Medicine & Health

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  • (2007) Wong, Justin; Hawkins, Nicholas; Ward, Robyn
    Journal Article
    Recent advances in basic and clinical science have driven epigenetics to the forefront of cancer research. Together with genetic changes, the disruption of epigenetic mechanisms is now established as a hallmark of cancer in humans. Colorectal cancer, long a classic model for the genetic basis of cancer, is now providing researchers with the opportunity to view epigenetic events in the context of neoplasia in humans. Knowledge of the heritable changes in gene expression that result from epigenetic events is of increasing relevance to clinical practice, particularly in terms of diagnostic and prognostic molecular markers, as well as novel therapeutic targets.

  • (1996) Vochteloo, J; Elphinstone, Kevin; Russell, Susan; Heiser, Gernot
    Conference Paper
    The Mungi single address space operating system provides a protected procedure call mechanism named protection domain extension (PDX). The PDX call executes in a protection domain which is the union of (a subset of) the caller`s, and a fixed domain associated with the procedure. On return, the caller`s original protection domain is reestablished. Extensive caching of validation data allows amortisation of setup costs over a possibly large number of invocations. The PDX mechanism forms the basis for object support in Mungi, particularly encapsulation. It is also used for accessing devices, and to implement user-level page fault handlers.

  • (2007) Chan, Bibiana Chi Wing
    Under-utilisation of mental health services is widespread globally and within Australia, especially among culturally and linguistically diverse (CALD) communities. Improving service access is a priority, as is the need to deliver culturally competent services to the CALD communities. Having migrated to Australia in waves for approximately 150 years from China and South East Asia for various social, political and economic reasons, the Chinese population in Sydney is now the fastest growing non-English speaking ethnic group. There is a need to better understand the impact of culture on the emotional experiences of these Chinese in Australia. How do Chinese make sense of their depressive episodes? To address this question, this study explored the ways participants reach out for medical and/or non-medical help. Lay concepts of illness underpin these decisions and were thus unveiled. Mixed-method research design provided the opportunity to bring together multiple vantage points of investigation: population mental health, transcultural psychiatry and medical anthropology. A study combining quantitative survey and qualitative focus groups was undertaken in metropolitan Sydney. Narratives on symptoms, explanatory models and help-seeking strategies were articulated by focus group informants. Surveys covered demographics, symptom-recognition, previous depressive experiences and professional help sought. Depression measurement tools were cross-culturally validated. Self-ratings of ethnic identities and the Suinn-Lew Self-Identity Acculturation Scale were used to quantify Chinese participants’ acculturation level. This allowed comparisons between ‘low-acculturated’ Chinese’, ‘highly-acculturated’ Chinese and Australians. Survey results showed comparable levels of symptom-recognition in all subgroups. Focus group discussions provided rich data on informants’ help-seeking strategies. Highly acculturated Chinese closely resembled the Australians in many study variables, yet qualitative data suggested cultural gaps beyond language barriers in influencing service use. Participants believed that trustful relationships could work as the bridge to link services with those in need. The implications for Australia’s mental health policy include recognising the importance of rapport-building and the existence of cultural gaps. The study indicated professionals can benefit from acquiring information about the mental health beliefs both of individual clients and the wider ethnic communities in which they belong, and respecting the cultural differences between helper and helped as the first step towards cultural competency.

  • (2008) Chan, Bibiana Chi Wing
    心理衛生服務不被廣泛採用﹐不單是澳洲也是全球性的現象﹐尤其是那些多元文化和語言背景 (Cultural and Linguistically Diverse)的社區。改善接觸服務的各種 門徑自然是當前急務﹐還需要考慮到服務範疇對多元文化的社區是否適切。華裔人士早於一百五十年前從中國及東南亞地區移民到澳洲﹐他們包括來自不同社會﹑政治﹑經濟背景的人士。悉尼的華人人口是澳洲近年增長最迅速的少了民族! 有見及此, 我們需要了解一下文化對情緒表現的影響. 華裔人士怎樣解釋他們的 抑鬱經歷呢? 要回答以上的問題﹐這個研究主要探討參加者怎樣尋求醫療和非醫療的服務。一般華人做這些決定時所持的病理概念就得以揭示出來! 混合式的研究設計 正好提供一個 機會去從一個垮躍多個學術領域 (公共衛生﹑ 跨文化心理學和 醫護人類學)的角度 來進行研究。這個在悉尼市區進行的研究,融合了‘數量’的問卷調查和‘質量’的社區座談會。取得的資料包括 病癥﹑病人的詮釋方法﹐求助途徑等. 問卷搜集到背 景資料, 病癥識辨﹐以往的抑鬱經歷和 曾向那些專業服務求助, 抑鬱症的量表和其 他跨文化的工具都經過嚴格測試覆核﹐其中用來量度華裔參加者的文化適應能力的量表 Suinn-Lew Self-Identity Acculturation Scale, 把參加者客觀地分成較傳統 和較澳洲化兩個組別﹑ 和澳洲人的一組作比較。 問卷調查顯示兩組華人和一組澳洲人對抑鬱症的病癥識辨能力相約﹔社區座談會的討論則引出了有關求助途徑的豐富資料。較澳洲化的華人跟澳洲人組別在很多個研究指標 (或稱變數﹐variables) 上都很接近。不過座談會資料卻指出文化上的差異對選 擇甚麼樣的服務有一定影響,很明顯這是超越語言上的障礙!參加者認為對專業人士或服務機構的信任是連接服務與病者的重要一環。研究結果呼籲澳洲心理衛生的策劃者必須正視‘建立良好關係的重要’。專業人士必需增強了解個別病者和少數民族對精神或心理病的詮釋。尊重求助者和施予援助者之間的文化差異’是踏出推動多元民化心理衛生服務的第一步.

  • (2007) Amoroso, Cheryl; Proudfoot, Judy; Bubner, Tanya; Swan, Edward; Espinel, Paola; Barton, Christopher; Beilby, Justin; Harris, Mark
    Journal Article
    BACKGROUND: Clinical audit is recognised worldwide as a useful tool for quality improvement. METHODS: A feedback report profiling capacity for chronic disease care was sent to 97 general practices. These practices were invited to complete a clinical audit activity based on that feedback. Data were analysed quantitatively and case studies were developed based on the free text responses. RESULTS: Eighty-two (33%) of 247 general practitioners participated in the clinical audit process, representing 57 (59%) of 97 general practices. From the data in their feedback report, 37 (65%) of the 57 practices recognised the area most in need of improvement. This was most likely where the need related to clinical practice or teamwork, and least likely where the need related to linkages with other services, and business and finance. Only 25 practices (46%) developed an action plan related to their recognised area for improvement, and 22 (39%) practices implemented their chosen activity. Participating GPs judged that change activity focused on teamwork was most successful. DISCUSSION: The clinical audit process offered participating GPs and practices an opportunity to reflect on their performance across a number of key areas and to implement change to enhance the practice’s capacity for quality chronic disease care. The relationship between need and action was weak, suggesting a need for greater support to overcome barriers.

  • (2009) Chen, Hui; Morris, Margaret
    Journal Article
    Maternal obesity due to long-term high-fat diet (HFD) consumption leads to faster growth in offspring during suckling, and increased adiposity at 20 days of age. Decreased expression of the orexigenic neuropeptide Y (NPY) and increased anorexigenic proopiomelanocortin (POMC) mRNA expression were observed in the fed state. However, hunger is the major drive to eat and hypothalamic appetite regulators change in response to meals. Therefore it is important to compare both satiated and fasting states. Female Sprague Dawley rats (8 weeks old) were fed a cafeteria-style HFD (15.33kJ/g) or chow for 5 weeks before mating, with the same diet continuing throughout gestation and lactation. At postnatal day 20, male pups were killed either after overnight fasting or in the fed state. Pups from obese dams were hyperphagic during both pre- and post-weaning periods. Pups from obese dams had higher hypothalamic mRNA expression of POMC and NPY Y1 receptor, but lower hypothalamic melanocortin-4 receptor (MC4R) and its downstream target single-minded gene 1 (Sim1), in the fed state. Overnight fasting reduced circulating glucose, insulin, and leptin and increased hypothalamic NPY Y1 receptor mRNA in pups from both lean and obese dams. Hypothalamic NPY and agouti-related protein were only increased by fasting in pups from obese dams; reductions in MC4R and Sim1 were only seen in pups from lean dams. At weaning, the suppressed orexigenic signals in offspring from obese dams were normalized after overnight fasting, while anorexigenic signaling appeared impaired in these animals. This may contribute to their hyperphagia and faster growth.

  • (2009) Gorrie, Catherine; Waite, PME; Rogers, LJ
    Journal Article
    Cortical asymmetries are well established in humans for language and motor regions and correlate with handedness. Here the authors investigate structural differences in the hemispheres of left- and right-handed common marmosets using surface photography and histology. The hand preferences of 11 marmosets were assessed over their adult life span using a simple reaching task. A significant correlation was found between the length of the right lateral sulcus/brain weight and the % right-hand preference (r = .86, p = .001). Cortical thickness on the superior bank of the right lateral sulcus posteriorly was also positively correlated with % right-hand preference (r = .69, p = .025). Comparison of this site with previously published functional maps of the marmoset cortex show this area corresponds to SII, a region involved in tactile processing and somatosensory discriminations. It is suggested that the correlation between SII thickness and right-hand preference would be consistent with the fact that right-handed marmosets are more proactive than left-handers in exploring novel objects by touch. Enlargement of a cortical area involved tactile discriminations could be a precursor to the evolution of right-handedness as a population bias.

  • (2007) Chase, J; Donaldson, L; Duflou, J; Gorrie, Catherine
    Journal Article
    Background: This study focused on whether there are clear indications of seat belt use to be found at autopsy, evaluating the sensitivity and specificity of seat belt marks (SBM), and whether use of seat belt and seating location affects the type and severity of injuries sustained. Methods: Information on the type of injuries sustained and seatbelt use was retrieved from autopsy reports and police reports respectively, for cases of fatal motor vehicle collisions occurring in Sydney, Australia over a 5 year period. Results: A SBM was only found on restrained occupants. The proportion of restrained occupants with evidence of a SBM was 36% (sensitivity), whilst unrestrained occupants showed no evidence of a SBM (100% specificity). A SBM was also found to reliably reflect seating position of occupant. Conclusion: Restrained occupants can be expected to show evidence of the seat belt in just over 1/3 of cases. A spurious SBM is very unlikely to be present if the occupant was unrestrained.

  • (2007) Mireskandari, Shab; Sherman, K; Meiser, Bettina; Taylor, Alan; Gleeson, Margaret; Andrews, L; Tucker, Katherine
    Journal Article
    Purpose: The aim of the current research was to characterize psychological adjustment among partners of women at high risk of developing breast/ovarian cancer and to explore the relationship between women`s and partners` adjustment. Methods: A study of 95 unaffected at-risk women and 95 partners was carried out using mailed, self-administered questionnaires with validated measures of psychological outcome. Results: Elevated levels of distress were noted in up to 10% of partners. High monitoring coping style and greater perceived breast cancer risk for their wife were associated with higher distress levels for partners. However, communicating openly with their wife and the occurrence of a recent cancer-related event in the woman`s family were related to lower distress for partners. Partners` cancer-specific distress was positively related to their wives` distress. Conclusion: Among partners with elevated levels of distress, the ability to provide effective support to the at-risk women and participate appropriately in their decision making may be compromised. These partners are likely to benefit from targeted clinical interventions designed to reduce their distress levels. The findings emphasize the importance of considering partners of at-risk women in service provision and highlight the need for partners to obtain information and support specifically tailored to their needs.

  • (2009) Leong, G; Gorrie, Catherine; Ng, K; Rutkowski, S; Waite, P.M.E
    Journal Article
    Study Design : Prospective experimental Objectives : To investigate inter-rater and intra-rater reliability of electrical perceptual threshold (EPT) testing in assessing somatosensory function in healthy volunteers. Setting: Spinal Injuries Unit, Royal North Shore Hospital, Sydney, NSW, Australia Methods: Cutaneous electrical stimulation of 4 dermatomes at American Spinal Injuries Association (ASIA) sensory key points (C3, T1, L3, S2) was performed on 40 control subjects. The lowest ascending stimulus intensity at which sensation was perceived was recorded as the EPT. Mean EPT values for each dermatome, as determined by 2 testers at two time points, were examined and plotted against a normative template. Differences and associations between intra- and inter-rater measurements, and left-right measurements were investigated. EPT results for 2 people with spinal cord injuries were also examined. Results : EPT measurements from left and right sides, obtained from the two time points and two testers, were found to be strongly associated, with the exception of left and right side measurements at the S2 dermatome. No significant differences in the mean EPT for tester or time period were found. The intra- and inter-rater reliability was good for all dermatomes tested. Mean EPT measurements fell within the range of a normative template at each of the 4 dermatomes tested. Conclusion : EPT is an objective, reproducible and quantifiable method of assessing sensation in a control group. However, caution should be applied in certain dermatomes such as S2 where there was large variation between left and right side measurements. Sponsorship : New South Wales Office of Science and Medical Research