ORCID Profile
0000-0002-2276-8999
Current Organisation
University of Tasmania
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Publisher: Wiley
Date: 22-09-2021
DOI: 10.1111/ANS.17174
Abstract: Inguinal hernia repair is one of the most common operations performed worldwide with most of the burden of these occurring in low‐ or middle‐income countries (LMICs). There has been much research investigating the most effective method of hernia repair in resource‐rich countries, however very little has been done to determine the most cost‐beneficial method of hernia repair in LMICs. A systematic review of the English literature through PubMed and Scopus was conducted according to the PRISMA statement. Twenty‐eight studies met the inclusion criteria of which 17 were randomised controlled trials and 11 were systematic reviews. Three areas of investigation were established from the literature search, namely operative method and type of mesh used (where applicable). Open‐mesh procedures were shown to be less costly and have shorter operative times than laparoscopic methods. People who underwent laparoscopic hernia repair regularly returned to normal activities earlier than those who had open‐mesh procedures. However, there was no other difference in complication rates between these two methods. Recent investigations have revealed that sterilised synthetic mosquito net was similar to hernia‐specific meshes whilst significantly reducing cost. We postulate that the most cost‐beneficial method of hernia repair for implementation in LMICs is using open‐mesh procedures with sterilised mosquito net under local anaesthetic. Further cost–benefit research is required in this area.
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.PAN.2015.12.006
Abstract: Because of increasing awareness of variations in the use of pancreatic exocrine replacement therapy, the Australasian Pancreatic Club decided it was timely to re-review the literature and create new Australasian guidelines for the management of pancreatic exocrine insufficiency (PEI). A working party of expert clinicians was convened and initially determined that by iding the types of presentation into three categories for the likelihood of PEI (definite, possible and unlikely) they were able to consider the difficulties of diagnosing PEI and relate these to the value of treatment for each diagnostic category. Recent studies confirm that patients with chronic pancreatitis receive similar benefit from pancreatic exocrine replacement therapy (PERT) to that established in children with cystic fibrosis. Severe acute pancreatitis is frequently followed by PEI and PERT should be considered for these patients because of their nutritional requirements. Evidence is also becoming stronger for the benefits of PERT in patients with unresectable pancreatic cancer. However there is as yet no clear guide to help identify those patients in the 'unlikely' PEI group who would benefit from PERT. For ex le, patients with coeliac disease, diabetes mellitus, irritable bowel syndrome and weight loss in the elderly may occasionally be given a trial of PERT, but determining its effectiveness will be difficult. The starting dose of PERT should be from 25,000-40,000 IU lipase taken with food. This may need to be titrated up and there may be a need for proton pump inhibitors in some patients to improve efficacy.
Publisher: Wiley
Date: 03-09-2019
DOI: 10.1111/ANS.15386
Abstract: Peer review of surgical deaths can identify deficits in in idual and systemic delivery of healthcare, ultimately informing quality improvement. From 2008 to 2016, cases reported to the Australia and New Zealand Audit of Surgical Mortality were analysed. Variables associated with peer-judged adverse events were sought. Of 21 045 cases evaluated, 24.8% incurred at least one adverse event judgement. The proportion of cases with reported adverse event significantly decreased over time. Following adjustment for demographic and clinical characteristics, significant negative patient-related associations were advanced age, greater American Society of Anesthesiologists grade, and neurological and malignant comorbidities. Significant associations were also found with systemic or organizational factors, including state/territory, surgical specialty and hospital regionality. Examination of this peer-reviewed database revealed systemic or organizational predictors of adverse events that may have implications for quality improvement at an institutional or jurisdictional level. The extent to which these associations are due to the peer-review process itself should be the focus of further research.
Publisher: Hindawi Limited
Date: 12-08-2021
DOI: 10.1111/HSC.13130
Publisher: Wiley
Date: 09-09-2020
DOI: 10.1111/MEDU.14357
Publisher: Wiley
Date: 03-2021
DOI: 10.1111/ANS.16612
Publisher: Wiley
Date: 20-01-2020
DOI: 10.1111/ANS.15659
Abstract: Bowel resections have high morbidity and mortality rates and are becoming increasingly common in Australia. To reduce the burden on patients and the health system, measures for improving patient outcomes after resection must be investigated. One possible method for improving patient outcomes is prehabilitation with exercise. The aim of this systematic review is to determine the effect that exercise prehabilitation has on the functional status of patients undergoing colorectal resection. Studies examining the effect of exercise prehabilitation on colorectal patients were gathered from online databases, including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and the Australia New Zealand clinical trial registry. The study design, population, intervention and outcomes were extracted from each study. This systematic review included six studies involving a total of 415 patients. Three studies were randomized control trials and three were prospective cohort studies. Those that tested participants post-operatively found that the intervention group improved their 6-min walking distance more than the control group. This result was statistically significant in three studies. Similarly, two studies found that self-reported physical activity was significantly greater in the intervention group than in control groups. The rate of complications and length of hospital stay were not significantly different between intervention and control groups in any study. Prehabilitation significantly improves functional capacity and self-reported physical activity but its effect on complication rate was not significant in this review.
Publisher: Informa UK Limited
Date: 27-09-2019
No related grants have been discovered for Richard Turner.