Medical tourism

Provides an outline of the current research around medical tourism, especially its impact on Australians. Background Medical tourism is a burgeoning industry in our region. It involves patients traveling outside of their home country for medical treatment. Objective This article provides an outline of the current research around medical tourism, especially its impact on Australians. Discussion Patients are increasingly seeking a variety of medical treatments abroad, particularly those involving cosmetic surgery and dental treatment, often in countries in South-East Asia. Adverse events may occur during medical treatment abroad, which raises medico-legal and insurance issues, as well as concerns regarding follow-up of patients. General practitioners need to be prepared to offer advice, including travel health advice, to patients seeking medical treatment abroad. &nbsp

Changing health professionals’ scope of practice: how do we continue to make progress?

Executive Summary What are the issues related to health professionals’ changing scope of practice in Australia? There is evidence that the current organisation of health professionals and health practitioners, and their associated scope of practice, are not suited to meet the needs of the Australian health system. This is contributing to unsafe and inefficient care delivery. There have been substantial changes in population health needs and the technologies, structures and processes of the health care system, yet there has been little change in the health workforce to adapt to the system requirements. Many of the difficulties in adapting the workforce are created by existing legislation and regulation, the funding models for health professional services, and entrenched professional cultures. There is no agreement on coherent policy for the health workforce even though the national, state, and territory governments have focused on this issue What are the implications if these issues are not addressed? Individual health services and health systems will be unable to implement changes to their health professional and practitioner workforce that enable them to meet the access, quality and financial targets necessary for sustainable operation of the public health system. What can we do? While there have been a range of health practitioner scope of practice changes documented in the literature, there is no analytical framework to categorise the changes to enable benchmarking of achievements and outcomes. In addition, few of the scope of practice changes have been evaluated, and those that have, suffer from poor methodology and lack of economic evaluation. This suggests that there are no ready-made solutions waiting on the shelf and leads to the following recommendations. Include health professional and practitioner scope of practice as a standing item on the national, and state and territory health policy agendas, with the goal to develop national policy directions that are supported by all parties. Three actions are required to procure the data needed to enable this policy development to proceed: Establish and maintain a central repository of Australian health professional and practitioner scopes of practice. Develop inter-disciplinary agreement on essential work roles in community and primary care, mental health, aged and chronic care and Aboriginal and Torres Strait Islander health. Prioritise health services research directed to evaluation of changes in health professional and health practitioner scope of practice. Once the policy has been developed, undertake legislative changes to facilitate scope of practice changes, amend health service purchasing rules to encourage safe service delivery by a broader range of health professionals, and reform health professional education to better address the workforce needs of the health system. These changes will be required to support health workforce policy that encourages a flexible approach to health practitioner scope of practice, but that still ensures sufficient protection for the population

Chitosan and Its Modifications: Are They Possible Vehicles for Gene Therapy?

[Extract] In gene therapy, the most important step is how to effectively deliver the therapeutic gene to the target cells or organ. At present, there are two methods, which are those using a viral and a non-viral vector system. The most common viral vectors that have been used include retroviruses, herpes simplex viruses, lentiviruses, adenoviruses and adeno-associated viruses (Oligino et al., 2000). The advantages of most viral vectors are high transfection efficiency and fast transcription of the foreign material inserted in the viral genome. However, a number of disadvantages have also been described, such as poor target-specificity, low capacity to incorporate foreign deoxyribonucleic acid (DNA) sequence to their genome (Mansouri et al., 2004), toxic and inflammatory effects, wild– type mutations, potential oncogenic effects (Lee et al., 1998), and, in particular, unwanted immune responses. In clinical trials of gene replacement therapy using viral vectors, significant adverse effects have been reported, including a fatal inflammatory response associated with adenoviral vector (Raper et al., 2003), and the development of acute leukaemia in recipients of ex-vivo, adenoviral vector-transduced hematopoietic cells (Woods et al., 2006). Intravenous adenoviral vector has also resulted in high liver toxicity due to uptake by hepatocytes or Kupffer cells of the liver reticular endothelial system, immediately following systemic administration

The development of a rule based expert system to automate the digital analysis of condition monitoring parameters captured on rolling element bearings subjected to simulated failure

This synopsis provides a brief summary of the development of a rule based expert system to diagnose bearing failure. Firstly it covers the proposal of a generic, expert system based industrial condition monitoring system. It then discusses in more detail the development of a specific aspect ofthe system, viz. the analysis of rolling element bearing condition. The bearing test rig and data capture system are described, followed by primary research to define the bearing analysis solution space. This includes the use of vibration parameters, measured and derived operating conditions and the bearing running condition. It then explains the development of rulebases for the three analysis tasks of detection, diagnosis and prognosis. Included is a discussion on techniques used to normalise and adjust the vibration parameters to allow analysis under any operating conditions. Finally the synopsis is concluded with a discussion on the performance of the system and contributions made to the developing field of condition monitoring using expert systems

'Processing' nutrition advice: how to inform guidelines on ultra-processed food

Food processing has been part of our food environment for millennia, but recent advances in technology have taken processing to the next level, creating myriad packaged foods that our ancestors would not even have recognised as edible. Whilst this advancement in processing was certainly advantageous at a time of significant malnutrition following the World Wars, its adoption as a staple of our diet has fundamentally changed the way we eat and, along with it, our health. Recent evidence suggests that the consumption of ultra-processed foods is linked to metabolic morbidity, but these findings are not reflected in nutritional advice in the UK. I argue that public health advice and policy in the UK does not go far enough to highlight the risks of consuming ultra-processed food and, by focusing on a reductionist approach to nutrition, actually promotes the consumption of these products. I further recommend that Public Health England should consider adopting a whole foods approach to nutrition advice. Not only would this serve to minimise the confusion over macronutrient balances, it would also promote the consumption of whole, unprocessed or minimally processed foods, thereby fostering an improvement in our collective health and wellbeing

Tackling obesity—for the few

In response to the growing evidence that obesity increases COVID-19 mortality, the British Government introduced new measures designed to tackle the obesity epidemic that currently plagues the United Kingdom.Whilst many of the measures appear to be much like previous iterations of the anti-obesity strategy, the inclusion of a measure to limit junk food marketing provides promise that the government recognises the role of the obesogenic environment on weight gain. However, these policies fail to acknowledge the impact of social inequality on the pathogenesis of obesity, drastically limiting their potential. I argue that future policies to tackle obesity must apply proportionate universalism, as without addressing social inequality, these strategies cannot be effective

Study of single top quarks in association with vector bosons

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University Londo

Healthy children, healthy country: the use of governing instruments in shifting the policy paradigm

The evidence on early childhood strongly suggests the need to shift child health policy from the current focus on social welfare to a socio-ecologically based approach. This paper reviews three governing instruments, exhortation, expenditure and regulation, that have been used by governments in Australia and discusses the relative effectiveness of these approaches in shifting the child health policy paradigm