Hospitals

A hospital was one of the first European institutions set up in Australia in 1788. The aim in this article is to summarise the ensuring events, and particularly to demonstrate how hospitals have dramatically changed. One theme is to clarify the nature of convict hospitals and the low level of care expected in charity hospitals during the nineteenth and early twentieth centuries. Other themes are the impact of medical innovations, and the strong and increasingly interventionist role of the state in hospital governance. More recently, a theme has been the closure of small hospitals and the development of large hospital complexes. Throughout, the role of nurses has been crucial as they have provided the bulk of hospital care. Hospitals have always been plagued by scandals but the striking feature throughout their history in Sydney is the strength of the demand for hospital care

Nursing

The history of nursing in Sydney is central to understanding a range of issues including healthcare and gendered employment. This article is an introduction to nursing’s complex, fascinating and much neglected history in Sydney, Australia. Its focus is on hospitals as these have been, and remain, a central site for nursing practice and education. It explores the very different experiences of nursing students and matrons, the difficult working conditions which led to the ‘battleaxe’ stereotype, and the battle for even senior nurses to match their responsibilities with adequate power. Two major themes since the introduction of trained nursing has been the chronic nursing shortage and the sustained hostility towards formal education for nurses. Despite all the problems, nurses have practiced in such a way that they are perceived as the most ethical of all professions

Growth Regulation in Breast Cancer

For the successful treatment of breast cancer it is important to understand the underlying mechanisms of growth regulation in breast tumours. This study has examined breast tumour cell growth at three different levels; growth factor regulation of cellular proliferation, growth factor effects on signal transduction pathways and fibroblast derived paracrine regulation of growth. Four different breast cancer cell lines were selected to cover a wide range of breast tumour characteristics. MCF-7WT and ZR-75-1 are two oestrogen and progesterone receptor positive cell lines which show oestrogen regulated growth, whilst MCF-7Adr and MDA-MB-231 are both oestrogen receptor (ER) negative but have increased levels of the epidermal growth factor receptor. Growth responses to oestradiol, the antiestrogen tamoxifen and a range of growth factors were examined in each of the cell lines using an MTT cell growth assay and cellular uptake of tritiated thymidine. Growth regulation by each of these factors was clearly seen in the two ER positive cell lines, although the effect was much smaller in the ZR-75-1 line. The ER negative cell lines produced no growth response to exogenously applied factors, although they did show a much higher level of growth in basal medium conditions. Given the importance of tyrosine kinase activity in signal transduction, patterns of tyrosine phosphorylation were compared in each of the cell lines when grown in low stimulatory growth conditions. It was interesting to note that overall tyrosine phosphorylation was much higher in the MCF-7Adr line than its parent MCF-7WT line, suggesting increased phosphorylation activity may partly explain why these cells have escaped external growth control. Evidence points to altered regulation of the ras GTPase activating (GAP) protein as one possible factor involved in the autonomous growth of the ER negative MCF-7Adr cell line. Tyrosine phosphorylation response to growth factor stimulation was also examined in the ER positive MCF-7WT and the ER negative MCF-7Adr cell lines. This generally resulted in phosphorylation of proteins specific to the growth factor, as well as phosphorylation of a number of substrate proteins which were common to each of the growth factors tested, suggesting different growth factors share the same signal transduction pathways. Finally, growth regulation of each of the breast cancer cell lines was examined within the broader context of a multicellular tumour environment. Fibroblast cell lines derived from breast tumour stromal tissue were examined for their capacity to regulate tumour cell growth through paracrine mechanisms. Breast cancer cell lines were exposed to conditioned medium from the fibroblasts and the growth response measured in an MTT assay. The two ER positive cell lines MCF-7WT and ZR-75-1 responded to fibroblast conditioned medium, again the affect was greater in the MCF-7WT line. The ER negative cell lines showing autonomous growth were unaffected by exposure to the conditioned medium. The conditioned medium was found to synergise with oestradiol to produce very large increases in the growth of MCF-7WT cells. This study suggests paracrine influences on tumour cell growth may be important in the progression of hormonally dependent breast tumours. In contrast, hormonally responsive or hormonally independent breast tumours show the capacity for self-regulated growth therefore appear to be less influenced by external factors. It is by defining the major growth influences affecting both hormone dependent and hormone independent tumours that new and important therapeutic targets will be identified

Para-infectious brain injury in COVID-19 persists at follow-up despite attenuated cytokine and autoantibody responses

To understand neurological complications of COVID-19 better both acutely and for recovery, we measured markers of brain injury, inflammatory mediators, and autoantibodies in 203 hospitalised participants; 111 with acute sera (1–11 days post-admission) and 92 convalescent sera (56 with COVID-19-associated neurological diagnoses). Here we show that compared to 60 uninfected controls, tTau, GFAP, NfL, and UCH-L1 are increased with COVID-19 infection at acute timepoints and NfL and GFAP are significantly higher in participants with neurological complications. Inflammatory mediators (IL-6, IL-12p40, HGF, M-CSF, CCL2, and IL-1RA) are associated with both altered consciousness and markers of brain injury. Autoantibodies are more common in COVID-19 than controls and some (including against MYL7, UCH-L1, and GRIN3B) are more frequent with altered consciousness. Additionally, convalescent participants with neurological complications show elevated GFAP and NfL, unrelated to attenuated systemic inflammatory mediators and to autoantibody responses. Overall, neurological complications of COVID-19 are associated with evidence of neuroglial injury in both acute and late disease and these correlate with dysregulated innate and adaptive immune responses acutely

Philanthropy and the woman's sphere, Sydney, 1870-circa 1900

'Biographical references': leaf 384-409.Thesis (PhD) -- Macquarie University, School of History, Philosophy and Politics, 1983.Bibliography: leaf 418-434.Introduction -- PART I: The 1870s -- Philanthropy for children: the Royal Commission and women philanthropists' "Natural rights" -- Philanthropic care for adults within the woman's sphere: diversity and limits -- Nuns and evangelicals: ladies and females: a case study of two refuges for prostitutes -- PART II: The 1880s -- Women's philanthropic care of the young: influence and expansion within the woman's sphere -- Women's philanthropy for adults: confidence within the woman's sphere -- A lady and a philanthropist: Helen Fell, 1882-92 -- PART III: The 1890s -- Philanthropic care of the young: from the lady and towards the mother -- Philanthropy for adults: the declining role of the lady within the woman's sphere -- Conclusion.This thesis investigates the impact of an ideological construct - the woman's sphere - on philanthropy in Sydney during 1870-1900. The woman's sphere was a hegemonic concept which denoted the activities and functions deemed appropriate for women. Women were encouraged to work within their sphere in philanthropy and restricted from working in areas or ways outside their sphere. Within these limits, women had a distinct and important impact on philanthropy. -- Part I examines women's philanthropy in the 870s. The first two chapters deal with the major areas of women's philanthropy; the care of girls, mixed-sex groups of children, the sick and working class women. It is argued that women's involvement in these areas was increasingly justified as being within the woman's sphere. Chapter 3 analyses two Refuges for ex-prostitutes, the essential agreement on philanthropic aims between sectarian organisations and the relationship between the lady and the female within the woman's sphere. -- The 1880s, it is argued in Part II, was a decade when the lady became increasingly confident of her right to solve social problems considered to be within the philanthropic woman's sphere. In successive chapters, the impact of the woman's sphere concept on the philanthropic care of children and adults is analysed. The impact on the individual of the woman's sphere concept and the meaning of being a lady within that sphere is examined in Chapter 6. -- Part III discusses the changes in, and the expansion of, woman's sphere philanthropy during the 1890s. Although a select group of ladies still dominated women's philanthropy, much of their power and prestige was eroded. The woman's sphere concept remained but it was much less a means by which women philanthropists could justify independent action. -- In conclusion, it is argued that the woman's sphere concept is essential to an understanding of nineteenth-century life. Whilst this thesis demonstrates its impact on philanthropy, the concept was also a key determinant of women's activities in other areas.Mode of access: World Wide Web.xxiii, 434 leaves il

Book review: Sex and Suffering: Women's Health in a Women's Hospital - the Royal Women's Hospital, Melbourne, 1856-1996

Review of: Sex and Suffering: Women's Health in a Women's Hospital - the Royal Women's Hospital, Melbourne, 1856-1996 by Janet McCalman. Melbourne : Melbourne University Press, 1998. ISBN: 0522849024