Medicine & Health

Publication Search Results

Now showing 1 - 10 of 26
  • (2009) Packham, Deborah; Ward, Robyn L; Lin, Vita Ap; Hawkins, Nicholas J; Hitchins, Megan P
    Journal Article
    Abstract: Activating mutations of the BRAF and KRAS genes cause constitutive stimulation of an important cell-signaling pathway promoting tumorigenesis, and are increasingly recognized as determinants of response to targeted cancer therapies. The V600E mutation accounts for most of the BRAF mutations in cancer, and KRAS mutations are predominantly encoded by nucleotide substitutions within codons 12 and 13. We designed novel pyrosequencing assays for the detection of the common ‘‘hotspot’’ mutations in these genes, which demonstrated analytical sensitivities of Z10% in titrations of mutant cell AQ1 lines. The KRAS pyrosequencing assay has the ability to simultaneously identify all potential nucleotide changes within the mutation cluster at codons 12 and 13, with a sequence output in the sense direction to facilitate results interpretation. These assays were used to determine the mutation status in a prospective series of 1198 sporadic colorectal cancers. The BRAF V600E mutation was detected in 13.2% of the colorectal cancers. The frequency of KRAS mutations in our cohort was 32.4%, with G>A transitions at position 2 of codons 12 and 13 being most prevalent. Both assays proved highly sensitive and specific when applied to clinical specimens, and were applicable to both fresh-frozen and formalin-fixed paraffin-embedded archival tissues. These assays would serve as a suitable platform for large-scale mutation detection in cancer specimens where the facility for pyrosequencing is available.

  • (2009) Gao, Steven; Lees, Justin; Wong, Jennifer; Croll, Tristan; George, Peter; Cooper-White, Justin; Tuch, Bernard
    Journal Article
    Human embryonic stem cells (hESCs) have previously been cultured on three dimensional (3D) biodegradable polymer scaffolds. Although complex structures were formed from the hESCs, very little is known about the mechanism of adhesion of these cells to the surfaces of the scaffolds. In this study, we achieved the efficient adhesion of pluripotent hESCs to 3D poly(lactic-co-glycolic acid) (PLGA) scaffolds based on our data from a novel two dimensional (2D) model that imitates the surface properties of the scaffolds. In the 2D model, single cell preparations of pluripotent hESCs adhered efficiently and predominantly to PLGA surfaces coated with laminin in comparison to collagen I, collagen IV, or fibronectin-coated surfaces. Flow cytometry analysis revealed that almost all of the pluripotent single cells expressed the integrin 6, with a small percentage also expressing 3ß1, which facilitates adhesion to laminin. This data was then translated into the 3D environment, with the efficient binding of single pluripotent hESCs to PLGA scaffolds coated with laminin. The utility of this system was shown by the directed differentiation of single hESCs seeded within laminin-coated scaffolds toward the endoderm lineage.

  • (2009) Nielssen, O.; Large, M.; Westmore, B.; Lackersteen, S.
    Journal Article
    Objective: To examine the circumstances of homicides of children in New South Wales from 1991 to 2005. Design and setting: Retrospective analysis of all identified child homicides in NSW from 1991 to 2005, based on data on offenders and victims obtained from crime statistics, documents located by systematic searches of legal databases and media reports, and medicolegal reports of offenders who committed child homicides during psychotic illness. Main outcome measures: Demographic characteristics of homicides and a history of prior psychiatric treatment among offenders with psychosis. Results: We located documents describing 165 homicides by 157 offenders. Fifty-nine deaths were a consequence of child abuse, including those of five children who died from methadone overdoses. Both the offenders and the victims in fatal child abuse were significantly younger than in other forms of child homicide. The courts found that 27 child homicides had been committed by 26 offenders during the acute phase of psychotic illness, and 15 of these offenders had never been treated with antipsychotic medication. Conclusions: Earlier identification and treatment of psychotic illness in mothers, and changes in the way methadone is provided to opiate-dependent parents, might result in a small overall reduction in the number of child deaths. More lives could be saved by measures that reduce the incidence of child abuse, including the prohibition of corporal punishment of children.

  • (2009) Large, M.; Nielssen, O.
    Journal Article
    Objective: To examine the relationship between the numbers of psychiatric hospital beds and prisoners using recent statistics. Design: An analysis of published data from 158 countries. Methods: Multiple linear regression techniques were used to examine the relationship between per capita measures of income and numbers of psychiatric hospital beds and the dependant variable of per capita prison populations, in high and low-and-middle-income countries. Results: Prison and psychiatric populations were positively correlated in low-and-middle-income countries. There was no relationship between the number of psychiatric hospital beds and prison populations in high-income countries. Conclusions: In low-and-middle income countries the association between prison and psychiatric hospital populations may depend on the ability of governments to pay for custodial institutions as well as differences in cultural attitudes towards abnormal and criminal behaviour. In high-income (HI) countries psychiatric and prison populations are not related and probably determined by separate social and political factors.

  • (2009) Short, Alison; Holdgate, Anna; Ahern , Nicole; Morris, Jennifer
    Journal Article
    The interdisciplinary context of the emergency department encompasses diverse clinical presentations requiring teamwork by doctors, nurses and allied health workers to achieve optimal patient care. This interdisciplinary focus is extended by adding a research perspective. This project sought to systematically examine the current research capacity of emergency department staff at a major Australian tertiary urban hospital and to derive information about further research-related needs with a view to enhancing research capacity. The mixed method project utilized a department-wide staff survey followed by focus groups and individual interviews. Adequate response rates to the two phases were achieved (n¼67, n¼17 respectively). Not surprisingly, 89% of participants reported that they needed help with developing their research skills. Clinicians reported little or no experience with (i) finding literature (35%) and critical review (50%), (ii) research skills and techniques, both qualitative (72%) and quantitative (63%), and (iii) research output: publishing (68%), writing & presenting (34%). Data from focus groups and individual interviews yielded themes around developing research skills, communication, meaningfulness, team work and interdisciplinary strategies, forming part of the Dimensional Enhancing Research Capacity (DERC) model. This project highlighted not only interdisciplinary needs for research but also the way that research may additionally assist with building interprofessional linkage.

  • (2009) Ekholm , Jodie; Short, Alison
    Journal Article
    Background: Responding to an imposed health area merger, all those involved in nurse education were required to amalgamate their activities across the newly created larger and diverse health area. Methods: This reflective paper outlines issues arising as a result of the merger, puts forward responses of ED nurse education staff based on a simple questionnaire, and reviews changes implemented as a result of the merger. Results: Whilst there was some initial resistance, strategies were developed from within the educator staff involved in order to facilitate the merger process. The questionnaire indicated that initial concerns were gradually overcome during the transition process. Ultimately, a successful merger occurred, leading to a range of educational benefits. Conclusions: Although difficult, a successful merger transitional process led to the development of a broad, systemised career pathway for ED nurses. Further benefits were ultimately apparent as a result of the merger, including issues of resource allocation, cost-savings, and potential staff retention.

  • (2009) Senadheera, S.; Markus, I.; Bertrand, R. L.; Liu, L.; Morris, M. .J.; Bertrand, P. P
    Conference Paper

  • (2009) O'Sullivan, Anthony; Huang, Denise
    Journal Article
    Objective: Oral oestrogen has been shown to dissociate the growth hormone (GH)/insulin-like growth factor (IGF)-I axis and alter energy metabolism in postmenopausal women. This study was designed to determine whether these metabolic changes occur with short-term oral oestrogen in premenopausal women. Study design: A double-blind placebo controlled randomised-crossover design study was performed in 12 premenopausal women. Investigations were performed after either 5 days of oral 17β-oestradiol valerate 2 mg twice daily or placebo. Outcomes included body composition measured by bio-impedance, energy metabolism measured by indirect calorimetry and blood sampling. Results: Oral oestrogen significantly suppressed IGF-I levels and increased fasting GH levels. No significant changes in energy metabolism or body composition were detected. Conclusions:Short-term oral oestrogen suppresses IGF-I and elevates GH levels in premenopausal women. No effects were seen on body composition and energy metabolism. Further research is required to determine whether metabolic effects of oral oestrogen may become apparent if longer courses of treatment were administered to premenopausal women.

  • (2009) Adam, Philippe; de Wit, John; Toskin, I; Mathers, Bradley; Nashkhoev, I; Lyerla, Rob; Rugg, D
    Journal Article
    Background: HIV prevalence data suggest that men who have sex with men (MSM) in low-income and middle-income countries (LMIC) are at increased risk of HIV The aim of this article is to present global estimates on key HIV prevention needs and responses among MSM in LMIC. Methods: Data on HIV testing, HIV prevention coverage, HIV knowledge and condom use among MSM were derived from UNGASS country progress reports submitted in 2008. Eligible country estimates were used to calculate global and regional estimates, weighted for the size of MSM populations. Results: Of 147 LMIC, 45% reported at least 1 indicator that reflects the HIV prevention needs and responses in MSM. Global weighted estimates indicate that on average 31 % of MSM in LMIC were tested for HIV; 33% were reached by HIV prevention programs; 44% had correct HIV knowledge; and 54% used condoms the last time they had anal sex with a man. Conclusions: The 2008 UNGASS country reports represent the largest harmonized data set to date of HIV prevention needs and responses among MSM in LMIC. Although reporting is incomplete and does not always conform to requirements, findings confirm that, in many LMIC, HIV prevention responses in MSM need substantial strengthening.

  • (2009) Zablotska, I; Imrie, John; Prestage, Garrett; Crawford, June; Rawstorne, Patrick; Grulich, Andrew; Jin, Feng Yi; Kippax, Susan
    Journal Article
    We explored seroguessing (serosorting based on the assumption of HIV seroconcordance) and casual unprotected anal intercourse (UAIC) associated with seroguessing. The ongoing Positive Health and Health in Men cohorts, Australia, provided data for trends in seroconcordant UAIC and HIV disclosure to sex partners. In event-level analyses, we used log-binomial regression adjusted for within-individual correlation and estimated prevalence rate ratios (PRRs) and 95% confidence intervals (95% CIs) for the association between the knowledge of a casual partner`s seroconcordance and UAIC. UAIC and HIV disclosure significantly increased during 2001-2006. HIV-positive men knew partners were seroconcordant in 54% and assumed it in 13% of sex encounters (42 and 17% among HIV-negative men). Among HIV-positive men, the likelihood of UAIC was higher when a partner`s status was known (Adjusted PRR = 5.17, 95% CI: 3.82-7.01) and assumed seroconcordant because of seroguessing (Adjusted PRR = 3.70, 95% CI: 2.56-5.35) compared with unknown. Among HIV-negative men, the likelihood of UAIC was also higher when a partner`s status was known (Adjusted PRR = 1.88, 95% CI: 1.58-2.24) and assumed seroconcordant (Adjusted PRR = 2.12, 95% CI: 1.72-2.62) compared with unknown. As levels of UAIC remain high, seroguessing increasingly exposes gay men to the risk of HIV infection. Because both HIV-positive and HIV-negative men often seroguess, education and prevention programs should address the fact that HIV-negative men who engage in UAI due to this practice may be at high risk of HIV infection. HIV prevention should take into account these contemporary changes in behaviors, especially among HIV-negative gay men.