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Introduction
Current institution
Publications
Publications (63)
The purpose of this study was to examine correlations between health indicators (age, BMI, blood pressure (BP), functional strength (FS), handgrip strength, and predicted VO2 max) and carotid intima-media thickness (cIMT) in an active 50 years+ population. Study participants’ mean cIMT was also compared to the cIMT mean of the general population. H...
Background
Research activities undertaken during University studies contribute to preparation of medical students for practice of evidence-based medicine. This study aimed to understand medical students’ experiences, perceived research skills development and satisfaction associated with completion of mandatory research projects.
Methods
An online...
The complexity of genetic variant interpretation means that a proportion of individuals who undergo genetic testing for a hereditary cancer syndrome will have their test result reclassified over time. Such a reclassification may involve a clinically significant upgrade or downgrade in pathogenicity, which may have significant implications for medic...
The COVID-19 pandemic has adversely affected tertiary science and medical education, with significant impact on research-related activities. Research projects are a mandatory requirement of the Doctor of Medicine (MD) Program at the University of Sydney, and medical student projects are delivered across multiple sites in metropolitan and rural New...
Research question:
What are health professionals' clinical practices, views and self-rated competencies regarding the transfer of mosaic embryos?
Design:
This was a cross-sectional study using surveys.
Results:
Data were collected from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and the Fertility Society of...
Abstract
STUDY QUESTION
What are the roles of individual and interpersonal factors in couples’ decision-making regarding preimplantation genetic testing for monogenic disorders (PGT-M)?
SUMMARY ANSWER
Couples’ decision-making regarding PGT-M was associated with individual and interpersonal factors, that is the perceived consistency of information r...
STUDY QUESTION
What are patients’ reasoning and decisional needs in relation to the transfer of mosaic embryos following preimplantation genetic testing (PGT)?
SUMMARY ANSWER
This study identified four themes, which were patients’ reasoning behind decision-making, their decisional needs, the influence of the mosaic embryos on the decision-making,...
Background
Ashkenazi Jewish (AJ) people have a higher incidence of BRCA1/2 pathogenic variants (PVs) than unselected populations. Three BRCA -Jewish founder mutations (B-JFMs) comprise >90% of BRCA1/2 PVs in AJ people. Personal/family cancer history-based testing misses ≥50% of people with B-JFM.
Methods
We compared two population-based B-JFM scre...
Abstract Background Medical degree programs use scholarly activities to support development of basic research skills, critical evaluation of medical information and promotion of medical research. The University of Sydney Doctor of Medicine Program includes a compulsory research project. Medical student projects are supervised by academic staff and...
Rapid advances in the genetics of psychiatric disorders mean that diagnostic and predictive genetic testing for schizophrenia risk may one day be a reality. This study examined how causal attributions for schizophrenia contribute to interest in a hypothetical genetic test. People with schizophrenia and first-degree relatives of people with schizoph...
Carriers of germline mutations in genes associated with Lynch syndrome are at increased risk for colorectal, endometrial, ovarian, and other cancers. There is evidence that daily consumption of aspirin may reduce cancer risk in these individuals. There is a need for educational resources to inform carriers of the risk‐reducing effects of aspirin or...
This study aimed to describe the acceptability and perceived barriers and enablers to establish a national registry targeting carriers of pathogenic variants in cancer susceptibility genes from stakeholders’ perspectives. Such a registry may effectively target carriers to translate existing research findings into optimised clinical care and provide...
Background
This nationwide study assessed the impact of nationally agreed cancer genetics guidelines on use of BRCA1/2 germline testing, risk management advice given by health professionals to women with pathogenic BRCA1/2 variants and uptake of such advice by patients.
Methods
Clinic files of 883 women who had initial proband screens for BRCA1/2...
This review reports on the needs and sources of support in patients’ decision-making regarding the uptake of preimplantation genetic testing. Five databases were searched systematically to capture qualitative and quantitative studies. A total of 2,336 articles were screened by title and abstract. Twelve articles met the eligibility criteria and rep...
To prospectively assess patient reported outcomes and risk management behavior of women choosing to receive (receivers) or decline (decliners) their breast cancer polygenic risk score (PRS).
Women either unaffected or affected by breast cancer and from families with no identified pathogenic variant in a breast cancer risk gene were invited to recei...
Poly ADP ribose polymerase (PARP) inhibitors offer a survival advantage to women with high-grade serous ovarian cancer who have a germline BRCA1/2 pathogenic variant (PV). Yet, rates of genetic testing among this population have remained persistently low. A national, centralized telephone genetic counseling service was established in January 2016 i...
Hereditary breast cancer is associated with known genetic changes: either variants that affect function in a few rare genes or an ever‐increasing number of common genomic risk variants, which combine to produce a cumulative effect, known as a polygenic risk (PR) score. While the clinical validity and utility of PR scores are still being determined,...
Introduction
People of Ashkenazi Jewish (AJ) ancestry are more likely than unselected populations to have a BRCA1/2 pathogenic variant, which cause a significantly increased risk of breast, ovarian and prostate cancer. Three specific BRCA1/2 pathogenic variants, referred to as BRCA -Jewish founder mutations (B-JFM), account for >90% of BRCA1/2 path...
Objective
To describe the communication of polygenic risk scores (PRS) in the familial breast cancer setting.
Methods
Consultations between genetic healthcare providers (GHP) and female patients who received their PRS for breast cancer risk were recorded (n = 65). GHPs included genetic counselors (n = 8) and medical practitioners (n = 5) (i.e. cli...
Background
As immunisation program launches have previously demonstrated, it is essential that careful planning occurs now to ensure the readiness of the public for a COVID-19 vaccine. As part of that process, this study aimed to understand the public perceptions regarding a future COVID-19 vaccine in Australia.
Methods
A national cross-sectional...
It is estimated that polygenic factors can explain up to 18% of familial breast cancer. Clinical implementation of polygenic testing has begun, with several commercial laboratories now testing. Despite commercial implementation, there is little research investigating how women respond and understand polygenic risk information. This study aimed to e...
Background: There is an indication that vaccine(s) for COVID-19 could be available by early 2021. As immunisation program launches have previously demonstrated, it is essential that careful planning occurs now to ensure the readiness of the public for a COVID-19 vaccine. As part of that process, this study aimed to understand the public perceptions...
Background
Since the emergence of SARS-CoV-2, the virus that causes coronavirus disease (COVID-19) in late 2019, communities have been required to rapidly adopt community mitigation strategies rarely used before, or only in limited settings. This study aimed to examine the attitudes and beliefs of Australian adults towards the COVID-19 pandemic, an...
Background: Since the emergence of SARS-CoV-2, the virus that causes coronavirus disease (COVID-19) in late 2019, communities have been required to rapidly adopt community mitigation strategies rarely used before, or only in limited settings. This study aimed to examine the attitudes and beliefs of Australian adults towards the COVID-19 pandemic, a...
IntroductionThis nationwide study assessed the impact of Lynch syndrome-related risk management guidelines on clinicians’ recommendations of risk management strategies to carriers of pathogenic variants in mismatch repair genes and the extent to which carriers took up strategies in concordance with guidelines.Materials and methodsClinic files of 46...
Background:
Polygenic risk scores (PRSs) summarise genetic risk in complex genetic disorders such as bipolar disorder (BD). The aim of this study was to gain in-depth, nuanced information regarding the understanding and experience of receiving a PRS for BD from individuals who already have a BD diagnosis.
Methods:
Participants from a previous ge...
A meta-analysis was conducted to estimate schizophrenia incidence in first-degree relatives (FDRs) of probands diagnosed with schizophrenia. The aim was to inform future schizophrenia research and improve accuracy of risk communication to patients. Schizophrenia risk in FDRs with 1 or 2 probands with schizophrenia was investigated by conducting a s...
Polygenic risk scores (PRSs) are increasingly being implemented to assess breast cancer risk. This study aimed to assess and determine factors associated with uptake of PRS among women at increased risk of breast cancer for whom genetic testing to date had been uninformative. Participants were recruited from the Variants in Practice study from whic...
Background:
Early Childhood Education Centre (ECEC) staff are strongly recommended to receive several immunizations including influenza and pertussis. However, evidence regarding the uptake is either old or lacking across all Australian States/Territories. This study aimed to explore the attitudes and barriers around ECEC staff vaccination and the...
Objective
This study aimed to develop and assess the feasibility of an online communication skills training intervention to increase cultural competence amongst oncology nurses working with individuals from minority backgrounds.
Methods
The intervention provided examples of communication strategies using vignette-based, professionally produced vid...
The inclusion of polygenic risk scores in breast cancer risk prediction models provides a more personalised and accurate prediction of breast cancer risk for women with and without breast cancer, who would otherwise receive negative results from traditional testing of moderate- and high-risk genes. This study aimed to develop, and pilot test a leaf...
Background
Access to information about prenatal screening is important particularly in light of new techniques such as non-invasive prenatal testing (NIPT). This study aimed to develop and examine the acceptability of a low literacy decision aid (DA) about Down syndrome screening among pregnant women with varying education levels and GPs.
Methods...
This study aims to determine the attitudes and barriers of Australian oncology health professionals towards using tamoxifen as a breast cancer risk‐reducing medication (RRM). Our target group was health professionals involved in breast cancer risk assessment or treatment. Members of relevant medical organizations in Australia and New Zealand were i...
This study aimed to ascertain the systemic barriers encountered by oncology health professionals (HPs) working with patients from ethnic minorities to guide the development of a communication skills training programme. Twelve medical and five radiation oncologists and 21 oncology nurses were invited to participate in this qualitative study. Partici...
Background
The ‘common variant, common disease’ model predicts that a significant component of hereditary breast cancer unexplained by pathogenic variants in moderate or high-penetrance genes is due to the cumulative effect of common risk variants in DNA (polygenic risk). Assessing a woman’s breast cancer risk by testing for common risk variants ca...
Purpose:
Oncology health professionals (HPs) are increasingly required to care for patients from minority backgrounds. Yet many HPs have not had formal training in how to communicate effectively in culturally diverse settings. More information is needed about the challenges that oncology HPs face in communicating with minority patients to inform t...
A pre and post intervention study was conducted to evaluate the impact of a new hand hygiene (HH) teaching module on the knowledge and attitudes amongst medical students towards HH. The teaching module significantly improved knowledge related to HH indications and duration (T1=7.9, T2=9.2, T3=9.1; P=0.001), about the use of HH materials (T1=1.3, T2...
About 2.5 % of the Ashkenazi-Jewish population carry one of three “founder” mutations in BRCA1 and BRCA2 (BRCA1/2). Currently, testing is offered to Jewish people with a personal and/or family history of breast and/or ovarian cancer; however less than half of BRCA1/2 carriers within the Jewish population are aware of their family history. Populatio...
Recent research has shown that aspirin reduces the risk of cancers associated with Lynch Syndrome. However, uncertainty exists around the optimal dosage, treatment duration and whether the benefits of aspirin as a risk-reducing medication (RRM) outweigh adverse medication related side-effects. Little is known about clinicians' attitudes, current pr...
Aim:
The uptake of influenza vaccination in children with high-risk medical conditions continues to be low in Australia and internationally. We aimed to determine Australian paediatricians' beliefs and practices around the influenza vaccination of children.
Methods:
This was conducted as a cross sectional survey of paediatricians from two tertia...
Somatic mutations in key oncogenes in non-small cell lung cancer (NSCLC) and melanoma are important determinants of tumour sensitivity to targeted therapies. Molecular screening for these predictive biomarkers is routinely used to inform treatment decisions; however, little is known about how best to communicate testing and results to patients. Thi...
Background
Migrant travellers who return to their country of origin to visit family and friends (VFR) are less likely to seek travel-related medical care and are less likely to adhere to recommended medications and travel precautions. Through this study, we aimed to get an understanding of the views of stakeholders from community migrant centres an...
Background:
Poor hand hygiene (HH) practices among medical students have previously been attributed to students not being exposed to sufficient teaching materials during their training.
Aim:
To develop and evaluate a teaching module directed at improving the knowledge and attitudes of undergraduate medical students towards HH.
Methods:
The HH...
Background
Currently the uptake of the influenza vaccine amongst Australian hospital staff remains low. While some staff members choose not to receive the vaccine, others may feel decisional conflict around whether to receive the vaccine or not. Having access to information that is personalized to the staff members’ concerns may alleviate this conf...
Rotavirus has been identified as the most common pathogen associated with severe diarrhoea. Two effective vaccines against the pathogen have been licensed. However, many countries including Indonesia have yet to introduce the vaccine into their national immunisation programs. This study aimed to examine the attitudes of healthcare providers (HCPs)...
Introduction: Somatic mutations in key oncogenes in lung adenocarcinoma and melanoma are important determinants of tumour sensitivity to genetically targeted therapies. Predictive molecular testing for these somatic mutations is routinely used to guide the effective and efficient use of personalised anticancer treatment. This qualitative study will...
Background:
Any approach promoting a culture of safety and the prevention of health care-associated infections (HCAIs) should involve all stakeholders, including by definition the patients themselves. This qualitative study explored the knowledge and attitudes of health care workers toward the concept of patient empowerment focused on improving in...
Background:
Recent audit data has revealed that the hand hygiene (HH) rates of Australian medical students is suboptimal. It has been suggested that new approaches are needed to teach students about infection control. As a first step, we undertook a study to determine the current educational approaches used to teach Australian medical students abo...
Background:
Patients have, traditionally, been assumed to be the passive party in the healthcare-associated infections equation, with relatively little research focused on the patients' perspective. This study aimed to explore the attitudes of hospital patients towards patient empowerment as one of the key components of patient engagement.
Method...
Over the last decade, there has been a slow shift toward the more active engagement of patients and families in preventing health care-associated infections (HCAIs). This pilot study aimed to examine the receptiveness of hospital patients toward a new empowerment tool aimed at increasing awareness and engagement of patients in preventing HCAI.
Pati...
It is crucial to assess patients’ understanding of and readiness to participate in infection control programs. While 80% of hospital patients reported that they were willing to help hospital staff with infection prevention, many felt that they would not feel comfortable asking a healthcare worker to sanitize his or her hands.
Infect Control Hosp Ep...
Background
Currently, there is limited literature examining the impact and appropriateness of the educational approaches used to teach medical students concepts around hand hygiene (HH).
Aim
To explore: (i) the perspectives of key academics and medical students towards HH and factors influencing compliance; (ii) the current teaching practices arou...
Despite long-standing recommendations, the uptake of influenza vaccination in children with high risk medical conditions is low. This study aimed to examine the uptake of influenza vaccination amongst a cohort of Australian children and factors associated with vaccine acceptance. Three hundred and sixteen parents of children attending outpatient cl...
Nursing in Australian general practice has grown rapidly over the last decade in response to government initiatives to strengthen primary care. There are limited data about how this expansion has impacted on the nursing role, scope of practice and workforce characteristics. This study aimed to describe the current demographic and employment charact...
Currently, hand hygiene (HH) compliance rates amongst Australian medical students are below 70% nationally. Previous attempts to improve medical students’ knowledge of HH have had only short-term successes with follow-up studies reporting poor long-term retention of knowledge worldwide. It has been previously suggested that the importance of HH mus...
Research conducted to date, has documented hand hygiene (HH) compliance rates for medical students ranging between 8% and 52%. While compliance rates have increased in recent years for medical students, they are still well below the ideal levels. The audit data by hand hygiene Australia indicate that currently hand hygiene of medical studnets in Au...
Background
In Australia, whether to provide free influenza vaccine to health care workers (HCWs) is a policy decision for each hospital or jurisdiction, and is therefore not uniform across the country. This study explored hospital policies and practices regarding occupational influenza vaccination of HCWs in Australia.
Methods
A study using qualit...
Background: The World Health Organization guidance for the protection of healthcare workers against pandemic influenza virus infection recommends the use of standard and droplet precautions (including surgical masks or a face shield) during most patient interactions and N95 or equivalent respirators for aerosol-generating procedures. However, it is...
Due to the advent of the new influenza A (H1N1) strain in 2009, many countries introduced mass immunization programs. Healthcare workers (HCWs) were amongst the key groups targeted for the vaccine in these programs. However, experience with the seasonal influenza vaccine has shown that there are multiple barriers related to the attitudes and percep...
Questions
Questions (2)
I need to compare continuous measurement done on patients with changes observed over several time points. These time points are days over three years. So each patient has a measurement taken over more than three years on several days. These days are not same for all patients and no. of days is also not the same. For example a patient get a measurement done on day 0, then on days 13, 47, 62, 84, 111, 242 ...1265. These days are not the same for all patients. Please suggest how to measure the change in the continuous variable over time.
Thank yon in advance.
We have conducted a file audit for risk reduction recommendation advice given to the patients and docuemented in the files. We want to compare it with the actual risk reduction measures undertaken by patients ascertained through patient interviews. We have matched the patients with their files and was wondering which tests to use to compare the proportions of files compilant and actual compliance by the patients?
