The Rac-GEF Tiam1 controls integrin-dependent neutrophil responses.

Rac GTPases are required for neutrophil adhesion and migration, and for the neutrophil effector responses that kill pathogens. These Rac-dependent functions are impaired when neutrophils lack the activators of Rac, Rac-GEFs from the Prex, Vav, and Dock families. In this study, we demonstrate that Tiam1 is also expressed in neutrophils, governing focal complexes, actin cytoskeletal dynamics, polarisation, and migration, in a manner depending on the integrin ligand to which the cells adhere.

The GPCR adaptor protein Norbin regulates S1PR1 trafficking and the morphology, cell cycle and survival of PC12 cells.

Norbin is an adaptor protein that binds numerous G protein-coupled receptors (GPCRs), is highly expressed in neurons, and is essential for a functioning nervous system in rodent models. Yet, beyond its control of neurite outgrowth and synaptic plasticity, few cellular roles of Norbin have been investigated to date. Furthermore, while Norbin is known to regulate the steady-state cell surface levels of several GPCRs, only in one case has the protein been shown to control the agonist-induced receptor internalisation which serves to attenuate GPCR signalling.

Age-related decline in the resistance of mice to bacterial infection and in LPS/TLR4 pathway-dependent neutrophil responses.

Host defense against bacterial and fungal infections diminishes with age. In humans, impaired neutrophil responses are thought to contribute to this decline. However, it remains unclear whether neutrophil responses are also impaired in old mice.

The GPCR adaptor protein norbin suppresses the neutrophil-mediated immunity of mice to pneumococcal infection.

Streptococcal pneumonia is a worldwide health problem that kills ∼2 million people each year, particularly young children, the elderly, and immunosuppressed individuals. Alveolar macrophages and neutrophils provide the early innate immune response to clear pneumococcus from infected lungs. However, the level of neutrophil involvement is context dependent, both in humans and in mouse models of the disease, influenced by factors such as bacterial load, age, and coinfections.

General practitioners with special interests: An integrative review of their role, impact and potential for the future.

Background And Objectives: A 'general practitioner with special interest (GPwSI)' refers to a GP who functions as a clinical intermediary between primary, secondary and tertiary care. This study aimed to advance understanding of the role, impact and potential of the GPwSI in Australia.

Method: A systematic literature search was conducted.

The Primary Care Practice Improvement Tool (PC-PIT) process for organisational improvement in primary care: application by Australian Primary Health Networks.

The Primary Care Practice Improvement Tool (PC-PIT) is an organisational performance improvement tool recently implemented by two Primary Health Networks (PHNs). This study explored barriers and facilitators to implementing the PC-PIT process at scale, from the initial introduction of the tool to completion of Plan-Do-Study-Act cycles with general practices. Using a qualitative design, in-depth, semi-structured interviews were conducted with 10 PHN staff to seek feedback on the delivery of the PC-PIT to general practices.

Questionnaires that measure the quality of relationships between patients and primary care providers: a systematic review.

Background: International guidance on models of care stress the importance of good quality, continuous patient-provider relationships to support high quality and efficient care and hospital avoidance. However, assessing the quality of patient-provider relationships is challenging due to its experiential nature. The aim of this study was to undertake a systematic review to identify questionnaires previously developed or used to assess the quality of continuous relationships between patients and their provider in primary care.

Successfully implementing a diabetic retinopathy screening service in general practice: What does the evidence tell us?

Background: We previously showed that general-practice based screening for diabetic retinopathy significantly improves recording of screening outcomes and follow-up for Australians with type 2 diabetes. In 2016, two Medicare Benefits Schedule item numbers were launched to support screening in general practice. However, there is little evidence-based information to guide practices in successfully implementing screening models for diabetic retinopathy.

What do patients with diabetes and providers think of an innovative Australian model of remote diabetic retinopathy screening? A qualitative study.

Background: Diabetic retinopathy (DR) is the commonest cause of preventable blindness in working age populations, but up to 98% of visual loss secondary to DR can be prevented with early detection and treatment. In 2012, an innovative outreach DR screening model was implemented in remote communities in a state of Australia. The aim of this study was to explore the acceptability of this unique DR screening model to patients, health professionals and other key stakeholders.

Embracing value co-creation in primary care services research: a framework for success.

Value co-creation redresses a key criticism of researcher-driven approaches to research - that researchers may lack insight into the end users' needs and values across the research journey. Value co-creation creates, in a step-wise way, value with, and for, multiple stakeholders through regular, ongoing interactions leading to innovation, increased productivity and co-created outcomes of value to all parties - thus creating a "win more-win more" environment. The Centre of Research Excellence (CRE) in Building Primary Care Quality, Performance and Sustainability has co-created outcomes of value that have included robust and enduring partnerships, research findings that have value to end users (such as the Primary Care Practice Improvement Tool and the best-practice governance framework), an International Implementation Research Network in Primary Care and the International Primary Health Reform Conference.

A Delphi study assessing the utility of quality improvement tools and resources in Australian primary care.

Objectives: To determine the relevance and utility of online tools and resources to support organisational performance development in primary care and to complement the Primary Care Practice Improvement Tool (PC-PIT).

Design: A purposively recruited Expert Advisory Panel of 12 end users used a modified Delphi technique to evaluate 53 tools and resources identified through a previously conducted systematic review. The panel comprised six practice managers and six general practitioners who had participated in the PC-PIT pilot study in 2013-2014.

Quality tools and resources to support organisational improvement integral to high-quality primary care: a systematic review of published and grey literature.

Objective: To conduct a systematic review of the literature to identify existing online primary care quality improvement tools and resources to support organisational improvement related to the seven elements in the Primary Care Practice Improvement Tool (PC-PIT), with the identified tools and resources to progress to a Delphi study for further assessment of relevance and utility.

Study Design: Systematic review of the international published and grey literature.

Data Sources: CINAHL, Embase and PubMed databases were searched in March 2014 for articles published between January 2004 and December 2013.

Trial of the Primary Care Practice Improvement Tool: building organisational performance in Australian general practice and primary health care.

Objective: To nationally trial the Primary Care Practice Improvement Tool (PC-PIT), an organisational performance improvement tool previously co-created with Australian primary care practices to increase their focus on relevant quality improvement (QI) activities.

Design: The study was conducted from March to December 2015 with volunteer general practices from a range of Australian primary care settings. We used a mixed-methods approach in two parts.

On the road to value co-creation in health care: the role of consumers in defining the destination, planning the journey and sharing the drive.

The role of consumers is now extending beyond being passive health care recipients and even active participants in their own care to involvement in innovation and value co-creation in health care - from being "users and choosers" to becoming "makers and shapers" of services. For active dialogue to occur in co-creation, consumers must become equal partners with health care organisations and providers, with the focus on areas of interest to all parties. The use of value co-creation in health care involves embedding the approach across the whole health care system - from the microsystem level to the mesosystem and the entire macrosystem.

Diabetic Retinopathy Screening and Monitoring of Early Stage Disease in Australian General Practice: Tackling Preventable Blindness within a Chronic Care Model.

Introduction: Diabetic retinopathy (DR) is the leading cause of preventable blindness in Australia. Up to 50% of people with proliferative DR who do not receive timely treatment will become legally blind within five years. Innovative and accessible screening, involving a variety of primary care providers, will become increasingly important if patients with diabetes are to receive optimal eye care.

An Innovative Australian Outreach Model of Diabetic Retinopathy Screening in Remote Communities.

Background. Up to 98% of visual loss secondary to diabetic retinopathy (DR) can be prevented with early detection and treatment. Despite this, less than 50% of Australian and American diabetics receive appropriate screening.

Development and pilot study of the Primary Care Practice Improvement Tool (PC-PIT): an innovative approach.

Objective: To assess the usability and validity of the Primary Care Practice Improvement Tool (PC-PIT), a practice performance improvement tool based on 13 key elements identified by a systematic review. It was co-created with a range of partners and designed specifically for primary health care.

Design: This pilot study examined the PC-PIT using a formative assessment framework and mixed-methods research design.

Key elements of high-quality practice organisation in primary health care: a systematic review.

Objectives: To identify elements that are integral to high-quality practice and determine considerations relating to high-quality practice organisation in primary care.

Study Design: A narrative systematic review of published and grey literature.

Data Sources: Electronic databases (PubMed, CINAHL, the Cochrane Library, Embase, Emerald Insight, PsycInfo, the Primary Health Care Research and Information Service website, Google Scholar) were searched in November 2013 and used to identify articles published in English from 2002 to 2013.

Triggering change in diabetes care delivery in general practice: a qualitative evaluation approach using the clinical microsystem framework.

Background: In 2008, the Sunshine Coast Division of General Practice (SCDGP) in Queensland, Australia initiated a highly successful Improved Diabetes Management (IDM) program with general practices in a regional area. The IDM program was evaluated against the 10 elements of a high functioning clinical microsystem framework as identified by Nelson et al. (2007) in order to determine key factors contributing to the successful adoption and uptake of the program in participating general practices.

Patients' experiences of referral for colorectal cancer.

Background: Outcomes for colorectal cancer patients vary significantly. Compared to other countries, Australia has a good record with patient outcomes, yet there is little information available on the referral pathway. This paper explores the views of Australian patients and their experiences of referral for colorectal cancer treatment following diagnosis; the aim was to improve our understanding of the referral pathway and guide the development of future interventions.

Referral pathways in colorectal cancer: an audit of surgeons's records.

Purpose: To explore the referral pathways of patients with newly diagnosed colorectal cancer to surgeons.

Method: Australian surgeons from three states completed a questionnaire and their records were audited.

Results: Thirty-three surgeons provided data on 530 patients seen in the preceding 12 months.

Patients with colorectal cancer - a qualitative study of referral pathways and continuing care.

Background: This article explores the views of general practitioners on their referral of colorectal cancer patients following diagnosis to specialist surgeons.

Methods: Sampling was purposive. Nineteen GPs representing urban and rural areas participated in four focus groups.

Diabetic retinopathy screening and monitoring of early stage disease in general practice: design and methods.

Diabetic retinopathy is the leading cause of preventable blindness in Australians younger than 60 years, mainly from the development of diabetic macular oedema and the sequelae of advanced proliferative diabetic retinopathy. However, early detection and subsequent treatment of diabetic retinopathy, as recommended in Australian national guidelines, can prevent nearly all cases of severe vision loss and blindness, but few people achieve this goal. This paper describes the design and methods of an open controlled trial that aims to assess the feasibility, acceptability, and relative costs and benefits of identification and management of early stages of diabetic retinopathy in primary care, with tele-ophthalmic support and education.

Assessing the impact of the requirement for explicit consent in a hospital-based stroke study.

Background: Increasing regulation of medical research, in particular the requirement for explicit consent, may reduce the quantity and quality of clinical epidemiological research.

Aim: To assess the potential biases arising from the need for explicit consent in our hospital-based stroke research register.

Design: Comparison of patients enrolled into our stroke research register with those included in a concurrent clinical stroke audit that targeted the same population but did not require explicit consent.