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1.
Rural Remote Health ; 22(1): 6930, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35130708

RESUMO

INTRODUCTION: Access to healthcare services should be equitable no matter where you live. However, the podiatry needs of rural populations are poorly addressed, partly because of workforce maldistribution. Encouraging emerging podiatrists to work in rural areas is a key solution. The aims were to explore (1) recently graduated podiatrists' perceptions regarding working rurally and (2) broader industry views of the factors likely to be successful for rural recruitment and retention. METHODS: Recruitment for interviews pertaining to podiatrist recruitment and retention was conducted during 2017. Recruitment was through social media, podiatry professional association newsletters, public health podiatry emails. Graduate perceptions were explored via two focus groups of Australian podiatrists enrolled in the Podiatrists in Australia: Investigating Graduate Employment longitudinal survey. Industry views were explored through semistructured interviews with podiatry profession stakeholders. Inductive thematic analysis was used to analyse data about the perceptions of recently graduated podiatrists and stakeholders and the themes were triangulated between the two groups. RESULTS: Overall, 11 recent graduate podiatrists and 15 stakeholders participated. The overarching themes among the two groups were the importance of 'growing me' and 'growing the profession'. Three superordinate themes were generated through analysis of both datasets, including (i) building a career, (ii) why I stay, and (iii) it cannot be done alone. CONCLUSION: This study identified that recently graduated podiatrists are likely to be attracted to rural work and retained in rural areas if they foresee opportunities for career progression in stable jobs, have a background of training and living in rural areas, like the lifestyle, and are able to access appropriate professional and personal supports. Building employment that spans public and private sector opportunities might be attractive to new graduate podiatrists seeking a breadth of career options. It is also important to recognise rural generalist podiatrists for any extended scope of services they provide along with raising public awareness of the role of rural podiatrist as a core part of multidisciplinary rural healthcare teams. Future training and workforce planning in podiatry must promote podiatrists taking up rural training and work so that maldistribution is reduced.


Assuntos
Podiatria , Serviços de Saúde Rural , Pessoal Técnico de Saúde , Austrália , Humanos , Pesquisa Qualitativa , População Rural
2.
Aust J Gen Pract ; 51(5): 367-371, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35491463

RESUMO

BACKGROUND AND OBJECTIVES: Refugee women exhibit some of the highest rates of chronic pain, but the relationship between chronic pain and refugee-related challenges arising from migration trajectories remains unclear. This article outlines the study protocol for a secondary analysis that seeks to identify pre- and post-migration factors associated with chronic pain and long-term disability in refugee women five years into resettlement in Australia. This study will examine the association between migration factors and chronic pain in refugee women five years into resettlement in Australia. METHOD: This protocol design uses data from Building a New Life in Australia, a prospective longitudinal cohort study. The primary outcome is chronic pain in refugee women resettled in Australia. The variables of interest are pre- and post-migration factors, which have been categorised using a model adapted from a conceptual framework of social determinants of health. A two-step process of univariate and multivariate logistic regression analysis will be used to examine associations. A subset analysis of factors associated with chronic pain in women who report a long-term disability will also be investigated DISCUSSION: Outcomes of this research will inform existing resettlement services to promote or improve chronic pain management for refugee women.


Assuntos
Dor Crônica , Refugiados , Austrália/epidemiologia , Dor Crônica/etiologia , Feminino , Humanos , Estudos Longitudinais , Estudos Prospectivos
3.
Aust J Gen Pract ; 51(5): 373-379, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35491464

RESUMO

BACKGROUND AND OBJECTIVES: General practitioners (GPs) are often the first source of vaccine information for expectant parents. A multicomponent intervention package (P3-MumBubVax) has been designed for midwives, but interventions to support GPs' vaccine discussions are limited. This qualitative study explored Australian GPs' attitudes, practices and educational needs to inform adaptation of the P3-MumBubVax intervention for primary care. METHOD: Semi-structured interviews with 30 GPs explored attitudes towards recommending maternal vaccines, vaccine communication approaches and training preferences. Data were analysed using thematic template analysis. RESULTS: Vaccination was central to the role of GPs and most felt confident discussing vaccines. GPs had opportunities to discuss maternal vaccines before and during pregnancy using a variety of communication techniques. GPs preferred convenient, interactive training with examples and up-to-date maternal vaccine resources. DISCUSSION: Findings informed adaptation of the P3-MumBubVax intervention, which offers GPs tailored vaccine resources, online communication training and interactive quizzes for individual or group learning.


Assuntos
Clínicos Gerais , Vacinas , Austrália , Feminino , Humanos , Gravidez , Pesquisa Qualitativa , Vacinação
4.
Bone Joint J ; 104-B(5): 613-619, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35491580

RESUMO

AIMS: This study aimed to describe the use of revision knee arthroplasty in Australia and examine changes in lifetime risk over a decade. METHODS: De-identified individual-level data on all revision knee arthroplasties performed in Australia from 2007 to 2017 were obtained from the Australian Orthopaedic Association National Joint Replacement Registry. Population data and life tables were obtained from the Australian Bureau of Statistics. The lifetime risk of revision surgery was calculated for each year using a standardized formula. Separate calculations were undertaken for males and females. RESULTS: In total, 43,188 revision knee arthroplasty procedures were performed in Australia during the study period, with a median age at surgery of 69 years (interquartile range (IQR) 62 to 76). In 2017, revision knee arthroplasty rates were highest for males aged 70 to 79 years (102.9 procedures per 100,000 population). Lifetime risk of revision knee arthroplasty for females increased slightly from 1.61% (95% confidence interval (CI) 1.53% to 1.69%) in 2007 to 2.22% (95% CI 2.13% to 2.31%) in 2017. A similar pattern was evident for males, with a lifetime risk of 1.43% (95% CI 1.36% to 1.51%) in 2007 and 2.02% (95% CI 1.93% to 2.11%) in 2017. A decline in procedures performed for loosening/lysis (from 41% in 2007 to 24% in 2017) and pain (from 14% to 9%) was evident, while infection became an increasingly common indication (from 19% in 2007 to 29% in 2017). CONCLUSION: Well-validated national registry data can help us understand the epidemiology of revision knee arthroplasty, including changing clinical indications. Despite a small increase over a decade, the lifetime risk of revision knee arthroplasty in Australia is low at one in 45 females and one in 50 males. These methods offer a population-level approach to quantifying revision burden that can be used for ongoing national surveillance and between-country comparisons. Cite this article: Bone Joint J 2022;104-B(5):613-619.


Assuntos
Artroplastia do Joelho , Ortopedia , Idoso , Artroplastia do Joelho/métodos , Austrália/epidemiologia , Feminino , Humanos , Masculino , Sistema de Registros , Reoperação
6.
J Anim Ecol ; 91(5): 912-915, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35509202

RESUMO

Research Highlight: Lunn, T. J., Peel, A. J., Eby, P., Brooks, R., Plowright, R. K., Kessler, M. K., & McCallum, H. (2021). Counterintuitive scaling between population abundance and local density: Implications for modelling transmission of infectious diseases in bat populations. Journal of Animal Ecology, https://doi.org/10.1111/1365-2656.13634. Quantifying the transmission of an infectious disease is often difficult and for natural animal systems it can be a major challenge. Animals move over time and space changing their degree of aggregation and rate of contact, which, in turn, affects the risk of infection and the onward spread of the pathogen. Capturing the fundamentals of these processes requires the identification of both the correct spatial scale at which the processes take place and what constitutes a meaningful host population unit. Lunn et al. collected data on the gregarious Pteropus (flying foxes) bats from roost sites in Australia and investigated whether total bat abundance at the roost level, the spatial scale commonly used to model pathogen spread in bat populations, was representative of bat measurements at the tree level, the scale at which pathogen transmission between bats most likely occurs. Their findings showed that bat population measurements at the sub-plot level were strong predictors for potential transmission at the tree scale, while roost-level measurements were less robust. This study suggests that bat abundance at roost is inadequate to capture the gregarious structure of bat populations and the fundamental processes of transmission at lower scale.


Assuntos
Quirópteros , Animais , Austrália , Árvores
7.
Biol Lett ; 18(5): 20220058, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35506236

RESUMO

Male-male competition after mating (sperm competition) favours adaptations in male traits, such as elevated sperm numbers facilitated by larger testes. Ultimately, patterns of female distribution will affect the strength of sperm competition by dictating the extent to which males are able to prevent female remating. Despite this, our understanding of how the spatial and temporal distributions of mating opportunities have shaped the evolutionary course of sperm competition is limited. Here, we use phylogenetic comparative methods to explore interspecific variation in testes size in relation to patterns of female distribution in Australian rodents. We find that as mating season length (temporal distribution of females) increases, testes size decreases, which is consistent with the idea that it is difficult for males to prevent females from remating when overlap among oestrous females is temporally concentrated. Additionally, we find that social species (spatially clustered) have smaller testes than non-social species (spatially dispersed). This result suggests that males may be effective in monopolizing reproduction within social groups, which leads to reduced levels of sperm competition relative to non-social species where free-ranging females cannot be controlled. Overall, our results show that patterns of female distribution, in both space and time, can influence the strength of post-mating sexual selection among species.


Assuntos
Espermatozoides , Testículo , Animais , Austrália , Feminino , Masculino , Filogenia , Roedores
8.
Biol Lett ; 18(5): 20210576, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35506241

RESUMO

While mouthbrooding is not an uncommon parental care strategy in fishes, paternal mouthbrooding only occurs in eight fish families and is little studied. The high cost of paternal mouthbrooding to the male implies a low risk of investment in another male's offspring but genetic parentage patterns are poorly known for paternal mouthbrooders. Here, we used single-nucleotide polymorphism genetic data to investigate parentage relationships of broods of two mouthbrooders of northern Australian rivers, mouth almighty Glossamia aprion and blue catfish Neoarius graeffei. For N. graeffei, we found that the parentage pattern was largely monogamous with the brooder male as the sire. For G. aprion, the parentage pattern was more heterogeneous including observations of monogamous broods with the brooder male as the sire (73%), polygyny (13%), cuckoldry (6%) and a brood genetically unrelated to the brooder male (6%). Findings demonstrate the potential for complex interrelationships of male care, paternity confidence and mating behaviour in mouthbrooding fishes.


Assuntos
Reprodução , Comportamento Sexual Animal , Animais , Austrália , Peixes , Humanos , Masculino , Comportamento Paterno
9.
Subst Abus ; 43(1): 1126-1138, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35499404

RESUMO

Background: This study aimed to investigate the longitudinal changes in emergency department (ED) presentations incurred by patients with alcohol use disorders. Methods: A retrospective quantitative analysis was conducted on patients' ED presentations between December 2011 and January 2019 in an Australian regional health district. The health district has five EDs serving rural, regional, and metropolitan areas. Patients with alcohol use disorders were divided into two groups for comparison: those who had interactions with the community-based Drug and Alcohol (D&A) services and those who did not. Results: A total of 2,519 individual patients with alcohol use disorders made 21,715 ED presentations. Among these patients, 75.4% did not have interactions with the community-based D&A services. Compared with those who had, these patients were older, more likely to be diagnosed with abdominal pain (26.9% vs 12.0%, p < 0.001) and chest pain (16.2% vs 8.6%, p < 0.001), and had longer mean length of ED stay (7 hours and 41.7 minutes vs 6 hours and 25.6 minutes, p < 0.001). For the patients who had interactions with the community-based D&A services, their 28-day re-presentation rates decreased from 55.5% (2013-14) to 45.1% (2017-18); however, were higher than that of those who had no interactions (41.1% to 32.8%). Overall, 21.9%-24.5% of the patients were frequent ED presenters (i.e., ≥4 visits per year). Frequent ED presenters were proportionately higher among the patients who had interactions with the community-based D&A services, consistently over the relevant years. Although patients with alcohol use disorders frequently presented to EDs, their alcohol use disorders were only identified in 8.9% of their presentations. Conclusions: Patients with alcohol use disorders were often unidentified in EDs. Those who did not have interactions with the community-based D&A services were less likely to be diagnosed with alcohol use disorders when presenting to EDs.


Assuntos
Alcoolismo , Alcoolismo/epidemiologia , Austrália/epidemiologia , Serviço Hospitalar de Emergência , Etanol , Humanos , Estudos Retrospectivos
10.
PLoS One ; 17(5): e0266571, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35511808

RESUMO

Adolescents can easily access esports betting sites and place bets using cash or skins. This descriptive cross-sectional study examined the characteristics of adolescent esports bettors and relationships between their esports betting, video gaming activities, monetary gambling participation, and at-risk/problem gambling. Two survey samples of Australians aged 12-17 years were recruited through advertisements (n = 841) and online panel providers (n = 826). In both samples, gender and parents' living situation did not differ by past-month esports cash and skin betting, but recent esports betting was associated with engaging in esports gaming activities such as playing and watching esports, and in monetary gambling activities. Past-month esports betting using cash and skins was significantly associated with at-risk/problem gambling. After controlling for recent monetary gambling, recent esports skin bettors were over 3 times more likely to meet criteria for at-risk/problem gambling. Esports betting using skins appears to pose risks for young people and is easily accessible through unlicensed operators.


Assuntos
Comportamento Aditivo , Jogo de Azar , Esportes , Jogos de Vídeo , Adolescente , Austrália , Comportamento Aditivo/epidemiologia , Estudos Transversais , Humanos
11.
PLoS One ; 17(5): e0267877, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35511876

RESUMO

The aim of this study was to investigate differences in psychological characteristics between people with knee osteoarthritis (OA) from Japan and Australia. Sixty-two adults from Japan and 168 adults from Australia aged over 50 years with knee pain were included. Japanese data were collected from patients with knee OA diagnosed by medical doctors. Australian data were baseline data from a randomized controlled trial. Participants were not exercising regularly or receiving physiotherapy at the time. Psychological characteristics evaluated were depressive symptoms, fear of movement, and pain catastrophizing. These psychological characteristics were compared between the Japanese and Australian cohorts by calculating 95% confidence intervals (CIs) for difference of the mean. To test for equivalence, an equivalence margin was set at 0.5 standard deviations (SD) of the mean, where these SDs were based on the Australian data. When the 95%CI for the difference of the mean value lay entirely within the range of equivalence margin (i.e. between -0.5 and 0.5 times the Australian SD), the outcome was considered equivalent. There were no differences between the groups from Japan and Australia for depressive symptoms and the two groups were considered equivalent. There was no difference between groups for fear of movement, however the criteria for equivalence was not met. People from Japan with knee OA had higher scores for pain catastrophizing than people from Australia. The findings should be confirmed in other samples of people with knee OA from Japan and Australia due to the limitations of the participant recruitment strategy in this study. However, our findings suggest there may be a greater need to consider pain catastrophizing and build pain self-efficacy when managing Japanese people with knee OA. Implementation of international clinical practice guidelines for OA management may require different strategies in different countries due to different psychological profiles.


Assuntos
Osteoartrite do Joelho , Adulto , Idoso , Austrália , Estudos Transversais , Humanos , Japão , Osteoartrite do Joelho/diagnóstico , Dor/psicologia
12.
Rural Remote Health ; 22(2): 7000, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35513773

RESUMO

INTRODUCTION: Pain is a common and distressing symptom in people living with cancer that requires a patient-centred approach to management. Since 2010, the Australian Government has invested heavily in developing regional cancer centres to improve cancer outcomes. This study explored patient and carer experiences of care from a regional cancer centre with specific reference to cancer pain management. METHODS: A qualitative approach was used with semi-structured telephone interviews. Participants were outpatients at a regional cancer centre in New South Wales who had reported worst pain of 2 or more on a 0-10 numerical rating scale, and their carers. Questions explored experiences of pain assessment and management, and perceptions of how these were affected by the regional setting. Researchers analysed data using a deductive approach, using Mead and Bower's (2000) framework of factors influencing patient-centred care. RESULTS: Eighteen telephone interviews were conducted with 13 patients and 5 carers. Participants perceived that living in a regional setting conferred advantages to the patient-centredness of care via influences at the levels of professional context, the doctor-patient relationship, and consultation. These influences included established and ongoing relationships with a smaller number of care providers who were members of the community, and heightened accessibility in terms of travel/parking, flexible appointments, and ample time spent with each patient. The first of these factors was also perceived to contribute to continuity of care between specialist and primary care providers. However, one negative case reported disagreement between providers and a difficulty accessing specialist pain services. Several participants also reported a preference, and unmet need, for non-pharmacological rather than pharmacological pain management. CONCLUSION: While much research has focused on lack of services and poorer outcomes for people with cancer in rural areas, the Australian regional setting may offer benefits to the patient-centredness of cancer pain management and continuity of care. More research is needed to better understand the benefits and trade-offs of cancer care in regional versus urban settings, and how each can learn from the other. An unmet need for non-pharmacological rather than pharmacological pain management is among the most consistent findings of qualitative studies of patient/carer preferences across settings.


Assuntos
Cuidadores , Neoplasias , Austrália , Humanos , Neoplasias/complicações , Neoplasias/terapia , Dor , Relações Médico-Paciente , Pesquisa Qualitativa
13.
J Foot Ankle Res ; 15(1): 31, 2022 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-35513821

RESUMO

BACKGROUND: Pressure offloading treatment is critical for healing diabetes-related foot ulcers (DFU). Yet the 2011 Australian DFU guidelines regarding offloading treatment are outdated. A national expert panel aimed to develop a new Australian guideline on offloading treatment for people with DFU by adapting international guidelines that have been assessed as suitable to adapt to the Australian context. METHODS: National Health and Medical Research Council procedures were used to adapt suitable International Working Group on the Diabetic Foot (IWGDF) guidelines to the Australian context. We systematically screened, assessed and judged all IWGDF offloading recommendations using best practice ADAPTE and GRADE frameworks to decide which recommendations should be adopted, adapted or excluded in the Australian context. For each recommendation, we re-evaluated the wording, quality of evidence, strength of recommendation, and provided rationale, justifications and implementation considerations, including for geographically remote and Aboriginal and Torres Strait Islander peoples. This guideline, along with five accompanying Australian DFU guidelines, underwent public consultation, further revision and approval by ten national peak bodies (professional organisations). RESULTS: Of the 13 original IWGDF offloading treatment recommendations, we adopted four and adapted nine. The main reasons for adapting the IWGDF recommendations included differences in quality of evidence ratings and clarification of the intervention(s) and control treatment(s) in the recommendations for the Australian context. For Australians with plantar DFU, we recommend a step-down offloading treatment approach based on their contraindications and tolerance. We strongly recommend non-removable knee-high offloading devices as first-line treatment, removable knee-high offloading devices as second-line, removable ankle-high offloading devices third-line, and medical grade footwear as last-line. We recommend considering using felted foam in combination with the chosen offloading device or footwear to further reduce plantar pressure. If offloading device options fail to heal a person with plantar DFU, we recommend considering various surgical offloading procedures. For people with non-plantar DFU, depending on the type and location of the DFU, we recommend using a removable offloading device, felted foam, toe spacers or orthoses, or medical grade footwear. The six new guidelines and the full protocol can be found at: https://diabetesfeetaustralia.org/new-guidelines/ . CONCLUSIONS: We have developed a new Australian evidence-based guideline on offloading treatment for people with DFU that has been endorsed by ten key national peak bodies. Health professionals implementing these offloading recommendations in Australia should produce better DFU healing outcomes for their patients, communities, and country.


Assuntos
Diabetes Mellitus , Pé Diabético , Doenças do Pé , Úlcera do Pé , Austrália , Pé Diabético/terapia , Humanos , Cicatrização
14.
Int J Popul Data Sci ; 7(1): 1732, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35520098

RESUMO

The Population Health Research Network (PHRN) is an Australian national data linkage infrastructure that links a wide range of health and human services data in privacy-preserving ways. The data linkage infrastructure enables researchers to apply for access to routinely collected, linked, administrative data from the six states and two territories which make up the Commonwealth of Australia, as well as data collected by the Australian Government. The PHRN is a distributed network where data is collected and managed at the respective jurisdictional and/or cross-jurisdictional levels. As a result, access to linked data from multiple jurisdictions requires complex approval processes. This paper describes Australia's approach to enabling access to linked data from multiple jurisdictions. It covers the identification of, and agreement to, a minimum set of data items to be included in a unified national application form, the development and implementation of a national online application system and the harmonisation of business processes for cross-jurisdictional research projects. Utilisation of the online application system and the ongoing challenges of data linkage across jurisdictions are discussed. Changes to the data custodian and ethics committee approval criteria were out of scope for this project.


Assuntos
Armazenamento e Recuperação da Informação , Web Semântica , Austrália/epidemiologia , Coleta de Dados , Governo , Humanos
15.
Chiropr Man Therap ; 30(1): 22, 2022 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-35505334

RESUMO

BACKGROUND: To report the national prevalence, years lived with disability (YLDs) and attributable risk factors for all musculoskeletal conditions and separately for low back pain (LBP), as well as compare the disability burden related to musculoskeletal with other health conditions in Australia in 2019. METHODS: Global Burden of Disease (GBD) 2019 study meta-data on all musculoskeletal conditions and LBP specifically were accessed and aggregated. Counts and age-standardised rates, for both sexes and across all ages, for prevalence, YLDs and attributable risk factors are reported. RESULTS: In 2019, musculoskeletal conditions were estimated to be the leading cause of YLDs in Australia (20.1%). There were 7,219,894.5 (95% UI: 6,847,113-7,616,567) prevalent cases of musculoskeletal conditions and 685,363 (95% UI: 487,722-921,471) YLDs due to musculoskeletal conditions. There were 2,676,192 (95% UI: 2,339,327-3,061,066) prevalent cases of LBP and 298,624 (95% UI: 209,364-402,395) YLDs due to LBP. LBP was attributed to 44% of YLDs due to musculoskeletal conditions. In 2019, 22.3% and 39.8% of YLDs due to musculoskeletal conditions and LBP, respectively, were attributed to modifiable GBD risk factors. CONCLUSIONS: The ongoing high burden due to musculoskeletal conditions impacts Australians across the life course, and in particular females and older Australians. Strategies for integrative and organisational interventions in the Australian healthcare system should support high-value care and address key modifiable risk factors for disability such as smoking, occupational ergonomic factors and obesity.


Assuntos
Pessoas com Deficiência , Dor Lombar , Doenças Musculoesqueléticas , Austrália/epidemiologia , Feminino , Carga Global da Doença , Humanos , Dor Lombar/epidemiologia , Masculino , Doenças Musculoesqueléticas/epidemiologia
16.
PLoS One ; 17(5): e0267203, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35507597

RESUMO

Conservation areas are critical for biodiversity conservation, but few citizen science studies have evaluated their efficiency. In the absence of thorough survey data, this study assessed which species benefit most from conservation areas using citizen science bird counts extracted from the Atlas of Living Australia. This was accomplished by fitting temporal models using citizen science data taken from ALA for the years 2010-2019 using the INLA approach. The trends for six resident shorebird species were compared to those for the Australian Pied Oystercatcher, with the Black-fronted Dotterel, Red-capped Dotterel, and Red-kneed Dotterel exhibiting significantly steeper increasing trends. For the Black-fronted Dotterel, Masked Lapwing, and Red-kneed Dotterel, steeper rising trends were recorded in conservation areas than in other locations. The Dotterel species' conservation status is extremely favourable. This study demonstrates that, with some limits, statistical models can be used to track the persistence of resident shorebirds and to investigate the factors affecting these data.


Assuntos
Charadriiformes , Ciência do Cidadão , Animais , Austrália , Biodiversidade , Aves , Conservação dos Recursos Naturais
17.
PLoS One ; 17(5): e0267969, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35507635

RESUMO

BACKGROUND: Admission to hospital introduces risks for people with Parkinson's disease in maintaining continuity of their highly individualized medication regimens, which increases their risk of medication errors. This is of particular concern as omitted medications and irregular dosing can cause an immediate increase in an individual's symptoms as well as other adverse outcomes such as swallowing difficulties, aspiration pneumonia, frozen gait and even potentially fatal neuroleptic malignant type syndrome. OBJECTIVE: To determine the occurrence and identify factors that contribute to Parkinson's medication errors in Australian hospitals. METHODS: A retrospective discharge diagnosis code search identified all admissions for people with Parkinson's disease to three tertiary metropolitan hospitals in South Australia, Australia over a 3-year period. Of the 405 case notes reviewed 351 admissions met our inclusion criteria. RESULTS: Medication prescribing (30.5%) and administration (85%) errors during admission were extremely common, with the most frequent errors related to administration of levodopa preparations (83%). A higher levodopa equivalent dosage, patients with a modified swallowing status or nil by mouth order during admission, and patients who did not have a pharmacist led medication history within 24 hours of admission had significantly higher rates of medication errors. CONCLUSIONS: This study identified 3 major independent factors that increased the risk of errors during medication management for people with Parkinson's disease during hospitalization. Thus, targeting these areas for preventative interventions have the greatest chance of producing a clinically meaningful impact on the number of hospital medication errors occurring in the Parkinson's population.


Assuntos
Doença de Parkinson , Austrália/epidemiologia , Hospitalização , Hospitais Urbanos , Humanos , Levodopa/uso terapêutico , Erros de Medicação , Doença de Parkinson/diagnóstico , Estudos Retrospectivos , Fatores de Risco
18.
BMJ Open ; 12(5): e058901, 2022 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-35501079

RESUMO

INTRODUCTION: The aim of this evaluation is to understand whether introducing stabilisation rooms equipped with pulse oximetry and oxygen systems to frontline health facilities in Ikorodu, Lagos State, alongside healthcare worker (HCW) training improves the quality of care for children with pneumonia aged 0-59 months. We will explore to what extent, how, for whom and in what contexts the intervention works. METHODS AND ANALYSIS: Quasi-experimental time-series impact evaluation with embedded mixed-methods process and economic evaluation. SETTING: seven government primary care facilities, seven private health facilities, two government secondary care facilities. TARGET POPULATION: children aged 0-59 months with clinically diagnosed pneumonia and/or suspected or confirmed COVID-19. INTERVENTION: 'stabilisation rooms' within participating primary care facilities in Ikorodu local government area, designed to allow for short-term oxygen delivery for children with hypoxaemia prior to transfer to hospital, alongside HCW training on integrated management of childhood illness, pulse oximetry and oxygen therapy, immunisation and nutrition. Secondary facilities will also receive training and equipment for oxygen and pulse oximetry to ensure minimum standard of care is available for referred children. PRIMARY OUTCOME: correct management of hypoxaemic pneumonia including administration of oxygen therapy, referral and presentation to hospital. SECONDARY OUTCOME: 14-day pneumonia case fatality rate. Evaluation period: August 2020 to September 2022. ETHICS AND DISSEMINATION: Ethical approval from University of Ibadan, Lagos State and University College London. Ongoing engagement with government and other key stakeholders during the project. Local dissemination events will be held with the State Ministry of Health at the end of the project (December 2022). We will publish the main impact results, process evaluation and economic evaluation results as open-access academic publications in international journals. TRIAL REGISTRATION NUMBER: ACTRN12621001071819; Registered on the Australian and New Zealand Clinical Trials Registry.


Assuntos
COVID-19 , Pneumonia , Austrália , Pré-Escolar , Hospitais , Humanos , Hipóxia/complicações , Lactente , Recém-Nascido , Nigéria , Oximetria , Oxigênio/uso terapêutico , Pneumonia/complicações
20.
Funct Plant Biol ; 49(6): i-iii, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35533097

RESUMO

sion="1.0" encoding="utf-8"?> FP Functional Plant Biology Funct. Plant Biol. 1445-4408 1445-4416 CSIRO Publishing 36 Gardiner Road Clayton VIC 3168 Australia FP22050 10.1071/FP22050 Foreword Advanced technologies in studying plant photosynthesis: principles and applications A. Zavafer et al . https://orcid.org/0000-0002-8905-1618 Zavafer Alonso A Fan Dayong B * https://orcid.org/0000-0001-8150-9535 Murakami Keach C Handling Editor Shabala Sergey Plant Science Division, Research School of Biology, The Australian National University, Canberra, ACT 2001, Australia. Hokkaido Agricultural Research Center (HARC), National Agriculture and Food Research Organization (NARO), 1 Hitsujigaoka, Toyohira, Sapporo 062-8555, Japan. College of Forestry, Beijing Forestry, University, Beijing 100083, China. * Correspondence to: Dayong Fan Hokkaido Agricultural Research Center (HARC), National Agriculture and Food Research Organization (NARO), 1 Hitsujigaoka, Toyohira, Sapporo 062-8555, Japan Email: dayong73fan@163.com 9 May 2022 49 6 Special Issue i iii 9 May 2022 Published: 9 May 2022 © 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing 2022 The Authors The foreword to this special issue on the advanced technologies in studying photosynthesis focuses on the main contributions of Fred Chow, one of the key Australian scientists studying light reactions in plants.


Assuntos
Agricultura Florestal , Fotossíntese , Agricultura , Austrália , Humanos , Pesquisa
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