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Article ; Online: Life expectancy for Indigenous people is improving, but closing the gap remains unacceptably slow.

Ring, Ian T / Griffiths, Kalinda

2022 Volume 217, Issue 1, Page(s) 26–27

MeSH term(s)	Health Services, Indigenous ; Humans ; Indigenous Peoples ; Life Expectancy ; Native Hawaiian or Other Pacific Islander
Language	English
Publishing date	2022-06-09
Publishing country	Australia
Document type	Editorial
ZDB-ID	186082-3
ISSN	1326-5377 ; 0025-729X
ISSN (online)	1326-5377
ISSN	0025-729X
DOI	10.5694/mja2.51606
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Article ; Online: Are Indigenous mortality gaps closing: how to tell, and when?

Ring, Ian T / Dixon, Tracy / Lovett, Raymond W / Al-Yaman, Fadwa

The Medical journal of Australia

2016 Volume 205, Issue 1, Page(s) 11

MeSH term(s)	Australia/epidemiology ; European Continental Ancestry Group/statistics & numerical data ; Humans ; Mortality ; Oceanic Ancestry Group/statistics & numerical data
Language	English
Publishing date	2016-06-02
Publishing country	Australia
Document type	Journal Article
ZDB-ID	186082-3
ISSN	1326-5377 ; 0025-729X
ISSN (online)	1326-5377
ISSN	0025-729X
DOI	10.5694/mja16.00185
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Article: Interventions to halt child abuse in Aboriginal communities.

Ring, Ian T / Wenitong, Mark

The Medical journal of Australia

2007 Volume 187, Issue 4, Page(s) 204–205

MeSH term(s)	Child ; Child Abuse, Sexual/ethnology ; Child Abuse, Sexual/legislation & jurisprudence ; Child Abuse, Sexual/prevention & control ; Humans ; Northern Territory ; Oceanic Ancestry Group ; Public Policy ; Risk Factors ; Socioeconomic Factors
Language	English
Publishing date	2007-08-20
Publishing country	Australia
Document type	Editorial
ZDB-ID	186082-3
ISSN	1326-5377 ; 0025-729X
ISSN (online)	1326-5377
ISSN	0025-729X
DOI	10.5694/j.1326-5377.2007.tb01198.x
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Article ; Online: Aboriginal community controlled health services: leading the way in primary care.

Panaretto, Kathryn S / Wenitong, Mark / Button, Selwyn / Ring, Ian T

The Medical journal of Australia

2014 Volume 200, Issue 11, Page(s) 649–652

Abstract: The national Closing the Gap framework commits to reducing persisting disadvantage in the health of Aboriginal and Torres Strait Islander people in Australia, with cross-government-sector initiatives and investment. Central to efforts to build healthier ... ...

Abstract	The national Closing the Gap framework commits to reducing persisting disadvantage in the health of Aboriginal and Torres Strait Islander people in Australia, with cross-government-sector initiatives and investment. Central to efforts to build healthier communities is the Aboriginal community controlled health service (ACCHS) sector; its focus on prevention, early intervention and comprehensive care has reduced barriers to access and unintentional racism, progressively improving individual health outcomes for Aboriginal people. There is now a broad range of primary health care data that provides a sound evidence base for comparing the health outcomes for Indigenous people in ACCHSs with the outcomes achieved through mainstream services, and these data show: models of comprehensive primary health care consistent with the patient-centred medical home model; coverage of the Aboriginal population higher than 60% outside major metropolitan centres; consistently improving performance in key performance on best-practice care indicators; and superior performance to mainstream general practice. ACCHSs play a significant role in training the medical workforce and employing Aboriginal people. ACCHSs have risen to the challenge of delivering best-practice care and there is a case for expanding ACCHSs into new areas. To achieve the best returns, the current mainstream Closing the Gap investment should be shifted to the community controlled health sector.
MeSH term(s)	Australia ; Community Health Services/standards ; Health Services, Indigenous/organization & administration ; Humans ; Oceanic Ancestry Group ; Process Assessment (Health Care)/methods ; Public Health
Language	English
Publishing date	2014-05-13
Publishing country	Australia
Document type	Journal Article ; Review
ZDB-ID	186082-3
ISSN	1326-5377 ; 0025-729X
ISSN (online)	1326-5377
ISSN	0025-729X
DOI	10.5694/mja13.00005
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Article ; Online: Clinical outcomes in patients with triple negative or HER2 positive lobular breast cancer: a single institution experience.

Okines, Alicia / Irfan, Tazia / Asare, Bernice / Mohammed, Kabir / Osin, Peter / Nerurkar, Ashutosh / Smith, Ian E / Parton, Marina / Ring, Alistair / Johnston, Stephen / Turner, Nicholas C

Breast cancer research and treatment

2022 Volume 192, Issue 3, Page(s) 563–571

Abstract: Purpose: Invasive lobular carcinomas (ILC) are characterised by loss of the cell adhesion molecule E-cadherin. Approximately 15% of ILC are ER negative at the time of breast cancer diagnosis, or at relapse due to loss of ER expression. Less than 5% of ... ...

Abstract	Purpose: Invasive lobular carcinomas (ILC) are characterised by loss of the cell adhesion molecule E-cadherin. Approximately 15% of ILC are ER negative at the time of breast cancer diagnosis, or at relapse due to loss of ER expression. Less than 5% of classical ILC but up to 35% of pleomorphic ILC are HER2 positive (HER2+). Methods: Retrospective analysis of clinic-pathological data from patients with Triple negative (TN) or HER2+ ILC diagnosed 2004-2014 at the Royal Marsden Hospital. The primary endpoint was median overall survival (OS) in patients with metastatic disease. Secondary endpoints included response rate to neo-adjuvant chemotherapy (NAC), median disease-free interval (DFI) and OS for patients with early disease. Results: Three of 16 patients with early TN ILC and 7/33 with early HER2+ ILC received NAC with pCR rates of 0/3 and 3/5 patients who underwent surgery, respectively. Median DFI was 28.5 months [95% Confidence interval (95%CI) 15-78.8] for TN ILC and not reached (NR) (111.2-NR) for HER2+ early ILC. Five-year OS was 52% (95%CI 23-74%) and 77% (95%CI 58-88%), respectively. Twenty-three patients with advanced TN ILC and 14 patients with advanced HER2+ ILC were identified. Median OS was 18.3 months (95%CI 13.0-32.8 months) and 30.4 months (95%CI 8.8-NR), respectively. Conclusions: In our institution we report a high relapse rate after treatment for early TN ILC, but median OS from metastatic disease is similar to that expected from TN IDC. Outcomes for patients with advanced HER2+ ILC were less favourable than those expected for IDC, possibly reflecting incomplete exposure to anti-HER2 therapies. Clinical trial registration: ROLo (ClinicalTrials.gov Identifier: NCT03620643), ROSALINE (ClinicalTrials.gov Identifier: NCT04551495).
MeSH term(s)	Breast Neoplasms/drug therapy ; Breast Neoplasms/metabolism ; Carcinoma, Ductal, Breast/pathology ; Carcinoma, Lobular/drug therapy ; Carcinoma, Lobular/metabolism ; Female ; Humans ; Neoplasm Recurrence, Local ; Receptor, ErbB-2/metabolism ; Receptors, Estrogen/metabolism ; Retrospective Studies
Chemical Substances	Receptors, Estrogen ; Receptor, ErbB-2 (EC 2.7.10.1)
Language	English
Publishing date	2022-02-04
Publishing country	Netherlands
Document type	Clinical Study ; Journal Article
ZDB-ID	604563-7
ISSN	1573-7217 ; 0167-6806
ISSN (online)	1573-7217
ISSN	0167-6806
DOI	10.1007/s10549-021-06432-z
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Article: Strengthening the link between policy formulation and implementation of Indigenous health policy directions.

Matthews, Anna / Jackson Pulver, Lisa R / Ring, Ian T

Australian health review : a publication of the Australian Hospital Association

2008 Volume 32, Issue 4, Page(s) 613–625

Abstract: This study aimed to understand the problems within the Indigenous health policy process in Australia and how weaknesses in the process impact on policy implementation. Using semi-structured questions, 23 key stakeholders in the policy-making process were ...

Abstract	This study aimed to understand the problems within the Indigenous health policy process in Australia and how weaknesses in the process impact on policy implementation. Using semi-structured questions, 23 key stakeholders in the policy-making process were interviewed. Three main themes dominated; a need for increased Indigenous involvement in policy formulation at the senior Australian Government level, increased participation of Indigenous community-controlled health organisations in the policy-making process and, most importantly, ensuring that policies have the necessary resources for their implementation. The emergence of these specific themes demonstrated weaknesses in policy process from the formulation stage onward. Tackling these would, according to our informants, significantly enhance the effectiveness of the policy process and contribute to further improvement of the health of Indigenous Australians.
MeSH term(s)	Australia ; Female ; Health Policy ; Humans ; Interviews as Topic ; Male ; Policy Making ; Population Groups ; Primary Health Care
Language	English
Publishing date	2008-10-17
Publishing country	Australia
Document type	Journal Article
ZDB-ID	639155-2
ISSN	0156-5788 ; 0159-5709
ISSN	0156-5788 ; 0159-5709
DOI	10.1071/ah080613
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Article: Indigenous health: chronically inadequate responses to damning statistics.

Ring, Ian T / Brown, Ngaire

The Medical journal of Australia

2002 Volume 177, Issue 11-12, Page(s) 629–631

Abstract: In the 10 years 1990-2000, despite improvements in some conditions, there has been little or no overall progress in the health of the Aboriginal and Torres Strait Islander populations of Australia. This is in stark contrast to the gains made in ... ...

Abstract	In the 10 years 1990-2000, despite improvements in some conditions, there has been little or no overall progress in the health of the Aboriginal and Torres Strait Islander populations of Australia. This is in stark contrast to the gains made in Indigenous health in other countries. The issue is one of lack of commitment to and implementation of already existing policies. We need to (i) fully and adequately fund the Primary Health Care Access Program to provide the out-of-hospital services for prevention and early treatment required to break the cycle of ill-health; (ii) implement a National Training Plan to train the necessary health workforce; and (iii) introduce a National Infrastructure Plan to rectify the continuing deficiencies in water supply, sanitation, education and other basic services.
MeSH term(s)	Australia ; Health Expenditures ; Health Services Accessibility ; Health Services, Indigenous ; Health Status ; Humans ; Oceanic Ancestry Group ; Rural Health Services
Language	English
Publishing date	2002-12
Publishing country	Australia
Document type	Journal Article
ZDB-ID	186082-3
ISSN	1326-5377 ; 0025-729X
ISSN (online)	1326-5377
ISSN	0025-729X
DOI	10.5694/j.1326-5377.2002.tb04989.x
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Article: Our hearts and minds--what would it take for Australia to become the healthiest country in the world?

Ring, Ian T / O'Brien, John F

The Medical journal of Australia

2007 Volume 187, Issue 8, Page(s) 447–451

Abstract: Objective: To highlight recent reductions in mortality rates in Australia and identify conditions and population groups with the greatest potential for further reduction in mortality rates.: Design: International benchmarking and intranational ... ...

Abstract	Objective: To highlight recent reductions in mortality rates in Australia and identify conditions and population groups with the greatest potential for further reduction in mortality rates. Design: International benchmarking and intranational comparisons of mortality rates were used to identify areas with the greatest potential for improvement. Results: Latest data from Organisation for Economic Cooperation and Development (OECD) countries confirm that, while Japan's death rates remain the lowest in the world, Australia's are decreasing rapidly and we now rival Switzerland for second overall ranking. When the contributions of specific conditions are compared, the areas with the greatest potential for reductions are circulatory diseases (especially ischaemic heart disease); suicide; injury and violence; smoking-related conditions; and cancers amenable to prevention/early detection. Intranational comparisons show considerable scope for reduction in inequalities, especially those between Aboriginal and Torres Strait Islander peoples and other Australians, between males and females, and between low and high socioeconomic groups. These conditions and inequalities are highly interrelated, as differentials in health status are often mediated through broader societal inequalities. Conclusions: Australia should aim to become the country with the lowest mortality rate in the world. This could realistically be achieved by benchmarking performance nationally and internationally, applying current knowledge and available interventions, matching policies with funding, and implementing systemic national programs and activities to promote health and prevent "illth".
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Australia ; Child ; Child, Preschool ; Developed Countries ; Female ; Health Status ; Humans ; Infant ; Male ; Middle Aged ; Mortality ; Needs Assessment ; Risk Factors ; Sex Factors ; Socioeconomic Factors
Language	English
Publishing date	2007-08-08
Publishing country	Australia
Document type	Journal Article
ZDB-ID	186082-3
ISSN	1326-5377 ; 0025-729X
ISSN (online)	1326-5377
ISSN	0025-729X
DOI	10.5694/j.1326-5377.2007.tb01355.x
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Article ; Online: Development and responses of brain metastases during treatment with trastuzumab emtansine (T-DM1) for HER2 positive advanced breast cancer: A single institution experience.

Okines, Alicia / Irfan, Tazia / Khabra, Komel / Smith, Ian / O'Brien, Mary / Parton, Marina / Noble, Jill / Stanway, Susie / Somaiah, Navita / Ring, Alistair / Johnston, Stephen / Turner, Nicholas

The breast journal

2017 Volume 24, Issue 3, Page(s) 253–259

Abstract: Ado-trastuzumab emtansine (T-DM1) is an antibody-drug conjugate that does not cross an intact ... blood-brain barrier. In the EMILIA trial of T-DM1 vs capecitabine/lapatinib for HER2 positive advanced breast cancer ... new brain disease during T-DM1. We assessed the frequency of brain progression in clinical practice ...

Abstract	Ado-trastuzumab emtansine (T-DM1) is an antibody-drug conjugate that does not cross an intact blood-brain barrier. In the EMILIA trial of T-DM1 vs capecitabine/lapatinib for HER2 positive advanced breast cancer, all patients had baseline brain imaging, and 9/450 (2%) of patients with negative baseline imaging developed new brain disease during T-DM1. We assessed the frequency of brain progression in clinical practice, without routine baseline imaging. We undertook a retrospective study of all patients treated with T-DM1 at the Royal Marsden Hospital from 2011 to 2016. Data collected included baseline characteristics, previous treatment for advanced breast cancer, sites of metastatic disease, duration of T-DM1, sites of progression, and treatment of CNS progression. Fifty-five patients were identified who had received a median of two prior lines of treatment (range 0-5). All were HER2 positive; 45 patients had IHC 3+ tumors and 10 were ISH positive. Patients received a median of 12 cycles of T-DM1 (range 1-34), and six remain on treatment at the time of analysis. Before commencing T-DM1, 16/55 (29%) had known brain metastases (treated with whole brain [9] stereotactic radiotherapy [6] or both [1]). Brain was the first site of progression in 56% (9/16) patients, with a median time to brain progression of 9.9 months (95% CI 3.9-12.2). In patients without known baseline brain metastases, 17.9% (7/39) developed new symptomatic brain disease during T-DM1, after a median of 7.5 months (95%CI 3.8-9.6). Brain progression was isolated, with control of extra-cranial disease in 4/7 patients. Only one patient was suitable for stereotactic radiotherapy. Median time to extra-cranial progression in all patients was 11.5 months (95% CI 9.1-17.7), and median OS in all patients was 17.8 months (95% CI 14.2-22). In patients not screened for brain metastases at baseline, the brain was the first site of progression in a significant proportion. Baseline brain imaging may have a role in standard practice for patients commencing T-DM1 therapy.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents, Immunological/adverse effects ; Antineoplastic Agents, Immunological/therapeutic use ; Brain Neoplasms/drug therapy ; Brain Neoplasms/mortality ; Brain Neoplasms/secondary ; Breast Neoplasms/metabolism ; Breast Neoplasms/mortality ; Breast Neoplasms/pathology ; Cerebral Hemorrhage/chemically induced ; Female ; Humans ; Maytansine/adverse effects ; Maytansine/analogs & derivatives ; Maytansine/therapeutic use ; Middle Aged ; Receptor, ErbB-2/metabolism ; Retrospective Studies ; Trastuzumab/adverse effects ; Trastuzumab/therapeutic use ; Treatment Outcome
Chemical Substances	Antineoplastic Agents, Immunological ; Maytansine (14083FR882) ; ERBB2 protein, human (EC 2.7.10.1) ; Receptor, ErbB-2 (EC 2.7.10.1) ; Trastuzumab (P188ANX8CK) ; ado-trastuzumab emtansine (SE2KH7T06F)
Language	English
Publishing date	2017-08-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	1289960-4
ISSN	1524-4741 ; 1075-122X
ISSN (online)	1524-4741
ISSN	1075-122X
DOI	10.1111/tbj.12906
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Article ; Online: Impact of timing of adjuvant chemothapy for early breast cancer: the Royal Marsden Hospital experience.

Okines, Alicia F C / Kipps, Emma / Irfan, Tazia / Coakley, Maria / Angelis, Vaselios / Asare, Bernice / Mohammed, Kabir / Walsh, Geraldine / Ring, Alistair / Johnston, Stephen R D / Parton, Marina / Turner, Nicholas C / Smith, Ian E

British journal of cancer

2021 Volume 125, Issue 2, Page(s) 299–304

Abstract: Background: The optimal time to deliver adjuvant chemotherapy has not been defined.: Methods: A retrospective study of consecutive patients receiving adjuvant anthracycline and/or taxane 1993-2010. Primary endpoint included 5-year disease-free ... ...

Abstract	Background: The optimal time to deliver adjuvant chemotherapy has not been defined. Methods: A retrospective study of consecutive patients receiving adjuvant anthracycline and/or taxane 1993-2010. Primary endpoint included 5-year disease-free survival (DFS) in patients commencing chemotherapy <31 versus ≥31 days after surgery. Secondary endpoints included 5-year overall survival (OS) and sub-group analysis by receptor status. Results: We identified 2003 eligible patients: 1102 commenced chemotherapy <31 days and 901 ≥31 days after surgery. After a median follow-up of 115 months, there was no difference in 5-year DFS rate with chemotherapy <31 compared to ≥31 days after surgery in the overall population (81 versus 82% hazard ratio (HR) 1.15, 95% confidence interval (95% CI) 0.92-1.43, p = 0.230). The 5-year OS rate was similar in patients who received chemotherapy <31 or ≥31 days after surgery (90 versus 91%, (HR 1.21, 95% CI 0.89-1.64, p = 0.228). For 250 patients with triple-negative breast cancer OS was significantly worse in patients who received chemotherapy ≥31 versus <31 days (HR = 2.18, 95% CI 1.11-4.30, p = 0.02). Discussion: Although adjuvant chemotherapy ≥31 days after surgery did not affect DFS or OS in the whole study population, in TN patients, chemotherapy ≥31 days after surgery significantly reduced 5-year OS; therefore, delays beyond 30 days in this sub-group should be avoided.
MeSH term(s)	Adult ; Anthracyclines/therapeutic use ; Breast Neoplasms/drug therapy ; Breast Neoplasms/pathology ; Breast Neoplasms/surgery ; Breast Neoplasms, Male/drug therapy ; Breast Neoplasms, Male/pathology ; Breast Neoplasms, Male/surgery ; Bridged-Ring Compounds/therapeutic use ; Chemotherapy, Adjuvant ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Survival Analysis ; Taxoids/therapeutic use ; Time Factors ; Treatment Outcome ; United Kingdom
Chemical Substances	Anthracyclines ; Bridged-Ring Compounds ; Taxoids ; taxane (1605-68-1)
Language	English
Publishing date	2021-05-20
Publishing country	England
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80075-2
ISSN	1532-1827 ; 0007-0920
ISSN (online)	1532-1827
ISSN	0007-0920
DOI	10.1038/s41416-021-01428-4
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