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Fei B, Zhan L, Gou J, Wu Y, Sun H. Exploring the efficacy of structured nursing via web-based interaction platforms in sustaining hemodialysis patients. Technol Health Care 2024:THC241021. [PMID: 39269864 DOI: 10.3233/thc-241021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2024]
Abstract
BACKGROUND Discussed based on the network interactive platform of structured care for patients with chronic renal failure (CRF) in the process of hemodialysis. OBJECTIVE This study seeks to elucidate the application value of structured nursing, deployed through network interaction platforms, in sustaining patients undergoing maintenance hemodialysis. METHODS A total of 62 patients diagnosed with Chronic Renal Failure (CRF) between April 2022 and August 2023 were randomly allocated into two distinct care groups: conventional and structured nursing care based on a web-interactive platform. Both cohorts were comparatively analyzed with respect to psychological states, quality of life within therapeutic interventions, and relationships with complications. Renal function indicators, including Creatinine Clearance (Ccr), Serum Creatinine (SCr), and Blood Urea Nitrogen (BUN), were subjected to Pearson analysis to appraise their predictive value in prognostication, while Receiver Operating Characteristic (ROC) curve analysis was constructed to further discern their diagnostic precision. RESULTS Post-intervention, notable improvements were observed in the emotional states of patients in both cohorts, with the structured care group exhibiting significantly lower Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores (p< 0.05). Furthermore, patients under the web-interactive structured nursing regimen demonstrated superior overall adherence, a reduced incidence rate of complications, and markedly higher scores in quality of life assessments compared to those under conventional care (p< 0.05). The derived cut-off values for Ccr, SCr, and BUN were 32.5 ml/min, 251.5 umol/L, and 14.5 mmol/L, respectively, with sensitivities and specificities pegged at 0.645% and 0.645% for Ccr, 0.774% and 0.548% for SCr, and 0.774% and 0.774% for BUN. The corresponding areas under the ROC curve (AUC) for each parameter were 0.816, 0.653, and 0.856, respectively. CONCLUSION Comprehensive hemodialysis care for patients with chronic renal failure can improve self-care ability to improve quality of life and reduce the incidence of complications, which has great potential for clinical progress and is worthy of further research.
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McCaffrey N, White V, Engel L, Mihalopoulos C, Orellana L, Livingston PM, Paul CL, Aranda S, De Silva D, Bucholc J, Hutchinson AM, Steiner A, Ratcliffe J, Lane K, Spence D, Harper T, Livingstone A, Fradgley E, Hutchinson CL. What is the economic and social return on investment for telephone cancer information and support services in Australia? An evaluative social return on investment study protocol. BMJ Open 2024; 14:e081425. [PMID: 38925706 PMCID: PMC11202755 DOI: 10.1136/bmjopen-2023-081425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 06/03/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Over 50% of people affected by cancer report unmet support needs. To address unmet information and psychological needs, non-government organisations such as Cancer Councils (Australia) have developed state-based telephone cancer information and support services. Due to competing demands, evidence of the value of these services is needed to ensure that future investment makes the best use of scarce resources. This research aims to determine the costs and broader economic and social value of a telephone support service, to inform future funding and service provision. METHODS AND ANALYSIS A codesigned, evaluative social return on investment analysis (SROI) will be conducted to estimate and compare the costs and monetised benefits of Cancer Council Victoria's (CCV) telephone support line, 13 11 20, over 1-year and 3-year benefit periods. Nine studies will empirically estimate the parameters to inform the SROI and calculate the ratio (economic and social value to value invested): step 1 mapping outcomes (in-depth analysis of CCV's 13 11 20 recorded call data; focus groups and interviews); step 2 providing evidence of outcomes (comparative survey of people affected by cancer who do and do not call CCV's 13 11 20; general public survey); step 3 valuing the outcomes (financial proxies, value games); step 4 establishing the impact (Delphi); step 5 calculating the net benefit and step 6 service improvement (discrete choice experiment (DCE), 'what if' analysis). Qualitative (focus groups, interviews) and quantitative studies (natural language processing, cross-sectional studies, Delphi) and economic techniques (willingness-to-pay, financial proxies, value games, DCE) will be applied. ETHICS AND DISSEMINATION Ethics approval for each of the studies will be sought independently as the project progresses. So far, ethics approval has been granted for the first two studies. As each study analysis is completed, results will be disseminated through presentation, conferences, publications and reports to the partner organisations.
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Affiliation(s)
- Nikki McCaffrey
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University Faculty of Health, Burwood, Victoria, Australia
| | - Victoria White
- School of Psychology, Deakin University Faculty of Health, Burwood, Victoria, Australia
| | - Lidia Engel
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Cathrine Mihalopoulos
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Liliana Orellana
- Biostatistics Unit, Deakin University Faculty of Health, Burwood, Victoria, Australia
| | | | - Christine L Paul
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Sanchia Aranda
- Department of Nursing, University of Melbourne, Melbourne, Victoria, Australia
| | - Daswin De Silva
- Centre for Data Analytics and Cognition, La Trobe University, Bundoora, Victoria, Australia
| | - Jessica Bucholc
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University Faculty of Health, Burwood, Victoria, Australia
| | - Alison M Hutchinson
- School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University Faculty of Health, Burwood, Victoria, Australia
- Barwon Health, Geelong, Victoria, Australia
| | - Anna Steiner
- Consumer Engagement, Cancer Council Victoria, East Melbourne, Victoria, Australia
| | - Julie Ratcliffe
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | | | - Danielle Spence
- Strategy & Support, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Todd Harper
- Cancer Council Victoria, East Melbourne, Victoria, Australia
| | - Ann Livingstone
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University Faculty of Health, Burwood, Victoria, Australia
| | - Elizabeth Fradgley
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Claire Louise Hutchinson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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Taylor J, Fradgley EA, Clinton‐McHarg T, Hall A, Paul CL. Perceived importance of emotional support provided by health care professionals and social networks: Should we broaden our focus for the delivery of supportive care? Asia Pac J Clin Oncol 2023; 19:681-689. [PMID: 36698247 PMCID: PMC10947305 DOI: 10.1111/ajco.13922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 12/08/2022] [Accepted: 12/26/2022] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Emotional support provided by health care professionals (HCPs) for people diagnosed with cancer is associated with improved outcomes. Support via social networks may also be important. AIMS To report among a sample of distressed patients and caregivers, (1) the importance attributed to different sources of emotional support (HCPs and social networks) by distressed cancer patients and caregivers; (2) the proportion who indicate they did not receive sufficient levels of emotional support; and (3) potential associations between respondents' demographic and clinical characteristics and reported lack of emotional support. METHODS This study utilised cross-sectional data from telephone interviews collected during the usual-care phase of the Structured Triage and Referral by Telephone (START) trial. Participants completed a telephone interview 6 months after their initial call to the Cancer Council Information and Support service and included recall of importance and sufficiency of emotional support. RESULTS More than two-thirds of patients (n = 234) and caregivers (n = 152) reported that family and friends were very important sources of emotional support. Nurses (69% and 42%) and doctors (68% and 47%) were reported very important, while a lower proportion reported that psychologists and psychiatrists were very important (39%, and 43%). Insufficient levels of support were reported by 36% of participants. Perceptions of insufficient support were significantly associated with distress levels (p < .0001) and not having a partner (p = .0115). CONCLUSION Social networks, particularly family, are an important source of emotional support. Higher levels of distress, those without partners, and caregivers may require targeted interventions to increase their access to emotional support.
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Affiliation(s)
- Jo Taylor
- School of Medicine and Public healthUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Health BehaviourUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Cancer Research Innovation and TranslationUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNewcastleNew South WalesAustralia
| | - Elizabeth A. Fradgley
- School of Medicine and Public healthUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Health BehaviourUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Cancer Research Innovation and TranslationUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNewcastleNew South WalesAustralia
- Cancer Institute New South WalesCancer Institute New South Wales, EveleighSydneyAustralia
| | - Tara Clinton‐McHarg
- Priority Research Centre for Health BehaviourUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Cancer Research Innovation and TranslationUniversity of NewcastleCallaghanNew South WalesAustralia
- School of PsychologyUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Alix Hall
- School of Medicine and Public healthUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Health BehaviourUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNewcastleNew South WalesAustralia
- Hunter New England Population HealthHunter New England Area Health ServiceNewcastleNew South WalesAustralia
| | - Christine L. Paul
- School of Medicine and Public healthUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Health BehaviourUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Cancer Research Innovation and TranslationUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNewcastleNew South WalesAustralia
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Carlson MA, Fradgley EA, Bridge P, Taylor J, Morris S, Coutts E, Paul C. The dynamic relationship between cancer and employment-related financial toxicity: an in-depth qualitative study of 21 Australian cancer survivor experiences and preferences for support. Support Care Cancer 2021; 30:3093-3103. [PMID: 34850273 DOI: 10.1007/s00520-021-06707-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND People with a cancer diagnosis experience physical and emotional impacts that may affect employment. Alongside cancer care costs, reduced ability to generate an income is a key contributor to financial toxicity which is associated with poor emotional wellbeing, quality of life, treatment adherence and survival. This study aimed to explore people's experiences of changes to employment and their suggestions for how cancer survivors can be better supported. METHODS Semi-structured telephone interviews were conducted with a purposive sample of 21 cancer survivors identified as part of a larger study of emotional distress. Purposive sampling was used to include a diverse group of people across age, gender, tumour type, self-reported financial difficulties and employment status. Interviews were inductively and iteratively coded by two independent coders and analysed using thematic analysis. RESULTS There is a dynamic relationship between a person's cancer treatment and their employment. For some, employment was disrupted due to physical or emotional impacts of cancer, or workplace stigma and discrimination. Others continued to work at the detriment of their health. Participants wished they had been made aware earlier how cancer might impact their capacity to work, their finances and their health. There was a lack of knowledge on the financial supports that may be available to them. CONCLUSIONS Healthcare professionals may have a role in minimising the financial impact of a cancer diagnosis through early assessment, communication of patients' potential work capacity and appropriate referrals to occupational therapy to aid return to work or financial planning. A robust government social support system specifically for households experiencing cancer is urgently required.
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Affiliation(s)
- Melissa A Carlson
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Cancer Research Alliance, HMRI Building, New Lambton Heights, Australia
| | - Elizabeth A Fradgley
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia.,Hunter Cancer Research Alliance, HMRI Building, New Lambton Heights, Australia.,Priority Research Centre for Health Behavior, University of Newcastle, Callaghan, Australia
| | - Paula Bridge
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Cancer Research Alliance, HMRI Building, New Lambton Heights, Australia.,Priority Research Centre for Health Behavior, University of Newcastle, Callaghan, Australia
| | - Jo Taylor
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Cancer Research Alliance, HMRI Building, New Lambton Heights, Australia.,Priority Research Centre for Health Behavior, University of Newcastle, Callaghan, Australia
| | - Sarah Morris
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia
| | - Emily Coutts
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia
| | - Christine Paul
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia. .,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia. .,Hunter Cancer Research Alliance, HMRI Building, New Lambton Heights, Australia. .,Priority Research Centre for Health Behavior, University of Newcastle, Callaghan, Australia.
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Taylor J, Fradgley EA, Clinton-McHarg T, Hall A, Paul CL. Referral and uptake of services by distressed callers to the Cancer Council Information and Support telephone service. Asia Pac J Clin Oncol 2021; 18:303-310. [PMID: 34185960 DOI: 10.1111/ajco.13604] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/10/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patient-centered cancer care includes emotional, informational, and practical support that is personalised to the needs of patients and inclusive of family and friends. However, when supportive care referrals are offered in hospital settings, distressed patients and carers do not consistently act on those referrals, which can prolong patient suffering. The degree to which sub-optimal referral uptake also occurs in Australian telephone support services is unknown. AIMS To report, among a sample of distressed patients and caregivers who called a cancer information and support service: 1) the types of services used; 2) proportion who received and actioned a referral (uptake); 3) associations between referral to a service and callers' characteristics); and, 4) associations between uptake of a referred service and callers' characteristics. METHODS This study used cross-sectional data collected at 3-month post-baseline from control participants (usual care group) enrolled in the Structured Triage and Referral by Telephone (START) trial. The START trial recruited distressed adult cancer patients and caregivers from the Cancer Council Information and Support Service (CIS). A research assistant conducted a 30-45 min telephone interview with participants, which included recall of referrals provided by CIS staff and reported uptake of referral(s) to the offered service types. RESULTS Most patients (98%) and caregivers (97%) reported receiving a referral to a service. For patients and caregivers respectively, information materials (71%, 77%), CIS call-back (51%, 43%), practical services (52%, 45%), and group peer support (49%, 51%) were the services most frequently offered. For callers receiving a referral, uptake was highest for information materials (91%) and CIS call-backs (89%) and lowest for specialist psychological services (30%). Significant association was found between older age and reduced uptake of services (p = 0.03). CONCLUSION The high uptake rate of CIS call-backs suggests it is a potentially more acceptable form of support compared to specialist psychological services. Efforts to reduce the barriers to telephone-based psychological services are required. Specifically, older age peoples' and caregivers' preferences for support and priorities who may benefit from a referral coordinator.
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Affiliation(s)
- Jo Taylor
- School of Medicine and Public health, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, Newcastle, New South Wales, Australia
| | - Elizabeth A Fradgley
- School of Medicine and Public health, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, New South Wales, Australia.,Cancer Institute New South Wales, Cancer Institute New South Wales, Eveleigh, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, Newcastle, New South Wales, Australia
| | - Tara Clinton-McHarg
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, New South Wales, Australia.,School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
| | - Alix Hall
- School of Medicine and Public health, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, Newcastle, New South Wales, Australia
| | - Christine L Paul
- School of Medicine and Public health, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, Newcastle, New South Wales, Australia
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Taylor J, Fradgley E, Clinton-McHarg T, Byrnes E, Paul C. What are the sources of distress in a range of cancer caregivers? A qualitative study. Support Care Cancer 2020; 29:2443-2453. [PMID: 32929537 DOI: 10.1007/s00520-020-05742-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/04/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Caring for a person diagnosed with cancer is associated with elevated distress that may impact on caregiver health and patient outcomes. However, caregivers' distress is relatively under-researched. This Australian study explored a range of caregivers' reported sources of distress. METHODS The grounded theory approach informed semi-structured interviews that were conducted with a purposive and broad range sample of distressed caregivers identified through the 'Structured Triage And Referral by Telephone' (START) trial. A grounded theory framework was used to generate themes with data analysed by two independent coders using the NVivo software. RESULTS Caregivers (n = 14) were aged from 25 to 80 years, including two bereaved caregivers. The relationships of the caregivers to the patients were as follows: partner (n = 8), parent (n = 1), child (n = 3), sibling (n = 1), and friend (n = 1). Six major themes emerged in relation to sources of distress: (1) a lack of sufficient and timely information; (2) uncertainty; (3) the role and duties of caregiving; (4) lack of family-centred services; (5) practical challenges; and (6) impact of distress. CONCLUSION Caregivers face a number of specific challenges beyond those experienced by patients. It is essential to ensure that caregivers are actively well-informed and well-supported alongside the person who is diagnosed with cancer.
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Affiliation(s)
- Jo Taylor
- School of Medicine and Public Health, University of Newcastle, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia. .,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia. .,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia.
| | - Elizabeth Fradgley
- School of Medicine and Public Health, University of Newcastle, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia.,Cancer Institute New South Wales, Eveleigh, Australia
| | - Tara Clinton-McHarg
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia.,School of Psychology, University of Newcastle, Callaghan, Australia
| | - Emma Byrnes
- School of Medicine and Public Health, University of Newcastle, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Generational Health and Aging, University of Newcastle, Callaghan, Australia
| | - Christine Paul
- School of Medicine and Public Health, University of Newcastle, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia.,Hunter Research Cancer Alliance, HMRI Building, New Lambton Heights, Australia
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