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Biomedical subjects

Frances M Boyle

Publications and source records attributed to Frances M Boyle.

14 recordsLinked to original sources
PubMed2007

Childhood sexual abuse and adult sexual dysfunction: response to commentary by Rind and Tromovitch (2007).

Rind and Tromovitch (2007) raised four concerns relating to our article (Najman, Dunne, Purdie, Boyle, & Coxeter, 2005. Archives of Sexual Behavior, 34, 517-526.) which suggested a causal association between childhood sexual abuse (CSA) and adult sexual dysfunction. We consider each of these concerns: magnitude of effect, cause and effect, confounding, and measurement error. We suggest that, while the concerns they raise represent legitimate reservations about the validity of our findings, on balance the available evidence indicates an association between CSA and sexual dysfunction that is of "moderate" magnitude, probably causal, and unlikely to be a consequence of confounding or measurement error.

Adaptation, Psychological↗
PubMed2007

Enantioselectivity of thalidomide serum and tissue concentrations in a rat glioma model and effects of combination treatment with cisplatin and BCNU.

Thalidomide is currently under evaluation as an anti-angiogenic agent in cancer treatment, alone and in combination with cytotoxic agents. Thalidomide is a racemate with known pharmacologic and pharmacokinetic enantioselectivity. In a previous study with thalidomide combination chemotherapy, we found evidence of anti-tumour synergy. In this study, we examined whether the synergy involved altered pharmacokinetics of thalidomide enantiomers. Adult female F344 rats were implanted with 9L gliosarcoma tumours intracranially, subcutaneously (flank), or both. Effectiveness of oral thalidomide alone, and with intraperitoneal BCNU or cisplatin combination chemotherapy, was assessed after several weeks treatment. Presumed pseudo steady-state serum, tumour and other tissues, collected after treatment, were assayed for R- and S-thalidomide by chiral HPLC. Both serum and tissue concentrations of R-thalidomide were 40-50% greater than those of S-thalidomide. Co-administration of BCNU or cisplatin with thalidomide did not alter the concentration enantioselectivity. Poor correlation of concentration with subcutaneous anti-tumour effect was found for individual treatments, and with all treatments for intracranial tumours. The consistency of the enantiomer concentration ratios across treatments strongly suggests that the favourable antitumour outcomes from interactions between thalidomide and the cytotoxic agents BCNU and cisplatin did not have altered enantioselectivity of thalidomide pharmacokinetics as their basis.

Animals↗
PubMed2006

Prevalence and risk factors for lifetime exposure to Pap smear abnormalities in the Australian community.

BACKGROUND: This study examined the prevalence, correlates and consequences of abnormal Pap smears in a population-based survey of sexuality and health in the Australian community. METHODS: Cross-sectional telephone survey of 908 women aged 18-59 years randomly selected from the Commonwealth electoral roll. RESULTS: Most women (91%) reported having had at least one Pap smear test, a figure directly comparable with national estimates. Being single (prevalence ratio (PR) 4.61; 95% CI 2.09-10.17) and not having had sexual intercourse (PR 5.31, 95% CI 3.11-9.07) were strong predictors of never having been tested. One in four women (26%) who reported being screened also reported having had an abnormal Pap smear result, of whom 66% said they had further testing and 52% some form of treatment. A minority (19%) reported negative effects of treatment on their sex lives. Having been diagnosed with human papillomavirus (HPV) (PR 2.87, 95% CI 1.84-4.48), and to a lesser degree, having had a greater number of male sexual partners (PR 1.38, 95% CI 1.01-1.89), and experiencing sexual problems in the last year (PR 0.99, 95% CI 0.99-1.88) were independently associated with reporting of abnormal Pap smear results. CONCLUSIONS: Approximately one in four women self report lifetime exposure to Pap smear abnormalities. It is important that women are well prepared for this common experience. A causal association between multiple sexual partners and risk of acquiring HPV infection is supported by these data.

Adolescent↗
PubMed2004

ask for it: development of a health advocacy intervention for adults with intellectual disability and their general practitioners.

Two per cent of people in Australia have intellectual disability and the adults in this population often have poor health status. This poor health can be partly attributed to communication difficulties encountered by people with intellectual disability and also health professionals in consultation settings. The design and development processes of an educational intervention to improve communication between patients, general practitioners (GPs) and also advocates in a population of adults with intellectual disability are described. The design process was collaborative and involved adults with intellectual disability, GPs, parents, support workers and other professionals. It was a nine-step development process and led to the final communication tool package, the ask (advocacy skills kit) 5-year health diary and educational session. As a result of the collaborative design and development processes, this diary included qualities not found in most other medical record keeping systems: visual appeal, advice on how to be a health advocate, utility for a range of users, privacy, portability and sufficient capacity to record personal patient information which enhanced communication between doctor, patient and advocate. It is proving to be very popular. Clear implications were found for applying established criteria and incorporating the needs of users in the design of educational interventions in the intellectually disabled population. Health promotion tools aiming to improve the current poor health status of adults with intellectual disability should be developed further.

Adult↗
PubMed2004

Cancer: communicating in the team game.

There is increasing evidence that effective communication is a critical means by which surgeons can assist their patients to achieve the best outcomes. This paper examines the processes and outcomes of effective communication by surgeons in cancer teams, and includes: (i). strategies that promote collaborative relationships with patients and lead to more effective treatment; (ii). strategies to improve multidisciplinary team performance; and (iii). methods to minimize the risk of error and litigation. The experience of a cancer diagnosis involves radical changes in patients' lives, somewhat akin to suddenly finding yourself in the middle of a rugby scrum for the first time. The analogy of rugby throws fresh light on such critical factors in communication as prematch preparation, orientation to the game and the team, a good kick off, sizing up the opposition, creative plays and optimizing teamwork to promote quality of life and survival.

Humans↗
PubMed2004

Penetration of intra-arterially administered vincristine in experimental brain tumor.

Vincristine is an integral part of the "PCV" regimen that is commonly administered to treat primary brain tumors. The efficacy of vincristine as a single agent in these tumors has been poorly studied. This study was designed to determine whether vincristine enters normal rat brain or an intracranially or subcutaneously implanted glioma and to assess the presence of the efflux pump P-glycoprotein (P-gp) on tumor and vascular endothelial cells. The 9L rat gliosarcoma was implanted intracranially and subcutaneously in three Fischer 344 rats. On day 7, [3H]vincristine (50 microCi, 4.8 microg) was injected into the carotid artery, and the animals were euthanized 10 or 20 min later. Quantitative autoradiography revealed that vincristine levels in the liver were 6- to 11-fold greater than in the i.c. tumor, and 15- to 37-fold greater than in normal brain, the reverse of the expected pattern with intraarterial delivery. Vincristine levels in the s.c. tumor were 2-fold higher than levels in the i.c. tumor. P-gp was detected with JSB1 antibody in vascular endothelium of both normal brain and the i.c. tumor, but not in the tumor cells in either location, or in endothelial cells in the s.c. tumor. These results demonstrate that vincristine has negligible penetration of normal rat brain or i.c. 9L glioma despite intra-arterial delivery and the presence of blood-brain barrier dysfunction as demonstrated by Evan's blue. Furthermore, this study suggests that P-gp-mediated efflux from endothelium may explain these findings. The lack of penetration of vincristine into brain tumor and the paucity of single-agent activity studies suggest that vincristine should not be used in the treatment of primary brain tumors.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed2003

Hormone replacement therapy: to use or not to use?

The main indication for hormone replacement therapy (HRT) is to control menopausal symptoms and improve quality of life. Ideally, withdrawal of HRT should be attempted after 4-5 years of therapy. HRT reduces fracture risk and remains appropriate therapy for osteoporosis, particularly in women with symptoms. HRT is not appropriate for primary or secondary cardioprotection. HRT leads to a small increase in breast cancer incidence, which increases with duration of therapy and age. HRT increases the risk of thromboembolism. Patient management and therapy should be reviewed annually with risk-benefit counselling.

Aged↗
PubMed2003

Patient barriers to optimal cancer pain control.

Poorly controlled pain is a significant problem for cancer patients. Contributing factors may include concerns about analgesics and fears about the implications of pain, which may hinder open communication. We surveyed the prevalence of these concerns in Australian oncology patients and investigated associations with inadequate pain control. Ninety-three adult patients with cancer, undergoing treatment at a teaching hospital, completed the patient barriers questionnaire (BQ) and a self-report questionnaire to determine pain severity, interference with daily activities, use of analgesics and alternative therapies, and hesitation to report pain. Overall, there was a high prevalence of agreement with the BQ scales assessing concerns about communication and analgesic use. One-third of patients had clinically significant pain, which interfered with daily activities, despite use of analgesics. They were more likely to use alternative therapies for pain control, to hesitate to discuss their pain, and had significantly greater concerns about side effects of analgesics and injections. Our study confirms that patient barriers exist in this Australian population and are associated with inadequate pain control. Oncology staff need to actively screen for pain, particularly targeting patients using alternative therapies and experiencing side effects, develop communication and prescribing skills, and diversify pain management approaches beyond analgesics.

Adolescent↗
PubMed2003

Is child sexual abuse declining? Evidence from a population-based survey of men and women in Australia.

OBJECTIVE: Substantiated cases of child sexual abuse (CSA) in the United States have declined significantly over the past decade. This may, or may not, reflect change in the underlying rate in the general population. This study examines age-cohort differences in the prevalence of self-reported CSA experiences of men and women aged 18-59 years in a community-based sample from a comparable western nation. METHOD: In April 2000, we completed a cross-sectional, telephone-based survey of a randomly selected national sample of men and women in Australia. Volunteers (876 males, 908 females) answered a range of questions about health status and sexuality, including unwanted sexual experiences before the age of 16 years. Of selected adults with publicly-listed telephone numbers, 61% agreed to participate. There were few differences between the volunteers and the Australian population on demographic variables and health indicators. RESULTS: Non-penetrative CSA was twice as common among women (33.6%) than men (15.9%). Approximately 12% of women and 4% of men reported unwanted penetrative experiences. CSA was reported significantly less often by younger males, with a linear decline from the oldest to youngest men. Among all females who had intercourse before age 16, older women were much more likely than younger women to say they were an unwilling partner on the first occasion. If first intercourse occurred at age 16 or later, there were no age-cohort differences in risk of first-time abuse. Self-reported "openness" and "comfort" during the telephone interviews was not systematically related to prevalence of CSA. CONCLUSION: These population-based findings provide evidence of a decline in the underlying rate of CSA in Australia. Although every measure of CSA inevitably is flawed to some extent, these trends in self-report complement official statistics that show substantial decline in recent years.

Adolescent↗
PubMed2003

Early patterns of sexual activity: age cohort differences in Australia.

Patterns of first sexual activity among Australians born between the 1940s and 1980s were analysed using data from a national telephone survey of 1784 adults (876 males; 908 females). Sixty-one percent of those randomly selected from the Australian electoral roll and contactable by telephone responded. Many trends, including earlier first intercourse--from 20 to 18 years (females) and 18.8 to 17.8 years (males)--were established with the 40-49 year cohort, whose sexual debut was in the late 1960s-70s. Significant age-cohort effects saw women in the contemporary (18-29 year) cohort draw level with males for age at first intercourse and first sex before age 16 and before leaving school. First intercourse contraceptive use climbed from 30% to 80%. Condom use quadrupled to 70%. Australian age-cohort effects are remarkably consistent with those in similar western cultures: gender convergence in sexual experience and increasing avoidance of sexually transmitted disease and pregnancy. If such trends continue, positive long-term outcomes for health and social wellbeing should result.

Adolescent↗
PubMed2003

Sexual dysfunction in the Australian population.

AIM: To describe the prevalence and forms of sexual dysfunction experienced by Australians, and compare these with people in the United States. METHODS: A cross sectional, telephone interview survey of a randomly selected sample of men (n = 876) and women (n = 908) aged between 18 and 59 years on the electoral roll in all states and territories of Australia (response rate = 61%) was conducted between November 1999 and April 2000. RESULTS: Large proportions of Australian men (55.0%) and women (60.5%) reported at least one sexual problem within the preceding year. More serious sexual dysfunction (> 3 symptoms) was observed in 13.2% of men and 19.7% of women. DISCUSSION: Australia and the USA are similar with regard to the high rate of symptoms of sexual dysfunction observed in the population. The low rate of treatment points to both patient and doctor reluctance to discuss sexual performance and practices.

Adolescent↗
PubMed2002

Does research into sensitive areas do harm? Experiences of research participation after a child's diagnosis with Ewing's sarcoma.

OBJECTIVE: To investigate family members' experiences of involvement in a previous study (conducted August 1995 to June 1997) following their child's diagnosis with Ewing's sarcoma. DESIGN: Retrospective survey, conducted between 1 November and 30 November 1997, using a postal questionnaire. PARTICIPANTS: Eighty-one of 97 families who had previously completed an in-depth interview as part of a national case-control study of Ewing's sarcoma. MAIN OUTCOME MEASURES: Participants' views on how participation in the previous study had affected them and what motivated them to participate. RESULTS: Most study participants indicated that taking part in the previous study had been a positive experience. Most (n = 79 [97.5%]) believed their involvement would benefit others and were glad to have participated, despite expecting and finding some parts of the interview to be painful. Parents whose child was still alive at the time of the interview recalled participation as more painful than those whose child had died before the interview. Parents who had completed the interview less than a year before our study recalled it as being more painful than those who had completed it more than a year before. CONCLUSIONS: That people suffering bereavement are generally eager to participate in research and may indeed find it a positive experience is useful information for members of ethics review boards and other "gatekeepers", who frequently need to determine whether studies into sensitive areas should be approved. Such information may also help members of the community to make an informed decision regarding participation in such research.

Adolescent↗