    V. Haverd

    2013-02-01

    Full Text Available This paper reports a study of the full carbon (C-CO2 budget of the Australian continent, focussing on 1990–2011 in the context of estimates over two centuries. The work is a contribution to the RECCAP (REgional Carbon Cycle Assessment and Processes project, as one of numerous regional studies. In constructing the budget, we estimate the following component carbon fluxes: net primary production (NPP; net ecosystem production (NEP; fire; land use change (LUC; riverine export; dust export; harvest (wood, crop and livestock and fossil fuel emissions (both territorial and non-territorial. Major biospheric fluxes were derived using BIOS2 (Haverd et al., 2012, a fine-spatial-resolution (0.05° offline modelling environment in which predictions of CABLE (Wang et al., 2011, a sophisticated land surface model with carbon cycle, are constrained by multiple observation types. The mean NEP reveals that climate variability and rising CO2 contributed 12 ± 24 (1σ error on mean and 68 ± 15 TgC yr−1, respectively. However these gains were partially offset by fire and LUC (along with other minor fluxes, which caused net losses of 26 ± 4 TgC yr−1 and 18 ± 7 TgC yr−1, respectively. The resultant net biome production (NBP is 36 ± 29 TgC yr−1, in which the largest contributions to uncertainty are NEP, fire and LUC. This NBP offset fossil fuel emissions (95 ± 6 TgC yr−1 by 38 ± 30%. The interannual variability (IAV in the Australian carbon budget exceeds Australia's total carbon emissions by fossil fuel combustion and is dominated by IAV in NEP. Territorial fossil fuel emissions are significantly smaller than the rapidly growing fossil fuel exports: in 2009–2010, Australia exported 2.5 times more carbon in fossil fuels than it emitted by burning fossil fuels.

  13. An update on MS Nurse PROfessional, an ongoing project of the European Multiple Sclerosis Platform.

    Science.gov (United States)

    Winslow, Anne

    2016-12-01

    Within the multidisciplinary team required to manage people with multiple sclerosis (MS) effectively, the nurse is the central component of coordinated care and support. A 2009 survey led by the European Multiple Sclerosis Platform, an umbrella organization of national MS associations, identified variance and disparity across Europe in the nursing care of MS patients. This led to development of MS Nurse PROfessional, a continuing medical education-accredited modular online learning program endorsed and approved by leading international nursing and professional groups, and people with MS, as a tool to support the evolving role of the European MS nurse. Analysis of participant experience and nurse practice to date has been overwhelmingly positive. Expansion of MS Nurse PRO is underway or planned for future.

  14. Ten-year all-cause mortality and its association with vision among Indigenous Australians within Central Australia: the Central Australian Ocular Health Study.

    Science.gov (United States)

    Liu, Ebony; Ng, Soo K; Kahawita, Shyalle; Andrew, Nicholas H; Henderson, Tim; Craig, Jamie E; Landers, John

    2017-05-01

    No studies to date have explored the association of vision with mortality in Indigenous Australians. We aimed to determine the 10-year all-cause mortality and its associations among Indigenous Australians living in Central Australia. Prospective observational cohort study. A total of 1257 (93.0%) of 1347 patients from The Central Australian Ocular Health Study, over the age of 40 years, were available for follow-up during a 10-year period. All-cause mortality and its associations with visual acuity, age and gender were analysed. All-cause mortality. All-cause mortality was 29.3% at the end of 10 years. Mortality increased as age of recruitment increased: 14.2% (40-49 years), 22.6% (50-59 years), 50.3% (60 years or older) (χ = 59.15; P < 0.00001). Gender was not associated with mortality as an unadjusted variable, but after adjustment with age and visual acuity, women were 17.0% less likely to die (t = 2.09; P = 0.037). Reduced visual acuity was associated with increased mortality rate (5% increased mortality per one line of reduced visual acuity; t = 4.74; P < 0.0001) after adjustment for age, sex, diabetes and hypertension. The 10-year all-cause mortality rate of Indigenous Australians over the age of 40 years and living in remote communities of Central Australia was 29.3%. This is more than double that of the Australian population as a whole. Mortality was significantly associated with visual acuity at recruitment. Further work designed to better understand this association is warranted and may help to reduce this disparity in the future. © 2016 Royal Australian and New Zealand College of Ophthalmologists.

  15. Molecular analysis of intact preen waxes of Calidris Canutus (Aves: Scolopacidae) by GC/MS and GC/MS/MS

    NARCIS (Netherlands)

    Sinninghe Damsté, J.S.; Dekker, M.H.A.; Piersma, T.

    2000-01-01

    The intact preen wax esters of the red knot Calidris canutus were studied with gas chromatography/mass spectrometry (GC/MS) and GC/MS/MS. In this latter technique, transitions from the molecular ion to fragment ions representing the fatty acid moiety of the wax esters were measured, providing

  16. Selenium speciation analysis of Misgurnus anguillicaudatus selenoprotein by HPLC-ICP-MS and HPLC-ESI-MS/MS

    Science.gov (United States)

    Analytical methods for selenium (Se) speciation were developed using high performance liquid chromatography (HPLC) coupled to either inductively coupled plasma mass spectrometry (ICP-MS) or electrospray ionization tandem mass spectrometry (ESI-MS/MS). Separations of selenomethionine (Se-Met) and sel...

  17. Thrombin generation correlates with disease duration in multiple sclerosis (MS): Novel insights into the MS-associated prothrombotic state.

    Science.gov (United States)

    Parsons, Martin Em; O'Connell, Karen; Allen, Seamus; Egan, Karl; Szklanna, Paulina B; McGuigan, Christopher; Ní Áinle, Fionnuala; Maguire, Patricia B

    2017-01-01

    Thrombin is well recognised for its role in the coagulation cascade but it also plays a role in inflammation, with enhanced thrombin generation observed in several inflammatory disorders. Although patients with multiple sclerosis (MS) have a higher incidence of thrombotic disease, thrombin generation has not been studied to date. The aim of this study was to characterise calibrated automated thrombography parameters in patients with relapsing-remitting MS (RRMS) and primary progressive MS (PPMS) in comparison to healthy controls (HCs). Calibrated automated thrombography was performed on platelet poor plasma from 15 patients with RRMS, 15 with PPMS and 19 HCs. We found that patients with RRMS generate thrombin at a significantly faster rate than the less inflammatory subtype, PPMS or HCs. In addition, the speed of thrombin generation was significantly correlated with time from clinical diagnosis in both subtypes. However, in RRMS the rate of thrombin generation was increased with increased time from clinical diagnosis, while in PPMS the rate of thrombin generation decreased with increased time from clinical diagnosis. These data likely reflect the differential active proinflammatory states in each MS subtype and provide novel mechanistic insights into the clinically relevant prothrombotic state observed in these patients.

  18. Substance misuse in Aboriginal Australians.

    Science.gov (United States)

    Gracey, M

    1998-01-01

    Australia's Aborigines lived in isolation from the rest of humanity as successful hunter-gatherers for tens of thousands of years. That isolation ended abruptly with British colonization in the late 18th century and was followed by a traumatic 200 years for Aborigines who are now seriously disadvantaged, socio-economically and in terms of their health standards. It has often been assumed that the Aborigines had no access to psychotropic substances before permanent European contact but several pieces of evidence dispute this view. The history of Aboriginal contact with and usage of intoxicating substances, including alcohol, is extremely complex and affected by a maze of restrictive government policies. These interact with a wide range of other Federal and State policies which have changed rapidly since the late 1960s when Aborigines were first granted the franchise; access to unrestricted drinking followed soon afterwards. Today Aborigines suffer disproportionately to other Australians from the physical and social consequences of excess alcohol consumption, tobacco usage, petrol and other solvent sniffing, usage of marijuana, amphetamines, cocaine and heroin, as well as other drugs. The Aboriginal population is dispersed in cities, towns, fringe settlements, rural and remote areas over this vast continent and there are different patterns of drug usage from place to place. This review attempts to synthesize some of this information in order to give an overview to the history, background, current status of substance misuse by Aborigines as well as some strategies being used to try to overcome this serious problem.

  19. Introducing the Australian Uranium Association

    International Nuclear Information System (INIS)

    Angwin, M.

    2007-01-01

    The Australian Uranium Association was formed in September last year in the midst of a very exciting period of change for the industry. What forged this new grouping was the industry's belief that it needed a strong representative organisation to play an advocacy role for uranium exploration and mining, at a very important moment of opportunity for the industry. That 'moment of opportunity' was the result of some critical trends and events, First, the very rapid increase in the price of uranium was driving renewed exploration and investment across Australia and the world. In the previous twelve months, the spot price of uranium had risen more than 90%. Second, the Federal Government had established the Uranium Industry Framework as a means by which government and industry could discuss a better regulatory framework. This led to some very fruitful interchanges between industry players. While the UIF talks were continuing, the Federal Government announced a parallel inquiry into whether Australia ought to move further into the nuclear power cycle. Third, the new interest in Australia in climate change and greenhouse gas emissions had led to a steep increase in public interest in the nuclear power option, with many former opponents now willing to listen to the argument

  20. MS-SQL data base programming

    Energy Technology Data Exchange (ETDEWEB)

    Noh, Chang Bae; Kim, Nam Jung; Lee, Hyeong Gyo

    2002-07-15

    This is about MS-SQL data base programming which is divided into thirteen chapters. The contents of this book are to understand MS-SQL 2000 DBMS with its composition, new function and history of MS-SQL, to learn conception of data base, install, run and closing of MS-SQL 2000 DBMS, to deal with the basic of MS-SQL DBMS, to handle the intermediate level of MS-SQL DBMS, to deal with MS-SQL DBMS in advanced level, to practice query like changing data base and checking of data lists, function on its use and data diff, get date, date add, char, upper and system function, set-up of MS-SQL ODBC, constructing of web server of windows 2000, web programming using visual studio.net.making board and making reference room.

  1. MS-SQL data base programming

    International Nuclear Information System (INIS)

    Noh, Chang Bae; Kim, Nam Jung; Lee, Hyeong Gyo

    2002-07-01

    This is about MS-SQL data base programming which is divided into thirteen chapters. The contents of this book are to understand MS-SQL 2000 DBMS with its composition, new function and history of MS-SQL, to learn conception of data base, install, run and closing of MS-SQL 2000 DBMS, to deal with the basic of MS-SQL DBMS, to handle the intermediate level of MS-SQL DBMS, to deal with MS-SQL DBMS in advanced level, to practice query like changing data base and checking of data lists, function on its use and data diff, get date, date add, char, upper and system function, set-up of MS-SQL ODBC, constructing of web server of windows 2000, web programming using visual studio.net.making board and making reference room.

  2. Challenges for environmental hygiene practices in Australian paramedic-led health care: A brief report.

    Science.gov (United States)

    Barr, Nigel; Holmes, Mark; Roiko, Anne; Dunn, Peter; Lord, Bill

    2018-06-01

    This study explored the self-reported behaviors and perceptions of Australian paramedics in relation to their environmental hygiene practices. A national online survey was conducted with Paramedics Australasia members (N = 417). Participants reported working in ambulances often contaminated with body fluids. Widespread noncompliance with routine and deep cleaning of ambulances, and misunderstandings about environmental hygiene practices were apparent. Improvements to environmental hygiene practices of Australian paramedics are recommended to avoid pathogen transmission and ensure patient safety. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  3. Homocysteine is the confounding factor of metabolic syndrome-confirmed by siMS score.

    Science.gov (United States)

    Srećković, Branko; Soldatovic, Ivan; Colak, Emina; Mrdovic, Igor; Sumarac-Dumanovic, Mirjana; Janeski, Hristina; Janeski, Nenad; Gacic, Jasna; Dimitrijevic-Sreckovic, Vesna

    2018-04-06

    Abdominal adiposity has a central role in developing insulin resistance (IR) by releasing pro-inflammatory cytokines. Patients with metabolic syndrome (MS) have higher values of homocysteine. Hyperhomocysteinemia correlates with IR, increasing the oxidative stress. Oxidative stress causes endothelial dysfunction, hypertension and atherosclerosis. The objective of the study was to examine the correlation of homocysteine with siMS score and siMS risk score and with other MS co-founding factors. The study included 69 obese individuals (age over 30, body mass index [BMI] >25 kg/m2), classified into two groups: I-with MS (33 patients); II-without MS (36 patients). Measurements included: anthropometric parameters, lipids, glucose regulation parameters and inflammation parameters. IR was determined by homeostatic model assessment for insulin resistance (HOMA-IR). ATP III classification was applied for diagnosing MS. SiMS score was used as continuous measure of metabolic syndrome. A significant difference between groups was found for C-reactive protein (CRP) (psiMS risk score showed a positive correlation with homocysteine (p=0.023), while siMS score correlated positively with fibrinogen (p=0.013), CRP and acidum uricum (p=0.000) and homocysteine (p=0.08). Homocysteine correlated positively with ApoB (p=0.036), HbA1c (p=0.047), HOMA-IR (p=0.008) and negatively with ApoE (p=0.042). Correlation of siMS score with homocysteine, fibrinogen, CRP and acidum uricum indicates that they are co-founding factors of MS. siMS risk score correlation with homocysteine indicates that hyperhomocysteinemia increases with age. Hyperhomocysteinemia is linked with genetic factors and family nutritional scheme, increasing the risk for atherosclerosis.

  4. Why and how to compensate living organ donors: ethical implications of the new Australian scheme.

    Science.gov (United States)

    Giubilini, Alberto

    2015-05-01

    The Australian Federal Government has announced a two-year trial scheme to compensate living organ donors. The compensation will be the equivalent of six weeks paid leave at the rate of the national minimum wage. In this article I analyse the ethics of compensating living organ donors taking the Australian scheme as a reference point. Considering the long waiting lists for organ transplantations and the related costs on the healthcare system of treating patients waiting for an organ, the 1.3 million AUD the Australian Government has committed might represent a very worthwhile investment. I argue that a scheme like the Australian one is sufficiently well designed to avoid all the ethical problems traditionally associated with attaching a monetary value to the human body or to parts of it, namely commodification, inducement, exploitation, and equality issues. Therefore, I suggest that the Australian scheme, if cost-effective, should represent a model for other countries to follow. Nonetheless, although I endorse this scheme, I will also argue that this kind of scheme raises issues of justice in regard to the distribution of organs. Thus, I propose that other policies would be needed to supplement the scheme in order to guarantee not only a higher number of organs available, but also a fair distribution. © 2014 John Wiley & Sons Ltd.

  5. REGULATION OF AUSTRALIAN MEDICAL PROFESSIONALS AND NATIONAL SECURITY: LESSONS FROM THREE CASE STUDIES.

    Science.gov (United States)

    Faunce, Thomas; McKenna, Michael; Rayner, Johanna; Hawes, Jazmin

    2016-03-01

    In recent times, Australia's national security concerns have had controversial impacts on regulation of Australian medical practitioners in areas related to immigration detention. This column explores three recent case studies relevant to this issue. The first involves the enactment of the Australian Border Force Act 2015 (Cth), which has a significant impact on the regulation of medical professionals who work with people in immigration detention. The second involves the decision of the High Court of Australia in Plaintiff M68/2015 v Minister for Immigration and Border Protection [2016] HCA 1 that an amendment to Australian federal legislation justified sending children back to immigration detention centres in Papua New Guinea and Nauru. This legislation was previously heavily criticised by the Australian Human Rights Commissioner. The third concerns the deregistration of Tareq Kamleh, an Australian doctor of German-Palestinian heritage who came to public attention on ANZAC Day 2015 with his appearance online in a propaganda video for the Islamic State terrorist organisation al-Dawla al-Islamyia fil Iraq wa'al Sham, also known as Islamic State of Iraq and Syria (ISIS) or Daesh. Australia's professional regulatory system should presumptively respect professional virtues, such as loyalty to the relief of individual patient suffering, when dealing with doctors (whether in Australia or ISIS-occupied Syria) working under regimes whose principles appear inconsistent with those of ethics and human rights.

  6. Status of costing hospital nursing work within Australian casemix activity-based funding policy.

    Science.gov (United States)

    Heslop, Liza

    2012-02-01

    Australia has a long history of patient level costing initiated when casemix funding was implemented in several states in the early 1990s. Australia includes, to some extent, hospital payment based on nursing intensity adopted within casemix funding policy and the Diagnostic Related Group system. Costing of hospital nursing services in Australia has not changed significantly in the last few decades despite widespread introduction of casemix funding policy at the state level. Recent Commonwealth of Australia National Health Reform presents change to the management of the delivery of health care including health-care costing. There is agreement for all Australian jurisdictions to progress to casemix-based activity funding. Within this context, nurse costing infrastructure presents contemporary issues and challenges. An assessment is made of the progress of costing nursing services within casemix funding models in Australian hospitals. Valid and reliable Australian-refined nursing service weights might overcome present cost deficiencies and limitations. © 2012 Blackwell Publishing Asia Pty Ltd.

  7. Diet and pregnancy status in Australian women.

    Science.gov (United States)

    Hure, Alexis; Young, Anne; Smith, Roger; Collins, Clare

    2009-06-01

    To investigate and report the diet quality of young Australian women by pregnancy status. Pregnancy status was defined as pregnant (n 606), trying to conceive (n 454), had a baby in the last 12 months (n 829) and other (n 5597). The Dietary Questionnaire for Epidemiological Studies was used to calculate diet quality using the Australian Recommended Food Score (ARFS) methodology. Nutrient intakes were compared with the Nutrient Reference Values for Australia and New Zealand. A population-based cohort participating in the Australian Longitudinal Study on Women's Health (ALSWH). A nationally representative sample of Australian women, aged 25 to 30 years, who completed Survey 3 of the ALSWH. The 7486 women with biologically plausible energy intake estimates, defined as >4.5 but food group accounted for this small difference. Across all pregnancy categories there were important nutrients that did not meet the current nationally recommended levels of intake, including dietary folate and fibre. Women do not appear to consume a wider variety of nutritious foods when planning to become pregnant or during pregnancy. Many young Australian women are failing to meet key nutrient targets as nationally recommended.

  8. Urinary amino acid analysis: a comparison of iTRAQ-LC-MS/MS, GC-MS, and amino acid analyzer.

    Science.gov (United States)

    Kaspar, Hannelore; Dettmer, Katja; Chan, Queenie; Daniels, Scott; Nimkar, Subodh; Daviglus, Martha L; Stamler, Jeremiah; Elliott, Paul; Oefner, Peter J

    2009-07-01

    Urinary amino acid analysis is typically done by cation-exchange chromatography followed by post-column derivatization with ninhydrin and UV detection. This method lacks throughput and specificity. Two recently introduced stable isotope ratio mass spectrometric methods promise to overcome those shortcomings. Using two blinded sets of urine replicates and a certified amino acid standard, we compared the precision and accuracy of gas chromatography/mass spectrometry (GC-MS) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) of propyl chloroformate and iTRAQ derivatized amino acids, respectively, to conventional amino acid analysis. The GC-MS method builds on the direct derivatization of amino acids in diluted urine with propyl chloroformate, GC separation and mass spectrometric quantification of derivatives using stable isotope labeled standards. The LC-MS/MS method requires prior urinary protein precipitation followed by labeling of urinary and standard amino acids with iTRAQ tags containing different cleavable reporter ions distinguishable by MS/MS fragmentation. Means and standard deviations of percent technical error (%TE) computed for 20 amino acids determined by amino acid analyzer, GC-MS, and iTRAQ-LC-MS/MS analyses of 33 duplicate and triplicate urine specimens were 7.27+/-5.22, 21.18+/-10.94, and 18.34+/-14.67, respectively. Corresponding values for 13 amino acids determined in a second batch of 144 urine specimens measured in duplicate or triplicate were 8.39+/-5.35, 6.23+/-3.84, and 35.37+/-29.42. Both GC-MS and iTRAQ-LC-MS/MS are suited for high-throughput amino acid analysis, with the former offering at present higher reproducibility and completely automated sample pretreatment, while the latter covers more amino acids and related amines.

  9. Urinary Amino Acid Analysis: A Comparison of iTRAQ®-LC-MS/MS, GC-MS, and Amino Acid Analyzer

    Science.gov (United States)

    Kaspar, Hannelore; Dettmer, Katja; Chan, Queenie; Daniels, Scott; Nimkar, Subodh; Daviglus, Martha L.; Stamler, Jeremiah; Elliott, Paul; Oefner, Peter J.

    2009-01-01

    Urinary amino acid analysis is typically done by cation-exchange chromatography followed by post-column derivatization with ninhydrin and UV detection. This method lacks throughput and specificity. Two recently introduced stable isotope ratio mass spectrometric methods promise to overcome those shortcomings. Using two blinded sets of urine replicates and a certified amino acid standard, we compared the precision and accuracy of gas chromatography/mass spectrometry (GC-MS) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) of propyl chloroformate and iTRAQ® derivatized amino acids, respectively, to conventional amino acid analysis. The GC-MS method builds on the direct derivatization of amino acids in diluted urine with propyl chloroformate, GC separation and mass spectrometric quantification of derivatives using stable isotope labeled standards. The LC-MS/MS method requires prior urinary protein precipitation followed by labeling of urinary and standard amino acids with iTRAQ® tags containing different cleavable reporter ions distinguishable by MS/MS fragmentation. Means and standard deviations of percent technical error (%TE) computed for 20 amino acids determined by amino acid analyzer, GC-MS, and iTRAQ®-LC-MS/MS analyses of 33 duplicate and triplicate urine specimens were 7.27±5.22, 21.18±10.94, and 18.34±14.67, respectively. Corresponding values for 13 amino acids determined in a second batch of 144 urine specimens measured in duplicate or triplicate were 8.39±5.35, 6.23±3.84, and 35.37±29.42. Both GC-MS and iTRAQ®-LC-MS/MS are suited for high-throughput amino acid analysis, with the former offering at present higher reproducibility and completely automated sample pretreatment, while the latter covers more amino acids and related amines. PMID:19481989

  10. Data Convergence - An Australian Perspective

    Science.gov (United States)

    Allen, S. S.; Howell, B.

    2012-12-01

    Coupled numerical physical, biogeochemical and sediment models are increasingly being used as integrators to help understand the cumulative or far field effects of change in the coastal environment. This reliance on modeling has forced observations to be delivered as data streams ingestible by modeling frameworks. This has made it easier to create near real-time or forecasting models than to try to recreate the past, and has lead in turn to the conversion of historical data into data streams to allow them to be ingested by the same frameworks. The model and observation frameworks under development within Australia's Commonwealth and Industrial Research Organisation (CSIRO) are now feeding into the Australian Ocean Data Network's (AODN's) MARine Virtual Laboratory (MARVL) . The sensor, or data stream, brokering solution is centred around the "message" and all data flowing through the gateway is wrapped as a message. Messages consist of a topic and a data object and their routing through the gateway to pre-processors and listeners is determined by the topic. The Sensor Message Gateway (SMG) method is allowing data from different sensors measuring the same thing but with different temporal resolutions, units or spatial coverage to be ingested or visualized seamlessly. At the same time the model output as a virtual sensor is being explored, this again being enabled by the SMG. It is only for two way communications with sensor that rigorous adherence to standards is needed, by accepting existing data in less than ideal formats, but exposing them though the SMG we can move a step closer to the Internet Of Things by creating an Internet of Industries where each vested interest can continue with business as usual, contribute to data convergence and adopt more open standards when investment seems appropriate to that sector or business.Architecture Overview

  11. Water metabolism in Australian marsupials

    International Nuclear Information System (INIS)

    Hume, I.D.

    1982-01-01

    Several studies are discussed in which tritiated water (TOH) has been used to investigate water metabolism in Australian marsupials, particularly arid-zone species. Equilibration of injected TOH in large kangaroos was slower than in smaller marsupials and similar to that in ruminants and camels, presumably because of the high gut water space of all large forestomach fermenters. Loss of TOH in urine, faeces and insensible water during equilibration was also similar to that in ruminants. Total body water (TBW) was similar whether estimated by equilibration or extrapolation. TBW of small marsupial species (16 g to 6.5 kg body weight) was usually in the range found for small eutherian mammals (56 to 68% of body weight). However, in the larger kangaroos TBW ranged from 73 to 78% of body weight, possibly due to the low body fat content and the high ratio of gut contents to total body weight of kangaroos. In general, the water turnover rate of marsupials is about 30% below that of eutherians; this has been related to their lower metabolic rate. Nevertheless, significant differences in water turnover have been found between some species. It has been suggested that there may be a correlation between the water turnover rates measured under ad libitum water availability and the aridity of the animal's habitat. However, this is not always so; differences in behaviour and in the water content of the natural diet explain why some marsupials with high ad libitum water turnovers can survive in desert environments. The physiological state of the animals (e.g. lactation) has also been shown to affect water turnover, both in the laboratory and in the field. (author)

  12. The Australian Managed Entry Scheme: Are We Getting it Right?

    Science.gov (United States)

    Tuffaha, Haitham W; Scuffham, Paul A

    2018-05-01

    In 2010, the Australian Government introduced the managed entry scheme (MES) to improve patient access to subsidised drugs on the Pharmaceutical Benefits Scheme and enhance the quality of evidence provided to decision makers. The aim of this paper was to critically review the Australian MES experience. We performed a comprehensive review of publicly available Pharmaceutical Benefits Advisory Committee online documents from January 2010 to July 2017. Relevant information on each MES agreement was systematically extracted, including its rationale, the conditions that guided its implementation and its policy outcomes. We identified 11 drugs where an MES was considered. Most of the identified drugs (75%) were antineoplastic agents and the main uncertainty was the overall survival benefit. More than half of the MES proposals were made by sponsors and most of the schemes were considered after previous rejected/deferred submissions for reimbursement. An MES was not established in 8 of 11 drugs (73%) despite the high evidence uncertainty. Nevertheless, six of these eight drugs were listed after the sponsors reduced their prices. Three MESs were established and implemented by Deeds of Agreement. The three cases were concluded and the required data were submitted within the agreed time frames. The need for feasibility and value of an MES should be carefully considered by stakeholders before embarking on such an agreement. It is essential to engage major stakeholders, including patient representatives, in this process. The conditions governing MESs should be clear, transparent and balanced to address the expectations of various stakeholders.

  13. The Symbol Digit Modalities Test is an effective cognitive screen in pediatric onset multiple sclerosis (MS).

    Science.gov (United States)

    Charvet, Leigh E; Beekman, Rachel; Amadiume, Nneka; Belman, Anita L; Krupp, Lauren B

    2014-06-15

    To evaluate the Symbol Digit Modalities Test (SDMT) as a tool for identifying pediatric-onset MS patients at risk for cognitive impairment. The SDMT is a brief measure of cognitive processing speed that is often used in adult MS patients. Approximately one-third of pediatric-onset MS patients have cognitive impairment and there is a need for an effective screening instrument. Seventy (70) consecutive outpatients with pediatric-onset MS underwent clinical evaluations including the SDMT and were compared to those with other pediatric neurological diagnoses (OND, n=40) and healthy controls (HC, n=32). A subset of the MS group and all healthy controls completed neuropsychological evaluation within one year of SDMT administration. The MS group performed worse on the SDMT compared to the HC group (p=0.02). Thirty-seven percent (37%) of the MS, 20% of the OND, and 9% of HC groups scored in the impaired range. For MS participants who underwent neuropsychological testing (n=31), the SDMT showed 77% sensitivity and 81% specificity for detecting neuropsychological impairment when administered within one year and reached 100% sensitivity when the interval was under two months (n=17). Overall, older age and increased disability predicted poorer SDMT performance (age r=-0.26, p=0.03) and the Expanded Disability Status Scale score or EDSS (r=-0.47, pMS. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Effect of slow release-Fampridine on muscle strength, rate of force development, functional capacity and cognitive function in an enriched population of MS patients. A randomized, double blind, placebo controlled study

    DEFF Research Database (Denmark)

    Jensen, H B; Nielsen, J L; Ravnborg, M.

    2016-01-01

    contraction (MVC) and rate of force development (RFD) of the lower extremities and 2) to replicate previously published data on the effect of slow release-Fampridine (SR-Fampridine) on the functional capacity of the lower limbs, the upper limb and cognitive function, in persons with multiple sclerosis (pw....... Furthermore, a significant effect of SR-Fampridine on T25FW, SSST and 5-STS was demonstrated. CONCLUSION: Gold standard dynamometry assessment of muscle strength showed improved MVC and RFD in persons with MS treated with SR-Fampridine compared to placebo. Furthermore, previous findings on the effects of SR...

  15. Australian mineral industry annual review for 1982

    Energy Technology Data Exchange (ETDEWEB)

    1984-01-01

    The Australian mineral industry annual review records the activities and development of the Australian mineral industry and reports production, consumption, treatment, trade, prices, new developments, exploration and resources for mineral commodities including fuels, and summarises equivalent developments abroad. The present volume reviews activities and developments in 1982. Part 1 (General Review) - after briefly surveying the world mineral industry, summarises developments in the Australian mineral industry as a whole, under the headings: the industry in the national economy; important recent developments; production; overseas trade; prices; exploration expenditure; investment; income tax; royalties; structural data; wages and salaries; industrial disputes; and government assistance, legislation and controls. Part 2 (Commodity Review) - covers industrial mineral commodities, from abrasives to zirconium. Part 3 (Mining Census) - tabulates statistics extracted from the mining census, together with some mineral processing statistics from the manufacturing census. Part 4 (Miscellaneous) - tabulates quantum and value data on mineral output provided by State departments of mines and their equivalents.

  16. Australian minerals industry 1985-6

    Energy Technology Data Exchange (ETDEWEB)

    1987-01-01

    The performance of the Australian mineral industry in 1985-86 was again adversely affected by low commodity prices and tight market conditions. This is shown in a survey conducted by chartered accountants Coopers and Lybrand and published by the Australian Mining Industry Council (AMIC). In a preface to the report, the president of AMIC (Sir Bruce Watson) said: In just 10 years the minerals industry has emerged as Australia's major exporter, accounting for over 40% of total Australian exports of goods. This preeminent ranking has depended on a significant investment effort, and in the creation of a very large asset base. Financing this investment, and achieving the cash flow necessary to service it, are enormous tasks.

  17. Medical radioisotope production - the Australian experience

    Energy Technology Data Exchange (ETDEWEB)

    Druce, M. [Australian Nuclear Science and Technology Organisation, Menai (Australia)

    1996-12-31

    The Australian government, through its instrumentality, the Australian Nuclear Science and Technology Organization (ANSTO), owns and operates a 10-MW Dido-class research reactor at Lucas Heights on the southern outskirts of Sydney. This is the only operating nuclear reactor in Australia. It was built in 1958 and has a maximum flux of 1 x 10{sup 14} n/cm{sup 2}{center_dot}s. ANSTO also jointly owns and operates a 30-MeV IBA negative ion cyclotron at Camperdown in central Sydney, which began operation in 1992. ANSTO is predominantly a research organization; however, radioisotopes are commercially produced through Australian Radioisotopes (ARI), an ANSTO business entity. Seventy-four people are employed by ARI, which is a vertically integrated organization, i.e., everything from target preparation to sale of products is undertaken.

  18. Australian coal - on top down under

    Energy Technology Data Exchange (ETDEWEB)

    1988-04-01

    Australian coal exports have risen to record levels of 102mt in 1987. Whilst the industry is characterised by impressive export tonnages and high quality product, these assets do not always indicate real returns for the coal exporter when faced with today's competitive international market. The Australian coal industry has initiated large scale cost reduction and rationalisation programmes to offset losses in revenue, accompanied by the construction of sophisticated, efficient loading facilities. The article examines some of the reasons behind continued success by exporters in the international market, before going on to consider the longer term outlook for the Australian ndustry as a whole. A historical perspective is described, tracing the development of the coal industry from early exploratory development to the highly-tuned industry of today. 2 tabs., 12 figs.

  19. Suicide of Australians during the Vietnam War.

    Science.gov (United States)

    Pridmore, Saxby; Ahmadi, Jamshid; Pridmore, William

    2018-04-01

    National suicide rates fall during times of war. This fits with the notion of the population coming together against a common foe. But, what happens in the case of a war which is not fully supported, which draws the population and families apart? We consider this question by examining the Australian suicide rates during the divisive Vietnam War. We graphed and examined the Australian suicide figures for 1921-2010. We found clear evidence of a decrease in the suicide rate for World War II (consistent with other studies), but a marked elevation of suicide during the Vietnam War. The elevation of the Australian suicide rate during the Vietnam War is consistent with Durkheim's social integration model - when social integration is lessened, either by individual characteristics or societal characteristics, the risk of suicide rises.

  20. Aboriginal Agency and Marginalisation in Australian Society

    Directory of Open Access Journals (Sweden)

    Terry Moore

    2014-09-01

    Full Text Available It is often argued that while state rhetoric may be inclusionary, policies and practices may be exclusionary. This can imply that the power to include rests only with the state. In some ways, the implication is valid in respect of Aboriginal Australians. For instance, the Australian state has gained control of Aboriginal inclusion via a singular, bounded category and Aboriginal ideal type. However, the implication is also limited in their respect. Aborigines are abject but also agents in their relationship with the wider society. Their politics contributes to the construction of the very category and type that governs them, and presses individuals to resist state inclusionary efforts. Aboriginal political elites police the performance of an Aboriginality dominated by notions of difference and resistance. The combined processes of governance act to deny Aborigines the potential of being both Aboriginal and Australian, being different and belonging. They maintain Aborigines’ marginality.