ORCID Profile
0000-0002-2275-081X
Current Organisations
James Cook University
,
Queensland Ambulance Service
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Publisher: Bowling Green State University Libraries
Date: 05-2014
Publisher: Public Library of Science (PLoS)
Date: 25-02-2015
Publisher: Springer Science and Business Media LLC
Date: 19-08-2015
Publisher: BMJ
Date: 07-2016
Publisher: BMJ
Date: 05-06-2014
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.BURNS.2017.05.008
Abstract: Hot beverage scalds are a leading cause of burns in young children. The aim of this study was to look at the circumstances surrounding these injuries in terms of setting, mechanism, supervision and first aid to inform a prevention c aign. A cross-sectional study was delivered via iPad to parents and caregivers presenting with a child aged 0-36 months with a hot beverage scald at a major paediatric burns centre. Of the 101 children aged 0-36 months that presented with a hot beverage scald over a 12-month period, 54 participants were included. The scald aetiology was as expected with the peak prevalence in children aged 6-24 months, pulling a cup of hot liquid down over themselves. The majority of injuries occurred in the child's home and were witnessed by the caregiver or parent. The supervising adult was often in close proximity when the scald occurred. Less than a third (28%) of participants received recommended first aid treatment at the scene, with an additional 18% receiving this treatment with three hours of the injury-usually at an emergency department. While the aetiology of these scalds were as expected, the low use of recommended burn first aid was of concern. Although supervision was present in almost all cases, with the parent/caregiver close-by, this proximity still permitted injury. Attentiveness and continuity of supervision, which can be difficult with competing parental demands, appear to play a more important role role as do considerations of other safety mechanisms such as hazard reduction through keeping hot drinks out of reach and engineering factors such as improved cup design. By incorporating the findings from this study and other research into a hot beverage scald prevention c aign, we hope to see a change in knowledge and behaviour in parents and caregivers of young children, and ultimately a reduction in the incidence of hot beverage scalds.
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.MSKSP.2016.11.012
Abstract: Current conservative management of subacromial shoulder impingement (SSI) includes generic strengthening exercises, especially for internal (IR) and external (ER) shoulder rotators. However, there is no evidence that the strength or the ratio of strength between these muscle groups is different between those with SSI (cases) and an asymptomatic population (controls). To identify if isokinetic rotator cuff strength or the ratio of strength is significantly different between cases and controls. Case Control Study. Fifty one cases with SSI and 51 asymptomatic controls matched for age, gender, hand dominance and physical activity level completed isokinetic peak torque glenohumeral IR and ER testing. Within the SSI group, 31 dominant limbs were symptomatic and 20 non-dominant limbs were symptomatic. IR and ER were measured separately using continuous reciprocal concentric (con) and eccentric (ecc) contraction cycles at a speed of 60 degrees per second and again at 120 degrees per second. Values of peak torque (PT), relative peak torque (RPT) and ratios were compared using independent t-tests between the SSI and asymptomatic groups. Significant strength differences between the two groups were present only when the symptomatic SSI shoulder was the dominant shoulder (con ER PT at 60°/second, ecc ER PT at 120°/second, ecc ER RPT at 120°/second and ecc IR PT at 60°/second and 120°/second). Changes in rotator cuff strength in SSI may be related to limb dominance, which may have implications for strengthening regimes. Level 3a.
Publisher: Elsevier BV
Date: 04-2017
Publisher: Elsevier BV
Date: 02-2022
DOI: 10.1016/J.RADONC.2021.11.032
Abstract: There are several options for real-time prostate monitoring during radiation therapy including fiducial markers (FMs) and transperineal ultrasound (TPUS). However, the patient experience for these procedures is very different. This study aimed to determine patient preferences around various aspects of prostate image-guidance, focusing on FMs and TPUS. A discrete choice experiment (DCE) was conducted, describing the image-guidance approach by: pain, cost, accuracy, side effects, additional appointments, and additional time. Participants were males with prostate cancer (PCa) and from the general Australian population. A DCE survey required participants to make hypothetical choices in each of 8 choice sets. Multinomial logit modelling and Latent Class Analysis (LCA) were used to analyse the responses. Marginal willingness to pay (mWTP) was calculated. 476 respondents completed the survey (236 PCa patients and 240 general population). The most important attributes for both cohorts were pain, cost and accuracy (p < 0.01). PCa patients were willing to pay more to avoid the worst pain than the general population, and willing to pay more for increased accuracy. LCA revealed 3 groups: 2 were focused more on the process-related attributes of pain and cost, and the third was focused on the clinical efficacy attributes of accuracy and side effects. Both cohorts preferred less cost and pain and improved accuracy, with men with PCa valuing accuracy more than the general population. In addition to the clinical and technical evidence, radiation oncology centres should consider the preferences of patients when considering choice of image-guidance techniques.
Publisher: Informa UK Limited
Date: 30-08-2022
Publisher: Elsevier BV
Date: 12-2020
Publisher: MDPI AG
Date: 05-04-2018
Publisher: BMJ
Date: 11-2017
DOI: 10.1136/BMJOPEN-2017-018562
Abstract: A challenge of conducting research in critically ill children is that the therapeutic window for the intervention may be too short to seek informed consent prior to enrolment. In specific circumstances, most international ethical guidelines allow for children to be enrolled in research with informed consent obtained later, termed deferred consent (DC) or retrospective consent. There is a paucity of data on the attitudes of parents to this method of enrolment in paediatric emergency research. To explore the attitudes of parents to the concept of DC and to expand the knowledge of the limitations to informed consent and DC in these situations. Children presenting with uncomplicated febrile seizures or bronchiolitis were identified from three separate hospital emergency department databases. Parents were invited to participate in a semistructured telephone interview exploring themes of limitations of prospective informed consent, acceptability of the DC process and the most appropriate time to seek DC. Transcripts underwent inductive thematic analysis with intercoder agreement, using Nvivo 11 software. A total of 39 interviews were conducted. Participants comprehended the limitations of informed consent under emergency circumstances and were generally supportive of DC. However, they frequently confused concepts of clinical care and research, and support for participation was commonly linked to their belief of personal benefit. Participants acknowledged the requirement for alternatives to prospective informed consent in emergency research, and were supportive of the concept of DC. Our results suggest that current research practice seems to align with community expectations.
Publisher: Wiley
Date: 18-06-2017
Abstract: Paediatric status epilepticus (SE) is a medical emergency and a common critical condition confronting pre-hospital providers. Management in the pre-hospital environment is challenging but considered extremely important as a potentially modifiable factor on outcome. Recent data from multicentre clinical trials, quality observational studies and consensus documents have influenced management in this area, and is important to both pre-hospital providers and emergency physicians. The objective of this review was to: (i) present an overview of the available evidence relevant to pre-hospital care of paediatric SE and (ii) assess the current pre-hospital practice guidelines in Australia and New Zealand. The review outlines current definitions and guidelines of SE management, regional variability in pre-hospital protocols within Australasia and aspects of pre-hospital care that could potentially be improved. Contemporary data is required to determine current practice in our setting. It is important that paediatric neurologists, emergency physicians and pre-hospital care providers are all engaged in future endeavours to improve clinical care and knowledge translation efforts for this patient group.
Publisher: BMJ
Date: 27-01-2011
Publisher: Elsevier BV
Date: 12-2020
Publisher: Public Library of Science (PLoS)
Date: 2016
Publisher: Wiley
Date: 12-2001
Publisher: Springer Science and Business Media LLC
Date: 13-03-2014
Publisher: BMJ
Date: 13-03-2015
Publisher: AMPCo
Date: 11-2015
DOI: 10.5694/MJA15.00190
Abstract: To compare the dose intensity and toxicity profiles for patients undergoing chemotherapy at the Townsville Cancer Centre (TCC), a tertiary cancer centre in northern Queensland, with those for patients treated in Mount Isa, supervised by the same medical oncologists via teleoncology. A quasi-experimental design comparing two patient groups. TCC and Mount Isa Hospital, which both operate under the auspices of the Townsville Teleoncology Network (TTN). Eligible patients who received chemotherapy at TCC or Mt Isa Hospital between 1 May 2007 and 30 April 2012. Teleoncology model for managing cancer patients in rural towns. Dose intensity (doses, number of cycles and lines of treatment) and toxicity rates (rate of serious side effects, hospital admissions and mortality). Over 5 years, 89 patients received a total of 626 cycles of various chemotherapy regimens in Mount Isa. During the same period, 117 patients who received a total of 799 cycles of chemotherapy at TCC were eligible for inclusion in the comparison group. There were no significant differences between the Mount Isa and TCC patients in most demographic characteristics, mean numbers of treatment cycles, dose intensities, proportions of side effects, and hospital admissions. There were no toxicity-related deaths in either group. It appears safe to administer chemotherapy in rural towns under the supervision of medical oncologists from larger centres via teleoncology, provided that rural health care resources and governance arrangements are adequate.
Publisher: Springer Science and Business Media LLC
Date: 21-08-2019
Publisher: Wiley
Date: 25-01-2019
DOI: 10.1002/PRI.1768
Abstract: To compare the effect of specific interventions aimed at (1) the upper thoracic spine (passive mobilization) and (2) the posterior shoulder (massage, passive mobilization, and stretching) to (3) an active control intervention in a homogeneous group with extrinsic subacromial shoulder impingement (SSI). Single-centre, prospective, double-blinded, randomized controlled trial. Eligible in iduals with clearly defined extrinsic SSI were randomized to each group. Treatment duration was 12 consecutive weeks consisting of nine treatments over 6 weeks, followed by 6 weeks when one home exercise was performed daily. Outcomes included (1) active thoracic flexion/extension range of motion, (2) passive glenohumeral internal rotation and posterior shoulder range, (3) pain rating, and (4) shoulder pain and function disability index. Data were analysed at baseline, 6 and 12 weeks. Shoulder pain and function disability index scores were investigated via email 6 months after commencement of treatment. Twenty participants completed treatment in each group. No differences were identified between groups at baseline. Upper thoracic and posterior shoulder interventions, with a targeted home exercise, both significantly decreased pain and increased function scores and increased posterior shoulder range compared with active control at 12 weeks, and 6 months following cessation of the trial. Manual therapy treatment that addresses these extrinsic factors, of thoracic spine or posterior shoulder tightness, decreases the signs and symptoms of SSI. The trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR 12615001303538).
Publisher: CSIRO Publishing
Date: 2017
DOI: 10.1071/PY16033
Abstract: Aboriginal Community Controlled Health Services deliver holistic and culturally appropriate primary health care to over 150 communities in Australia. Health promotion is a core function of comprehensive primary health care however, little has been published on what enables or challenges health promotion practice in an Aboriginal Community Controlled Health Service. Apunipima Cape York Health Council (Apunipima) delivers primary health care to 11 remote north Queensland communities. The workforce includes medical, allied health, Aboriginal and Torres Strait Islander health workers and health practitioners and corporate support staff. This study aimed to identify current health promotion practices at Apunipima, and the enablers and challenges identified by the workforce, which support or hinder health promotion practice. Sixty-three staff from across this workforce completed an online survey in February 2015 (42% response rate). Key findings were: (1) health promotion is delivered across a continuum of one-on-one approaches through to population advocacy and policy change efforts (2) the attitude towards health promotion was very positive and (3) health promotion capacity can be enhanced at both in idual and organisational levels. Workforce insights have identified areas for continued support and areas that, now identified, can be targeted to strengthen the health promotion capacity of Apunipima.
Publisher: Elsevier BV
Date: 2015
Publisher: Wiley
Date: 20-04-2016
DOI: 10.1071/HE15078
Publisher: Oxford University Press (OUP)
Date: 11-04-2017
DOI: 10.1093/NTR/NTW331
Abstract: Similar to other high-income countries, smoking rates in pregnancy can be high in specific vulnerable groups in Australia. Several clinical guidelines exist, including the 5A's (Ask, Advice, Assess, Assist, and Arrange), ABCD (Ask, Brief advice, Cessation, and Discuss), and AAR (Ask, Advice, and Refer). There is lack of data on provision of smoking cessation care (SCC) of Australian General Practitioners (GPs) and Obstetricians. A cross-sectional survey explored the provision of SCC, barriers and enablers using the Theoretical Domains Framework, and the associations between them. Two s les were invited: (1) GPs and Obstetricians from a college database (n = 5571) (2) GPs from a special interest group for Indigenous health (n = 500). Dimension reduction for the Theoretical Domains Framework was achieved with factor analysis. Logistic regression was carried out for performing all the 5A's and the AAR. Performing all of the 5A's, ABCD, and AAR "often and always" was reported by 19.9%, 15.6%, and 49.2% respectively. "Internal influences" (such as confidence in counselling) were associated with higher performance of the 5A's (Adjusted OR 2.69 (95% CI 1.5, 4.8), p < .001), whereas "External influences" (such as workplace routine) were associated with higher performance of AAR (Adjusted OR 1.7 (95% CI 1, 2.8), p = .035). Performance in providing SCC to pregnant women is low among Australian GPs and Obstetricians. Training clinicians should focus on improving internal influences such as confidence and optimism. The AAR may be easier to implement, and interventions at the service level should focus on ensuring easy, effective, and acceptable referral mechanisms are in place. Improving provision of the 5A's approach should focus on the in idual level, including better training for GPs and Obstetricians, designed to improve specific "internal" barriers such as confidence in counselling and optimism. The AAR may be easier to implement in view of the higher overall performance of this approach. Interventions on a more systemic level need to ensure easy, effective, and acceptable referral mechanisms are in place. More research is needed specifically on the acceptability of the Quitline for pregnant women, both Indigenous and non-Indigenous.
Publisher: BMJ
Date: 04-09-2015
DOI: 10.1136/INJURYPREV-2014-041216
Abstract: Drowning remains a leading cause of preventable death in children across the world. This systematic review identifies and critically analyses studies of interventions designed to reduce fatal and non-fatal drowning events among children and adolescents or reduce the injury severity incurred by such incidents. A systematic search was undertaken on literature published between 1980 and 2010 relating to interventions around fatal and non-fatal drowning prevention in children and adolescents 0-19 years of age. Search methods and protocols developed and used by the WHO Global Burden of Disease Injury Expert Group were applied. Seven studies fulfilled the inclusion criteria. Interventions were categorised into three themes of Education, Swimming Lessons and Water Safety, and Pool Fencing. All are possible effective strategies to prevent children from drowning, particularly young children aged 2-4 years, but very little evidence exists for interventions to reduce drowning in older children and adolescents. There were methodological limitations associated with all studies, so results need to be interpreted in the context of these. Relatively few studies employ rigorous methods and high levels of evidence to assess the impact of interventions designed to reduce drowning. Studies are also limited by lack of consistency in measured outcomes and drowning terminology. Further work is required to establish efficacy of interventions for older children and adolescents. There is a need for rigorous, well-designed studies that use consistent terminology to demonstrate effective prevention solutions.
Publisher: Wiley
Date: 28-07-2019
Abstract: To describe temporal trends in incidence of pre-hospital outcomes from adult out-of-hospital cardiac arrest (OHCA) of presumed cardiac aetiology attended by Queensland Ambulance Service (QAS) paramedics between 2002 and 2014, by age, gender, geographical remoteness and socio-economic status. Cases included in this retrospective cohort study were identified from the QAS OHCA Registry. Included cases were linked with Queensland Hospital Admitted Patient Data Collection and Queensland Death Registry. Population data were obtained from the Australian Bureau of Statistics to calculate incidence rates for each year. Analyses were undertaken by four mutually exclusive pre-hospital outcomes: (i) no resuscitation (No-Resus) (ii) resuscitation, no pre-hospital return of spontaneous circulation (No-ROSC) (iii) resuscitation, pre-hospital return of spontaneous circulation not sustained to hospital (Unsustained-ROSC) and (iv) resuscitation, pre-hospital return of spontaneous circulation sustained to hospital (Sustained-ROSC). Trends over time were analysed for crude and specific rates for total OHCA events and for each outcome. Between 2002 and 2014, there were 30 560 OHCA cases. Crude incidence significantly increased over time for No-Resus and Sustained-ROSC, and significantly decreased for No-ROSC. These trends were reflected in major cities, inner and outer regional areas. There was a significant increase in Sustained-ROSC in remote areas, and no significant trends in very remote areas. Incidence of withholding resuscitation and ROSC sustained to hospital have independently increased over time. Factors of middle age, more rural location and lower socio-economic status should all be targeted in the development and implementation of future strategies.
Publisher: Wiley
Date: 28-07-2019
Abstract: To describe incidence in pre-hospital outcomes of adult out-of-hospital cardiac arrest (OHCA) of presumed cardiac aetiology, attended by Queensland Ambulance Service (QAS) paramedics between 2002 and 2014, by age, gender, geographical remoteness and socio-economic status. The QAS OHCA Registry was used to identify cases, which was then linked with Queensland Hospital Admitted Patient Data Collection and Queensland Death Registry. Population data were obtained for each calendar year by age and gender from the Australian Bureau of Statistics in order to calculate incidence rates. Four mutually exclusive pre-hospital outcomes were analysed: (i) no resuscitation (No-Resus) (ii) resuscitation, no pre-hospital return of spontaneous circulation (No-ROSC) (iii) resuscitation, pre-hospital return of spontaneous circulation not sustained to hospital (Unsustained-ROSC) and (iv) resuscitation, pre-hospital return of spontaneous circulation sustained to hospital (Sustained-ROSC). Over the 13 years, there were 30 560 OHCA cases for analyses. Incidence was significantly greater in males than females and incrementally increased with age, for each outcome. Incidence of total OHCA events generally increased as remoteness increased (major cities: 72.39 per 100 000 [95% CI 71.35-73.45] very remote: 87.01 per 100 000 [95% CI 78.03-95.98]). There was an inverse association between incidence of OHCA events and socio-economic status (SEIFA 1 and 2: 81.34 per 100 000 [95% CI 79.28-83.40] SEIFA 9 and 10: 61.57 per 100 000 [95% CI 59.67-63.46]). Rural-specific strategies should be continued. Prevention and management strategies for OHCA targeting lower socio-economic groups require focus.
Publisher: JMIR Publications Inc.
Date: 24-10-2017
DOI: 10.2196/RESPROT.8189
Publisher: Springer Science and Business Media LLC
Date: 31-10-2018
Publisher: JMIR Publications Inc.
Date: 10-10-2018
DOI: 10.2196/10361
Publisher: Springer Science and Business Media LLC
Date: 19-01-2019
Publisher: Wiley
Date: 05-09-2016
DOI: 10.1111/AJR.12320
Publisher: Elsevier BV
Date: 06-2023
DOI: 10.1016/J.AUEC.2022.10.006
Abstract: To identify predictors of longer-term outcomes from adult out-of-hospital cardiac arrest of presumed cardiac aetiology. In this retrospective cohort study, three large routinely collected databases were linked: 1)QAS Out-of-Hospital Cardiac (OHCA) Registry 2)Queensland Hospital Admitted Patient Data Collection and 3)Queensland Registrar General Death Registry. Participants were adult (18years+) residents of Queensland, who suffered an OHCA of presumed cardiac aetiology and had resuscitation attempted by QAS paramedics between 2002 and 2014. Four mutually exclusive outcomes were analysed: 1) No pre-hospital return of spontaneous circulation (ROSC) sustained to the Emergency Department (ED) or ROSC in ED 2) Survival< 30 days (Pre-hospital ROSC sustained to ED or ROSC in ED but death within 30 days 3) survival between 30 and 364 days and 4) survival to 365 + days. Multinomial logistic regression was used to calculate odds ratios and 95 % confidence intervals. Variables significantly predictive of survival to 365 + days after adjusting for all measured confounders are: an initial shockable rhythm bystander witnessed events with bystander CPR paramedic witnessed events intubation placement time of day (midday-2.59 pm) and attendance by Critical Care Paramedic (CCP). From a service provision perspective, attendance of a CCP at an OHCA may be an important factor to achieve preferred long-term outcomes. Enhanced experience, exposure and expertise, together with extended clinical practice, may explain this finding.
Publisher: Wiley
Date: 22-07-0012
DOI: 10.1111/WVN.12014
Publisher: Springer Science and Business Media LLC
Date: 11-03-2014
Publisher: Cambridge University Press (CUP)
Date: 09-10-2012
DOI: 10.1017/S1041610212001573
Abstract: Background: Globally, falls in older people are a leading cause of injury-related mortality and morbidity. Cognitive impairment is a well-known risk factor for falls in this population group. While there is now a large body of evidence to support effective interventions for falls reduction across care settings, very little is known about interventions in the vulnerable, but increasing population of cognitively impaired community-dwelling older people. Therefore, the purpose of this systematic review is to investigate interventions designed to reduce falls in community-dwelling, cognitively impaired older adults. Methods: A literature search of databases was conducted to identify original research published in English, which met predefined inclusion and exclusion criteria for effective (non-pharmacological) falls prevention interventions in cognitively impaired community-dwelling people over 65 years of age. Data from the selected papers were extracted into data extraction tables and analyzed according to study characteristics, measures, results, and quality. Results: The review identified 11 studies providing data from 1,928 participants. Interventions included exercise, health assessment and management of risk, multi-component and cognitive behavioral programs, and hip protectors as falls risk reduction strategies. Seven of the selected studies showed an intervention effect in decreasing falls risk however, only two of these showed a significant improvement in physical performance measures specifically in a cognitively impaired group. Conclusions: The ersity of interventions, study designs, populations, and quality of the studies, which met inclusion criteria, resulted in conflicting evidence and inconclusive results for falls prevention interventions in this highly complex population.
Publisher: Springer Science and Business Media LLC
Date: 22-10-2022
DOI: 10.1007/S00520-021-06570-6
Abstract: With increasing rates of cancer survival due to advances in screening and treatment options, the costs of breast cancer diagnoses are attracting interest. However, limited research has explored the costs to the Australian healthcare system associated with breast cancer. We aimed to describe the cost to hospital funders for hospital episodes and emergency department (ED) presentations for Queensland women with breast cancer, and whether costs varied by demographic characteristics. We used a linked administrative dataset, CancerCostMod, limited to all breast cancer diagnoses aged 18 years or over in Queensland between July 2011 and June 2015 (n = 13,285). Each record was linked to Queensland Health Admitted Patient Data Collection and Emergency Department Information Systems records between July 2011 and June 2018. The cost of hospital episodes and ED presentations were determined, with mean costs per patient modelled using generalised linear models with a gamma distribution and log link function. The total cost to the Queensland healthcare system from hospital episodes for female breast cancer was AUD$309 million and AUD$12.6 million for ED presentations during the first 3 years following diagnosis. High levels of costs and service use were identified in the first 6 months following diagnosis. Some significant differences in cost of hospital and ED episodes were identified based on demographic characteristics, with Indigenous women and those from lower socioeconomic backgrounds having higher costs. Hospitalisation costs for breast cancer in Queensland exert a high burden on the healthcare system. Costs are higher for women during the first 6 months from diagnosis and for Indigenous women, as well as those with underlying comorbidities and lower socioeconomic position.
Publisher: Public Library of Science (PLoS)
Date: 25-06-2015
Publisher: Wiley
Date: 20-07-2004
Publisher: BMJ
Date: 31-01-2019
DOI: 10.1136/INJURYPREV-2017-042650
Abstract: The high incidence of hot beverage scalds among young children has not changed in the past 15 years, but preventive c aigns have been scarce. A novel approach was used to engage mothers of young children in an app-based hot beverage scald prevention c aign ‘Cool Runnings’. This paper provides baseline data for this randomised controlled trial (RCT). Queensland-based mothers aged 18+ years with at least one child aged 5–12 months were recruited via social media to Cool Runnings, which is a two-group, parallel, single-blinded RCT. In total, 498 participants from across Queensland completed the baseline questionnaire. The most common source of burn first aid information was the internet (79%). One-third (33%) correctly identified hot beverage scalds as the leading cause of childhood burns, 43% knew the age group most at risk. While 94% reported they would cool a burn with water, only 10% reported the recommended 20min duration. After adjusting for all relevant variables, there were two independent predictors of adequate burn first aid knowledge: first aid training in the past year (OR=3.32 95% CI 1.8 to 6.1) and smoking status (OR=0.17 95% CI 0.04 to 0.7). In this study, mothers of young children were largely unaware how frequently hot beverage scalds occur and the age group most susceptible to them. Inadequate burn first aid knowledge is prevalent across mothers of young children there is an urgent and compelling need to improve burn first aid knowledge in this group. Given the high incidence of hot beverages scalds in children aged 6–24 months, it is important to target future burn prevention/first aid c aigns at parents of young children. ACTRN12616000019404 Pre-results.
Publisher: Cambridge University Press (CUP)
Date: 04-2019
DOI: 10.1017/S1049023X19000104
Abstract: First aid, particularly bystander cardiopulmonary resuscitation (CPR), is an important element in the chain of survival. However, little is known about what influences populations to undertake first aid/CPR training, update their training, and use of the training. The aim of this study was to explore the characteristics of people who have first aid/CPR training, those who have updated their training, and use of these skills. As part of the 2011 state-wide, computer-assisted telephone interviewing (CATI) survey of people over 18 years of age living in Queensland, Australia, stratified by gender and age group, three questions about first aid training, re-training, and skill uses were explored. Of the 1,277 respondents, 73.2% reported having undertaken some first aid/CPR training and 39.5% of those respondents had used their first aid/CPR skills. The majority of respondents (56.7%) had not updated their first aid/CPR skills in the past three years, and an additional 2.5% had never updated their skills. People who did not progress beyond year 10 in school and those in lower income groups were less likely to have undertaken first aid/CPR training. Males and people in lower income groups were less likely to have recently updated their first aid/CPR training. People with chronic health problems were in a unique demographic sub-group they were less likely to have undertaken first aid/CPR training but more likely to have administered first aid/CPR. Training initiatives that target people on the basis of education level, income group, and the existence of chronic health problems might be one strategy for improving bystander CPR rates when cardiac arrest occurs in the home. Franklin RC, Watt K, Aitken P, Brown LH, Leggat PA. Characteristics associated with first aid and cardiopulmonary resuscitation training and use in Queensland, Australia. Prehosp Disaster Med . 2019 (2):155–160
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.MSKSP.2016.12.003
Abstract: To date, the significance of factors purported to be associated with subacromial shoulder impingement (SSI) and what differences, if any, are present in those with SSI compared to a matched asymptomatic population has not been identified. Gaining information about differences between people with SSI and asymptomatic people may direct clinicians towards treatments that impact upon these differences. Compare the assessment findings of factors suggested to be associated with SSI passive posterior shoulder range, passive internal rotation range, resting cervical and thoracic postures, active thoracic range in standing and scapula positioning between cases experiencing SSI and a matched asymptomatic group (controls). Case Control Study. Fifty one SSI cases and 51 asymptomatic controls were matched for age, gender, hand dominance and physical activity level. The suggested associated factors were measured bilaterally. Independent t-tests were used to compare each of these measurements between the groups. Any variables for which a significant difference was identified, were then included in a conditional logistic regression analysis to identify independent predictors of SSI. The SSI group had significantly increased resting thoracic flexion and forward head posture, as well as significantly reduced upper thoracic active motion, passive internal rotation range and posterior shoulder range than the matched asymptomatic group. No independent predictors of SSI were identified in conditional logistic regression analysis. Thoracic posture, passive internal rotation range and posterior shoulder range were significantly different between cases experiencing SSI and a matched asymptomatic group. Level 3a.
Publisher: Wiley
Date: 30-11-2016
DOI: 10.1111/DMCN.13340
Abstract: Limited information exists on the ability of children with cerebral palsy (CP) to ride a two-wheel bicycle, an activity that may improve health and participation. We aimed to describe bicycle-riding ability and variables associated with ability to ride in children with CP (Gross Motor Functional Classification System [GMFCS] levels I-II) compared with children with typical development. This case-control study surveyed parents of 114 children with CP and 87 children with typical development aged 6 to 15 years (115 males, mean age 9y 11mo, standard deviation [SD] 2y 10mo). Kaplan-Meier methods were used to compare proportions able to ride at any given age between the two groups. Logistic regression was used to assess variables associated with ability to ride for children with CP and typical development separately. The proportion of children with CP able to ride at each level of bicycle-riding ability was substantially lower at each age than peers with typical development (p<0.001). While most children with typical development were able to ride independently by 10 years of age, 51% of children with CP classified as GMFCS level I and 3% of those classified as GMFCS level II had obtained independent riding in the community by 15 years of age. Variables associated with ability to ride for children classified as GMFCS level I were age and parent-rated importance of their child being able to ride. Some independently ambulant children with CP can learn to ride a bicycle, in particular if they are classified as GMFCS level I. Variables associated with ability to ride deserve consideration in shaping future efforts for the majority of this population who are not yet able to ride.
Publisher: Wiley
Date: 27-10-2014
Abstract: The present study evaluates the prehospital care of paediatric burn patients in Queensland (QLD). As first aid (FA) treatment has been shown to affect burn progression and outcome, the FA treatment and the risk of associated hypothermia in paediatric patients were specifically examined in the context of paramedic management of burn patients. Data were retrospectively collected from electronic ambulance response forms (eARFs) for paediatric burn patients (0-5 years) who were attended by Queensland Ambulance Service (QAS) from 2008 to 2010. Data were collected from 117 eARFs of incidents occurring within the Brisbane, Townsville and Cairns regions. Initial FA measures were recorded in 77.8% of cases, with cool running water FA administered in 56.4% of cases. The duration of FA was recorded in 29.9% of reports. The duration of FA was significantly shorter for patients in Northern QLD (median = 10 min, n = 10) compared with Brisbane (median = 15 min, n = 18), P = 0.005. Patient temperatures were recorded significantly more often in Brisbane than in other regions (P = 0.041) however, in total, only 24.8% of all patients had documented temperature readings. Of these, six (5%) were recorded as having temperatures ≤ 36.0°C. Burnaid(TM) was the most commonly used dressing and was applied to 55.6% of all patients however, it was applied with a variety of different outer dressings. Brisbane paramedics applied Burnaid significantly less often (44.3%) compared with paramedics from Northern QLD (72.7%) and Far Northern QLD (60.9%), P = 0.025. Despite FA and patient temperatures being important prognostic factors for burn patients, paramedic documentation of these was often incomplete, and there was no consistent use of burns dressings.
Publisher: SAGE Publications
Date: 02-10-2019
DOI: 10.33151/AJP.16.752
Abstract: IntroductionHistorically, survival rates from out-of-hospital cardiac arrest (OHCA) have been low. In recent times, survival rates have increased substantially in some small population pockets, which sparked general interest in this field and the volume of research increased. Included was an increase in the number of strategies being investigated to improve outcomes. The aim of this review is to assemble these strategies and consolidate the findings of the pharmaceutical strategies.MethodsThis is a systematic search and review, rather than a systematic review. Four databases (MEDLINE, CINAHL, Informit, Scopus) were searched for papers published between 2007 and 2017 containing strategies that may be used by paramedics when resuscitating adult (18+ years) patients in cardiac arrest from presumed cardiac aetiology in the out-of-hospital environment. The search was undertaken in February 2017. Five separate search concepts were used on all databases. Each concept consisted of multiple search terms.ResultsThis review identified 28 separate studies for final review, which formulated six strategies. These were: use of a modified resuscitation protocol use of a mechanical chest compression device intra-thoracic pressure regulation vasopressin administration thrombolysis administration application of therapeutic hypothermia. This paper reports on the full results of the pharmaceutical strategies (vasopressin or thrombolysis administration). Part B will address the non-pharmaceutical strategies.ConclusionThere is no evidence to support the introduction of vasopressin or thrombolysis use during OHCA. Future studies should focus on study design and specific patient subsets.
Publisher: Elsevier BV
Date: 02-2015
DOI: 10.1016/J.SCITOTENV.2014.10.084
Abstract: Rapid global expansion of unconventional natural gas development (UNGD) raises environmental health concerns. Many studies present information on these concerns, yet the strength of epidemiological evidence remains tenuous. This paper is a review of the strength of evidence in scientific reporting of environmental hazards from UNGD activities associated with adverse human health outcomes. Studies were drawn from peer-reviewed and grey literature following a systematic search. Five databases were searched for studies published from January 1995 through March 2014 using key search terms relevant to environmental health. Studies were screened, ranked and then reviewed according to the strength of the evidence presented on adverse environmental health outcomes associated with UNGD. The initial searches yielded >1000 studies, but this was reduced to 109 relevant studies after the ranking process. Only seven studies were considered highly relevant based on strength of evidence. Articles spanned several relevant topics, but most focussed on impacts on typical environmental media, such as water and air, with much of the health impacts inferred rather than evidenced. Additionally, the majority of studies focussed on short-term, rather than long-term, health impacts, which is expected considering the timeframe of UNGD therefore, very few studies examined health outcomes with longer latencies such as cancer or developmental outcomes. Current scientific evidence for UNGD that demonstrates associations between adverse health outcomes directly with environmental health hazards resulting from UNGD activities generally lacks methodological rigour. Importantly, however, there is also no evidence to rule out such health impacts. While the current evidence in the scientific research reporting leaves questions unanswered about the actual environmental health impacts, public health concerns remain intense. This is a clear gap in the scientific knowledge that requires urgent attention.
Publisher: Informa UK Limited
Date: 2014
Publisher: Elsevier BV
Date: 03-2018
Publisher: Elsevier BV
Date: 06-2017
Publisher: SAGE Publications
Date: 2019
DOI: 10.33151/AJP.16.753
Abstract: Out-of-hospital cardiac arrest (OHCA) historically has low survival rates. Higher rates of survival have recently developed in some small geographical areas, which pre-empted an increase in the volume of research in this field. The aim of this paper is to consolidate the findings of the strategies that do not focus on drugs. This is a systematic search and review, rather than a systematic review. A search of four databases (MEDLINE, CINAHL, Informit, Scopus) was undertaken in February 2017. Papers published between 2007 and 2017 containing strategies that may be used by paramedics when resuscitating adult patients in OHCA from presumed cardiac aetiology were identified. Twenty-eight studies were included in the review, comprising six separate strategies. This manuscript reports on the four non-pharmaceutical strategies (use of a modified resuscitation protocol use of a mechanical chest compression device intra-thoracic pressure regulation and application of therapeutic hypothermia). Use of a modified resuscitation protocol to improve the quality of cardiopulmonary resuscitation, was the only strategy showing evidence to warrant a recommendation for immediate implementation. Future studies should focus on strategy specific patient subsets.
Publisher: BMJ
Date: 28-09-2012
Publisher: Wiley
Date: 09-05-2019
DOI: 10.1002/HPJA.254
Abstract: Cycling participation rates in Australia and Queensland remain low. Rural residents typically do not have distinct cycling infrastructure available for use. Investigating current cycling participation and barriers to cycling engagement will inform future work to promote cycling engagement. Data were collected through the inclusion of cycling-related questions in the 2012 Queensland Social Survey. The majority of the s le had not cycled in the previous 12 months (66% n = 831). Significantly more rural residents reported not cycling due to environmental concerns (P < 0.05) and preferring other modes of transport or exercise (P < 0.01). Rural cyclists (31.4% n = 113) had higher levels of cycling engagement in the previous week (41.6% to 32.6% urban χ One-third of all adults cycled in the previous 12 months irrespective of location however reasons for not cycling varied by urban/rural location. Results indicate that environmental factors appear to be inhibiting cycling participation in rural areas. Advocating for government commitment for infrastructure development to support safe cycling across Queensland including outside of metropolitan areas is required. SO WHAT?: This research explores self-reported cycling engagement amongst a s le of urban and rural dwelling Queenslanders. Differences in cycling exposure and reasons for lack of engagement offer insights into what may encourage greater cycling participation.
Publisher: Informa UK Limited
Date: 03-07-2018
Publisher: Wiley
Date: 02-05-2018
Abstract: To give voice to the general public's views of prospective and retrospective (deferred) consent in the emergency research setting. A cross-sectional, stratified population-based, telephone survey was conducted in April to July 2016. A questionnaire consisting of standardised health and demographic details, and seven specifically designed, and pilot-tested questions, five closed and two open text, based on literature review and previous surveys in the field was used. Quantitative and qualitative techniques were used in the data analysis. This was a centrally coordinated national telephone survey in Australia, the 2016 National Social Survey, coordinated by Central Queensland University. Data for 1217 adult (18+ years) participants were included in the analysis, with a response rate of 26%. The s le demographics were broadly representative of the Australian population. The majority of respondents were supportive of research in emergency circumstances without prospective informed consent. However, the type of research and level of risk influence its acceptability. Common themes in qualitative analysis included the critical or life-threatening nature of the illness being researched, and the potential harms and benefits of participation. This research provided the first opportunity for the community to contribute to discourse about prospective and retrospective (deferred) consent in the emergency research setting in Australia. Further work is needed to determine community expectations of how this process can be optimised and implemented, and to identify potential situations where this may not be acceptable.
Publisher: Wiley
Date: 08-2018
DOI: 10.1002/HPJA.184
Abstract: The recommended first aid for burns, consisting of 20 minutes of cool running water (CRW) delivered within three hours of the injury, offers a simple yet effective means of improving health outcomes. The aim of this study was to determine patient and injury characteristics associated with inadequate CRW therapy among children with thermal burns, with the goal of identifying populations at greatest risk of undertreatment. A cross-sectional study was performed on children treated at a large tertiary paediatric burns centre. First aid was evaluated as either "adequate" or "inadequate", and then descriptive analyses were conducted to examine differences between the groups in age, ethnicity, location and socioeconomic status, among others. From 2013 to 2016, the families of 2522 patients were interviewed. Overall, 31.3% of children received adequate CRW at the scene of the injury. Provision of adequate CRW did not significantly differ with sex, ethnicity or nationality. Factors that were associated with inadequate first aid included very young age and early adolescence (P < 0.001), rural or remote location (P = 0.045), low socioeconomic status (P = 0.030), radiant heat and flame burns (P < 0.001), as well as burns occurring at recreational sites, on farm/trade/industrial properties and in the street (P = 0.001). Although most burns occurred in close proximity to sources of CRW, first aid was poor across all demographics. The highest levels of undertreatment were found in children aged 0-2, adolescents aged 15-16, those living rurally or remotely, and the socioeconomically disadvantaged. SO WHAT?: The study highlights the need for improved public education of first aid for burn injuries.
Publisher: Wiley
Date: 12-1999
Publisher: Springer Netherlands
Date: 2013
Publisher: Springer Science and Business Media LLC
Date: 03-08-2016
Publisher: Rural and Remote Health
Date: 10-04-2018
DOI: 10.22605/RRH4224
Publisher: Springer Science and Business Media LLC
Date: 17-07-2017
Publisher: Springer Science and Business Media LLC
Date: 20-11-2018
Publisher: Springer Science and Business Media LLC
Date: 18-12-2007
Publisher: BMJ
Date: 11-2015
Publisher: Cambridge University Press (CUP)
Date: 09-03-2016
DOI: 10.1017/DMP.2016.3
Abstract: The study aim was to undertake a qualitative research literature review to analyze available databases to define, describe, and categorize public health infrastructure (PHI) priorities for tropical cyclone, flood, storm, tornado, and tsunami-related disasters. Five electronic publication databases were searched to define, describe, or categorize PHI and discuss tropical cyclone, flood, storm, tornado, and tsunami-related disasters and their impact on PHI. The data were analyzed through aggregation of in idual articles to create an overall data description. The data were grouped into PHI themes, which were then prioritized on the basis of degree of interdependency. Sixty-seven relevant articles were identified. PHI was categorized into 13 themes with a total of 158 descriptors. The highest priority PHI identified was workforce. This was followed by water, sanitation, equipment, communication, physical structure, power, governance, prevention, supplies, service, transport, and surveillance. This review identified workforce as the most important of the 13 thematic areas related to PHI and disasters. If its functionality fails, workforce has the greatest impact on the performance of health services. If addressed post-disaster, the remaining forms of PHI will then be progressively addressed. These findings are a step toward providing an evidence base to inform PHI priorities in the disaster setting. ( Disaster Med Public Health Preparedness . 2016 :598–610)
Publisher: Oxford University Press (OUP)
Date: 19-03-2015
Abstract: The aim of this study was to validate a modified version of the Paddington Alcohol Test for use in the Australian emergency department (ED) setting. A cross sectional survey was used to screen patients attending an Australian tertiary hospital ED. Data were collected over a three-month period at randomly allocated time periods and days. Consenting participants were screened using the Alcohol Use Disorders Identification Test (AUDIT) and a modified-for-Australia version of the Paddington Alcohol Test (AusPAT). The association between the two tools was investigated, as well as the sensitivity and specificity of AusPAT at various AUDIT cut-off scores and by gender and age group. The s le comprised 637 ED attendees. Their mean age was 49.9 (SD 20.0) years with a mean AUDIT score of 5.21 (SD 6.58). Most (73.2%) consumed alcohol, and a quarter was AusPAT-positive (n = 153, 24.0%). AusPAT demonstrated a moderate fit with AUDIT at a cut-off score of 8 (Kappa = 0.63, P < 0.001). At this cut-off 23.4% (n = 149) were identified by AUDIT as problematic drinkers. AusPAT sensitivity was 72.5% (95% CI 65.3-79.7) with a specificity of 90.8% (95% CI 88.3-93.4). Our results indicate that AusPAT was moderately well associated with AUDIT. When used universally in the ED setting, its sensitivity and specificity were moderate.
Publisher: Wiley
Date: 04-2006
DOI: 10.1111/J.1742-6723.2006.00817.X
Abstract: The objective of the present study was to quantify the relationship between acute alcohol consumption and injury severity. A cross-sectional study was conducted at the Gold Coast Hospital, Gold Coast, Queensland, Australia between October 2000 and October 2001. Data were collected from a systematic s le of patients greater than 15 years of age who presented to the ED for treatment of an injury sustained less than 24 h prior to presentation. Study participants were interviewed face to face on-site. Information obtained included: demographics details situational variables relative to time of injury (i.e. location, activity and companions at time of injury) self-reported alcohol consumption in the 6 and 24 h prior to time of injury usual alcohol consumption patterns self-reported substance use in the 6 and 24 h prior to time of injury and risk-taking behaviour. Injury severity was coded from patient medical records using the New Injury Severity Score. Of 789 eligible patients presenting during the study periods, 593 were interviewed (75.2%). Patients who reported drinking above low-risk levels (odds ratio [OR] = 3.35 95% confidence interval [CI] 1.2-9.6) or who drank beer (OR = 3.54 95% CI 1.1-11.1) in 6 h prior to injury were significantly more likely to sustain serious than minor injury. Drinking setting and usual drinking patterns were not significantly associated with injury severity, either in crude analyses, or after adjusting for relevant variables. The results of the present study support the conclusion that among injured patients who presented for treatment at a large metropolitan ED, although acute alcohol consumption does not appear to be associated with minor or moderate injury, there is some evidence to suggest that acute alcohol consumption is associated with serious injury.
Publisher: BMJ
Date: 21-01-2014
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Publisher: BMJ
Date: 20-11-2021
DOI: 10.1136/HEARTJNL-2020-317333
Abstract: To describe annual incidence and temporal trends (2002–2014) in incidence of long-term outcomes of adult out-of-hospital cardiac arrest (OHCA) of presumed cardiac aetiology attended by Queensland Ambulance Service (QAS) paramedics, by age, gender, geographical remoteness and socioeconomic status (SES). This is a retrospective cohort study. Cases were identified using the QAS OHCA Registry and were linked with entries in the Queensland Hospital Admitted Patient Data Collection and the Queensland Registrar General Death Registry. Population data were obtained from the Australian Bureau of Statistics to calculate incidence. Inclusion criteria were adult (18+ years) residents of Queensland who suffered OHCA of presumed cardiac aetiology and survived to hospital admission. Analyses were undertaken by three mutually exclusive outcomes: (1) survival to less than 30 days (Surv days) (2) survival from 30 to 364 days (Surv30–364 days) and (3) survival to 365 days or more (Surv365+ days). Incidence rates were calculated for each year by gender, age, remoteness and SES. Temporal trends were analysed. Over the 13 years there were 4393 cases for analyses. The incidence of total admitted events (9.72–10.13 p .01), Surv30–364 days (0.18–0.42 p .05) and Surv365+ days (1.94–4.02 p .001) increased significantly over time no trends were observed for Surv days. An increase in Surv365+ days over time was observed in all remoteness categories and most SES categories. Evidence suggests that implemented strategies to improve outcomes from OHCA have been successful and penetrated groups living in more remote locations and the lower socioeconomic groups. These populations still require focus. Ongoing reporting of long-term outcomes from OHCA should be undertaken using population-based incidence.
Publisher: Oxford University Press (OUP)
Date: 25-04-2005
Abstract: The aim of this study was to quantify the relationship between acute alcohol consumption and injury type (nature of injury, body region injured), while adjusting for the effect of known confounders (i.e. demographic and situational variables, usual drinking patterns, substance use and risk-taking behaviour). A cross-sectional study was conducted between October, 2000 and October, 2001 of patients aged >or=15 years presenting to a Queensland Emergency Department for treatment of an injury sustained in the preceding 24 h. There were three measures of acute alcohol consumption: drinking setting, quantity, and beverage type consumed in the 6 h prior to injury. Two variables were used to quantify injury type: nature of injury (fracture/dislocation, superficial, internal, and CNS injury) and body part injured (head/neck, facial, chest, abdominal, external, and extremities). Both were derived from patient medical records. Five hundred and ninety three patients were interviewed. Logistic regression analyses indicated that, after controlling for relevant confounding variables, there was no significant association between any of the three measures of acute alcohol consumption and injury type. The effects of acute alcohol consumption are not specific to injury type. Interventions aimed at reducing the incidence of alcohol-related injury should not be targeted at specific injury types.
Publisher: Public Library of Science (PLoS)
Date: 2015
Publisher: Rural and Remote Health
Date: 18-05-2018
DOI: 10.22605/RRH4413
Publisher: MDPI AG
Date: 18-05-2017
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.SEIZURE.2018.01.025
Abstract: Status epilepticus (SE) is a paediatric emergency with significant morbidity and mortality. Recommendations beyond first line care are not based on high quality evidence. Emergency physicians and neurologists are key stakeholders in managing this condition. A collaborative, widely consulted approach to identifying priorities can help direct limited research funds appropriately. The objectives of this study are to identify consensus research priorities in paediatric SE among experts and health consumers. A three-stage Delphi process was conducted. Paediatric Neurologists and Emergency Physicians in Australia and New Zealand participated. Round one asked participants to generate three research questions important for further research in paediatric status epilepticus. Responses were refined into unique in idual questions. Rounds two and three required participants to rate questions on a seven point ordinal scale. Health consumers were invited to participate by providing up to three problem areas that could be addressed by research. 54 experts and 76 health consumers participated in the process. Nine questions reached our definition of consensus "high priority", 21 questions achieved consensus "low priority" and seven questions did not achieve consensus. High priority areas included second line management including levetiracetam (efficacy, dose and timing), use of third line agents, induction of anaesthesia (timing and best agent), management of focal SE, and indicators of "subtle SE". Consumer priority areas included themes of treatment efficacy, aetiology, and community education. We identified nine priority research questions in paediatric SE, congruent with the health consumer theme of treatment efficacy. Future research efforts should be directed towards these priority areas.
Publisher: Wiley
Date: 04-06-2018
DOI: 10.1111/JPC.14079
Abstract: Despite increasing rates of emergency department (ED) utilisation, little is known about low-acuity presentations in children ≤5 years. The aims of the study were to estimate the proportion and cost of low-acuity presentations in children ≤5 years presenting to the ED and to determine the relative effect of socio-economic status (SES) on paediatric low-acuity presentations at the ED. This is a retrospective observational study of children ≤5 years presenting to the Cairns Hospital ED over 4 years. A multivariate logistic regression model was used to assess the association between SES and low-acuity presentations. Cost of low-acuity presentations was calculated based on triage score and admission status, using costs obtained from the National Hospital Cost Data Collection. A total of 23 086 children were included in the study, of whom 56.7% were male (mean age = 1.85 ± 1.63 years). Approximately one-third of ED visits were low-acuity presentations (32.4%), and low-acuity presentations increased progressively with SES. In multivariate analysis, children from families with very high SES were twice as likely to have a low-acuity presentation (odds ratio 2.17 95% confidence interval, 1.66-2.85). Low-acuity ED presentations cost the health-care system in excess of A$895 000-A$1 110 000 per year. These findings demonstrate that a significant proportion of paediatric ED visits are of low acuity and that these visits yield a substantial cost to the health system. Further research is required regarding care givers' rationale and potentially other reasons underlying these low-acuity ED presentations.
Publisher: Informa UK Limited
Date: 09-2001
Publisher: Wiley
Date: 20-12-2019
DOI: 10.1111/JPC.14352
Abstract: There has been an increase in the use of the emergency department (ED) for non-urgent presentations. The aim of this systematic review was to identify the proportion, criteria and predictors of non-urgent ED presentations in paediatric populations. A search of multiple databases was conducted for articles published from inception of the databases to 20 August 2018, which reported the proportion, criteria and predictors of non-urgent ED presentation in paediatric populations. Thirty-one articles met the inclusion criteria. The mean proportion of non-urgent paediatric ED presentations was 41.06 ± 15.16%. There appears to be a weak association between predisposing, enabling and needs factors and non-urgent ED use in paediatric populations. The findings of this review suggest that non-urgent ED use in paediatric populations is high. However, non-urgent ED use and the reasons for the visits in paediatric populations remain understudied.
Publisher: Springer Science and Business Media LLC
Date: 06-04-2018
Publisher: Springer Science and Business Media LLC
Date: 21-06-2019
DOI: 10.1007/S00520-019-04942-7
Abstract: The aim of this descriptive study was to assess the prevalence of vitamin D deficiency in patients on active therapy for multiple myeloma in a tropical climate. We also tested for the association of vitamin D status on clinical outcomes. This was a single centre, observational study performed in Townsville, Australia, which has a sunlight heavy, tropical climate. Patients on active therapy for multiple myeloma underwent testing of serum 25-hydroxyvitamin D (25(OH)D). Information on disease stage, skeletal morbidity and symptoms of peripheral neuropathy were collected from medical records and self-reported patient questionnaires. A total of 41 patients were included. With a median disease duration of 38 months, 27% were found to be vitamin D deficient. Patients with vitamin D deficiency had a higher likelihood of peripheral neuropathy compared with their non-vitamin D counterparts (73% vs. 33%, P = 0.03). Although those with vitamin D deficiency had more skeletal morbidity, this was not statistically significant (73% vs 50%, P = 0.19). Reduced 25(OH) D was associated with a poor performance status (P = 0.003). There was no association between vitamin D status and stage of myeloma. There is a relatively high prevalence of vitamin D deficiency in patients with myeloma in our study. This is despite a sunlight heavy, tropical climate. We report an association between vitamin D deficiency and peripheral neuropathy. Prospective interventional trials are required to further assess this.
Publisher: Elsevier BV
Date: 2015
Publisher: Springer Singapore
Date: 2021
Publisher: Springer Science and Business Media LLC
Date: 02-03-2018
Publisher: Cambridge University Press (CUP)
Date: 29-12-2014
DOI: 10.1017/S1049023X1400137X
Abstract: Traditionally, post disaster response activities have focused on immediate trauma and communicable diseases. In developed countries such as Australia, the post disaster risk for communicable disease is low. However, a “disease transition” is now recognized at the population level where noncommunicable diseases (NCDs) are increasingly documented as a post disaster issue. This potentially places an extra burden on health care resources and may have implications for disaster-management systems. With increasing likelihood of major disasters for all sectors of global society, there is a need to ensure that health systems, including public health infrastructure (PHI), can respond properly. There is limited peer-reviewed literature on the impact of disasters on NCDs. Research is required to better determine both the impact of NCDs post disaster and their impact on PHI and disaster-management systems. A literature review was used to collect and analyze data on the impact of the index case event, Australia's Severe Tropical Cyclone Yasi (STC Yasi), on PHI and the management of NCDs. The findings were compared with data from other world cyclone events. The databases searched were MEDLINE, CINAHL, Google Scholar, and Google. The date range for the STC Yasi search was January 26, 2011 through May 2, 2013. No time limits were applied to the search from other cyclone events. The variables compared were tropical cyclones and their impacts on PHI and NCDs. The outcome of interest was to identify if there were trends across similar world events and to determine if this could be extrapolated for future crises. This research showed a tropical cyclone (including a hurricane and typhoon) can impact PHI, for instance, equipment (oxygen, syringes, and medications), services (treatment and care), and clean water availability/access that would impact both the treatment and management of NCDs. The comparison between STC Yasi and worldwide tropical cyclones found the challenges faced were linked closely. These relate to communication, equipment and services, evacuation, medication, planning, and water supplies. This research demonstrated that a negative trend pattern existed between the impact of STC Yasi and other similar world cyclone events on PHI and the management of NCDs. This research provides an insight for disaster planners to address concerns of people with NCDs. While further research is needed, this study provides an understanding of areas for improvement, specifically enhancing protective PHI and the development of strategies for maintaining treatment and alternative care options, such as maintaining safe water for dialysis patients. Ryan BJ , Franklin RC , Burkle FM Jr , Watt K , Aitken P , Smith EC , Leggat P . Analyzing the impact of Severe Tropical Cyclone Yasi on public health infrastructure and the management of noncommunicable diseases . Prehosp Disaster Med . 2015 30 ( 1 ): 1 - 10 .
No related grants have been discovered for Kerrianne Watt.