A5055664351- Palliative Care and End-of-Life Issues
- Health Systems, Economic Evaluations, Quality of Life
- Primary Care and Health Outcomes
- Grief, Bereavement, and Mental Health
- Childhood Cancer Survivors' Quality of Life
- Patient Dignity and Privacy
- Geriatric Care and Nursing Homes
- Patient-Provider Communication in Healthcare
- Healthcare innovation and challenges
- Interprofessional Education and Collaboration
- Ethics in medical practice
- Mental Health and Patient Involvement
- Pain Management and Opioid Use
- Chronic Disease Management Strategies
- Global Health Workforce Issues
- Healthcare Decision-Making and Restraints
- Streptococcal Infections and Treatments
- Pneumonia and Respiratory Infections
- Statistical Methods in Clinical Trials
- Antimicrobial Resistance in Staphylococcus
- demographic modeling and climate adaptation
- Pediatric health and respiratory diseases
- Child and Adolescent Health
- Neonatal and Maternal Infections
- Health Policy Implementation Science
Flinders University
2007-2025
Repatriation General Hospital
2005-2012
University of Newcastle Australia
2012
Duke University
2007
Queen Elizabeth Hospital
2006
Menzies School of Health Research
1996-2002
Royal Children's Hospital
2002
The University of Melbourne
2002
Flinders Medical Centre
1998
Queensland Health
1997
Abstract Background The Karnofsky Performance Status (KPS) is a gold standard scale. Thorne-modified KPS (TKPS) focuses on community-based care and has been shown to be more relevant palliative settings than the original KPS. Australia-modified (AKPS) blends TKPS accommodate any setting of care. Methods status was measured using all three scales for patients enrolled in randomized controlled trial South Australia. Care occurred range settings. Survival defined from enrollment death. Results...
In February 1995, single-dose azithromycin was given to children with trachoma and their household contacts who were children. For trachoma, rates of carriage pneumococci immediately before treatment 2–3 weeks, 2 months, 6 months after 68% (54 79), 29% (11 38), 78% (29 37), 87% (34 39), respectively. The proportion carriage-positive azithromycin-resistant Streptococcus pneumoniae strains 1 54 (1.9%) then 11 (54.5%), 10 29 (34.5%), 34 (5.9%) at follow-up visits. profile pneumococcal serotypes...
Place of death is at times suggested as an outcome for palliative care services. This study aimed to describe longitudinal preferences place and over time patients their caregivers. Longitudinal paired data patient/caregiver dyads from a prospective unblinded cluster randomised control trial were used. Patients caregivers separately asked by the nurse preference that death. changes both questions mapped; patterns agreement (patient caregiver; when last actual placed death) analysed with...
To determine how prescribing for comorbid illnesses and symptom control changes during the palliative phase of a terminal illness.This prospective cohort study explores relative contribution to symptom-specific medications (SSMs) long-term medical conditions.Regional consultative care program, Adelaide, South Australia.Two hundred sixty consecutive patients, 96% whom had cancer, who enrolled subsequently died in larger randomized trial exploring service delivery.Medication performance data...
We conducted a 12-year review of all cases group A streptococcal (GAS) bacteremia that were seen at Royal Children's Hospital in Melbourne, Australia, from 1982 through 1993. Forty-two identified. There was trend towards increased incidence infections, as well clear increase their severity, during the study period; more previously healthy children affected last 6 years (80% cases) than first (47% cases), and complications occurred latter period former (40% vs. 20%, respectively, with an 88%...
Abstract Background The demand for mental health services in Australia is substantial and has grown beyond the capacity of current workforce. As a result, it currently difficult many to access secondary healthcare providers. Within sector, however, peer workers who have lived experience managing conditions been increasingly employed intentionally use their journey recovery supporting others living with communities. Currently, presence primary care limited, despite potential benefits...
Objectives: General practice plays an important role in delivering and supporting mental health care within communities, particularly for those living rural areas where access to specialised support is limited. This study sought understand the barriers facilitators providing Australian general practices. Methods: A descriptive qualitative was undertaken involving online interviews with 14 staff at three practices between June September 2023. Participants included nurses ( n = 4), GPs,...
The 'Service Navigation Measure' (SNM) initiative was introduced in 2020 as part of Commonwealth Psychosocial supports delivered through the Primary Health Networks (PHNs) Australia. aim this study to explore experiences clients who received initiative. An exploratory sequential mixed method undertaken Australian primary care setting. Quantitative data, which involved closed-ended questions, were collected via a survey. Qualitative data then open-ended questions survey and during one-on-one,...
Rigorous clinical research in palliative care is challenging but achievable. Trial participants are likely to have deteriorating performance status, co-morbidities and progressive disease. It difficult recruit patients, attrition unrelated the intervention being trialled high. The aim of this paper highlight practical considerations from a forum held discuss these issues by active researchers. To date, Australian Palliative Care Clinical Studies Collaborative (PaCCSC) has randomized more...
SUMMARY Ribotyping with the restriction enzyme Xba I was used to study dynamics of carriage non-encapsulated Haemophilus influenzae (NCHi) in Aboriginal infants at risk otitis media. Carriage rates NCHi community were very high; median age for detection 50 days and colonization virtually 100% by 120 persisted a high level throughout first year life [1]. Eighteen different ribotypes identified from 34 positive swabs taken 3 over period 9 months. The same recovered up months consecutive...
The use of handheld computers in medicine has increased the last decade, they are now used a variety clinical settings. There is an underlying assumption that electronic data capture more accurate paper-based methods have been rarely tested. This report documents study to compare accuracy hand held computer versus traditional methods.Clinical nurses involved randomised controlled trial collected patient information on parallel with form. Both sets were entered into access database and...
Australia's population is ageing and the consequential burden of chronic disease increasingly challenges health system. This has raised interest in, awareness of, approaches built on multidisciplinary teams integrated coordinated care in managing complex needs patient groups such as chronically ill or frail aged. A systematic investigation literature relating to these provided opportunity explore meaning terms their potential application relevance Australian primary setting. Five reviews a...
Regulatory bodies including the European Medicines Agency register medications (formulation, route of administration) for specific clinical indications. Once registered, prescription is at clinicians' discretion. Off-label use beyond registered use. While off-label prescribing may, times, be appropriate, efficacy and toxicity data are often lacking.The aim this study was to document policies (including disclosure consent) in Australian palliative care units current practices by clinicians.A...
Aboriginal children living in remote Australia experience high rates of bacterial infection such as trachoma, otitis media and streptococcal skin infection, which often progress to associated chronic diseases later life.In February, 1995, single dose azithromycin was given 130 with trachoma their contacts. The impact this program on respiratory group A Streptococcus pyogenes carriage also monitored.Immediately before treatment 90% had sores, 38% sores pus 74% (GAS). Overall 57% GAS...
This study investigated the impact of a three-year randomized control trial different models service provision on palliative care staff associated with hospice where was being conducted. Eleven open access de-identified qualitative focus groups were held over period three years: months into trial, one year after its inception, and at end trial. Four involved: inpatient nurses, outreach medical specialists, administrative social workers. Initially produced high levels stress which largely...
End-of-life care must be informed by methodologically rigorous, high-quality research, but well-documented barriers make the conduct of palliative clinical trials difficult. With careful consideration to study design and procedures, these are surmountable. This paper discusses approach used in a large scale, randomised, controlled trial service-based interventions regional service South Australia, impact this on research more broadly, changes which it was conducted, health policy beyond...
Many of the drugs prescribed commonly to palliative care patients have potentially significant side-effects and are unproven benefit. The acquisition evidence support prescribing these has been very slow. Single patient trials (SPTs) (also known as n-of-1 trials) offer a potential means obtaining necessary or refute use several interventions whose is currently based on physician experience anecdote alone. A list SPTs considered “most urgent”, for employed treatments most common troublesome...