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Groos A, Peardon-Freeman S, McFarlane K, Braithwaite S, Gajjar D, Murch P, Spucches C. Free online chlamydia and gonorrhoea urine test request in Queensland, Australia: convenience of home sample collection versus pathology collection centre attendance for faster results. Sex Health 2021; 18:254-259. [PMID: 34148563 DOI: 10.1071/sh21029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/09/2021] [Indexed: 11/23/2022]
Abstract
Background A free online chlamydia and gonorrhoea urine testing service (Webtest) is available for people living in Queensland, Australia. There are two options to provide a urine sample: at a pathology collection centre or by using a home mailing kit. The study aimed to trial these two testing options designed for young people and describe which is the preferred testing choice. METHODS Data for online requests made from 3 August 2017 to 31 December 2019 provides information for age, gender, location of clients, results received, treatment and partner notification reported by people with positive results. RESULTS For 29 months, there were 4642 Webtest requests and 2906 valid results received. For young people (16-29 years), chlamydia positivity was 8.2% (172/2105; 95% CI, 7.1-9.4) versus 3.2% (26/801; 95% CI, 2.2-4.7) for people aged ≥30 years, and 6.8% (198/2906; 95% CI, 6.0-7.8) for all ages. Home mailing kits were the most popular testing choice, with 68.0% (1977/2906) of results received from urine submitted by post and 32.0% (929/2906) via pathology collection centre. CONCLUSIONS The free online test request service engaged young people at risk of sexually transmissible infections and found home sample collection was most popular.
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Affiliation(s)
- Anita Groos
- Communicable Diseases Branch, Queensland Department of Health, 15 Butterfield Street, Herston, Qld 4006, Australia; and Corresponding author.
| | | | - Kim McFarlane
- Health Contact Centre, Health Support Queensland, GPO Box 48, Brisbane, Qld 4001, Australia
| | - Simone Braithwaite
- Preventive Health Branch, Queensland Department of Health, 15 Butterfield Street, Herston, Qld 4006, Australia
| | - Deepa Gajjar
- Health Service Strategy and Planning, Metro North Hospital and Health Services, Level 14, Block 7, Royal Brisbane and Women's Hospital, Royal Brisbane Hospital, Qld 4029, Australia
| | - Pamela Murch
- Communicable Diseases Branch, Queensland Department of Health, 15 Butterfield Street, Herston, Qld 4006, Australia
| | - Catherine Spucches
- Communicable Diseases Branch, Queensland Department of Health, 15 Butterfield Street, Herston, Qld 4006, Australia
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Groos A, Peardon-Freeman S, McFarlane K, Braithwaite S, Gajjar D, Murch P. Free online chlamydia and gonorrhoea urine test request in Queensland: sexually transmissible infections testing can be hard for young people even if the process is easy. Sex Health 2020; 17:543-546. [PMID: 33334415 DOI: 10.1071/sh20118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 12/03/2020] [Indexed: 11/23/2022]
Abstract
Online options to request sexually transmissible infections testing are increasingly popular and a free online chlamydia and gonorrhoea urine testing service is available for people living in Queensland, Australia. Data from 3 August 2017 to 31 August 2019 provide information for 1316 reminder calls to young people (aged 16-29 years) to encourage sample submission. The reminder calls generated few additional samples for testing, suggesting young people may have changed their mind about using the service, sought testing elsewhere or were reluctant to talk further about their original decision to request a test online.
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Affiliation(s)
- Anita Groos
- Blood Borne Viruses and Sexually Transmissible Infections Unit, Communicable Diseases Branch, Queensland Health, 15 Butterfield Street, Herston, Qld 4006, Australia; and Corresponding author.
| | | | - Kim McFarlane
- Health Contact Centre, Health Support Queensland, GPO Box 48, Brisbane, Qld 4001, Australia
| | - Simone Braithwaite
- Preventive Health Branch, Queensland Health, 15 Butterfield Street, Herston, Qld 4006, Australia
| | - Deepa Gajjar
- Health Service Strategy & Planning, Metro North Hospital and Health Services, Block 7, Royal Brisbane & Women's Hospital, Royal Brisbane Hospital, Qld 4029, Australia
| | - Pamela Murch
- Blood Borne Viruses and Sexually Transmissible Infections Unit, Communicable Diseases Branch, Queensland Health, 15 Butterfield Street, Herston, Qld 4006, Australia
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Katz A, Gajjar D, Zwi AB, Hill PS. Great expectations: An analysis of researchers' and policy makers' perceptions of the potential value of the Australian indigenous burden of disease study for policy. Int J Health Plann Manage 2017; 33:e181-e193. [PMID: 28758235 DOI: 10.1002/hpm.2445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 12/06/2016] [Accepted: 06/30/2017] [Indexed: 11/07/2022] Open
Abstract
The "Burden of disease and injury in Aboriginal and Torres Strait Islander Peoples" was commissioned by the Australian government as part of the Australian Burden of Disease study. This paper explores the extent to which key actors in the research and policy communities expected the Indigenous Burden of Disease study's findings to inform, influence, or drive federal decisions concerning Indigenous health in Australia. This qualitative research undertook interviews with 13 key informants with significant involvement in the Indigenous Burden of Disease study: six researchers, five policy makers, and two knowledge brokers. Interviews were recorded, transcribed, and analyzed, and the findings were triangulated with a review of the literature. Policy makers and researchers anticipated that the Indigenous Burden of Disease study would improve the available information for policy deliberations about Indigenous health. Beyond that, their expectations about its policy influence differed substantially, with researchers more confident of the study's capacity to guide health priorities, and policy makers situating findings in the context of other critical inputs. Expectations of policy influence are shaped by the disciplinary perspectives of actors, and their relationship to policy outcomes and cannot be examined without also considering the policy, political, and financing context of the study being analyzed.
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Affiliation(s)
- Aaron Katz
- Department of Global Health, University of Washington, USA
| | - Deepa Gajjar
- School of Public Health, The University of Queensland, Australia
| | - Anthony B Zwi
- Department of Global Health and Development, The University of New South Wales, Australia
| | - Peter S Hill
- School of Public Health, The University of Queensland, Australia
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Gajjar D, Zwi AB, Hill PS, Shannon C. A case study in the use of evidence in a changing political context: an Aboriginal and Torres Strait Islander health service re-examines practice models, governance and financing. AUST HEALTH REV 2015; 38:383-6. [PMID: 24976304 DOI: 10.1071/ah13221] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 03/14/2014] [Indexed: 11/23/2022]
Abstract
This paper examines the response of a regional body, the Institute for Urban Indigenous Health (IUIH), coordinating Aboriginal community controlled health organisations (ACCHOs) in south-east Queensland, to research evidence as they prioritise and plan services in response to internal economic and organisational factors, as well as external policy change. An event-based analysis of a quarterly management meeting of the IUIH allowed an exploration of how the IUIH uses a range of evidence to respond to the challenges faced within the Aboriginal community controlled health sector. The study identified three distinct but interconnected processes: (1) identifying evidence for change; (2) exploring and reframing this evidence; and (3) the application of this evidence at different levels of policy and practice. These processes were evident in each of the three major agendas addressed during the meeting, namely navigating current political change, reforming the ACCHO business model and reframing the available evidence for advocacy. The result has been the emergence of a new service delivery model, in which evidence supports accountability, change management, self-sufficiency and attempts to redefine community control.
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Affiliation(s)
- Deepa Gajjar
- School of Population Health, The University of Queensland, Public Health Building, Herston, Qld 4006, Australia.
| | - Anthony B Zwi
- Department of Global Health and Development, The University of New South Wales, School of Social Sciences, Morven Brown Building (Rm G25), Sydney, NSW 2052, Australia.
| | - Peter S Hill
- School of Population Health, The University of Queensland, Public Health Building, Herston, Qld 4006, Australia.
| | - Cindy Shannon
- Office of the Pro-Vice-Chancellor (Indigenous Education), The University of Queensland Brisbane, JD Story Building (Rm 444), St Lucia, Qld 4072, Australia.
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Shannon C, Brolan CE, Gajjar D. Realising the potential of the post-2015 development agenda for Indigenous health. Med J Aust 2014; 201:202. [PMID: 25164844 DOI: 10.5694/mja14.00059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 06/13/2014] [Indexed: 11/17/2022]
Affiliation(s)
| | | | - Deepa Gajjar
- University of Queensland, Brisbane, QLD, Australia
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Gajjar D, Patel D, Alapure B, Praveen MR, Patel A, Johar K, Vasavada AR. Rapid action of oestradiol against hydrogen peroxide-induced oxidative stress in cataractous lens epithelium: an in vitro study. Eye (Lond) 2008; 23:1456-63. [DOI: 10.1038/eye.2008.284] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Andrews J, Honeybourne D, Jevons G, Boyce M, Wise R, Bello A, Gajjar D. Concentrations of garenoxacin in plasma, bronchial mucosa, alveolar macrophages and epithelial lining fluid following a single oral 600 mg dose in healthy adult subjects. J Antimicrob Chemother 2003; 51:727-30. [PMID: 12615879 DOI: 10.1093/jac/dkg110] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A microbiological assay was used to measure concentrations of garenoxacin (BMS-284756) in plasma, bronchial mucosa (BM), alveolar macrophages (AM) and epithelial lining fluid (ELF), following a single 600 mg oral dose. Twenty-four healthy subjects were allocated into four nominal time intervals after the dose, 2.5-3.5, 4.5-5.5, 10.5-11.5 and 23.5-24.5 h. Mean concentrations in plasma, BM, AM and ELF, respectively, for the four nominal time windows were for 2.5-3.5 h 10.0 mg/L (S.D. 2.8), 7.0 mg/kg (S.D. 1.3), 106.1 mg/L (S.D. 60.3) and 9.2 mg/L (S.D. 3.6); 4.5-5.5 h 8.7 mg/L (S.D. 2.2), 6.0 mg/kg (S.D. 1.9), 158.6 mg/L (S.D. 137.4) and 14.3 mg/L (S.D. 8.2); 10.5-11.5 h 6.1 mg/L (S.D. 1.9), 4.0 mg/kg (S.D. 1.4), 76.0 mg/L (S.D. 47.7) and 7.9 mg/L (S.D. 4.6); and 23.5-24.5 h 2.1 mg/L (S.D. 0.5), 1.7 mg/kg (S.D. 0.7), 30.7 mg/L (S.D. 12.9) and 3.3 mg/L (S.D. 2.3). Concentrations at all sites exceeded MIC(90)s for the common respiratory pathogens Haemophilus influenzae (0.03 mg/L), Moraxella catarrhalis (0.015 mg/L) and Streptococcus pneumoniae (0.06 mg/L). These data suggest that garenoxacin should be effective in the treatment of community-acquired pneumonia and chronic obstructive pulmonary disease.
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Affiliation(s)
- J Andrews
- Department of Medical Microbiology, City Hospital NHS Trust, Birmingham, UK.
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Noveck RJ, Vargas R, Russo R, Bello A, Gajjar D, Grasela D. Pharmacokinetics (PK) of Garenoxacin in Healthy Subjects and in Subjects With Hepatic Impairment. Clin Pharmacol Ther 2003. [DOI: 10.1016/s0009-9236(03)90650-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Gajjar D, Egan B, Curè J, Rust P, VanTassel P, Patel SJ. Vascular compression of the rostral ventrolateral medulla in sympathetic mediated essential hypertension. Hypertension 2000; 36:78-82. [PMID: 10904016 DOI: 10.1161/01.hyp.36.1.78] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The pathophysiological factors of neurogenic or sympathetically mediated essential hypertension are unknown. Neurons close to the surface of the ventrolateral medulla (specifically, in the retro-olivary sulcus [ROS]) are integrally involved in the control of blood pressure by means of efferent connections to presympathetic neurons in the spinal cord. It is hypothesized that vascular contact with the ROS is pathogenically involved in neurogenically mediated hypertension. We evaluated that theory in 20 subjects with uncomplicated stage 1 to stage 2 essential hypertension (EHTN) (18 of whom completed the study). The baseline supine plasma norepinephrine level served as an index of central sympathetic outflow. The response of blood pressure to clonidine was used as a surrogate marker for neurogenically mediated hypertension. We also examined the relationship between those markers and evidence of anatomic abnormalities in the area of the ROS that was provided by magnetic resonance imaging. A vessel contacted the left ROS in 5 of the 18 subjects. Those 5 subjects had higher plasma norepinephrine concentrations than did the 13 subjects without this vascular contact (358+/-46 versus 76+/-43 pg/mL, P<0.001). These 5 subjects also exhibited a significant depressor response to clonidine that tended to be greater than that seen in the 13 subjects without vascular contact (-20.6+/-3.2 versus -13.6+/-9 mm Hg). Both race and baseline mean blood pressure had only an independent effect on the depressor response to clonidine. The findings are consistent with the theory that vascular contact with the left ROS may contribute to neurogenically mediated "essential" hypertension in some patients.
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Affiliation(s)
- D Gajjar
- Department of Neurosurgery, Medical University of South Carolina, Charleston, USA
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Herron J, Lee P, Pesco-Koplowitz L, Gajjar D, Soo YW, Woestenborghs R. Determination of the dose proportionality of single intravenous doses (5, 10, and 15 mg) of lubeluzole in healthy volunteers. Clin Ther 1998; 20:682-90. [PMID: 9737828 DOI: 10.1016/s0149-2918(98)80131-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The dose proportionality of lubeluzole, a drug in clinical development for the treatment of acute ischemic stroke, was evaluated in a Phase I, single-center, open-label, randomized-dosing-sequence, three-way crossover clinical trial in 12 healthy adults. An equal number of male and female volunteers were enrolled in the trial, with a mean weight (+/- SD) of 73.2 +/- 11.9 kg, mean height (+/- SD) of 66.8 +/- 4.6 inches, and a mean age of 36.1 +/- 5.2 years. Subjects received intravenous infusions of 5 (A), 10 (B), and 15 mg (C) of lubeluzole over 1 hour on three separate occasions, with a minimum washout period of 2 weeks. The treatment sequences were A-B-C; A-C-B; B-A-C; B-C-A; C-A-B; and C-B-A. One male and one female were assigned to each sequence. After the 5-, 10-, and 15-mg doses, maximum concentration (Cmax) was 58.1, 113, and 138 microg/L, respectively, and the area under the curve from 0 to (AUC(0-infinity)) was 771, 1384, and 2025 microg x h/L. There were no statistically significant differences among the groups in mean terminal half-life, steady-state volume of distribution, total plasma clearance, or dose-normalized AUC(0-infinity). Dose-normalized values of Cmax differed significantly between the groups. No serious adverse events were reported, and no changes were observed in cardiac function, as judged by the QT(c) interval. The pharmacokinetics of lubeluzole appear to be linear at intravenous infusion doses of 5, 10, and 15 mg, and these doses are well tolerated by healthy adults.
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Affiliation(s)
- J Herron
- Arkansas Research Medical Testing Center, Little Rock, USA
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Walker AR, Gajjar D. Gastro-intestinal transit time and serum lipid levels in Black schoolchildren. S Afr Med J 1977; 52:677-9. [PMID: 601635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Gastro-intestinal transit time was measured in 150-200 Black schoolchildren, aged 10-12 years, at each of 3 schools in country areas of South Africa. Pupils were accustomed to a low fat/high crude fibre diet. At each centre, a selection was made of 50 children with fast transit times (9 hours or less), and 50 with relatively slow times (roughly 24 hours or more). Fasting levels of serum cholesterol and triglyceride were determined in these subjects. At two schools there were no significant differences in mean lipid levels between subjects with fast and slow transit: only at the third school were mean lipid levels of pupils slightly, but significantly lower in those with fast transit times. These observations agree with those on White adults, that an increase in intake of fibre-containing foods, and a decrease in transit time, have very little effect on serum lipid levels. The low values in Black children are believed to be due primarily to their low intakes of fat and cholesterol.
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