Mater Hospital Research Articles

Some Thoughts on Methodologies and Practice Research Networks

Australian and New Zealand Journal of Family TherapyVolume 24, Issue 1 p. 51-52 Some Thoughts on Methodologies and Practice Research Networks Alistair Campbell, Alistair Campbell Alistair Campbell: , Research into Practice Co-Ordinator, ANZJFT, is a Senior Psychologist at the Mater Hospital, Brisbane. Email: Alistair_Campbell@mater.org.au.Search for more papers by this author Alistair Campbell, Alistair Campbell Alistair Campbell: , Research into Practice Co-Ordinator, ANZJFT, is a Senior Psychologist at the Mater Hospital, Brisbane. Email: Alistair_Campbell@mater.org.au.Search for more papers by this author First published: 23 July 2013 https://doi.org/10.1002/j.1467-8438.2003.tb00539.xCitations: 7 AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume24, Issue1March 2003Pages 51-52 RelatedInformation

Survival with brain metastases following radiation therapy.

The onset of intracranial metastases is a common development during the course of malignancy. The treatment of these patients represents a significant workload in any radiation oncology department. Much debate has occurred regarding the most appropriate fractionation schedules employed given the perception of limited life expectancy and symptomatic relief following cranial radiation. The aim of this study was to identify the spectrum of primary sites in patients developing intracranial metastases and to assess survival postradiation for the group overall and for selected subgroups. The records of 378 patients undergoing palliative cranial radiation in the years 1993-1998 at Sydney's Mater and Royal North Shore hospitals were analysed retrospectively. Major primary sites were lung (42%), breast (18%), colorectal (9%), melanoma (7%), and unknown primary (7%). Overall median survival post-treatment was 3 months. Lung cancer patients showed a median survival of 6 months, breast 5 months, colorectal 4 months and melanoma 3 months. Long-term survivors were noted with up to 15% of certain groups alive beyond 12 months and 2% alive at 24 months. Multivariate analysis revealed improved survival in patients undergoing resection, and those receiving higher dose radiation justifying a more aggressive approach in selected patients.

Sentinel lymph node biopsy and impalpable breast cancer. A two-year Mater Hospital retrospective

This study highlights the ability of a labelled isotope to accurately identify the nodal status of patients with early breast cancer. However, the presence of two patients with false negative sentinel lymph nodes highlights the necessity to retain axillary clearance as the gold standard axillary staging procedure.

Elderly patients with deliberate self-poisoning treated in an Australian general hospital.

To examine the demographic, prescription, ingestion, and psychiatric diagnostic factors that distinguished elderly from nonelderly patients treated for deliberate self-poisoning (DSP). A prospective case series study of 2,667 patients presenting to a regional referral center for poisoning (Newcastle Mater Hospital, NSW, Australia), January 1991 to July 1998. The sample was stratified into two groups, 65 years or greater (n = 110) and 64 years or less (n = 2,557) at the time of index admission. The groups were compared using a forward stepwise logistic regression model. Uncontrolled comparisons were analyzed by chi-square statistic with Bonferroni-adjusted p values and controlled comparisons by odds ratio (OR) with 95% confidence interval (CI). The elderly group represented 4.1% of the total. The logistic regression analysis found the elderly DSP group was more likely to have a longer length of stay (OR 5.90, CI 3.87-9.00), to have been prescribed "other" drugs (neither benzodiazepines, mood treatment drugs, nor paracetamol) before admission (OR 5.32, CI 3.34-8.48), to have been prescribed benzodiazepines (OR 3.15, CI 2.03-4.89), and to be diagnosed with major depression (OR 2.17, CI 1.41-3.36) than the younger group. The elderly group was less likely to have ingested paracetamol (OR 0.28, CI 0.14-0.54) or "other" drugs (neither benzodiazepines nor mood treatment drugs) in the DSP episode (OR 0.33, CI 0.20-0.54). Elderly DSP patients differ in several important respects from younger patients. They have higher morbidity as a result of the DSP. Major depression plays a more important role. The strong relationship between benzodiazepine prescription and DSP in the elderly raises questions and possible prevention strategies.

Evidence in clinical toxicology: the role of therapeutic drug monitoring.

Department of Clinical Toxicology & Pharmacology, University of Newcastle, Newcastle Mater Hospital, Newcastle, Australia Received August 2, 2001; accepted September 24, 2001. Address correspondence and reprint requests to Ian M. White, Department of Clinical Toxicology & Pharmacology, Newcastle Mater Hospital, Locked Bag 7, Hunter Regional Mail Centre, Newcastle, New South Wales, Australia; E-mail: [email protected]

Assessment of need in patients attending an inner city psychiatric service

AbstractObjectives: The aims of this study were to identify the social and clinical needs of patients attending an inner city psychiatric service, to examine the relationship between need and various demographic and social parameters, and to demonstrate the usefulness of the Camberwell Assessment of Need (CAN) in an Irish population.Methods: A random sample of patients was selected from a census of patients attending the Mater Hospital (Dublin) sector psychiatric service on March 1, 1997 for inclusion in the study. Needs were assessed using the Camberwell Assessment of Need.Results: Fifty-seven patients agreed to participate in the study. The mean number of needs identified by patients was 2.14 (+/− 2.09) and by staff 1.92 (+/−1.18). There was a high level of correlation between staff and patients. The areas where patients most frequently expressed a need were ‘psychological distress’, ‘company’, ‘physical health’, ‘information’ and ‘looking after the home’. Eighteen patients (32%) identified needs that were not being met.Conclusions: This study confirms the usefulness of the Camberwell Assessment of Need in the identification of clinical and social needs in psychiatric populations and demonstrates its usefulness in an Irish population.

Identification of the rectal stump after a Hartmann procedure.

Journal of Surgical OncologyVolume 75, Issue 1 p. 59-59 How I Do It Identification of the rectal stump after a Hartmann procedure Vikas M. Palkar MS, FRCS, Corresponding Author Vikas M. Palkar MS, FRCS [email protected] General and Hepatobiliary Surgery, Mater Hospital, Belfast, United KingdomSpecialist Registrar, General and Hepatobiliary Unit, Mater Hospital, Crumlin Road, Belfast BT14 6AB, United Kingdom. Fax No.: 0044-1232-742903Search for more papers by this author Vikas M. Palkar MS, FRCS, Corresponding Author Vikas M. Palkar MS, FRCS [email protected] General and Hepatobiliary Surgery, Mater Hospital, Belfast, United KingdomSpecialist Registrar, General and Hepatobiliary Unit, Mater Hospital, Crumlin Road, Belfast BT14 6AB, United Kingdom. Fax No.: 0044-1232-742903Search for more papers by this author First published: 03 October 2000 https://doi.org/10.1002/1096-9098(200009)75:1<59::AID-JSO11>3.0.CO;2-6AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume75, Issue1September 2000Pages 59-59 RelatedInformation

An assessment of the needs of oncology outpatients for the development of allied health services.

This article presents the findings of a study that arose out of the desire by the Allied Health Professionals (AHP) at the Mater Hospital, Brisbane, to better understand the needs of their clients in order to be able to offer a more effective and appropriate service. A questionnaire designed specifically to explore the needs of patients and their families for AHP services was administered to consecutive patients (n = 62) attending the Mater out-patient oncology clinic during one month. The findings provide a wealth of practical information for AHPs to use in planning for the effective utilisation of their services, as well as fresh insights into a number of theoretical issues that need further research.

Is there more than one late radiation proctitis syndrome?

Purpose: To investigate the significance of the various late rectal symptoms that appear after radical prostatic irradiation.Patients and methods: Patients with localised prostate cancer treated between 1987 and 1994 at the Mater Hospital, Newcastle with radical megavoltage irradiation were recalled for examination and to complete a detailed questionnaire concerning late radiation-induced symptoms and their effects on normal daily life. The influence of patient age treatment related variables and acute proctitis symptoms occurring during therapy or the late symptoms recorded were assessed and the relationship between late symptoms and late EORTC/RTOG score and impact on normal daily life were studied.Results: The presence of symptoms of acute proctitis was the only factor to predict any of three late symptoms (urgency, frequency and diarrhoea) and late EORTC/RTOG score in this series (odds ratios: 1.7–2.57, P-values: 0.009–0.0007). Cluster and discriminant function analyses revealed the presence of five subgroups of patients with varying permutations of different late rectal symptoms, including one group with minimal symptoms (P<0.0001). While bleeding and rectal discharge were the major contributors to late EORTC/RTOG score (P<0.0001 and 0.04), faecal urgency and bleeding were the most important factors to impact on normal daily life (P<0.0001 and P<0.0003). A relatively low concordance was found between late EORTC/RTOG score and the patients’ self assessment on the effect of their symptoms on their normal daily lives. Some late symptoms, including bleeding and rectal discharge become less prevalent after 3 years of follow-up with a resulting improvement in EORTC/RTOG score.Conclusions: There may be more than one late (chronic) proctitis syndrome which may be linked in greater or lesser degrees to acute proctitis symptoms occurring during therapy. Urgency is a common late symptom which often has an important impact on normal daily life and deserves recognition in late normal tissue scoring systems. Assessment of the incidence of bleeding as a measure of late rectal morbidity following prostate irradiation may underestimate the impact of these chronic effects. Confirmatory studies are necessary.

Review: Topical nonsteroidal anti-inflammatory drugs are effective and safe for pain

TherapeuticsJuly 1, 1998Review: Topical nonsteroidal anti-inflammatory drugs are effective and safe for painDavid Henry, MB, ChBDavid Henry, MB, ChBMater Hospital, Waratah, New South Wales, Australia (D.H.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJC-1998-129-1-010 SectionsAboutFull Text ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookTwitterLinkedInRedditEmail Source CitationMoore RA, Tramèr MR, Carroll D, Wiffen PJ, McQuay HJ. Quantitative systematic review of topically applied non-steroidal anti-inflammatory drugs. BMJ. 1998 Jan 31;316:333-8.Reference1 Evans JM, McMahon AD, McGilchrist MM, et al. Topical non-steroidal anti-inflammatory drugs and admission to hospital for upper gastrointestinal bleeding and perforation: a record linkage case-control study. BMJ. 1995;311:22-6. Google Scholar Author, Article, and Disclosure InformationAffiliations: Mater Hospital, Waratah, New South Wales, Australia (D.H.) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails July 1, 1998Volume 129, Issue 1Page: 10KeywordsAdverse reactionsAnalgesicsArthritisBloodDatabasesDrug safetyDrugsHeart failureHemorrhageInformation storage and retrievalNSAIDsOintmentsPainRheumatic painSafetySportsSystematic reviewsToxicityUlcers ePublished: 9 March 2020 Issue Published: July 1, 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.Loading ...

Elderly patients with heart failure: a study of satisfaction with care and quality of life.

To assess the level of patient satisfaction with care, patient quality of life, the relationship between these measures and hospital readmission rates, and patient outcomes. A prospective cohort study was conducted of all patients aged 60 years and over admitted to the John Hunter and Mater Hospitals, in the Hunter Area, in whom congestive heart failure contributed to the need for hospital admission. Patients recruited into the main study were then asked to complete a questionnaire on discharge from hospital. Patients were asked to complete the satisfaction questionnaire on discharge because this would reflect the patients' satisfaction with the overall stay. To provide a baseline quality-of-life score, patients were asked to complete a questionnaire 2 weeks after discharge. Overall scores on the satisfaction questionnaire were high, indicating that the patients were very satisfied with their care. There were six questions in which 17-35% of patients indicated some degree of dissatisfaction, four related to patient knowledge. No difference in satisfaction was found between patients who had or did not have a readmission. Quality-of-life results showed that patients who had a readmission had a significantly lower quality-of-life score at 12 month follow up (P=0.007) than those without a readmission. This finding has supported our hypothesis that a higher level of quality of life would be related to fewer readmissions.

A memorable patient: Deja vu

It was a dark winter afternoon in January 1981. The friendly Dublin porter at the top of the formidable entrance steps to the Mater Hospital pointed to the corridor where the membership examination was being held. The old high ceilinged wards were dim, and the lights outside brightened the gloom. The long case was behind the screens in the corner of the ward and my well rehearsed approach of history taking followed by examination started. He was an active lively 13 year …

Socioeconomic status and maternal cigarette smoking before, during and after a pregnancy.

Research suggests that cigarette use declines when women find out they are pregnant, increasing again after the birth. Pregnancy may provide many women with a substantial impetus to stopping smoking. Also, rates of smoking cessation and reduction may be class-related, with the highest socioeconomic-status groups manifesting higher rates of reduction. Using data from the Mater Hospital--University of Queensland Study of Pregnancy, we report family income related to rates of smoking before, during and after a pregnancy. Before becoming pregnant, 45.9 per cent of women in the sample were smokers. This declined to 34.7 per cent of women at their first clinic visit. Rates of heavy smoking (20 or more cigarettes per day) had returned to earlier levels by the six-month (after birth) follow-up. Women in the lowest family-income group had the highest rates of cigarette use before, during and after their pregnancy. Of the lowest family-income group, 8.4 per cent were heavy smokers before, during and after their pregnancy, compared with 2.8 per cent of women in the highest family-income group. Smoking cessation rates were highest in the highest family-income group (those who smoked least), but relapse rates after the birth were similar for all income groups. Arresting rates of smoking relapse by pregnant women should be seen as a major public health priority.

Antecedents to and outcomes of Rh(D) isoimmunization: Mater Mothers Hospital, Brisbane, 1988-1995.

We analyzed the antecedents and outcomes of Rh(D) isoimmunization in a local population. Forty-two Rh(D) isoimmunized women attending Mater Mothers Hospital for antenatal care were identified through the Mater Hospital Blood Bank database; their records were reviewed for variables including sensitizing events, obstetric interventions and pregnancy outcomes. In this group, 74% of women became sensitized despite receiving anti-D immune globulin, 17% did not receive anti-D appropriately and the other failed to attend for treatment of bleeding in pregnancy. Antenatal sensitization was implicated in 6 women (14%) and potentially responsible for isoimmunization in another 18. Over half of the 80 viable pregnancies in this study group required some form of obstetric intervention. Thirty pregnancies required amniocentesis and 1 in 3 babies underwent either intrauterine or exchange transfusion. Three fetal deaths occurred as a result of severe disease. This study offers information highlighting circumstances in which immunoprophylaxis guidelines have failed to impart protection against Rh(D) sensitization and the consequences of such failures.

Neuromotor behavioural assessment of preterm infants at risk for impaired development

This study was undertaken to evaluate the effectiveness of a new neuromotor behavioural assessment in identifying preterm infants whose development was potentially at risk as a result of their early birth and immediate postnatal experiences. All infants born at less than 30 weeks gestation or who weighed less than 1000g at birth and cared for in the Mater Hospital's Neonatal Intensive Care Unit in Brisbane over a two year period were included in the study. Infants were assessed in their third week of life and again at 36 weeks gestational equivalent age, or prior to discharge, whichever occurred sooner. Results indicate that the assessment is effective in differentiating those infants who suffered from adverse neonatal events from those who did not, when assessed between 30 and 36 weeks gestational equivalent age. The assessment did not prove useful for infants of less than 30 or greater than 36 weeks gestational equivalent age.

Cholesterol levels in normal Irish adults: the Mater Hospital Cholesterol Screening Survey.

Serum samples from 954 Irish adults (604 males, 350 females) aged 18 to 65 years were analyzed within 24 hours of receipt for non-fasting total serum cholesterol levels. The subjects were volunteer blood donors (Blood Transfusion Service Board, Pelican House, Dublin) presenting from June 1990 to February 1991. Serum cholesterol increased significantly with age in both males and females. Mean serum cholesterol in males increased from 4.5 (+/- 0.9) mmol/l in those < 25 years, to 5.7 (+/- 1.0) mmol/l at age 55-64 years. In females, mean serum cholesterol increased from 4.3 (+/- 0.9) mmol/l less than 25 years to 6.2 (+/- 0.8) mmol/l at age 55-64 years. Options for reporting cholesterol ranges are discussed. The overall mean cholesterol concentration of 5.1 mmol/l seen in this study is lower than that reported for comparable studies of U.K. and American subjects, but higher than observed in Japanese individuals. Almost 48% of the studied population had a serum cholesterol value less than 5 mmol/l and over 56% had levels less than 5.2 mmol/l.

Clinical use of carbon-loaded thermoluminescent dosimeters for skin dose determination

Carbon-loaded thermoluminescent dosimeters (TLDs) are designed for surface/skin dose measurements. Following 4 years in clinical use at the Mater Hospital, the accuracy and clinical usefulness of the carbon-loaded TLDs was assessed. Teflon-based carbon-loaded lithium fluoride (LiF) disks with a diameter of 13 mm were used in the present study. The TLDs were compared with ion chamber readings and TLD extrapolation to determine the effective depth of the TLD measurement. In vivo measurements were made on patients receiving open-field treatments to the chest, abdomen, and groin. Skin entry dose or entry and exit dose were assessed in comparison with doses estimated from phantom measurements. The effective depth of measurement in a 6 MV therapeutic x-ray beam was found to be about 0.10 mm using TLD extrapolation as a comparison. Entrance surface dose measurements made on a solid water phantom agreed well with ion chamber and TLD extrapolation measurements, and black TLDs provide a more accurate exit dose than the other methods. Under clinical conditions, the black TLDs have an accuracy of +/- 5% (+/- 2 SD). The dose predicted from black TLD readings correlate with observed skin reactions as assessed with reflectance spectroscopy. In vivo dosimetry with carbon-loaded TLDs proved to be a useful tool in assessing the dose delivered to the basal cell layer in the skin of patients undergoing radiotherapy.

Does maintenance therapy with 5-aminosalicylic acid compounds sulphasalazine, olsalazine or mesalazine in patients with inflammatory bowel disease cause renal disease: D. Booth∗, S.Keating∗, M.Buckley∗, J.Crowe∗∗, D.Kelliher∗∗∗, DG.Weir∗∗∗ and C.O'Morain∗. Depts of Gastro., ∗Meath/Adelaide Hospitals, ∗∗Mater Hospital & ∗∗∗ St. Jame's Hospital, Dublin

Does maintenance therapy with 5-aminosalicylic acid compounds sulphasalazine, olsalazine or mesalazine in patients with inflammatory bowel disease cause renal disease: D. Booth∗, S.Keating∗, M.Buckley∗, J.Crowe∗∗, D.Kelliher∗∗∗, DG.Weir∗∗∗ and C.O'Morain∗. Depts of Gastro., ∗Meath/Adelaide Hospitals, ∗∗Mater Hospital & ∗∗∗ St. Jame's Hospital, Dublin

Parental asthma knowledge: its association with readmission of children to hospital.

To assess whether poor parental knowledge about asthma was a risk factor for readmission of their children to hospital. Parents of children who were admitted to the paediatric facility at Newcastle Mater and John Hunter Hospitals were administered a previously validated asthma knowledge questionnaire with a maximum possible score of 31. The mean parental knowledge scores for three groups of children were determined: those with a previous diagnosis of asthma being readmitted to hospital (170 children, mean score 18.3); those with a previous diagnosis of asthma being admitted for the first time (114 children, mean score 17.2); and children being admitted with their first attack of asthma (65 children, mean score 15.6). There was a significant difference in parental asthma knowledge between the first and third group (P < 0.001) but not between the first and second group. A linear regression model with knowledge score as an outcome found that increased knowledge was associated with previously diagnosed asthma, higher parental occupation and no smoker in the home. Knowledge was poor in all groups. Readmission rate was related to the severity of the child's asthma.

Imaging of abdominal complications following cardiac surgery.

Ten thousand seven hundred fifty-six patients underwent cardiac bypass surgery at the Mater Hospital national cardiac unit between September 1979 and April 1993. Of this group, 49 patients were identified who had developed postoperative gastrointestinal complications leading to 16 deaths. Twenty-five patients developed gastrointestinal hemorrhage, eight patients developed gallbladder disease, five patients developed phlegmonous pancreatitis, eight patients developed bowel perforations, and three patients developed intestinal pseudoobstruction. The particular radiological features that lead to diagnosis in each case are discussed and relevant literature is briefly reviewed.