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Taylor W.J.,University of Otago | Mease P.J.,Seattle Rheumatology Associates | Adebajo A.,Barnsley District General Hospital | Nash P.J.,Rheumatology Research Unit | And 2 more authors.
Journal of Rheumatology | Year: 2010

Objective. To determine the categories of the International Classification of Functioning, Disability and Health (ICF) checklist and core sets of rheumatoid arthritis and ankylosing spondylitis frequently occurring in people with psoriatic arthritis (PsA) and to compare the number of such categories with scores on self-report measures of participation restrictions and activity limitations. Methods. Data were collected from 94 patients with PsA attending rheumatology clinics in 6 centers. For each ICF category affected by PsA in at least 30% of patients, the percentage of such patients was determined for Body Structures, Body Functions, Activities and Participation, and Environmental Factors. A count of all affected categories by ICF chapter was compared to patient self-report scores on a number of functional and health status instruments using Spearman's correlation. Results. There were 25 categories in the Body Functions section, 6 categories in the Body Structures section, and 51 categories in the Activities and Participation section that were relevant in at least 30% of participants. Thirteen Environmental Factors were facilitating and 1 Environmental Factor (climate) was a barrier in at least 30% of participants. The number of involved Activities and Participation categories by chapter did not correlate in predictable ways with self-report measures of participation restrictions and activity limitations. Conclusion. PsA is associated with a wide range of impairments, limitations, and restrictions across the ICF categories. People with PsA find environmental factors to be helpful more often than to be barriers. The unexpected pattern of correlation between ICF chapters and self-report measures suggests the need for a better way of quantitatively representing the ICF concepts. Copyright © 2010. All rights reserved.

Egerton-Warburton D.,Monash Medical Center Clayton | Egerton-Warburton D.,Monash University | Povey K.,Dandenong Hospital
EMA - Emergency Medicine Australasia | Year: 2013

Objective: The study aims to determine if slow intravenous infusion of metoclopramide reduces the incidence of acute drug-induced akathisia (DIA) compared with intravenous bolus. Methods: A prospective, double-blind, double dummy trial of adult patients requiring intravenous metoclopramide in the ED. Participants were randomised to receive either: metoclopramide 20mg as a bolus and normal saline infusion over 15min, or normal saline bolus and metoclopramide 20mg infused over 15min. Patients were assessed for DIA using the Prince Henry Akathisia Rating Scale before treatment was commenced and at 20, 40 and 60min post. Nausea was assessed with a visual analog scale. Results: Of 210 participants assessed for eligibility, 206 were randomised and 205 were included in the final analysis. Participant characteristics and indication for metoclopramide were well matched between the treatment groups. Overall, incidence of DIA was 26 out of 205 participants (12.68%, 95% confidence interval [CI] 8.09-17.3). DIA occurred in 11 out of 103 (10.68%, 95% CI 4.61-16.74%) in the bolus group, and in 15 out of 102 (14.71%, 95% CI 7.71-21.70%) in the infusion group (P = 0.67). Severe DIA occurred in six patients in each group. The mean age of patients experiencing DIA was 34 years (interquartile range 29-40) and 42 years (interquartile range 40-45) in those without akathisia (P = 0.04). Nausea reduction was equivalent in both groups. Conclusion: The incidence of DIA and reduction in nausea is unaffected by the rate of administration of intravenous metoclopramide 20mg. © 2013 The Authors. EMA © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Lim A.K.H.,Monash University | Choi M.J.,Dandenong Hospital
Internal Medicine Journal | Year: 2013

Renal tubular acidosis is a common cause of normal anion gap metabolic acidosis but these disorders can be easily missed or misdiagnosed. We highlight the approach to assessing renal tubular acidosis by discussing a case study with a temporal data set collected over more than 5 weeks. We highlight the principles and the necessary information required for a diagnosis of classic distal renal tubular acidosis. We also briefly review several aspects of type 1 renal tubular acidosis related to autoimmune disease, drugs and thyroid disorders. © 2013 Royal Australasian College of Physicians.

Campbell I.S.,Gold Coast Hospital | Fox C.M.,Dandenong Hospital
New Zealand Medical Journal | Year: 2012

Aims Medical education in Australia has changed considerably in recent times. As a result, hours dedicated to subjects such as anatomy have been reduced. Young doctors preparing for a career in anatomy-focussed specialties such as surgery and radiology require an indepth knowledge of this subject matter. Many Australian and New Zealand universities now offer postgraduate anatomy courses to address this potential gap in a budding surgeon's education. This article summarises the current options for postgraduate surgical anatomy education in Australia and New Zealand. Methods All universities in Australia and New Zealand were contacted between September 2010 and December 2010 regarding the nature and content of course offerings. An Internet-based search was also conducted. Results There are currently nine universities in Australia and New Zealand offering postgraduate anatomy courses. Courses vary in contact hours, dissection time, lecture content, and examination methods. There are currently two universities offering a Postgraduate Diploma of Surgical Anatomy-the University of Melbourne, and the University of Otago. University of Western Australia and the University of New England offer a graduate diploma and a graduate certificate, respectively. Several other universities offer courses that deliver quality anatomical education but do not award students a university-recognised qualification. The Australian Orthopaedic Association now offers courses in Perth, Sydney and Brisbane, which delivers anatomy education specific to orthopaedics. Conclusions There are a number of courses available to budding surgeons and radiologists to help fill the anatomy education void. With the development of such courses questions of accessibility, affordability and equity remain. © NZMA.

Sloane T.,Dandenong Hospital | Shaban R.Z.,Griffith University | Gillespie B.,Griffith University
Healthcare Infection | Year: 2012

Background In 2011, the Therapeutic Goods Administration approved the use of alcohol-based rubs for hand antisepsis in surgical settings in Australia. The purpose of this research was to assess the knowledge, attitudes and perceptions of operating room healthcare professionals with respect to alcohol-based surgical rubs in order to gain insight into the potential barriers and enablers to their uptake. Methods A descriptive, two-phase study assessed operating room healthcare professionals' knowledge, attitudes, and perceptions towards the use of alcohol-based surgical rubs within a large multi-campus public health care service in Melbourne, Australia. Results Central to the successful uptake of alcohol-based surgical rubs is the provision of education that emphasises the significant benefits the rubs bring to patient safety and to staff occupational health, specifically with respect to hand skin integrity. Other enablers included distributing international evidence demonstrating their safety and efficacy and the revision to the Australian College of Operating Room Nurses Standard's other relevant policies, standards, and guidelines within health services. Inclusion of alcohol-based surgical rub protocols in national standards was deemed and important motivator. While most participants welcomed the introduction of alcohol-based surgical rubs, changing tradition and culture were reported as significant barriers to its uptake. Conclusions Identifying the likely motivators and barriers to change will assist in the uptake of alcohol-based surgical rubs. Further research should examine the actual barriers and enablers to the uptake of alcohol-based surgical rubs that materialised in organisations following the approval and their introduction into Australian surgical settings. © 2012 Australian Infection Control Association.

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