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  1. Book ; Online: Tracking Rural Change

    Merlan, Francesca / Raftery, David

    2009  

    Abstract: A key, intensifying change affecting rural areas in the last few decades has been a decline in the proportion of national populations whose principal livelihood is farming. The corresponding re-distribution of population has typically resulted in a net ... ...

    Abstract A key, intensifying change affecting rural areas in the last few decades has been a decline in the proportion of national populations whose principal livelihood is farming. The corresponding re-distribution of population has typically resulted in a net population loss to rural areas, and diversification of rural activity. The corporatization and technological modification of food production has prompted new policy challenges, and has bound rural and urban populations together in new relationships articulated in moral discourses of custodianship, food safety, and sustainability. Contributors to this volume came together in the attempt to stimulate collective insight into trends of rural change in Australia, New Zealand and Europe. The first two countries have been characterised by avowedly `neoliberal' rural policy - with considerable departures from it in practice; Europe, on the other hand, by a mix of policy measures which attempt to integrate land management and sustainability, diversification and maintenance of a competitive farming sector within an overarching policy framework more overtly, though only partially, oriented towards sustaining rural society. Aiming to build on research relating to the character of rural transitions, this volume offers substantive and critical contributions to the understanding of the sources of unpredictability, instability, and continuity, that underpin rural transition. The papers explore changes and continuities in policy, the governance of rural spaces, technological developments relating to rural areas and populations, and social forms of subjectivation and participation in increasingly diverse rural settings
    Keywords Geography (General) ; Communities. Classes. Races
    Size 1 electronic resource (187 p.)
    Publisher ANU Press
    Document type Book ; Online
    Note English ; Open Access
    HBZ-ID HT020087534
    ISBN 9781921536533 ; 1921536535
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  2. Article: Prolonged Ileus after Colorectal Surgery, a Systematic Review.

    Shereef, Anzil / Raftery, David / Sneddon, Fraser / Emslie, Katy / Mair, Lyn / Mackay, Craig / Ramsay, George / Forget, Patrice

    Journal of clinical medicine

    2023  Volume 12, Issue 18

    Abstract: Background: The development of prolonged post-operative ileus (POI) remains a significant problem in the general surgical patient population. The aetiology of ileus is poorly understood and management options/preventative measures are currently ... ...

    Abstract Background: The development of prolonged post-operative ileus (POI) remains a significant problem in the general surgical patient population. The aetiology of ileus is poorly understood and management options/preventative measures are currently extremely limited. The pathophysiology leading to a post-operative ileus is relatively poorly understood, and there is no validated method to estimate ileus occurrence or duration. Ileus in the post-operative period commonly occurs following major colorectal surgery and leads to painful abdominal distension, vomiting, nutritional deficit, pneumonia, prolonged hospital stays and susceptibility to hospital-acquired infection. An increased hospital stay, the burden of treatment costs and the burden on the health system highlight the importance of future research on finding definitions, preventions and predictions of ileus.
    Methods: A systematic literature review was performed to identify randomized controlled trials (RCTs) comparing the rate of ileus on various treatments for prolonged post-operative ileus following colorectal surgery. A confidence evaluation in a meta-analysis were performed using CINeMA. Direct and indirect comparisons of all interventions were simultaneously carried out using a network meta-analysis. The level of certainty was appraised using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. The method of assessing the risk of bias, the quality assessment, used the Cochrane Risk of Bias 2 tool (RoB2).
    Results: Among the seven included studies, the majority suffered from considerable within-study bias, affecting the confidence rates of study findings. Heterogeneity and incoherence made the pairwise meta-analysis and ranking of interventions unfeasible. Indirect comparisons were considered unreliable due to this incoherence.
    Conclusions: This systematic review, with a confidence evaluation in the network meta-analysis, determined that there is a knowledge gap in the field of study on prolonged ileus following digestive surgery. The current evidence suffers from heterogeneity and incoherence more than imprecision. There is a gap in the data on ileus occurrence in interventional trials for digestive surgery. This could inform clinicians and trialists to better appraise the current literature and plan future trials.
    Language English
    Publishing date 2023-09-05
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12185769
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Use of opioids in patients with cancer with hepatic impairment-a systematic review.

    Hughes, Lewis Thomas / Raftery, David / Coulter, Paul / Laird, Barry / Fallon, Marie

    BMJ supportive & palliative care

    2021  Volume 12, Issue 2, Page(s) 152–157

    Abstract: Purpose: Opioids are recommended for moderate-to-severe cancer pain; however, in patients with cancer, impaired hepatic function can affect opioid metabolism. The aim of this systematic review was to evaluate the evidence for the use of opioids in ... ...

    Abstract Purpose: Opioids are recommended for moderate-to-severe cancer pain; however, in patients with cancer, impaired hepatic function can affect opioid metabolism. The aim of this systematic review was to evaluate the evidence for the use of opioids in patients with cancer with hepatic impairment.
    Methods: A systematic review was conducted and the following databases searched: AMED (-2021), MEDLINE (-2021), EMBASECLASSIC + EMBASE (-2021) and Cochrane Central Register of Controlled Trials (-2021). Eligible studies met the following criteria: patients with cancer-related pain, taking an opioid (as defined by the WHO Guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents); >18 years of age; patients with hepatic impairment defined using recognised or study-defined definitions; clinical outcome hepatic impairment related; and primary studies. All eligible studies were appraised using the Grading of Recommendations Assessment, Development and Evaluation system.
    Results: Three studies (n=95) were eligible but heterogeneity meant meta-analysis was not possible. Each individual study focused on only one each of oxycodone±hydrocotarnine, oxycodone/naloxone and morphine. No recommendations could be formulated on the preferred opioid in patients with hepatic impairment.
    Conclusions: Morphine is the preferred opioid in hepatic impairment owing to clinical experience and pharmacokinetics. This review, however, found little clinical evidence to support this. Dose adjustments of morphine and the oxycodone formulations reviewed remain necessary in the absence of quality evidence. Overall, the quality of existing evidence on opioid treatments in cancer pain and hepatic impairment is low and there remains a need for high-quality clinical studies examining this.
    MeSH term(s) Adolescent ; Analgesics, Opioid/therapeutic use ; Cancer Pain/drug therapy ; Humans ; Morphine/adverse effects ; Neoplasms/complications ; Neoplasms/drug therapy ; Oxycodone/therapeutic use
    Chemical Substances Analgesics, Opioid ; Morphine (76I7G6D29C) ; Oxycodone (CD35PMG570)
    Language English
    Publishing date 2021-09-01
    Publishing country England
    Document type Journal Article ; Systematic Review
    ISSN 2045-4368
    ISSN (online) 2045-4368
    DOI 10.1136/bmjspcare-2021-003065
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Book: Tracking rural change

    Merlan, Francesca / Raftery, David

    community, policy and technology in Australia, New Zealand and Europe

    2009  

    Author's details ed. by Francesca Merlan and David Raftery
    Keywords Rural conditions ; Rural development ; Social policy ; Sociology, Rural ; Ländliche Entwicklung ; Ländlicher Raum ; Ländliche Wirtschaft ; Australien ; Neuseeland ; Europa
    Language English
    Size V, 187 S., Ill.
    Publisher ANU E Press
    Publishing place Canberra, ACT
    Document type Book
    Note Enth. 8 Beitr.
    ISBN 1921536527 ; 9781921536526 ; 9781921536533 ; 1921536535
    Database ECONomics Information System

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