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Heslop K.,Curtin University Australia | Ross C.,Royal Perth Hospital Perth | Osmond B.,Royal Perth Hospital Perth | Wynaden D.,Curtin University Australia
International Journal of Mental Health and Addiction | Year: 2013

Up to sixty percent of people admitted to acute mental health services in Australia present with a clinically significant co-occurring drug and/or alcohol problem. These individuals experience poorer health outcomes when compared to the general population and to those people who have a mental illness but have no co-morbid alcohol and drug problems. Anecdotal evidence also suggests that many nurses working in the area do not have the knowledge and skills and confidence to work effectively with this patient population. Drug and alcohol assessment tools, considered the gold standard, generally assess only one substance at a time or provide little specific information on the particular substance of use or abuse. An amended version of the World Health Organisation, (WHO) Alcohol Smoking and Substance Involvement Screening Test Version 3 (ASSIST V3.0) and associated brief interventions was implemented following an in-vivo education program at an acute mental health inpatient unit in Western Australia. This before and after intervention' study utilised a self-rating questionnaire and a knowledge quiz to assess nurses' knowledge of drug and alcohol issues as well as their level of confidence to work with people who have a mental illness and co-occurring drug and alcohol problems. Translation of acquired knowledge into patient care was also evaluated through a review of patient medical records. Significant improvement in nurses' knowledge was reported along with increased clinical confidence and skills to identify, assess, and manage this group of patients and to provide them with information and referral to appropriate agencies in the community. © 2013 Springer Science+Business Media New York. Source


Dissanayake S.,Western Hospital | Dissanayake D.,Royal Perth Hospital Perth | Taylor D.B.,Royal Perth Hospital Perth | Taylor D.B.,University of Western Australia
Journal of Medical Radiation Sciences | Year: 2015

Cancer screening and surveillance programmes and the use of sophisticated imaging tools such as positron emission tomography-computed tomography (PET-CT) have increased the detection of impalpable lesions requiring imaging guidance for excision. A new technique involves intra-lesional insertion of a low-activity iodine-125 (125I) seed and detection of the radioactive signal in theatre using a hand-held gamma probe to guide surgery. Whilst several studies describe using this method to guide the removal of impalpable breast lesions, only a handful of publications report its use to guide excision of lesions outside the breast. We describe a case in which radio-guided occult lesion localisation using an iodine 125 seed was used to guide excision of an impalpable posterior chest wall metastasis detected on PET-CT. © 2015 Australian Institute of Radiography and New Zealand Institute of Medical Radiation Technology. Source


Bourke A.G.,University of Western Australia | Taylor D.B.,University of Western Australia | Westcott E.,University of Western Australia | Hobbs M.,Royal Perth Hospital Perth | Saunders C.,University of Western Australia
ANZ Journal of Surgery | Year: 2016

Background: The aim of this study was to confirm that radio-guided occult lesion localization using low activity iodine 125 (I-125) seeds (ROLLIS) could be safely and accurately used for localization and guided excision of impalpable breast lesions in different multidisciplinary settings and to prepare staff for a randomized controlled trial. Method: Preoperative image-guided localization of 102 lesions using one or two I-125 seeds with hook-wire back-up was performed in 99 participants at two tertiary hospitals. Preoperative core biopsy in 24 lesions was benign or indeterminate (Group A) and malignant in 78 lesions (Group B). Imaging and histopathology findings and re-excision rates were recorded. Training requirements for new staff and seed handling protocols were refined. Results: All seeds and lesions were successfully removed. In five of 23 Group A participants, malignancy on final pathology required definitive surgery for positive margins. The re-excision rate in Group B was 17%. Overall re-excision rate was 18%. Thirty-seven clinical staff members were trained. Sentinel node localization was successful in all 76 cases. Seeds of low activity were successfully used. Conclusion: The ROLLIS technique using a lower dose (∼2MBq) seed is safe, effective and can easily be adopted in a large multi-disciplinary setting. © 2016 Royal Australasian College of Surgeons. Source

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