ORCID Profile
0000-0003-2149-9069
Current Organisation
James Cook University
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Publisher: Wiley
Date: 03-2017
DOI: 10.1111/IMJ.13333
Abstract: Neuroendocrine tumours (NET) arise from neuroendocrine cells, which are widely distributed throughout the body. However, diagnosing NET is difficult due to nonspecific symptoms and the paucity of experience among health professionals. This retrospective study was carried out to improve our understanding about NET. This knowledge can be used for optimal utilisation and distribution of limited resources. To study the clinical profile, treatment and survival outcomes for advanced NET patients in Australian regional and remote settings. We reviewed all adult patients who were diagnosed with NET between 1994 and 2012. Patients' data were extracted from electronic databases of The Townsville Cancer Centre. Remoteness was based on postcodes, with patients stratified as regional or rural North Queensland according to Australian Standard Geographical Classification (ASGC). Overall survival was studied using survival analysis. Data from 79 patients were included in the study. The median age at diagnosis was 60 years. A total of 48 patients (60.8%) was male and 31 (39.2%) female. The majority of the patients lived in rural areas (51, 64%) as compared to residing in regional areas (28, 36%). There were 34 deaths at the study cut-off point. Median overall survival of NET patients in rural areas is significantly less than those living in regional areas (1613 days vs. 2935 days, respectively), P = 0.03. Remoteness has an adverse impact on overall survival of NET patients. This outcome may be because of varied access to health services and/or lack of access to specialised scans and medical and surgical expertise.
Publisher: Wiley
Date: 23-07-2019
DOI: 10.1111/AJR.12547
Abstract: To describe the development and evaluation of an educational resource that aimed to provide the non-midwifery workforce in rural and remote health facilities with basic knowledge and skills to assist women who present when birth is imminent. Descriptive methods using surveys were employed to evaluate the resource named the Imminent Birth Education Program. Health professionals employed in Queensland Health rural and remote non-birthing facilities. An evidence-based, blended educational program comprising an online component, a face-to-face workshop and an education package for midwives to facilitate the workshop in their health service. More than 600 participants completed the online course component, and the majority of these participants were employed in non-birthing facilities. Throughout the project, two project officers facilitated face-to-face workshops, training participants to facilitate the workshop in their own health services. The reach of the Imminent Birth Education Program was statewide with clinical staff from all 16 Hospital and Health Services participating. The uptake of the Imminent Birth Education Program has been widespread across the state and positively evaluated by the rural and remote non-midwifery workforce in non-birthing facilities. This evidence-based program is an effective way to provide the knowledge, skills and confidence to assist health professionals to care for women who present to these facilities when birth is imminent.
Publisher: Elsevier BV
Date: 09-2014
DOI: 10.1016/J.WOMBI.2014.06.002
Abstract: Marked differences exist between the maternal and neonatal outcomes of Australian Aboriginal and Torres Strait Islander women and their babies compared with the outcomes for other Australian women and their babies. Australian government policies underline the need to increase the number of practising Aboriginal and Torres Strait Islander midwives and nurses as a strategy for delivering culturally appropriate healthcare to improve health outcomes for Aboriginal and Torres Strait Islander families. Additional challenges are experienced by Aboriginal and/or Torres Strait Islander midwifery students providing Continuity of Care (COC) to Australian Aboriginal and/or Torres Strait Islander childbearing women. One such ex le is the challenge presented due to the close connections and relationships that exist within some Aboriginal and/or Torres Strait Islander cultures in terms of the maintenance of a professional relationship, in particular, the maintenance of professional boundaries. Whilst there is a growing body of evidence on the benefits to women of continuity of midwifery care models, little is known about the experiences of Aboriginal and Torres Strait Islander women who receive COC from Aboriginal and Torres Strait Islander midwifery students. To explore the experiences of Australian Aboriginal and Torres Strait Islander childbearing women who participated in a Continuity of Care journey with an Aboriginal and/or Torres Strait Islander Bachelor of Midwifery student. Exploratory, descriptive study using semi-structured interviews informed by an Indigenous Research Methodology. Thematic analysis identified four major themes: (i) communicating our way, (ii) the role of relationships, (iii) support and assistance and (iv) challenges of the system. The findings illustrated the benefits Aboriginal women experience as a result of having Aboriginal and/or Torres Strait Islander midwifery students provide Continuity of Care. Increasing the number of Australian Aboriginal and/or Torres Strait Islander midwives is essential to improving health outcomes for Australian Aboriginal and Torres Strait Islander childbearing women and their families. Caseload midwifery models with Aboriginal and Torres Strait Islander midwives across Australia are needed. Health services, in partnership with Universities and Aboriginal and Torres Strait Islander communities, have a vital role to play in the development and expansion of these models.
Publisher: Springer Science and Business Media LLC
Date: 12-2016
Publisher: Public Library of Science (PLoS)
Date: 24-06-2022
DOI: 10.1371/JOURNAL.PONE.0269788
Abstract: To understand healthcare worker and patient experience with peripheral intravenous catheter (PIVC) insertion in patients with difficult intravenous access (DIVA) including the use of ultrasound (US). Descriptive study using 1-on-1 semi-structured interviews conducted between August 2020 and January 2021. Purposeful s ling was used to recruit healthcare practitioners (HCPs) and patients with DIVA who had PIVC experience. Data were analysed using inductive thematic analysis. Interview data were than mapped to the implementation theory Behaviour Change Wheel to inform implementation strategies. In total 78 interviews (13 patients 65 HCPs) were completed with respondents from metropolitan (60%), regional (25%) and rural/remote (15%) settings across Australia. Thematic analysis revealed 4 major themes: i) Harmful patient experiences persist, with patient insights not leveraged to effect change ii) ‘Escalation’ is just a word on the front lines iii) Heightened risk of insertion failure without resources and training and iv) Paving the way forward–‘measures need to be in place to prevent failed insertion attempts. Themes were mapped to the behaviour change wheel and implementation strategies developed, these included: staff education, e-health record for DIVA identification, DIVA standard of care and DIVA guidelines to support escalation and ultrasound use. DIVA patients continue to have poor healthcare experiences with PIVC insertion. There is poor standardisation of DIVA assessment, escalation, US use and clinician education across hospitals. Quality, safety, and education improvement opportunities exist to improve the patient with DIVA experience and prevent traumatic insertions. We identified a number of implementation strategies to support future ultrasound and DIVA pathway implementation.
Publisher: Elsevier BV
Date: 12-2011
DOI: 10.1016/J.HEALTHPOL.2011.07.004
Abstract: To develop culturally appropriate and effective strategies to reduce the risk from pandemic influenza (H1N109) in rural and remote Australian Aboriginal and Torres Strait Islander communities. Participatory Action Research (PAR) approach that enabled communities and researchers to work together to develop understanding and take action to reduce risk. The H1N109 pandemic raised deep concerns and serious issues in all of the Aboriginal and Torres Strait Islander communities involved in this project. The participants expressed distrust and scepticism in relation to current Australian health policies on containment and told the researchers that specific plans for Aboriginal and Torres Strait Islander peoples were needed. Respondents indicated that policies and plans had been developed without respectful engagement with communities. The strong and recurring themes that emerged from the PAR cycles were: the importance of family ways of life and realities of living in response to influenza and key messages to government and health services to focus on communication, understanding and respect. The essential work of reducing risk of pandemic influenza with Aboriginal and Torres Strait Islander communities is not straightforward, but this project has highlighted a number of useful pathways to continue to journey along with communities. A number of strategies to reduce the spread of pandemic influenza in Aboriginal and Torres Strait Islander communities were identified. These strategies would make a good starting point for conversations with communities and health services. In Aboriginal and Torres Strait Islander communities the environment, community structures and traditions vary. Respectful engagement with communities is needed to develop effective policy.
Publisher: Mary Ann Liebert Inc
Date: 10-2010
Abstract: In advanced cancer, the prevalence of fatigue is high and can be related to treatment or disease. Methylphenidate hydrochloride (MPH) is a central nervous system stimulant that has been used to palliate fatigue. There is no standard dose for MPH when used for this indication recommended doses range from 5–20 + mg/d. To identify a dose to test formally in a subsequent n-of-1 trial of fatigue, we recruited patients with advanced cancer and a fatigue score of 4 or more on a 10-point scale. Following a 3-day baseline assessment, each patient titrated MPH at doses ranging from 5 mg/d to 15 mg twice daily at 3-day intervals. In a daily diary, patients recorded measures of fatigue, depression, toxicity, and symptom control. Ten patients provided consent, 9 completed 8 days and 5 received maximum dose at day 15. Three patients were unwilling to increase the dose to maximum levels as they were satisfied with the response at a lower dose. Across all patients, there was a pattern of rapidly improving fatigue and depression scores to day 9 (5 mg twice daily), with minimal improvement thereafter. The results indicate a dose of 5 mg twice daily for the definitive study. There was little correlation between performance status and maximum tolerated dose. No patient withdrew because of toxicity.
Publisher: Wiley
Date: 08-2016
DOI: 10.1111/IMJ.13138
Abstract: This study aims to examine differences between outer regional (OR) and remote/very remote (RVR) patients in northern Queensland, Australia in the times taken to receive various aspects of head and neck cancer management. Our study prospectively recruited head and neck cancer patients presenting to three North Queensland regional hospitals from January 2009 to January 2011. Data on demographic and cancer-specific details, comorbidities and timing of presentation to various services, were collected using a self-administered questionnaire that included two questions in relation to possible reason for delays to health services. Multivariate linear regression analyses were conducted to assess the effects of various demographic characteristics on time delays. Survival and disease recurrence data were analysed in 2014. One hundred and fifty-eight patients participated. RVR patients had significantly longer median times between diagnosis and first treatment compared with OR patients (P = 0.015). Indigenous patients had significant delays from diagnosis to first treatment (P = 0.013) and visit to first specialist and treatment (P = 0.031) compared to non-Indigenous patients. Longer median times between symptoms and first treatment was associated with low income (P = 0.03) and lower education level (P = 0.04). Disease recurrence was higher for RVR patients compared with OR patients (P = 0.04), without significant differences in overall survival. Possible reasons for delays included patient and professional factors. Significant delays in various aspects of head and neck cancer management were associated with remoteness, Indigenous and socioeconomic status. While patient and professional factors could be addressed at local levels, sustainable improvement in outcomes requires a state and national level approach.
Publisher: Springer Science and Business Media LLC
Date: 2012
Publisher: American Society of Clinical Oncology (ASCO)
Date: 10-2071
Abstract: The discussion of a cancer diagnosis and prognosis often is difficult. This study explored the expectations of Tamil-speaking patients with cancer and their families with respect to receiving their cancer diagnosis in northern Sri Lanka. This exploratory, descriptive, qualitative study used semistructured interviews. Thematic analysis identified two major themes: communication and information seeking. The findings illustrate a discrepancy between patient preference for direct disclosure of the diagnosis and that of families. Ninety-five percent of patients wanted medical staff to disclose their cancer diagnosis, whereas only 45% of family members believed that the diagnosis should be disclosed to the patient rather than to the family. Although patients and their family members’ views and expectations of the disclosure of diagnosis and prognosis differ, a majority of patients want to be told directly about their diagnosis rather than to learn of it from a relative. The findings are similar to the literature on other ethnic groups from Sri Lanka and studies from English-speaking developed countries. Therefore, the main questions are how to educate families and physicians about the benefits of open disclosure to patients and how to change culture. Results of this study along with a previous study call for the development of strategies and guidelines to improve societal views, educate patients and families, and train health professionals in the area of breaking bad news and discussing prognosis in the Sri Lankan setting.
Publisher: Hindawi Limited
Date: 14-04-2016
DOI: 10.1111/ECC.12309
Abstract: Townsville Cancer Centre (TCC), a tertiary cancer centre in North Queensland, Australia, provides chemotherapy services to surrounding small rural towns using the Queensland Remote Chemotherapy Supervision model (QReCS). Under this model, selected chemotherapy regimens are administered in rural hospitals by rural based generalist doctors and nurses, under the supervision of TCC-based medical oncologists and chemotherapy competent nurses through videoconferencing. We sought to explore the perspectives of health professionals participating in QReCS. This qualitative study used semi-structured interviews with 19 participants, including nine nurses, eight doctors, one rural pharmacist and one administration officer. The interviews were recorded and transcribed. Transcripts were examined using iterative thematic analysis. Four major themes were identified from the data: (1) benefits of the model, (2) enablers of implementation, (3) operational requirements for optimal functioning and (4) disadvantages of the model. The reported benefits of the model were patient convenience, inter-professional communication across health district borders, expanded scope of practice, continuity of care and maintenance of patient safety and compliance with guidelines while delivering chemotherapy. Further improvements in the quality of training for rural nurses, coordination between urban and rural sites and between health professionals and documentation of clinical encounters would optimise the operation of the model. QReCS appears to provide many benefits to patients and health professionals and a framework for safe administration of chemotherapy in rural areas. Coordination of care, the quality of training for rural nurses as well as clinical documentation needs to improve to optimise the operation of the model.
Publisher: Elsevier BV
Date: 06-2017
Publisher: Wiley
Date: 12-2009
Publisher: AMPCo
Date: 03-2015
DOI: 10.5694/MJA14.01021
Publisher: Informa UK Limited
Date: 05-02-2021
Publisher: SAGE Publications
Date: 18-03-2014
Abstract: We explored the experiences of patients using the Townsville Tele-oncology clinic, where most patients are no longer seen face-to-face. All medical oncology patients who received services via telehealth at the Townsville Cancer Centre in 2012 were invited to participate in an interview. None refused. Thirty two patients were interviewed by telephone and three via videoconference at their local health service facility. Data analysis identified five major themes (quality of the consultation communication and relationships familiarity with technology and initial fears local services and support and lack of coordination of services between the local rural hospital and the major regional hospital) and each major theme included a number of sub-themes. Most patients interviewed (69%) had not seen their oncology specialist face-to-face, but 86% of them found the video-consultation to be of high quality and were extremely satisfied with the interaction. The acceptance of teleconsultation appeared to be linked to the patients' trust with their local health system and staff. Overall, the tele-oncology model that replaced face-to-face care in North Queensland was accepted and welcomed by patients.
Publisher: Springer Science and Business Media LLC
Date: 31-05-2021
Publisher: Elsevier BV
Date: 07-2008
Publisher: Hindawi Limited
Date: 07-10-2014
DOI: 10.1111/ECC.12251
Abstract: Teleoncology models are used increasingly throughout the world as a means to provide access to quality cancer care for people in rural, remote and other disadvantaged settings. Some authors have suggested that teleoncology is merely about avoiding long distance travel. In this commentary we argue that the benefits of teleoncology extend beyond those of the patients and their families to the rural health system and beyond. We draw upon the literature and results of an evaluation of the Townsville Teleoncology Network (TTN) in North Queensland, Australia to support our arguments.
Publisher: Hindawi Limited
Date: 17-10-2023
DOI: 10.1155/2023/4981800
Publisher: Elsevier BV
Date: 12-2016
DOI: 10.1016/J.WOMBI.2016.05.003
Abstract: Evidence is emerging of the benefits to students of providing continuity of midwifery care as a learning strategy in midwifery education, however little is known about the value of this strategy for midwifery students. To explore Indigenous students' perceptions of providing continuity of midwifery care to Indigenous women whilst undertaking a Bachelor of Midwifery. Indigenous Bachelor of Midwifery students' experiences of providing continuity of midwifery care to Indigenous childbearing women were explored within an Indigenous research approach using a narrative inquiry framework. Participants were three Indigenous midwifery students who provided continuity of care to Indigenous women. Three interconnected themes facilitating connection, being connected, and journeying with the woman. These themes contribute to the overarching finding that the experience of providing continuity of care for Indigenous women creates a sense of personal affirmation, purpose and a validation of cultural identity in Indigenous students. Midwifery philosophy aligns strongly with the Indigenous health philosophy and this provides a learning platform for Indigenous student midwives. Privileging Indigenous culture within midwifery education programs assists students develop a sense of purpose and affirms them in their emerging professional role and within their community. The findings from this study illustrate the demand for, and pertinence of, continuity of care midwifery experiences with Indigenous women as fundamental to increasing the Indigenous midwifery workforce in Australia. Australian universities should provide this experience for Indigenous student midwives.
Publisher: Springer Science and Business Media LLC
Date: 17-09-2014
No related grants have been discovered for Jenny Kelly.