http://espace.library.uq.edu.au/ The University of Queensland en Fez http://blogs.law.harvard.edu/tech/rss http://espace.library.uq.edu.au/view/UQ:287478 2012-12-17T16:43:59Z Lonsdale, Dagan O. og Udy, Andrew A. og Roberts, Jason A. og Lipman, Jeffrey http://espace.library.uq.edu.au/view/UQ:281658 2012-09-10T11:40:47Z Chang, Anne B. og Grimwood, Keith og Robertson, Colin F. og Wilson, Andrew C. og van Asperen, Peter P. og O'Grady, Kerry-Ann F. og Sloots, Theo P. og Torzillo, Paul J. og Bailey, Emily J. og Mccallum, Gabrielle B. og Masters, Ian B. og Byrnes, Catherine .A og Buntain, Helen M. og Morris, Peter S. og Mackay, Ian M. og Chatfield, Mark D. http://espace.library.uq.edu.au/view/UQ:287346 In primary care settings, the diagnosis of rhinosinusitis is generally based on clinical signs and symptoms. Technical investigations are not routinely performed, nor recommended. Individual trials show a trend in favour of antibiotics, but the balance of benefit versus harm is unclear. To assess the effect of antibiotics in adults with clinically diagnosed rhinosinusitis in primary care settings. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2012), MEDLINE (January 1950 to February week 4, 2012) and EMBASE (January 1974 to February 2012). Randomised controlled trials (RCTs) of antibiotics versus placebo in participants with rhinosinusitis-like signs or symptoms. Two authors independently extracted data and assessed the risk of bias. We contacted trial authors for additional information. We collected information on adverse effects from the trials. We included 10 trials involving 2450 participants. Overall, the risk of bias in these studies was low. Irrespective of the treatment group, 47% of participants were cured after one week and 71% after 14 days. Antibiotics can shorten the time to cure, but only five more participants per 100 will cure faster at any time point between 7 and 14 days if they receive antibiotics instead of placebo (number needed to treat to benefit (NNTB)) 18 (95% confidence interval (CI) 10 to 115, I(2) statistic 0%, eight trials). Purulent secretion resolves faster with antibiotics (odds ratio (OR) 1.58 (95% CI 1.13 to 2.22)), (NNTB 11, 95% CI 6 to 51, I(2) statistic 0%, three trials). However, 27% of the participants who received antibiotics and 15% of those who received placebo experienced adverse events (OR 2.10, 95% CI 1.60 to 2.77) (number needed to treat to harm (NNTH)) 8 (95% CI 6 to 13, I(2) statistic 13%, seven trials). More participants in the placebo group needed to start antibiotic therapy because of an abnormal course of rhinosinusitis (OR 0.49, 95% CI 0.36 to 0.66), NNTH 20 (95% CI 14 to 35, I(2) statistic 0%, eight trials). Only one disease-related complication (brain abscess) occurred in a patient treated with antibiotics. The potential benefit of antibiotics in the treatment of clinically diagnosed acute rhinosinusitis needs to be seen in the context of a high prevalence of adverse events. Taking into account antibiotic resistance and the very low incidence of serious complications, we conclude that there is no place for antibiotics for the patient with clinically diagnosed, uncomplicated acute rhinosinusitis. This review cannot make recommendations for children, patients with a suppressed immune system and patients with severe disease, as these populations were not included in the available trials. 2012-12-16T00:27:08Z Lemiengre, Marieke B. og van Driel, Mieke L. og Merenstein, Dan og Young, James og De Sutter, An I. M. http://espace.library.uq.edu.au/view/UQ:295434 2013-03-31T13:50:49Z Mulholland, Selamawit og Gavranich, John B. og Gillies, Malcolm B. og Chang, Anne B. http://espace.library.uq.edu.au/view/UQ:273695 2012-05-07T19:10:50Z Kroon, Ben og Hart, Roger J. og Wong, Brittany M. S. og Ford, Emily og Yazdani, Anusch http://espace.library.uq.edu.au/view/UQ:278352 The effective treatment of pneumonia in a critical care setting involves optimal administration of antibiotics. Various micro-organisms are responsible for causing pneumonia. As the pathogen may not always be evident, empiric broad spectrum antibiotic regimens are often used. There are various resources available to guide antibiotic therapy but unfortunately these have not been validated in critically ill patients. Of increasing concern, multidrug resistant bacteria are becoming more prevalent in the critical care units causing a paradigm shift for antibiotic therapy. In the context of a diminishing pipeline of antibiotic development, optimal use of available antibiotics is essential. Alternative modes of administration such as aerosolisation should be considered especially in nosocomial, multidrug resistant organisms. Further to this, de-escalation of antibiotics and antibiotic cycling are some of the strategies that can be utilised to reduce the emergence of multidrug resistant bacteria. Improvement of clinical outcomes for pneumonia in critical care may also be achieved through use of therapeutic drug monitoring and combination therapy. We advocate that the rational development of local antibiograms for critical care units to better guide the empiric antibiotic therapy in these patients. 2012-07-31T02:05:04Z Dhanani, J. og Roberts, J.A. og Lipman, J. http://espace.library.uq.edu.au/view/UQ:274872 2012-05-28T23:40:37Z Teoh, Laurel og Cates, Christopher J. og Hurwitz, Mark og Acworth, Jason P. og van Asperen, Peter og Chang, Anne B. http://espace.library.uq.edu.au/view/UQ:295831 There are few reports regarding outcomes of anti-glomerular basement membrane (GBM) disease in patients who underwent renal replacement therapy. To help define this we studied all patients with anti-GBM disease who started renal replacement therapy for end-stage renal disease (ESRD) in Australia and New Zealand (ANZDATA Registry) between 1963 and 2010 encompassing 449 individuals (0.8 percent of all ESRD patients). The median survival on dialysis was 5.93 years with death predicted by older age and a history of pulmonary hemorrhage. Thirteen patients recovered renal function, although 10 subsequently experienced renal death after a median period of 1.05 years. Of the 224 patients who received their first renal allograft, the 10-year median patient and renal allograft survival rates were 86% and 63%, respectively. Six patients experienced anti-GBM disease recurrence in their allograft, which led to graft failure in two. Using multivariable Cox regression analysis, patients with anti-GBM disease had comparable survival on dialysis or following renal transplantation (hazard ratios of 0.86 and 1.03, respectively) compared to those with ESRD due to other causes. Also, renal allograft survival (hazard ratio of 1.03) was not altered compared to other diseases requiring a renal transplant. Thus, anti-GBM disease was an uncommon cause of ESRD, and not associated with altered risks of dialysis, transplant or first renal allograft survival. Death on dialysis was predicted by older age and a history of pulmonary hemorrhage. 2013-04-04T14:02:44Z Tang, Wen og McDonald, Stephen P. og Hawley, Carmel M. og Badve, Sunil V. og Boudville, Neil C. og Brown, Fiona G. og Clayton, Philip A. og Campbell, Scott B. og de Zoysa, Janak R. og Johnson, David W. http://espace.library.uq.edu.au/view/UQ:265193 2012-01-17T09:40:12Z Gaddam, Krishna K. og Ventura, Hector og Lavie, Carl J. http://espace.library.uq.edu.au/view/UQ:272017 2012-04-02T11:02:12Z Peatey, Christopher L. og Leroy, Didier og Gardiner, Donald L. og Trenholme, Katherine R. http://espace.library.uq.edu.au/view/UQ:278316 Standard disc diffusion antimicrobial susceptibility testing (C+S) on individual Pseudomonas aeruginosa colonial morphotypes cultured from cystic fibrosis (CF) sputum has questionable clinical relevance. Direct sputum sensitivity testing (DSST) is a whole-sputum susceptibility test that removes bias associated with selecting individual colonial morphotypes. We sought to determine whether, in principle, the results from DSST support the possibility of improved clinical relevance compared with C+S. Individual (DSSTi) and combination (DSST) susceptibility to gentamicin, tobramycin, ceftazidime and meropenem were determined on 130 sputum samples referred from CF subjects with antibiotic-resistant chronic Gram-negative endobronchial infection. DSSTi and concurrent C+S were compared for categorical susceptibility, synergistic combinations were evaluated and the combination DSST efficacy index (DEI) calculated. Meropenem and tobramycin were the most active individual antibiotics by DSSTi on 89 P. aeruginosa-predominant samples, with 62 % of samples sensitive to each. C+S and DSSTi showed poor agreement (κ ranging from 0.02 to 0.6), discordance ranging from 20 % (meropenem) to 49 % (tobramycin), with DSSTi demonstrating both increased susceptibility and increased resistance. The combination that most frequently had the highest DEI was tobramycin + meropenem, occurring in 76 % of samples. DSSTi appears to be reproducible, yields different antimicrobial susceptibility results from C+S without simply identifying the most resistant isolates and DSST identifies the most effective in vitro antibiotic combinations, providing preliminary proof of concept of the potentially improved clinical relevance of whole-sputum testing. Future studies will determine whether these potential theoretical advantages translate into clinical benefits 2012-07-30T14:08:32Z Serisier, D.J. og Tuck, A. og Matley, D. og Carroll, M.P. og Jones, G. http://espace.library.uq.edu.au/view/UQ:275584 Many complications occurring after cardiac surgery are attributed to an acute increase in reactive oxygen and reactive nitrogen species, which under normal conditions are balanced by the antioxidant response. Two key enzymes of the antioxidant response, glutathione peroxidase (GPx) and superoxide dismutase (SOD), rely on trace elements for normal function. It was hypothesized that circulation of blood through the cardiopulmonary bypass (CPB) circuit would 1) reduce trace element levels and antioxidant function, 2) increase oxidative stress, and that 3) prepriming circuits with albumin would ameliorate trace element loss. This hypothesis was investigated by circulating fresh human whole blood in an in vitro CPB circuit. Plasma selenium, copper, and zinc levels were measured, as were SOD and GPx and oxidative stress by thiobarbituric acid reactive substances (TBARS). In spite of significant decreases in copper and zinc levels, SOD levels increased with time. Significant decreases in selenium were associated with a trend to increase TBARS but no change in GPx. Prepriming with albumin provided no benefit as it did not reduce trace element loss nor alter levels of oxidative stress. This study confirms that CPB circuits cause significant depletion of trace elements (selenium, copper, and zinc) necessary to maintain redox homeostasis. The loss of trace elements is a potential contributor to cardiac surgical morbidities, and further studies in the cardiac patient population are needed to investigate this. 2012-06-10T00:00:00Z McDonald, Charles I. og Fung, Yoke Lin og Fraser, John F. http://espace.library.uq.edu.au/view/UQ:295802 2013-04-04T12:44:54Z Sorrentino, D. og Buckton, S. http://espace.library.uq.edu.au/view/UQ:283217 Two cases of subfoveal choroidal neovascular membranes (CNVM) in the absence of other pathology are described in two young patients who were successfully treated with anti-vascular endothelial growth factor (anti-VEGF) agents. The natural history of idiopathic CNVM and factors influencing the decision to treat using various options are discussed. Current experience with use of anti-VEGF is also outlined. Lastly, the importance of timely referral for thorough investigations to exclude underlying aetiology and consideration for treatment is highlighted. 2012-10-14T00:01:49Z Hsing, Y. Eve og Lee, Lawrence R. http://espace.library.uq.edu.au/view/UQ:275158 2012-06-01T16:17:24Z Saha, Sukanta og Scott, James og Varghese, Daniel og McGrath, John http://espace.library.uq.edu.au/view/UQ:275748 2012-06-14T15:21:52Z Almeida, Osvaldo P. og Draper, Brian og Pirkis, Jane og Snowdon, John og Lautenschlager, Nicola T. og Byrne, Gerard og Sim, Moira og Stocks, Nigel og Kerse, Ngaire og Flicker, Leon og Pfaff, Jon J. http://espace.library.uq.edu.au/view/UQ:298886 2013-04-30T11:05:15Z van Schinkel, Linda D. og Auger, Dominique og van Elderen, Saskia G. C. og Marsan, Nina Ajmone og Delgado, Victoria og Lamb, Hildo J. og Ng, Arnold C. T. og Smit, Johannes W. A. og Bax. Jeroen J. og Westenber, Jos J. M. og de Roos, Albert http://espace.library.uq.edu.au/view/UQ:276251 2012-06-25T10:03:53Z Mollee, Peter og Tiley, Campbell og Cunningham, Ilona og Moore, John og Prince, H.Miles og Cannell, Paul og Gibbons, Steve og Tate, Jill og Paul, Sanjoy og Fan, Helen Mar og Gill, Devinder S. http://espace.library.uq.edu.au/view/UQ:288999 2013-01-13T00:35:47Z Bennell, Kim L. og Ahamed, Yasmin og Bryant, Christina og Jull, Gwendolen og Hunt, Michael A. og Kenardy, Justin og Forbes, Andrew og Harris, Anthony og Nicholas, Michael og Metcalf, Ben og Egerton, Thorlene og Keefe, Francis J. http://espace.library.uq.edu.au/view/UQ:269936 2012-03-15T10:09:00Z Rodrigo, E. Shan S. og Wimalaratne, Samantha R. U. og Marasinghe, Rohana B. og Edirippulige, Sisira http://espace.library.uq.edu.au/view/UQ:287681 2012-12-23T00:07:43Z Lambert, Sylvie D. og Girgis, Afaf og Turner, Jane og McElduff, Patrick og Kayser, Karen og Vallentine, Paula http://espace.library.uq.edu.au/view/UQ:285899 We conducted a pilot study to investigate the effectiveness of a home telehealth service for paediatric palliative care consultations. Over a 10 week period, 14 of the 17 caregivers approached to be part of the study agreed to participate. Families were allocated, non-randomly, to a control group (usual care) or an intervention group (usual care with the addition of home telehealth consultations). The primary outcome measure was quality-of-life score. Caregivers were surveyed for up to 99 days following recruitment. A descriptive analysis of the quality-of-life data showed no differences between caregivers in the two groups. However, important lessons were learnt regarding factors which influence the success of studies in this population group, and the domains of caregiver quality-of-life that warrant intervention. Palliative care is complex, and multiple interventions and supports are required if care is to be managed at home. Home telehealth consultations are a feasible and acceptable means of facilitating a palliative care consultation which can reduce the burden on families at a distressing time. 2012-11-20T11:13:45Z Bradford, Natalie og Young, Jeanine og Armfield, Ningel R. og Bensink, Mark E. og Pedersen, Lee-anne og Herbert, Anthony og Smith, Anthony C. http://espace.library.uq.edu.au/view/UQ:273376 2012-04-30T17:30:26Z Paynter, Jessica og Scott, James og Beamish, Wendi og Duhig, Michael og Heussler, Honey http://espace.library.uq.edu.au/view/UQ:275958 There are few effective treatments for metastatic melanoma. Checkpoint kinase 1 (Chk1) inhibitors are being trialled for their efficacy in enhancing conventional chemotherapeutic agents, but their effectiveness as single agents is not known. We have examined the effectiveness of two novel Chk1 selective inhibitors, AR323 and AR678, in a panel of melanoma cell lines and normal cell types. We demonstrate that these drugs display single-agent activity, with IC50s in the low nanomolar range. The drugs produce cytotoxic effects in cell lines that are most sensitive to these drugs, whereas normal cells are only sensitive to these drugs at the higher concentrations where they have cytostatic activity. The cytotoxic effect is the consequence of inhibition of S-phase Chk1, which drives cells prematurely from late S phase into an aberrant mitosis and results in either failure of cytokinesis or cell death through an apoptotic mechanism. The sensitivity to the Chk1 inhibitors was correlated with the level of endogenous DNA damage indicating replicative stress. Chk1 inhibitors are viable single-agent therapies that target melanoma cells with high levels of endogenous DNA damage. This sensitivity suggests that Chk1 is a critical component of an adaptation to replicative stress in these cells. It also suggests that markers of DNA damage may be useful in identifying the melanomas and potentially other tumour types that are more likely to be sensitive to Chk1 inhibitors as single agents. 2012-06-21T10:20:27Z Brooks, K. og Oakes, V. og Edwards, B. og Ranall, M. og Leo, P. og Pavey, S. og Pinder, A. og Beamish, H. og Mukhopadhyay, P. og Lambie, D. og Gabrielli, B. http://espace.library.uq.edu.au/view/UQ:289107 2013-01-15T14:24:13Z Jones, Fiona og Rodger, Sylvia og Ziviani, Jenny og Boyd, Roslyn http://espace.library.uq.edu.au/view/UQ:278356 2012-07-31T09:03:47Z Terrill, P.I. og Wilson, S.J. og Suresh, S. og Cooper, D. og Dakin, C. http://espace.library.uq.edu.au/view/UQ:287072 A key goal for patient safety is to improve the early recognition and management of patients whose conditions deteriorate whilst in hospital. Paper-based observation charts are the main means of recording and monitoring patients' physiological stability, yet observations (e.g., blood pressure, heart rate, and respiratory rate) are not always correctly recorded or appropriately acted upon. No prior published study has applied usability heuristics to systematically compare the usability of multiple observation chart designs. In this study, five evaluators with human factors, applied psychology, or medical expertise inspected 25 observation charts for usability problems. Every chart was found to have substantial usability problems, potentially affecting the ability of hospital staff to accurately record observations or recognize patient deterioration. We proposed a new observation chart design, which avoids many of the previously observed usability problems. 2012-12-11T10:06:50Z Preece, Megan H. W. og Hill, Andrew og Horswill, Mark S. og Karamatic, Rozemary og Hewett, David G. og Watson, Marcus O. http://espace.library.uq.edu.au/view/UQ:275355 2012-06-05T03:33:47Z Kisely, Steve og Ligate, Loys og Roy, Marc-André og Lavery, Terri http://espace.library.uq.edu.au/view/UQ:275315 Glioblastoma multiforme (GBM) is the most common primary brain tumour and extirpation followed by radio- and chemotherapy has had minimal impact on the median survival of patients which is still less than one year. Hence, a novel therapeutic modality is required if the survival of patients with this disease is to be improved. ATM, mutated in the human genetic disorder ataxia-telangiectasia (A-T), plays a central role in the response to DNA double strand breaks and patients with this disorder are characterised by extreme sensitivity to radiation, increased risk of cancer and neurodegeneration. Thus, ATM represents a potential target for radiosensitization of brain tumour cells. A safe, non-replicating lentivirus is used to abrogate ATM in GBM through the antisense and RNAi approaches for radiosensitization. With either techniques, ATM protein was reduced by >90% and there was a 3‑fold sensitization of GBM cells to radiation. ATM protein activation as well as ATM pS1981 foci formation were defective and downstream signalling determined by Ser15 phosphorylation on p53 was reduced. Success in the approaches provides a novel and exciting strategy for the treatment of GBM and thus improving the survival of patients with these tumours. 2012-06-05T03:17:26Z Chuah, Teong Lip og Walker, David Gregory og Wei, Ming og Scott, Shaun og Lavin, Martin Francis http://espace.library.uq.edu.au/view/UQ:292735 2013-03-04T11:09:20Z Feiner, Benjamin og O'Rourke, Peter og Maher, Christopher http://espace.library.uq.edu.au/view/UQ:290086 2013-01-27T00:41:15Z de Jersey, Susan J. og Nicholson, Jan. M. og Callaway, Leonie K. og Daniels, Lynne A. http://espace.library.uq.edu.au/view/UQ:287199 This qualitative study investigated the role of competition in the success and distress of law students. Participants from an Australian law faculty attended one of four focus groups (undergraduate, postgraduate, academic staff and administrative staff). They discussed their perceptions of competition, the competitive behaviours in law students, the purpose of competitive behaviour and its psychological and learning consequences and the contributing and discouraging factors of competition in law students. Competition was perceived by staff and students to be widespread and included antisocial and manipulative behaviours. The goal of competition was seen to be the best and obtain the best job upon graduation. Competition had a significant impact on the well-being of students, and implications for the structure of law programmes are discussed. 2012-12-13T14:49:11Z Stallman, Helen http://espace.library.uq.edu.au/view/UQ:269258 2012-03-07T15:15:49Z Coulthard, Mark G. og Long, Debbie A. og Ullman, Amanda J. og Ware, Robert S. http://espace.library.uq.edu.au/view/UQ:286308 2012-11-25T16:09:00Z Broom, Jennifer K. og Krishnasamy, Rathika og Hawley, Carmel M. og Playford, Elliot G. og Johnson, David W. http://espace.library.uq.edu.au/view/UQ:288227 2013-01-06T00:24:51Z Gardiner, Robert A. og Yaxley, John og Coughlin, Geoff og Dunglison, Nigel og Occhipinti, Stefano og Younie, Sandra og Carter, Rob og Williams, Scott og Medcraft, Robyn J. og Bennett, Nigel og Lavin, Martin F. og Chambers, Suzanne Kathleen http://espace.library.uq.edu.au/view/UQ:278133 2012-07-26T13:03:35Z Gardiner, Robert A. og Yaxley, John og Coughlin, Geoff og Dunglison, Nigel og Occhipinti, Stefano og Younie, Sandra og Carter, Rob og Williams, Scott og Medcraft, Robyn J. og Bennett, Nigel og Lavin, Martin F. og Chambers, Suzanne K. http://espace.library.uq.edu.au/view/UQ:284911 2012-11-15T11:06:11Z Dunne, Rachael Louise og Kenardy, Justin og Sterling, Michele http://espace.library.uq.edu.au/view/UQ:273902 2012-05-14T21:03:09Z Mudge, David W. og Tan, Ken-Soon og Miles, Rhianna og Johnson, David W. og Badve, Sunil V. og Campbell, Scott B. og Isbel, Nicole M. og van Eps, Carolyn L. og Hawley, Carmel M. http://espace.library.uq.edu.au/view/UQ:287432 2012-12-16T22:38:19Z Barraclough, Katherine A. og Brown, Fiona og Hawley, Carmel M. og Leary, Diana og Noble, Euan og Campbell, Scott B. og Isbel, Nicole M. og Mudge, David W. og van Eps, Carolyn L. og Johnson, David W. http://espace.library.uq.edu.au/view/UQ:280986 2012-09-02T00:16:23Z Almeida, Osvaldo P. og Pirkis, Jane og Kerse, Ngaire og Sim, Moira og Flicker, Leon og Snowdon, John og Draper, Brian og Byrne, Gerard og Goldney, Robert og Lautenschlager, Nicola T. og Stocks, Nigel og Alfonso, Helman og Pfaff, Jon J. http://espace.library.uq.edu.au/view/UQ:282081 This study examines whether the lure of injury compensation prompts whiplash claimants to overstate their symptoms. Claim settlement is the intervention of interest, as it represents the point at which there is no further incentive to exaggerate symptoms, and neck pain at 24 months is the outcome of interest. Longitudinal data on neck pain scores and timing of claim settlement were regressed, controlling for the effect of time on recovery, to compare outcomes in claimants who had and had not settled their compensation claims. The results show clearly that removing the financial incentive to over-report symptoms has no effect on self-reported neck pain in a fault-based compensation scheme, and this finding concurs with other studies on this topic. Policy decisions to limit compensation in the belief that claimants systematically misrepresent their health status are not supported empirically. Claimants do not appear to be "cured by a verdict". 2012-09-18T14:43:47Z Spearing, Natalie M. og Gyrd-Hansen, Dorte og Pobereskin, Louis H. og Rowell, David S. og Connelly, Luke B. http://espace.library.uq.edu.au/view/UQ:275270 Diagnostic tools appropriate for undertaking interventions to control helminth infections are key to their success. Many diagnostic tests for helminth infection have unsatisfactory performance characteristics and are not well suited for use in the parasite control programmes that are being increasingly implemented. Although the application of modern laboratory research techniques to improve diagnostics for helminth infection has resulted in some technical advances, uptake has not been uniform. Frequently, pilot or proof of concept studies of promising diagnostic technologies have not been followed by much needed product development, and in many settings diagnosis continues to rely on insensitive and unsatisfactory parasitological or serodiagnostic techniques. In contrast, PCR-based xenomonitoring of arthropod vectors, and use of parasite recombinant proteins as reagents for serodiagnostic tests, have resulted in critical advances in the control of specific helminth parasites. The Disease Reference Group on Helminths Infections (DRG4), established in 2009 by the Special Programme for Research and Training in Tropical Diseases (TDR) was given the mandate to review helminthiases research and identify research priorities and gaps. In this review, the diagnostic technologies relevant to control of helminth infections, either available or in development, are reviewed. Critical gaps are identified and opportunities to improve needed technologies are discussed. 2012-06-05T03:04:49Z McCarthy, James S. og Lustigman, Sara og Yang, Guo-Jing og Barakat, Rashida M. og Garcia, Héctor H. og Sripa, Banchob og Willingham, Arve Lee og Prichard, Roger K. og Basanez, María-Gloria http://espace.library.uq.edu.au/view/UQ:275267 Recognising the burden helminth infections impose on human populations, and particularly the poor, major intervention programmes have been launched to control onchocerciasis, lymphatic filariasis, soil-transmitted helminthiases, schistosomiasis, and cysticercosis. The Disease Reference Group on Helminth Infections (DRG4), established in 2009 by the Special Programme for Research and Training in Tropical Diseases (TDR), was given the mandate to review helminthiases research and identify research priorities and gaps. A summary of current helminth control initiatives is presented and available tools are described. Most of these programmes are highly dependent on mass drug administration (MDA) of anthelmintic drugs (donated or available at low cost) and require annual or biannual treatment of large numbers of at-risk populations, over prolonged periods of time. The continuation of prolonged MDA with a limited number of anthelmintics greatly increases the probability that drug resistance will develop, which would raise serious problems for continuation of control and the achievement of elimination. Most initiatives have focussed on a single type of helminth infection, but recognition of co-endemicity and polyparasitism is leading to more integration of control. An understanding of the implications of control integration for implementation, treatment coverage, combination of pharmaceuticals, and monitoring is needed. To achieve the goals of morbidity reduction or elimination of infection, novel tools need to be developed, including more efficacious drugs, vaccines, and/or antivectorial agents, new diagnostics for infection and assessment of drug efficacy, and markers for possible anthelmintic resistance. In addition, there is a need for the development of new formulations of some existing anthelmintics (e.g., paediatric formulations). To achieve ultimate elimination of helminth parasites, treatments for the above mentioned helminthiases, and for taeniasis and food-borne trematodiases, will need to be integrated with monitoring, education, sanitation, access to health services, and where appropriate, vector control or reduction of the parasite reservoir in alternative hosts. Based on an analysis of current knowledge gaps and identification of priorities, a research and development agenda for intervention tools considered necessary for control and elimination of human helminthiases is presented, and the challenges to be confronted are discussed. 2012-06-05T03:03:48Z Prichard, Roger K. og Basanez, María-Gloria og Boatin, Boakye A. og McCarthy, James S. og Garcia, Héctor H. og Yang, Guo-Jing og Sripa, Banchob og Lustigman, Sara http://espace.library.uq.edu.au/view/UQ:275266 Mathematical modelling of helminth infections has the potential to inform policy and guide research for the control and elimination of human helminthiases. However, this potential, unlike in other parasitic and infectious diseases, has yet to be realised. To place contemporary efforts in a historical context, a summary of the development of mathematical models for helminthiases is presented. These efforts are discussed according to the role that models can play in furthering our understanding of parasite population biology and transmission dynamics, and the effect on such dynamics of control interventions, as well as in enabling estimation of directly unobservable parameters, exploration of transmission breakpoints, and investigation of evolutionary outcomes of control. The Disease Reference Group on Helminth Infections (DRG4), established in 2009 by the Special Programme for Research and Training in Tropical Diseases (TDR), was given the mandate to review helminthiases research and identify research priorities and gaps. A research and development agenda for helminthiasis modelling is proposed based on identified gaps that need to be addressed for models to become useful decision tools that can support research and control operations effectively. This agenda includes the use of models to estimate the impact of large-scale interventions on infection incidence; the design of sampling protocols for the monitoring and evaluation of integrated control programmes; the modelling of co-infections; the investigation of the dynamical relationship between infection and morbidity indicators; the improvement of analytical methods for the quantification of anthelmintic efficacy and resistance; the determination of programme endpoints; the linking of dynamical helminth models with helminth geostatistical mapping; and the investigation of the impact of climate change on human helminthiases. It is concluded that modelling should be embedded in helminth research, and in the planning, evaluation, and surveillance of interventions from the outset. Modellers should be essential members of interdisciplinary teams, propitiating a continuous dialogue with end users and stakeholders to reflect public health needs in the terrain, discuss the scope and limitations of models, and update biological assumptions and model outputs regularly. It is highlighted that to reach these goals, a collaborative framework must be developed for the collation, annotation, and sharing of databases from large-scale anthelmintic control programmes, and that helminth modellers should join efforts to tackle key questions in helminth epidemiology and control through the sharing of such databases, and by using diverse, yet complementary, modelling approaches. 2012-06-05T03:03:32Z Basanez, María-Gloria og McCarthy, James S. og French, Michael D. og Yang, Guo-Jing og Walker, Martin og Gambhir, Manoj og Prichard, Roger K. og Churcher, Thomas S. http://espace.library.uq.edu.au/view/UQ:275268 A disproportionate burden of helminthiases in human populations occurs in marginalised, low-income, and resource-constrained regions of the world, with over 1 billion people in developing areas of sub-Saharan Africa, Asia, and the Americas infected with one or more helminth species. The morbidity caused by such infections imposes a substantial burden of disease, contributing to a vicious circle of infection, poverty, decreased productivity, and inadequate socioeconomic development. Furthermore, helminth infection accentuates the morbidity of malaria and HIV/AIDS, and impairs vaccine efficacy. Polyparasitism is the norm in these populations, and infections tend to be persistent. Hence, there is a great need to reduce morbidity caused by helminth infections. However, major deficiencies exist in diagnostics and interventions, including vector control, drugs, and vaccines. Overcoming these deficiencies is hampered by major gaps in knowledge of helminth biology and transmission dynamics, platforms from which to help develop such tools. The Disease Reference Group on Helminths Infections (DRG4), established in 2009 by the Special Programme for Research and Training in Tropical Diseases (TDR), was given the mandate to review helminthiases research and identify research priorities and gaps. In this review, we provide an overview of the forces driving the persistence of helminthiases as a public health problem despite the many control initiatives that have been put in place; identify the main obstacles that impede progress towards their control and elimination; and discuss recent advances, opportunities, and challenges for the understanding of the biology, epidemiology, and control of these infections. The helminth infections that will be discussed include: onchocerciasis, lymphatic filariasis, soil-transmitted helminthiases, schistosomiasis, food-borne trematodiases, and taeniasis/cysticercosis. 2012-06-05T03:04:11Z Lustigman, Sara og Prichard, Roger K. og Gazzinelli, Andrea og Grant, Warwick N. og Boatin, Boakye A. og McCarthy, James S. og Basanez, María-Gloria http://espace.library.uq.edu.au/view/UQ:275265 Human helminthiases are of considerable public health importance in sub-Saharan Africa, Asia, and Latin America. The acknowledgement of the disease burden due to helminth infections, the availability of donated or affordable drugs that are mostly safe and moderately efficacious, and the implementation of viable mass drug administration (MDA) interventions have prompted the establishment of various large-scale control and elimination programmes. These programmes have benefited from improved epidemiological mapping of the infections, better understanding of the scope and limitations of currently available diagnostics and of the relationship between infection and morbidity, feasibility of community-directed or school-based interventions, and advances in the design of monitoring and evaluation (M&E) protocols. Considerable success has been achieved in reducing morbidity or suppressing transmission in a number of settings, whilst challenges remain in many others. Some of the obstacles include the lack of diagnostic tools appropriate to the changing requirements of ongoing interventions and elimination settings; the reliance on a handful of drugs about which not enough is known regarding modes of action, modes of resistance, and optimal dosage singly or in combination; the difficulties in sustaining adequate coverage and compliance in prolonged and/or integrated programmes; an incomplete understanding of the social, behavioural, and environmental determinants of infection; and last, but not least, very little investment in research and development (R&D). The Disease Reference Group on Helminth Infections (DRG4), established in 2009 by the Special Programme for Research and Training in Tropical Diseases (TDR), was given the mandate to undertake a comprehensive review of recent advances in helminthiases research, identify research gaps, and rank priorities for an R&D agenda for the control and elimination of these infections. This review presents the processes undertaken to identify and rank ten top research priorities; discusses the implications of realising these priorities in terms of their potential for improving global health and achieving the Millennium Development Goals (MDGs); outlines salient research funding needs; and introduces the series of reviews that follow in this PLoS Neglected Tropical Diseases collection, "A Research Agenda for Helminth Diseases of Humans.". 2012-06-05T03:03:11Z Boatin, Boakye A. og Basanez, María-Gloria og Prichard, Roger K. og Awadzi, Kwablah og Barakat, Rashida M. og Garcia, Héctor H. og Gazzinelli, Andrea og Grant, Warwick N. og McCarthy, James S. og N'Goran, Eliézer K. og Osei-Atweneboana, Mike Y. og Sripa, Banchob og Yang, Guo-Jing og Lustigman, Sara http://espace.library.uq.edu.au/view/UQ:277100 Recent EUCAST advice asserts that, with low breakpoints, susceptibility results for cephalosporins and carbapenems can be reported 'as found', even for strains with extended-spectrum β-lactamases (ESBLs) and carbapenemases. The CLSI has similar advice, but with higher ceftazidime and cefepime breakpoints than those of EUCAST. Pharmacodynamic and animal data are used to support these views, along with some analysis of clinical case series. We contend that such advice is misguided on three counts. First, whilst there are cases on record where cephalosporins and carbapenems have proved effective against infections due to low-MIC ESBL producers and low-MIC carbapenemase producers, respectively, there are similar numbers of cases where such therapy has failed. Second, routine susceptibility testing is less precise than in research analyses, meaning that ESBL and carbapenemase producers with 'real' MICs of 1-8 mg/L will oscillate between susceptibility categories according to who tests them and how. Third, although EUCAST continues to advocate ESBL and carbapenemase detection for epidemiological purposes, the likely consequence of not seeking these enzymes for treatment purposes is that some laboratories will not seek them at all, leading to a loss of critical infection control information. In short, it is prudent to continue to seek ESBLs and carbapenemases directly and, where they are found, generally to avoid substrate drugs as therapy. 2012-07-09T10:06:12Z Livermore, David M. og Andrews, Jenny M. og Hawkey, Peter M. og Ho, Pak-Leung og Keness, Yoram og Doi, Yohei og Paterson, David og Woodford, Neil http://espace.library.uq.edu.au/view/UQ:269061 2012-03-06T09:03:33Z Byrnes, Patrick D. og Crawford, Margaret og Wong, Brittany http://espace.library.uq.edu.au/view/UQ:285245 2012-11-15T12:08:27Z Brand, Caroline A. og Barker, Anna L. og Morello, Renata T. og Vitale, Michael R. og Evans, Sue M. og Scott, Ian A. og Stoelwinder, Johannes U. og Cameron, Peter A. http://espace.library.uq.edu.au/view/UQ:273179 2012-04-24T12:08:22Z Smith, A.C. og Armfield, N.R. og Croll, J. og Gray, L.C.