School of Rural Medicine
Permanent URI for this collection
Browse
Browsing School of Rural Medicine by Department "#PLACEHOLDER_PARENT_METADATA_VALUE#"
Results Per Page
Sort Options
- Publication(+)-(1R,2S,3R)-2-[(Benzyloxycarbonyl)methyl]-3-phenylcyclopropanecarboxylic acid(John Wiley & Sons, Inc, 2007)
;Avery, Thomas D; ;Taylor, Dennis KTiekink, Edward R TIn the title compound, C19H18O4, the carboxyl group lies on the opposite side of the cyclopropane ring to the other substituents. Molecules associate via (···HOC=O)2 synthons around centres of symmetry and are linked into double layers by cooperative C-HO··· contacts. - PublicationThe 2019-2020 bushfires and COVID-19: The ongoing impact on the mental health of people living in rural and farming communities(Wiley-Blackwell Publishing Asia, 2021-02)
; ; ; ; ; ;Coffey, YumikoIt is well established that bushfires and other natural disasters have long‐term effects on the mental health of affected individuals and communities (Black Dog Institute, 2020). These effects can last for years as demonstrated following the 2009 Black Saturday fires in Victoria, Australia: one fifth (21.9%) of the highest impacted communities reported mental health symptoms at the five‐year follow‐up (Gibbs et al. 2013). The recent 2019–2020 catastrophic bushfires in Australia was nothing like we have experienced before (Morton 2019), resulting in unprecedented devastation across much of the country with current estimates suggesting 14.5 million acres have been affected (White & Gilbert 2020) and numerous lives, houses, and livelihoods impacted. The 2019–2020 bushfires in New South Wales, Victoria, South Australia, Western Australia, and Tasmania caused much loss of life and property, environmental destruction, and community disturbance (Flanagan 2020), leaving an estimated one third of Australians now affected by the bushfires (Morton 2020). The last month of summer in the Northern Hemisphere has resulted in bushfires affecting and almost destroying small towns in the USA (Newburger, 2020). With predictions that globally, temperatures will continue to increase with more frequent heatwaves and less rainfall (CSIRO 2018), bushfires are likely to be a more frequent event, and the consequences of them being more widespread. - PublicationAccess to Dental Health and Social Inequality: How the poor is alienated from advanced dentistry
Research has shown that the status of oral health has an association with general health of an individual. This means that if an individual suffers dental diseases, it is likely that the individual could also suffer other general health conditions. Similarly, research has shown that dental health is an important determinant of the health status of the individual.This means that an individual will feel sick and therefore will be unable to perform normal functions because of a dental disease. In addition, dental health improves the aesthetics, general profile and the outlook of the individual. All above indicate the importance of dental health care and social responsibility of any government to provide such dental care without any discrimination.
- PublicationAchieving High-Efficiency Organic Photovoltaics from a New Completely Amorphous Donor Polymer(American Chemical Society, 2022)
;Pan, Xun ;Bjuggren, Jonas Mattiasson; ;Tan, Wen Liang ;McNeill, Christopher RAndersson, Mats RThe development of non-fullerene acceptors (NFAs) such as ITIC andY6 has greatly improved the efficiency of polymer solar cells. Therefore, focus should now shift towards the design of donor polymers with better compatibility with these NFAs to attempt to push efficiencies to higher levels. The indacenodithienothiophene (IDT) unit has up till now been typically incorporated into donor polymers for fullerene-based solar cells" however, the application of IDT-based polymers in NFA solar cells is rare. In order to increase the number of donor polymer candidates, we have synthesized two new polymers PIDT-T8BT and PIDT-T12BT conjugating IDT and perfluorinated benzothiadiazole moieties through octyl and dodecyl thiophene bridging units, respectively. These polymers were studied and revealed to be completely amorphous without aggregates, and their glass transition temperatures were distinct owing to the different lengths of the alkyl groups attached to the thiophene units. In addition, the length of the side groups greatly affects the solar cell performance. The longer dodecyl side groups in the polymer PIDT-T12BT resulted in a lower glass transition temperature and favorable thermal annealing conditions of the active layer blend with Y6. A promising power conversion efficiency of over 12% was achieved for PIDT-T12BT when paired with the Y6 acceptor and thermally annealed at 170 °C, which is the highest reported value so far for IDT-based donor polymers.
- PublicationActual and projected gaps in the provision of residential aged care in New South Wales, AustraliaObjective. The need for residential care services will grow significantly over the coming years as the general population in Australia continues to age. The aim of this study was to assess the adequacy of residential care services across New South Wales (NSW), Australia, in relation to the current and predicted future aging population.
Method. This study was a secondary data analysis. Existing datasets were compiled for analysis by creation of a temporal geodatabase, with predicted population data from 2019 to 2029 linked to corresponding geographic zones.
Results. Demand for operational places was over capacity in 2019, at 101.5%. From 2019 to 2029, this will grow to 120.2% of 2019 capacity by 2024 and to 135.6% by 2029. An additional 25 800 operational places will be required by 2029 to meet targets. During the previous decade of 2008-18, operational places grew by only 11 502 places.
Conclusions. NSW was not providing an adequate level of residential aged care and, under current allocations, this problem will worsen substantially over time, with flow-on impacts for the health sector. With aged care reform a current federal government focus, the results of this study may guide decisions that better support the provision of residential aged care. - PublicationAcute pelvic pain associated with an intra-osseous lipoma of the hip joint(Société Internationale de Chirurgie Orthopédique et de Traumatologie [International Society of Orthopaedic Surgery and Traumatology] (SICOT), 2003)A case report of a 64-year old woman who presented with recurrent pelvic and hip pain secondary to an intra-osseous lipoma of the acetabulum (with intra-articular extension) is reported. An acetabular labral tear developed in association with this tumour. There was no history of trauma. Usually intra-osseous lipomas are asymptomatic. To my knowledge, this is the first case report in the literature of an intra-osseous lipoma of the acetabulum causing severe pelvic pain requiring laparotomy. Hip pathology should be considered in the differential diagnosis of recurrent pelvic pain. Intra-osseous lipomas tend to resolve spontaneously by fat necrosis altering their radiological appearance. Consistent with this case, a negative bone scintigraph does not exclude their presence.
- PublicationAdaptive interviewing for the inclusion of people with intellectual disability in qualitative research(Wiley-Blackwell Publishing Ltd, 2024-01)
;McFarland, Bridget ;Bryant, Lia; Morales-Boyce, TysonBackground: Historically the voices of people with intellectual disability have been occluded by barriers imposed by research practice. More recently, adaptive research approaches have been proposed to enhance the inclusion of people with intellectual disability in qualitative research.
Method: This article presents an adaptive interviewing approach employed with five people ageing with intellectual disabilities in rural South Australia. The interviews were conducted within a broader participatory action research project in which tools and resources were co-designed for post-parental care planning.
Results: We describe our adaptive interviewing approach incorporating multiple methods: (i) responsive communication techniques; (ii) the inclusion and support of family carers; (iii) visual tools; (iv) walking interviews.
Conclusion: Findings contribute knowledge about how an adaptive interview approach supports the participation of people with an intellectual disability in qualitative research.
- PublicationAddressing elder abuse in general practice
This paper discusses how a social psychology principle, the bystander effect, can help us determine whether elder abuse policy, guidelines, and learning materials aid general practitioners (GPs) to make decisions to intervene in suspected elder abuse cases. GPs are mandated to recognise, assess, understand, and manage elder abuse and neglect. However, research demonstrates that GPs do not consistently notice elder abuse signs, struggle to define cases as abusive, do not always recognise their professional responsibility to intervene, experience a lack of education about elder abuse response, and hold ethical concerns about damaging the GP / patient relationship by intervening. The professional bystander intervention model describes five steps to helping which mirror these GP challenges very closely: (1) noticing relevant cues; (2) construing the situation as suspected elder abuse; (3) deciding the situation is a personal responsibility; (4) knowing how to deal with the situation; and (5) deciding to intervene. Based on an analysis of key elder abuse sources, the authors illustrate five major themes from the data and focus on the central theme; separating intention to harm and carer stress when defining elder abuse. Our analysis reveals that the sources include information that may help GPs to define elder abuse, particularly when carer stress is present, however, their efficacy to do so may depend on the ability of individual GPs to separate these concepts
- PublicationAdvancing interprofessional theory: Deliberative democracy as a participatory research antidote to power differentials in aged care(Elsevier Inc, 2019-06)
;Nugus, Peter; ;Travaglia, Joanne ;Greenfield, David ;Lamothe, Josianne ;Hogden, Anne ;Kolne, KendallBraithwaite, JeffreyIntroduction: Interprofessional relations in health care have been examined through the frame of "clinical democracy". Yet, traditional interpretations of democracy have assumed a zero-sum, competitive interpretation of power, leading to unelaborated invocations for health professionals to "collaborate" more or do "teamwork" better. The aim of this study was to understand the priorities that health professionals from different occupations have for individual patient care, and the opportunities they have to express those priorities, as a foundation for a more expansive democratic theory.
Materials and methods: The case setting was a mixed-method, pre-post, participatory research (PR) study examining the dynamics and levels of satisfaction of interprofessional information-sharing and decision-making on an acute aged care unit.
Results: Stage 1, pre-intervention, revealed that non-medical health professionals – nursing and, in particular, allied health professionals – lacked opportunities for input into decision-making for patient care. Following deliberative, public feedback of the findings to managers and health professionals, an intervention was negotiated to re-structure the weekly case conference and referral processes. Stage 2, the post-interventional findings showed an increase in perceptions of information-sharing, and participation in case conferences, as well as recognition of power differentials in interprofessional relations.
Conclusions: In the public negotiation of increased prominence of particular roles and aligning role clarity with the needs of particular patients, the findings show that the notion of deliberative democracy characterizes the qualitative-cumulative, rather than merely quantitative-redistributive power among health professionals in different occupational roles. As a case of conscientization, deliberation engages practical interprofessional improvement simultaneously as educational empowerment. - PublicationAdvising patients to increase fluid intake for treating acute respiratory infections(John Wiley & Sons Ltd, 2011)
; ;Mickan, Sharon M ;Del Mar, Chris B ;Thorning, SarahRack, AlexanderBackground Acute respiratory infection is a common reason for people to present for medical care. Advice to increase fluid intake is a frequent treatment recommendation. Attributed benefits of fluids include replacing increased insensible fluid losses, correcting dehydration from reduced intake and reducing the viscosity of mucus. However, there are theoretical reasons for increased fluid intake to cause harm. Anti-diuretic hormone secretion is increased in lower respiratory tract infections of various aetiologies. This systematic examination of the evidence sought to determine the benefit versus harm from increasing fluid intake. Objectives To answer the following questions. 1. Does recommending increased fluid intake as a treatment for acute respiratory infections improve duration and severity of symptoms? 2. Are there adverse effects from recommending increased fluids in people with acute respiratory infections? 3. Are any benefits or harms related to site of infection (upper or lower respiratory tract) or a different severity of illness? Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, issue 4), which contains the Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to November Week 3, 2010), EMBASE (1974 to December 2010), Current Contents (2000 to December 2010) and CINAHL (1982 to December 2010). We searched reference lists of articles identified and contacted experts in the relevant disciplines. Selection criteria Randomised controlled trials (RCTs) that examined the effect of increasing fluid intake in people with acute respiratory infections. Data collection and analysis Two review authors independently assessed the identified studies to determine eligibility for inclusion. Main results No RCTs assessing the effect of increasing fluid intake in acute respiratory infections were found. Authors' conclusions There is currently no evidence from RCTs for or against the recommendation to increase fluids in acute respiratory infections. The implications for fluid management of acute respiratory infections in the outpatient or primary care setting have not been studied in any RCTs to date. Some non-experimental (observational) studies report that increasing fluid intake in acute respiratory infections of the lower respiratory tract may cause harm. RCTs need to be done to determine the true effect of this very common medical advice. - PublicationAerobic Exercise, Metabolic Syndrome, and Lipid Profiles: Protocol for a Quantitative Review(Allen Press, 2021-07-08)
; ; ; ; ;Patil, Aditya; ;Wolden, MitchBackground:
We describe two systematic reviews and univariate meta-analyses of randomized controlled trials to estimate the effect size of aerobic exercise training on the standard lipid profile of adults diagnosed with, and free of, metabolic syndrome; and the determination if study or intervention covariates explain change in lipid outcomes.
Methods:
English language searches of online databases from inception to June 2020. Data will be included from (a) randomized controlled trials of sedentary adult humans with intervention and non-exercising control groups of n ≥ 10; (b) an aerobic exercise training intervention duration ≥12 weeks of at least moderate intensity (>40% VO2MAX); and (c) reporting of pre/post lipid measurements. Subjects with chronic disease (except diabetes mellitus or metabolic syndrome), or pregnant/lactating, or trials testing diet/medication, or resistance/isometric/unconventional training will be excluded.
Results:
We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. Univariate meta-analysis will estimate the effect size of aerobic exercise training on the standard lipid profile, using a random raw mean difference, Knapp-Hartung adjusted, 95% confidence interval, model. Statistical tests and precision and standard error funnel plots will evaluate heterogeneity. Multivariate meta-regression will explore whether study or intervention covariates explain change in lipids. Analyses will be performed in Comprehensive Meta-Analysis 3.0. Study quality will be evaluated using TESTEX.
Conclusion:
We aim to estimate the effect size of aerobic exercise training on the standard lipid profiles of adults with and free of metabolic syndrome, and establish if these changes result in minimal meaningful change to cardiovascular disease risk. We aim to determine if meta-regression covariates might explain change in lipids. - PublicationAgeing, end-of-life care, and the National Disability Insurance Scheme: What can we learn from overseas?The author of this conceptual article was awarded a Churchill Fellowship to travel to the United States, Ireland, and United Kingdom to meet with researchers, practitioners, and community agencies and review how support for people with intellectual disability is provided. A specific focus was upon provision of care for individuals who were either ageing or requiring palliative care. The project took place from June to August 2013 and involved face-to-face interviews and site visits with key academics, government representatives, and community providers in Los Angeles, Chicago, New York, New Jersey, Dublin, Edinburgh, London, Oxford, Cambridge, Bath, Bristol, Birmingham, and Stoke-on-Trent. A priority was placed upon examining how the key features of leading practice models could be implemented within the Australian environment featuring a National Disability Insurance Scheme (NDIS). On the basis of the observations of practice, key points are discussed regarding the potential for improvements to the support of people with intellectual disability within the Australian context of the NDIS.
- PublicationAgeing-in-a-chosen-place: commonalities and dissonance in life choice-making in elders with and without intellectual disability(Wiley-Blackwell Publishing Ltd, 2014)
; ; ;Knox, Marie; ;Leggatt-Cook, Chez; ;Cannon, Miranda ;Edwards, MeaghanParmenter, MarieAim: The past century has seen a significant increase in the life expectancy of both people with and without lifelong disabilities. The purpose of the current research was to examine the respective experiences of people ageing with and without intellectual disability across both rural and metropolitan locations. Methods: This project utilised semi-structured interviews with participants who were still living in the community and also those who had moved into residential care facilities. The focus of these interviews was to gain an understanding of the experience of ageing both with and without an intellectual disability and to contrast the similarities and differences across both cohorts. Results: The paper will report the findings of the research, with a particular focus on the concept of "ageing-in-a-chosen-place" rather than "ageing-in-place". The key similarities and differences in the life experience of ageing individuals with and without intellectual disabilities will be discussed. Conclusion: As the life expectancy of people around the world continues to rise, we need to ensure that support structures are based around assessed individual need. Such models need to be based upon accurate information and ensure that the informed decision-making capacity of all individuals is supported. - PublicationAgeing-in-Place: Perceptions of people with intellectual disability and those without lifelong disability in rural and metropolitan NSW(Australasian Society for Intellectual Disability (ASID), 2014)
; ; ; ;Knox, Marie ;O'Brien, Patricia ;Leggatt-Cook, Chez; ;Cannon, Miranda ;Edwards, MeaghanParmenter, MariePurpose of the Presentation: • Part of wider study that aimed to provide an assessment of gaps currently preventing the successful ageing in place of both people with and without life-long intellectual disability in rural and urban areas of NSW. • Study funded by the Illawarra Research Trust Research Foundation Grant. • This focus of this paper is an exploration of the individual's own understanding of ageing-in-place and the features that facilitate or impede the achievement of this goal. - Publication'Alive and Kicking Goals!': Preliminary findings from a Kimberley suicide prevention programSuicide is an enormous problem in the Kimberley, a region in northern-Western Australia. An 18-year-old Indigenous male is seven-times more likely to die by suicide, compared to his non-Indigenous peers. 'Alive and Kicking Goals!' (AKG) was a pilot program that took an innovative approach to suicide prevention peer education. Players from the Broome Saints Football Club formed a youth sub-committee. Guided by a Project Mentor (PM), these young men undertook training in suicide prevention in order to become Peer Educators (PEs) for the Kimberley region. AKG created a safe space for healing which allowed these young men to come to terms with the 'cycle of grief' experienced in the region. AKG also tackled suicide stigma as the PEs, who were well-respected sportsmen, demonstrated that seeking help does not display weakness. At the conclusion of the pilot, 16 young men became PEs. They learned practical skills in suicide awareness and prevention which they can teach within and across the different communities within the Kimberley region. Preliminary results from this pilot have informed ways in which AKG can be developed for the future. Further research can indicate to long-term positive impacts.
- PublicationAn Analysis of Medico Legal Functions Rendered by Non Specialist Medical Officers in the Central Province of Sri Lanka(University of Peradeniya, Faculty of Medicine, 2009)
; ;Dayaratne, P ;Munasighe, M A MPremasinghe, KMany government medical officers in Sri Lan ka are expected by law to perform all medico-legal duties even though they may not get a practical exposure of all medico-legal functions in their undergraduate curriculum. District Medical Officer (DMO), Medical Officer In Charge (MO-IC), MO-Medico Legal are some non specialist positions in the Ministry of Health that perform med ico-legal functions. There are no formal training provided to these officers to perform medico-legal funct ions other than what they learnt in the undergraduate curriculum (Chandrasiri , 2002; Gooneratne and Edussuriya, 2007). There have been no studies to identify the varying medico-legal functions performed by non specialist medical officers in Sri Lanka. Therefore th is study was designed to understand the varying types, nature and extent of medicolegal duties non specialist medical officers perform in Sri Lanka and their training needs.
- PublicationAnswering your significant research questions with the aid of a research matrix(Australian Council for Educational Research Press (ACER Press), 2012)
; There are two parts to this chapter: the first contains some ideas about identifying significant research questions and how to structure the argument leading to their identification. On the way, we point out some useful tools to assist you in your study. The second part introduces you to our research matrix as a device to facilitate your work. The matrix is a table or spreadsheet that uses the significant questions as the organising feature (left-hand column) guiding the research design and the methodological decisions of the study (headings of the first row). Many of our candidates have found using the research matrix has repaid their efforts for a number of reasons. For some it is a tool that allows them to see the study as it develops, and eventually the whole study is apparent in the one place. For others it keeps them on track because it provides a vehicle for discussion with supervisors. In its simplest relatively complete form, the research matrix looks like Table 10.1 for a primary research question and three sub-questions. For a matrix like this to work effectively the research questions have to be largely established beforehand. There is little point in working out the matrix until the key concepts have been identified and established by identifying what they are in the research questions and, if required, their sub-questions. Put another way, the research design and methodology follow the articulation of the research questions. However, getting the research questions right is not straightforward. Let's begin with this issue. - PublicationAntibacterial Compounds and Phytochemistry of Plants from the New England Tablelands (NSW) and the Genus Eremophila(University of New England, 2021-03-02)
; ; ; Antibacterial resistance is increasing at a time when few new antibacterial compounds are being discovered. Many of the most important antibacterial agents that have been discovered to date are natural products. Plants are avid producers of natural products which they use, among other reasons, to defend against microbial invaders. To tap into these plant defences, this study relied upon a screening platform which included general antimicrobial assays, a new and robust thin layer chromatography with bioautography protocol, phytochemical profiling, compound isolation tools such as flash chromatography, and nuclear magnetic resonance spectroscopy for compound elucidation. The study revealed details of the phytochemistry and antibacterial potential of a number of plants, including Olearia fulgens and other species from the New England Tablelands of New South Wales, and several species from the genus Eremophila. More intensive work to uncover the antibacterial secondary metabolites of plants with bioactive extracts resulted in the discovery of previously undescribed compounds including a labdane glycoside, a serrulatic acid and clerodanes. The activity of isolated antibacterial compounds in this work supports a view that many plants generally produce poorly or moderately active secondary metabolites rather than compounds which are highly active. An additional output of the study was the creation of an extensive online phytochemical database of Eremophila. This tool was created to avoid rediscovering known compounds and to indicate which species had poorly describable phytochemical profiles and were thus worthy of further investigation. It is hoped that this database can now benefit other researchers in fields as diverse as ethnobotany, chemistry and taxonomy.
- PublicationArtificial Neural Network Modeling of Phytoestrogen Binding to Estrogen ReceptorsDifferential pathophysiological roles of estrogen receptors alpha (ERα) and beta (ERβ) are of particular interest for phytochemical screening. A QSAR incorporating theoretical descriptors was developed in the present study utilizing sequential multiple-output artificial neural networks. Significant steric, constitutional, topological and electronic descriptors were identified enabling ER affinity differentiation.
- PublicationAspects of the Biology, Ecology and Management of the Green Mirid, Creontiades dilutus (Stal), in Australian CottonThe green mirid, Creontiades dilutus (Stal) (GM) is one of the important early season sucking pests in cotton in Australia. They prefer to feed on the growing parts of the cotton plant, particularly terminals and squares, causing shedding of squares and partial to complete wilting of terminals depending on the severity of feeding. GM feeding early in the season causes delay in maturity. Currently they are controlled mainly by the broad spectrum insecticides applied to control Helicoverpa spp., but this disrupts biological control of other major cotton pests. To increase our understanding of the pest, research on biology, behaviour, damage etiology and ecology of the GM was undertaken during the period 1994-97 in cotton growing areas of northern New South Wales.
C. dilutus was studied extensively on cotton plants under glasshouse and field conditions and its life cycle and biology was documented. Effects of temperature on female fecundity and egg and nyrnphal development were also studied. Both fecundity and development rate were found to be maximum at around 30°C. Threshold temperatures for development of eggs, individual stages of nymphs and the total nymphal period were calculated.
The oviposition pattern of GM on the cotton plants and the distribution of GM eggs in relation to the position of the main stern nodes were studied. GM preferred to deposit their eggs dorsally on the petiole end of 4 to 8 main stern node. Two factors, hardness and hairiness influence GM to discriminate preferred oviposition sites.
Damage etiology of GM on cotton was studied in detail under glasshouse and field conditions. Both nymphs and adults caused similar damage to the cotton plant. The damage caused by GM was cumulative and very apparent as nymphs entered the 4th instar. GM confined their attack to young growing parts of cotton plants, especially squares and terminals, causing squares to shed and terminals to wilt. The shedding of squares depended on feeding site, frequency of feeding and the size or age of the square. The amount of damage increased with the increase of insect number. Their feeding extended to the vascular bundle region and during feeding the insect released pectinase that destroyed surrounding cells of the feeding point. GM feeding in the field did not cause any significant yield loss in irrigated cotton. However, their feeding at early stages of plant growth caused significant delay in maturity.
The economic injury level for GM for the first time was calculated using maturity delay from field experiments by manipulating field population. An economic threshold (1 GM/m of row) was proposed which is higher than the currently recommended economic threshold and therefore will assist in the successful implementation of IPM programmes.
Extensive studies were made on GM ecology during 1994-97 in two locations. GM was more abundant in early to maximum squaring stage in all seasons in both locations. Analysis of GM population suggested that populations were regulated by contest competition during early cotton season (October - December) and scramble competition during middle and late cotton season (January - March). Egg populations may have been regulated by delayed density dependent factors, possibly predators. Insecticides targeted for Helicoverpa, temperature extremities, heavy rainfall along with strong wind, predators, alternative hosts, intraspecific competition and emigration may also have influenced GM populations in the field. Other than these factors, overwintering hosts allowed the build up of populations toward the end of spring, contributing to GM invasion of cotton. Study on the overwintering hosts also suggested that in northern NSW cotton growing regions, GM populations continued throughout the winter, though population growth was reduced.