Jeryl Francis | The University of Newcastle (original) (raw)

Papers by Jeryl Francis

Immunology and Cell Biology, 2002

Salivary immunoglobulin and albumin levels were examined for differences between stations and exp... more Salivary immunoglobulin and albumin levels were examined for differences between stations and expeditions, and for monthly changes over the expedition year. Salivary IgA and IgM concentrations were on average higher for the 1993 Casey expeditioners, and all salivary protein levels were lower for 1996 Mawson expeditioners compared to levels of the other expeditions. The change in salivary IgA and IgM concentrations over the 1-year period revealed a consistent pattern between expeditions. Salivary IgA levels were lower in March, April and May compared to other months of the year (P = 0.0002). Salivary IgM levels were lowest in the first 4 months of the year, with peak levels in June and July (P < 0.0001). There were no changes in salivary IgG and albumin concentrations over the expedition year. Though the cause of the changes in salivary IgA and IgM levels over the year is unknown, the changes could reflect alterations in mucosal immunity in response to stressors associated with isolation.

Journal of Nutrition

Two studies were conducted to investigate whether vitamin A-deficient rats were more susceptible ... more Two studies were conducted to investigate whether vitamin A-deficient rats were more susceptible to intestinal injury caused by methotrexate (MTX), since vitamin A deficiency alone causes only mild changes to jejunal structure and function. Weanling male rats were fed a vitamin A-deficient diet (-VA) for 40-42 d and compared to rats either pair-fed (PF) or with free access (+VA) to the same diet. Drinking water of PF and +VA rats was supplemented with 37.5 microg (Study 1) or 75 microg (Study 2) vitamin A (Rovimix A 500W)/d. Rats in each group received MTX (-VAMTX, PFMTX, +VAMTX) or vehicle. MTX administration reduced intestinal mucosal wet weight, protein and DNA concentrations, and sucrase and maltase activities in -VA and PF rats (P < 0.02). In Study 1, -VAMTX rats developed a severe jejunal enteropathy and had a higher incidence of diarrhea (P < 0.005), greater weight loss (P < 0.005), more disruption of villus architecture (P < 0.0001) and lower disaccharidase activity (P < 0.007) than PFMTX rats. Similar results were observed in Study 2. Liver retinol concentration (but no other variable) was greater in rats receiving 75 microg vitamin A/d (P < 0.001) than in those receiving 37.5 microg/d. The interaction of vitamin A deficiency and small intestinal injury may explain the efficacy of vitamin A supplementation in preventing childhood diarrheal disease mortality in developing countries, and highlights the need for ensuring adequate vitamin A status in people worldwide with diseases and/or treatments which may injure the gastrointestinal tract.

The Medical journal of Australia

Because of concern over the unsupervised use of bronchodilator aerosols, we studied the character... more Because of concern over the unsupervised use of bronchodilator aerosols, we studied the characteristics of a group of asthmatic subjects who purchased their salbutamol inhalers and a group of asthmatic subjects who obtained their inhalers by prescription. Community pharmacists distributed 360 questionnaires to consecutive patients who requested salbutamol inhalers; 320 questionnaires were returned (response rate, 89%). Of these, 240 respondents described themselves as asthmatic and stated that they obtained their inhalers exclusively or predominantly by either purchase (120 subjects) or prescription (120 subjects). Purchasers were younger than were users of prescribed inhalers and were more likely to be in current employment. The &amp;quot;purchase&amp;quot; group perceived less disability from chest disease than did the &amp;quot;prescription&amp;quot; group but were not different from the prescription group with respect to more-objective measures of disease severity, such as the occurrence of wheeze every day, nocturnal wakening with wheezing, and admissions to hospital with asthma. The purchasers had a low rate of consultation with family practitioners and specialists and reported a low use of prescription-only medications, particularly of inhaled corticosteroid agents. This study highlights the possible disadvantages of providing bronchodilator aerosols without prescription, and emphasizes an important counselling role for community pharmacists in the management of bronchial asthma.

Journal of Paediatrics and Child Health

Health promotion journal of Australia: official journal of Australian Association of Health Promotion Professionals

The aim of this study was to identify the strengths and weaknesses of asthma management in child ... more The aim of this study was to identify the strengths and weaknesses of asthma management in child care services in the Hunter region and to develop, implement and evaluate a health education program to address the deficiencies. A questionnaire was sent to the 190 child care services in the Hunter region in 1997 to assess their asthma management practices. Results of the survey were used to develop a two-hour training workshop for child care staff in the management of asthma. District-based workshops were conducted for 535 child care staff (representing 140 services) over two years. Participants completed pre- and post-workshop knowledge and confidence questionnaires. The survey was repeated in 2000. The baseline survey identified potential for substantial improvement in the management of asthma in child care services and in the training of staff. Training workshops significantly improved asthma knowledge and confidence in managing asthma (p<0.0001). The follow-up survey showed tha...

Communicable diseases intelligence

Surveillance for influenza is an important public health function as it allows initiation and eva... more Surveillance for influenza is an important public health function as it allows initiation and evaluation of public health measures. Flutracking is a weekly online survey of influenza-like illness (ILI) completed by community members that has been trialled in the 2006, 2007, and 2008 winter influenza seasons. The online survey allows participants to record their past and current influenza immunisation status and they receive a weekly email prompt to answer questions on the previous week's experience of cough, fever and time absent from normal activities. The weekly survey takes participants less than 15 seconds to complete. Symptom rates of Flutracking participants were compared by influenza vaccination status to estimate the incidence and severity of influenza and the field effectiveness of influenza vaccine. Participation rates increased from 394 in 2006 to 982 in 2007 and 4,827 in 2008. In 2008, 56% of participants were from New South Wales and 26% were from Tasmania. Greater ...

Australian and New Zealand journal of public health, 2014

To describe the impact of a training and support intervention to encourage completion of the Heal... more To describe the impact of a training and support intervention to encourage completion of the Healthy Kids Check (HKC) by general practitioners (GP) or practice nurses (PN) and provision of brief advice on diet and physical activity. The intervention (June 2008 to July 2010) was delivered by Divisions of General Practice (DGP) in the Hunter New England (HNE) region of NSW, Australia, to members in 300 practices. Intervention impact was evaluated using Medicare data on the number of HKCs completed and a post-intervention telephone survey of randomly selected parents in HNE and rest of NSW. Training reached 31% of GPs (n∼ 216/700) and 71% of PNs (n∼320/450); 31% of four-year-olds received a HKC in HNE compared to 15% in NSW; 27% of HNE parents (n=162) reported a GP or PN had provided advice during their child's vaccinations visit compared to 15% of parents (n=154) in NSW (p=0.002). There was no significant difference in proportion of children who had weight or height assessed (55.6...

Canadian journal of public health = Revue canadienne de santé publique, 2012

Licensed premises are associated with a considerable level of alcohol-related harm. This study ex... more Licensed premises are associated with a considerable level of alcohol-related harm. This study examined the effectiveness of an educational policing strategy, implemented as routine policing practice, to reduce the number of patrons of licensed premises involved in police-recorded incidents of violence, disorder and motor vehicle crashes. The educational policing strategy targeted on-licensed premises registered as operating in 2003. The strategy was delivered by police and was overseen by the research team. The intervention was conducted in 21 non-metropolitan New South Wales Police Force commands. On the basis of routinely collected and recorded police data, premises received one of three levels of police response on three separate occasions from December 2002 to July 2003. The police responses were letters, incident reports, covert audits and feedback meetings. The rate of patrons who had last consumed alcohol on licensed premises before being involved in police-recorded incident...

International journal of sports medicine, 2000

The impact of a 12-week training program by elite swimmers on systemic and mucosal immunity was s... more The impact of a 12-week training program by elite swimmers on systemic and mucosal immunity was studied prospectively to examine the relationship between changes in immune parameters and the incidence of respiratory illness. Saliva was collected before and after selected training sessions at 2 weekly intervals. There were significant decreases in salivary IgA (p=0.05) and salivary IgM (p < 0.0001) concentrations after individual training sessions, but no significant changes in salivary IgG or albumin concentrations. Over the 12-week training program there were small but statistically significant increases in pre-exercise concentrations of salivary IgA (p<0.001), IgM (p=0.015) and IgG (p=0.003) and post-exercise salivary IgA (p <0.001). There were no significant trends over the 12 weeks for any class of serum immunoglobulins but a significant fall in NK-cell numbers (p<0.001). There were no associations between serum or salivary immunoglobulin levels or NK-cell numbers an...

Journal of Studies on Alcohol and Drugs, 2010

Although strategies exist to minimize alcohol-related harms associated with establishments licens... more Although strategies exist to minimize alcohol-related harms associated with establishments licensed to serve alcohol, such establishments are associated with a disproportionate level of harm. To date, understanding the association between such establishments and alcohol-related harms, and hence the opportunities for reducing harm, has been limited by inadequate information regarding incidents of alcohol-related crime. To address this deficiency, this study was undertaken to describe the association between such establishments and incidents of crime using enhanced police-recorded, alcohol-related crime intelligence. A descriptive analysis was undertaken of intoxicated people who had last consumed alcohol in establishments licensed to serve alcohol (841 bars, 551 licensed social clubs, 11 nightclubs, and 18 other locations) preceding their involvement in police-recorded incidents of violence, disorder, or motor vehicle crashes. The study area encompassed 21 nonmetropolitan police commands in the state of New South Wales, Australia. Among intoxicated persons involved in incidents of violence, disorder, or motor vehicle crashes, the risk of being recorded as having last consumed alcohol in a bar or nightclub before the incident was at least twice that of licensed social clubs and other establishments. Approximately 20% of establishments accounted for 80% of intoxicated persons involved in such incidents, and 6% of establishments were in the top 20% of establishments for all three offense types. The disproportionate burden of alcohol-related crime associated with establishments licensed to serve alcohol may be reduced if harm-reduction strategies address the specific risks posed by bars and nightclubs, and individual high-risk establishments.

Nuclear Medicine Communications, 1999

Public Health Nutrition, 2014

Objective: To determine the impact of an implementation intervention designed to introduce polici... more Objective: To determine the impact of an implementation intervention designed to introduce policies and practices supportive of healthy eating in centre-based child-care services. Intervention strategies included staff training, resources, incentives, follow-up support, and performance monitoring and feedback. Design: A quasi-experimental design was used to assess change over 20 months in healthy eating policy and practice in intervention and comparison child-care services. Setting: The Hunter New England (HNE) region of New South Wales (NSW), Australia. Subjects: All centre-based child-care services (n 287) in the intervention region (HNE) were invited and 240 (91 % response rate) participated. Two hundred and ninety-six services in the rest of NSW were randomly selected as a comparison region and 191 participated (76 % response rate). A sub-analysis was conducted on those services that provided children food (n 196 at baseline and n 190 at follow-up). Ninety-six provided menus for analysis at baseline (HNE, n 36; NSW, n 50) and 102 provided menus at follow-up (HNE, n 50; NSW, n 52). Results: Services in the intervention region were significantly more likely to provide only plain milk and water for children (P 5 0?018) and to engage parents in nutrition policy or programmes (P 5 0?002). They were also more likely (P 5 0?056) to have nutrition policy on home packed food. In addition, menus of services that provided lunch were significantly more likely to comply with healthy eating guidelines for sweetened drinks (P , 0?001), fruit (P , 0?001) and vegetables (P 5 0?01). Conclusions: An implementation intervention was able to modify policy and practice in a large number of child-care services so that they were more supportive of healthy eating.

Pediatric Pulmonology, 1998

Recombinant human deoxyribonuclease (rhDNase) has been shown to reduce sputum viscoelasticity and... more Recombinant human deoxyribonuclease (rhDNase) has been shown to reduce sputum viscoelasticity and to improve lung function in patients with cystic fibrosis (CF). The aim of this study was to determine whether airway inflammation would decrease after administration of rhDNase. Twenty patients with CF and chronic suppurative lung disease inhaled 2.5 mg of rhDNase daily for 1 month. Before and after the 1-month trial, lung function was measured and sputum was obtained, either after spontaneous expectoration or after sputum induction with hypertonic saline. Sputum total cell and differential counts were measured using techniques previously described. The mean age of the patients was 16.8 years (range, 6.7-27.5). After 1 month of rhDNase, mean FEV 1 increased from a baseline of 62.3% predicted to 70.8% (P = 0.02, paired t test); and FVC increased from 74.4% to 83.9% predicted (P = 0.007). No significant differences were found in sputum cytology before or after rhDNase (median total cell counts 16.0 × 10 6 /ml vs. 19.3 × 10 6 /ml, P = 0.68). Thirteen patients had a 10% or greater increase in FEV 1 after rhDNase (responders). Initial lung function was less in responders than in nonresponders (53.5% vs. 78.6%, P = 0.007). There was no significant change in total cell count and neutrophil count after rhDNase in either responders or nonresponders. We conclude that airway inflammation, as measured by total cell counts in sputum, was a prominent feature in cystic fibrosis, and neutrophils were the dominant inflammatory cells. Although the administration of rhDNase resulted in significant improvements in FEV 1 , there was no evidence of accompanying changes in airway inflammation. Pediatr Pulmonol. 1998; 26:97-100.

Medicine & Science in Sports & Exercise, 1999

Medicine & Science in Sports & Exercise, 2001

Medicine & Science in Sports & Exercise, 2002

The aim of this study was to investigate the relationships between latent viral shedding of Epste... more The aim of this study was to investigate the relationships between latent viral shedding of Epstein-Barr virus (EBV) in saliva, upper-respiratory illness, and mucosal immune suppression in a cohort of highly trained swimmers undertaking intensive training. Saliva was collected before selected training sessions from 14 elite male swimmers during a 30-d period of intensive training. Prior infection with EBV was determined by EBV antibody serology. Salivary IgA concentrations were measured by enzyme linked immunosorbent assay (ELISA), and EBV viral shedding (EBV-DNA) was detected by polymerase chain reaction (PCR). Symptoms of upper-respiratory illness were recorded daily. Eleven swimmers (79%) were seropositive for prior EBV infection. Seven EBV seropositive swimmers (64%) had EBV-DNA detected during the study period. Upper-respiratory symptoms (URS) were reported in six of seven swimmers in whom EBV-DNA was detected and in three of four swimmers with no EBV-DNA detection. No URS were reported in the EBV seronegative swimmers. There was a statistically significant relationship between EBV serology status and URS (P = 0.027). EBV-DNA was detected in saliva before the appearance of URS. Salivary IgA levels were significantly lower immediately before the URS (P = 0.01) compared with subsequent peak IgA levels and declined to pre-URS levels on average 11 d after the first appearance of URS. The time course of appearance of EBV-DNA in relation to URS suggests latent viral EBV shedding may be a contributing factor in the URS. The low levels of salivary IgA detected before the URS indicated transient mucosal immune suppression in the study cohort. The viral shedding may alternatively be a reflection of the altered immune control mechanisms that occur in response to intensive exercise and unrelated to the URS.

Journal of Pediatric Gastroenterology &amp Nutrition, 1997

The high energy requirements in cystic fibrosis (CF) increase the likelihood of malnutrition. Del... more The high energy requirements in cystic fibrosis (CF) increase the likelihood of malnutrition. Delayed mouth-to-cecum transit times have been reported and raise the possibility that abnormalities of gastric function in CF contribute to reduced food intake. The aims of this project were to document solid-phase gastric emptying times in young people with CF and age- and sex-matched healthy controls, and to investigate whether delayed gastric emptying contributes to suboptimal energy intakes. Nineteen subjects with CF, mean age 12.6 years (11 girls and 8 boys), and 17 control subjects, mean age 12.8 years (9 girls and 8 boys), were studied. Energy intake was assessed by means of a 4-day weighed food record. Fecal fat excretion was determined from a 3-day stool collection. Gastric emptying was assessed with a standard test meal of pancakes labeled with 99mTc-macroalbumin aggregates. The half emptying time of solids from the stomach was recorded. The mean solid-phase gastric emptying time was significantly faster in the CF subjects compared with normal, healthy, age- and sex-matched control subjects (53 min vs. 72.2 min, p &amp;lt; 0.05). Energy intakes, measured as the percentage of the recommended energy intake for age and sex, were greater in the CF subjects than in the control subjects (115% vs. 89%, p &amp;lt; 0.01), whereas the mean % FFE for the CF subjects was 9.9%. CF subjects with longer gastric emptying times also had lower relative energy intakes (r = -0.50, p &amp;lt; 0.05). Gastric emptying time in healthy subjects with CF is rapid. Faster solid-phase gastric emptying times may be secondary to high-fat, high-energy intakes and may represent a survival advantage.

Journal of Paediatrics and Child Health, 1996

To determine whether a single assessment of children at the time of presentation to the emergency... more To determine whether a single assessment of children at the time of presentation to the emergency department would discriminate accurately between those requiring admission and those who could be managed at home and to examine the appropriateness of these decisions. Methodology: Fifty-three children were assessed using a table recommended by Australian and New Zealand respiratory pediatricians, which categorizes children as probably being able to manage at home (group l ) , may need admission to hospital (group 2) and certainly need admission to hospital (group 3) on the basis of oximetry, presence of wheeze and pulsus paradoxus. Results: Nine out of 1 1 children assigned to group 1 were managed at home and 15/17 who were predicted to require admission were admitted. No individual component of the assessment dominated the decision made. Of the 25 children allocated to group 2, 18 were admitted. Conclusions: The method employed was highly predictive of outcome for half of the children who presented with asthma. However, 25/53 (47%) were assigned by the table to a recommendation for further assessment; this limits its usefulness.

Journal of Paediatrics and Child Health, 1995

Objective: To assess whether information about asthma acquired by individual teachers, following ... more Objective: To assess whether information about asthma acquired by individual teachers, following attendance at an inservice seminar, would be communicated to other school staff, and whether policies about asthma management would be subsequently developed in schools. Methodology: A telephone interview was conducted of 50 primary school teachers in the Hunter Region who were selected randomly from those who had represented their school at an inservice seminar about asthma. Results: All 48 respondents had provided feedback to their colleagues, mostly at a staff meeting. After the seminar the number of schools with a written policy about the management of asthma had increased from 1 to 20. Initially the school'sfirst aid kits contained a bronchodilator inhaler in 25 schools (increasing to 43 after the seminar), a spacer device in six schools (increasing to 47) and written guidelines for management of an asthma attack in seven schools (increasing to 32). Teachers from four schools indicated that all school staff knew how to recognize an acute attack prior to the seminar compared with 22 schools afterwards. Before the seminar 18 schools asked parents to supply written instructions for the management of their children at school but this increased to 44 after the seminar.