Nurse Practitioner Led Services in Primary Health Care in Rural NSW– Two Case Studies

Background Nurse Practitioners (NPs) are a relatively new advanced nursing role. It was hoped that NPs would reduce some of the challenges facing health care, address workforce shortages and improve access to services for rural populations. The most recent census of Australian NPs showed that just twelve of 208 working NPs were located in primary health care settings. It also showed the majority of NPs were employed in metropolitan areas. Few previous studies describe NP roles in detail, or in rural primary health care settings. Aims This study aims to describe, in detail, the roles of two NPs in rural New South Wales in primary health care settings. One case study focuses on the delivery of an integrated mental health service and the other on leadership in aged care. Methods A case study methodology was employed, using multiple data sources. Data were gathered using semi-structured interviews with 31 key stakeholders, the examination of key documentation, and observation of the NPs within these settings. In the first case study, quantitative data were also analysed. Interview data were analysed thematically. Results The case studies offer an in-depth description of why and how these roles were established, what the NPs do and their impact within the context of small rural towns. They illustrate how NPs established intersectoral partnerships, new service delivery models and advocacy regarding the way health care was provided. The case studies also provide valuable information on how to best incorporate NPs into rural primary health care. Conclusion This study details the complexity of two NP roles within rural primary health care settings. The two case studies show that in these settings, NPs are providing leadership, supporting other services, helping to address workforce shortages, improving access to services for rural populations, and therefore demonstrating the positive impact of NPs working in these settings

Profits Over Patriotism: Black Market Crime in World War II Sydney

This thesis examines the multi-faceted phenomenon of black market crime in World War II Sydney. Using previously classified archives, coupled with oral sources and newspaper articles I provide a complete survey of this phenomenon. As a concept the black market was a social construct with a level of stigma attached to offenders that would not exist in peace time. This was moral policing. I begin by discussing the relationship between the geography and morals of the city. Both women and men in Sydney related to the black market differently. I outline and evaluate the official response to the problem. I also examine broader community attitudes in relation to this issue. The research provided here should form the basis for a more comprehensive understanding of white-collar crime and the moral regulation of behaviour

Dopingcontrole

Contains fulltext : 142585.pdf (publisher's version ) (Open Access

Verwijdering van amfetaminen, efedrinen en aminopropiofenonen uit het lichaam

Contains fulltext : 142278.pdf (publisher's version ) (Open Access

Lack of male-female differences in disposition and esterase hydrolysis of ramipril to ramiprilat in healthy volunteers after a single oral dose.

Contains fulltext : 188999.pdf (publisher's version ) (Open Access)The objective of this study was to identify differences in disposition and esterase hydrolysis of ramipril between male and female volunteers. Plasma concentration and area under the concentration-time curve until the last measured concentration (AUCt) data of ramipril and its active metabolite ramiprilat (-diacid) were obtained from a randomised, cross-over bioequivalence study in 36 subjects (18 females and 18 males). Participants received a single 5-mg oral dose of two different formulations of ramipril (Formulation I and II). Plasma ramipril and ramiprilat concentrations were determined according to validated methods involving liquid chromatography-mass spectrometry. A total number of 2 ' 34 available plasma concentration-time curves of both the parent drug and the metabolite could be analysed, and variations (50-100% coefficient of variation [CV]) in plasma concentrations of both parent drug and metabolite were found. With both the formulations, the mean plasma concentrations-time curves of males and females were identical. The groups of female and male volunteers showed similar yields (AUCt = mg.h/L) of the metabolite ramiprilat (p = 0.37); however, females showed a higher AUCt/kg than males (p = 0.046). This difference was solely attributed to the difference in body weight between males and females (p = 0.00049). In both male and female groups, a subject-dependent yield of active metabolite ramiprilat was demonstrated, which was independent of the formulation. There is a large variation in the ramiprilat t1/2b (50-60% CV). There is a group of subjects who showed a t1/2b of approximately 80 h (15% CV), and two apparent groups with a longer t1/2b for each formulation (124 h, 22.5% CV; 166 h, 21.6% CV, respectively, p = 0.0013). This variation in the terminal half-life of ramiprilat is not sex related. In all three groups of half-lives, the corresponding Cmax values (mean +/- SD) of ramiprilat in males and females were identical. Thus, with identical Cmax and half-lives, the difference found in the AUCt/kg of ramiprilat must be due to the difference in dose, as the consequence of the difference in body weight, following a standard dose of 5 mg in both males and females. This study showed clearly that despite subject-dependent hydrolysis of ramipril to the active metabolite ramiprilat, the variability in the rate of hydrolysis between males and females is similar. With a fixed dose (5 mg), females received a higher dose/kg than males and consequently showed a higher AUCt/kg of the active metabolite ramiprilat. Vree, Tom

Pharmacokinetics and metabolism of amphetamines

Contains fulltext : mmubn000001_250015994.pdf (publisher's version ) (Open Access)Promotor : J. van Rossum cum laude196 p

Metaboliet en/of conjugaat: wanneer wat meten? Metabolite and/or conjugate: what must be measured?

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