ORCID Profile
0000-0002-8159-2620
Current Organisations
Metro North Health
,
Cooperative Research Centre for Aboriginal & Tropical Health
,
Queensland University of Technology
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Publisher: Elsevier BV
Date: 09-1999
Publisher: University of Illinois Libraries
Date: 22-06-2013
Abstract: Adjectives attend the new: fresh, clean, exciting, dynamic, innovative and productive. Oppositional binaries cling to the old: tired, worn, redundant, sick, slow and useless. While anti-discrimination policies can address these connotations when applied to people, the consequences of such ideologies on ‘old media’ are under-researched. While media and cultural studies departments teach ‘New Media’ courses, ‘Old Media’ courses remain invisible and unpopular. This article extends these adjectives and narratives by following a challenge Bruce Sterling posed to researchers: to understand ‘Dead Media.’ I explore the origins of this term and how and why an interest in Dead Media has – in itself – died.
Publisher: Walter de Gruyter GmbH
Date: 1999
Publisher: Oxford University Press (OUP)
Date: 1995
Publisher: Elsevier BV
Date: 10-2018
Publisher: Springer Science and Business Media LLC
Date: 11-07-2016
DOI: 10.1007/S00455-016-9727-5
Abstract: In this study, we aimed to determine if the use of cervical auscultation (CA) as an adjunct to the clinical feeding evaluation (CFE + CA) improves the reliability of predicting oropharyngeal aspiration (abbreviated to aspiration) in children. The design of the study is based on open label, randomized controlled trial with concealed allocation. Results from children (<18 years) randomized to either CFE or CFE + CA were compared to videofluoroscopic swallow study (VFSS), the reference standard data. Aspiration was defined using the Penetration-Aspiration Scale. All assessments were undertaken at a single tertiary pediatric hospital. 155 children referred for a feeding/swallowing assessment were randomized into the CFE n = 83 [38 males mean age = 34.9 months (SD 34.4)] or CFE + CA n = 72 [43 males mean age = 39.6 months (SD 39.3)] group. kappa statistic, sensitivity, and specificity values, area under receiver operating curve (aROC). No significant differences between groups were found, although CFE + CA (kappa = 0.41, 95 % CI 0.2-0.62) had higher agreement for aspiration detection by VFSS, compared to the clinical feeding exam alone (kappa = 0.31, 95 % CI 0.10-0.52). Sensitivity was 85 % (95 % CI 62.1-96.8) for CFE + CA and 63.6 % (95 % CI 45.1-79.6) for CFE. aROC was not significantly greater for CFE + CA (0.75, 95 % CI 0.65-0.86) than CFE (0.66, 95 % CI 0.55-0.76) across all age groups. Although using CA as an adjunct to the clinical feeding evaluation improves the sensitivity of predicting aspiration in children, it is not sensitive enough as a diagnostic tool in isolation. Given the serious implications of missing the diagnosis of aspiration, instrumental assessments (e.g., VFSS), remain the preferred standard.
Publisher: BMJ
Date: 03-2017
Publisher: Wiley
Date: 21-03-2011
Publisher: University of Illinois Libraries
Date: 05-12-2005
Abstract: The proportion and number of wired seniors is small. A grey gap punctuates in the digital ide. The World Wide Web is not a panacea or salve for the isolation and ageism that confronts senior citizens. Yet a proactive and political desire to wire those who are living, dancing, talking and thinking in God’s Waiting Rooms around the world provide one more safety net and social safeguard to collectivize the dispersed and dispossessed. This article uses quantitative and qualitative studies to investigate how and why older populations dis/connect from the digital environment. Commencing with international surveys monitoring Web users, the study then drills down to regions with a high proportion of older residents, exploring if and then how seniors use the World Wide Web.
Publisher: KOME Journal
Date: 2016
Publisher: Frontiers Media SA
Date: 12-08-2020
Publisher: Informa UK Limited
Date: 26-06-2018
Publisher: JSTOR
Date: 1999
DOI: 10.2307/20637820
Publisher: Faculty of Geography, Bucharest University
Date: 30-11-2015
Publisher: Elsevier BV
Date: 09-2019
Publisher: Informa UK Limited
Date: 11-2006
Publisher: Routledge
Date: 12-10-2012
Publisher: Wiley
Date: 03-2005
DOI: 10.1111/J.1440-1754.2005.00561.X
Abstract: To examine the epidemiology and burden of respiratory illness during winter in urban children from temperate Australia. We conducted a cohort study of healthy Melbourne children, aged from 12 to 71 months. Parents kept a daily respiratory symptom diary and recorded resource use when an influenza-like illness (ILI) occurred. One-hundred and eighteen children had 137 ILI episodes over 12 weeks for a rate of 0.53 ILI episodes per child-month (95% CI 0.44-0.61). Risk factors for ILI included younger age, fewer people residing in the household, structured exposure to other children outside the home, and a higher household income. Episodes had a mean duration of 10.4 days with 64 visits to a general practitioner (46.7 GP visits per 100 episodes), 27 antibiotic courses prescribed (19.7 antibiotic courses per 100 episodes), and three overnight hospitalizations (2.2 admissions per 100 episodes). Parents reported an average of 11.7 h excess time spent caring for a child per episode. Respiratory illnesses are a common and largely neglected cause of illness in Australian children. Pathogen-specific data are required to better assess the likely impact of available and developing vaccines and other treatment options.
Publisher: Wiley
Date: 02-12-2018
DOI: 10.1111/ADJ.12662
Publisher: Springer International Publishing
Date: 13-12-2015
Publisher: Springer Science and Business Media LLC
Date: 14-11-2016
Publisher: Springer Science and Business Media LLC
Date: 14-10-2014
Publisher: Informa UK Limited
Date: 29-09-2016
DOI: 10.1080/17549507.2016.1222452
Abstract: Limited data exist that support the reproducibility of cervical auscultation (CA) use in children. This study aimed to determine the reliability of CA in detecting oropharyngeal aspiration (OPA) in children within a controlled environment. This observational study included eight speech-language pathologists who rated clips of 40 normal and 40 OPA swallowing sounds on two separate occasions (i.e.160 sound clips rated by each speech-language pathologist) to comprise a total of 1280 swallow clips rated. Swallowing sound clips were collected from (1) a volunteer s le of 20 healthy children from the general community (mean 16.2 ± 10.7 months 65% female) (2) a referred s le of 19 children with demonstrated OPA (mean 22.8 ± 25.5 months 36.8% female), as determined on videofluoroscopic swallow studies (VFSS) using the Penetration-Aspiration Scale (PAS) (≥6 score). Inter-rater reliability was very good (kappa =0.81, 95%CI 0.79-0.84). Intra-rater reliability for each rater was good to very good (kappa range 0.72-0.98). Overall sensitivity was 93.9% (95%CI 91.8-95.6) and specificity was 94.5% (95%CI 92.5-96.2). High reliability values were found for the detection of OPA versus normal swallows using CA alone. Future research should investigate the use of CA in a variety of clinical settings with less environmental control before CA can be advocated for use in routine clinical practice.
Publisher: Springer Science and Business Media LLC
Date: 2013
Publisher: Oxford University Press (OUP)
Date: 1994
Publisher: Springer Science and Business Media LLC
Date: 29-04-2015
Publisher: Elsevier BV
Date: 04-2023
Publisher: BMJ
Date: 24-06-2014
Publisher: Oxford University Press (OUP)
Date: 04-2010
DOI: 10.1086/651079
Abstract: Australian Indigenous children are the only population worldwide to receive the 7-valent pneumococcal conjugate vaccine (7vPCV) at 2, 4, and 6 months of age and the 23-valent pneumococcal polysaccharide vaccine (23vPPV) at 18 months of age. We evaluated this program's effectiveness in reducing the risk of hospitalization for acute lower respiratory tract infection (ALRI) in Northern Territory (NT) Indigenous children aged 5-23 months. We conducted a retrospective cohort study involving all NT Indigenous children born from 1 April 2000 through 31 October 2004. Person-time at-risk after 0, 1, 2, and 3 doses of 7vPCV and after 0 and 1 dose of 23vPPV and the number of ALRI following each dose were used to calculate dose-specific rates of ALRI for children 5-23 months of age. Rates were compared using Cox proportional hazards models, with the number of doses of each vaccine serving as time-dependent covariates. There were 5482 children and 8315 child-years at risk, with 2174 episodes of ALRI requiring hospitalization (overall incidence, 261 episodes per 1000 child-years at risk). Elevated risk of ALRI requiring hospitalization was observed after each dose of the 7vPCV vaccine, compared with that for children who received no doses, and an even greater elevation in risk was observed after each dose of the 23vPPV (adjusted hazard ratio [HR] vs no dose, 1.39 95% confidence interval [CI], 1.12-1.71 P=.002). Risk was highest among children vaccinated with the 23vPPV who had received <3 doses of the 7vPCV (adjusted HR, 1.81 95% CI, 1.32-2.48). Our results suggest an increased risk of ALRI requiring hospitalization after pneumococcal vaccination, particularly after receipt of the 23vPPV booster. The use of the 23vPPV booster should be reevaluated.
Publisher: Wiley
Date: 02-11-2018
Publisher: Wiley
Date: 26-04-2021
DOI: 10.1002/PPUL.25424
Abstract: Cough is an important contributor to the health burden of children and their families. There are limited data describing healthcare utilization and medication use over the course of a cough illness beyond the initial presentation. Our primary objective was to describe medication and healthcare use in children with a respiratory illness with cough as a symptom over the course of the illness. A cohort study of children aged less than 15‐years presenting to three primary healthcare centers and three emergency departments with a cough illness between July 7, 2015 and October 6, 2018. Children with immunosuppression, known chronic lung diseases (except asthma) and those requiring hospitalization at screening were excluded. The primary outcomes were cough‐related frequency and type of healthcare seeking and medication use up to 28 days following enrolment. Data for 465 children were analyzed median age 2.2‐years (interquartile range = 1.1–5.3). Cough at Day 28 persisted in 117 children (25.2%). Overall, 436 (94%) children received medications in the week before and/or 4 weeks following enrolment. Half with upper respiratory tract infections were prescribed antibiotics. Among children with no diagnosis of asthma, reactive airways disease or croup ( n = 404), 16.8% were given steroids. Fifty‐eight percent of children sought healthcare at least once before their baseline presentation (median = 1, range = 0–20) and 49.7% had at least one further presentation in the following 28 days. High healthcare utilization, inappropriate medication use, and suboptimal parent knowledge regarding cough suggests targeted education is needed to improve management and reduce cough burden.
Publisher: Australian Government Department of Health
Date: 19-05-2022
Abstract: Background Immunisation timeliness continues to present challenges to achieving optimal vaccine coverage in infancy, particularly in disadvantaged groups and Australian First Nations infants. We aimed to determine whether a tailored, educational SMS reminder improves the timeliness of immunisation in infants up to seven months of age. Methods A pragmatic, three-arm, parallel-group, randomised controlled trial of immunisation reminders was conducted in two First-Nations-specific primary health care centres and two public hospital antenatal clinics in South East Queensland, Australia. Live-born infants of mothers enrolled during pregnancy were randomised at birth and followed to eight months of age. One group received a simple SMS reminder at two weeks before, the week of, and two weeks after the due date for immunisation at two, four and six months of age. The second group received a tailored SMS with an educational message at two weeks before and on the date immunisations were due those not immunised two weeks following the due date were offered support to immunise the baby. Controls received no intervention or contact until the baby turned seven months of age. The primary outcome was the proportion of infants age-appropriately vaccinated at seven months of age as recorded on the Australian Immunisation Register. Secondary outcomes included vaccination status at three and five months of age. Results Between 30 May 2016 and 24 May 2018, one hundred and ninety-six infants (31% First Nations infants) were randomised. At seven months of age, 54/65 (83.1%) infants in the educational SMS ± additional support group (ESMS±S) were age-appropriately immunised, compared to 45/64 (70.3%) in the simple SMS group and 45/67 (67.2%) in controls. Differences were most marked at five months of age: ESMS±S 95.5% simple SMS 73.4% controls 75.8%. The difference between the ESMS±S group and the other two groups at seven months of age was no longer apparent when those who received additional support beyond the SMS were assumed to have not been vaccinated if that support had not been received. Discussion A tailored SMS reminder system using an educational message and with provision of additional support to mothers is more effective in improving immunisation timeliness in infants at three and five months of age than a simple message and no intervention. The additional support was required at seven months of age in order to achieve higher coverage in the ESMS±S group.
Publisher: Springer Science and Business Media LLC
Date: 31-08-2012
Publisher: University of Technology, Sydney (UTS)
Date: 13-09-2013
Abstract: If democratisation in the tertiary sector is to be taken seriously, then we must carefully survey how previously disadvantaged groups are incorporated into higher education. In response to the words of my ex-postgraduate, I sent emailed questions to my six female doctoral students. Their testimony was then labelled ‘A’ through to ‘F’ to connote the seniority of their candidature. I then pleated their answers against DEST surveys of the Australian academy and theoretical/historical approaches to the university’s purpose. Via this approach, the attitudes of my students wedge the page, providing an intervention in the calm facade of DEST documents stressing science, training and vocationalism. We do not hear—let alone read—the experi- ences of postgraduates in sufficient depth. When presented in this way, different approaches to the postgraduate journey are revealed that are distinct from the imperatives of completion rates, supervisory training and professional competencies.
Publisher: Springer Science and Business Media LLC
Date: 11-2009
DOI: 10.1057/PB.2009.22
Publisher: Informa UK Limited
Date: 02-2013
Publisher: BMJ
Date: 08-2020
DOI: 10.1136/BMJGH-2020-002708
Abstract: Healthcare providers in resource-limited settings rely on the presence of tachypnoea and chest indrawing to establish a diagnosis of pneumonia in children. We aimed to determine the test characteristics of commonly assessed signs and symptoms for the radiographic diagnosis of pneumonia in children 0–59 months of age. We conducted an analysis using patient-level pooled data from 41 shared datasets of paediatric pneumonia. We included hospital-based studies in which % of children had chest radiography performed. Primary endpoint pneumonia (presence of dense opacity occupying a portion or entire lobe of the lung or presence of pleural effusion on chest radiograph) was used as the reference criterion radiographic standard. We assessed the sensitivity, specificity, and likelihood ratios for clinical findings, and combinations of findings, for the diagnosis of primary endpoint pneumonia among children 0–59 months of age. Ten studies met inclusion criteria comprising 15 029 children 24.9% (n=3743) had radiographic pneumonia. The presence of age-based tachypnoea demonstrated a sensitivity of 0.92 and a specificity of 0.22 while lower chest indrawing revealed a sensitivity of 0.74 and specificity of 0.15 for the diagnosis of radiographic pneumonia. The sensitivity and specificity for oxygen saturation % was 0.40 and 0.67, respectively, and was 0.17 and 0.88 for oxygen saturation %. Specificity was improved when in idual clinical factors such as tachypnoea, fever and hypoxaemia were combined, however, the sensitivity was lower. No single sign or symptom was strongly associated with radiographic primary end point pneumonia in children. Performance characteristics were improved by combining in idual signs and symptoms.
Publisher: SAGE Publications
Date: 2008
DOI: 10.2304/ELEA.2008.5.3.275
Abstract: The move toward online course facilitation in tertiary education has the intent of providing education at any time in any place to any person. However, the advent of blended learning and e-learning innovations has ostracised, marginalised or ignored those who cannot afford or who are unable to access the latest hardware and software to take advantage of these opportunities. The Web 2.0 age is an era of assumptions: assumptions of participation, literacy and democracy. Yet such inferences are based on the need for high-speed Internet connections, and the latest computers are standard requirements. Those without the ability to access these necessities are being indirectly marginalised by the universities, which is particularly ironic in an era of ‘widening participation’. This article reveals a few tears in the fabric of wiki-enabled democratic education. The authors argue that there is a community of students that are subjected to what Bourdieu termed symbolic violence. Digitisation in tertiary education is reinforcing what it has always been through its history – a haven of the wealthy and the advantaged.
Publisher: Elsevier
Date: 2012
Publisher: Wiley
Date: 08-2018
DOI: 10.1111/JPC.14146
Abstract: In children presenting to an emergency department (ED) with an acute coughing illness, the aims of this study were to: (i) describe the frequency of doctor visits and medication use and (ii) describe management and relate it to current evidence-based guidelines. This was a cross-sectional study in ED of a major teaching hospital (Royal Children's Hospital, Brisbane, Australia). Participants included 537 children (<15 years) presenting with acute (<2 weeks) cough, with a median age of 2.2 years (interquartile range 1.0-4.0) 61.5% were boys. Hospitalised children and those with asthma, pneumonia or chronic illnesses were excluded. Main outcome measures were: (i) frequency of pre-ED doctor visits and medication use and (ii) comparison of management to current evidence-based recommendations related to four discharge diagnoses: bronchiolitis, 'wheeze/reactive airway disease (RAD)', croup and 'non-specific acute respiratory illness'. A total of 300 children (55.9%) had seen a doctor prior to their ED presentation, and use of medications pre-ED was high (53.4%). While 93.4% of children with croup were treated in accordance with guidelines, concordance was lower for children with bronchiolitis or 'wheeze/RAD'. The majority of children with a discharge diagnosis of 'wheeze/RAD' (95.6%) received bronchodilators, and 72.7% also received oral corticosteroids but were not diagnosed with asthma. More than half (55.1%) of the children with non-specific acute respiratory illness received medication(s) either prior to or during their ED presentation. The burden of acute cough-related illnesses in children is high, and there is a need for improved uptake of evidence-based guidelines. In addition, the large number of children diagnosed with 'wheeze/RAD' suggests asthma is likely under-diagnosed in this setting.
Publisher: Routledge
Date: 18-04-2006
Publisher: Springer Science and Business Media LLC
Date: 22-01-2018
DOI: 10.1007/S11136-017-1779-Y
Abstract: Acute respiratory infections (ARIs), and associated symptoms such as cough, are frequently experienced among children and impose a burden on families (e.g., use of medical resources and time off work/school). However, there are little data on changes in, and predictors of, quality of life (QoL) over the duration of an ARI with cough (ARIwC) episode. We therefore aimed to determine cough-specific QoL and identify its influencing factors among children with ARIwC, at the time of presentation to a pediatric emergency department (ED), and over the following 4 weeks. Data from 283 children aged < 15 years were included in our analyses. We used the validated parent-proxy children's acute cough-specific QoL questionnaire (PAC-QoL) at each time-point. Linear regression and mixed effect modeling were used to identify factors influencing QoL at baseline and over the follow-up period. Median PAC-QoL at baseline was 2.7 (IQR 2.1-3.6) and significantly improved by Day-7 (4.9, IQR 3.8-6.1) and Day-14 (6.59, IQR 5.1-7.0), both p < 0.001. The improvements in median PAC-QoL between Days-14, -21, and -28 were not significant. Regression modeling identified that day-cough severity, night-cough severity, and financial concerns had the highest impact on both baseline, and follow-up, PAC-QoL scores. There were five additional independent significant factors at baseline and six at follow-up. Quality of life is considerably impaired at presentation to ED, but improves significantly by Days-7 and -14. As cough severity and financial concerns had the highest impact on QoL, effectively managing cough to reduce the clinical and financial burden on children and families is important.
Publisher: Wiley
Date: 09-2010
DOI: 10.1111/J.1440-1754.2010.01845.X
Abstract: Despite Australia being one of the wealthiest countries of the world, Australian Indigenous children have a health status and social circumstance comparable to developing countries. Indigenous infants have 10 times the mortality rate for respiratory conditions. The lower respiratory infection (LRI) rate in Australian Indigenous children is at least as high as that of children in developing countries the frequency of hospitalisations of Indigenous infants is triple that of non-Indigenous Australian infants (201.7 vs. 62.6/1000, respectively). While Indigenous Australian children have many risk factors for LRIs described in developing countries, there is little specific data, and hence, evidence-based intervention points are yet to be identified. Efficacy of conjugate vaccines for common bacterial causes of pneumonia has been less marked in Indigenous children than that documented overseas. Gaps in the management and prevention of disease are glaring. Given the burden of LRI in Indigenous children and the association with long-term respiratory dysfunction, LRIs should be addressed as a matter of priority.
Publisher: SAGE Publications
Date: 2002
DOI: 10.1177/13678779020050010401
Abstract: This article presents a history of Robbie Williams. However, the meaning of that word — history — does not convey a seamless narrative of linear, normalizing truths of a great man. Instead, the recent past is fractured, severed and then quilted. Four keypads of culture are pressed. First, an exploration of boy bands is enacted, followed by a survey of masculinity theory, Generation X and dance culture. These four snatches of myth and memory are summoned to offer an innovative trajectory through an un(der) written history of the pop present.
Publisher: Springer Science and Business Media LLC
Date: 09-11-2016
DOI: 10.1007/S00455-016-9755-1
Abstract: Limited data on cervical auscultation (CA) sounds during the transitional feeding period of 4-36 months in healthy children exist. This study examined the acoustic and perceptual parameters of swallowing sounds in children aged 4-36 months over a range of food and fluid consistencies. Using CA, swallowing sounds were recorded from a microphone as children ate or drank. Acoustic parameters of duration, peak frequency and peak intensity were determined. Perceptual parameters of swallowing/breath sounds heard pre-, during and post-swallow were rated ('present', 'absent', 'cannot be determined') for each texture. 74 children (35 males mean age = 17.1 months [SD 10.0]) demonstrated mean swallow durations of <1 s. Increasing age correlated to reduced peak frequency on puree (r = -0.48, 95 % CI -0.66, -0.24). Age correlated to peak litude when swallowing puree (r = 0.27, 95 % CI 0.02, 0.49), chewable solids (r = 0.31, 95 % CI 0.02, 0.56) and thin fluids (r = 0.48, 95 % CI 0.27, 0.64). The bolus transit sound was present in all swallows. A majority of children had normal breathing sounds and coordinated swallows. A swallow duration of <1 s and the presence of a quick bolus transit sound with normal breathing sounds were found in healthy children. The normative data reported in this study provide a platform for future comparison to abnormal swallowing sounds in children.
Publisher: OMICS Publishing Group
Date: 11-2014
DOI: 10.4155/CLI.14.103
Publisher: University of Texas at Arlington Libraries
Date: 2013
Publisher: Elsevier BV
Date: 04-2009
DOI: 10.1016/J.VACCINE.2009.02.065
Abstract: Immunogenicity and reactogenicity of DTPa and reduced antigen dTpa booster vaccines were compared to a hepatitis A control vaccine in DTPa-primed toddlers aged 18 - 20 months. Post-booster, all DTPa and dTpa recipients were seroprotected against diphtheria and tetanus, and > or = 93.3% had a booster response to pertussis. There were similar reactogenicity rates in the DTPa and dTpa vaccine recipients. Few Grade 3 symptoms were reported. Just over one in four children in the control group had diphtheria antibody at or potentially below the correlate of protection benchmark (0.016IU/ml). Larger studies should evaluate potential benefits of reduced antigen vaccines and seroprotection in children who do not receive a booster dose of DTPa at this age, including protection against diphtheria until subsequent booster doses are given.
Publisher: Elsevier BV
Date: 12-2009
DOI: 10.1016/J.PCL.2009.09.003
Abstract: Acute lower respiratory infections (ALRI) are the major cause of morbidity and mortality in young children worldwide. ALRIs are important indicators of the health disparities that persist between Indigenous and non-Indigenous children in developed countries. Bronchiolitis and pneumonia account for the majority of the ALRI burden. The epidemiology, diagnosis, and management of these diseases in Indigenous children are discussed. In comparison with non-Indigenous children in developing countries they have higher rates of disease, more complications, and their management is influenced by several unique factors including the epidemiology of disease and, in some remote regions, constraints on hospital referral and access to highly trained staff. The prevention of repeat infections and the early detection and management of chronic lung disease is critical to the long-term respiratory and overall health of these children.
Publisher: Frontiers Media SA
Date: 03-12-2018
Publisher: MDPI AG
Date: 07-12-2021
DOI: 10.3390/JCM10245735
Abstract: We describe the prevalence and risk factors for protracted bacterial bronchitis (PBB) following healthcare presentation for an acute cough illness in children. Data from three studies of the development of chronic cough (CC) in children were combined. PBB was defined as a wet cough of at least 4-weeks duration with no identified specific cause of cough that resolved following 2–4 weeks of appropriate antibiotics. Anterior nasal swabs were tested for 17 viruses and bacteria by polymerase chain reaction. The study included 903 children. Childcare attendance (adjusted relative risk (aRR) = 2.32, 95% CI 1.48–3.63), prior history of chronic cough (aRR = 2.63, 95% CI 1.72–4.01) and age -years ( -months: aRR = 4.31, 95% CI 1.42–13.10 12- months: aRR = 2.00, 95% CI 1.35–2.96) increased risk of PBB. Baseline diagnoses of asthma/reactive airways disease (aRR = 0.30, 95% CI 0.26–0.35) or bronchiolitis (aRR = 0.15, 95% CI 0.06–0.38) decreased risk. M. catarrhalis was the most common organism (52.4%) identified in all children (PBB = 72.1% no PBB = 50.2%, p 0.001). We provide the first data on risks for PBB in children following acute illness and a hypothesis for studies to further investigate the relationship with wheeze-related illnesses. Clinicians and parents/guardians should be aware of these risks and seek early review if a wet cough lasting more than 4-weeks develops the post-acute illness.
Publisher: John Wiley & Sons, Ltd
Date: 08-12-2010
Publisher: Walter de Gruyter GmbH
Date: 2016
Publisher: Wiley
Date: 26-07-2016
DOI: 10.1002/PPUL.23527
Publisher: CSIRO Publishing
Date: 2011
DOI: 10.1071/AH10973
Abstract: Objectives. In Aboriginal and Torres Strait Islander peoples in Queensland, to (a) determine the disease burden of common chronic lung diseases and (b) identify areas of need with respect to lung health services. Methods. Literature reviews and analyses of hospitalisation and mortality data were used to describe disease epidemiology and available programs and services. Key stakeholder interviews and an online survey of health professionals were used to evaluate lung health services across the state and to identify services, needs and gaps. Results. Morbidity and mortality from respiratory diseases in the Indigenous population is substantially higher than the non-Indigenous population across all age groups and regions. There are inadequate clinical services and resources to address disease prevention, detection, intervention and management in an evidence-based and culturally acceptable fashion. There is a lack of culturally appropriate educational resources and management programs, insufficient access to appropriately engaged Indigenous health professionals, a lack of multi-disciplinary specialist outreach teams, fragmented information systems and inadequate coordination of care. Conclusions. Major initiatives are required at all levels of the healthcare system to adequately address service provision for Indigenous Queenslanders with lung diseases, including high quality research to investigate the causes for poor lung health, which are likely to be multifactorial. What is known about the topic? Chronic diseases, including lung disease contribute to, and influence outcomes of, the well-known health and socioeconomic disadvantage among Aboriginal and Torres Strait Islander Australians. Nationwide, the most common reason for hospitalisation of Indigenous Australians is for lung diseases (after renal dialysis). What does this paper add? There is currently no state- or nation-wide comprehensive review of chronic lung disease burden and the health services available to prevent, treat and manage lung disease. This review fills this gap in Queensland and has found that chronic lung disease burden is not homogenous. There are substantial gaps in, and barriers to, the provision of high quality, evidence based services and a paucity of well-designed research to inform policy and health service delivery. What are the implications for practitioners? Evidence-based strategies are needed at the primary, secondary and tertiary levels of the healthcare system. Fourteen recommendations relevant to practitioners and policy makers were formulated.
Publisher: Springer Science and Business Media LLC
Date: 11-04-2022
DOI: 10.1186/S13063-022-06256-2
Abstract: Globally, bronchiectasis (BE) unrelated to cystic fibrosis (CF) is recognized as a major cause of respiratory morbidity, mortality, and healthcare utilization. Children with BE regularly experience exacerbations of their condition resulting in frequent hospitalizations and decreased health-related quality of life (HR-QoL). Guidelines for the treatment and management of BE call for regular exercise as a means of improving aerobic fitness and HR-QoL. Moreover, research in adults with BE has shown that exercise can reduce the frequency of exacerbations, a potent predictor of future lung function decline and respiratory morbidity. Yet, to date, the health benefits resulting from therapeutic exercise have not been investigated in children with BE. The BREATH, Bronchiectasis - Exercise as Therapy, trial will test the efficacy of a novel 8-week, play-based therapeutic exercise program to reduce the frequency of acute exacerbations over 12 months in children with BE (aged ≥ 4 and 13 years). Secondary aims are to determine the cost-effectiveness of the intervention and assess the program’s impact on aerobic fitness, fundamental movement skill (FMS) proficiency, habitual physical activity, HR-QoL, and lung function. This multi-center, observer-blinded, parallel-group (1:1 allocation), randomized controlled trial (RCT) will be conducted at three sites. One hundred and seventy-four children ≥ 4 and 13 years of age with BE will be randomized to a developmentally appropriate, play-based therapeutic exercise program (eight, 60-min weekly sessions, supplemented by a home-based program) or usual care. After completing the baseline assessments, the number of exacerbations and secondary outcomes will be assessed immediately post-intervention, after 6 months of follow-up, and after 12 months of follow-up. Monthly, parental contact and medical review will document acute respiratory exacerbations and parameters for cost-effectiveness outcomes. The BREATH trial is the first fully powered RCT to test the effects of a therapeutic exercise on exacerbation frequency, fitness, movement competence, and HR-QoL in children with bronchiectasis. By implementing a developmentally appropriate, play-based exercise program tailored to the in idual needs of children with bronchiectasis, the results have the potential for a major paradigm shift in the way in which therapeutic exercise is prescribed and implemented in children with chronic respiratory conditions. The exercise program can be readily translated. It does not require expensive equipment and can be delivered in a variety of settings, including the participant’s home. The program has strong potential for translation to other pediatric patient groups with similar needs for exercise therapy, including those with obesity, childhood cancers, and neurological conditions such as cerebral palsy. Australian and New Zealand Clinical Trials Register (ANZCTR) ACTRN12619001008112
Publisher: Cambridge University Press (CUP)
Date: 06-2000
DOI: 10.1017/S0950268801005568
Abstract: Acute poststreptococcal glomerulonephritis (APSGN) is an inflammatory kidney condition that can complicate Group A streptococcal infections. Two clusters of APSGN occurred recently in New South Wales (NSW), Australia one in a rural town in December 1999 and the other in a Sydney suburb in January 2000. We interviewed carers of the affected children but found no common exposures except three of the Sydney cases were cousins in frequent contact. To assess the probability of these clusters occurring, we analysed hospital admissions for acute glomerulonephritis, as a proxy for APSGN in younger patients. The incidence of acute glomerulonephritis in NSW during 1989/90–1997/8 in residents aged under 20 years was 2·2/100000/year (95% CI 2·0–2·5). Incidence was highest in children aged 5–9 years, boys and Aboriginal children. We found no evidence for other clusters during that period. The recent clusters highlight the continued potential for unexpected future outbreaks of APSGN.
Publisher: Informa UK Limited
Date: 02-2005
Publisher: Elsevier BV
Date: 10-2021
Publisher: Elsevier BV
Date: 10-2021
Publisher: Walter de Gruyter GmbH
Date: 22-01-2006
Publisher: Springer Science and Business Media LLC
Date: 18-02-2019
Publisher: SAGE Publications
Date: 03-2005
Abstract: Cultural studies theorists have neglected two topics: the changes to the workplace and innovations in comedy. This article reconnects cultural studies with both work and comedy through attention to one of the finest British satires ever made: The Office. I track this programme by situating it in the three intertwined ‘crises’ of our era: in television, work and masculinity.
Publisher: Springer Science and Business Media LLC
Date: 03-02-2020
DOI: 10.1186/S12903-020-1024-X
Abstract: Many factors influence how a person experiences oral health and how such experiences may facilitate supportive oral health behaviours. Women in particular face different challenges due to their environment, responsibilities and physiological differences to men. Within Australia, Aboriginal and Torres Strait Islander women are reported to have poorer oral health and are faced with additional barriers to supporting their oral health compared with non-Indigenous women. The objective of this paper is to report the experiences and perceptions of oral health from the perspective of urban, Aboriginal and Torres Strait Islander women. The present data derive from a descriptive study that used yarning circles and face-to-face interviews with women who were mothers/carers of urban, Aboriginal and/or Torres Strait Islander children. This was a qualitative study to investigate the impact of child oral health on families. Participants used the opportunity to share their own personal experiences of oral health as women, thus providing data for the present analyses. Information collected was transcribed and analysed thematically. Twenty women shared their personal narratives on the topic of oral health which were reflective of different time points in their life: growing up, as an adult and as a mother/carer. Although women are trying to support their oral health across their life-course, they face a number of barriers, including a lack of information and the costs of accessing dental care. The teenage years and pregnancy were reported as important time periods for oral health support. To improve the oral health of Indigenous Australian women, policymakers must consider the barriers reported by women and critically review current oral health information and services. Current oral health services are financially out of reach for Indigenous Australian women and there is not sufficient or appropriate, oral information across the life-course.
Publisher: Wiley
Date: 10-2000
DOI: 10.1046/J.1365-3156.2000.00622.X
Abstract: To determine whether the seroprevalence of antibodies to varicella zoster virus (VZV) in adults is similar to that reported in tropical populations elsewhere. We measured the seroprevalence of VZV IgG antibodies, using an enzyme immunoassay (EIA) in women attending an antenatal clinic in an urban centre in tropical Australia. The overall seroprevalence of VZV antibodies in 298 women was 92% (95% CI 88-95), with no difference between women who spent their childhoods in the tropics and colleagues. None of the overseas-born women was seronegative. The seroprevalence of VZV antibodies in this tropical population in Australia is as high as that reported from temperate regions, suggesting that social and cultural factors and population mobility are more important determinants of age distribution of VZV immunity than tropical climate.
Publisher: International Global Health Society
Date: 09-10-2021
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/AH13136
Abstract: Objective Respiratory diseases are a leading cause of morbidity and mortality in Indigenous Australians. However, there are limited approaches to specialist respiratory care in rural and remote communities that are culturally appropriate. A specialist Indigenous Respiratory Outreach Care (IROC) program, developed to address this gap, is described. Methods The aim of the present study was to implement, pilot and evaluate multidisciplinary specialist respiratory outreach medical teams in rural and remote Indigenous communities in Queensland, Australia. Sites were identified based on a perception of unmet need, burden of respiratory disease and/or capacity to use the clinical service and capacity building for support offered. Results IROC commenced in March 2011 and, to date, has been implemented in 13 communities servicing a population of approximately 43 000 Indigenous people. Clinical service delivery has been possible through community engagement and capacity building initiatives directed by community protocols. Conclusion IROC is a culturally sensitive and sustainable model for adult and paediatric specialist outreach respiratory services that may be transferrable to Indigenous communities across Queensland and Australia. What is known about this topic? The high rates of respiratory illnesses in Australian Indigenous children have been poorly explored. There is a dearth of research quantifying and qualifying risk from birth and throughout early childhood, and there are virtually no evidence-based evaluations of interventions to prevent and manage disease. Despite data suggesting an excess burden of disease, there has been little attention paid to respiratory health in this population. The limited research that has been done highlights that a ‘one size fits all’ model will not be effective in all communities, and that health service must meet the needs of communities, be culturally appropriate and be accessible to Aboriginal people for it to be effective and sustainable. The ‘common theme’ is that although health services are improving, service delivery needs to adapt to meet the needs of communities this is not happening quickly enough for many Aboriginal people. What does this paper add? This paper highlights the importance of working with communities in the development and delivery of a culturally appropriate and accessible specialist respiratory service. In addition, this paper acknowledges the importance of recruiting Indigenous staff in the implementation, engagement and delivery of the project. What are the implications for clinicians? This paper provides an outline on how best to deliver a culturally appropriate respiratory outreach service and the role of clinicians, communities and Indigenous staff. This model supports the view that Aboriginal people must be a part of service delivery that is aligned to the ‘holistic concept of health’ for Aboriginal people, thus providing a culturally appropriate service that meets their needs and addresses the health continuum from within culture and community.
Publisher: University of Technology, Sydney (UTS)
Date: 27-08-2013
Abstract: A review of Ros Jennings and Abigail Gardner (eds), ‘Rock on’: Women, Ageing and Popular Music (Ashgate, 2012) and Andy Bennett and Paul Hodkinson (eds), Ageing and Youth Cultures: Music, Style and Identity (Berg, 2012).
Publisher: Walter de Gruyter GmbH
Date: 2002
DOI: 10.1515/LIBR.2002.28
Publisher: Informa UK Limited
Date: 12-1999
Publisher: Informa UK Limited
Date: 03-2006
Publisher: Ishik University
Date: 2017
Publisher: Chandos Publishing
Date: 2012
Publisher: WHO Press
Date: 02-2010
Publisher: Intellect
Date: 09-2009
Abstract: This paper probes a moment in the history of Media Studies education. My study enters iTunes U to explore how teaching, learning and scholarship are defined and operate in this environment. Podcasting is neither celebrated nor vilified, but situated within a much longer history of sound in education. Instead of positioning the iPod as a rupture in music, commerce and downloading practices thereby triggering the historical redundancy of analogue sound this platform becomes an opportunity to reconfigure the function of sound in media education. The interest remains, not Media Studies 2.0 or 1.0, but media literacy. Such a phrase and study does not require a designation or an imperative for platform migration. The development of media literacy remains contiguous, gradual, considered, contemporary, passionate and planned.
Publisher: Wiley
Date: 26-11-2018
DOI: 10.1111/RESP.13446
Abstract: Bronchiectasis has received increased attention recently, including an emphasis on preventing infective exacerbations that are associated with disease progression and lung function decline. While there are several bacteria and viruses associated with bronchiectasis, licensed vaccines are only currently available for Streptococcus pneumoniae, Haemophilus influenzae (H. influenzae protein D as a conjugate in a pneumococcal vaccine), Mycobacterium tuberculosis, Bordetella pertussis and influenza virus. The evidence for the efficacy and effectiveness of these vaccines in both preventing and managing bronchiectasis in children and adults is limited with the focus of most research being on other chronic lung disorders, such as chronic obstructive pulmonary diseases, asthma and cystic fibrosis. We review the existing evidence for these vaccines in bronchiectasis and highlight the existing gaps in knowledge. High-quality experimental and non-experimental studies using current state-of-the-art microbiological methods and validated, standardised case definitions are needed across the depth and breadth of the vaccine development pathway.
Publisher: Elsevier
Date: 2008
Publisher: Wiley
Date: 11-08-2016
Publisher: SAGE Publications
Date: 2011
DOI: 10.2304/ELEA.2011.8.4.296
Abstract: This is an article of activism, application and intervention. It offers new models and modes of teaching and learning by aligning information literacy, media literacy and multiliteracy. The priority is on learning outcomes rather than technological choices, and social justice rather than transferable skills. These are not – obviously – ‘either/or’ categories, but the author wishes to shift thinking to demonstrate the ersity of assessment options that can activate the insights and innovations of literacy theory. The aim is to show, through ex les and applications in university assessment, how students can move from everyday competencies and skill development and into disciplinary and transdisciplinary scholarship. With public funding under threat, the time for ‘easy’ technological solutions to complicated problems in widening participation agendas requires renewed commitment to literacy, professional development and academic expertise.
Publisher: Springer Netherlands
Date: 03-08-2013
Publisher: Frontiers Media SA
Date: 05-10-2022
Abstract: Current bronchiectasis management guidelines recommend regular physical activity but a large proportion of children with bronchiectasis do not meet public health recommendations which call for 60 min or more of moderate-to-vigorous intensity physical activity daily. Knowing the factors that influence physical activity in children with bronchiectasis is necessary for the development of effective interventions to increase physical activity in this patient group. The objective of this study was to identify facilitators and barriers to physical activity in children with bronchiectasis unrelated to cystic fibrosis (CF) from the perspectives of children and their parents. This was a qualitative study informed by the theoretical domains framework (TDF). Children aged 7–15 years (8.8 years, 8.4–11.0) (median, interquartile range) and parents (45.8 years, 39.7–48.3) completed separate, semi-structured interviews ( n = 21). Recordings were transcribed verbatim, and barriers and facilitators related to each TDF domain deductively coded. Emergent themes were inductively derived via consensus moderation. From the perspectives of children, fun with friends, organized sport and activities, and family co-participation in physical activity emerged as facilitators. Inability to keep up with their peers and time on technology emerged as barriers. From the perspectives of parents, instrumental and logistic support for physical activity and supportive social and physical activity environments emerged as facilitators, while management of symptoms associated with bronchiectasis emerged as a barrier. Programs to increase physical activity in children with bronchiectasis should be fun, accessible, provide opportunities for social interaction and address barriers related to exercise tolerance, perceived competence, and presence of respiratory symptoms.
Publisher: Springer Science and Business Media LLC
Date: 2013
Publisher: Oxford University Press (OUP)
Date: 1996
Publisher: Frontiers Media SA
Date: 24-03-2017
Publisher: Faculty of Geography, Bucharest University
Date: 30-11-2017
Publisher: Informa UK Limited
Date: 04-1997
Publisher: Public Library of Science (PLoS)
Date: 10-04-2018
Publisher: Springer International Publishing
Date: 13-12-2015
Publisher: University of Illinois Libraries
Date: 04-06-2001
DOI: 10.5210/FM.V6I6.867
Publisher: Informa UK Limited
Date: 2006
Publisher: Elsevier BV
Date: 04-1999
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.VACCINE.2017.01.075
Abstract: In Australia, influenza vaccination is recommended for all women who will be pregnant during the influenza season. Vaccine safety and effectiveness are key concerns and influencers of uptake for both vaccine providers and families. We assessed the safety of receiving an influenza vaccination during any trimester of pregnancy with respect to preterm births and infant birthweight. We conducted a nested retrospective cohort study of 'FluMum' participants (2012-2014). Our primary exposure of interest was influenza vaccination during pregnancy. The primary outcomes of interest were infant birthweight and weeks' gestation at birth for live singleton infants. Analyses included comparisons of these birth outcomes by vaccination status and trimester of pregnancy an influenza vaccine was given. We calculated means, proportions, and relative risks and performed multivariable logistic regression for potential confounding factors. In the 7126 mother-infant pairs enrolled in this study, mean maternal age at infant birth was 31.7years. Influenza vaccine uptake in pregnancy was 34%. Most mothers with a known date of vaccination received a vaccine in the second trimester (51%). Those mothers with a co-morbidity or risk factor were 13% more likely to have influenza vaccine during pregnancy compared to other mothers (RR 1.13, 95% CI 1.04-1.24, p=0.007). Mean weeks' gestation at birth was 38.7 for the vaccinated and 38.8 for the unvaccinated group (p=0.051). Infants in the vaccinated group weighed 15g less in birthweight compared to the unvaccinated infants (95% CI -12.8 to 42.2, p=0.29). Results arising from this large Australian cohort study are reassuring with respect to two critical safety outcomes preterm births and low infant birthweights. Studies examining a broader range of birth outcomes following influenza vaccination during pregnancy are required, particularly now that maternal vaccination in pregnancy has expanded to include pertussis as well as influenza.
Publisher: Frontiers Media SA
Date: 13-02-2015
Publisher: Springer Science and Business Media LLC
Date: 2013
Publisher: Elsevier
Date: 2012
Publisher: Faculty of Geography, Bucharest University
Date: 30-11-2014
Publisher: Springer Science and Business Media LLC
Date: 13-08-2019
Publisher: Springer Science and Business Media LLC
Date: 06-05-2020
DOI: 10.1007/S11482-020-09840-3
Abstract: Health-related quality of life (HR-QoL) is a valued patient-related outcome measure. HR-QoL is typically measured using a psychometric tool. Although there are a number of general and illness-specific HR-QoL measurement tools available globally, no tool has been validated for Australian Aboriginal and/or Torres Strait Islander children. The purpose of this study was to gather Australian Aboriginal and Torres Strait Islander parent/carer perspectives of HR-QoL in children in order to inform the development of a culturally appropriate tool. Yarning circles and face to face interviews were used to document the experiences of parents and carers of Aboriginal and Torres Strait Islander children who had experienced a chronic illness. Participants were recruited through word of mouth and via established social and professional networks in Queensland and the Northern Territory of Australia. Information collected was transcribed and analysed thematically and placed into a concept map. HR-QoL was defined as more than just physical, social and psychological wellbeing. Family and social support were valued aspects of HR-QoL, as was knowledge, communication and the relationship with the health system. Participants described the importance of being heard their voice trusted and valued by health practitioners. Racism and prejudicial behaviour had negative impacts on HR-QoL. The concepts of HR-QoL identified in this study are not included in conventional HR-QoL measurement tools. Consideration should be given to concepts proposed by Australian Aboriginal and Torres Strait Islander populations in order to adequately capture perceived HR-QoL.
Publisher: Elsevier BV
Date: 12-2019
Publisher: University of Texas at Arlington Libraries
Date: 2012
Publisher: Frontiers Media SA
Date: 31-10-2017
Publisher: Springer International Publishing
Date: 13-12-2015
Publisher: Informa UK Limited
Date: 03-07-2014
Publisher: Springer Science and Business Media LLC
Date: 15-08-2013
Abstract: Acute respiratory illness, a leading cause of cough in children, accounts for a substantial proportion of childhood morbidity and mortality worldwide. In some children acute cough progresses to chronic cough ( weeks duration), impacting on morbidity and decreasing quality of life. Despite the importance of chronic cough as a cause of substantial childhood morbidity and associated economic, family and social costs, data on the prevalence, predictors, aetiology and natural history of the symptom are scarce. This study aims to comprehensively describe the epidemiology, aetiology and outcomes of cough during and after acute respiratory illness in children presenting to a tertiary paediatric emergency department. A prospective cohort study of children aged years attending the Royal Children’s Hospital Emergency Department, Brisbane, for a respiratory illness that includes parent reported cough (wet or dry) as a symptom. The primary objective is to determine the prevalence and predictors of chronic cough (≥4 weeks duration) post presentation with acute respiratory illness. Demographic, epidemiological, risk factor, microbiological and clinical data are completed at enrolment. Subjects complete daily cough dairies and weekly follow-up contacts for 28(±3) days to ascertain cough persistence. Children who continue to cough for 28 days post enrolment are referred to a paediatric respiratory physician for review. Primary analysis will be the proportion of children with persistent cough at day 28(±3). Multivariate analyses will be performed to evaluate variables independently associated with chronic cough at day 28(±3). Our protocol will be the first to comprehensively describe the natural history, epidemiology, aetiology and outcomes of cough during and after acute respiratory illness in children. The results will contribute to studies leading to the development of evidence-based clinical guidelines to improve the early detection and management of chronic cough in children during and after acute respiratory illness.
Publisher: Springer Science and Business Media LLC
Date: 14-05-2015
Publisher: Elsevier BV
Date: 2009
DOI: 10.1016/J.VACCINE.2008.09.096
Abstract: Childhood immunisation coverage reported at 12 to <15 months and 2 years of age, may mask deficiencies in the timeliness of vaccines designed to protect against diseases in infancy. This study aimed to evaluate immunisation timeliness in Indigenous infants in the Northern Territory, Australia. Coverage was analysed at the date children turned 7, 13 and 18 months of age. By 7 months of age, 45.2% of children had completed the recommended schedule, increasing to 49.5% and 81.2% at 13 and 18 months of age, respectively. Immunisation performance benchmarks must focus on improving the timeliness in these children in the first year of life.
Publisher: BMJ
Date: 08-2021
DOI: 10.1136/BMJOPEN-2020-046007
Abstract: Within Australia, Aboriginal and Torres Strait Islander (First Nations) populations perceive health and well-being differently to non-Indigenous Australians. Existing health-related quality of life (HR-QoL) measurement tools do not account for these differences. The objective of this study was to develop and validate a culturally specific parent-proxy HR-QoL measurement tool for First Nations children. Scale development was informed by parents/carers of children with a chronic illness and an expert panel. The preliminary 39-item survey was reviewed (n=12) and tested (n=163) with parents/carers of First Nations children aged 0–12 years at baseline with comparative scales: the Kessler Psychological Distress Scale, generic HR-QoL (Paediatric QoL Inventory 4.0, PedsQL 4.0 ) and Spence Children’s Anxiety Scale, and repeated (n=46) 4 weeks later. Exploratory Factor Analysis was used for scale reduction. Reliability and validity were assessed by internal consistency, test–retest, and correlations with comparison scales. Items within our First Nations-Child Quality of Life (FirstNations-CQoL) were internally consistent with Cronbach’s alpha coefficients of ≥0.7 (quality of life, 0.808 patient experience, 0.880 patient support, 0.768) and overall test–retest reliability was good (r=0.75 95% CI 0.593 to 0.856). Convergent validity was observed with the PedsQL 4.0 with Pearson’s coefficients of r=0.681 (ages 2–4 years) r=0.651 (ages 5–12 years) and with the Kessler Psychological Distress scale (r=−0.513). Divergent validity against the Spence Anxiety Scale was not demonstrated. The FirstNations-CQoL scale was accepted by the participants, reliable and demonstrated convergent validity with comparison measures. This tool requires further evaluation to determine responsiveness, its minimal important difference and clinical utility.
Publisher: SAGE Publications
Date: 10-2016
Abstract: Cervical auscultation (CA) may be used to complement feeding/swallowing evaluations when assessing for aspiration. There are no published pediatric studies that compare the properties of sounds between aspirating and nonaspirating swallows. To establish acoustic and perceptual profiles of aspirating and nonaspirating swallow sounds and determine if a difference exists between these 2 swallowing types. Aspiration sound clips were obtained from recordings using CA simultaneously undertaken with videofluoroscopic swallow study. Aspiration was determined using the Penetration-Aspiration Scale. The presence of perceptual swallow/breath parameters was rated by 2 speech pathologists who were blinded to the type of swallow. Acoustic data between groups were compared using Mann Whitney U-tests, while perceptual differences were determined by a test of 2 proportions. Combinations of perceptual parameters of 50 swallows (27 aspiration, 23 no aspiration) from 47 children (57% male) were statistically analyzed using area under a receiver operating characteristic (aROC), sensitivity, specificity, and positive and negative predictive values to determine predictors of aspirating swallows. The combination of post-swallow presence of wet breathing and wheeze and absence of GRS and normal breathing was the best predictor of aspiration (aROC = 0.82, 95% CI, 0.70-0.94). There were no significant differences between these 2 swallow types for peak frequency, duration, and peak litude. Our pilot study has shown that certain characteristics of swallow obtained using CA may be useful in the prediction of aspiration. However, further research comparing the acoustic swallowing sound profiles of normal children to children with dysphagia (who are aspirating) on a larger scale is required.
Publisher: BMJ
Date: 16-08-2017
DOI: 10.1136/ARCHDISCHILD-2017-312848
Abstract: Data on the aetiology of persistent cough at the transitional stage from subacute to chronic cough (>4 weeks duration) are scarce. We aimed to (1) identify the prevalence of chronic cough following acute respiratory illness (ARI) and (2) determine the diagnostic outcomes of children with chronic cough. Prospective cohort study. A paediatric emergency department (ED) in Brisbane, Australia. Children aged <15 years presenting with an ARI with cough. Children were followed weekly for 28 days those with a persistent cough at day 28 were reviewed by a paediatric pulmonologist. Cough persistence at day 28 and pulmonologist diagnosis. 2586 children were screened and 776 (30%) were ineligible 839 children (median age=2.3 years, range=0.5 months to 14.7 years, 60% male) were enrolled over 2 years. Most children (n=627, 74.8%) had cough duration of <7 days at enrolment. At day 28, 171/839 (20.4%, 95% CI 17.7 to 23.1) children had persistent cough irrespective of cough duration at enrolment. The cough was wet in 59/171 (34.5%), dry in 45/171 (26.4%) and variable in 28/171 (16.1%). Of these 117 children , 117 (68.4%) were reviewed by a paediatric pulmonologist. A new and serious chronic lung disease was diagnosed in 36/117 (30.8%) children 55/117 (47.0%) were diagnosed with protracted bacterial bronchitis. When chronic cough develops post-ARI, clinical review is warranted, particularly if parents report a history of prolonged or recurrent cough. Parents of children presenting acutely to ED with cough should be counselled about the development of chronic cough, as an underlying respiratory condition is not uncommon.
Publisher: Wiley
Date: 24-04-2017
DOI: 10.1111/JPC.13536
Abstract: There are no published data on factors impacting on acute respiratory illness (ARI) among urban Indigenous children. We describe the characteristics and respiratory risk profile of young urban Indigenous children attending an Aboriginal-friendly primary health-care practice. We conducted a cross-sectional analysis of data collected at baseline in a cohort study investigating ARI in urban Indigenous children aged less than 5 years registered with an Aboriginal primary health-care service. Descriptive analyses of epidemiological, clinical, environmental and cultural factors were performed. Logistic regression was undertaken to examine associations between child characteristics and the presence of ARI at baseline. Between February 2013 and October 2015, 180 Indigenous children were enrolled the median age was 18.4 months (7.7-35), 51% were male. A total of 40 (22%) children presented for a cough-related illness however, ARI was identified in 33% of all children at the time of enrolment. A total of 72% of children were exposed to environmental tobacco smoke. ARI at baseline was associated with low birthweight (adjusted odds ratio (aOR) 2.54, 95% confidence interval (CI) 1.08-5.94), a history of eczema (aOR 2.67, 95% CI 1.00-7.15) and either having a family member from the Stolen Generation (aOR 3.47, 95% CI 1.33-9.03) or not knowing this family history (aOR 3.35, 95% CI 1.21-9.26). We identified an urban community of children of high socio-economic disadvantage and who have excessive exposure to environmental tobacco smoke. Connection to the Stolen Generation or not knowing the family history may be directly impacting on child health in this community. Further research is needed to understand the relationship between cultural factors and ARI.
Publisher: Wiley
Date: 13-09-2011
DOI: 10.1002/PPUL.21551
Abstract: A reliable standardized diagnosis of pneumonia in children has long been difficult to achieve. Clinical and radiological criteria have been developed by the World Health Organization (WHO), however, their generalizability to different populations is uncertain. We evaluated WHO defined chest radiograph (CXRs) confirmed alveolar pneumonia in the clinical context in Central Australian Aboriginal children, a high risk population, hospitalized with acute lower respiratory illness (ALRI). CXRs in children (aged 1-60 months) hospitalized and treated with intravenous antibiotics for ALRI and enrolled in a randomized controlled trial (RCT) of Vitamin A/Zinc supplementation were matched with data collected during a population-based study of WHO-defined primary endpoint pneumonia (WHO-EPC). These CXRs were reread by a pediatric pulmonologist (PP) and classified as pneumonia-PP when alveolar changes were present. Sensitivities, specificities, positive and negative predictive values (PPV, NPV) for clinical presentations were compared between WHO-EPC and pneumonia-PP. Of the 147 episodes of hospitalized ALRI, WHO-EPC was significantly less commonly diagnosed in 40 (27.2%) compared to pneumonia-PP (difference 20.4%, 95% CI 9.6-31.2, P < 0.001). Clinical signs on admission were poor predictors for both pneumonia-PP and WHO-EPC the sensitivities of clinical signs ranged from a high of 45% for tachypnea to 5% for fever + tachypnea + chest-indrawing. The PPV range was 40-20%, respectively. Higher PPVs were observed against the pediatric pulmonologist's diagnosis compared to WHO-EPC. WHO-EPC underestimates alveolar consolidation in a clinical context. Its use in clinical practice or in research designed to inform clinical management in this population should be avoided.
Publisher: Wiley
Date: 17-01-2018
DOI: 10.1111/JPC.13812
Abstract: The majority of Australia's Aboriginal and/or Torres Strait Islander children live in urban areas however, little is known about their health service use. We aimed to describe health service utilisation amongst a cohort of urban Aboriginal and/or Torres Strait Islander children aged <5 years. We analysed health service utilisation data collected in an ongoing prospective cohort study of children aged <5 years registered with an Aboriginal-owned and operated primary health-care service. Enrolled children were followed monthly for 12 months, with data on health service utilisation collected at baseline and at each monthly follow-up. Health service utilisation rates, overall and by service provider and reason for presentation, were calculated and reported as incidence rates per 100 child-months with the corresponding 95% confidence intervals (CIs). Between February 2013 and November 2015, 180 children were enrolled, and 1541 child-months of observation were available for analysis. The overall incidence of health service utilisation was 52.5 per 100 child-months (95% CI 48.7-56.5) 81% of encounters were with general practitioners. Presentation rates were the highest for acute respiratory illnesses (30.7/100 child-months, 95% CI 27.8-33.9). In this community, acute respiratory illnesses are predominant causes of health service utilisation in young children. The health-care utilisation profile of these children presents important opportunities for health promotion and intervention.
Publisher: Informa UK Limited
Date: 02-12-2013
DOI: 10.1586/17476348.2014.852960
Abstract: Acute exacerbations of chronic lung disease are usually associated with viral and bacterial pathogens. They contribute to declining lung function, poor quality of life and exert an excess burden on in iduals, families, communities and the healthcare sector. Hence, preventing exacerbations is important in clinical management. Several vaccines providing protection against respiratory pathogens (Streptococcus pneumoniae, Bordetella pertussis and influenza) that can trigger exacerbations are available, but evidence to support their effectiveness in preventing exacerbations of chronic lung disease is limited. Candidate vaccines in pre-clinical or clinical development phases include those targeting Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, Pseudomonas aeruginosa, respiratory syncytial virus and human rhinoviruses. However, it is likely to be several years before vaccines against these pathogens are available for children and adults with chronic lung diseases. For vaccination to play an important role in managing chronic lung disease efforts need to be directed at understanding how various pathogens cause exacerbations and alter long-term lung function.
Publisher: Elsevier BV
Date: 06-2016
Publisher: Informa UK Limited
Date: 1997
Publisher: Springer Science and Business Media LLC
Date: 04-04-2017
Publisher: Springer Science and Business Media LLC
Date: 14-11-2013
Publisher: Elsevier
Date: 2012
Location: Australia
No related grants have been discovered for Kerry-Ann O'Grady.