ORCID Profile
0000-0003-1494-5630
Current Organisations
Queen Elizabeth Hospital
,
Royal Adelaide Hospital
,
University of Adelaide
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Publisher: Springer Science and Business Media LLC
Date: 27-05-2016
DOI: 10.1038/SREP26846
Abstract: Age is well-known to be a significant factor in both disease pathology and response to treatment, yet the molecular changes that occur with age in humans remain ill-defined. Here, using transcriptome profiling of healthy human male skin, we demonstrate that there is a period of significantly elevated, transcriptome-wide expression changes occurring predominantly in middle age. Both pre and post this period, the transcriptome appears to undergo much smaller, linear changes with increasing age. Functional analysis of the transient changes in middle age suggest a period of heightened metabolic activity and cellular damage associated with NF-kappa-B and TNF signaling pathways. Through meta-analysis we also show the presence of global, tissue independent linear transcriptome changes with age which appear to be regulated by NF-kappa-B. These results suggest that aging in human skin is associated with a critical mid-life period with widespread transcriptome changes, both preceded and proceeded by a relatively steady rate of linear change in the transcriptome. The data provides insight into molecular changes associated with normal aging and will help to better understand the increasingly important pathological changes associated with aging.
Publisher: Wiley
Date: 11-2021
DOI: 10.1111/HEAD.14230
Abstract: To describe the epidemiology of nontraumatic headache in adults presenting to emergency departments (EDs). Headache is a common reason for presentation to EDs. Little is known about the epidemiology, investigation, and treatment of nontraumatic headache in patients attending EDs internationally. An international, multicenter, observational, cross‐sectional study was conducted over one calendar month in 2019. Participants were adults (≥18 years) with nontraumatic headache as the main presenting complaint. Exclusion criteria were recent head trauma, missing records, interhospital transfers, re‐presentation with same headache as a recent visit, and headache as an associated symptom. Data collected included demographics, clinical assessment, investigation, treatment, and outcome. We enrolled 4536 patients (67 hospitals, 10 countries). “Thunderclap” onset was noted in 14.2% of cases (644/4536). Headache was rated as severe in 27.2% (1235/4536). New neurological examination findings were uncommon (3.2% 147/4536). Head computed tomography (CT) was performed in 36.6% of patients (1661/4536), of which 9.9% showed clinically important pathology (165/1661). There was substantial variation in CT scan utilization between countries (15.9%–75.0%). More than 30 different diagnoses were made. Presumed nonmigraine benign headache accounted for 45.4% of cases (2058/4536) with another 24.3% classified as migraine (1101/4536). A small subgroup of patients have a serious secondary cause for their headache (7.1% 323/4536) with subarachnoid hemorrhage (SAH), stroke, neoplasm, non‐SAH intracranial hemorrhage/hematoma, and meningitis accounting for about 1% each. Most patients were treated with simple analgesics (paracetamol, aspirin, or nonsteroidal anti‐inflammatory agents). Most patients were discharged home (83.8% 3792/4526). In‐hospital mortality was 0.3% (11/4526). Diagnosis and management of headache in the ED is challenging. A small group of patients have a serious secondary cause for their symptoms. There is wide variation in the use of neuroimaging and treatments. Further work is needed to understand the variation in practice and to better inform international guidelines regarding emergent neuroimaging and treatment.
Publisher: Wiley
Date: 27-09-2021
DOI: 10.1111/AJAG.12999
Abstract: To describe the characteristics, assessment and management of older emergency department (ED) patients with non‐traumatic headache. Planned sub‐study of a prospective, multicentre, international, observational study, which included adult patients presenting to ED with non‐traumatic headache. Patients aged ≥75 years were compared to those aged years. Outcomes of interest were epidemiology, investigations, serious headache diagnosis and outcome. A total of 298 patients (7%) in the parent study were aged ≥75 years. Older patients were less likely to report severe headache pain or subjective fever (both P 0.001 ). On examination, older patients were more likely to be confused, have lower Glasgow Coma Scores and to have new neurological deficits (all P 0.001). Serious secondary headache disorder (composite of headache due to subarachnoid haemorrhage (SAH), intracranial haemorrhage, meningitis, encephalitis, cerebral abscess, neoplasm, hydrocephalus, vascular dissection, stroke, hypertensive crisis, temporal arteritis, idiopathic intracranial hypertension or ventriculoperitoneal shunt complications) was diagnosed in 18% of older patients compared to 6% of younger patients ( P 0.001). Computed tomography brain imaging was performed in 66% of patients ≥75 years compared to 35% of younger patients ( P 0.001). Older patients were less likely to be discharged (43% vs 63%, P 0.001). Older patients with headache had different clinical features to the younger cohort and were more likely to have a serious secondary cause of headache than younger adults. There should be a low threshold for investigation in older patients attending ED with non‐traumatic headache.
Publisher: Wiley
Date: 28-04-2020
Publisher: Wiley
Date: 10-02-2020
Publisher: AMPCo
Date: 28-03-2021
DOI: 10.5694/MJA2.50990
Publisher: Cold Spring Harbor Laboratory
Date: 04-01-2021
DOI: 10.1101/2021.01.03.21249171
Abstract: Time-based-targets for emergency department length-of-stay were introduced in England in 2000 followed by Canada, Ireland, New Zealand, and Australia after emergency department crowding was associated with poor quality of care and increased mortality. The aim of the systematic review was to evaluate qualitative literature to investigate how implementing time-based-targets for emergency department length-of-stay has influenced the quality of care of patients. Systematic review of qualitative studies that described knowledge, attitudes to or experiences regarding a time-based-target for emergency department length-of-stay. Searches were conducted in Cochrane library, Medline, Embase, CInAHL, Emerald, ABI/Inform, and Informit. In idual studies were evaluated using the Critical Appraisal Skills Programme tool. In idual study findings underwent thematic analysis. Confidence in findings was assessed using the Confidence in the Evidence from Reviews of Qualitative research approach. The review included thirteen studies from four countries, incorporating 617 interviews. Themes identified were: quality of care, access block and overcrowding, patient experience, staff morale and workload, intrahospital and interdepartmental relationships, clinical education and training, gaming, and enablers and barriers to achieving targets. The confidence in findings is moderate or high for most themes. More patient and junior doctor perspectives are needed. Emergency time-based-targets have impacted on the quality of emergency patient care. The impact can be both positive and negative and successful implementation depends on whole hospital resourcing and engagement with targets. The Australasian College for Emergency Medicine provided administrative support for the study, no funding was received. PROSPERO CRD42019107755 (prospective)
Publisher: Wiley
Date: 23-02-2021
Abstract: Time‐based targets for ED length of stay were introduced in England in 2000, followed by the rest of the UK, Canada, Ireland, New Zealand, and Australia after ED crowding was associated with poor quality of care and increased mortality. This systematic review evaluates qualitative literature to see if ED time‐based targets have influenced patient care quality. We included 13 studies from four countries, incorporating 617 interviews. We conclude that time‐based targets have impacted on the quality of emergency patient care, both positively and negatively. Successful implementation depends on whole hospital resourcing and engagement with targets.
Publisher: AMPCo
Date: 29-04-2021
DOI: 10.5694/MJA2.51047
Publisher: Wiley
Date: 08-11-2020
Publisher: Informa UK Limited
Date: 03-04-2023
Publisher: Society for Neuroscience
Date: 16-07-2008
DOI: 10.1523/JNEUROSCI.1135-08.2008
Abstract: Topographically ordered projections are established by molecular guidance cues and refined by neuronal activity. Retinal input to a primary visual center, the superior colliculus (SC), is bilateral with a dense contralateral projection and a sparse ipsilateral one. Both projections are topographically organized, but in opposing anterior–posterior orientations. This arrangement provides functionally coherent input to each colliculus from the binocular visual field, supporting visual function. When guidance cues involved in contralateral topography (ephrin-As) are absent, crossed retinal ganglion cell (RGC) axons form inappropriate terminations within the SC. However, the organization of the ipsilateral projection relative to the abnormal contralateral input remains unknown, as does the functional capacity of both projections. We show here that in ephrin-A −/− mice, the SC contains an expanded, diffuse ipsilateral projection. Electrophysiological recording demonstrated that topography of visually evoked responses recorded from the contralateral superior colliculus of ephrin-A −/− mice displayed similar functional disorder in all genotypes, contrasting with their different degrees of anatomical disorder. In contrast, ipsilateral responses were retinotopic in ephrin-A2 −/− but disorganized in ephrin-A2/A5 −/− mice. The lack of integration of binocular input resulted in specific visual deficits, which could be reversed by occlusion of one eye. The discrepancy between anatomical and functional topography in both the ipsilateral and contralateral projections implies suppression of inappropriately located terminals. Moreover, the misalignment of ipsilateral and contralateral visual information in ephrin-A2/A5 −/− mice suggests a role for ephrin-As in integrating convergent visual inputs.
Publisher: Wiley
Date: 29-06-2020
Publisher: Wiley
Date: 16-03-2021
Publisher: Wiley
Date: 18-07-2021
Publisher: Wiley
Date: 28-03-2023
DOI: 10.5694/MJA2.51907
No related grants have been discovered for Daniel Haustead.