ORCID Profile
0000-0002-1160-9837
Current Organisation
Eastern Health
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Publisher: Wiley
Date: 11-07-2023
Abstract: To explore student and staff satisfaction with the use of medical students as a surge workforce during the COVID‐19 pandemic. We conducted a mixed methods analysis of staff and student experiences with the medical student workforce at a single metropolitan ED over an 8‐month period between December 2021 and July 2022, using an online survey tool. Students were invited to complete the survey fortnightly, whereas senior medical and nursing staff were invited weekly. There was a 32% response rate for surveys sent to medical student assistants (MSAs) and 18% and 15% for medical and nursing staff, respectively. Most students felt well prepared and supported in the role and would recommend it to other students. They reported that the role allowed them to gain experience and confidence within the ED, especially after much of their learning had moved online throughout the pandemic. Senior nurses and doctors found MSAs to be useful members of the team, largely through their assistance with task completion. Both staff and students recommended a more comprehensive orientation, changes to the supervision model and increased clarity in the students' scope of practice. The results of the present study provide insight into the use of medical students as an emergency surge workforce. Responses from medical students and staff suggested that the project was beneficial for both groups as well as for overall departmental performance. These findings are likely to be translatable beyond the COVID‐19 pandemic setting.
Publisher: Hindawi Limited
Date: 28-02-2012
DOI: 10.1111/J.1365-2354.2012.01325.X
Abstract: This review aimed to address studies of cancer control in Indigenous populations, with a focus on: (1) the nature and extent of community engagement and (2) the extent to which community engagement has facilitated successful outcomes. Articles addressing Indigenous cancer control using some degree of community engagement were identified by a search of the following electronic databases: MEDLINE (via Ovid and Pubmed), psycINFO, CINAHL and Google Scholar. Relevant studies were scored and analysed according to Green et al.'s guidelines for participatory research. Studies often engaged the community only minimally. Where studies resulted in successful outcomes, they tended to have included Indigenous community members in genuine research roles, from planning, to implementation, to presentation of results at conferences. Studies with positive health outcomes were often initiated by a combination of academic researchers and community members or organisations. This narrative review highlighted significant scope for improvement in community-based studies addressing Indigenous cancer control. Increased attention to the philosophical underpinnings of community engagement is required to ensure that the benefits of this approach are translated to achieve improved cancer control outcomes. An increased awareness of the benefits of community engagement may prove effective in conducting cancer control research that leads to improved outcomes in Indigenous communities.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2016
DOI: 10.1097/GOX.0000000000001124
Abstract: Lichen sclerosus (LS) is an inflammatory dermatosis with autoimmune pathogenesis. Although relatively common, its true incidence is unknown and likely underestimated. LS is usually anogenital, but in around 10% of patients, it can present as extragenital lesions. Continuous administration of topical corticosteroids is the mainstay of medical treatment. Other treatments are available but are only occasionally prescribed along with or instead of topical steroids. Injection of platelet-rich plasma (PRP) into affected areas has been reported to result in the regeneration of normal skin. In this study, we aimed to evaluate the safety, symptom resolution, and objective improvement in patients with autoimmune condition like genital LS after treatment with PRP. Over a 2-year period at FBW Gynaecology Plus, we had a total of 28 patients with confirmed LS on biopsy, unresponsive to topical steroid treatment. After acquiring informed consent, patients’ own blood was centrifuged on site and injected under local anesthesia to the external genitalia. Almost all of our patients showed clinical improvement in the size of their lesions, and in 8 cases, lesions totally disappeared after treatment with PRP. Symptoms disappeared in 15 of the 28 patients after treatment, with no need for further steroid therapy in 23 patients. Thirteen women experienced partial symptom relief. Based on our limited findings, we hypothesize that PRP presents a potential alternative to topical steroids for treatment of vulvovaginal autoimmune conditions such as LS. A larger pilot and/or randomized controlled trial study is required to evaluate this finding further.
Publisher: BMJ
Date: 12-2022
DOI: 10.1136/BMJOPEN-2022-065568
Abstract: To determine the negative predictive value (NPV) of the FebriDx point-of-care host response device in patients presenting with symptoms suggestive of COVID-19 infection in a mostly immunised Australian emergency department (ED) population during the late 2021 phase of the COVID-19 pandemic. Observational diagnostic accuracy study comparing FebriDx point-of-care test to SARS-CoV-2 PCR. An ED in Melbourne, Australia, with 63 000 annual presentations in 2021. Patients aged 16 and over who met the Victorian Department of Health case definition for suspected COVID-19 infection PCR testing. Patients meeting any of the following criteria were excluded: years of age acute respiratory symptom(s) with onset days prior to testing current immunosuppressive or interferon therapy live immunisation within the last 30 days fever lasting days antibiotic or antiviral use in the preceding 14 days experience of major trauma, major surgical intervention or severe burns within the last 30 days. COVID-19 PCR results (detected, not detected) and FebriDx results (bacterial positive, viral negative, viral positive). 94 participants were enrolled (female: 46 male: 48), 34% of participants (tested positive for COVID-19 according to PCR results, with a background incidence among all adult ED attenders of 2.5%. The sensitivity of FebriDx for detection of COVID-19 was 56% (95% CI 40% to 100%) and specificity was 92% (95% CI 84% to 100%). For the population tested, this resulted in an NPV of 80% (95% CI 71% to 100%) and a positive predictive value of 78% (95% CI 60% to 100%). In the context of a population with low COVID-19 infection rates, an evolved variant of COVID-19 and a very high community COVID-19 vaccination rate, FebriDx demonstrated reduced sensitivity and NPV relative to results from earlier international tests. These contextual factors should be considered during any attempt to generalise the current results. ACTRN12620001029987 (Australian Clinical Trials).
Publisher: Wiley
Date: 17-04-2021
Abstract: Emergency medicine researchers face the challenge of prioritising patients' immediate interests and maintaining hospital flow while attempting to collect clinical data. Even in low‐risk scenarios, excessive consent processes can make it difficult to recruit patients while observing guidelines on efficient triage. We discuss a recent situation in which a six‐page consent form appeared to deter clinicians from recruiting patients to a low‐risk intervention. We then argue that there need be no conflict between the imperatives of patient wellbeing and clinical research. Apparent conflicts between treatment and research could be reduced through creative recruitment techniques: the adoption of an ‘opt‐out’ approach securing the budget for a dedicated research assistant early consultation with the institution's human research ethics committee and the use of a short, simple participant information and consent form with a QR code linking to a more detailed outline of the study.
Publisher: Informa UK Limited
Date: 02-10-2017
Publisher: Hindawi Limited
Date: 03-06-2013
DOI: 10.1111/ECC.12053
Abstract: Many users of Complementary and Alternative Medicines (CAMs) claim that participation leads to improved well-being however, contradictory evidence exists, with some studies linking CAM use with poorer quality of life (QoL) or increased distress. This study explored whether an in idual's experience of post-traumatic growth (PTG) following cancer may play a role in explaining these disparate outcomes. One hundred and sixty-one cancer survivors (mean age = 58.96, SD = 12.12) completed measures comprised of PTG (Post-Traumatic Growth Inventory), CAM use, QoL (Functional Assessment of Cancer Therapy scale + Functional Assessment of Chronic Illness Therapy Spiritual Well-Being Scale), post-traumatic stress disorder symptoms (Impact of Event Scale Revised) and depression, anxiety and stress (21-item short-form Depression Anxiety Stress Scale). A multiple regression controlling for gender, age, general and cancer-specific distress indicated support for PTG as a mediator of the relationship between CAM and QoL. An in idual's experience of PTG following cancer may be an important determinant of gaining benefit from participation in CAMs. Future research aimed at identifying potential facilitators of PTG may result in increased benefits of interventions aimed at improving adjustment among cancer survivors.
Publisher: Mary Ann Liebert Inc
Date: 12-2014
Abstract: Consuming an unhealthy level of alcohol is a significant problem for some young women. Potential determinants of excess consumption include perceptions of usual consumption among peers-perceptions of what is "normal." The present study examined whether perceptions of social normative endorsement of drinking, operationalized by measures of perceived alcohol consumption of close friends (proximal norms), the consumption of the "average student" (distal norms), and the extent of alcohol-related content posted by peers on Facebook were related to alcohol-related attitudes and self-reported consumption. Female university students (n=129 Mage=21.48 years, SD=3.00) completed an online questionnaire assessing Facebook use, perceived alcohol-related norms, and self-reported alcohol attitudes and consumption. Perceptions of the consumption of the average female student were a negative predictor of attitudes. Positive alcohol attitudes, extent of own alcohol-related photographic posts on Facebook, average female student alcohol consumption, and report of male close friend consumption predicted self-report of own alcohol consumption. Interestingly, female close friend norms failed to predict consumption, whereas male close friend norms predicted consumption but not attitudes, suggesting the possibility of separate cognitive pathways for alcohol-related attitudes and behavior. This study builds on existing research by casting new light on predictors of alcohol-related attitudes, as well as describing the potential role of social networking sites such as Facebook in the formation of social norms and the modulation of drinking behavior.
No related grants have been discovered for Joseph Miller.