Papers by Patrick McElduff
Medical Journal of Australia, 2008
Medical Journal of Australia, 2001
Environmental Health, 2014
Acta Cytologica, 2014
Background: Fine-needle aspiration (FNA) of difficult breast lesions often results in an atypical... more Background: Fine-needle aspiration (FNA) of difficult breast lesions often results in an atypical (C3) report. The assortment of outcomes generated by C3 reports varies widely, and this has given rise to different clinical management pathways. Objective: To identify and objectively assess microscopic features associated with atypical/C3 breast FNA cases. Materials and Methods: A total of 230 atypical breast FNAs were subjected to a blind microscopic rescreen using a range of robust qualitative and quantitative cytological criteria including cellularity, architectural qualities, cytomorphology and background features. A logistic regression with a receiver operating characteristic (ROC) curve and the resultant forward stepwise analysis were conducted to assess the results. This statistical testing was measured against malignant, benign proliferative and benign non-proliferative outcomes. Results: The malignant and benign proliferative outcomes showed a mixture of opposing protective a...
Background: Given the prevalence and adverse effects of psychological distress on treatment outco... more Background: Given the prevalence and adverse effects of psychological distress on treatment outcomes, particularly the influence of depression on nutritional outcomes, clinical practice guidelines recommend dietitian screening and referral of head and neck cancer patients for psychosocial distress. However, research suggests that the provision of this care is sub-optimal. This study describes a clinical practice change intervention that aims to improve the provision of depression screening and referral by dietitians in head and neck cancer patients undergoing radiotherapy. Methods: The study employs a multi-site, stepped-wedge randomised controlled trial design. The intervention will be implemented across five Australian radiotherapy departments who provide care to patients with head and neck cancer. The intervention to facilitate depression screening and referral will include the following evidence based clinical practice change strategies: executive support, staff training, academ...
British Journal of Nutrition, 2004
It is generally accepted that supplemental Ca and/or vitamin D is effective in reducing the incid... more It is generally accepted that supplemental Ca and/or vitamin D is effective in reducing the incidence of bone fractures; this is supported by numerous randomised controlled trials and meta-analyses. However, a question that has received much less attention is whether dietary Ca, i.e. Ca in physiological doses in normal food intake, also affects bone fracture risk. The present study aims to review the effect of dietary Ca on bone fractures at the hip, spine and radius in women >35 years old, and to compare these results with previous meta-analyses. MEDLINE (1966–1999) and reference lists in papers were searched for observational dietary Ca studies. Data were extracted in duplicate and separately. Heterogeneity and publication bias were tested. Observational studies failed to show any association between dietary Ca intake and risk of hip fracture (risk ratio 1·01, 95% CI 0·96, 1·07 for each increment of 300mg dietary Ca intake/d). There is a suggestion that either extremely low Ca ...
Psycho-Oncology, 2011
ObjectiveTo describe the change in pain and distress over time to demonstrate the effectiveness o... more ObjectiveTo describe the change in pain and distress over time to demonstrate the effectiveness of the QUICATOUCH program in an outpatient oncology population.MethodsDescriptive study of the first 29 months of the QUICATOUCH program (13 736 assessments for 5775 patients). A longitudinal cohort design was used to examine the patients with three or more assessments (8129 assessments for 1778 patients). Effectiveness of this complex intervention (repeated assessment, clinician report and referral to speciality psycho‐oncology service) was examined using: reduction in proportion over threshold for pain and distress, predictors of mean pain and distress scores and comparison of the number of new patients treated by the psycho‐oncology service during the study and in the preceding 29 months.ResultsPain and distress declined during the study. The risk of being over threshold at endpoint was reduced for pain (odds ratio (OR) 0.70, confidence interval (CI) 95% 0.60–0.81) and for distress (OR...
Patient Education and Counseling, 2014
Neurorehabilitation and Neural Repair, 2010
Objective. An enriched environment (EE) refers to conditions that facilitate or enhance sensory, ... more Objective. An enriched environment (EE) refers to conditions that facilitate or enhance sensory, cognitive, motor, and social stimulation relative to standard (laboratory) conditions. Despite numerous published studies investigating this concept in animal stroke models, there is still debate around its efficacy. The authors performed a systematic review and meta-analysis to determine the efficacy of an EE on neurobehavioral scores, learning, infarct size, and mortality in animal models of ischemic stroke. Methods. Systematic review of controlled studies of the use of an EE in experimental stroke was conducted. Data extracted were analyzed using weighted mean difference meta-analysis. For pooled tests of neurobehavioral scores, a random effects standardized method was used. Results. Animals recovering in an EE poststroke had mean neurobehavioral scores 0.9 standard deviations (95% confidence interval [CI] = 0.5-1.3; P < .001) above the mean scores of animals recovering in standard...
JNCI Journal of the National Cancer Institute, 2011
The Journal of Clinical Endocrinology & Metabolism, 2005
Journal of Cerebral Blood Flow & Metabolism, 2010
We hypothesized that pretreatment magnetic resonance imaging (MRI) diffusion-weighted imaging (DW... more We hypothesized that pretreatment magnetic resonance imaging (MRI) diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) lesion volumes may have influenced clinical response to thrombolysis in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET). In 98 patients randomized to intravenous (IV) tissue plasminogen activator (tPA) or placebo 3 to 6 h after stroke onset, we examined increasing acute DWI and PWI lesion volumes (Tmax—with 2-sec delay increments), and increasing PWI/DWI mismatch ratios, on the odds of both excellent (modified Rankin Scale (mRS): 0 to 1) and poor (mRS: 5 to 6) clinical outcome. Patients with very large PWI lesions (most had internal carotid artery occlusion) had increased odds ratio (OR) of poor outcome with IV-tPA (58% versus 25% placebo; OR=4.13, P=0.032 for Tmax +2-sec volume >190 mL). Excellent outcome from tPA treatment was substantially increased in patients with DWI lesions <18 mL (77% versus 18% placebo, OR=15.0, P<0...
Journal of Allergy and Clinical Immunology, 2003
International Psychogeriatrics, 2012
ABSTRACTBackground: Identification of factors associated with quality of life (QoL) in people hav... more ABSTRACTBackground: Identification of factors associated with quality of life (QoL) in people having dementia will help develop strategies for maintenance and improvement of patient QoL. This study examined the predictors of QoL in a community-dwelling population aged 75 years and over, with or without dementia.Methods: This was a cross-sectional study involving 169 GPs and 2,028 patients. Patients were interviewed to collect information on personal circumstances. Several instruments were administered including the WHOQOL-BREF (quality of life outcome measure), Geriatric Depression Scale, GPAQ (satisfaction with GP care), and the CAMCOG-R (cognitive function). Patients with a CAMCOG-R score < 80 were allocated to the dementia group. GPs provided an independent clinical judgment of cognitive function for each of their participating patients.Results: The dementia group had significantly lower QoL scores in all four domains of the WHOQOL-BREF (all p ≤ 0.002). The GDS score was negat...
Hypertension, 2006
Aortic pulse wave velocity (aPWV), a noninvasive measure of vascular stiffness, is an independent... more Aortic pulse wave velocity (aPWV), a noninvasive measure of vascular stiffness, is an independent predictor of cardiovascular disease both before and in overt vascular disease. Its characteristics in early life and its relationship to maternal factors have hardly been studied. To test the hypothesis that infant aPWV was positively related to maternal anthropometry and blood pressure (BP) at 28 weeks gestation, after adjusting for neonatal anthropometry and BP, 148 babies born in Manchester were measured 1 to 3 days after birth. A high reproducibility of aPWV, assessed in 30 babies within 3 days of birth, was found with a mean difference between occasions of −0.04 m/s (95% CI: −0.08 to 0.16 m/s). Contrary to our hypothesis, a significant inverse relation was found between neonatal aPWV (mean: 4.6 m/s) and maternal systolic BP (mean: 108.9 mm Hg; r =−0.57; 95% CI: −0.67 to −0.45) but not maternal height nor weight. Neonatal aPWV was positively correlated with birth length, birth weigh...
Drug and Alcohol Review, 2014
Introduction and Aims.In 2008 pub closing times were restricted from 5am to 3:30am in the central... more Introduction and Aims.In 2008 pub closing times were restricted from 5am to 3:30am in the central business district (CBD) of Newcastle, Australia. A previous study showed a one‐third reduction in assaults in the 18 months following the restriction. We assessed whether the assault rate remained lower over the following 3.5 years and whether the introduction of a ‘lockout’ in nearby Hamilton was associated with a reduction in assaults there.Design and Methods.We used a pre‐post design with comparison against two post‐change periods. The setting was Greater Newcastle (population 530 000) and subjects were persons apprehended for assault in the CBD and nearby Hamilton, an area with late trading pubs where a lockout and other strategies were implemented in 2010. Cases were police‐recorded assault apprehensions occurring from 10pm to 6am in one pre‐change period: January 2001 to March 2008, and two post‐change periods: (i) April 2008 to September 2009 and (ii) October 2009 to March 2013. ...
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Papers by Patrick McElduff