Publications by authors named "Boffa J"

Article Synopsis
  • - The Northern Territory (NT) of Australia has the highest alcohol consumption and injury rates, leading to a study on alcohol-related injury (ARI) hospitalisations from 2007 to 2022 to assess the relationship between alcohol and injuries, and the impact of alcohol policies.
  • - Findings revealed that 22.6% of all injury hospitalisations were linked to alcohol, with assaults being the primary cause (46%), and a significant decline in ARI hospitalisations was noted in Central Australia after implementing alcohol policies in 2017-2018.
  • - The study emphasizes the effectiveness of these alcohol policies in reducing ARI hospitalisations in Central Australia, suggesting the need for sustained efforts to combat alcohol-related harm.
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BACKGROUND Focal segmental glomerulosclerosis (FSGS) very rarely occurs in patients with multiple myeloma. Much more common are renal impairments secondary to monoclonal light-chain tubulopathy, AL amyloidosis, light-chain deposition disease, and the so-called monoclonal gammopathy of renal significance. CASE REPORT We report the case of a 79-year-old myeloma patient without noticeable medical problems but with a long history of myeloma treatment beginning 13 years ago.

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Identifying case-finding strategies to reduce tuberculosis (TB) incidence in high-burden countries requires better knowledge of the disease burden in key contributing populations and settings. To inform South Africa's National Tuberculosis Strategic Plan 2023-2028, we conducted a systematic review of active TB disease and latent TB infection (LTBI) prevalence and incidence in underserved populations, defined as those living in informal settlements, townships, or impoverished communities. We identified articles published from January 2010 to December 2023, assessed study quality, and conducted a meta-analysis to estimate pooled TB and LTBI prevalence stratified by HIV status.

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The Northern Territory (NT) and Far North Queensland (FNQ) have a high proportion of Aboriginal and Torres Strait Islander women birthing who experience hyperglycaemia in pregnancy. A multi-component health systems intervention to improve antenatal and postpartum care in these regions for women with hyperglycaemia in pregnancy was implemented between 2016 and 2019. We explored health professional perspectives on the impact of the intervention on healthcare.

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Background: Nowhere is optimising healthcare staff retention more important than in primary health care (PHC) settings in remote Australia, where there are unacceptably high rates of staff burnout and turnover. Ensuing consequences for the remote health services and the community are acute - staffing shortfalls in clinics; organisational instability; excessive costs associated with frequent staff recruitment and orientation; diminished access to PHC for patients in need; and lack of continuity of patient care; all of which further entrench poor health outcomes for the community. Optimising remote healthcare staff retention is critical in order to provide high quality and continued PHC.

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Article Synopsis
  • AA amyloidosis (AAA) is a serious multisystem disease stemming from chronic inflammation, commonly affecting the kidneys and posing risks during pregnancy.
  • A study reviewed cases of AAA in pregnant women, identifying three new patients and highlighting that familial Mediterranean fever was the leading cause of AAA in this group.
  • The research found that pregnancies in AAA patients often led to complications like growth retardation and preterm birth, indicating the need for heightened medical monitoring during pregnancy.
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Background And Study Aims: Chronic kidney disease (CKD) is a well-known risk factor of gastrointestinal angiectasia (GIA). The aim was to compare this population with CDK patients without GIA.

Methods: Patients followed in the Nephrology Department of Tenon Hospital for which an endoscopy was performed between 2012 and 2022 were identified.

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Background: Aboriginal Community Controlled Health Services (ACCHSs) in Australia aim to optimise access to comprehensive and culturally safe primary health care (PHC) for Aboriginal populations. Central to quality service provision is the retention of staff. However, there is lack of published research reporting patterns of staff turnover and retention specific to ACCHSs.

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Introduction: The objective of this study was to describe kidney involvement in patients with myelodysplastic syndromes (MDS), their treatments, and outcomes.

Methods: We conducted a multicenter retrospective study in seven centers, identifying MDS patients with acute kidney injury (AKI), chronic kidney disease (CKD), and urine abnormalities.

Results: Fifteen patients developed a kidney disease 3 months after MDS diagnosis.

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Article Synopsis
  • The Northern Territory government re-introduced the Banned Drinker Register (BDR) in 2017 to tackle high alcohol-related harm, while considering other interventions like police presence in bottle shops and minimum alcohol pricing.
  • An analysis of emergency department visits and hospital admissions from January 2014 to December 2019 showed a significant increase in assault and maltreatment cases after the BDR was introduced, but this was not consistent in individual communities.
  • The study concluded that the BDR had minimal effect on reducing assault and maltreatment in children and adolescents, suggesting that a broader approach that combines effective alcohol policies and social interventions is necessary to decrease alcohol-related harm.
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Introduction: The COVID-19 pandemic period (2020 to 2022) challenged and overstretched the capacity of primary health care services to deliver health care globally. The sector faced a highly uncertain and dynamic period that encompassed anticipation of a new, unknown, lethal and highly transmissible infection, the introduction of various travel restrictions, health workforce shortages, new government funding announcements and various policies to restrict the spread of the COVID-19 virus, then vaccination and treatments. This qualitative study aims to document and explore how the pandemic affected primary health care utilisation and delivery in remote and regional Aboriginal and Torres Strait Islander communities.

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Key Points: We evidenced terminal pathway activation (C5b-9 deposits) in most of the glomeruli on kidney biopsy of C3 glomerulopathy. The amount of C5b-9 deposits correlated with disease prognosis in C3 glomerulopathy. Increased terminal pathway activation was found predominantly in a subgroup exhibiting an immuno-fibroblastic signature.

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In recent years, there has been an increasing trend of short-term staffing in remote health services, including Aboriginal Community-Controlled Health Services (ACCHSs). This paper explores the perceptions of clinic users' experiences at their local clinic and how short-term staffing impacts the quality of service, acceptability, cultural safety, and continuity of care in ACCHSs in remote communities. Using purposeful and convenience sampling, community users (aged 18+) of the eleven partnering ACCHSs were invited to provide feedback about their experiences through an interview or focus group.

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Written exposure therapy (WET) is a brief, manualized trauma-focused treatment typically delivered in five individual weekly sessions. Given the brevity and effectiveness of WET, researchers have begun to focus on its delivery in a massed format. However, only one case study examining massed delivery has been published to date.

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Article Synopsis
  • * A mixed-methods, co-design approach will involve young people with diabetes, their families, and health professionals to develop and improve care models, including guidelines, support networks, and training for healthcare providers.
  • * The study has received ethical approval and aims to produce valuable insights and practices for enhancing diabetes care that are both age-appropriate and culturally sensitive.
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Kidney Biopsy (KB) is a crucial diagnostic tool in the field of renal diseases and is routinely performed in nephrology departments. A previous survey conducted by the Société Francophone de Néphrologie Dialyse Transplantation (SFNDT) revealed significant disparities in clinical practices, sometimes conflicting with the existing literature and recently published recommendations. In response, the SFNDT wished to promote the development of best practice guidelines, under the auspices of the French National Authority for Health (HAS), to establish a standardized framework for performing kidney biopsies in France.

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Article Synopsis
  • Atypical anti-glomerular basement membrane (GBM) nephritis is a rare kidney condition that presents differently than typical cases, showing bright linear immunoglobulin staining without the usual serum anti-GBM antibodies.
  • In a study involving patients diagnosed from 2003 to 2022, 25 out of 38 potential cases were confirmed, with a majority exhibiting symptoms like hematuria and varying forms of glomerulonephritis.
  • The findings suggest that atypical anti-GBM nephritis often progresses slower than typical cases, but further research is necessary to understand its complete nature and implications.
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  • The study looked at how two substances, copeptin and iFGF23, in patients with chronic kidney disease (CKD) might predict bad health outcomes.
  • It involved 329 CKD patients and found that higher levels of iFGF23 were linked to worse kidney health and more deaths, while copeptin did not show this link.
  • The researchers suggest that checking iFGF23 levels could help doctors better monitor CKD patients, but copeptin levels may not be as helpful.
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Article Synopsis
  • * In a study of 50 patients with severe renal impairment, only one death occurred within the first 100 days post-transplant, with most patients showing significant improvements in hematological responses.
  • * Overall, after two years, 84% of patients were alive, 70% were free from disease progression, and 59% saw an improvement in kidney function, indicating that the procedure is both safe and effective for this population.
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Especially exposed to frequent cardiovascular events and its related mortality, some cardiovascular therapies of the hemodialyzed population as well as coronary investigations remain controversial. We have collected data and discussed recent trials and guidelines dedicated to this patient subset.

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Article Synopsis
  • - Familial Mediterranean fever (FMF) is a common genetic auto-inflammatory disease, primarily affecting people from the Mediterranean region, caused by mutations in the MEFV gene and transmitted in an autosomal recessive manner.
  • - Patients typically experience recurrent fever episodes from childhood, accompanied by abdominal or chest pain, joint pain, muscle pain, and skin issues, with a serious risk of complications like kidney failure due to amyloidosis.
  • - The paper outlines national guidelines for diagnosing and managing FMF in France, including a "treat-to-target" approach, genetic testing confirmation, and special considerations for kidney failure and pregnancy during treatment.
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Issue Addressed: The ASQ-TRAK, a strengths-based approach to developmental screening, has high acceptability and utility across varied Aboriginal and Torres Strait Islander contexts. While substantive knowledge translation has seen many services utilise ASQ-TRAK, we now need to move beyond distribution and support evidence-based scale-up to ensure access. Through a co-design approach, we aimed to (1) understand community partners' perspectives of barriers and enablers to ASQ-TRAK implementation and (2) develop an ASQ-TRAK implementation support model to inform scale-up.

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