ORCID Profile
0000-0001-9628-3057
Current Organisations
Prince Charles Hospital
,
Australian Catholic University
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Wiley
Date: 05-2011
DOI: 10.1111/J.1440-1797.2011.01471.X
Abstract: We quantified baseline and observed change in peak VO(2) , quality of life, cardiac function, strength and energy intake following exercise training in haemodialysis patients and optimal exercise delivery for producing greatest adherence, safety and patient improvements. A systematic literature search was completed in August 2010 to identify randomized, controlled trials of exercise training studies in haemodialysis patients. A subsequent meta-analysis was conducted and the search repeated in December 2010. Fifteen studies, yielding 565 patients were included. Baseline, peak VO(2) values were 70% of age-predicted values, exercise intervention patients improved post-training peak VO(2) to 88% predicted. Exercise training produced mean 26 ± 12% improvements in eight studies that reported peak VO(2) , mean difference 5.22 mL O(2) /kg per min (95% confidence interval 3.86, 6.59, P < 0.00001). Equivocal results for change in short-form 36 health questionnaire scores were reported post-training. Heart rate variability was improved after exercise training of normal to normal interval, mean difference 1634 milliseconds (95% confidence interval 8.3, 24.3, P < 0.0001). Significant improvements in lean body mass, quadriceps muscle area, knee extension, hip abduction and flexion strength were also reported (all P < 0.0001). Exercise training appears safe, with no deaths directly associated with exercise in 28 400 patient-hours and no differences in withdrawal rates between exercise and control participants, P = 0.98. Exercise training for 6 months or more conveyed larger improvements in peak VO(2) than shorter programmes. Data indicate about 25% of patients were excluded from exercise training studies for medical reasons. Exercise training is safe and imparts large improvements in peak VO(2) , and heart rate variability.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2011
Publisher: Elsevier BV
Date: 10-2021
Publisher: Wiley
Date: 16-01-2015
Abstract: To describe the effect of interventions designed to improve patient identification (PI) during pathology collection in the ED. A prospective before-and-after intervention study was conducted between June 2009 and June 2010 in a regional ED in Queensland, Australia. Interventions aimed to improve PI and specimen labelling, and consisted of: (i) education alone and (ii) education plus an armband scanner that voice-prompted collector behaviour. Main outcomes measured included: frequency of correct key behaviours (KBs) during specimen collection, pathology integrity errors and cost of interventions. Data from 282 ED pathology collections were analysed (before: n = 115, after with education: n = 95, after with education plus armband scanner: n = 72). KBs for PI and labelling improved significantly following education plus armband scanner use. Application of armbands before s le collection increased (36% vs 90%, P < 0.001), as did asking the patient to state their name (25% vs 93%, P < 0.001) and date of birth (22% vs 93%, P < 0.001). These results were similar, albeit less pronounced, when the effect of education only was assessed. No primary patient misidentification was detected in this small study. The annual costs for a hospital to adopt the education programme with and without the armband scanner were $104,045 and $5330 respectively. ED staff had poor behaviours for identifying patients and labelling pathology specimens before intervention. These safety behaviours were considered an assumed skill. Education alone improved critical KBs markedly that was further augmented by the armband scanner. The cost to adopt education alone is relatively low compared to the addition of armband scanner technology.
Publisher: Informa UK Limited
Date: 15-09-2023
Publisher: Informa UK Limited
Date: 07-06-2022
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2015
Publisher: SAGE Publications
Date: 2021
DOI: 10.1177/14799731211017895
Abstract: What is the impact of including an allied health assistant (AHA) role on physiotherapy service delivery in an acute respiratory service? A pragmatic pre-post design study examined physiotherapy services across two 3-month periods: current service delivery [P1] and current service delivery plus AHA [P2]. Clinical and non-clinical activity quantified as number, type and duration (per day) of all staff activity categorised for skill level (AHA, junior, senior). Physiotherapy service delivery increased in P2 compared to P1 (n = 4730 vs n = 3048). Physiotherapists undertook fewer respiratory (p 0.001) and exercise treatments (p 0.001) but increased reviews for inpatients (p 0.001) and at multidisciplinary clinics in P2 (56% vs 76%, p 0.01). The AHA accounted for 20% of all service provision. AHA activity comprised mainly non-direct clinical care including oversight of respiratory equipment use (e.g. supply, set-up, cleaning, loan audits) and other patient-related administrative tasks associated with delegation handovers, supervision and clinical documentation (72%), delegated supervision of established respiratory (5%) and exercise treatments (10%) and delegated exercise tests (3%). The AHA completed most of the exercise tests (n = 25). AHA non-direct clinical tasks included departmental management activities (11%). No adverse events were reported. AHA inclusion in an acute respiratory care service changed physiotherapy service provision. The AHA completed delegated routine clinical and non-clinical tasks. Physiotherapists increased clinic activity and annual reviews. Including an AHA role offers sustainable options for enhancing physiotherapy service provision in acute respiratory care.
Publisher: Wiley
Date: 04-03-2011
DOI: 10.1111/J.1751-7133.2011.00217.X
Abstract: Systemic inflammation is associated with cardiovascular disease, especially the end stages of heart failure (HF). The authors sought to determine by systematic review whether physical therapy reduces serum levels of pro-inflammatory cytokines in HF patients. Potential studies were identified from a systematic search of Medline (Ovid) (1950-October 2010), Embase.com (1974-current), Cochrane Central Register of Controlled Trials, CINAHL (1981-current), and Web of Science (2000-current). The search strategy included a mix of MeSH and free text terms for key concepts. A total of 11 studies were included, with 4 reporting a post-training reduction in tumor necrosis factor α (TNF-α), of which 3 used traditional aerobic or resistance exercise and 1 used functional electrical stimulation. Reduced post-training serum levels of interleukin 6 were reported by one exercise study. The one study that employed combined resistance and aerobic training only showed soluble receptors TNF-α1 and TNF-α2 to be lower. The one study of respiratory muscle training and two studies that employed electrical stimulation had limited effect on cytokines and peak maximal oxygen uptake. With the exception of one study, those therapies that employed ≥ 5 sessions per week lowered serum TNF-α. Our review data suggest that physical therapies employing ≥ 5 sessions per week are most likely to reduce serum levels of TNF-α in HF patients. No isolated study of resistance training has yet examined the relationship between muscle wasting, glycogen depletion, and the ability of exercise training to reverse both of these conditions in HF patients.
Publisher: MDPI AG
Date: 10-09-2023
Publisher: Springer Science and Business Media LLC
Date: 18-08-2011
DOI: 10.1007/S00268-011-1231-3
Abstract: Initial management of trauma patients is focused on identifying life- and limb-threatening injuries and may lead to missed injuries. A tertiary survey can minimise the number and effect of missed injuries and involves a physical re-examination and review of all investigations within 24 h of admission. There is little information on current practice of tertiary survey performance in hospitals without a dedicated trauma service. We aimed to determine the rate of tertiary survey performance and the detail of documentation as well as the baseline rate of missed injuries. We performed a retrospective, descriptive study of all multitrauma patients who presented to an Australian level II regional trauma centre without a dedicated trauma service between May 2008 and February 2009. A medical records review was conducted to determine tertiary survey performance and missed injury rate. Of 252 included trauma patients, 20% (n = 51) had a tertiary survey performed. A total of nine missed injuries were detected in eight patients (3.2%). Of the multiple components of the tertiary survey, most were poorly documented. Documentation was more comprehensive in the subgroup of patients who did have a formal tertiary survey. Tertiary survey performance was poor, as indicated by low documentation rates. The baseline missed injury rate was comparable to previous that of retrospective studies, although in this study an underestimation of true missed injury rates is likely. Implementing a formal, institutional tertiary survey may lead to improved tertiary survey performance and documentation and therefore improved trauma care in hospitals without a dedicated trauma service.
Publisher: SAGE Publications
Date: 02-09-2019
Publisher: Springer Science and Business Media LLC
Date: 05-04-2017
Publisher: Wiley
Date: 11-09-2017
DOI: 10.1111/DME.13451
Abstract: To investigate the role of self-compassion in diabetes outcomes. Self-compassion is a construct which may be relevant to chronic conditions, given its focus on compassion toward oneself, especially in times of difficulty. In this cross-sectional study we collected data online from 310 adults diagnosed with diabetes. The questionnaire measured three primary outcomes: self-management behaviours HbA Multiple regression analyses showed that self-compassion had the most consistent association with better outcomes, including all forms of self-management behaviour, HbA Higher levels of self-compassion are typically associated with improved self-management behaviour, medical outcomes and psychological well-being in adults with diabetes mellitus. The present findings suggest that self-compassion may be a parsimonious and suitable intervention target. Future interventions and consultations with medical professionals may benefit from fostering self-compassion in adults with diabetes mellitus.
Publisher: Cold Spring Harbor Laboratory
Date: 18-11-2020
DOI: 10.1101/2020.11.16.20232256
Abstract: What is the impact of including an allied health assistant (AHA) role on physiotherapy service delivery in terms of service provision, scope of practice and skill mix changes in an acute respiratory service? A pragmatic pre-post design study examined physiotherapy services across two three-month periods: current service delivery [P1] and current service delivery plus AHA [P2]. Clinical and non-clinical activity contributing to physiotherapy services delivery quantified as number, type and duration (per day) of all staff activity, and categorised for skill level (AHA, junior, senior). Overall physiotherapy service delivery increased in P2 compared to P1 (n=4730 vs n=3048). Physiotherapists undertook fewer respiratory (p 0.001) and exercise treatments (p 0.001) but increased patient reviews for inpatients (p 0.001) and at multidisciplinary clinics in P2 (56% vs 76%, p 0.01). The AHA accounted for 20% of all service provision. AHA activity comprised mainly non-direct clinical care including oversight of respiratory equipment use (e.g. supply, set-up, cleaning, loan audits) and other patient related administrative tasks associated with delegation handovers, supervision and clinical documentation (72%) and delegated supervision of established respiratory (5%) and exercise treatments (10%) and delegated exercise tests (3%). The AHA completed most of the exercise tests (n = 25). AHA non-direct clinical tasks included departmental management activities such as statistics and ongoing training (11%). No adverse events were reported. Inclusion of an AHA in an acute respiratory care service changed physiotherapy service provision. The AHA completed delegated routine clinical and non-clinical tasks. Physiotherapists increased clinic activity and annual reviews. Including an AHA role offers safe and sustainable options for enhancing physiotherapy service provision in acute respiratory care services.
Publisher: Springer Science and Business Media LLC
Date: 07-01-2013
Publisher: Oxford University Press (OUP)
Date: 18-02-2014
Abstract: to test the effect of a 16-week multimodal exercise program on neurocognitive and physical functioning and brain-derived neurotrophic factor (BDNF). a single-blinded, parallel-group randomised controlled trial. university c us and community-based halls. forty-nine women aged 65 to 75 years, with no cognitive impairment and not undertaking more than 1 h of formal exercise training per week. the intervention group attended a 60-min multimodal class twice each week which included cardiovascular, strength and motor fitness training. The primary outcome was neurocognitive functioning and secondary outcomes were physical functioning and plasma levels of BDNF. twenty-five participants were randomised to the intervention group and 24 to the control group. One control participant withdrew before follow-up data collection. The intervention group performed significantly better than the control group at follow-up (when controlled for baseline) in the Trail Making test A and B, the California Older Adult Stroop test (Word, Interference and Total scores), Controlled Oral Word Association test and the Timed Up-and-Go test, Six-Minute Walk test, One-Legged Stance test and plasma BDNF. this multimodal exercise program resulted in neurocognitive and physical performance improvements and increased levels of plasma BDNF, in older women, when compared with controls. This RCT provides evidence that a multimodal exercise intervention can achieve larger effect sizes than those generally resulting from single modality interventions. Increases in BDNF levels imply neurogenesis may be a component of the mechanism underpinning the cognitive improvements associated with multimodal exercise. Australian and New Zealand Clinical Trial Registration Number: ANZCTR12612000451808.
Publisher: Walter de Gruyter GmbH
Date: 09-04-2018
Abstract: Early smoking is considered an indicator for risky behaviour in adolescents. Although social indicators predicting adolescent smoking are known, biological indicators have not been defined. This study aimed to establish whether salivary testosterone could be used as a “predictive biomarker” for smoking-associated peer pressure. Saliva s les were collected from Bruneian adolescents (aged 13–17 years) by the passive drool method. Salivary testosterone concentration was determined by enzyme-linked immunosorbent assay. Salivary testosterone concentration and smoking-associated peer pressure indicators were compared between adolescent males and females and statistical significance was determined by an independent s les t-test. A significant positive relationship between smoking-associated peer pressure and salivary testosterone levels in adolescents was found. However, this relationship was not significant when males and females were considered separately. Our data suggest that students who have tried cigarette smoking and have friends who are cigarette smokers have higher salivary testosterone levels.
Publisher: BMJ
Date: 13-08-2015
DOI: 10.1136/EMERMED-2013-203490
Abstract: To assess the effect of a single dose of intravenous dexamethasone in addition to routine treatment on visual analogue scale (VAS) pain scores at 24 h in emergency department (ED) patients with low back pain with radiculopathy (LBPR). Double-blind randomised controlled trial of 58 adult ED patients with LBPR, conducted in one tertiary and one urban ED. The intervention was 8 mg of intravenous dexamethasone (or placebo) in addition to current routine care. The primary outcome was the change in VAS pain scores between presentation and 24 h. Secondary outcomes included VAS pain scores at 6 weeks, ED length of stay (EDLOS), straight leg raise (SLR) angles and Oswestry functional scores. Patients treated with dexamethasone had a 1.86 point (95% CI 0.31 to 3.42, p=0.019) greater reduction in VAS pain scores at 24 h than placebo (dexamethasone: -2.63 (95% CI -3.63 to -1.63) versus placebo: -0.77 (95% CI -2.04 to 0.51)). At 6 weeks, both groups had similar significant and sustained decrease in VAS scores compared with baseline. Patients receiving dexamethasone had a significantly shorter EDLOS (median: 3.5 h vs 18.8 h, p=0.049) and improved SLR angle at discharge (14.7°, p=0.040). There was no difference in functional scores. In patients with LBPR, a single dose of intravenous dexamethasone in addition to routine management improved VAS pain scores at 24 h, but this effect was not statistically significant at 6 weeks. Dexamethasone may reduce EDLOS and can be considered as a safe adjunct to standard treatment. ACTRN12611001020976.
Publisher: Informa UK Limited
Date: 10-01-2021
DOI: 10.1080/11038128.2019.1709542
Abstract: Occupational therapy research has not fully utilized available research methods when exploring occupational therapists' views on specific interventions and service provision nor when exploring consumer priorities and the impact of occupational therapy services. Q methodology, a quantitative method for the systematic assessment of qualitative data, is an approach that can be used to examine viewpoints related to occupational therapy. To add experiential knowledge to guide researchers new to navigating Q methodology and encourage researchers to consider the application of Q methodology when exploring viewpoints pertinent to occupational therapy practice and research. The application of Q methodology in published occupational therapy and occupational science research is identified, and an experience-based review of Q methods undertaken. More detailed explanation and reflection on each stage of Q methodology, including the factor analysis stage, than is currently available in the literature is presented to support successful implementation of this method. Sharing experience in implementing Q methodology may inform and encourage researchers in its use as one method for bridging the gap between qualitative and quantitative data. The rigor of the method's processes may add credibility to identified viewpoints and how they could inform occupational therapy practice.Key messagesQ methodology can be used in occupational therapy research to explore consumer and therapist viewpoints regarding interventions, service provision, priorities and the profession itself.Q methodology employs a specific, repeatable process within each stage of the research process to ensure rigour.Q methodology provides an approach to combining qualitative research methods with quantitative analysis techniques to understand the viewpoints of interest.
Publisher: Medical Journals Sweden AB
Date: 2014
Abstract: Measure changes in pain and disability of primary care shoulder pain patients over a 12-month period. A non-randomized audit with repeated measures of pain and disability at 3 weeks, 3, 6 and 12 months. Of 208 patients, 161 agreed to participate with 96.9%, 98.1%, 86.3%, 83.9% follow-up at 3 weeks, at 3, 6 and 12 months, respectively. Mean age was 44 years, mean symptom duration 3.6 months. PATIENTS were treated with protocol driven corticosteroid injection and community based care. Primary outcome measure was the Shoulder Pain and Disability index (SPADI) questionnaire. Based on the SPADI and minimal clinically important difference (MCID), outcomes were categorized into: total recovery, 90% or more improved, better, unchanged and worse. There was significant reduction of pain and disability at 3 weeks (p < 0.001), no change at the 3- and 6-month follow-up and a significant reduction at the 12-month follow-up (p < 0.001). Excellent outcomes were achieved by 32.9% and 45.3%, and a poor clinical outcome resulted for 32.8% and 14.9% at the 3- and 12-month follow-up, respectively. Though there was significant improvement at the 3-week and 12-month follow-up, 45% achieved an excellent outcome and a 16.7% of patients were the same or worse than baseline at 12 months.
Publisher: Elsevier BV
Date: 04-2022
Publisher: Informa UK Limited
Date: 11-04-2020
Publisher: Informa UK Limited
Date: 08-11-2017
DOI: 10.1080/02699052.2017.1346298
Abstract: The Acute Brain Injury Physiotherapy Assessment (ABIPA) is a new outcome measure with face validity and sensitivity to change in the early stages of neuromotor recovery after acquired brain injury (ABI). Reliability of physiotherapists using the tool has not been established. Determine inter- and intra-tester reliability of physiotherapists using the ABIPA. An observational study using video-recorded assessments of patient performance (n = 7) was undertaken with two cohorts of physiotherapists: those receiving training (n = 23) and those provided with guidelines only (n = 7) to administer the ABIPA. Across all physiotherapists (n = 30), inter-tester reliability was excellent (α ≥ 0.9) for total ABIPA score. All in idual items, except trunk alignment in supine (α = 0.5), showed excellent or good internal consistency (α ≥ 0.7). For intra-tester reliability, substantial or perfect agreement was achieved for eight items (weighted Kappa K Physiotherapists are highly consistent using the ABIPA but several items may need revision to improve intra-tester reliability.
Publisher: Frontiers Media SA
Date: 24-11-2014
Publisher: Elsevier BV
Date: 12-2011
DOI: 10.1016/J.MATH.2011.06.004
Abstract: Hamstring strain (HS) is a common musculoskeletal condition and abnormal neurodynamics has been shown to influence HS and delay recovery. The efficacy of stretching for preventing and treating HS remains uncertain despite extensive research and wide-spread use. The effects of cervical spine mobilisation on peripheral nervous system function, neurodynamics and muscle force in the upper limb have been reported. Very few studies have reported effects of lumbar spine mobilisation on these variables in the lower limb. This study aimed to determine immediate effects of either a unilateral zygopophyseal joint posteroanterior mobilisation or a static posterior chain muscle stretch on the range of passive straight leg raise (SLR) in comparison to a non-treatment control. Using a single-blinded, randomised controlled study design, 36 healthy participants were allocated into one of three groups (control mobilisation static posterior chain muscle stretch). Measures of SLR were taken before and after intervention for each group on the day of testing. A General Linear Model (GLM) and a paired s le t-test showed a significant difference between base line and post-intervention for the mobilisation group only (p < 0.001), and suggests that unilateral lumbar spine zygopophyseal joint mobilisation can immediately restore posterior chain neurodynamics.
Publisher: Wiley
Date: 27-11-2012
DOI: 10.1111/J.1751-7133.2011.00274.X
Abstract: The authors compared the effects of continuous (CON) and intermittent (INT) exercise training programs on functional capacity, quality of life (QOL), and cardiac function in 23 congestive heart failure patients. Patients were randomized to CON exercise training (n=13 aged 66±7 years peak oxygen consumption [VO(2)], 12.4±2.5 mL/kg/min weight, 83±12 kg left ventricular ejection fraction [LVEF], 29.5%±7.2%) or INT exercise training (n=10 aged 59±11 years VO(2), 12.2±6.5 mL/kg/min weight, 87±24 kg LVEF 27%±7.9%). These groups completed 16 weeks of stationary cycling at 70% VO(2) thrice weekly for 30 minutes continuously or 60 minutes (60 seconds work:60 seconds rest) intermittently both groups completed the same absolute volume of work. Three QOL questionnaire responses, VO(2), LVEF, and regional tissue Doppler were quantified. After exercise training, VO(2) increased by 13% in the CON group (P=.12) and significantly by 21% in the INT group (P=.03), although not significantly between the groups (P=.72). In the CON group, Minnesota Living With Heart Failure score improved at 16 weeks (P=.02), while in the INT group, Hare-Davis scores improved (P=.02). Cardiac volumes, resting and peak LVEF, contractile reserve, and tissue velocities were all unchanged from baseline. Intermittent exercise may improve functional capacity to a greater extent than continuous exercise. QOL changes were variable between groups.
Publisher: Springer Science and Business Media LLC
Date: 10-2014
Publisher: Springer Science and Business Media LLC
Date: 12-2019
DOI: 10.1186/S12909-019-1894-2
Abstract: The Australian Physiotherapy Council mandates that physiotherapy clinical education be sufficient to produce graduates who are competent to practice across the lifespan. Due to a lack of opportunities for paediatric clinical placements, there is a risk of graduates not having the opportunity to develop competency in paediatric physiotherapy. To address this risk, simulation-based education (SBE) has been proposed as an educational strategy to address the placement shortfall. Despite encouraging evidence for its use in physiotherapy education, there is limited evidence supporting its use specifically in paediatric populations. The aims of this research were to investigate the effect of SBE on student self-efficacy in the physiotherapy assessment and management of paediatric clients, and to determine student satisfaction with SBE as a learning strategy. Three interactive SBE sessions were run during the undergraduate paediatric physiotherapy unit at the c us of one Australian university. Self-efficacy was surveyed before and after each session, to determine confidence in clinical skills, clinical decision-making, treatment preparation and planning, communication skills evaluating and modifying interventions, and interprofessional practice. Student satisfaction with SBE as a learning strategy was surveyed after the final SBE session. For the 164 participants included in this study, self-efficacy survey response rate varied from 77 to 96% for each session. Significant increases in mean student self-efficacy were recorded for all questions ( p 0.001). A total of 139 (85%) responded to the learning reactionnaire with 78.6% indicating they were very satisfied with SBE as a learning strategy. Written comments from 41 participants identified ‘experience’ as the primary theme. SBE had a significant positive effect on student self-efficacy in the physiotherapy assessment and management of paediatric patients. Students also perceived SBE to be a valuable learning experience. Future research is needed to investigate whether the improvement in self-efficacy achieved through SBE translates into improved student performance during workplace-based clinical placements.
Publisher: Elsevier BV
Date: 2012
DOI: 10.1016/J.HLC.2011.10.002
Abstract: Post-surgical pericardial adhesions pose an increased risk of complications during redo sternotomies. Adhesive tissue formation is a normal response to tissue injury and involves complex patho-physiological processes including the actions of prostaglandins to cause plasma leakage and fibrin formation. The purpose of this study was to assess the ability of two non-steroidal anti-inflammatory agents (Indomethacin and Rofecoxib) and a barrier (Coseal, a polyethylene glycol) to limit adhesion formation following cardiac surgery in a pig model. Forty-four piglets were allocated equally to four treatment groups: Group 1: Control, Group 2: intramuscular Indomethacin, Group 3: oral Rofecoxib and Group 4: Coseal sprayed on the heart. A full median sternotomy was performed on each animal and the heart exposed. Adhesions were induced by rubbing tissues with gauze, applying sutures and leaving blood in the pericardial sac before chest closure. Plasma inflammatory markers including prostaglandin E(2) and thromboxane B(2) were measured preoperatively and on Days 2, 5 and 10 after surgery. Eight animals from each group were slaughtered after 12 weeks and 3 after 25 weeks. Adhesions were assessed macroscopically and microscopically. Compared to the Control group, the extent of adhesions was significantly less in all other groups whilst adhesion density was least in the Indomethacin and Coseal groups. Indomethacin and less so Rofecoxib, inhibited the synthesis of prostaglandin E(2) and thromboxane B(2) but there were no significant changes in other inflammatory markers. We conclude that systemic Indomethacin, and locally applied Coseal are suitable methods to markedly reduce pericardial and retrosternal adhesions.
Publisher: Wiley
Date: 08-11-2013
Publisher: Wiley
Date: 13-07-2014
DOI: 10.1111/JPC.12689
Abstract: The aim of this study was to determine the effectiveness of quarter turn from prone compared with supine and prone positioning in maintaining respiratory function in premature infants managed in a neonatal intensive care unit. The study was a prospective, randomised, cross-over trial with concealed allocation and intention to treat analysis. Fifty-four infants ≤32 weeks gestation were randomly allocated to the order of the positions supine, prone and quarter turn from prone. Distribution of ventilation was assessed by measurement of regional impedance litude, global inhomogeneity index and phase angle analysis using electrical impedance tomography 30 min after each position change. Physiological characteristics of heart rate, respiratory rate (RR), oxygen saturation and inspired oxygen were also measured. There was a significant difference between positions for RR with the RR in quarter turn from prone significantly lower than for supine (mean difference 6.53 breaths/min 2.04-11.02), but not compared with the prone position. No significant differences between positions were found for any of the other outcomes measured. This study demonstrated that quarter turn from prone had an immediate positive positional effect on the RR of premature infants. The position of quarter turn from prone was comparable with prone in the maintenance of lung function and had a superior effect over supine on RR. These findings support the view that a quarter turn from prone can be confidently used in neonatal nurseries to manage premature infants.
Publisher: Informa UK Limited
Date: 04-05-2015
Publisher: Medknow
Date: 04-2016
Publisher: Elsevier BV
Date: 12-2013
DOI: 10.1016/J.AJIC.2013.05.019
Abstract: Recent research has suggested that episodes of gram-negative (GN) bloodstream infection (BSI) are more common in the population during summer months. Our objective was to determine if the same phenomenon could be observed in patients with health care-associated (HCA) BSI, and if so, whether a summer peak was less apparent in patients accommodated in a climate-controlled hospital environment. Data from episodes of HCA BSI spanning an 11-year period were analyzed. To test for seasonal variation in HCA BSI among hospitalized and nonhospitalized patients, and between GN and gram-positive organisms, the χ(2) goodness-of-fit test was used. There were 440 episodes of HCA GN BSI of which 259 (59%) occurred in inpatients and 181 (41%) occurred in noninpatients. A significant increase in the frequency of HCA GN BSI was observed in nonhospitalized patients during the summer months (P = .03) but not in climate-controlled hospitalized patients. The most common source of infection in these patents was an intravascular device (38%). We found an increased incidence of GN HCA BSI during summer that was not apparent in our inpatient cohort. The cause is unknown. It might be prudent to advise patients at risk of BSI (eg, those receiving intravascular infusions) to minimize exposure to high environmental temperature and to educate on possible behavioral factors that may increase risk.
Publisher: Bowling Green State University Libraries
Date: 02-2014
Publisher: Wiley
Date: 23-07-2019
DOI: 10.1111/INM.12634
Abstract: Undergraduate nursing students have been reported to hold negative and stigmatizing attitudes towards mental health consumers and to be under-prepared for mental health clinical placement. This study aimed to investigate undergraduate nurses' stigma and recovery attitudes to mental illness, and describe their understandings of personal recovery on entry and exit to traditional mental health clinical placement. A pre ost-test survey was administered to N = 249 nursing students in Australia. Demographic data, attitudes towards mental health nursing and clinical placement, the Opening Minds Scale for Healthcare Providers (OMS-HC), Recovery Attitudes Questionnaire (RAQ-7), and an open-ended question on understandings of personal recovery from mental illness were collected on entry (T1) and exit (T2) to placement. At T1, students reported moderate stigma and positive attitudes towards recovery (OMS-HC mean = 34.6 RAQ-7 mean = 4.0). At T2, there was a reduction in stigma (social distance P = 0.02, d = 0.26) and improvement in recovery attitudes (P < 0.01, d = 0.40). Attitudes towards mental health nursing and placement also improved (P < 0.01). Having a family member with mental illness predicted improvements in stigma and recovery attitudes. On entry to placement, most students described accurate understandings of personal recovery, which were maintained during placement. The findings indicate that mental health clinical placements are effective in improving students' mental health stigma and recovery attitudes and provide a prime opportunity to attract students into the field. Co-produced or consumer-led education provided by peer workers during clinical placements may improve students' stigmatizing attitudes and stimulate their interest to work in the field.
Publisher: Inter-Research Science Center
Date: 17-02-2012
DOI: 10.3354/DAO02416
Abstract: We analyzed submission data from a wildlife care group during hibian disease surveillance in Queensland, Australia. Between January 1999 and December 2004, 877 white-lipped tree frogs Litoria infrafrenata were classified according to origin, season and presenting category. At least 69% originated from urban Cairns, significantly more than from rural and remote areas. Total submissions increased during the early and late dry seasons compared with the early wet season. Frogs most commonly presented each year with injury, followed by 'other', sparganosis and irreversible emaciation of unknown aetiology. This is the first report of Spirometra erinacei infection in this species. A high prevalence (28%) of visible S. erinacei infection was found in emaciated frogs, but this was not statistically different from that in non-emaciated diseased frogs (25%). However, 14 emaciated specimens that were necropsied all had heavy S. erinacei infections, and the odds of visible sparganosis were statistically greater in emaciated frogs compared with injured, non-diseased frogs. We provide a detailed case definition for a new endemic disease manifesting as irreversible emaciation, for which S. erinacei may be the primary aetiological agent. The lack of significant spatial or temporal patterns in case presentation suggests that this is not a currently emerging disease. We show that community wildlife groups can play a valuable role in monitoring disease trends, particularly in urban areas, but identify a number of limitations associated with passive syndromic surveillance. We conclude that it is critical that professionals be involved in establishing syndromic case definitions, diagnostic pathology, complementary active disease surveillance, and data analysis and interpretation in all wildlife disease investigations.
Publisher: Elsevier BV
Date: 03-2022
DOI: 10.1016/J.AUCC.2021.04.007
Abstract: The aim of the study was to investigate the effectiveness of interventions to prevent pressure injury in adults admitted to intensive care settings. This is a systematic review and meta-analysis of randomised controlled trials. Five databases (CINAHL, MEDLINE, Scopus, Web of Science, and Embase) were searched in mid-2019. Searches were updated (in April 2020) to year end 2019. From an overarching systematic review and meta-analysis examining the effectiveness of pressure injury preventative interventions in adults admitted to acute hospital settings, trials conducted in intensive care were separated for an intensive care-specific synthesis. Two reviewers, with a third as an arbitrator, undertook study selection, data extraction, and risk-of-bias assessment. Included trials were grouped by intervention type for narrative synthesis and for random-effects meta-analysis using intention-to-treat data where appropriate. Overall, 26 trials were included. Ten intervention types were found (support surfaces, prophylactic dressings, positioning, topical preparations, continence management, endotracheal tube securement, heel protection devices, medication, noninvasive ventilation masks, and bundled interventions). All trials, except one, were at high or unclear risk of bias. Four intervention types (endotracheal tube securement, heel protection devices, medication, and noninvasive ventilation masks) comprised single trials. Support surface trials were limited to type (active, reactive, seating, other). Meta-analysis was undertaken for reactive surfaces, but the intervention effect was not significant (risk ratio = 0.24, p = 0.12, I Only prophylactic sacral and heel dressings demonstrated effectiveness in preventing pressure injury in adults admitted to intensive care settings. Further intensive care-specific trials are required across all intervention types. To minimise bias, we recommend that all future trials are conducted and reported as per relevant guidelines and recommendations.
Publisher: Informa UK Limited
Date: 09-06-2023
Publisher: Informa UK Limited
Date: 08-06-2019
DOI: 10.1080/17457300.2018.1476381
Abstract: Road fatality is one of the leading causes of death in Brunei with 79 deaths in 1993, the highest ever recorded. The Brunei government has been trying to reduce this by implementing new traffic measures and successfully reduced fatalities to 24 fatalities in 2014. Yearly road fatality has been fluctuating, but there has been a declining tendency overall. The aim of this study is to investigate road fatality in Brunei by extending the research. We developed a multiple regression model and carried out an analysis on road fatality in Brunei. Our analysis indicates that the road fatality appears to rise depending on the increase in the number of young drivers between 15 to 24 years and the number of unemployed people. Comparisons of Brunei road fatality rate per 10,000 vehicles are made with some other countries and we conclude that Brunei has approximately the same rate as Australia in 2014.
Publisher: Wiley
Date: 19-10-2023
DOI: 10.1111/INM.13246
Publisher: Wiley
Date: 09-10-2020
DOI: 10.1111/INM.12797
Publisher: Informa UK Limited
Date: 23-11-2006
Publisher: Elsevier BV
Date: 04-2010
DOI: 10.1016/J.IJCARD.2009.07.004
Abstract: BNP and the N-terminal portion (NT-pro-BNP) have emerged as powerful tools in the diagnosis and prognosis of heart failure on acute presentation. The aim of this work was to systematically review the effect of exercise training on BNP and NT-pro-BNP levels in patients with left ventricular dysfunction. A systematic search was conducted of Medline (Ovid) (1950-July 2008), Embase.com (1974-current), Cochrane Central Register of Controlled Trials, CINAHL (1981-current) and Web of Science (2000-current) to identify randomized controlled trials of aerobic and/or resistance exercise training in heart failure patients that measured BNP and/or pro-BNP. Primary outcome measures were changes in BNP and NT-pro-BNP. Secondary outcomes were changes in functional capacity and energy expenditure, measures of study quality were also recorded. Nine randomized controlled studies measuring BNP or NT-pro-BNP met our eligibility criteria. Exercise training had a favourable effect on BNP (mean difference -79 pg/ml 95% C.I. -141 to - 17 pg/ml, P=0.01) and NT-pro-BNP (mean difference -621 pg/ml, 95% C.I. -844 to -398 pg/ml, P=<0.00001). Moreover the trials that showed a significant change in NT-pro-BNP all had a weekly exercise energy expenditure of more than 400 Kcal. Data from nine published studies, suggest exercise training has a favorable effect on BNP and NT-pro-BNP in heart failure patients.
Publisher: F1000 Research Ltd
Date: 16-12-2019
DOI: 10.12688/F1000RESEARCH.21608.1
Abstract: Infantile hemangioma (IH) is one of the most common soft-tissue neoplasms of infancy. Although clinical diagnosis for IH is well-established, the haematological parameters associated with IH are not well explored. In this short study, we observed significantly higher eosinophil (EO) numbers in IH patient blood compared to healthy controls. This contributed to the observed higher EO % in the peripheral blood of IH patients and was irrespective of age. This new haematological finding could carry a potential diagnostic rognostic relevance for IH.
Publisher: Walter de Gruyter GmbH
Date: 08-2021
Abstract: Disruption in circadian rhythm affects the production of inflammatory cytokines. Understanding how it behaves in diseased conditions is essential. Despite the role of the interleukin-1β (IL-1β), a potent inflammatory cytokine, in human diseases, little is known about the steady-state circadian rhythm of IL-1β in healthy in iduals. This short study investigates the diurnal pattern of salivary IL-1β throughout the day in healthy young adults. Twelve participants provided saliva s les at various times throughout the day. Salivary IL-1β were assessed using enzyme-linked immunosorbent assay (ELISA) and Western blot analysis. Salivary IL-1β levels were highest at 0430 h and lowest at 0000 h and shared a similar diurnal pattern to that of salivary IL-6. Western blot analysis showed that these levels correspond to the mature form of IL-1β. Our findings are important as it established the diurnal pattern of salivary IL-1β is fluctuating normally throughout the day. The findings also open an incredible opportunity for developing research conducted in the field with saliva as the diagnostic tool.
Publisher: Elsevier BV
Date: 05-2015
Publisher: Springer Science and Business Media LLC
Date: 26-10-2012
Abstract: Semi-quantitative bacteruria counts (s-QBC) are important in the diagnosis of urinary tract infection (UTI) due to most uropathogens. The prognostic value of s-QBC for diagnosis of UTI due to group B streptococcus (GBS) is unknown. In this study, we assessed the value of s-QBC for differentiating acute GBS UTI from asymptomatic bacteruria (ABU), independent of other potential prognostic indicators. Medical record review and urinalysis (UA) values for 1593 patients who had urinary GBS isolated (10 3 to ≥10 5 CFU/ml) during a four-year period were analyzed using binary logistic regression to determine the predictive values of s-QBC, age, and gender for infection category (acute UTI, ABU) based on the clinical diagnosis. s-QBC alone had a strong predictive value for infection category but only for ABU. Multivariate logistic regression showed similar predictive power of s-QBC for infection category using age as a co-predictor, which was also independently associated with infection category. Typical s-QBC cut-off values that are commonly used in diagnostic settings had no significant power in predicting infection category. Among other UA measures, proteinuria and hematuria were significantly associated with acute infection. Together, these data show that s-QBC is not useful in the differential diagnosis of GBS UTI. Among the patients in this study, age was an equally effective prognostic indicator compared to s-QBC for identifying high- and low-risk patients for acute GBS UTI. Collectively, these findings indicate that age-based associations may be equally as useful as s-QBC for predicting infection category in the setting of adult patients with GBS-positive urine cultures.
Publisher: Elsevier BV
Date: 02-2017
Publisher: Korean Society for Microbiology and Biotechnology
Date: 28-12-2018
Publisher: Medical Journals Sweden AB
Date: 2015
Abstract: Identify predictor variables and models for clinical outcomes for primary care shoulder pain patients to 12 months follow-up. A non-randomized audit with measures of pain and disability at 3 weeks, 3, 6 and 12 months. Of 208 patients, 161 agreed to participate with 96.9, 98.1, 87.0 and 83.9% follow-up at 3 weeks, 3, 6 and 12 months respectively. Treatment consisted of exercise and manual therapy-based physiotherapy and corticosteroid injection under specified selection criteria. Potentially useful baseline variables were evaluated in univariate logistic regressions with the dependent variables determined by SPADI Questionnaire at 3 weeks, 3, 6 and 12 months. Variables associated (p-value ≤ 0.2) were retained for potential inclusion within multiple logistic regression analyses. Pain not improved by rest, intermittent pain, lower pain intensity with physical tests and absence of subacromial bursa pathology on ultrasound at the 3-week follow-up, constant pain and lower pain intensity with physical tests are predictors of excellent outcomes at the 3-month follow- up. Worse baseline pain and disability, no history of asthma, pain better with rest, better physical functioning, greater fear avoidance, male gender, no history of pain in the opposite shoulder, pain referred below the elbow, sleep disturbed by pain, smaller waist circumference, lower pain intensity with physical tests are factors predictive of excellent outcomes at the 12-month follow-up. Only higher pain intensity with physical tests was associated with a poor clinical outcome. Predictive models for clinical outcomes in primary-care patients with shoulder pain were achieved for excellent clinical outcomes, successfully classifying 70-90% of cases.
No related grants have been discovered for Michael Steele.