Xu C.,Shaanxi Normal University |
Gericke C.A.,The Wesley Research Institute |
Gericke C.A.,University of Queensland |
Gericke C.A.,Queensland University of Technology
F1000Research | Year: 2013
Introduction: Chronic disease has become a major problem affecting the health of the Chinese population. In response to this situation, the New Rural Cooperative Medical Scheme (NRCMS) has begun to provide health cover for outpatients with chronic disease expenses, made possible by the increased risk pool of previous years. We compare the differences between Benefit Packages for Chronic Diseases Outpatients (BPCDO) in order to produce a reference for policy makers. Methods: Information on the various BPCDO was located by searching the official NRCMS website in Chinese, using certain criteria to select the ideal BPCDO. Population coverage, service coverage and cost of coverage were chosen to form the analytical framework for this paper. The diseases were classified according to the World Health Organisation's (WHO) International Classification of Diseases (ICD-10). Results: To avoid "moral hazard"?, complex processes have been created. This has resulted in chronic disease patients finding it very difficult to become beneficiaries. Forty-one types of chronic diseases were listed in 32 different BPCDO. We found that different counties have different co-payment rates, deductible lines, ceilings, coverage of drugs and tests, appointed hospitals and reimbursement frequencies. Conclusion: High mortality diseases and diseases with a heavier cost burden should be the priority on the list of reimbursement. The BPCDO scheme should be introduced urgently at the national level. It should include twenty-one types of disease and eight essential factors. © 2013 Xu C et al.
Hung Y.-C.,University of Queensland |
Bauer J.D.,University of Queensland |
Bauer J.D.,The Wesley Research Institute |
Horsely P.,The Wesley Hospital |
And 4 more authors.
Nutrition | Year: 2014
Objective: The aim of this study was to assess the agreement between detected changes in body composition determined by bioimpedance spectroscopy (BIS) and air-displacement plethysmography (ADP) among patients with cancer undergoing peripheral blood stem cell transplantation (PBSCT); and to assess the agreement of absolute values of BIS with ADP and dual energy x-ray (DXA). Methods: Forty-four adult hematologic cancer patients undergoing PBSCT completed both BIS and ADP assessment at preadmission and at 3 mo after transplantation. A subsample (n = 11) was assessed by DXA at 3 mo after transplantation. Results were examined for the BIS instrument's default setting and three alternative predictive equations from the literature. Agreement was assessed by the Bland-Altman limits of agreement analysis while correlation was examined using the Lin's concordance correlation. Results: Changes in body composition parameters assessed by BIS were comparable with those determined by ADP regardless of the predictive equations used. Bias of change in fat-free mass was clinically acceptable (all <1 kg), although limits of agreement were wide (more than ±6 kg). Overall, the BIS predictive equation accounting for body mass index performed the best. Absolute body composition parameters predicted by the alternative predictive equations agreed with DXA and ADP better than the BIS instrument's default setting. Conclusion: Changes predicted by BIS were similar to those determined by ADP on a group level; however, agreement of predicted changes at an individual level should be interpreted with caution due to wide limits of agreement. © 2014 Elsevier Inc.
Gloeckl S.,Queensland University of Technology |
Ong V.A.,Queensland University of Technology |
Patel P.,Queensland University of Technology |
Tyndall J.D.A.,University of Otago |
And 13 more authors.
Molecular Microbiology | Year: 2013
The mechanistic details of the pathogenesis of Chlamydia, an obligate intracellular pathogen of global importance, have eluded scientists due to the scarcity of traditional molecular genetic tools to investigate this organism. Here we report a chemical biology strategy that has uncovered the first essential protease for this organism. Identification and application of a unique CtHtrA inhibitor (JO146) to cultures of Chlamydia resulted in a complete loss of viable elementary body formation. JO146 treatment during the replicative phase of development resulted in a loss of Chlamydia cell morphology, diminishing inclusion size, and ultimate loss of inclusions from the host cells. This completely prevented the formation of viable Chlamydia elementary bodies. In addition to its effect on the human Chlamydia trachomatis strain, JO146 inhibited the viability of the mouse strain, Chlamydia muridarum, both in vitro and in vivo. Thus, we report a chemical biology approach to establish an essential role for ChlamydiaCtHtrA. The function of CtHtrA for Chlamydia appears to be essential for maintenance of cell morphology during replicative the phase and these findings provide proof of concept that proteases can be targeted for antimicrobial therapy for intracellular pathogens. © 2013 John Wiley & Sons Ltd.
PubMed | The Wesley Research Institute and Queensland University of Technology
Type: Journal Article | Journal: Work (Reading, Mass.) | Year: 2015
Injuries occurring in the workplace can have serious implications for the health of the individual, the productivity of the employer and the overall economic community.The objective of this paper is to increase the current state of understanding of individual demographic and psychosocial characteristics associated with extended absenteeism from the workforce due to a workplace injury.Studies included in this systematic literature review tracked participants return to work status over a minimum of three months, identified either demographic, psychosocial or general injury predictors of poor return to work outcomes and included a heterogeneous sample of workplace injuries.Identified predictors of poor return to work outcomes included older age, female gender, divorced marital status, two or more dependent family members, lower education levels, employment variables associated with reduced labour market desirability, severity or sensitive injury locations, negative attitudes and outcome perceptions of the participant.There is a need for clear and consistent definition and measurement of return to work outcomes and a holistic theoretical model integrating injury, psychosocial and demographic predictors of return to work. Through greater understanding of the nature of factors affecting return to work, improved outcomes could be achieved.
Sarganas G.,Charité - Medical University of Berlin |
Gericke C.A.,University of Plymouth |
Gericke C.A.,The Wesley Research Institute
F1000Research | Year: 2013
Objective: The purpose of this qualitative case study was to assess the feasibility of scaling up exclusive breastfeeding for 6 months, antibiotics for pneumonia and integrated management of childhood illness (IMCI) child interventions in three districts of the Cusco region, Peru. Methods: During field visits, constraints, synergies and solutions to the implementation of the selected interventions were collected through observational recording and interviews of mothers, health workers, and health managers/decision makers. Results are presented for each intervention according to the health system level where they occurred: mother/community, health worker, health centre, and political/managerial levels. Findings: This case study demonstrates that it is feasible to scale up exclusive breastfeeding, antibiotics for pneumonia and IMCI interventions in poverty-stricken rural areas of a low-income country. Factors that helped and hindered the implementation were identified for each intervention. Conclusions: The need for a coherent multi-sector approach that includes regulation, implementation and monitoring of health policies and education of all involved stakeholders was apparent. This study also demonstrates that global health interventions need to undergo local adaptation. Identifying local constraints and facilitating factors in a systematic way as proposed in this study is a useful step to increase their effectiveness and reach at the local level and to identify areas for improvement in the original intervention policies. © 2012 Sarganas G et al.
Cristaudo A.,Princess Alexandra Hospital |
Nayak A.,Princess Alexandra Hospital |
Martin S.,The Wesley Research Institute |
Adib R.,The Wesley Hospital |
Martin I.,Princess Alexandra Hospital
International Journal of Surgery | Year: 2015
The totally extraperitoneal (TEP) approach for surgical repair of inguinal hernias has emerged as a popular technique. We conducted a prospective randomised trial to compare patient comfort scores using different mesh types and fixation using this technique.Over a 14 month period, 146 patients underwent 232 TEP inguinal hernia repairs. We compared the comfort scores of patients who underwent these procedures using different types of mesh and fixation. A non-absorbable 15 × 10 cm anatomical mesh fixed with absorbable tacks (Control group) was compared with either a non-absorbable 15 × 10 cm folding slit mesh with absorbable tacks (Group 2), a partially-absorbable 15 × 10 cm mesh with absorbable tacks (Group 3) or a non-absorbable 15 × 10 cm anatomical mesh fixed with 2 ml fibrin sealant (Group 4). Outcomes were compared at 1, 2, 4 and 12 weeks using the Carolina Comfort Scale (CCS) scores.At 1, 2, 4 and 12 weeks, the median global CCS scores were low for all treatment groups. Statistically significant differences were seen only for median CCS scores and subscores with the use of partially-absorbable mesh with absorbable tacks (Group 3) at weeks 2 and 4. However, these were no longer significant at week 12.In this study, the TEP inguinal hernia repair with minimal fixation results in low CCS scores. There were no statistical differences in CCS scores when comparing types of mesh, configuration of the mesh or fixation methods. © 2015 IJS Publishing Group Limited.
Bauer J.D.,University of Queensland |
Bauer J.D.,The Wesley Hospital |
Isenring E.,University of Queensland |
Isenring E.,Princess Alexandra Hospital |
Waterhouse M.,The Wesley Research Institute
Journal of Human Nutrition and Dietetics | Year: 2013
Background: Nutrition supplements enriched with immune function enhancing nutrients have been developed to aid wound-healing, although evidence regarding their effectiveness is limited and systematic reviews have lead to inconsistent recommendations. The present pragmatic, randomised, prospective open trial evaluated a wound-specific oral nutrition supplement enriched with arginine, vitamin C and zinc compared to a standard supplement with respect to outcomes in patients with chronic wounds in an acute care setting. Methods: Twenty-four patients [11 males and 13 females; mean (SD) age: 67.8 (22.3) years] with chronic wounds (14 diabetic or venous ulcers; 10 pressure ulcers or chronic surgical wounds) were randomised to receive either a wound-specific supplement (n = 12) or standard supplement (n = 12) for 4 weeks, with ongoing best wound and nutrition care for an additional 4 weeks. At baseline, and at 4 and 8 weeks, the rate of wound-healing, nutritional status, protein and energy intake, quality of life and product satisfaction were measured. Linear mixed effects modelling with random intercepts and slopes were fitted to determine whether the wound-specific nutritional supplement had any effect. Results: There was a significant improvement in wound-healing in patients receiving the standard nutrition supplement compared to a wound-specific supplement (P = 0.044), although there was no effect on nutritional status, dietary intake, quality of life and patient satisfaction. Conclusions: The results of the present study indicate that a standard oral nutrition supplement may be more effective at wound-healing than a specialised wound supplement in this clinical setting. © 2013 The British Dietetic Association Ltd.
Gericke C.A.,UK National Institute for Medical Research |
Gericke C.A.,The Wesley Research Institute |
Mohasseb I.,Plymouth Hospitals NHS Trust
F1000Research | Year: 2013
In this correspondence we discuss the results of the meta-analysis by De Luca et al. (2012) in the Archives of Internal Medicine which found that late myocardial reinfarction and stent thrombosis is more common in drug-eluting stents than in bare-metal stents. We discuss the clinical implications of this paper for dual anti-platelet therapy which did not receive sufficient attention in the original publication and the accompanying editorial. © 2012 Mohasseb I et al.
PubMed | Princess Alexandra Hospital, The Wesley Research Institute and The Wesley Hospital
Type: | Journal: International journal of surgery (London, England) | Year: 2015
The totally extraperitoneal (TEP) approach for surgical repair of inguinal hernias has emerged as a popular technique. We conducted a prospective randomised trial to compare patient comfort scores using different mesh types and fixation using this technique. Over a 14 month period, 146 patients underwent 232 TEP inguinal hernia repairs. We compared the comfort scores of patients who underwent these procedures using different types of mesh and fixation. A non-absorbable 15 10 cm anatomical mesh fixed with absorbable tacks (Control group) was compared with either a non-absorbable 15 10 cm folding slit mesh with absorbable tacks (Group 2), a partially-absorbable 15 10 cm mesh with absorbable tacks (Group 3) or a non-absorbable 15 10 cm anatomical mesh fixed with 2 ml fibrin sealant (Group 4). Outcomes were compared at 1, 2, 4 and 12 weeks using the Carolina Comfort Scale (CCS) scores. At 1, 2, 4 and 12 weeks, the median global CCS scores were low for all treatment groups. Statistically significant differences were seen only for median CCS scores and subscores with the use of partially-absorbable mesh with absorbable tacks (Group 3) at weeks 2 and 4. However, these were no longer significant at week 12. In this study, the TEP inguinal hernia repair with minimal fixation results in low CCS scores. There were no statistical differences in CCS scores when comparing types of mesh, configuration of the mesh or fixation methods.
McDonald C.,University of Queensland |
Bauer J.,University of Queensland |
Capra S.,University of Queensland |
Coll J.,The Wesley Research Institute
BMC Cancer | Year: 2014
Background: Loss of lean body mass (LBM) is a common occurrence after treatment for breast cancer and is related to deleterious metabolic health outcomes [Clin Oncol, 22(4):281-288, 2010; Appl Physiol Nutr Metab, 34(5):950-956, 2009]. The aim of this research is to determine the effectiveness of long chain omega-3 fatty acids (LCn-3s) and exercise training alone, or in combination, in addressing LBM loss in breast cancer survivors.Methods/design: A total of 153 women who have completed treatment for breast cancer in the last 12 months, with a Body Mass Index (BMI) of 20 to 35 kg/m2, will be randomly assigned to one of 3 groups: 3g/d LCn-3s (N-3), a 12-week nutrition and exercise education program plus olive oil (P-LC) or the education program plus LCn-3s (EX+N-3). Participants randomised to the education groups will be blinded to treatment, and will receive either olive oil placebo (OO+N-3) or LCn-3 provision, while the N-3 group will be open label. The education program includes nine 60-75min sessions over 12 weeks that will involve breast cancer specific healthy eating advice, plus a supervised exercise session run as a resistance exercise circuit. They will also be advised to conduct the resistance training and aerobic training 5 to 7 days per week collectively. Outcome measures will be taken at baseline, 12-weeks and 24-weeks. The primary outcome is % change in LBM as measured by the air displacement plethysmograhy. Secondary outcomes include quality of life (FACT-B + 4) and inflammation (C-Reactive protein: CRP). Additional measures taken will be erythrocyte fatty acid analysis, fatigue, physical activity, menopausal symptoms, dietary intake, joint pain and function indices.Discussion: This research will provide the first insight into the efficacy of LCn-3s alone or in combination with exercise in breast cancer survivors with regards to LBM and quality of life. In addition, this study is designed to improve evidence-based dietetic practice, and how specific dietary prescription may link with appropriate exercise interventions.Trials registration: ACTRN12610001005044; and World Health Organisation Universal trial number: U1111-1116-8520. © 2014 McDonald et al.; licensee BioMed Central Ltd.