ORCID Profile
0000-0002-2015-3579
Current Organisation
University of Queensland
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Publisher: Oxford University Press (OUP)
Date: 03-03-2015
DOI: 10.1093/IJNP/PYV021
Publisher: Elsevier BV
Date: 08-2021
Publisher: World Journal of Emergency Medicine
Date: 2014
Publisher: World Journal of Emergency Medicine
Date: 2012
Publisher: MDPI AG
Date: 16-12-2022
Abstract: To provide the latest evidence for future research and practice, this study critically reviewed Indigenous peoples’ cancer care experiences in the Australian healthcare system from the patient’s point of view. After searching PubMed, CINAHL and Scopus databases, twenty-three qualitative studies were included in this review. The inductive approach was used for analysing qualitative data on cancer care experience in primary, tertiary and transitional care between systems. Three main themes were found in healthcare services from Indigenous cancer care experiences: communication, cultural safety, and access to services. Communication was an important theme for all healthcare systems, including language and literacy, understanding of cancer care pathways and hospital environment, and lack of information. Cultural safety was related to trust in the system, privacy, and racism. Access to health services was the main concern in transitional care between healthcare systems. While some challenges will need long-term and collective efforts, such as institutional racism as a downstream effect of colonisation, cultural training for healthcare providers and increasing the volume of the Indigenous workforce, such as Indigenous Liaison Officers or Indigenous Care Coordinators, could effectively address this inequity issue for Indigenous people with cancer in Australia in a timely manner.
Publisher: Wiley
Date: 29-11-2012
Abstract: To compare access and utilisation of EDs in Queensland public hospitals between people who speak only English at home and those who speak another language at home. A retrospective analysis of a Queensland statewide hospital ED dataset (ED Information System) from 1 January 2008 to 31 December 2010 was conducted. Access to ED care was measured by the proportion of the state's population attending EDs. Logistic regression analyses were performed to determine the relationships between ambulance use and language, and between hospital admission and language, both after adjusting for age, sex and triage category. The ED utilisation rate was highest in English only speakers (290 per 1000 population), followed by Arabic speakers (105), and lowest among German speakers (30). Compared with English speakers, there were lower rates of ambulance use in Chinese (odds ratio 0.50, 95% confidence interval, 0.47-0.54), Vietnamese (0.87, 0.79-0.95), Arabic (0.87, 0.78-0.97), Spanish (0.56, 0.50-0.62), Italian (0.88, 0.80-0.96), Hindi (0.61, 0.53-0.70) and German (0.87, 0.79-0.90) speakers. Compared with English speakers, German speakers had higher admission rates (odds ratio 1.17, 95% confidence interval, 1.02-1.34), whereas there were lower admission rates in Chinese (0.90, 0.86-0.99), Arabic (0.76, 0.67-0.85) and Spanish (0.83, 0.75-0.93) speakers. This study showed that there was a significant association between lower utilisation of emergency care and speaking languages other than English at home. Further researches are needed using in-depth methodology to investigate if there are language barriers in accessing emergency care in Queensland.
Publisher: Wiley
Date: 08-04-2014
Abstract: The present study aims to investigate non-English-speaking background (NESB) patients' satisfaction with hospital ED service and compare it with that of English-speaking background (ESB) patients. A cross-sectional survey was conducted at the ED of an adult tertiary referral hospital in Queensland, Australia. Patients assigned an Australasian Triage Scale score of 3, 4 or 5 were surveyed in the ED, before and after their ED service. Pearson χ(2) -test and multivariate logistic regression analyses were performed to examine the differences between the ESB and NESB groups in terms of patient-reported satisfaction. In total, 828 patients participated in the present study. Although the overall satisfaction with the service was high - 95.1% (ESB) and 90.5% (NESB) - the NESB patients who did not use an interpreter were less satisfied with their ED service than the ESB patients (odds ratio 0.5, 95% confidence interval 0.3-0.8, P = 0.013). The promptness of service received the lowest satisfaction rates (ESB 85.4% [82.4-88.0], NESB 74.5% [68.5-79.7], P < 0.001), whereas courtesy and friendliness received the highest satisfaction rates (ESB 98.8 [97.6-99.4], NESB 97.0 [93.9-98.5], P = 0.063). All participants reported the promptness of service (33.5%), quality and professional care (18.5%) and communication (17.6%) as the most important elements of ED service. The NESB patients were significantly less satisfied than the ESB patients with the ED service. Use of an interpreter improved the NESB patients' level of satisfaction. Further research is required to examine what NESB patients' expectations of ED service are.
Publisher: Cambridge University Press (CUP)
Date: 06-2010
DOI: 10.1017/S1049023X00008141
Abstract: Floods are the most common hazard to cause disasters and have led to extensive morbidity and mortality throughout the world. The impact of floods on the human community is related directly to the location and topography of the area, as well as human demographics and characteristics of the built environment. The aim of this study is to identify the health impacts of disasters and the underlying causes of health impacts associated with floods. A conceptual framework is developed that may assist with the development of a rational and comprehensive approach to prevention, mitigation, and management. This study involved an extensive literature review that located references, which were analyzed to identify common themes, findings, and expert views. The findings then were distilled into common themes. The health impacts of floods are wide ranging, and depend on a number of factors. However, the health impacts of a particular flood are specific to the particular context. The immediate health impacts of floods include drowning, injuries, hypothermia, and animal bites. Health risks also are associated with the evacuation of patients, loss of health workers, and loss of health infrastructure including essential drugs and supplies. In the medium-term, infected wounds, complications of injury, poisoning, poor mental health, communicable diseases, and starvation are indirect effects of flooding. In the long-term, chronic disease, disability, poor mental health, and poverty-related diseases including malnutrition are the potential legacy. This article proposes a structured approach to the classification of the health impacts of floods and a conceptual framework that demonstrates the relationships between floods and the direct and indirect health consequences.
Publisher: American Medical Association (AMA)
Date: 28-09-2021
Publisher: Informa UK Limited
Date: 04-02-2015
Publisher: Wiley
Date: 30-07-2008
DOI: 10.1111/J.1742-6723.2008.01108.X
Abstract: Over the past 20 years, emergency medicine (EM) in China has been through a period of rapid development. This included the formal establishment of professional association of EM in 1986 and the establishment of ED in all county-level hospitals across the country in the late 1990s. In line with the rapid economic development of China, ED have been equipped with appropriate 'hardware' equipment, but the 'software' part of the ED system remains underdeveloped. Doctors do not usually work exclusively in ED, but on a rotational basis, while also working as specialists in their own departments, such as medicine and surgery. EM in China remains underdeveloped, at least partly, for two main reasons: the current financial status of the health-care system and lack of sufficient numbers of qualified EM specialists. Chinese education and training systems are now beginning to produce high-quality emergency specialists, although there is not yet consistency across all courses. In Australia, the specialty of EM is well developed and, as such, this country is well placed to contribute to the development of ED in China.
Publisher: Springer Science and Business Media LLC
Date: 28-03-2015
Publisher: Wiley
Date: 05-02-2018
Publisher: Hindawi Limited
Date: 2014
DOI: 10.1155/2014/593921
Publisher: Wiley
Date: 07-01-2016
Abstract: The aim of this study was to gather patients' perceptions regarding their choice between public and private hospital EDs for those who hold private health insurance. The findings of this study will contribute to knowledge regarding patients' decision-making processes and therefore may contribute to the development of evidence based public policies. An in-depth semi-structured guide was used to interview participants at public and private hospital EDs. Questions sought to identify the issues that were considered by the participants to decide to attend that hospital ED, previous ED experience, expectations of ED services and perceived benefits and barriers to accessing services. Interviews were audio recorded, transcribed verbatim and analysed using content and thematic approaches. Four core themes emerged: prior good experience with the hospital, perceived quality of care, perceived waiting times and perceived costs that may explain patients' choice. Patients' choice between public and private EDs can be explained by the interaction of these core themes. The principal issues appear to be concern for gap payments at private hospital ED and waiting times at public hospital ED. Patients who choose to attend public EDs appear to value financial concern over waiting time those who choose to attend private EDs appear to value waiting time ahead of financial concerns.
Publisher: Elsevier BV
Date: 12-2016
Publisher: World Journal of Emergency Medicine
Date: 2013
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.SCITOTENV.2016.11.146
Abstract: Epidemiologic evidence supports the positive association of cardiopulmonary morbidity and mortality, and lung cancer risk with exposure to airborne particulate matter (PM). Oxidative stress and inflammation have been proposed to be the major causal factors involved in mediating PM effects on both cardiovascular and pulmonary health outcomes. However, the mechanism whereby PM causes the health effects is not fully elucidated. To evaluate and investigate human exposure to PM, it is essential to have a specific, sensitive and robust characterization of in idual exposure to PM. Biomarkers may mark important intermediate steps leading to overt health effects after PM exposure. Thus biomarkers are promising indicators, which could serve as representative measures of the exposure to PM for assessing the health impacts and understanding the mechanism. Indeed, a number of biomarkers are already in use in the field of epidemiological studies and toxicological research. However, we are facing now the challenges to select robust, specific and sensitive biomarkers, which can be employed in large-scale of population to assess the health risk and to monitor the effectiveness of interventions. In this review, we describe a range of biomarkers that are associated with air pollution exposure, particularly markers of oxidative stress, inflammatory factors, and microRNAs, as well as markers of pollutants metabolites. Understanding the nature of the association of these biomarkers with PM exposure may shed some light on the process of selecting biomarkers for large-scale population studies, developing novel preventative and therapeutic strategies.
Publisher: Wiley
Date: 25-07-2013
Abstract: The 2010-2011 Queensland floods resulted in the most deaths from a single flood event in Australia since 1916. This article analyses the information on these deaths for comparison with those from previous floods in modern Australia in an attempt to identify factors that have contributed to those deaths. Haddon's Matrix, originally designed for prevention of road trauma, offers a framework for understanding the interplay between contributing factors and helps facilitate a clearer understanding of the varied strategies required to ensure people's safety for particular flood types. Public reports and flood relevant literature were searched using key words 'flood', 'fatality', 'mortality', 'death', 'injury' and 'victim' through Google Scholar, PubMed, ProQuest and EBSCO. Data relating to reported deaths during the 2010-2011 Queensland floods, and relevant data of previous Australian flood fatality (1997-2009) were collected from these available sources. These sources were also used to identify contributing factors. There were 33 deaths directly attributed to the event, of which 54.5% were swept away in a flash flood on 10 January 2011. A further 15.1% of fatalities were caused by inappropriate behaviours. This is different to floods in modern Australia where over 90% of deaths are related to the choices made by in iduals. There is no single reason why people drown in floods, but rather a complex interplay of factors. The present study and its integration of research findings and conceptual frameworks might assist governments and communities to develop policies and strategies to prevent flood injury and fatalities.
Publisher: SAGE Publications
Date: 30-01-2011
Abstract: This article describes the development and initial validation of a new instrument to measure academic stress—the Educational Stress Scale for Adolescents (ESSA). A series of cross-sectional questionnaire surveys were conducted with more than 2,000 Chinese adolescents to examine the psychometric properties. The final 16-item ESSA contains five latent variables: Pressure from study, Workload, Worry about grades, Self-expectation, and Despondency, which together explain 64% of the total item variance. Scale scores showed adequate internal consistency, 2-week test–retest reliability, and satisfactory concurrent validity. A confirmatory factor analysis suggested the proposed factor model fits well in a different s le. For researchers who have a particular interest in academic stress among adolescents, the ESSA promises to be a useful tool.
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.SCITOTENV.2016.10.070
Abstract: Temperature extremes and air pollution both pose significant threats to human health, but it remains uncertain whether pollutants' effects on mortality are modified by temperature levels. In this review, we summarized epidemiologic evidence on the modification by temperature of the acute effects of air pollutants on non-accidental and cardiovascular mortality. The EMBASE, PubMed, ProQuest Dissertations and Theses, and Elsevier Science Direct databases were used to identify papers published up to 2nd December 2014. Studies with appropriate design, exposures and outcome indicators, quantitative estimates and high/intermediate quality were included. Twenty-one studies met the inclusion criteria, of which 12 reported the effects of PM
Publisher: Elsevier BV
Date: 12-2009
DOI: 10.1016/J.SURNEU.2008.09.027
Abstract: With the combination of microsurgery and microinjection techniques, we investigated the development of motor neurons in the spinal cord of fetal rats with spina bifida occulta by injecting the retrograde trace FG into the levator ani muscle. The fetal rats were ided into 3 groups. On the day 9 of gestation, 6 mature Wistar rats (weighing 250-300 g) in the control group (group 1) were subcutaneously injected with 0.5 mL of normal saline at their hind limbs at 9:00 am and 4:00 pm. At these 2 time points, 15 rats in the treatment group (group 2 and group 3) were subcutaneously injected with 20% sodium valproate solution (400 mg/kg of body weight) at their hind limbs, too. On the day 20 of gestation, pregnant rats were anesthetized with 10% chloral hydrate (300 mg/kg of body weight) intraperitoneally, and then fetal microsurgery and microinjection were performed to expose the levator ani muscle, whereas 5% FG was administered with microinjector. Twenty-four hours later, transcardial perfusion of 4% paraformaldehyde in phosphate-buffered saline (PBS) was given to the operated fetus. After the spine s le was stained with Alcian blue GX, the image of stained spine was measured using a computer system for the distance of the 2 cartilaginous ends of the vertebra arch. Then, the lumbosacral spinal cord was cryopreserved in 20% sucrose in PBS for a later serial transverse cryosection after 24 hours. The FG-labeled motor neurons were visualized with a wide-band ultraviolet-fluorescent filter, and the number of the FG-labeled motor neurons was recorded. Nine fetal rats survived in group 1. Eighteen fetal rats survived in the treatment group, including 7 (with no malformation) of 18 fetuses in group 2 and 11 fetuses with spina bifida occulta in group 3. The FG-labeled motor neurons in the ventral horn of normal spinal cord clustered at the dorsolateral and dorsomedial corner of the ventral horn. The FG-labeled motor neurons in the ventral horn of deformed spinal cord were less than that of normal spinal cord, and the motor neurons were scattered around the space between the dorsomedial and dorsolateral corners. The number of FG-labeled motor neurons was 244 +/- 41 in group 3, 426 +/- 36 in group 1, and 397 +/- 20 in group 2. The data were statistically significant if P < .05. The motor neurons that innervate the levator ani muscle in fetal rats with spina bifida occulta are fewer than the normal fetal rats, and they are arranged in abnormal distribution.
Publisher: MDPI AG
Date: 18-06-2014
Publisher: World Journal of Emergency Medicine
Date: 2013
Publisher: MDPI AG
Date: 20-06-2019
Abstract: This study examined the associations of interpersonal conflict and school connectedness with depressive symptoms in Chinese adolescents. A cross-sectional study was conducted among 6576 adolescents in Shenzhen, China. Participants completed a battery of questionnaires that assessed adolescents’ depressive symptoms, conflict with parents, teachers, and peers, school connectedness, and demographics. Multiple linear regression analysis was used to explore the association of interpersonal conflict and school connectedness with depressive symptoms in adolescents. Results showed that conflicts with their mother, father, teachers, and peers were associated with higher levels of depressive symptoms in adolescents, while greater school connectedness was related to lower levels of depressive symptoms in adolescents. Gender proved to be a moderator of these relationships in that the associations of quarreling with mothers, mothers’ use of emotional punishments, teachers’ use of emotional punishments, and school connectedness with depressive symptoms were stronger in females than males. Moreover, grade level proved to be another moderator, with the associations of teachers’ use of physical punishment and fighting with peers with depressive symptoms being stronger in primary school students than in secondary school students. Our findings suggest that gender and grade level moderated the association of interpersonal conflict and school connectedness with depressive symptoms in Chinese adolescents.
Publisher: Springer Science and Business Media LLC
Date: 2013
Publisher: MDPI AG
Date: 27-09-2017
Publisher: Springer Science and Business Media LLC
Date: 25-10-2023
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.CLINTHERA.2018.06.009
Abstract: Imrecoxib is one type of cyclooxygenase-2 inhibitor with the capability of reducing the potential cardiovascular risk caused by other NSAIDs. Co-administration with other medications can affect the cytochrome P450 (CYP) 2C9 enzyme function thus, imrecoxib metabolism can be affected. The purpose of this research was to evaluate the effects of fluconazole, which is known to inhibit CYP2C9, on imrecoxib's pharmacokinetic (PK) parameters. In this single-center, single-arm, open-label, self-controlled study, 12 healthy Chinese male volunteers (mean [SD] age, 22.6 [2.43] years) received the following 2 treatments separated by a washout period of 8 days under a fasting state: (1) a single oral dose of imrecoxib 100 mg and (2) fluconazole 200 mg/d over 6 days followed by concurrent dosing of imrecoxib 100 mg and fluconazole 200 mg. Plasma concentrations of imrecoxib (M0) and its metabolites (4'-hydroxymethyl metabolite [M1] and 4'-carboxylic acid metabolite [M2]) for PK analysis were obtained at 0 (baseline) and 0.5, 1, 1.5, 2, 3, 4, 8, 12, 24, 48, and 72 hours after imrecoxib dosing. Safety and tolerability assessments were performed throughout the study. All subjects completed the study. There was 1 adverse event drug-induced liver damage in 1 subject occurred after he received imrecoxib plus fluconazole, and the subject recovered without any sequelae. Coadministration with fluconazole resulted in much higher plasma imrecoxib concentrations, with an increase of 88% in C Concurrent administration of imrecoxib and fluconazole did not seem to change imrecoxib's safety profile. The ratio (imrecoxib + fluconazole/imrecoxib) for AUC
Publisher: Wiley
Date: 05-2002
DOI: 10.1046/J.1475-097X.2002.00423.X
Abstract: This study tested the hypotheses that skeletal muscle mitochondrial ATP production rate (MAPR) is impaired in patients with peripheral arterial disease (PAD) and that it relates positively to their walking performances. Seven untrained patients, eight exercise-trained patients and 11 healthy controls completed a maximal walking test and had muscle s led from the gastrocnemius medialis muscle. Muscle was analysed for its MAPR in the presence of pyruvate, palmitoyl-L-carnitine or both, as well as citrate synthase (CS) activity. MAPRs were not different between untrained PAD and controls. In contrast, MAPRs (pyruvate) were significantly higher in trained PAD vs. controls. MAPR (pyruvate combinations) was also significantly higher in trained than untrained PAD muscle. MAPR and CS activity were highly correlated with walking performance in patients, but not in controls. These data do not support the hypothesis that isolated mitochondria are functionally impaired in PAD and demonstrate that the muscle mitochondrial capacity to oxidize carbohydrate is positively related to walking performance in these patients.
Publisher: Springer Science and Business Media LLC
Date: 06-02-2018
DOI: 10.1038/S41371-018-0030-9
Abstract: Literature showed that sugar-sweetened beverages (SSBs) could increase the risk of developing hypertension in school students, but there is no reported evidence from China yet, so this study aims to investigate the association of the SSBs consumption and school students' hypertension in urban areas of Nanjing, China. A cross-sectional survey was conducted among primary and junior high school students selected from 32 primary schools and 16 junior high schools using a multi-stage random s ling method, with a total number of 10,091 participants involved. The mean age of Grade 4 is 9.04 ± 0.38, while the mean age of Grade 7 is 12.03 ± 0.41. Blood pressure was measured and SSBs consumption was reported using a validated questionnaire. The overall prevalence of hypertension was 4.5% among the participants. After adjustment for school, parental education, physical activity, diet intake including meat and snacks, participants who had an experience of SSBs intake were at a higher risk of developing hypertension (odds ratio (OR) = 1.40, 95% confidence interval (CI) = 1.15, 1.70) compared with those who had no experience of SSBs intake. A significant association between the consumption of SSBs and hypertension was observed among the students who were at a healthy weight (OR = 1.78, 95% CI = 1.20, 2.65), as well as who were overweight or obese (OR = 1.28, 95% CI = 1.01, 1.61). SSBs may play a contributing role in developing childhood hypertension in this population in China, which is of important implications for future population-based childhood hypertension intervention in China and other countries.
Publisher: Springer Science and Business Media LLC
Date: 23-01-2014
Abstract: The overuse of antibiotics is becoming an increasing concern. Antibiotic resistance, which increases both the burden of disease, and the cost of health services, is perhaps the most profound impact of antibiotics overuse. Attempts have been made to develop instruments to measure the psychosocial constructs underlying antibiotics use, however, none of these instruments have undergone thorough psychometric validation. This study evaluates the psychometric properties of the Parental Perceptions on Antibiotics (PAPA) scales. The PAPA scales attempt to measure the factors influencing parental use of antibiotics in children. 1111 parents of children younger than 12 years old were recruited from primary schools’ parental meetings in the Eastern Province of Saudi Arabia from September 2012 to January 2013. The structure of the PAPA instrument was validated using Confirmatory Factor Analysis (CFA) with measurement model fit evaluated using the raw and scaled χ 2 , Goodness of Fit Index, and Root Mean Square Error of Approximation. A five-factor model was confirmed with the model showing good fit. Constructs in the model include: Knowledge and Beliefs, Behaviors, Sources of information, Adherence, and Awareness about antibiotics resistance . The instrument was shown to have good internal consistency, and good discriminant and convergent validity. The availability of an instrument able to measure the psychosocial factors underlying antibiotics usage allows the risk factors underlying antibiotic use and overuse to now be investigated.
Publisher: Cambridge University Press (CUP)
Date: 02-2014
DOI: 10.1017/DMP.2014.10
Abstract: The aim of this report is to identify from the literature common themes relating to the concept of hospital preparedness for emergencies to develop an agreed framework for evaluation. A systematic literature search identified appropriate articles for critical appraisal. A meta-ethnography approach was used to synthesize the findings, using both reciprocal translation and line-of-argument synthesis. From an initial 2162 articles, we identified 13 articles that specifically addressed the aims of this review and formed the basis of the intended analysis. Hospital emergency preparedness is essential for effective disaster relief. Developing a systematic and structured methodology is necessary to assess hospital preparedness. ( Disaster Med Public Health Preparedness : 2014:0:1-9)
Publisher: Wiley
Date: 09-2002
DOI: 10.1046/J.1475-097X.2002.00442.X
Abstract: To shed light on the potential efficacy of cycling as a testing modality in the treatment of intermittent claudication (IC), this study compared physiological and symptomatic responses to graded walking and cycling tests in claudicants. Sixteen subjects with peripheral arterial disease (resting ankle: brachial index (ABI) < 0.9) and IC completed a maximal graded treadmill walking (T) and cycle (C) test after three familiarization tests on each mode. During each test, symptoms, oxygen uptake (VO2), minute ventilation (VE), respiratory exchange ratio (RER) and heart rate (HR) were measured, and for 10 min after each test the brachial and ankle systolic pressures were recorded. All but one subject experienced calf pain as the primary limiting symptom during T whereas the symptoms were more varied during C and included thigh pain, calf pain and dyspnoea. Although maximal exercise time was significantly longer on C than T (690 +/- 67 vs. 495 +/- 57 s), peak VO2, peak VE and peak heart rate during C and T were not different whereas peak RER was higher during C. These responses during C and T were also positively correlated (P < 0.05) with each other, with the exception of RER. The postexercise systolic pressures were also not different between C and T. However, the peak decline in ankle pressures from resting values after C and T were not correlated with each other. These data demonstrate that cycling and walking induce a similar level of metabolic and cardiovascular strain, but that the primary limiting symptoms and haemodynamic response in an in idual's extremity, measured after exercise, can differ substantially between these two modes.
Publisher: Springer Science and Business Media LLC
Date: 12-2012
Publisher: Informa UK Limited
Date: 27-06-2022
DOI: 10.1080/10903127.2022.2068089
Abstract: There is limited research available on safe medication management practices in emergency medical services (EMS) practice, with most evidence-based medication safety guidelines based on research in nursing, operating theater and pharmacy settings. Prevention of errors requires recognition of contributing factors across the spectrum from the organizational level to procedural elements and patient characteristics. Evidence is inconsistent regarding the incidence of medication errors and multiple sources also state that errors are under-reported, making the true magnitude of the problem difficult to quantify. Definitions of error also vary, with the specific context of medication errors in prehospital practice yet to be established. The objective of this review is to identify the factors influencing the occurrence of medication errors by EMS personnel in the prehospital environment. The review included both qualitative and quantitative research involving interventions or phenomena related to medication safety or medication error by EMS personnel in the prehospital environment. A search of multiple databases was conducted to identify studies meeting these inclusion criteria. All studies selected were assessed for methodological quality however, this was not used as a basis for exclusion. Each stage of study selection, appraisal and data extraction was conducted by two independent reviewers, with a third reviewer deciding any unresolved conflicts. The review follows a convergent integrated approach, conducting a single qualitative synthesis of qualitative and "qualitized" quantitative data. Fifty-six articles were included in the review, with case reports and qualitative studies being the most frequent study types. Qualitative analysis revealed seven major themes: organizational factors (with reporting as a sub-theme), equipment/medications, environmental factors, procedure-related factors, communication, patient-related factors (with pediatrics as a sub-theme) and cognitive factors. Both contributing factors and protective factors were identified. The body of evidence regarding medication errors is heterogenous and limited in both quantity and quality. Multiple factors influence medication error occurrence knowledge of these is necessary to mitigate the risk of errors. Medication error incidence is difficult to quantify due to inconsistent measure, definitions and contexts of research conducted to date. Further research is required to quantify the prevalence of identified factors in specific practice settings.
Publisher: SAGE Publications
Date: 11-12-2014
Abstract: Hospital resilience is an emerging concept, which can be defined as ‘a hospital’s ability to resist, absorb, and respond to the shock of disasters while maintaining its critical health care functions, and then recover to its original state or adapt to a new one’. Our aim was to develop a comprehensive framework of key indicators of hospital resilience. A panel of 33 Chinese experts was invited to participate in a three-round, modified Delphi study to develop a set of potential measures previously derived from a literature review. In the first round, these potential measures were modified to cover the comprehensive domains of hospital resilience. The importance of proposed measures was scored by experts on a five-point Likert scale. Subsequently, the experts reconsidered their voting in light of the previous aggregated results. Agreement on measures was defined as at least 70% of the responders agreeing or strongly agreeing to the inclusion of a measure. A large proportion of preliminary measures (89.5%) were identified as having good potential for assessing hospital resilience. These measures were categorized into eight domains, 17 subdomains, and 43 indicators. The highest rated indicators (mean score) were: equipment for on-site rescue (4.7), plan initiation (4.6), equipment for referral of patients with complex care needs (4.5), the plan execution (4.4), medication management strategies (4.4), emergency medical treatment conditions (4.4), disaster committee (4.4), stock types and quantities for essential medications (4.4), surge capacity of emergency beds (4.4), and mass-casualty triage protocols (4.4). This framework identifies a comprehensive set of indicators of hospital resilience. It can be used for hospital assessment, as well as informing priority practices to address future disasters better.
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1016/J.PUHE.2022.02.012
Abstract: This study aimed to explore the association of visual, hearing, or dual sensory impairment with healthcare use and costs. This is a cohort study. These research data were from the China Health and Retirement Longitudinal Study spanning 2011-2018 and included 8982 community-dwelling middle-aged and older adults (aged ≥45 years at baseline). Sensory impairment was measured according to self-reported assessment of visual and hearing functions, and healthcare use and costs were ascertained via self-report. The associations of sensory impairment with healthcare use and costs were estimated using the mixed-effects regression models. Of the 8982 respondents, 4346 (48.39%) were females and their mean (standard deviation) age at baseline was 57.03 (8.26) years. In iduals with hearing impairment (HI) only, visual impairment (VI) only, and dual sensory impairment (DSI) were all at significantly higher risks of healthcare use and catastrophic health expenditure than those without sensory impairment (all P < 0.05), except that VI only non-significantly prolonged inpatient days. Compared with no impairment, DSI was associated with increases in outpatient (β = 50.67, 95% confidence interval [CI] = 17.47-83.86) and inpatient out-of-pocket costs (β = 40.35, 95% CI = 5.94-74.76), while VI only or HI only did not show significant effects. Further stratification analyses indicated that the associations between sensory impairment and outpatient use were more pronounced among males than among females but that age group did not moderate the associations with any healthcare outcomes. HI and VI were independently and together associated with higher risks of healthcare use and catastrophic health expenditure. Dual sensory impairment was the only category consistently associated with increased outpatient and inpatient costs.
Publisher: Springer Science and Business Media LLC
Date: 2013
Publisher: Elsevier BV
Date: 07-2015
DOI: 10.1016/J.APPET.2015.02.003
Abstract: The purpose of this research was to explore which demographic and health status variables moderated the relationship between psychological distress and three nutrition indicators: the consumption of fruits, vegetables and takeaway. We analysed data from the 2009 Self-Reported Health Status Survey Report collected in the state of Queensland, Australia. Adults (N = 6881) reported several demographic and health status variables. Moderated logistic regression models were estimated separately for the three nutrition indicators, testing as moderators demographic (age, gender, educational attainment, household income, remoteness, and area-level socioeconomic status) and health status indicators (body mass index, high cholesterol, high blood pressure, and diabetes status). Several significant interactions emerged between psychological distress, demographic (age, area-level socio-economic status, and income level), and health status variables (body mass index, diabetes status) in predicting the nutrition indicators. Relationships between distress and the nutrition indicators were not significantly different by gender, remoteness, educational attainment, high cholesterol status, and high blood pressure status. The associations between psychological distress and several nutrition indicators differ amongst population subgroups. These findings suggest that in distressed adults, age, area-level socio-economic status, income level, body mass index, and diabetes status may serve as protective or risk factors through increasing or decreasing the likelihood of meeting nutritional guidelines. Public health interventions for improving dietary behaviours and nutrition may be more effective if they take into account the moderators identified in this study rather than using global interventions.
Publisher: World Journal of Emergency Medicine
Date: 2011
Publisher: Wiley
Date: 04-2010
DOI: 10.1111/J.1742-6723.2010.01284.X
Abstract: Flood is the most common natural disaster in Australia and causes more loss of life than any other disaster. This article describes the incidence and causes of deaths directly associated with floods in contemporary Australia. The present study compiled a database of flood fatalities in Australia in the period of 1997-2008 inclusive. The data were derived from newspapers and historic accounts, as well as government and scientific reports. Assembled data include the date and location of fatalities, age and gender of victims and the circumstances of the death. At least 73 persons died as a direct result of floods in Australia in the period of 1997-2008. The largest number of fatalities occurred in New South Wales and Queensland. Most fatalities occurred during February, and among men (71.2%). People between the ages of 10 and 29 and those over 70 years are overrepresented among those drowned. There is no evident decline in the number of deaths over time. 48.5% fatalities related to motor vehicle use. 26.5% fatalities occurred as a result of inappropriate or high-risk behaviour during floods. In modern developed countries with adequate emergency response systems and extensive resources, deaths that occur in floods are almost all eminently preventable. Over 90% of the deaths are caused by attempts to ford flooded waterways or inappropriate situational conduct. Knowledge of the leading causes of flood fatalities should inform public awareness programmes and public safety police enforcement activities.
Publisher: Elsevier BV
Date: 11-2012
DOI: 10.1016/J.PEC.2012.07.002
Abstract: This study investigated the characteristics of the patient-practitioner relationship desired by overweight/obese in iduals in weight management. The aim was to identify characteristics of the relationship which empower patients to make lifestyle changes. Grounded theory was used inductively to build a model of the patient-practitioner relationship based on the perspectives of 21 overweight/obese adults. Emerging from the match between patient and practitioner characteristics, collaboration was the key process explicitly occurring in the patient-practitioner relationship, and was characterised by two subcategories perceived power dimensions and openness. Trust emerged implicitly from the collaborative process, being fostered by relational, informational, and credible aspects of the interaction. Patient trust in their practitioner consequently led to empowering outcomes including goal ownership and perceiving the utility of changes. An appropriate match between patient and practitioner characteristics facilitates collaboration which leads to trust, both of which appear to precede empowering outcomes for patients such as goal ownership and perceiving the utility of changes. Collaboration is an explicit process and precedes the patient trusting their practitioner. Practitioners should be sensitive to patient preferences for collaboration and the opportunity to develop trust with patients relationally, through information provision, and modelling a healthy lifestyle.
Publisher: Springer Science and Business Media LLC
Date: 12-2016
Publisher: Springer Science and Business Media LLC
Date: 19-08-2015
Publisher: MDPI AG
Date: 12-10-2023
Publisher: Wiley
Date: 25-12-2012
Abstract: Paramedic education has been undergoing major development in Australia in the past 20 years, with many different educational programmes being developed across all Australian jurisdictions. This paper aims to review the current paramedic education programmes in Australia to identify the similarities and differences between the programmes, and the strengths and challenges in these programmes. A literature search was performed using six scientific databases to identify any systematic reviews, literature reviews or relevant articles on the topic. Additional searches included journal articles and text references from 1995 to 2011. The search was conducted during December 2010 and November 2011. Included in this review are a total of 28 articles, which are focused around five major issues in paramedic education: (i) principle on paramedic programmes and the involvement of industry partners (ii) clinical placements (iii) contemporary methods of education (iv) needs for specific programmes within paramedic education and (v) articles related to the accreditation process for paramedic programmes. Paramedic programmes across Australian universities vary with many different practices, especially relating to clinical placements in the field. The further advances of the paramedic education programmes should aim to respond to population change and industry development, which would enhance the paramedic profession across Australia.
Publisher: Frontiers Media SA
Date: 09-09-2021
DOI: 10.3389/FPUBH.2021.718910
Abstract: Background: Catastrophic health expenditure (CHE) represents a key indicator for excessive financial burden due to out-of-pocket (OOP) healthcare costs, which could push the household into poverty and is highly pronounced in households with members at an advanced age. Previous studies have been devoted to understanding the determinants for CHE, yet little evidence exists on its association with frailty, an important geriatric syndrome attracting growing recognition. We thus aim to examine the relationship between frailty and CHE and to explore whether this effect is moderated by socioeconomic-related factors. Methods: A total of 3,277 older adults were drawn from two waves (2011 and 2013) of the China Health and Retirement Longitudinal Study (CHARLS). CHE was defined when OOP healthcare expenditure exceeded a specific proportion of the capacity of the household to pay. Frailty was measured following the Fried Phenotype (FP) scale. Mixed-effects logistic regression models were employed to assess the longitudinal relationship between frailty and CHE, and stratification analyses were conducted to explore the moderation effect. Results: The incidence of CHE among Chinese community-dwelling older adults was 21.76% in 2011 and increased to 26.46% in 2013. Compared with non-frail in iduals, prefrail or frail adults were associated with higher odds for CHE after controlling for age, gender, residence, education, marriage, income, health insurance, smoking, drinking, and comorbidity (prefrail: odds ratio (OR) = 1.32, 95%CI = 1.14–1.52 frail: OR = 1.67, 95%CI = 1.13–2.47). Three frailty components including weakness, exhaustion, and shrinking contributed to a significantly increased likelihood of CHE (all p & 0.05), while the other two components including slowness and inactivity showed a non-significant effect (all p & 0.05). Similar effects from frailty on CHE were observed across socioeconomic-related subgroups differentiated by gender, residence, education, household income, and social health insurance. Conclusions: Frailty is a significant predictor for CHE in China. Developing and implementing cost-effective strategies for the prevention and management of frailty is imperative to protect households from financial catastrophe.
Publisher: World Journal of Emergency Medicine
Date: 2016
Publisher: Wiley
Date: 18-04-2012
DOI: 10.1111/J.1742-6723.2012.01560.X
Abstract: To evaluate the impact of a government triple zero community awareness c aign on the characteristics of patients attending an ED. A study using Emergency Department Information System data was conducted in an adult metropolitan tertiary-referral teaching hospital in Brisbane. The three outcomes measured in the 3 month post-c aign period were arrival mode, Australasian Triage Scale and departure status. These measures reflect ambulance usage, clinical urgency and illness severity, respectively. They were compared with those in the 3 month pre-c aign period. Multivariate logistic regression models were used to investigate the impacts of the c aign on each of the three outcome measures after controlling for age, sex, day and time of arrival, and daily minimum temperature. There were 17,920 visits in the pre- and 17,793 visits in the post-c aign period. After the c aign, fewer patients arrived at the ED by road ambulance (odds ratio [OR] 0.90, 95% confidence interval [CI] 0.80-1.00), although the impact of the c aign on the arrival mode was only close to statistical significance (Wald χ(2) -test, P= 0.055) and patients were significantly less likely to have higher clinical urgency (OR 0.86, 95% CI 0.79-0.94), while more likely to be admitted (OR 1.68, 95% CI 1.38-2.05) or complete treatment in the ED (OR 1.46, 95% CI 1.23-1.73) instead of leaving without waiting to be seen. The c aign had no significant impact on the arrival mode of the patients. After the c aign, the illness acuity of the patients decreased, whereas the illness severity of the patients increased.
Publisher: Springer Science and Business Media LLC
Date: 20-02-2017
Publisher: Elsevier BV
Date: 06-2012
DOI: 10.1016/J.JIPH.2012.03.003
Abstract: Antibiotic overuse is a global public health issue that is influenced by several factors. The degree and prevalence of antibiotic overuse is difficult to measure directly. A more practical approach, such as the use of a psycho-social measurement instrument, might allow for the observation and assessment of patterns of antibiotic use. The aim of this paper is to review the nature, validity, and reliability of measurement scales designed to measure factors associated with antibiotic misuse/overuse. This study is descriptive and includes a systematic integration of the measurement scales used in the literature to measure factors associated with antibiotic misuse/overuse. The review included 70 international scientific publications from 1992 to 2010. Studies have presented scales to measure antibiotic misuse. However, the workup of these instruments is often not mentioned, or the scales are used with only early-phase validation, such as content or face validity. Other studies have discussed the reliability of these scales. However, the full validation process has not been discussed in any of the reviewed measurement scales. A reliable, fully validated measurement scale must be developed to assess the factors associated with the overuse of antibiotics. Identifying these factors will help to minimize the misuse of antibiotics.
Publisher: Wiley
Date: 19-09-2017
Abstract: The aim of this study was to understand what factors influence patients' choice between public and private hospital ED and the relative weight of those factors among adult patients with private health insurance in Australia. A survey of 280 patients was conducted in four public and private hospitals' EDs in Brisbane between May and August 2015. The survey included information about respondent's demographics, nature of illness, decision-making, attitudes and choice. Independent t-test and Pearson's χ²-test were used to identify binary associations, and logistic regression was used to determine what factors influence patients' choice. Patients who agreed that 'long waiting time is a barrier to access public hospital ED' were twice as likely to choose private hospitals (odds ratio [OR] 2.172, P = 0.001). Alternatively patients who did not consider that 'there were long waiting times in public hospital ED' were less likely to access private hospitals (OR 0.200, P = 0.003). More public hospital patients (70.7%) than private hospital patients (56.4%) (P = 0.015) agreed that 'out-of-pocket payment is a barrier to accessing private hospital ED'. Patients attending private hospitals rated the quality of service higher than those attending public hospitals (OR 1.26, P = 0.001). Longer waiting times in public EDs is the principal issue considered by patients choosing private EDs and the out-of-pocket payment for accessing private EDs is the principal issue considered by public ED patients. The study suggests that addressing the out-of-pocket payments will attract more patients with private health insurance to access private EDs.
Publisher: Informa UK Limited
Date: 10-09-2014
DOI: 10.3402/GHA.V7.24986
Publisher: Public Library of Science (PLoS)
Date: 03-07-2018
Publisher: Frontiers Media SA
Date: 06-08-2018
Publisher: BMJ
Date: 19-12-2014
DOI: 10.1136/EMERMED-2014-203770
Abstract: High utilisation of emergency department (ED) among the elderly is of worldwide concern. This study aims to review the effectiveness of interventions targeting the elderly population in reducing ED utilisation. Major biomedical databases were searched for relevant studies. Qualitative approach was applied to derive common themes in the myriad interventions and to critically assess the variations influencing interventions' effectiveness. Quality of studies was appraised using the Effective Public Health Practice Project (EPPHP) tool. 36 studies were included. Nine of 16 community-based interventions reported significant reductions in ED utilisation. Five of 20 hospital-based interventions proved effective while another four demonstrated failure. Seven key elements were identified. Ten of 14 interventions associated with significant reduction on ED use integrated at least three of the seven elements. All four interventions with significant negative results lacked five or more of the seven elements. Some key elements including multidisciplinary team, integrated primary care and social care often existed in effective interventions, while were absent in all significantly ineffective ones. The investigated interventions have mixed effectiveness. Our findings suggest the hospital-based interventions have relatively poorer effects, and should be better connected to the community-based strategies. Interventions seem to achieve the most success with integration of multi-layered elements, especially when incorporating key elements such as a nurse-led multidisciplinary team, integrated social care, and strong linkages to the longer-term primary and community care. Notwithstanding limitations in generalising the findings, this review builds on the growing body of evidence in this particular area.
Publisher: Informa UK Limited
Date: 08-2013
Publisher: BMJ
Date: 12-09-2013
DOI: 10.1136/EMERMED-2012-202282
Abstract: Despite 'hospital resilience' gaining prominence in recent years, it remains poorly defined. This article aims to define hospital resilience, build a preliminary conceptual framework and highlight possible approaches to measurement. Searches were conducted of the commonly used health databases to identify relevant literature and reports. Search terms included 'resilience and framework or model' or 'evaluation or assess or measure and hospital and disaster or emergency or mass casualty and resilience or capacity or preparedness or response or safety'. Articles were retrieved that focussed on disaster resilience frameworks and the evaluation of various hospital capacities. A total of 1480 potentially eligible publications were retrieved initially but the final analysis was conducted on 47 articles, which appeared to contribute to the study objectives. Four disaster resilience frameworks and 11 evaluation instruments of hospital disaster capacity were included. Hospital resilience is a comprehensive concept derived from existing disaster resilience frameworks. It has four key domains: hospital safety disaster preparedness and resources continuity of essential medical services recovery and adaptation. These domains were categorised according to four criteria, namely, robustness, redundancy, resourcefulness and rapidity. A conceptual understanding of hospital resilience is essential for an intellectual basis for an integrated approach to system development. This article (1) defines hospital resilience (2) constructs conceptual framework (including key domains) (3) proposes comprehensive measures for possible inclusion in an evaluation instrument and (4) develops a matrix of critical issues to enhance hospital resilience to cope with future disasters.
Publisher: Wiley
Date: 22-05-2013
Abstract: Public hospital EDs in Australia have become increasingly congested because of increasing demand and access block. Six per cent of ED patients attend private hospital EDs whereas 45% of the population hold private health insurance. This study describes the patients attending a small selection of four private hospital EDs in Queensland and Victoria, and tests the feasibility of a private ED database. De-identified routinely collected patient data were provided by the four participating private hospital and amalgamated into a single data set. The mean age of private ED patients was 52 years. Males outnumbered females in all age groups except > 80 years. Attendance was higher on weekends and Mondays, and between 08.00 and 20.00 h. There were 6.6% of the patients triaged as categories 1 and 2, and 60% were categories 4 or 5. There were 36.4% that required hospital admission. Also, 96% of the patients had some kind of insurance. Furthermore, 72% were self-referred and 12% were referred by private medical practitioners. Approximately 25% arrived by ambulance. There were 69% that completed their ED treatment within 4 h. This study is the first public description of patients attending private EDs in Australia. Private EDs have a significant role to play in acute medical care and in providing access to private hospitals which could alleviate pressure on public EDs. This study demonstrates the need for consolidated data based on a consistent data set and data dictionary to enable system-wide analysis, benchmarking and evaluation.
Publisher: MDPI AG
Date: 02-07-2021
Abstract: Universities are providing short-term overseas study programs for healthcare students to increase their cultural competence (i.e., capacity to work effectively in cross-cultural situations). However, there is limited empirical research evaluating the effects of these programs using well-controlled research designs. In the present research study, undergraduate healthcare students in an Australian university were selected as participants. Group 1 (n = 32) participated in a short-term overseas study program in Asia (i.e., China, Vietnam, Singapore, and Taiwan), whereas Group 2 (n = 46) stayed in Australia to continue their university education as usual. All participants completed a self-developed demographic questionnaire, Cultural Intelligence Scale, and Multicultural Personality Questionnaire. Cultural competence was surveyed pre- and post-short-term overseas programs. After controlling for prior overseas experiences and the open-mindedness trait, an ANCOVA indicated that Group 1 had a significantly higher scores than Group 2 in cultural knowledge (p 0.05), but not in cultural awareness, attitude, or skills. It is suggested that short-term overseas study programs may increase healthcare students’ cultural knowledge, a component of competence, and that more needs to be accomplished to improve other areas of cultural competence.
Publisher: Springer Science and Business Media LLC
Date: 25-03-2014
Publisher: Cambridge University Press (CUP)
Date: 22-10-2015
DOI: 10.1017/S1049023X15005257
Abstract: The incidence and mortality of traumatic brain injury (TBI) has increased rapidly in the last decade in China. Appropriate ambulance service can reduce case-fatality rates of TBI significantly. This study aimed to explore the factors (age, gender, education level, clinical experience, professional title, organization, specialty before prehospital care, and training frequency) that could influence prehospital doctors’ knowledge level and practices in TBI management in China, Hubei Province. A cross-sectional questionnaire survey was conducted in two cities in Hubei Province. The self-administered questionnaire consisted of demographic information and questions about prehospital TBI management. Independent s les t-test and one-way ANOVA were used to analyze group differences in the average scores in terms of demographic character. General linear regression was used to explore associated factors in prehospital TBI management. A total of 56 questionnaires were handed out and 52 (93%) were returned. Participants received the lowest scores in TBI treatment (0.64 SD=0.08) and the highest scores in TBI assessment (0.80 SD=0.14). According to the regression model, the education level was associated positively with the score of TBI identification ( P =.019) participants who worked in the emergency department (ED P =.011) or formerly practiced internal medicine ( P =.009) tended to get lower scores in TBI assessment participants’ scores in TBI treatment were associated positively with the training frequency ( P =.011) and no statistically significant associated factor was found in the overall TBI management. This study described the current situation of prehospital TBI management. The prehospital doctors’ knowledge level and practices in TBI management were quantified and the influential factors hidden underneath were explored. The results indicated that an appropriate continuing medical education (CME) program enables improvement of the quality of ambulance service in China. Kou K , Hou XY , Sun JD , Chu K . Doctor’s knowledge and practices of traumatic brain injury management in Chinese prehospital settings . Prehosp Disaster Med . 2015 30 ( 6 ): 560 – 568 .
Publisher: Springer Science and Business Media LLC
Date: 08-01-2020
No related grants have been discovered for Xiang-Yu Hou.