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Knowles SR, Apputhurai P, Jenkins Z, O'flaherty E, Ierino F, Langham R, Ski CF, Thompson DR, Castle DJ. Impact of chronic kidney disease on illness perceptions, coping, self-efficacy, psychological distress and quality of life. PSYCHOL HEALTH MED 2023; 28:1963-1976. [PMID: 36794381 DOI: 10.1080/13548506.2023.2179644] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 02/07/2023] [Indexed: 02/17/2023]
Abstract
Chronic kidney disease (CKD) negatively impacts psychological well-being and quality of life (QoL). Underpinned by the Common Sense Model (CSM), this study evaluated the potential mediating role of self-efficacy, coping styles and psychological distress on the relationship between illness perceptions and QoL in patients living with CKD. Participants were 147 people with stage 3-5 kidney disease. Measures included eGFR, illness perceptions, coping styles, psychological distress, self-efficacy and QoL. Correlational analyses were performed, followed by regression modelling. Poorer QoL was associated with greater distress, engagement in maladaptive coping, poorer illness perceptions and lower self-efficacy. Regression analysis revealed that illness perceptions predicted QoL, with psychological distress acting as a mediator. The proportion of variance explained was 63.8%. These findings suggest that psychological interventions are likely to enhance QoL in CKD, if they target the mediating psychological processes associated with illness perceptions and psychological distress.
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Affiliation(s)
- Simon R Knowles
- School of Health Sciences, Swinburne University, Melbourne, Australia
| | | | - Zoe Jenkins
- Mental Health Services, St. Vincent's Hospital, Melbourne, Australia
| | - Emmet O'flaherty
- Nephrology Service, St. Vincent's Hospital, Melbourne, Australia
| | - Francesco Ierino
- Nephrology Service, St. Vincent's Hospital, Melbourne, Australia
| | - Robyn Langham
- St. Vincent's Hospital, University of Melbourne Department of Medicine, Melbourne, Australia
| | - Chantal F Ski
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - David R Thompson
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - David J Castle
- Mental Health Services, St. Vincent's Hospital, Melbourne, Australia
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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2
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Sutton KP, Beauchamp A, Smith T, Waller S, Brown L, Fisher K, Woodfield M, Major L, Depczynski J, Versace VL, Maybery D, Wakely L, Mitchell EK, Drumm DW, Langham R, May J. Rationale and protocol for the Nursing and Allied Health Graduate Outcomes Tracking (NAHGOT) study: a large-scale longitudinal investigation of graduate practice destinations. Rural Remote Health 2021; 21:6407. [PMID: 34587455 DOI: 10.22605/rrh6407] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Inequitable distribution of health workforce limits access to healthcare services and contributes to adverse health outcomes. WHO recommends tracking health professionals from their points of entry into university and over their careers for the purpose of workforce development and planning. Previous research has focused on medical students and graduates' choice of practice location. Few studies have targeted nursing and allied health graduates' practice intentions and destinations. The Nursing and Allied Health Graduate Outcomes Tracking (NAHGOT) study is investigating factors affecting Australian nursing and allied health students and graduates' choice of graduate practice location over the course of their studies and up to 10 years after graduation by linking multiple data sources, including routinely collected university administrative and professional placement data, surveys of students and graduates, and professional registration data. METHODS By using a prospective cohort study design, each year a new cohort of about 2000 students at each participating university (Deakin University, Monash University and the University of Newcastle) is tracked throughout their courses and for 10 years after graduation. Disciplines include medical radiation practice, nursing and midwifery, occupational therapy, optometry, paramedicine, pharmacy, physiotherapy, podiatry and psychology. University enrolment data are collected at admission and professional placement data are collected annually. Students' practice destination intentions are collected via questions added into the national Student Experience Survey (SES). Data pertaining to graduates' practice destination, intentions and factors influencing choice of practice location are collected in the first and third years after graduation via questions added to the Australian Graduate Outcomes Survey (GOS). Additionally, participants may volunteer to receive a NAHGOT survey in the second and fourth-to-tenth years after graduation. Principal place of practice data are accessed via the Australian Health Practitioner Regulation Agency (Ahpra) annually. Linked data are aggregated and analysed to test hypotheses comparing associations between multiple variables and graduate practice location. RESULTS This study seeks to add to the limited empirical evidence about factors that lead to rural practice in the nursing and allied health professions. This prospective large-scale, comprehensive study tracks participants from eight different health professions across three universities through their pre-registration education and into their postgraduate careers, an approach not previously reported in Australia. To achieve this, the NAHGOT study links data drawn from university enrolment and professional placement data, the SES, the GOS, online NAHGOT graduate surveys, and Ahpra data. The prospective cohort study design enables the use of both comparative analysis and hypothesis testing. The flexible and inclusive study design is intended to enable other universities, as well as those allied health professions not regulated by Ahpra, to join the study over time. CONCLUSION The study demonstrates how the systematic, institutional tracking and research approach advocated by the WHO can be applied to the nursing and allied health workforce in Australia. It is expected that this large-scale, longitudinal, multifactorial, multicentre study will help inform future nursing and allied health university admission, graduate pathways and health workforce planning. Furthermore, the project could be expanded to explore health workforce attrition and thereby influence health workforce planning overall.
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Affiliation(s)
- Keith Paul Sutton
- School of Rural Health, Monash University, 15 Sargeant St, Warragul, Vic, 3820, Australia
| | - Alison Beauchamp
- School of Rural Health, Monash University, 15 Sargeant St, Warragul, Vic, 3820, Australia
| | - Tony Smith
- Department of Rural Health, The University of Newcastle, 114-148 Johnston St, Tamworth, NSW 2340, Australia
| | - Susan Waller
- School of Rural Health, Monash University, 25 Mercy St, Bendigo, Vic. 3552, Australia
| | - Leanne Brown
- Department of Rural Health, The University of Newcastle, 114-148 Johnston St, Tamworth, NSW 2340, Australia
| | - Karin Fisher
- Department of Rural Health, The University of Newcastle, 114-148 Johnston St, Tamworth, NSW 2340, Australia
| | - Mark Woodfield
- School of Rural Health, Monash University, 37 Rainforest Walk, Clayton, Vic. 3800, Australia
| | - Laura Major
- School of Rural Health, Monash University, 37 Rainforest Walk, Clayton, Vic. 3800, Australia
| | - Julie Depczynski
- The University of Newcastle Department of Rural Health, PO Box 138, Moree, NSW 2400, Australia
| | - Vincent L Versace
- Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Warrnambool, Vic. 3280, Australia
| | - Darryl Maybery
- School of Rural Health, Monash University, 15 Sargeant St, Warragul, Vic, 3820, Australia
| | - Luke Wakely
- Department of Rural Health, The University of Newcastle, 114-148 Johnston St, Tamworth, NSW 2340, Australia
| | - Eleanor Kl Mitchell
- School of Rural Health, Monash University, Cnr Day & Victoria Street, Bairnsdale, Vic. 3875, Australia
| | - Daniel W Drumm
- Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Warrnambool, Vic. 3280, Australia
| | - Robyn Langham
- School of Rural Health, Monash University, 37 Rainforest Walk, Clayton, Vic. 3800, Australia
| | - Jenny May
- Department of Rural Health, The University of Newcastle, 114-148 Johnston St, Tamworth, NSW 2340, Australia
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Anand S, Caplin B, Gonzalez-Quiroz M, Schensul SL, Bhalla V, Parada X, Nanayakkara N, Fire A, Levin A, Friedman DJ, Aguilar-Gonzalez A, Abbot K, Abeysekara T, Amann K, Anand S, Ashuntantang G, Bhalla V, Brooks D, Caplin B, Chavarria D, Christoph D, Rotter RC, De Broe M, De Silva PMC, Dominguez J, Eckardt KU, Fader D, Finkelstein F, Fire A, Fischer R, Friedman D, Ganguli A, Garcia Trabinho RA, Glaser J, Gonzalez Quiroz MA, Fischer R, Haider L(L, Harris D, Herath C, Herrera R, Hradsky A, Hoy W, Jakobsson K, Jayasinghe S, Jaysummana C, Jha V, Johnson R, Kambham N, Karanasema N, Kaze F, Kimmel P, Koritzinsky E, Langham R, Le Bellego L, Levin A, Levin N, Lyuckx V, Madero M, Martin E, Malik C, Moist L, Moxey-Mims M, Nanayakkara N, Narva A, Nerbass F, O'Donoghue D, Orantes C, Parada X, Pearce N, Ratnayake C, Roy-Chaudhury P, Ruggiero A, Sanchez-Lozada LG, Saran R, Schensul S, Segantini L, Seksek I, Sheikh-Hamad D, Star R, Strani L, Vlahos P, Wegman DH, Weiss I, Wijewickrama E, Wijkstrom J, Wise P, Wright E, Yang CW, Yeates K. Epidemiology, molecular, and genetic methodologies to evaluate causes of CKDu around the world: report of the Working Group from the ISN International Consortium of Collaborators on CKDu. Kidney Int 2019; 96:1254-1260. [DOI: 10.1016/j.kint.2019.09.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/19/2019] [Accepted: 09/27/2019] [Indexed: 11/30/2022]
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Jager KJ, Kovesdy C, Langham R, Rosenberg M, Jha V, Zoccali C. A single number for advocacy and communication-worldwide more than 850 million individuals have kidney diseases. Kidney Int 2019; 96:1048-1050. [PMID: 31582227 DOI: 10.1016/j.kint.2019.07.012] [Citation(s) in RCA: 248] [Impact Index Per Article: 49.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 07/30/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Kitty J Jager
- ERA-EDTA Registry, Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Csaba Kovesdy
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Robyn Langham
- School of Rural Health, Monash University, Melbourne, Victoria, Australia
| | - Mark Rosenberg
- Education and Academic Affairs, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Vivekanand Jha
- George Institute for Global Health, New Delhi, India; University of Oxford, Oxford, UK
| | - Carmine Zoccali
- CNR-IFC Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal, Italy.
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Jager KJ, Kovesdy C, Langham R, Rosenberg M, Jha V, Zoccali C. A single number for advocacy and communication—worldwide more than 850 million individuals have kidney diseases. Nephrol Dial Transplant 2019; 34:1803-1805. [DOI: 10.1093/ndt/gfz174] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 07/26/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Kitty J Jager
- ERA-EDTA Registry, Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Csaba Kovesdy
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Robyn Langham
- School of Rural Health, Monash University, Melbourne, VC, Australia
| | - Mark Rosenberg
- Education and Academic Affairs, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Vivekanand Jha
- George Institute for Global Health, New Delhi, India
- University of Oxford, Oxford, UK
| | - Carmine Zoccali
- CNR-IFC Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal, Italy
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6
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O'Sullivan B, McGrail M, Russell D, Walker J, Chambers H, Major L, Langham R. Duration and setting of rural immersion during the medical degree relates to rural work outcomes. Med Educ 2018; 52:803-815. [PMID: 29676022 DOI: 10.1111/medu.13578] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 12/18/2017] [Accepted: 02/05/2018] [Indexed: 05/13/2023]
Abstract
CONTEXT Providing year-long rural immersion as part of the medical degree is commonly used to increase the number of doctors with an interest in rural practice. However, the optimal duration and setting of immersion has not been fully established. This paper explores associations between various durations and settings of rural immersion during the medical degree and whether doctors work in rural areas after graduation. METHODS Eligible participants were medical graduates of Monash University between 2008 and 2016 in postgraduate years 1-9, whose characteristics, rural immersion information and work location had been prospectively collected. Separate multiple logistic regression and multinomial logit regression models tested associations between the duration and setting of any rural immersion they did during the medical degree and (i) working in a rural area and (ii) working in large or smaller rural towns, in 2017. RESULTS The adjusted odds of working in a rural area were significantly increased if students were immersed for one full year (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.15-2.79), for between 1 and 2 years (OR, 2.26; 95% CI, 1.54-3.32) and for 2 or more years (OR, 4.43; 95% CI, 3.03-6.47) relative to no rural immersion. The strongest association was for immersion in a mix of both regional hospitals and rural general practice (OR, 3.26; 95% CI, 2.31-4.61), followed by immersion in regional hospitals only (OR, 1.94; 95% CI, 1.39-2.70) and rural general practice only (OR, 1.91; 95% CI, 1.06-3.45). More than 1 year's immersion in a mix of regional hospitals and rural general practices was associated with working in smaller regional or rural towns (<50 000 population) (relative risk ratios [RRR] 2.97; 95% CI, 1.82-4.83). CONCLUSION These findings inform medical schools about effective rural immersion programmes. Longer rural immersion and immersion in both regional hospitals and rural general practices are likely to increase rural work and rural distribution of early career doctors.
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Affiliation(s)
| | - Matthew McGrail
- Monash University School of Rural Health, Bendigo, Victoria, Australia
| | - Deborah Russell
- Monash University School of Rural Health, Bendigo, Victoria, Australia
| | - Judi Walker
- Monash University School of Rural Health, Bendigo, Victoria, Australia
| | - Helen Chambers
- Monash University School of Rural Health, Bendigo, Victoria, Australia
| | - Laura Major
- Monash University School of Rural Health, Bendigo, Victoria, Australia
| | - Robyn Langham
- Monash University School of Rural Health, Bendigo, Victoria, Australia
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7
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North D, Jaw J, Hill P, Bateman S, Barraclough N, Langham R. Nephrogenic Adenoma Complicating Renal Transplantation: A Case Report and Discussion. Transplant Proc 2017; 49:2381-2383. [PMID: 29198684 DOI: 10.1016/j.transproceed.2017.09.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 09/02/2017] [Indexed: 11/27/2022]
Abstract
Nephrogenic adenoma (NA) is a benign adenomatous lesion of the urinary tract. Long considered to be a rare phenomenon, case series from the renal transplant population suggest that it may be much more common within this group. Although NA is considered to be a lesion with low premalignant potential, hematuria, lower urinary tract symptoms, and recurrent urinary tract infections (UTIs) are frequently observed in the context of NA. Furthermore, after resection of NA, lesion recurrence and persistent symptoms are frequently observed. Here we present the case of a 69-year-old male renal transplant recipient with NA and associated recurrent UTIs despite cystoscopic resection of the primary lesion. This case is illustrative of the clinical impact of NA and the need for ongoing work into the development of strategies to manage this problematic phenomenon.
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Affiliation(s)
- D North
- Department of Nephrology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
| | - J Jaw
- Department of Nephrology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - P Hill
- Department of Anatomical Pathology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - S Bateman
- Department of Nephrology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - N Barraclough
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - R Langham
- Monash Rural Health, Monash University, Clayton, Victoria, Australia
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8
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Knowles SR, Ski CF, Langham R, O'Flaherty E, Thompson DR, Rossell SL, Moore G, Hsueh YSA, Castle DJ. Design and protocol for the Dialysis Optimal Health Program (DOHP) randomised controlled trial. Trials 2016; 17:447. [PMID: 27612446 PMCID: PMC5018180 DOI: 10.1186/s13063-016-1558-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 08/13/2016] [Indexed: 11/23/2022] Open
Abstract
Background Chronic kidney disease (CKD) and end-stage kidney disease (ESKD) are serious and growing health problems with enormous impact on psychological and social functioning. Despite high rates of comorbid depression and anxiety in these patient populations, and the adverse impact these have upon treatment adherence, quality of life, social connectedness and healthcare costs there has been little attention focused on the prevention or management of these problems. Thus, our aim was to evaluate the Dialysis Optimal Health Program (DOHP) that adopts a person-centred approach and engages collaborative therapy to educate and support those diagnosed with ESKD who are commencing dialysis. Methods The study design is a randomised controlled trial. Ninety-six adult patients initiating haemodialysis or peritoneal dialysis will be randomly allocated to either the intervention (DOHP) or usual care group. Participants receiving the intervention will receive nine (8 + 1 booster session) sequential sessions based on a structured information/workbook, psychosocial and educational supports and skills building. The primary outcome measures are depression and anxiety (assessed by the Hospital Anxiety and Depression Scale; HADS). Secondary outcomes include health-related quality of life (assessed by the Kidney Disease Quality of Life instrument; KDQOL), self-efficacy (assessed by General Self-Efficacy Scale) and clinical indices (e.g. albumin and haemoglobin levels). Cost-effectiveness analysis and process evaluation will also be performed to assess the economic value and efficacy of the DOHP. Primary and secondary measures will be collected at baseline and at 3-, 6-, and 12-month follow-up time points. Discussion We believe that this innovative trial will enhance knowledge of interventions aimed at supporting patients in the process of starting dialysis, and will broaden the focus from physical symptoms to include psychosocial factors such as depression, anxiety, self-efficacy, wellbeing and community support. The outcomes associated with this study are significant in terms of enhancing an at-risk population’s psychosocial health and reducing treatment-related costs and associated pressures on the healthcare system. Trial registration ANZCTR no. 12615000810516. Registered on 5 August 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1558-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Simon R Knowles
- Department of Psychology, Swinburne University, Melbourne, VIC, 3122, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, VIC, 3010, Australia.,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia
| | - Chantal F Ski
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, 3010, Australia. .,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia. .,Centre for the Heart and Mind, Australian Catholic University, Melbourne, VIC, 3000, Australia.
| | - Robyn Langham
- Department of Neurology, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia
| | - Emmet O'Flaherty
- Department of Neurology, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia
| | - David R Thompson
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, 3010, Australia.,Centre for the Heart and Mind, Australian Catholic University, Melbourne, VIC, 3000, Australia
| | - Susan L Rossell
- Department of Psychology, Swinburne University, Melbourne, VIC, 3122, Australia.,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia
| | - Gaye Moore
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, 3010, Australia.,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia
| | - Ya-Seng Arthur Hsueh
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - David J Castle
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, 3010, Australia.,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia.,Centre for the Heart and Mind, Australian Catholic University, Melbourne, VIC, 3000, Australia
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9
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Stanley M, Worrall-Carter L, Rahman MA, McEvedy S, Langham R. Assessment of an established dialysis nurse practitioner model of care using mixed methods research. Contemp Nurse 2016; 51:148-62. [PMID: 26915511 DOI: 10.1080/10376178.2016.1157029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIMS AND OBJECTIVES To assess a dialysis nurse practitioner (NP) model of care by examining satisfaction, quality of life (QOL) and clinical outcomes of haemodialysis patients and explore experiences of dialysis nurses. DESIGN Mixed methods. METHODS Database analyses of dialysis indices amongst a sample (n = 45) of haemodialysis patients; a survey (n = 27) examining patient experience, satisfaction and QOL; and in-depth interviews with a sample (n = 10) of nurses. RESULTS Nurses commended the NP role, with five themes emerging: "managing and co-ordinating", "streamlining and alleviating", "developing capability", "supporting innovation and quality" and "connecting rurally". Patients' average age was 66 years and 71% were male. Patients' satisfaction with the care they received was rated 3.5/4 or higher across seven parameters and the average QOL score was 7.9/10. CONCLUSION The NP model of care is effective in enhancing patient care within a collaborative framework. The challenge is to sustain, and enhance the model, through mentorship programs for potential candidates.
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Affiliation(s)
| | - Linda Worrall-Carter
- a St. Vincent's Hospital , Melbourne , VIC , Australia.,b St. Vincent's Centre for Nursing Research (SVCNR), Faculty of Health Sciences , Australian Catholic University , Melbourne , VIC , Australia.,c The Cardiovascular Research Centre (CvRC), Faculty of Health Sciences , Australian Catholic University , Melbourne , VIC , Australia
| | - Muhammad Aziz Rahman
- b St. Vincent's Centre for Nursing Research (SVCNR), Faculty of Health Sciences , Australian Catholic University , Melbourne , VIC , Australia.,c The Cardiovascular Research Centre (CvRC), Faculty of Health Sciences , Australian Catholic University , Melbourne , VIC , Australia
| | - Samantha McEvedy
- b St. Vincent's Centre for Nursing Research (SVCNR), Faculty of Health Sciences , Australian Catholic University , Melbourne , VIC , Australia
| | - Robyn Langham
- a St. Vincent's Hospital , Melbourne , VIC , Australia.,d Faculty of Medicine, Dentistry and Health Sciences , The University of Melbourne , Melbourne , VIC , Australia
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Robson K, Hill P, Langsford D, Dwyer K, Goodman D, Langham R. Galactose therapy reduces proteinuria in patients with recurrent focal segmental glomerulosclerosis after kidney transplantation. Nephrology (Carlton) 2015; 20 Suppl 1:13-6. [PMID: 25807852 DOI: 10.1111/nep.12422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2014] [Indexed: 12/13/2022]
Abstract
Primary focal segmental glomerulosclerosis is an important cause of end-stage kidney disease with a high rate of recurrent disease after kidney transplantation. Current therapy achieves remission in only half of patients. Recent interest has focused on the potential role of galactose in binding and inactivating the putative circulating permeability factor, supported by in vitro and clinical case report studies. Orally active and without major adverse effects, galactose has a favourable treatment profile compared with current immunosuppressive treatment options. We describe our experience using galactose therapy in two patients with recurrent focal segmental glomerulosclerosis after renal transplantation. Galactose was associated with symptomatic improvement and stabilization of graft function in one case; the other case was complicated by concurrent malignancy. In both cases, we observed a marked reduction in proteinuria with galactose treatment.
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Robson K, Ngu K, Stanley M, Langham R. SP698NOCTURNAL IN-CENTRE HAEMODIALYSIS: AN AUSTRALIAN COHORT EXPERIENCE. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv200.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Brown MA, Crail SM, Masterson R, Foote C, Robins J, Katz I, Josland E, Brennan F, Stallworthy EJ, Siva B, Miller C, Urban AK, Sajiv C, Glavish RN, May S, Langham R, Walker R, Fassett RG, Morton RL, Stewart C, Phipps L, Healy H, Berquier I. ANZSN Renal Supportive Care Guidelines 2013. Nephrology (Carlton) 2013; 18:401-454. [DOI: 10.1111/nep.12065] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2013] [Indexed: 12/16/2022]
Affiliation(s)
- Mark A Brown
- Departments of Renal Medicine and Medicine; St George Hospital and University of NSW; Sydney New South Wales Australia
| | - Susan M Crail
- Central and North Adelaide Renal and Transplantation Service; Adelaide South Australia Australia
- Central and North Adelaide Renal and Transplant Services; Adelaide South Australia Australia
| | - Rosemary Masterson
- Department of Nephrology; Royal Melbourne Hospital; Melbourne Victoria Australia
| | - Celine Foote
- The George Institute for Global Health; Sydney New South Wales Australia
| | - Jennifer Robins
- Departments of Renal Medicine and Medicine; St George Hospital and University of NSW; Sydney New South Wales Australia
| | - Ivor Katz
- Departments of Renal Medicine and Medicine; St George Hospital and University of NSW; Sydney New South Wales Australia
| | | | - Frank Brennan
- Departments of Renal Medicine and Palliative Medicine; St George Hospital; Kogarah New South Wales Australia
- Deparments of Renal Medicine and Palliative Medicine; St George Hospital; Kogarah New South Wales Australia
| | | | - Brian Siva
- Fremantle Hospital; Fremantle Western Australia Australia
| | - Cathy Miller
- Palliative Care Service; Department of General Medicine; North Shore and Waitakere Hospitals; Waitemata District Health Board; Auckland New Zealand
| | - A Katalin Urban
- Concord Repatriation Hospital; Concord; New South Wales Australia
| | - Cherian Sajiv
- Alice Springs Hospital; Central Australian Renal Services; Alice Springs Northern Territory Australia
| | - R Naida Glavish
- He Kamaka Oranga - Department of Maori Health; Auckland District Health Board; Auckland New Zealand
| | - Steven May
- Tamworth Base Hospital; Tamworth New South Wales Australia
| | | | - Robert Walker
- Department of Medicine; Dunedin School of Medicine; University of Otago; Dunedin New Zealand
| | - Robert G Fassett
- Royal Brisbane and Women's Hospital; Herston Queensland Australia
| | - Rachael L Morton
- School of Public Health; University of Sydney; Sydney New South Wales Australia
| | - Cameron Stewart
- Centre for Health Governance, Law & Ethics; Sydney Law School; University of Sydney; Sydney
| | - Lisa Phipps
- Orange Base Hospital; Orange New South Wales Australia
| | - Helen Healy
- Deparment of Renal Medicine; Royal Brisbane and Women's Hospital; Brisbane Queensland Australia
| | - Ilse Berquier
- Central and North Adelaide Renal and Transplant Services; Adelaide South Australia Australia
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Langham R. Renal Supportive Care and the Primary Care Physician. Nephrology (Carlton) 2013:n/a-n/a. [PMID: 23586483 DOI: 10.1111/nep.12083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
General Practitioner are important and should be involved in decision making and Advanced Care Planning for patients with advanced kidney disease Advanced kidney disease has a biphasic nature of life trajectory No treatment does not mean no dialysis for the patient with CKD - CKD care and terminal phase care.
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Johnson DW, Brown FG, Clarke M, Boudville N, Elias TJ, Foo MWY, Jones B, Kulkarni H, Langham R, Ranganathan D, Schollum J, Suranyi MG, Tan SH, Voss D. The effects of biocompatible compared with standard peritoneal dialysis solutions on peritonitis microbiology, treatment, and outcomes: the balANZ trial. Perit Dial Int 2013; 32:497-506. [PMID: 22991015 DOI: 10.3747/pdi.2012.00052] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND A multicenter, multi-country randomized controlled trial (the balANZ study) recently reported that peritonitis rates significantly improved with the use of neutral-pH peritoneal dialysis (PD) solutions low in glucose degradation products ("biocompatible") compared with standard solutions. The present paper reports a secondary outcome analysis of the balANZ trial with respect to peritonitis microbiology, treatment, and outcomes. METHODS Adult incident PD patients with residual renal function were randomized to receive either biocompatible or conventional (control) PD solutions for 2 years. RESULTS The safety population analysis for peritonitis included 91 patients in each group. The unadjusted geometric mean peritonitis rates in those groups were 0.30 [95% confidence interval (CI): 0.22 to 0.41] episodes per patient-year for the biocompatible group and 0.49 (95% CI: 0.39 to 0.62) episodes per patient-year for the control group [incidence rate ratio (IRR): 0.61; 95% CI: 0.41 to 0.90; p = 0.01]. When specific causative organisms were examined, the rates of culture-negative, gram-positive, gram-negative, and polymicrobial peritonitis episodes were not significantly different between the biocompatible and control groups, although the biocompatible group did experience a significantly lower rate of non-pseudomonal gram-negative peritonitis (IRR: 0.41; 95% CI: 0.18 to 0.92; p = 0.03). Initial empiric antibiotic regimens were comparable between the groups. Biocompatible fluid use did not significantly reduce the risk of peritonitis-associated hospitalization (adjusted odds ratio: 0.80; 95% CI: 0.48 to 1.34), but did result in a shorter median duration of peritonitis-associated hospitalization (6 days vs 11 days, p = 0.05). Peritonitis severity was more likely to be rated as mild in the biocompatible group (37% vs 10%, p = 0.001). Overall peritonitis-associated technique failures and peritonitis-related deaths were comparable in the two groups. CONCLUSIONS Biocompatible PD fluid use was associated with a broad reduction in gram-positive, gram-negative, and culture-negative peritonitis that reached statistical significance for non-pseudomonal gram-negative organisms. Peritonitis hospitalization duration was shorter, and peritonitis severity was more commonly rated as mild in patients receiving biocompatible PD fluids, although other peritonitis outcomes were comparable between the groups.
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Affiliation(s)
- David W Johnson
- Department of Nephrology, University of Queensland, Brisbane, Australia.
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Gilbert RE, Zhang Y, Williams SJ, Zammit SC, Stapleton DI, Cox AJ, Krum H, Langham R, Kelly DJ. A purpose-synthesised anti-fibrotic agent attenuates experimental kidney diseases in the rat. PLoS One 2012; 7:e47160. [PMID: 23071743 PMCID: PMC3468513 DOI: 10.1371/journal.pone.0047160] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 09/10/2012] [Indexed: 11/18/2022] Open
Abstract
Background and Purpose Locally-active growth factors have been implicated in the pathogenesis of many diseases in which organ fibrosis is a characteristic feature. In the setting of chronic kidney disease (CKD), two such pro-fibrotic factors, transforming growth factor-ß (TGF-ß) and platelet-derived growth factor (PDGF) have emerged as lead potential targets for intervention. Given the incomplete organ protection afforded by blocking the actions of TGF-ß or PDGF individually, we sought to determine whether an agent that inhibited the actions of both may have broader effects in ameliorating the key structural and functional abnormalities of CKD. Experimental Approach Accordingly, we studied the effects of a recently described, small molecule anti-fibrotic drug, 3-methoxy-4-propargyloxycinnamoyl anthranilate (FT011, Fibrotech Therapeutics, Australia), which should have these effects. Key Results In the in vitro setting, FT011 inhibited both TGF-ß1 and PDGF-BB induced collagen production as well as PDGF-BB-mediated mesangial proliferation. Consistent with these in vitro actions, when studied in a robust model of non-diabetic kidney disease, the 5/6 nephrectomised rat, FT011 attenuated the decline in GFR, proteinuria and glomerulosclerosis (p<0.05 for all). Similarly, in the streptozotocin-diabetic Ren-2 rat, a model of advanced diabetic nephropathy, FT011 reduced albuminuria, glomerulosclerosis and tubulointerstitial fibrosis. Conclusions and Implications Together these studies suggest that broadly antagonising growth factor actions, including those of TGF-ß1 and PDGF-BB, has the potential to protect the kidney from progressive injury in both the diabetic and non-diabetic settings.
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Affiliation(s)
- Richard E. Gilbert
- Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
- * E-mail: (REG); (DJK)
| | - Yuan Zhang
- Department of Medicine, University of Melbourne, St. Vincent’s Hospital, Fitzroy, Victoria, Australia
| | - Spencer J. Williams
- Bio21 Molecular Science and Biotechnology Institute, School of Chemistry, University of Melbourne, Parkville, Victoria, Australia
| | - Steven C. Zammit
- Bio21 Molecular Science and Biotechnology Institute, School of Chemistry, University of Melbourne, Parkville, Victoria, Australia
| | - David I. Stapleton
- Department of Physiology, University of Melbourne, Parkville, Victoria, Australia
| | - Alison J. Cox
- Department of Medicine, University of Melbourne, St. Vincent’s Hospital, Fitzroy, Victoria, Australia
| | - Henry Krum
- Centre of Cardiovascular Research and Education in Therapeutics, School of Public Health, Monash University, Melbourne, Australia
| | - Robyn Langham
- Department of Medicine, University of Melbourne, St. Vincent’s Hospital, Fitzroy, Victoria, Australia
| | - Darren J. Kelly
- Department of Medicine, University of Melbourne, St. Vincent’s Hospital, Fitzroy, Victoria, Australia
- Fibrotech Therapeutics Pty Ltd, Melbourne, Australia
- * E-mail: (REG); (DJK)
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Johnson DW, Brown FG, Clarke M, Boudville N, Elias TJ, Foo MWY, Jones B, Kulkarni H, Langham R, Ranganathan D, Schollum J, Suranyi MG, Tan SH, Voss D. The effect of low glucose degradation product, neutral pH versus standard peritoneal dialysis solutions on peritoneal membrane function: the balANZ trial. Nephrol Dial Transplant 2012; 27:4445-53. [PMID: 22859794 PMCID: PMC3520083 DOI: 10.1093/ndt/gfs314] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background The balANZ trial recently reported that neutral pH, low glucose degradation product (biocompatible) peritoneal dialysis (PD) solutions significantly delayed anuria and reduced peritonitis rates compared with conventional solutions. This article reports a secondary outcome analysis of the balANZ trial with respect to peritoneal membrane function. Methods Adult, incident PD patients with residual renal function were randomized to receive either biocompatible or conventional (control) PD solutions for 2 years. Peritoneal equilibration tests were performed at 1, 6, 12, 18 and 24 months. Peritoneal small solute clearances and ultra-filtration (UF) were measured at 3, 6, 9, 12, 18 and 24 months. Results Of the 185 patients recruited into the trial, 85 patients in the Balance group and 82 patients in the control group had peritoneal membrane function evaluated. Mean 4-h dialysate:plasma creatinine ratios (D:P Cr 4h) at 1 month were significantly higher in the Balance group compared with controls (0.67 ± 0.10 versus 0.62 ± 0.10, P = 0.002). Over the 2-year study period, mean D:P Cr 4 h measurements remained stable in the Balance group but increased significantly in controls [difference −0.004 per month, 95% confidence interval (95% CI) −0.005 to −0.002, P < 0.001]. Similar results were obtained for dialysate glucose ratios (D/D0 glucose). Peritoneal UF was significantly lower in the Balance group than in controls at 3 and 6 months. Over the 2-year study period, peritoneal UF increased significantly in the Balance group but remained stable in controls (difference 24 mL/day/month, 95% CI 9–39, P = 0.002). No differences in peritoneal small solute clearances, prescribed dialysate fill volumes or peritoneal glucose exposure were observed between the two groups. Conclusions Biocompatible and conventional PD solutions exert differential effects on peritoneal small solute transport rate and UF over time. Adequately powered trials assessing the impact of these differential membrane effects on PD technique and patient survival rates are warranted.
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Affiliation(s)
- David W Johnson
- Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia.
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Johnson DW, Brown FG, Clarke M, Boudville N, Elias TJ, Foo MWY, Jones B, Kulkarni H, Langham R, Ranganathan D, Schollum J, Suranyi M, Tan SH, Voss D. Effects of biocompatible versus standard fluid on peritoneal dialysis outcomes. J Am Soc Nephrol 2012; 23:1097-107. [PMID: 22440906 DOI: 10.1681/asn.2011121201] [Citation(s) in RCA: 161] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The clinical benefits of using "biocompatible" neutral pH solutions containing low levels of glucose degradation products for peritoneal dialysis compared with standard solutions are uncertain. In this multicenter, open-label, parallel-group, randomized controlled trial, we randomly assigned 185 incident adult peritoneal dialysis patients with residual renal function to use either biocompatible or conventional solution for 2 years. The primary outcome measure was slope of renal function decline. Secondary outcome measures comprised time to anuria, fluid volume status, peritonitis-free survival, technique survival, patient survival, and adverse events. We did not detect a statistically significant difference in the rate of decline of renal function between the two groups as measured by the slopes of GFR: -0.22 and -0.28 ml/min per 1.73 m(2) per month (P=0.17) in the first year in the biocompatible and conventional groups, respectively, and, -0.09 and -0.10 ml/min per 1.73 m(2) per month (P=0.9) in the second year. The biocompatible group exhibited significantly longer times to anuria (P=0.009) and to the first peritonitis episode (P=0.01). This group also had fewer patients develop peritonitis (30% versus 49%) and had lower rates of peritonitis (0.30 versus 0.49 episodes per year, P=0.01). In conclusion, this trial does not support a role for biocompatible fluid in slowing the rate of GFR decline, but it does suggest that biocompatible fluid may delay the onset of anuria and reduce the incidence of peritonitis compared with conventional fluid in peritoneal dialysis.
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Affiliation(s)
- David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane, QLD 4102, Australia.
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Li PKT, Chow KM, Matsuo S, Yang CW, Jha V, Becker G, Chen N, Sharma SK, Chittinandana A, Chowdhury S, Harris DCH, Hooi LS, Imai E, Kim S, Kim SG, Langham R, Padilla BS, Teo BW, Togtokh A, Walker RG, Wang HY, Tsukamoto Y. Asian chronic kidney disease best practice recommendations: positional statements for early detection of chronic kidney disease from Asian Forum for Chronic Kidney Disease Initiatives (AFCKDI). Nephrology (Carlton) 2012; 16:633-41. [PMID: 21771177 DOI: 10.1111/j.1440-1797.2011.01503.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Philip Kam-Tao Li
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
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Guymer RH, Tao LW, Goh JK, Liew D, Ischenko O, Robman LD, Aung K, Cipriani T, Cain M, Richardson AJ, Baird PN, Langham R. Identification of Urinary Biomarkers for Age-Related Macular Degeneration. ACTA ACUST UNITED AC 2011; 52:4639-44. [DOI: 10.1167/iovs.10-7120] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Robyn H. Guymer
- From the Centre for Eye Research Australia (CERA), University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Lingwei W. Tao
- From the Centre for Eye Research Australia (CERA), University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Jonathan K. Goh
- From the Centre for Eye Research Australia (CERA), University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Danny Liew
- the Department of Medicine, University of Melbourne, Royal Melbourne Hospital, Melbourne, Victoria, Australia; and
| | - Olga Ischenko
- the Department of Nephrology, St. Vincent's Hospital, Melbourne, Fitzroy, Victoria, Australia
| | - Liubov D. Robman
- From the Centre for Eye Research Australia (CERA), University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - KhinZaw Aung
- From the Centre for Eye Research Australia (CERA), University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Tania Cipriani
- From the Centre for Eye Research Australia (CERA), University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Melinda Cain
- From the Centre for Eye Research Australia (CERA), University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Andrea J. Richardson
- From the Centre for Eye Research Australia (CERA), University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Paul N. Baird
- From the Centre for Eye Research Australia (CERA), University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Robyn Langham
- the Department of Nephrology, St. Vincent's Hospital, Melbourne, Fitzroy, Victoria, Australia
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Locsey L, Seres I, Sztanek F, Harangi M, Padra J, Asztalos L, Paragh G, Hutchison CA, Bevins A, Langham R, Mancini E, Wirta O, Cockwell P, Hutchison CA, Keir R, Vigano M, Stella A, Evans N, Chappell M, Cockwell P, Fabbrini P, Onuigbo M, Onuigbo N, Onuigbo M, Kim S, Chang JH, Jung JY, Lee HH, Chung W, Zanoli L, Rastelli S, Marcantoni C, Tamburino C, Castellino P, Cho A, Choi H, Lee JE, Jang HR, Huh W, Kim YG, Kim DJ, Oh HY, Zanoli L, Rastelli S, Marcantoni C, Tamburino C, Castellino P, Garcia-Fernandez N, Martin-Moreno PL, Varo N, Nunez-Cordoba JM, Schlieper G, Kruger T, Kelm M, Floege J, Westenfeld R, Choi H, Cho AJ, Jang HR, Lee JE, Huh W, Kim YG, Oh HY, Kim DJ, Doganay S, Oguz AK, Ergun I, Bardachenko N, Kuryata O, Bardachenko L, Garcia-Fernandez N, Martin-Moreno PL, Varo N, Nunez-Cordoba JM, Choi H, Cho AJ, Jang HR, Lee JE, Huh W, Kim YG, Oh HY, Kim DJ, Ravani P, Malberti F, Pirelli S, Scolari F, Barrett B, Presta P, Lucisano G, Rubino A, Serraino F, Amoruso T, Renzulli A, Fuiano G, Kielstein JT, Tolk S, Heiden A, Kuhn C, Hoeper MM, Lorenzen J, Broll M, Kaever V, Burhenne H, Hafer C, Haller H, Burkhardt O, Kielstein J, Zahalkova J, Petejova N, Strojil J, Urbanek K, Bertoli S, Musetti C, Cabiati A, Assanelli E, Lauri G, Marana I, De Metrio M, Rubino M, Campodonico J, Grazi M, Moltrasio M, Marenzi G, Unarokov Z, Mukhoedova T, Fidalgo P, Coelho S, Rodrigues B, Fernandes AP, Papoila AL, Liano F, Soto K, Vanmassenhove J, Vanholder R, Glorieux G, Van Biesen W, Challiner R, Ritchie J, Hutchison A, Challiner R, Ritchie J, Hutchison A, Challiner R, Ritchie J, Hutchison A, Zaharie SI, Maria DT, Zaharie M, Vaduva C, Grauntanu C, Cana-Ruiu D, Mota E, Hayer M, Baharani J, Thomas M, Eldehni T, Selby N, McIntyre C, Fluck R, Kolhe N, Fagugli RM, Patera F, Shah PR, Kaswan KK, Kute VB, Vanikar AV, Gumber MR, Patel HV, Munjappa BC, Enginner DP, Sainaresh VV, Trivedi HL, Teixeira C, Nogueira E, Lopes JA, Almeida E, Pais de Lacerda A, Gomes da Costa A, Franca C, Mariano F, Morselli M, Bergamo D, Hollo' Z, Scella S, Maio M, Tetta C, Dellavalle A, Stella M, Triolo G, Cantaluppi V, Quercia AD, Bertinetto P, Giacalone S, Tamagnone M, Basso E, Karvela E, Gai M, Leonardi G, Anania P, Guarena C, Fenocchio CM, Pacitti A, Segoloni GP, Kim YO, Kim HG, Kim BS, Song HCS, Min JK, Kim SY, Park WD, Dalboni M, Narciso R, Quinto M, Grabulosa C, Cruz E, Monte J, Durao M, Cendoroglo M, Santos O, Batista M, Cho A, Choi H, Lee JE, Jang HR, Huh W, Kim YG, Kim DJ, Oh HY, Mancini E, Bellasi A, Giannone S, Mordenti A, Zanoni A, Santoro A, Presta P, Lucisano G, Rubino A, Serraino F, Renzulli A, Fuiano G, Lee JH, Ha SH, Kim JH, Lee GJ, Jung YC, Malindretos P, Koutroumbas G, Patrinou A, Zagkotsis G, Makri P, Togousidis I, Syrganis C, Li Cavoli G, Tortorici C, Bono L, Ferrantelli A, Giammarresi C, Zagarrigo C, Rotolo U, Kim H, Jun K, Choi W, Kim H, Jun K, Choi W, Krzesinski JM, Parotte MC, Vandevelde C, Keenan J, Dieterle F, Sultana S, Pinches M, Ciorciaro C, Schindler R, Schmitz V, Gautier JC, Benain X, Matchem J, Murray P, Adler S, Haase M, Haase-Fielitz A, Devarajan P, Bellomo R, Cruz DN, Wagener G, Krawczeski CD, Koyner JL, Murray PT, Zappitelli M, Goldstein S, Makris K, Ronco C, Martensson J, Martling CR, Venge P, Siew E, Ware LB, Ikizler A, Mertens PR, Lacquaniti A, Buemi A, Donato V, Lucisano S, Buemi M, Vanmassenhove J, Vanholder R, Glorieux G, Van Biesen W, Panagoutsos S, Kriki P, Mourvati E, Tziakas D, Chalikias G, Stakos D, Apostolakis S, Tsigalou C, Gioka T, Konstantinides S, Vargemezis V, Torregrosa I, Montoliu C, Urios A, Aguado C, Puchades MJ, Solis MA, Juan I, Sanjuan R, Blasco M, Pineda J, Carratala A, Ramos C, Miguel A, Niculae A, Checherita IA, Sandulovici R, David C, Ciocalteu A, Espinoza M, Hidalgo J, Lorca E, Santibanez A, Arancibia F, Gonzalez F, Park MY, Kim EJ, Choi SJ, Kim JK, Hwang SD, Lee KH, Seok SJ, Yang JO, Lee EY, Hong SY, Gil HW, Astapenko E, Shutov A, Savinova G, Rechnik V, Melo MJ, Lopes JA, Raimundo M, Viegas A, Camara I, Antunes F, Kim MJ, Kwon SH, Lee SW, Song JH, Lee JW. Acute kidney injury - Human studies. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Chen N, Hsu CC, Yamagata K, Langham R. Challenging chronic kidney disease: experience from chronic kidney disease prevention programs in Shanghai, Japan, Taiwan and Australia. Nephrology (Carlton) 2010; 15 Suppl 2:31-6. [PMID: 20586945 DOI: 10.1111/j.1440-1797.2010.01309.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Chronic kidney disease (CKD) is now a global health problem. One important strategy to prevent and manage CKD is to offer a prevention program which could detect CKD early as well as raise awareness of the disease. In Shanghai, a community-based study demonstrated that the prevalence of CKD was high while awareness was low. The results from Shanghai urged the necessity of a screening and prevention program of CKD. In Japan, the urinalysis screening system was established to early diagnose and prevent CKD. Due to modification of lifestyle and prevalence of diabetes, urine dip-stick test for microalbuminuria might be necessary in adults while screening for proteinuria and haematuria are necessary for students and young adults. In Taiwan, two CKD programs - a CKD care program and diabetic share care program - were initiated. The cost-effectiveness study indicated that both programs could reduce end-stage renal disease (ESRD) burden in Taiwan because integrated pre-ESRD care was important for patients with CKD stage 4 and stage 5 while a diabetic shared care program was cost-effective to prevent nephropathy to patients with diabetic mellitus. In Australia, studies demonstrated that screening of high-risk individuals as well as promoting awareness were cost-effective to early detection of CKD. Furthermore, opportunistic screening with emphasis on early detection was effective in CKD prevention. The studies from those regions share experiences on early prevention and management of CKD.
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Affiliation(s)
- Nan Chen
- Department of Nephrology, Ruijin Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China.
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Abstract
BACKGROUND Peritonitis has a significant impact upon morbidity and mortality of peritoneal dialysis (PD) patients. Gram-positive organisms account for the majority of infections and vancomycin is a cost effective broad-spectrum antimicrobial treatment for PD peritonitis, but this may lead to the emergence of multiple antibiotic-resistant organisms. The purpose of the present paper was to evaluate the efficacy of a non-vancomycin-based protocol comprising cephazolin and gentamicin, which was introduced in the present PD population as empirical treatment for peritonitis. METHODS The study involved 82 peritonitis episodes over a 4-year period in 58 patients, excluding those with previous methicillin-resistant staphylococcal peritonitis. RESULTS With cephazolin and gentamicin there was no apparent difference in response or relapse rates in comparison to reported studies using vancomycin-based first-line therapy protocols. CONCLUSION We advocate initial treatment of PD peritonitis with non-vancomycin-based therapy given similar efficacy and the potential for reduction of resistant organisms.
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Affiliation(s)
- Nigel Toussaint
- Department of Nephrology, St Vincent's Hospital, Melbourne, Victoria, Australia.
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Toussaint N, Goodman D, Langham R, Gock H, Hill P. Haemorrhagic Campylobacter jejuni and CMV colitis in a renal transplant recipient. Nephrol Dial Transplant 2005; 20:823-6. [PMID: 15772269 DOI: 10.1093/ndt/gfh687] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Nigel Toussaint
- Department of Nephrology, St. Vincent's Hospital, PO Box 2900, Fitzroy, Victoria 3065, Australia.
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Cho MJ, Yano H, Okamoto D, Kim HK, Jung HR, Newcomb K, Le VK, Yoo HS, Langham R, Buchanan BB, Lemaux PG. Stable transformation of rice (Oryza sativa L.) via microprojectile bombardment of highly regenerative, green tissues derived from mature seed. Plant Cell Rep 2004; 22:483-489. [PMID: 14551731 DOI: 10.1007/s00299-003-0713-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2003] [Revised: 08/05/2003] [Accepted: 08/18/2003] [Indexed: 05/24/2023]
Abstract
A highly efficient and reproducible transformation system for rice ( Oryza sativa L. cv. Taipei 309) was developed using microprojectile bombardment of highly regenerative, green tissues. These tissues were induced from mature seeds on NB-based medium containing 2,4-dichlorophenoxyacetic acid (2,4-D), 6-benzylaminopurine (BAP) and high concentrations of cupric sulfate under dim light conditions; germinating shoots and roots were completely removed. Highly regenerative, green tissues were proliferated on the same medium and used as transformation targets. From 431 explants bombarded with transgenes [i.e. a hygromycin phosphotransferase ( hpt) gene plus one of a wheat thioredoxin h ( wtrxh), a barley NADP-thioredoxin reductase ( bntr), a maize Mutator transposable element ( mudrB) or beta-glucuronidase ( uidA; gus) gene], 28 independent transgenic events were obtained after an 8- to 12-week selection period, giving a 6.5% transformation frequency. Of the 28 independent events, 17 (61%) were regenerable. Co-transformation of the second introduced transgene was detected in 81% of the transgenic lines tested. Stable integration and expression of the foreign genes in T(0) plants and T(1) progeny were confirmed by DNA hybridization, western blot analyses and germination tests.
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Affiliation(s)
- M-J Cho
- Department of Plant and Microbial Biology, University of California, Berkeley 94720, USA.
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Kelly DJ, Aaltonen P, Cox AJ, Rumble JR, Langham R, Panagiotopoulos S, Jerums G, Holthöfer H, Gilbert RE. Expression of the slit-diaphragm protein, nephrin, in experimental diabetic nephropathy: differing effects of anti-proteinuric therapies. Nephrol Dial Transplant 2002; 17:1327-32. [PMID: 12105259 DOI: 10.1093/ndt/17.7.1327] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.1] [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: 11/13/2022] Open
Abstract
BACKGROUND Mutations in the gene coding for the podocyte slit-pore membrane protein, nephrin, are responsible for the Finnish-type congenital nephrotic syndrome. The present study sought to examine whether nephrin expression may also be altered in experimental diabetes, and how such changes related to the development of proteinuria. In addition, the study also sought to examine nephrin expression in animals treated with different anti-proteinuric therapies. METHODS Nephrin gene expression and localization were examined in rats with streptozotocin-induced diabetes at 6 months duration (proteinuric phase) and at 7 days (pre-proteinuric phase). In addition, the effects of anti-proteinuric drug therapies were also assessed in long-term diabetic rats, treated with either the angiotensin-converting enzyme inhibitor perindopril, or the blocker of advanced glycation end-product formation, aminoguanidine. Nephrin expression was determined using quantitative real-time PCR and in situ hybridization. RESULTS When compared with control animals, nephrin expression was reduced in the late proteinuric phase (45% reduction vs controls, P<0.01) but not in the early, pre-proteinuric phase of experimental diabetic nephropathy. While ACE inhibition and aminoguanidine both reduced proteinuria, only the former attenuated the diabetes-associated reduction in nephrin expression. CONCLUSIONS These findings suggests that reduction in nephrin may be a determinant of glomerular hyperpermeability in diabetic nephropathy. Attenuation of these changes with ACE inhibition suggest that this mechanism may contribute to the anti-proteinuric effects of this, but not all classes of drug which reduce urinary protein in diabetic nephropathy.
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Affiliation(s)
- Darren J Kelly
- University of Melbourne Department of Medicine at St Vincent's Hospital, Fitzroy, Victoria, Australia
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Langham R, Dowling J, Gilbert R, Thomson N. TRANSFORMING GROWTH FACTOR-beta1 (TGF-beta1) GENE EXPRESSION AND ACTIVATION IN THE PATHOGENESIS OF FIBROSIS IN PROTEINURIC RENAL DISEASE IN HUMANS. Nephrology (Carlton) 2002. [DOI: 10.1046/j.1440-1797.2002.00007-1-6.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Langham R. Developing cost-efficient information systems for small hospitals. Healthc Financ Manage 1988; 42:64-7. [PMID: 10288883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
It has been said that the small hospital cannot afford or easily maintain the information systems needed for efficient management. However, Northern Dutchess Hospital, a small institution located in Rhinebeck N.Y., has developed a cost-efficient and effective case-based information system that adequately handles their management needs. By using existing hardware and integrating software that could be easily inter-connected, the hospital created a basic system design without the need for huge financial and personnel investments.
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