ORCID Profile
0000-0002-5574-5099
Current Organisations
Monash University
,
University of Adelaide
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Publisher: Elsevier BV
Date: 10-2021
Publisher: Wiley
Date: 09-2012
Publisher: Royal College of General Practitioners
Date: 23-01-2023
Abstract: A risk-stratified approach to colorectal cancer (CRC) screening could result in a more acceptable balance of benefits and harms, and be more cost-effective. To determine the effect of a consultation in general practice using a computerised risk assessment and decision support tool (Colorectal cancer RISk Prediction, CRISP) on risk-appropriate CRC screening. Randomised controlled trial in 10 general practices in Melbourne, Australia, from May 2017 to May 2018. Participants were recruited from a consecutive s le of patients aged 50–74 years attending their GP. Intervention consultations included CRC risk assessment using the CRISP tool and discussion of CRC screening recommendations. Control group consultations focused on lifestyle CRC risk factors. The primary outcome was risk-appropriate CRC screening at 12 months. A total of 734 participants (65.1% of eligible patients) were randomised (369 intervention, 365 control) the primary outcome was determined for 722 (362 intervention, 360 control). There was a 6.5% absolute increase (95% confidence interval [CI] = −0.28 to 13.2) in risk-appropriate screening in the intervention compared with the control group (71.5% versus 65.0% odds ratio [OR] 1.36, 95% CI = 0.99 to 1.86, P = 0.057). In those due CRC screening during follow-up, there was a 20.3% (95% CI = 10.3 to 30.4) increase (intervention 59.8% versus control 38.9% OR 2.31, 95% CI = 1.51 to 3.53, P .001) principally by increasing faecal occult blood testing in those at average risk. A risk assessment and decision support tool increases risk-appropriate CRC screening in those due screening. The CRISP intervention could commence in people in their fifth decade to ensure people start CRC screening at the optimal age with the most cost-effective test.
Publisher: Informa UK Limited
Date: 19-09-2018
DOI: 10.1080/09540121.2018.1524120
Abstract: This paper explores the willingness to use and pay for HIV Self-testing (HIVST) among Australian gay and bisexual men (GBM). Bivariate and univariate multinominal logistic regression of data from an online survey was performed. Thirty-one (13%) had never HIV tested and 41.9% (88) were testing sub-optimally by Australian guidelines. Half (58.4%, 136) had never heard of HIVST, however, 56.2% (131) reported willingness to use HIVST, with sub-optimal (OR=2.13
Publisher: Elsevier BV
Date: 09-1995
DOI: 10.1016/1071-9164(95)90002-0
Abstract: Quantitative descriptions of the mechanical restitution curve as a description of variability in ventricular performance with coupling interval in isolated tissue preparations are widely available. In humans, however, in vivo examination of the force-interval relationship is restricted to test pulse intervals shorter than the sinus cycle length (i.e., incomplete mechanical restitution). The primary objectives in this investigation were therefore to examine this aspect of mechanical restitution in patients with ischemic heart disease and to develop a quantitative description of the phenomenon. Mechanical restitution curves were constructed in 40 patients, most of whom had well-preserved left ventricular (LV) systolic function, undergoing diagnostic cardiac catheterization for the investigation of chest pain, using a single premature test pulse interval during baseline atrial pacing. The mechanical restitution curve, the relationship between LV + dP/dtmax and test pulse interval, was fitted to a rectangular hyperbolic function. From this, the parameter c, the calculated proportional decrease in LV + dP/dtmax at 60% of the resting cycle length, was derived. The mechanical restitution curve-fitting model (involving determination of c) satisfactorily described the force-interval relationship in 37 of the 40 patients studied (as a rectangular hyperbola in 31 and with simple linear regression in 6 patients). The refractory period of the atria/atrioventricular node limited accurate use of the model in the remaining three patients. The parameter c was inversely proportional to both baseline atrial pacing cycle length (P < .001) and LV ejection fraction (P < .02) In patients with normal LV ejection fractions, the derived value of c at a cycle length of 800 ms (c800) was 29.0% baseline LV + dP/dtmax (95% confidence interval, 23.0, 35.0). The presence of hemodynamically significant ischemic heart disease was not a predictor of the parameters of the model. After intravenous injection of the beta-adrenoreceptor antagonist metoprolol in seven patients, there was a significant (P < .05) reduction in both c and LV + dP/dtmax at the baseline atrial pacing cycle length. Thus, the force-interval relationship can be quantitatively studied using incomplete mechanical restitution curves in humans in vivo. This quantitative description probably reflects relative intracellular calcium availability via slow channel activity and can be used to assess effects of cardioactive drugs on frequency-dependent inotropic mechanisms in humans. The predictive value of this mechanical restitution curve model for hemodynamic instability during tachycardia in patients with impaired LV function remains to be determined.
Publisher: Wiley
Date: 11-04-2023
DOI: 10.1002/SIM.9743
Abstract: Cluster randomized designs (CRD) provide a rigorous development for randomization principles for studies where treatments are allocated to cluster units rather than the in idual subjects within clusters. It is known that CRDs are less efficient than completely randomized designs since the randomization of treatment allocation is applied to the cluster units. To mitigate this problem, we embed a ranked set s ling design from survey s ling studies into CRD for the selection of both cluster and subs ling units. We show that ranking groups in ranked set s ling act like a covariate, reduce the expected mean squared cluster error, and increase the precision of the s ling design. We provide an optimality result to determine the s le sizes at cluster and sub‐s le level. We apply the proposed s ling design to a dental study on human tooth size, and to a longitudinal study from an education intervention program.
Publisher: Wiley
Date: 06-1986
Publisher: Springer Science and Business Media LLC
Date: 07-01-2021
DOI: 10.1186/S12913-020-06040-5
Abstract: The study aimed to estimate the comparative costs per positive diagnosis of previously undetected HIV in three testing regimes: conventional parallel and point of care (POC) testing. The regimes are analysed in six testing settings in Australia where infection is concentrated but with low prevalence. A cost model was developed to highlight the trade-offs between test and economic efficiency from a provider perspective. First, an estimate of the number of tests needed to find a true (previously undiagnosed) positive diagnosis was made. Second, estimates of the average cost per positive diagnosis in whole of population (WoP) and men who have sex with men (MSM) was made, then third, aggregated to the total cost for diagnosis of all undetected infections. Parallel testing is as effective as conventional testing, but more economically efficient. POC testing provide two significant advantages over conventional testing: they screen out negatives effectively at comparatively lower cost and, with confirmatory testing of reactive results, there is no loss in efficiency. The average and total costs per detection in WoP are prohibitive, except for Home Self Testing. The diagnosis in MSM is cost effective in all settings, but especially using Home Self Testing when the in idual assumes the cost of testing. This study illustrates the trade-offs between economic and test efficiency and their interactions with population(s) prevalence. The efficient testing regimes and settings are presently under or not funded in Australia. Home Self Testing has the potential to dramatically increase testing rates at very little cost.
Publisher: Informa UK Limited
Date: 2007
Publisher: Elsevier BV
Date: 02-2016
DOI: 10.1016/J.IJFOODMICRO.2015.11.014
Abstract: Predictive models, to estimate the reduction in Escherichia coli O157:H7 concentration in beef burgers, have been developed to inform risk management decisions no analogous model exists for Salmonella spp. in pork burgers. In this study, "Extra Lean" and "Regular" fat pork minces were inoculated with Salmonella spp. (Salmonella 4,[5],12,i:-, Salmonella Senftenberg and Salmonella Typhimurium) and formed into pork burger patties. Patties were cooked on an electric skillet (to imitate home cooking) to one of seven internal temperatures (46, 49, 52, 55, 58, 61, 64 °C) and Salmonella enumerated. A generalised linear logistic regression model was used to develop a predictive model for the Salmonella concentration based on the internal endpoint temperature. It was estimated that in pork mince with a fat content of 6.1%, Salmonella survival will be decreased by -0.2407log10 CFU/g for a 1 °C increase in internal endpoint temperature, with a 5-log10 reduction in Salmonella concentration estimated to occur when the geometric centre temperature reaches 63 °C. The fat content influenced the rate of Salmonella inactivation (P=0.043), with Salmonella survival increasing as fat content increased, though this effect became negligible as the temperature approached 62 °C. Fat content increased the time required for patties to achieve a specified internal temperature (P=0.0106 and 0.0309 for linear and quadratic terms respectively), indicating that reduced fat pork mince may reduce the risk of salmonellosis from consumption of pork burgers. Salmonella serovar did not significantly affect the model intercepts (P=0.86) or slopes (P=0.10) of the fitted logistic curve. This predictive model can be applied to estimate the reduction in Salmonella in pork burgers after cooking to a specific endpoint temperature and hence to assess food safety risk.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Richard Jarrett.