139 results on '"Kondalsamy‐Chennakesavan, Srinivas"'
Search Results
102. A systematic review: Identifying the prevalence rates of psychiatric disorder in Australia’s Indigenous populations
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Black, Emma B, primary, Ranmuthugala, Geetha, additional, Kondalsamy-Chennakesavan, Srinivas, additional, Toombs, Maree R, additional, Nicholson, Geoffrey C, additional, and Kisely, Steve, additional
- Published
- 2015
- Full Text
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103. Determinants of rural practice: positive interaction between rural background and rural undergraduate training
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Kondalsamy‐Chennakesavan, Srinivas, primary, Eley, Diann S, additional, Ranmuthugala, Geetha, additional, Chater, Alan B, additional, Toombs, Maree R, additional, Darshan, Deepak, additional, and Nicholson, Geoffrey C, additional
- Published
- 2015
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104. Carcinoma of the cervix in elderly patients treated with radiotherapy: patterns of care and treatment outcomes.
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Ming Yin Lin, Kondalsamy-Chennakesavan, Srinivas, Bernshaw, David, Khaw, Pearly, and Narayan, Kailash
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CERVICAL cancer , *RADIOTHERAPY , *OLDER patients , *PATIENT acceptance of health care , *QUALITY of life , *MEDICAL care - Abstract
Objective: The aim of this analysis was to examine the management of cervix cancer in elderly patients referred for radiotherapy and the results of treatment in terms of overall survival (OS), relapse-free survival (RFS), and treatment-related toxicities. Methods: Patients were eligible if they were aged ≥75 years, newly diagnosed with cervix cancer and referred for radiotherapy as part of their treatment. Patient details were retrieved from the gynaecology service database where clinical, histopathological treatment and follow-up data were prospectively collected. Results: From 1998 to 2010, 126 patients aged ≥75 years, met selection criteria. Median age was 81.5 years. Eighty-one patients had definitive radiotherapy, 10 received adjuvant radiotherapy and 35 had palliative radiotherapy. Seventy-one percent of patients had the International Federation of Gynecology and Obstetrics stage 1b-2b disease. Median followup was 37 months. OS and RFS at 3 years among those treated with curative intent were 66.6% and 75.9% respectively with majority of patients dying without any evidence of cervix cancer. Grade 2 or more late toxicities were: bladder 5%, bowel 11%, and vagina 27%. Eastern Cooperative Oncology Group (ECOG) status was a significant predictor of OS and RFS with each unit increment in ECOG score increased the risk of death by 1.69 times (p<0.001). Conclusion: Following appropriate patient selection, elderly patients treated curatively with radiotherapy for cervix cancer have good disease control. Palliative hypofractionated regimens are well tolerated in patients unsuitable for radical treatment. [ABSTRACT FROM AUTHOR]
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- 2016
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105. Smokers With Cervix Cancer Have More Uterine Corpus Invasive Disease and an Increased Risk of Recurrence After Treatment With Chemoradiation
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Mileshkin, Linda, primary, Paramanathan, Ashvin, additional, Kondalsamy-Chennakesavan, Srinivas, additional, Bernshaw, David, additional, Khaw, Pearly, additional, and Narayan, Kailash, additional
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- 2014
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106. We should not settle for low-level evidence but should always use the best available evidence
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Narayan, Kailash, primary, Mileshkin, Linda, additional, van Dyk, Sylvia, additional, Bernshaw, David, additional, Khaw, Pearly, additional, and Kondalsamy Chennakesavan, Srinivas, additional
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- 2014
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107. Ultrasound guided conformal brachytherapy of cervix cancer: survival, patterns of failure, and late complications
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Narayan, Kailash, primary, van Dyk, Sylvia, additional, Bernshaw, David, additional, Khaw, Pearly, additional, Mileshkin, Linda, additional, and Kondalsamy-Chennakesavan, Srinivas, additional
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- 2014
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108. The survival outcome and patterns of failure in node positive endometrial cancer patients treated with surgery and adjuvant radiotherapy with curative intent
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Rajasooriyar, Chrishanthi, primary, Bernshaw, David, additional, Kondalsamy-Chennakesavan, Srinivas, additional, Mileshkin, Linda, additional, and Narayan, Kailash, additional
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- 2014
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109. Pretreatment malnutrition and quality of life - association with prolonged length of hospital stay among patients with gynecological cancer: A cohort study
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Laky, Brenda, Janda, Monika, Kondalsamy-Chennakesavan, Srinivas, Cleghorn, Geoffery, Obermair, Andreas, Laky, Brenda, Janda, Monika, Kondalsamy-Chennakesavan, Srinivas, Cleghorn, Geoffery, and Obermair, Andreas
- Abstract
Background Length of hospital stay (LOS) is a surrogate marker for patients' well-being during hospital treatment and is associated with health care costs. Identifying pretreatment factors associated with LOS in surgical patients may enable early intervention in order to reduce postoperative LOS. Methods This cohort study enrolled 157 patients with suspected or proven gynecological cancer at a tertiary cancer centre (2004-2006). Before commencing treatment, the scored Patient Generated - Subjective Global Assessment (PG-SGA) measuring nutritional status and the Functional Assessment of Cancer Therapy-General (FACT-G) scale measuring quality of life (QOL) were completed. Clinical and demographic patient characteristics were prospectively obtained. Patients were grouped into those with prolonged LOS if their hospital stay was greater than the median LOS and those with average or below average LOS. Results Patients' mean age was 58 years (SD 14 years). Preoperatively, 81 (52%) patients presented with suspected benign disease/pelvic mass, 23 (15%) with suspected advanced ovarian cancer, 36 (23%) patients with suspected endometrial and 17 (11%) with cervical cancer, respectively. In univariate models prolonged LOS was associated with low serum albumin or hemoglobin, malnutrition (PG-SGA score and PG-SGA group B or C), low pretreatment FACT-G score, and suspected diagnosis of cancer. In multivariable models, PG-SGA group B or C, FACT-G score and suspected diagnosis of advanced ovarian cancer independently predicted LOS. Conclusions Malnutrition, low quality of life scores and being diagnosed with advanced ovarian cancer are the major determinants of prolonged LOS amongst gynecological cancer patients. Interventions addressing malnutrition and poor QOL may decrease LOS in gynecological cancer patients.
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- 2010
110. Depression, anxiety and body image after treatment for invasive stage one epithelial ovarian cancer
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Bisseling, Karin, Kondalsamy-Chennakesavan, Srinivas, Bekkers, Rudd, Janda, Monika, Obermair, Andreas, Bisseling, Karin, Kondalsamy-Chennakesavan, Srinivas, Bekkers, Rudd, Janda, Monika, and Obermair, Andreas
- Abstract
Background: Diagnosis of epithelial ovarian cancer (EOC) in young women has major implications including those to their reproductive potential. We evaluated depression, anxiety and body image in patients with stage I EOC treated with fertility sparing surgery (FSS) or radical surgery (RS). We also investigated fertility outcomes after FSS.----- Methods: A retrospective study was undertaken in which 62 patients completed questionnaires related to anxiety, depression, body image and fertility outcomes. Additional information on adjuvant therapy after FSS and RS and demographic details were abstracted from medical records. Both bi and multivariate regression models were used to assess the relationship between demographic, clinical and pathological results and scores for anxiety, depression and body image.----- Results: Thirty-nine patients underwent RS and the rest, FSS. The percentage of patients reporting elevated anxiety and depression (subscores ≥ 11) were 27 % and 5% respectively. The median (inter quartile range) score for body image scale (BIS) was 6 (3-15). None of the demographic or clinical factors examined showed significant association with anxiety and BIS with the exception of ‘time since diagnosis’. For depression, post-menopausal status was the only independent predictor. Among those 23 patients treated by FSS, 14 patients tried to conceive (7 successful), resulting in 7 live births, one termination of pregnancy and one miscarriage.----- Conclusion: This study shows that psychological issues are common in women treated for stage I EOC. Reproduction after FSS is feasible and lead to the birth of healthy babies in about half of patients who wished to have another child. Further prospective studies with standardised instruments are required.
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- 2009
111. Nomogram to Predict the Probability of Relapse in Patients Diagnosed With Borderline Ovarian Tumors
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Obermair, Andreas, primary, Tang, Amy, additional, Kondalsamy–Chennakesavan, Srinivas, additional, Ngan, Hextan, additional, Zusterzeel, Petra, additional, Quinn, Michael, additional, Carter, Jonathan, additional, Leung, Yee, additional, and Janda, Monika, additional
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- 2013
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112. Radiation with cisplatin or carboplatin for locally advanced cervix cancer: The experience of a tertiary cancer centre
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Au-Yeung, George, primary, Mileshkin, Linda, additional, Bernshaw, David M, additional, Kondalsamy-Chennakesavan, Srinivas, additional, Rischin, Danny, additional, and Narayan, Kailash, additional
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- 2012
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113. Reviewing the Role of Parametrial Boost in Patients With Cervical Cancer With Clinically Involved Parametria and Staged With Positron Emission Tomography
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Rajasooriyar, Chrishanthi, primary, Van Dyk, Sylvia, additional, Lindawati, Mery, additional, Bernshaw, David, additional, Kondalsamy-Chennakesavan, Srinivas, additional, and Narayan, Kailash, additional
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- 2012
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114. Validation of the FIGO 2009 Staging System for Carcinoma of the Vulva
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Tan, Jason, primary, Chetty, Naven, additional, Kondalsamy-Chennakesavan, Srinivas, additional, Crandon, Alex, additional, Garrett, Andrea, additional, Land, Russell, additional, Nascimento, Marcelo, additional, Nicklin, Jim, additional, Perrin, Lewis, additional, and Obermair, Andreas, additional
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- 2012
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115. Prognostic Significance of Lymphovascular Space Invasion and Nodal Involvement in Intermediate- and High-Risk Endometrial Cancer Patients Treated With Curative Intent Using Surgery and Adjuvant Radiotherapy
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Narayan, Kailash, primary, Khaw, Pearly, additional, Bernshaw, David, additional, Mileshkin, Linda, additional, and Kondalsamy-Chennakesavan, Srinivas, additional
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- 2012
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116. Evaluation of Tumor-Free Distance and Depth of Myometrial Invasion as Prognostic Factors for Lymph Node Metastases in Endometrial Cancer
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Kondalsamy-Chennakesavan, Srinivas, primary, Vugt, Stijn van, additional, Sanday, Karen, additional, Nicklin, Jim, additional, Land, Russell, additional, Perrin, Lewis, additional, Crandon, Alex, additional, and Obermair, Andreas, additional
- Published
- 2010
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117. Pretreatment malnutrition and quality of life - association with prolonged length of hospital stay among patients with gynecological cancer: a cohort study
- Author
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Laky, Brenda, primary, Janda, Monika, additional, Kondalsamy-Chennakesavan, Srinivas, additional, Cleghorn, Geoffrey, additional, and Obermair, Andreas, additional
- Published
- 2010
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118. Clinical Audit in Gynecological Cancer Surgery: Development of a Risk Scoring System to Predict Adverse Events
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Kondalsamy-Chennakesavan, Srinivas, primary, Bouman, Chantal, additional, De Jong, Suzanne, additional, Sanday, Karen, additional, Nicklin, Jim, additional, Land, Russell, additional, and Obermair, Andreas, additional
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- 2010
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119. Clinical audit in gynecological cancer surgery: Development of a risk scoring system to predict adverse events
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Kondalsamy-Chennakesavan, Srinivas, primary, Bouman, Chantal, additional, De Jong, Suzanne, additional, Sanday, Karen, additional, Nicklin, Jim, additional, Land, Russell, additional, and Obermair, Andreas, additional
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- 2009
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120. A Comparison Between LDR and MRI Conformal HDR Brachytherapy of Cervical Cancer: Results, Patterns of Failure and Late Complications
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Bernshaw, David L., primary, van Dyk, Sylvia, additional, Rajasooriyar, Chrishanthi I., additional, Narayan, Kailash, additional, and Kondalsamy-Chennakesavan, Srinivas, additional
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- 2009
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121. Clinical outcomes associated with changes in a chronic disease treatment program in an Australian Aboriginal community
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Hoy, Wendy E, primary, Kondalsamy‐Chennakesavan, Srinivas N, additional, and Nicol, Jennifer L, additional
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- 2005
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122. Kidney and related chronic disease profiles and risk factors in three remote Australian Aboriginal communities
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Hoy, Wendy, primary, Kondalsamy-Chennakesavan, Srinivas, additional, Scheppingen, Joanne, additional, and Sharma, Suresh, additional
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- 2005
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123. Pretreatment malnutrition and quality of life --association with prolonged length of hospital stayamong patients with gynecological cancer: acohort study.
- Author
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Laky, Brenda, Janda, Monika, Kondalsamy-Chennakesavan, Srinivas, Cleghorn, Geoffrey, and Obermair, Andreas
- Subjects
CERVICAL cancer ,CANCER patients ,CANCER treatment ,MEDICAL care costs ,NUTRITION disorders ,MALNUTRITION - Abstract
Background: Length of hospital stay (LOS) is a surrogate marker for patients' well-being during hospital treatment and is associated with health care costs. Identifying pretreatment factors associated with LOS in surgical patients may enable early intervention in order to reduce postoperative LOS. Methods: This cohort study enrolled 157 patients with suspected or proven gynecological cancer at a tertiary cancer centre (2004-2006). Before commencing treatment, the scored Patient Generated - Subjective Global Assessment (PGSGA) measuring nutritional status and the Functional Assessment of Cancer Therapy-General (FACT-G) scale measuring quality of life (QOL) were completed. Clinical and demographic patient characteristics were prospectively obtained. Patients were grouped into those with prolonged LOS if their hospital stay was greater than the median LOS and those with average or below average LOS. Results: Patients' mean age was 58 years (SD 14 years). Preoperatively, 81 (52%) patients presented with suspected benign disease/pelvic mass, 23 (15%) with suspected advanced ovarian cancer, 36 (23%) patients with suspected endometrial and 17 (11%) with cervical cancer, respectively. In univariate models prolonged LOS was associated with low serum albumin or hemoglobin, malnutrition (PG-SGA score and PG-SGA group B or C), low pretreatment FACT-G score, and suspected diagnosis of cancer. In multivariable models, PG-SGA group B or C, FACT-G score and suspected diagnosis of advanced ovarian cancer independently predicted LOS. Conclusions: Malnutrition, low quality of life scores and being diagnosed with advanced ovarian cancer are the major determinants of prolonged LOS amongst gynecological cancer patients. Interventions addressing malnutrition and poor QOL may decrease LOS in gynecological cancer patients. [ABSTRACT FROM AUTHOR]
- Published
- 2010
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124. MORTALITY IN PERSONS WITH MENTAL ILLNESS IN THE DARLING DOWNS AND SOUTHWEST QUEENSLAND: A CASE-CONTROL STUDY
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Gill, Neeraj, Geoffrey Nicholson, Kondalsamy-Chennakesavan, Srinivas, and Finlay, Angus
125. Determinants of rural practice: positive interaction between rural background and rural undergraduate training.
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Arnold, Mark H., Nicholson, Geoffrey C., and Kondalsamy-Chennakesavan, Srinivas
- Abstract
A letter to the editor is presented in response to an article related to interaction between rural background and rural undergraduate training.
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- 2015
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126. Impact of the COVID‐19 pandemic on student supervision and education in health care settings: A state‐wide survey of health care workers
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Priya Martin, Adam Hulme, Tony Fallon, Saravana Kumar, Matthew McGrail, Geoff Argus, Tiana Gurney, Srinivas Kondalsamy‐Chennakesavan, Martin, Priya, Hulme, Adam, Fallon, Tony, Kumar, Saravana, McGrail, Matthew, Argus, Geoff, Gurney, Tiana, and Kondalsamy-Chennakesavan, Srinivas
- Subjects
clinical supervision ,student supervision ,clinical education ,Public Health, Environmental and Occupational Health ,COVID-19 pandemic ,Family Practice - Abstract
Objective: To investigate student supervisor experiences of supervising students on clinical placements since the onset of the COVID-19 pandemic. Background: Studies on the impact of COVID-19 on student clinical placements have focused largely on student reports and have been specific to individual professions or topic areas. There is a need to investigate student supervisor experiences. This study was conducted in Queensland (Australia) in four regional and rural public health services and four corresponding primary health networks. Methods: The anonymous, mixed methods online survey, consisting of 35 questions, was administered to student supervisors from allied health, medicine, nursing and midwifery between May and August 2021. Numerical data were analysed descriptively using chi-square tests. Free-text comments were analysed using content analysis. Results: Complete datasets were available for 167 respondents. Overall trends indicated perceived significant disruptions to student learning and support, plus mental health and well-being concerns for both students and supervisors. Extensive mask wearing was noted to be a barrier to building rapport, learning and teaching. Some positive impacts of the pandemic on student learning were also noted. Conclusions: This study has highlighted the perceived impact of the pandemic on supervisors' mental health, and on the mental health, learning and work readiness of students. This study provides evidence of the pandemic impacts on student clinical placements from a supervisor point of view. Findings can assist in future-proofing clinical education and ensuring that students continue to receive learning experiences of benefit to them, meeting curriculum requirements, in the event of another pandemic Refereed/Peer-reviewed
- Published
- 2023
127. Rebooting effective clinical supervision practices to support healthcare workers through and following the COVID-19 pandemic
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Priya Martin, Saravana Kumar, Esther Tian, Geoff Argus, Srinivas Kondalsamy-Chennakesavan, Lucylynn Lizarondo, Tiana Gurney, David Snowdon, Martin, Priya, Kumar, Saravana, Tian, Esther, Argus, Geoff, Kondalsamy-Chennakesavan, Srinivas, Lizarondo, Lucylynn, Gurney, Tiana, and Snowdon, David
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clinical supervision ,SARS-CoV-2 ,Health Personnel ,Health Policy ,Preceptorship ,Public Health, Environmental and Occupational Health ,Humans ,COVID-19 ,effectiveness ,General Medicine ,Pandemics ,mental health - Abstract
The importance of clinical supervision, a professional support and clinical governance mechanism, to patients, healthcare workers and organizations has been well documented. Clinical supervision has been shown to support healthcare workers during challenging times, by reducing burnout, enhancing mental health and wellbeing at work, and improving job satisfaction. However, clinical supervision participation and effectiveness are pre-requisites for realising these benefits. During times of stress and increased workloads (e.g. during the Coronavirus pandemic), healthcare workers tend to prioritise clinical duties and responsibilities over clinical supervision. Effective supervision practices can be restored, and healthcare workers can be better supported in their roles during and in the post-pandemic period only if healthcare workers, policy makers, healthcare organizations, clinical supervision trainers and researchers join forces. This paper sheds light on this important topic and offers a number of practical recommendations to reboot effective clinical supervision practices at the point of care.
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- 2022
128. Impact of the COVID-19 Pandemic on Clinical Supervision of Healthcare Students in Rural Settings: A Qualitative Study
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Priya Martin, Lucylynn Lizarondo, Geoff Argus, Saravana Kumar, Srinivas Kondalsamy-Chennakesavan, Martin, Priya, Lizarondo, Lucylynn, Argus, Geoff, Kumar, Saravana, and Kondalsamy Chennakesavan, Srinivas
- Subjects
Rural Population ,Health, Toxicology and Mutagenesis ,education ,Public Health, Environmental and Occupational Health ,COVID-19 pandemic ,COVID-19 ,clinical supervision ,Preceptorship ,student placements ,rural health ,Humans ,Rural Health Services ,Students ,Delivery of Health Care ,Pandemics - Abstract
The COVID-19 pandemic has caused significant disruptions to healthcare student placements worldwide, including already challenged rural areas in Australia. While accounts are emerging of student experiences in larger centers and from a student perspective, there is a need for in-depth exploration of student supervisor experiences in rural areas at the onset of the pandemic. This study aims to address this gap through 23 individual, semi-structured interviews with healthcare workers from ten health professions who were either direct student supervisors or in roles supporting student supervisors A reflexive thematic analysis approach was used to develop four themes, namely compounding stress, negative impacts on student learning, opportunity to flex and innovate, and targeted transitioning support strategies. The findings indicate that healthcare workers with student supervision responsibilities at the onset of the pandemic experienced high levels of stress and wellbeing concerns. This study sheds light on the importance of supporting student supervisors in rural areas, and the need for implementing targeted support strategies for new graduates whose placements were impacted by the pandemic. This is not only essential for supporting the rural health-care workforce but is also imperative for addressing inequalities to healthcare access experienced in rural communities. Refereed/Peer-reviewed
- Published
- 2022
129. Anthropometric Measurements in Australian Aborigines
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Sidya Raghavan, Kerin O'Dea, Srinivas Kondalsamy-Chennakesavan, Leonard S. Piers, Kondalsamy-Chennakesavan, Srinivas, Piers, Leonard S, Raghavan, Sidya, and O'Dea, Kerin
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adiposity ,Food intake ,body-fat distribution ,Anthropometry ,Overweight ,medicine.disease ,Obesity ,Subcutaneous fat ,BMI ,Geography ,Fat free mass ,Diabetes mellitus ,medicine ,medicine.symptom ,anthropometric measurements ,Body mass index ,Demography - Abstract
Aborigines have inhabited Australia for many thousands of years. They led a 'hunter-gatherer' lifestyle prior to European contact. They are known to have lower sitting-height to stature ratio with long legs, relatively short trunks and narrow across the torso and hips (a 'linear' body build). European expeditions in the early twentieth century confirm that overweight and obesity was rarely observed. In the second half of the twentieth century, the traditional lifestyle of Aborigines had transitioned to a westernised lifestyle. Associated with such a transition to western lifestyle is the epidemic of non-communicable chronic health conditions such as diabetes, cardio-vascular diseases and renal failure. Average weight and Body Mass Index (BMI) of Aborigines have increased over time. However, this increase is not uniform across Aboriginal Australia. There are major differences in the body habitus profile between different clan groups/communities. In spite of these variations, the pattern of preferential central obesity in both men and women is uniform in almost all the communities. This could have provided a survival advantage under conditions of traditional lifestyle (with its 'feast-and-famine' pattern of food intake) experienced by Aborigines prior to European contact. Our studies have shown that BMI significantly underestimated overweight and obesity when compared to other indices of body fat. Aborigines have preferential central fat deposition and exhibit consistently higher waist-hip ratios when compared to other Australians. Also, prevalences of overweight and obesity depend on the anthropometric definitions used. The relationship of surrogate estimates of body composition such as S4 for subcutaneous fat and height2/resistance for FFM (fat free mass) to body weight and BMI are significantly different between Aboriginal people and European Australians. Even at lower levels of body habitus profiles, Aborigines have increased risk for chronic conditions. Also, anthropometric characteristics differ substantially among different Aboriginal communities and stereotyping and generalisations should be avoided.
- Published
- 2012
130. Can digital innovation transform rural primary health care? A systematic review protocol.
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Nasir BF, Leedie F, Fox J, Martin P, Alam K, Wallis K, McGrail MR, and Kondalsamy-Chennakesavan S
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- Humans, Digital Technology, Research Design, Telemedicine organization & administration, Primary Health Care organization & administration, Primary Health Care standards, Systematic Reviews as Topic, Rural Health Services organization & administration, Rural Health Services standards
- Abstract
Introduction: Digital technology is increasingly being adopted within primary healthcare services to improve service delivery and health outcomes; however, the scope for digital innovation within primary care services in rural areas is currently unknown. This systematic review aims to synthesise existing research on the use and integration of digital health technology within primary care services for rural populations across the world., Methods and Analysis: A systematic approach to the search strategy will be conducted. Relevant medical and healthcare-focused electronic databases will be searched using key search terms between January 2013 and December 2023. Searches will be conducted using specific inclusion and exclusion criteria. A systematic study selection and data extraction process will be implemented, using standardised templates. Outcomes will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-analyses- Protocol statement guidelines. Quality assessment and risk of bias appraisal will be conducted using the Mixed Methods Appraisal Tool., Ethics and Dissemination: Ethical approval will not be required because there is no individual patient data collected or reviewed. The finding of this review will be disseminated through peer-reviewed publications and conference presentations. Outcomes will help to understand existing knowledge and identify gaps in delivering digital healthcare services, while also providing potential future practice and policy recommendations., Prospero Registration Number: CRD42023477233., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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131. A community-led design for an Indigenous Model of Mental Health Care for Indigenous people with depressive disorders.
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Farah Nasir B, Brennan-Olsen S, Gill NS, Beccaria G, Kisely S, Hides L, Kondalsamy-Chennakesavan S, Nicholson G, and Toombs M
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- Adult, Aged, Australia, Delivery of Health Care methods, Female, Focus Groups, Humans, Indigenous Peoples, Male, Middle Aged, Qualitative Research, Community Health Services organization & administration, Delivery of Health Care organization & administration, Health Services, Indigenous organization & administration, Mental Health statistics & numerical data, Native Hawaiian or Other Pacific Islander psychology, Social Determinants of Health ethnology
- Abstract
Objective: To generate outcomes for the development of a culturally appropriate mental health treatment model for Indigenous Australians with depression., Methods: Three focus group sessions and two semi-structured interviews were undertaken over six months across regional and rural locations in South West Queensland. Data were transcribed verbatim and coded using manual thematic analyses. Transcripts were thematically analysed and substantiated. Findings were presented back to participants for authenticity and verification., Results: Three focus group discussions (n=24), and two interviews with Elders (n=2) were conducted, from which six themes were generated. The most common themes from the focus groups included Indigenous autonomy, wellbeing and identity. The three most common themes from the Elder interviews included culture retention and connection to Country, cultural spiritual beliefs embedded in the mental health system, and autonomy over funding decisions., Conclusions: A treatment model for depression must include concepts of Indigenous autonomy, identity and wellbeing. Further, treatment approaches need to incorporate Indigenous social and emotional wellbeing concepts alongside clinical treatment approaches. Implications for public health: Any systematic approach to address the social and cultural wellbeing of Indigenous peoples must have a community-led design and delivery., (© 2021 The Authors.)
- Published
- 2021
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132. How can mobile applications support suicide prevention gatekeepers in Australian Indigenous communities?
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Brown K, Toombs M, Nasir B, Kisely S, Ranmuthugala G, Brennan-Olsen SL, Nicholson GC, Gill NS, Hayman NS, Kondalsamy-Chennakesavan S, and Hides L
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- Australia, Humans, Native Hawaiian or Other Pacific Islander, Qualitative Research, Health Services, Indigenous, Mobile Applications, Suicide Prevention
- Abstract
Rationale: Suicide prevention training in Aboriginal and Torres Strait Islander communities is a national health priority in Australia., Objective: This paper describes a qualitative study to increase understanding of how a mobile application (app) could be used to support suicide prevention gatekeepers in Indigenous communities. We respectfully use the term Indigenous to refer to Australian peoples of Aboriginal and/or Torres Strait Islander descent., Method: Two participatory design workshops were held with 12 participants who were either Indigenous health workers or community members. The workshops first explored what knowledge, skills, and support suicide prevention gatekeepers in Indigenous communities may require, as well as how technology, specifically mobile apps, could be used to support these needs., Results: Qualitative analysis identified four themes related to perceptions of who gatekeepers are, their role requirements, technology and supporting resources, as well as broader community issues. Participants thought training programs should target key, accessible, and respected people from diverse, designated, and emergent groups in Indigenous communities to act as gatekeepers, but requested an alternative, more culturally appropriate term to 'gatekeeper' (e.g., responder). Training should prepare gatekeepers for multifaceted suicide prevention roles, including the identification and management of at-risk Indigenous persons, the provision of psychoeducation and ongoing support, as well as facilitate integrated care in collaboration with community services. A combination of multiple support resources was recommended, including multi-platform options in the technology (e.g., mobile applications, social media) and physical domains (e.g., wallet cards, regular meetings). Recommended app features included culturally appropriate refresher content on suicide intervention, training recall, integrated care, how to access gatekeeper peer support, and debriefing. Broader community concerns on gatekeeper support needs were also considered., (Copyright © 2020 Elsevier Ltd. All rights reserved.)
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- 2020
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133. Mortality in hospital patients with and without mental disorders: A data-linkage cohort study.
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Karim RS, Kwan MM, Finlay AJ, Kondalsamy-Chennakesavan S, Toombs MR, Nicholson GC, McGrail M, and Gill NS
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- Adolescent, Adult, Aged, Aged, 80 and over, Australia epidemiology, Cause of Death, Child, Child, Preschool, Female, Humans, Infant, Male, Mental Disorders ethnology, Mental Disorders mortality, Middle Aged, Retrospective Studies, Young Adult, Comorbidity, Hospital Mortality ethnology, Hospitalization statistics & numerical data, Hospitals, Public statistics & numerical data, Mental Disorders epidemiology, Native Hawaiian or Other Pacific Islander ethnology
- Abstract
Objective: In the general population, people with mental disorders have increased mortality. This association, however, has not been explored in a population who at some time were inpatients of a public hospital., Methods: The sampling frame was patients admitted to an Australian regional public hospital 1996-2010. Those with known mental disorder were compared with an equal number of randomly selected patients without known mental disorder, matched for age, sex, and year of admission. Mortality outcomes were determined by linkage of hospital data and the National Death Index., Results: We identified 15,356 patients with mental disorder and 15,356 without known mental disorder, 25.2% of the former and 17.3% of the latter died during the study period. The odds ratio (OR) for death in those with mental disorder was 2.20 (95% confidence interval: 2.01-2.41) after adjusting for confounders, and their mean age at death was 4.6 years younger (p < 0.001). Other independent risk factors for mortality were being Indigenous (OR 1.72, 1.32-2.24), not partnered (OR 1.55, 1.36-1.76) or having multiple comorbidities (OR 1.65, 1.43-1.90). In the model that included multiple interactions, the ORs for death in Indigenous patients with mental disorder were markedly higher (6.6-9.5), regardless of other risk factors., Discussion: Among patients with a history of public hospital admission, those with mental disorders have higher mortality than those without mental disorders. This gap in life expectancy mandates increased attention, by clinicians and health services alike, to preventable causes of death in people with mental illness., (Copyright © 2019 Elsevier Ltd. All rights reserved.)
- Published
- 2019
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134. The Australian Rural Clinical School (RCS) program supports rural medical workforce: evidence from a cross-sectional study of 12 RCSs.
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McGirr J, Seal A, Barnard A, Cheek C, Garne D, Greenhill J, Kondalsamy-Chennakesavan S, Luscombe GM, May J, Mc Leod J, O'Sullivan B, Playford D, and Wright J
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- Australia, Capacity Building, Career Choice, Cross-Sectional Studies, Female, Humans, Male, Medically Underserved Area, Organizational Innovation, Rural Population, Students, Medical statistics & numerical data, Curriculum standards, Health Workforce statistics & numerical data, Professional Practice Location statistics & numerical data, Rural Health Services standards, Schools, Medical standards
- Abstract
Introduction: Many strategies have been implemented to address the shortage of medical practitioners in rural areas. One such strategy, the Rural Clinical School Program supporting 18 rural clinical schools (RCSs), represents a substantial financial investment by the Australian Government. This is the first collaborative RCS study summarising the rural work outcomes of multiple RCSs. The aim of this study was to combine data from all RCSs' 2011 graduating classes to determine the association between rural location of practice in 2017 and (i) extended rural clinical placement during medical school (at least 12 months training in a rural area) and (ii) having a rural background., Methods: All medical schools funded under the RCS Program were contacted by email about participation in this study. De-identified data were supplied for domestic students about their gender, origin (rural background defined as having lived in an Australian Standard Geographic Classification-Remoteness Area (ASGC-RA) 2-5 area for at least 5 years since beginning primary school) and participation in extended rural clinical placement (attended an RCS for at least 1 year of their clinical training). The postcode of their practice location according to the publicly available Australian Health Practitioner Regulation Agency (AHPRA) register was collected (February to August 2017) and classified into rural and metropolitan areas using the ASGC 2006 and the more recent Modified Monash Model (MMM). The main outcome measure was whether graduates were working in a 'rural' area (ASGC categories RA2-5 or MMM categories 3-7) or 'metropolitan' area. Pearson's χ2 test was used to detect differences in gender, rural background and extended placement at an RCS between rural and metropolitan practice locations. Binary logistic regression was used to determine odds of rural practice and 95% confidence intervals (CIs) were calculated., Results: Although data were received from 14 universities, two universities had not started collecting origin data at this point so were excluded from the analysis. The proportion of students with a rural background had a range of 12.3-76.6% and the proportion who had participated in extended RCS placement had a range of 13.7-74.6%. Almost 17% (16.6%) had a principal practice postcode in a rural area (according to ASGC), range 5.8-55.6%, and 8.3% had a principal practice postcode in rural areas (according to MMM 3-7), range 4.5-29.9%. After controlling for rural background, it was found that students who attended an RCS were 1.5 times more likely to be in rural practice (95%CI 1.2-2.1, p=0.004) using ASGC criteria. Using the MMM 3-7 criteria, students who participated in extended RCS placement were 2.6 times as likely to be practising in a rural location (95%CI 1.8-3.8, p<0.001) after controlling for rural background. Regardless of geographic classification system (ASGC, MMM) used for location of practice and of student background (metropolitan or rural), those students with an extended RCS had an increased chance of working rurally., Conclusion: Based on the combined data from three-quarters (12/16) of the Australian medical schools who had a graduating class in 2011, this suggests that the RCS initiative as a whole is having a significant positive effect on the regional medical workforce at 5 years post-graduation.
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- 2019
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135. Clinical outcomes from an innovative protocol using serial ultrasound imaging and a single MR image to guide brachytherapy for locally advanced cervix cancer.
- Author
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van Dyk S, Narayan K, Bernshaw D, Kondalsamy-Chennakesavan S, Khaw P, Lin MY, and Schneider M
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- Adult, Aged, Aged, 80 and over, Clinical Protocols, Female, Humans, Kaplan-Meier Estimate, Magnetic Resonance Imaging methods, Middle Aged, Neoplasm Staging, Radiotherapy Dosage, Radiotherapy, Conformal methods, Treatment Outcome, Ultrasonography, Interventional methods, Uterine Cervical Neoplasms diagnostic imaging, Uterine Cervical Neoplasms pathology, Young Adult, Brachytherapy methods, Uterine Cervical Neoplasms radiotherapy
- Abstract
Purpose: The aim of this study was to report clinical outcomes in a series of patients who underwent serial ultrasound and a single MRI to plan and verify intracavitary brachytherapy., Methods and Materials: Data for patients who were referred for curative intent radiotherapy for International Federation of Gynecology and Obstetrics (FIGO) Stage 1-1V cervix cancer between January 2007 and March 2012 were analyzed. All patients received external beam radiotherapy with concurrent chemotherapy and sequential high-dose rate brachytherapy. Brachytherapy was planned and verified using serial ultrasound imaging and a single MRI., Results: Data from 191 patients were available for analyses. The median (range) followup time was 5.08 (0.25-8.25) years. Five-year local control, failure-free survival, cancer-specific survival, and overall survival were 86%, 57.3%, 70% and 63%, respectively. Mean (standard deviation) combined external beam radiotherapy and brachytherapy target doses, equivalent to doses in 2 Gy fractions were 80.4 Gy10 (3.89), median (range) 80 (49-96) Gy10. Grade 3 or greater gastrointestinal, genitourinary, or vaginal late toxicity occurred in 3%, 1.6%, and 2% of patients, respectively. Survival, patterns of failure, and late complication rates were similar to published series of MRI/CT-based brachytherapy practices., Conclusions: This large study demonstrates that favorable treatment outcomes can be obtained using a pragmatic and innovative combination of ultrasound and MR imaging., (Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.)
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- 2016
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136. Reproducibility and interoperator reliability of obtaining images and measurements of the cervix and uterus with brachytherapy treatment applicators in situ using transabdominal ultrasound.
- Author
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van Dyk S, Garth M, Oates A, Kondalsamy-Chennakesavan S, Schneider M, Bernshaw D, and Narayan K
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- Adult, Aged, Female, Humans, Magnetic Resonance Imaging, Middle Aged, Organ Size, Radiotherapy Dosage, Reproducibility of Results, Uterine Cervical Neoplasms diagnostic imaging, Brachytherapy, Cervix Uteri diagnostic imaging, Cervix Uteri pathology, Radiotherapy, Image-Guided standards, Ultrasonography, Interventional standards, Uterine Cervical Neoplasms radiotherapy
- Abstract
Purpose: To validate interoperator reliability of brachytherapy radiation therapists (RTs) in obtaining an ultrasound image and measuring the cervix and uterine dimensions using transabdominal ultrasound., Methods and Materials: Patients who underwent MRI with applicators in situ after the first insertion were included in the study. Imaging was performed by three RTs (RT1, RT2, and RT3) with varying degrees of ultrasound experience. All RTs were required to obtain a longitudinal planning image depicting the applicator in the uterine canal and measure the cervix and uterus. The MRI scan, taken 1 hour after the ultrasound, was used as the reference standard against which all measurements were compared. Measurements were analyzed with intraclass correlation coefficient and Bland-Altman plots., Results: All RTs were able to obtain a suitable longitudinal image for each patient in the study. Mean differences (SD) between MRI and ultrasound measurements obtained by RTs ranged from 3.5 (3.6) to 4.4 (4.23) mm and 0 (3.0) to 0.9 (2.5) mm on the anterior and posterior surface of the cervix, respectively. Intraclass correlation coefficient for absolute agreement between MRI and RTs was >0.9 for all posterior measurement points in the cervix and ranged from 0.41 to 0.92 on the anterior surface. Measurements were not statistically different between RTs at any measurement point., Conclusions: RTs with variable training attained high levels of interoperator reliability when using transabdominal ultrasound to obtain images and measurements of the uterus and cervix with brachytherapy applicators in situ. Access to training and use of a well-defined protocol assist in achieving these high levels of reliability., (Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.)
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- 2016
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137. Assessing changes to the brachytherapy target for cervical cancer using a single MRI and serial ultrasound.
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van Dyk S, Kondalsamy-Chennakesavan S, Schneider M, Bernshaw D, and Narayan K
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- Adult, Aged, Aged, 80 and over, Dose Fractionation, Radiation, Female, Humans, Middle Aged, Treatment Outcome, Ultrasonography, Young Adult, Brachytherapy, Cervix Uteri diagnostic imaging, Magnetic Resonance Imaging, Organs at Risk diagnostic imaging, Uterine Cervical Neoplasms diagnostic imaging, Uterine Cervical Neoplasms radiotherapy
- Abstract
Purpose: To assess changes to the brachytherapy target over the course of treatment and the impact of these changes on planning and resources., Methods and Materials: Patients undergoing curative treatment with radiotherapy between January 2007 and March 2012 were included in the study. Intrauterine applicators were positioned in the uterine canal while patients were under anesthesia. Images were obtained by MRI and ultrasound at Fraction 1 and ultrasound alone at Fractions 2, 3, and 4. Cervix and uterine dimensions were measured on MRI and ultrasound and compared using Bland-Altman plots and repeated measures one-way analysis of variance., Results: Of 192 patients who underwent three fractions of brachytherapy, 141 of them received four fractions. Mean differences and standard error of differences between MRI at Fraction 1 and ultrasound at Fraction 4 for anterior cervix measurements were 2.9 (0.31), 3.5 (0.25), and 4.2 (0.27) mm and for posterior cervix 0.8 (0.3), 0.3 (0.3), and 0.9 (0.3) mm. All differences were within clinically acceptable limits. The mean differences in the cervix over the course of brachytherapy were less than 1 mm at all measurement points on the posterior surface. Replanning occurred in 11 of 192 (5.7%) patients, although changes to the cervix dimensions were not outside clinical limits., Conclusions: There were small changes to the cervix and uterus over the course of brachytherapy that were not clinically significant. Use of intraoperative ultrasound as a verification aid accurately assesses the target at each insertion, reduces uncertainties in treatment delivery, and improves efficiency of the procedure benefiting both the patient and staff., (Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.)
- Published
- 2015
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138. Ultrasound use in gynecologic brachytherapy: Time to focus the beam.
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van Dyk S, Schneider M, Kondalsamy-Chennakesavan S, Bernshaw D, and Narayan K
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- Brachytherapy adverse effects, Brachytherapy instrumentation, Female, Humans, Magnetic Resonance Imaging, Quality of Life, Radiotherapy Dosage, Tomography, X-Ray Computed, Ultrasonography, Uterine Perforation diagnostic imaging, Uterine Perforation etiology, Brachytherapy methods, Uterine Cervical Neoplasms diagnostic imaging, Uterine Cervical Neoplasms radiotherapy
- Abstract
There is wide disparity in the practice of brachytherapy for cervical cancer around the world. Although select well-resourced centers advocate use of MRI for all insertions, planar X-ray imaging remains the most commonly used imaging modality to assess intracavitary implants, particularly where the burden of cervical cancer is high. Incorporating soft tissue imaging into brachytherapy programs has been shown to improve the technical accuracy of implants, which in turn has led to improved local control and decreased toxicity. These improvements have a positive effect on the quality of life of patients undergoing brachytherapy for cervical cancer. Finding an accessible soft tissue imaging modality is essential to enable these improvements to be available to all patients. A modality that has good soft tissue imaging capabilities, is widely available, portable, and economical, is needed. Ultrasound fulfils these requirements and offers the potential of soft tissue image guidance to a much wider brachytherapy community. Although use of ultrasound is the standard of care in brachytherapy for prostate cancer, it only seems to have limited uptake in gynecologic brachytherapy. This article reviews the role of ultrasound in gynecologic brachytherapy and highlights the potential applications for use in brachytherapy for cervical cancer., (Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.)
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- 2015
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139. A chronic disease outreach program for Aboriginal communities.
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Hoy WE, Kondalsamy-Chennakesavan S, Scheppingen J, Sharma S, and Katz I
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- Adult, Australia epidemiology, Diabetes Mellitus epidemiology, Diabetes Mellitus ethnology, Female, Health Planning, Humans, Hypertension epidemiology, Kidney Failure, Chronic epidemiology, Male, Mass Screening, Middle Aged, Community Networks organization & administration, Hypertension ethnology, Hypertension prevention & control, Kidney Failure, Chronic ethnology, Kidney Failure, Chronic prevention & control, Native Hawaiian or Other Pacific Islander, Rural Health
- Abstract
Background: Our objective is to describe a program to improve awareness and management of hypertension, renal disease, and diabetes in 3 remote Australian Aboriginal communities., Methods: The program espouses that regular integrated checks for chronic disease and their risk factors are essential elements of regular adult health care. Programs should be run by local health workers, following algorithms for testing and treatment, with backup, usually from a distance, from nurse coordinators. Constant evaluation is essential to develop community health profiles and adapt program structure., Results: Participation ranged from 65% to 100% of adults. Forty-one percent of women and 72% of men were current smokers. Body weight varied markedly by community. Although excessive in all, rates of chronic diseases also differed markedly among communities. Rates increased with age, but the greatest numbers of people with morbidities were middle age and young adults. Multiple morbidities were common by middle age. Hypertension and renal disease were early features, whereas diabetes was a variable and later manifestation of this integrated chronic disease syndrome. Adherence to testing and treatment protocols improved markedly over time. Substantial numbers of new diagnoses were made. Blood pressure improved in people in whom antihypertensive agents were started or increased. Components of a systematic activity plan became more clearly defined with time. Treatment of people in the community with the greatest disease burden posed a large additional workload. Lack of health workers and absenteeism were major impediments to productivity., Conclusion: We cannot generalize about body habitus, and chronic disease rates among Aboriginal adults. Pilot data are needed to plan resources based on the chronic disease burden in each community. Systematic screening is useful in identifying high-risk individuals, most at an early treatable stage. Community-based health profiles provide critical information for the development of rational health policy and needs-based health services.
- Published
- 2005
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