Browsing by Subject "Australia"

Now showing 1 - 11 of 11
  • Thumbnail Image
    ItemOpen Access
    A Comprehensive National Ocean Policy: America's Next Step?
    (2005) Gove, Matt
    Historically, ocean governance has been sectoral in nature: different levels and sectors of government divide responsibility for ocean issues among them. In 1998, Australia released Australia’s Oceans Policy, the first comprehensive national ocean policy statement in the world. This policy framework addresses every level and sector of Australian ocean governance. Since then, other nations have joined Australia in unifying and clarifying their ocean governance. The U.S. may be next. Two reports, the Pew Oceans Commission and the U.S. Commission on Ocean Policy, recommend sweeping overhauls to U.S. oceans governance, including the creation of a comprehensive national ocean policy. Released within the last two years, these reports have caught the attention of legislators. I examined and compared the creation and implementation of other nation’s comprehensive national ocean policies, gaining insights into the composition of a successful policy. I recommend, among other things, that the U.S. pass an integrated, fully encompassing, authoritative, and binding National Ocean Policy Act.
  • Thumbnail Image
    ItemOpen Access
    An Analysis of Water Management Strategies in Drought Prone Areas
    (2018-04-26) Vogel, Sarah
    There is an old adage in the West: “whiskey is for drinking; water is for fighting”. In the American West, as well as locales all over the globe, water scarcity is a subject rife with conflicts and emotion. Human beings approach drought in reactionary ways. Rather than plan for the eventuality of drought, societies enact drought policy or regulations well into, and not before experiencing drought conditions. Researchers have predicted that more than half of humanity will live in water-stressed areas in the near future. Understanding the significant role drought plays in water management and the costs of reactionary decision making can help stakeholders create proactive approaches to water allocation. This paper seeks to understand how drought affects water management strategies; how regulation is affected by drought conditions; how local agencies and state authorities interact to manage water resources in California; and how California water management compares to water management strategies employed in other drought prone areas of the globe.
  • Thumbnail Image
    ItemOpen Access
    Anti-cholinergic load, health care utilization, and survival in people with advanced cancer: a pilot study.
    (J Palliat Med, 2010-06) Agar, Meera; To, Timothy; Plummer, John; Abernethy, Amy; Currow, David
    INTRODUCTION: Anti-cholinergic medications have been associated with increased risks of cognitive impairment, premature mortality and increased risk of hospitalisation. Anti-cholinergic load associated with medication increases as death approaches in those with advanced cancer, yet little is known about associated adverse outcomes in this setting. METHODS: A substudy of 112 participants in a randomised control trial who had cancer and an Australia modified Karnofsky Performance Scale (AKPS) score (AKPS) of 60 or above, explored survival and health service utilisation; with anti-cholinergic load calculated using the Clinician Rated Anti-cholinergic Scale (modified version) longitudinally to death. A standardised starting point for prospectively calculating survival was an AKPS of 60 or above. RESULTS: Baseline entry to the sub-study was a mean 62 +/- 81 days (median 37, range 1-588) days before death (survival), with mean of 4.8 (median 3, SD 4.18, range 1 - 24) study assessments in this time period. Participants spent 22% of time as an inpatient. There was no significant association between anti-cholinergic score and time spent as an inpatient (adjusted for survival time) (p = 0.94); or survival time. DISCUSSION: No association between anti-cholinergic load and survival or time spent as an inpatient was seen. Future studies need to include cognitively impaired populations where the risks of symptomatic deterioration may be more substantial.
  • Thumbnail Image
    ItemRestricted
    Application description and policy model in collaborative environment for sharing of information on epidemiological and clinical research data sets.
    (PLoS One, 2010-02-19) de Carvalho, EC; Batilana, AP; Simkins, J; Martins, H; Shah, J; Rajgor, D; Shah, A; Rockart, S; Pietrobon, R
    BACKGROUND: Sharing of epidemiological and clinical data sets among researchers is poor at best, in detriment of science and community at large. The purpose of this paper is therefore to (1) describe a novel Web application designed to share information on study data sets focusing on epidemiological clinical research in a collaborative environment and (2) create a policy model placing this collaborative environment into the current scientific social context. METHODOLOGY: The Database of Databases application was developed based on feedback from epidemiologists and clinical researchers requiring a Web-based platform that would allow for sharing of information about epidemiological and clinical study data sets in a collaborative environment. This platform should ensure that researchers can modify the information. A Model-based predictions of number of publications and funding resulting from combinations of different policy implementation strategies (for metadata and data sharing) were generated using System Dynamics modeling. PRINCIPAL FINDINGS: The application allows researchers to easily upload information about clinical study data sets, which is searchable and modifiable by other users in a wiki environment. All modifications are filtered by the database principal investigator in order to maintain quality control. The application has been extensively tested and currently contains 130 clinical study data sets from the United States, Australia, China and Singapore. Model results indicated that any policy implementation would be better than the current strategy, that metadata sharing is better than data-sharing, and that combined policies achieve the best results in terms of publications. CONCLUSIONS: Based on our empirical observations and resulting model, the social network environment surrounding the application can assist epidemiologists and clinical researchers contribute and search for metadata in a collaborative environment, thus potentially facilitating collaboration efforts among research communities distributed around the globe.
  • Thumbnail Image
    ItemOpen Access
    CAMERA2 - combination antibiotic therapy for methicillin-resistant Staphylococcus aureus infection: study protocol for a randomised controlled trial.
    (Trials, 2016-03-31) Tong, Steven YC; Nelson, Jane; Paterson, David L; Fowler, Vance G; Howden, Benjamin P; Cheng, Allen C; Chatfield, Mark; Lipman, Jeffrey; Van Hal, Sebastian; O'Sullivan, Matthew; Robinson, James O; Yahav, Dafna; Lye, David; Davis, Joshua S; CAMERA2 study group and the Australasian Society for Infectious Diseases Clinical Research Network
    BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia is a serious infection resulting in 20-50 % 90-day mortality. The limitations of vancomycin, the current standard therapy for MRSA, make treatment difficult. The only other approved drug for treatment of MRSA bacteraemia, daptomycin, has not been shown to be superior to vancomycin. Surprisingly, there has been consistent in-vitro and in-vivo laboratory data demonstrating synergy between vancomycin or daptomycin and an anti-staphylococcal β-lactam antibiotic. There is also growing clinical data to support such combinations, including a recent pilot randomised controlled trial (RCT) that demonstrated a trend towards a reduction in the duration of bacteraemia in patients treated with vancomycin plus flucloxacillin compared to vancomycin alone. Our aim is to determine whether the addition of an anti-staphylococcal penicillin to standard therapy results in improved clinical outcomes in MRSA bacteraemia. METHODS/DESIGN: We will perform an open-label, parallel-group, randomised (1:1) controlled trial at 29 sites in Australia, New Zealand, Singapore, and Israel. Adults (aged 18 years or older) with MRSA grown from at least one blood culture and able to be randomised within 72 hours of the index blood culture collection will be eligible for inclusion. Participants will be randomised to vancomycin or daptomycin (standard therapy) given intravenously or to standard therapy plus 7 days of an anti-staphylococcal β-lactam (flucloxacillin, cloxacillin, or cefazolin). The primary endpoint will be a composite outcome at 90 days of (1) all-cause mortality, (2) persistent bacteraemia at day 5 or beyond, (3) microbiological relapse, or (4) microbiological treatment failure. The recruitment target of 440 patients is based on an expected failure rate for the primary outcome of 30 % in the control arm and the ability to detect a clinically meaningful absolute decrease of 12.5 %, with a two-sided alpha of 0.05, a power of 80 %, and assuming 10 % of patients will not be evaluable for the primary endpoint. DISCUSSION: Key potential advantages of adding anti-staphylococcal β-lactams to standard therapy for MRSA bacteraemia include their safety profile, low cost, and wide availability. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02365493 . Registered 24 February 2015.
  • Thumbnail Image
    ItemOpen Access
    Meta-analysis of genome-wide association studies identifies common variants in CTNNA2 associated with excitement-seeking.
    (Translational psychiatry, 2011-10-18) Terracciano, A; Esko, T; Sutin, AR; de Moor, MHM; Meirelles, O; Zhu, G; Tanaka, T; Giegling, I; Nutile, T; Realo, A; Allik, J; Hansell, NK; Wright, MJ; Montgomery, GW; Willemsen, G; Hottenga, J-J; Friedl, M; Ruggiero, D; Sorice, R; Sanna, S; Cannas, A; Räikkönen, K; Widen, E; Palotie, A; Eriksson, JG; Cucca, F; Krueger, RF; Lahti, J; Luciano, M; Smoller, JW; van Duijn, CM; Abecasis, GR; Boomsma, DI; Ciullo, M; Costa, PT; Ferrucci, L; Martin, NG; Metspalu, A; Rujescu, D; Schlessinger, D; Uda, M
    The tendency to seek stimulating activities and intense sensations define excitement-seeking, a personality trait akin to some aspects of sensation-seeking. This trait is a central feature of extraversion and is a component of the multifaceted impulsivity construct. Those who score high on measures of excitement-seeking are more likely to smoke, use other drugs, gamble, drive recklessly, have unsafe/unprotected sex and engage in other risky behaviors of clinical and social relevance. To identify common genetic variants associated with the Excitement-Seeking scale of the Revised NEO Personality Inventory, we performed genome-wide association studies in six samples of European ancestry (N=7860), and combined the results in a meta-analysis. We identified a genome-wide significant association between the Excitement-Seeking scale and rs7600563 (P=2 × 10(-8)). This single-nucleotide polymorphism maps within the catenin cadherin-associated protein, alpha 2 (CTNNA2) gene, which encodes for a brain-expressed α-catenin critical for synaptic contact. The effect of rs7600563 was in the same direction in all six samples, but did not replicate in additional samples (N=5105). The results provide insight into the genetics of excitement-seeking and risk-taking, and are relevant to hyperactivity, substance use, antisocial and bipolar disorders.
  • Thumbnail Image
    ItemOpen Access
    Not published, not indexed: issues in generating and finding hospice and palliative care literature.
    (J Palliat Med, 2010-06) Tieman, Jennifer J; Abernethy, Amy; Currow, David C
    INTRODUCTION: Accessing new knowledge as the evidence base for hospice and palliative care grows has specific challenges for the discipline. This study aimed to describe conversion rates of palliative and hospice care conference abstracts to journal articles and to highlight that some palliative care literature may not be retrievable because it is not indexed on bibliographic databases. METHODS: Substudy A tracked the journal publication of conference abstracts selected for inclusion in a gray literature database on www.caresearch.com.au . Abstracts were included in the gray literature database following handsearching of proceedings of over 100 Australian conferences likely to have some hospice or palliative care content that were held between 1980 and 1999. Substudy B looked at indexing from first publication until 2001 of three international hospice and palliative care journals in four widely available bibliographic databases through systematic tracing of all original papers in the journals. RESULTS: Substudy A showed that for the 1338 abstracts identified only 15.9% were published (compared to an average in health of 45%). Published abstracts were found in 78 different journals. Multiauthor abstracts and oral presentations had higher rates of conversion. Substudy B demonstrated lag time between first publication and bibliographic indexing. Even after listing, idiosyncratic noninclusions were identified. DISCUSSION: There are limitations to retrieval of all possible literature through electronic searching of bibliographic databases. Encouraging publication in indexed journals of studies presented at conferences, promoting selection of palliative care journals for database indexing, and searching more than one bibliographic database will improve the accessibility of existing and new knowledge in hospice and palliative care.
  • Thumbnail Image
    ItemOpen Access
    Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients.
    (Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019-04) Di Pasquale, Marta Francesca; Sotgiu, Giovanni; Gramegna, Andrea; Gramegna, Andrea; Radovanovic, Dejan; Terraneo, Silvia; Reyes, Luis F; Rupp, Jan; González Del Castillo, Juan; Blasi, Francesco; Aliberti, Stefano; Restrepo, Marcos I; GLIMP Investigators

    Background

    The correct management of immunocompromised patients with pneumonia is debated. We evaluated the prevalence, risk factors, and characteristics of immunocompromised patients coming from the community with pneumonia.

    Methods

    We conducted a secondary analysis of an international, multicenter study enrolling adult patients coming from the community with pneumonia and hospitalized in 222 hospitals in 54 countries worldwide. Risk factors for immunocompromise included AIDS, aplastic anemia, asplenia, hematological cancer, chemotherapy, neutropenia, biological drug use, lung transplantation, chronic steroid use, and solid tumor.

    Results

    At least 1 risk factor for immunocompromise was recorded in 18% of the 3702 patients enrolled. The prevalences of risk factors significantly differed across continents and countries, with chronic steroid use (45%), hematological cancer (25%), and chemotherapy (22%) the most common. Among immunocompromised patients, community-acquired pneumonia (CAP) pathogens were the most frequently identified, and prevalences did not differ from those in immunocompetent patients. Risk factors for immunocompromise were independently associated with neither Pseudomonas aeruginosa nor non-community-acquired bacteria. Specific risk factors were independently associated with fungal infections (odds ratio for AIDS and hematological cancer, 15.10 and 4.65, respectively; both P = .001), mycobacterial infections (AIDS; P = .006), and viral infections other than influenza (hematological cancer, 5.49; P < .001).

    Conclusions

    Our findings could be considered by clinicians in prescribing empiric antibiotic therapy for CAP in immunocompromised patients. Patients with AIDS and hematological cancer admitted with CAP may have higher prevalences of fungi, mycobacteria, and noninfluenza viruses.
  • Thumbnail Image
    ItemUnknown
    Public goods and procreation.
    (Monash Bioeth Rev, 2014-09) Anomaly, Jonathan
    Procreation is the ultimate public goods problem. Each new child affects the welfare of many other people, and some (but not all) children produce uncompensated value that future people will enjoy. This essay addresses challenges that arise if we think of procreation and parenting as public goods. These include whether individual choices are likely to lead to a socially desirable outcome, and whether changes in laws, social norms, or access to genetic engineering and embryo selection might improve the aggregate outcome of our reproductive choices.
  • Thumbnail Image
    ItemUnknown
    Relevant Journals for Identifying Implementation Science Articles: Results of an International Implementation Science Expert Survey.
    (Frontiers in public health, 2021-01) Mielke, Juliane; Brunkert, Thekla; Zullig, Leah L; Bosworth, Hayden B; Deschodt, Mieke; Simon, Michael; De Geest, Sabina
    In implementation science (IS), conducting well-targeted and reproducible literature searches is challenging due to non-specific and varying terminology that is fragmented over multiple disciplines. A list of journals that publish IS-relevant content for use in search strings can support this process. We conducted a cross-sectional online survey of 56 Australian, European, and North American IS experts to identify and prioritize relevant journals that publish IS articles. Journals' relevance was assessed by providing each with a list of 12 journals, to which they were encouraged to add additional journal names and comments as free text. We also assessed which journals had published special IS-focused issues-identified via PubMed and Google searches-over the last 20 years. Data were analyzed descriptively. Between February 28 and March 15, 2020, a purposive sample of 34/56 experts participated in the survey (response rate: 60.7%). Implementation Science and BMC Health Services Research were perceived as relevant by 97.1% of participants; other journals' relevance varied internationally. Experts proposed 50 additional journals from various clinical fields and health science disciplines. We identified 12 calls and 53 special issues on IS published within various journals and research fields. Experts' comments confirmed the described challenges in identifying IS literature. This report presents experts' ratings of IS journals, which can be included in strategies supporting searches of IS evidence. However, challenges in identifying IS evidence remain geographically and interdisciplinary. Further investment is needed to develop reproducible search strings to capture IS evidence as an important step in improving IS research quality.
  • Thumbnail Image
    ItemUnknown
    Using metapopulation theory for practical conservation of mangrove endemic birds.
    (Conservation biology : the journal of the Society for Conservation Biology, 2020-02) Huang, Ryan; Pimm, Stuart L; Giri, Chandra
    As a landscape becomes increasingly fragmented through habitat loss, the individual patches become smaller and more isolated and thus less likely to sustain a local population. Metapopulation theory is appropriate for analyzing fragmented landscapes because it combines empirical landscape features with species-specific information to produce direct information on population extinction risks. This approach contrasts with descriptions of habitat fragments, which provide only indirect information on risk. Combining a spatially explicit metapopulation model with empirical data on endemic species' ranges and maps of habitat cover, we calculated the metapopulation capacity-a measure of a landscape's ability to sustain a metapopulation. Mangroves provide an ideal model landscape because they are of conservation concern and their patch boundaries are easily delineated. For 2000-20015, we calculated global metapopulation capacity for 99 metapopulations of 32 different bird species endemic to mangroves. Northern Australia and Southeast Asia had the highest richness of mangrove endemic birds. The Caribbean, Pacific coast of Central America, Madagascar, Borneo, and isolated patches in Southeast Asia in Myanmar and Malaysia had the highest metapopulation losses. Regions with the highest loss of habitat area were not necessarily those with the highest loss of metapopulation capacity. Often, it was not a matter of how much, but how the habitat was lost. Our method can be used by managers to evaluate and prioritize a landscape for metapopulation persistence.