ORCID Profile
0000-0001-7404-8144
Current Organisations
University of Queensland
,
UNSW Simpson Centre for Health Services Research
,
Murdoch University
,
Queensland University of Technology
,
Deakin University
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Publications
Randomised controlled trial examining the effect of an outpatient exercise training programme on haemodynamics and cardiac MR parameters of right ventricular function in patients with pulmonary arteri
Publisher: BMJ
Date: 02-2017
Rate of venous thromboembolism among surgical patients in Australian hospitals: a multicentre retrospective cohort study
Publisher: BMJ
Date: 10-2014
DOI: 10.1136/BMJOPEN-2014-005502
Abstract: Despite the burden of venous thromboembolism (VTE) among surgical patients on health systems in Australia, data on VTE incidence and its variation within Australia are lacking. We aim to explore VTE and subsequent mortality rates, trends and variations across Australian acute public hospitals. A large retrospective cohort study using all elective surgical patients in 82 acute public hospitals during 2002–2009 in New South Wales, Australia. Patients underwent elective surgery within 2 days of admission, aged between 18 and 90 years, and who were not transferred to another acute care facility 4 362 624 patients were included. VTE incidents were identified by secondary diagnostic codes. Poisson mixed models were used to derive adjusted incidence rates and rate ratios (IRR). 2/1000 patients developed postoperative VTE. VTE increased by 30% (IRR=1.30, CI 1.19 to 1.42) over the study period. Differences in the VTE rates, trends between hospital peer groups and between hospitals with the highest and those with the lowest rates were significant (between-hospital variation). Smaller hospitals, accommodated in two peer groups, had the lowest overall VTE rates (IRR=0.56:0.33 to 0.95 IRR=0.37:0.23 to 0.61) and exhibited a greater increase (64% and 237% vs 19%) overtime and greater between-hospital variations compared to larger hospitals (IRR=8.64:6.23 to 11.98 IRR=8.92:5.49 to 14.49 vs IRR=3.70:3.32 to 4.12). Mortality among patients with postoperative VTE was 8% and remained stable overtime. No differences in post-VTE death rates and trends were seen between hospital groups however, larger hospitals exhibited less between-hospital variations (IRR=1.78:1.30 to 2.44) compared to small hospitals (IRR ). Hospitals performed differently in prevention versus treatment of postoperative VTE. VTE incidence is increasing and there is large variation between-hospital and within-hospital peer groups suggesting a varied compliance with VTE preventative strategies and the potential for targeted interventions and quality improvement opportunities.
Variation in the incidence and timing of diagnosis of hospital‐associated venous thromboembolism using linked administrative data
Publisher: Wiley
Date: 09-2018
DOI: 10.1111/IMJ.14019
Abstract: Venous thromboembolism (VTE) is a potentially preventable adverse effect of hospitalisation. Inter-hospital variation in the incidence of hospital-associated VTE (HA-VTE) and timing of diagnosis (in-hospital or post-discharge) in New South Wales public hospitals were examined. Large variations in incidence (22% risk difference) and post-discharge diagnosis (115% odds difference) were evident after adjustment for case mix, which only explained 59% and 32% of inter-hospital variation respectively. The need for improved compliance with best practice guidelines is reinforced.
Pedestals and feedback in fusion-plasma relevant sandpile models
Publisher: AIP Publishing
Date: 2018
DOI: 10.1063/1.4998793
Abstract: We present modifications to the sandpile model [Chapman, Phys. Rev. E 62, 1905 (2000)] (Classic Model). A feedback loop is added to the Classic Model, elements of which may have relevance to the behaviour of a fusion plasma. Those elements include variation of the total energy of the system in proportion to a proxy for the Larmor radius, ρ, and resulting variations in mass loss event (MLE) size and waiting times between MLEs. We also show other variants of the Classic Model which produce pedestals, without introducing feedback. The modifications produce a pedestal similar to that seen in a fusion plasma, as well as feedback effects. We observe that maximum MLE sizes, and maximum waiting times between MLEs, grow with pedestal size only in the presence of feedback. If, as we purport, the edge localised mode (ELM) process is captured by an MLE model with feedback, then a conclusion is that ELMs can be reduced if feedback effects are reduced.
Are highway constructions associated with increased transport incidents? A case study of NSW Pacific Highway construction zones 2011-16
Publisher: Australasian College of Road Safety
Date: 02-2021
Abstract: Transport incidents are among the major causes of trauma and injury in Australia and worldwide. While improving infrastructure can decrease the rate of incidents, the required construction imposes challenges regarding simultaneous public use of the relevant road sections. This study focused on construction zones along the New South Wales (NSW) Pacific Highway. We aimed to investigate if the rate of people who had major trauma as a result of a transport incident in a construction zone was higher than the rate of people with similar incidents at other times. This was a retrospective study, conducted by screening the data of patients admitted to the trauma services, or who died due to traffic incidents on the NSW Pacific Highway 2011-2016. We identified 35 causalities who experienced a traffic incident within a construction zone, 19 of these incidents occurred during the construction dates and 16 before or after those dates. The rate of casualty in construction periods was 2.21 per 1000 days, which is significantly higher than the rate in non-construction periods (1.2 per 1000 days, p-value: 0.037). There was no significant difference between the age, injury severity score and mortality rate of casualties who had an incident during the construction dates and those who had an incident in non-construction periods. This study indicated that the rate of incidents increased at NSW Pacific Highway construction zones during construction periods. More investigation is needed to improve the safety of road users during highway road constructions.
Sandpile modeling of pellet pacing in fusion plasmas
Publisher: American Physical Society (APS)
Date: 29-01-2020
Inpatient palliative care of people dying in New South Wales hospitals or soon after discharge
Publisher: Wiley
Date: 02-2019
DOI: 10.1111/IMJ.14074
Abstract: Palliative care can benefit all patients with life-limiting diseases. To describe hospital use in the final year of life, timing of palliative care and variations by age and disease for patients receiving inpatient palliative care. Retrospective cohort study of all New South Wales residents aged 50 years and older who died (decedents) between July 2010 and June 2015 in hospital or within 30 days of discharge. Care type and diagnosis codes identified decedents who received inpatient palliative care. Of 150 770 decedents, 34.4% received palliative care a median of 10 days before death. Decedents were more likely to receive palliative care if they had cancer (64.7% vs 13.3% for those without chronic conditions) or were younger (46.3% vs 25.0% of the oldest decedents). In their last year of life, palliated decedents, on average, had three emergency department presentations and four hospital admissions - one involving surgery and one where palliation was the intent of care. Of the 30.1 days spent in hospital, 8.7 days involved palliative care. Older age and non-cancer diagnoses were associated with fewer days of inpatient palliation and shorter time between first palliative admission and death. Decedents dying out of hospital started palliative care 18 days earlier than those dying in hospital. Most decedents did not receive palliative care during hospital admission, and even then only very late in life, limiting its benefits. Improved recognition of palliative need, including earlier identification regardless of age and disease, will enhance the quality of care for the dying.
Variation in Hospital Use at the End of Life Among New South Wales Residents Who Died in Hospital or Soon After Discharge
Publisher: SAGE Publications
Date: 26-05-2019
Abstract: Objective: Hospital use increases in the last 3 months of life. We aimed to examine its association with where people live and its variation across a large health jurisdiction. Methods: We studied a number of emergency department presentations and days spent in hospital, and in-hospital deaths among decedents who were hospitalized within 30 days of death across 153 areas in New South Wales (NSW), Australia, during 2010-2015. Results: Decedents’ demographics and health status were associated with hospital use. Primary care and aged care supply had no or minimal influence, as opposed to the varying effects of areal factors—socioeconomic status, remoteness, and distance to hospital last admitted. Overall, there was an approximate 20% difference in hospital use by decedents across areas. In all, 18% to 57% of areas had hospital use that differed from the average. Discussion: The observed disparity can inform targeted local efforts to strengthen the use of community care services and reduce the burden of end-of-life care on hospitals.
Sandpile modelling of dual location fuelling in fusion plasmas
Publisher: IOP Publishing
Date: 23-03-2020
Variation in out‐of‐hospital death among palliative care inpatients across public hospitals in New South Wales, Australia
Publisher: Wiley
Date: 04-2019
DOI: 10.1111/IMJ.14045
Abstract: Place of death is an important indicator in palliative care, as out-of-hospital death is often preferred by patients and is less costly for the healthcare system. To examine variation and contributing factors in out-of-hospital death after receiving palliative care in hospital to inform improvement in transition of care between hospitals and communities. Using hospital linked data (July 2010, June 2015) we followed in iduals aged 50 or older who received palliative care in hospital and within 3 months to death who were last admitted to a public acute-care hospital in New South Wales, Australia (73 hospitals). Among 25 359 palliative care inpatients, 3677 (14%) died out of hospital. The out-of-hospital death rate was lower for younger patients, males and those living in the most deprived areas it was higher for cancer patients and those who received palliative care before their last admission. Hospital size, location and availability of hospice care unit were not influential. Across hospitals, the median crude rate of out-of-hospital death was 14% (interquartile range 10-19%). The contributing factors explained 19% of the variation, resulting in a rate difference of 44% between hospitals with high versus low rates 25% of hospitals had a higher and 14% had a lower than average adjusted out-of-hospital death rate. The majority of patients who received palliative care in hospital stayed in hospital until death. The variation in out-of-hospital death across hospitals was considerable and mostly remained unexplained. This variability warrants investigation into transition of palliative care between hospitals and communities to inform interventions.
Behaviour of multiple discrete waiting times between mass loss events in a sandpile model
Publisher: IOP Publishing
Date: 10-07-2020
Delay time embedding of mass loss avalanches in a fusion plasma-oriented sandpile model
Publisher: AIP Publishing
Date: 10-2016
DOI: 10.1063/1.4964667
Abstract: The sandpile paradigm is widely used to model aspects of the phenomenology of magnetically confined fusion (MCF) plasmas, including enhanced confinement, edge pedestals and, potentially, the impulsive energy and particle release process known as ELMing. Here we identify new points of contact between ELMing and the systemwide avalanches in a sandpile. We compare the quantified response [Calderon et al., Phys. Plasmas 20, 042306 (2014)] to increased fuelling of the time sequence of edge localised mode events in a series of similar Joint European Torus plasmas with the response to increased fuelling of the time sequence of systemwide avalanches in a sandpile model [Chapman et al., Phys. Rev. Lett. 86, 2814 (2001)] that has well established links to MCF plasma phenomenology. Both the probability density functions of inter-event time intervals, and delay time embeddings of event time sequences, at different fuelling rates, show common features and point to shared underlying physics.
Related Organisations
Related Funding Activities
No related grants have been discovered for Hassan Assareh.