Digital Commons Network^™

Vulnerability To Environmental And Climatic Health Provocations Among Women And Men Hospitalized With Chronic Heart Disease: Insights From The Resilience Trial Cohort, Simon Stewart, Sheila Patel, Terase Lancefield, Thalys Rodrigues, Nicholas Doumtsis, Ashleigh Jess, Emily-Rose Vaughan-Fowler, Yih Kai Chan, Jay Ramchand, Paul Yates, Jason Kwong, Christine Mcdonald, Louise Burrell

IHR Papers and Journal Articles

Aims: We aimed to recruit a representative cohort of women and men with multi-morbid chronic heart disease as part of a trial testing an innovative, nurse-co-ordinated, multi-faceted intervention to lower rehospitalization and death by addressing areas of vulnerability to external challenges to their health.
Methods and results: The prospective, randomized open, blinded end-point RESILIENCE Trial recruited 203 hospital inpatients (mean age 75.7 ± 10.2 years) of whom 51% were women and 94% had combined coronary artery disease, heart failure, and/or atrial fibrillation. Levels of concurrent multi-morbidity were high (mean Charlson Index of Comorbidity Score 6.5 ± 2.7), and 8.9% had …

Association Of Pulmonary Artery Pressures With Mortality In Adults With Reduced Left Ventricular Ejection Fraction, Seshika Ratwatte, Simon Stewart, Geoff Strange, David Playford, David Celermajer

IHR Papers and Journal Articles

Background

The independent effect of pulmonary hypertension (PHT) severity on mortality in those with reduced left ventricular ejection fraction (LVEF) is not well known.

Objectives

The authors aimed to examine the prognostic impact of increasingly elevated pulmonary pressures in a large clinical cohort of adults with reduced LVEF.

Methods

The authors analyzed data from the National Echocardiography Database of Australia, a large clinical registry linking routine echocardiographic investigations to mortality. In 23,675 adults with a recorded tricuspid regurgitation peak velocity (TRV) and reduced LVEF (<50%), the authors evaluated the relationship between conventional thresholds of increasing risk of PHT and mortality during median follow-up of 2.9 years (Q1-Q3: 1.0-5.4 years).

Results

Mean age was 70 ± 15 years, and 7,498 (31.7%) individuals were female. Overall, …

Impact Of Multimorbidity On Mortality In Heart Failure With Reduced Ejection Fraction: Which Comorbidities Matter Most? An Analysis Of Paradigm-Hf And Atmosphere, Pooja Dewan, Joao P. Ferreira, Jawad H. Butt, Mark C. Petrie, William T. Abraham, Akshay S. Desai, Kenneth Dickstein, Lars Kober, Milton Packer, Jean L. Rouleau, Simon Stewart, Karl Swedberg, Michael R. Zile, Scott D. Solomon, Pardeep S. Jhund, John Jv Mcmurray

IHR Papers and Journal Articles

Aims: Multimorbidity, the coexistence of two or more chronic conditions, is synonymous with heart failure (HF). How risk related to comorbidities compares at individual and population levels is unknown. The aim of this study is to examine the risk related to comorbidities, alone and in combination, both at individual and population levels.

Methods and results: Using two clinical trials in HF – the Prospective comparison of ARNI (Angiotensin Receptor–Neprilysin Inhibitor) with ACEI (Angiotensin-Converting Enzyme Inhibitor) to Determine Impact on Global Mortality and morbidity in HF trial (PARADIGM-HF) and the Aliskiren Trial to Minimize Outcomes in Patients with Heart Failure trials …

Economic Cost Of Secondary Postpartum Haemorrhage: A Case-Control Study At A Tertiary Hospital In Australia, Nicole Young, Julie Quinlivan, Rachael Fox, Jess Anderson, Laura Davis, Samantha S. Mooney

IHR Papers and Journal Articles

Background

Secondary postpartum haemorrhage (PPH) is a condition which affects 0.2–3.0% of women. Despite its impact on maternal morbidity, there is a lack of understanding of the cost burden of disease.

Aims

To determine the economic cost of secondary PPH in the postpartum period, compared to the costs for women without this diagnosis.

Materials and methods

Data were prospectively collected on a cohort of 97 women who presented with secondary PPH to the emergency department (ED) between July 2020 and February 2021. A case–control design was then used to compare postpartum cost data from these patients to a group of …

Technology-Guided Assessment Of Vocalisations And Their Diagnostic Value As Pain Indicators For People Living With Dementia, Kreshnik Hoti, Atee Mustafa, Paola Chivers, Ipsit Vahia, Jeff Hughes

IHR Papers and Journal Articles

Background

during pain assessment in persons unable to self-report, such as people living with dementia, vocalisations are commonly used as pain indicators. However, there is a lack of evidence from clinical practice regarding their diagnostic value and relationship with pain. We aimed to explore vocalisations and pain in people with dementia undergoing pain assessments in clinical practice settings. Methods

a total of 22,194 pain assessments were reviewed in people with dementia (n = 3,144) from 34 different Australian aged care homes and two dementia specific programs. Pain assessments were conducted by 389 purposely trained health care professionals and cares …

Outcomes Of Completed Quality Activities In An Australian Tertiary Hospital, 2015-2019, Qun Catherine Li, Jonathan Karnon, Jim Codde

IHR Papers and Journal Articles

Quality activities including quality assurance and quality improvement are an integral part of safety and quality governance for hospitals. Previous studies identified that (i) majority are for quality assurance and knowledge-acquiring purposes and (ii) adherence to the quality cycle as well as impact on patient-related outcomes at the hospital level are unclear, neither associated with costs. This study aims to (i) assess adherence to the quality cycle for quality activities in a large Australian tertiary hospital; (ii) report outcomes of quality activities at the hospital level, including impact on patient-related outcomes measured by the occurrence of hospital-acquired complications; and (iii) …

Accessing Antenatal Care When You Are Rough Sleeping: Barriers And Enablers, Lisa Wood, Natalie Bogoias

IHR Papers and Journal Articles

No abstract provided.

The Association Between Diabetes Mellitus Of Different Durations And Risk Of Pancreatic Cancer: An Australian National Data-Linkage Study In Women, Sitwat Ali, Renhua Na, Karen Tuesley, Katrina Spilsbury, Louise M. Stewart, Michael Coory, Penelope M. Webb, Peter Donovan, Sally-Anne Pearson, Susan J. Jordan, Rachel E. Neale

IHR Papers and Journal Articles

Aims: The bidirectional association between diabetes mellitus (DM) and pancreatic cancer (PC) is established; however, the strength of association between duration of DM and risk of PC needs further investigation.

Methods: We conducted a case-control study nested within a population-based cohort of Australian women established using record linkage. Women diagnosed with PC from July 2007 to December 2013, were matched to five controls based on age and state of residence. DM was defined according to prescription of anti-diabetic medication from administrative prescription data. We used conditional logistic regression to calculate odds ratios (OR) and 95% confidence intervals (CI), adjusted for …

Designing And Evaluating Falls Prevention Education With Residents And Staff In Aged Care Homes: A Feasibility Study, Jacqueline Francis-Coad, Tessa Watts, Caroline Bulsara, Anne-Marie Hill

IHR Papers and Journal Articles

Purpose: The purpose of this study was to co-design a falls prevention education programme with aged care home residents and staff and evaluate its feasibility. The intention of providing the education programme was to assist residents to stay safe and mobile whilst reducing their risk of falling.

Design/methodology/approach: A two-phase mixed methods participatory design using a resident (n = 6) and care staff (n = 5) consumer engagement panel, pre- and post-programme resident (n = 35) survey and semi-structured care staff interviews (n = 8) was undertaken in two countries.

Findings: A poster, brochure, video and staff education guide featuring …

Childhood And Infant Exposure To Famine In The Biafran War Is Associated With Hypertension In Later Life: The Abia Ncds Study, Okechukwu S. Ogah

IHR Papers and Journal Articles

There are very few studies in Africans investigating the association between early life exposure to malnutrition and subsequent hypertension in adulthood. We set out to investigate this potential association within an adult cohort who were born around the time of the Biafran War (1968–1970) and subsequent famine in Nigeria. This was a retrospective analysis of Abia State NonCommunicable Diseases and Cardiovascular Risk Factors (AS-NCD-CRF) Survey, a community-based, cross-sectional study that profiled 386 adults (47.4% men) of Igbo ethnicity born in the decade between January 1965 and December 1974. Based on their date of birth and the timing of the famine, …

Accuracy Of The Australian National Subacute And Nonacute Patient Classification In Predicting Rehabilitation Length Of Stay For Stroke Survivors Who Are ≥65 Years Of Age And Have Lateropulsion, Jessica Nolan, Erin Godecke, Katrina Spilsbury, Andy Wu, Barbara Singer

IHR Papers and Journal Articles

Background

Lateropulsion is a common impairment after stroke. Regardless of stroke severity, functional recovery is slower in people with lateropulsion, resulting in requirement for longer rehabilitation duration. In Australia, inpatient rehabilitation funding is determined via the Australian National Sub-Acute and Non-Acute Patient Classification (AN-SNAP). AN-SNAP class is determined using age, diagnosis, weighted Functional Independence Measure (FIM) motor score, and FIM cognitive score.

Objectives

To explore accuracy of the AN-SNAP to predict length of stay (LOS) for people with poststroke lateropulsion.

Methods

A retrospective database audit was undertaken. AN-SNAP predicted LOS for each participant was calculated based on 2019 calendar year …

Association Between Motor Planning And The Frontoparietal Network In Children: An Exploratory Multimodal Study, Ranila Bhoyroo, Beth Hands, Karen Caeyenberghs, Alberto De Luca, Alexander Leemans, Adam Wigley, Christian Hyde

IHR Papers and Journal Articles

Objective: Evidence from adult literature shows the involvement of cortical grey matter areas of the frontoparietal lobe and the white matter bundle, the superior longitudinal fasciculus (SLF) in motor planning. This is yet to be confirmed in children.

Method: A multimodal study was designed to probe the neurostructural basis of childhood motor planning. Behavioural (motor planning), magnetic resonance imaging (MRI) and diffusion weighted imaging (DWI) data were acquired from 19 boys aged 8–11 years. Motor planning was assessed using the one and two colour sequences of the octagon task. The MRI data were preprocessed and analysed using FreeSurfer 6.0. Cortical …

Delirium In Hospitalised Adults With Acute Burns – A Systematic Review, Guy H.M Stanley, Angus R.J Barber, Aoife M. O'Brien, Cheryl Hamill, Glenn Boardman, Cody C. Frear, Dale W. Edgar, Hannah Seymour, Fiona M. Wood

IHR Papers and Journal Articles

Introduction: Delirium is a potentially modifiable, acutely altered mental state, commonly characterised as a hospital-acquired complication. Studies of adult inpatients with acute burns with and without delirium identify causative risks related to the injury or treatment and outcomes related to the patient and healthcare system. We compare patients with and without delirium, providing a high-level quantitative synthesis of delirium risks and outcomes to inform guidelines and future research.

Methods: A systematic review, meta-analysis and GRADE evaluation of risks and outcomes associated with delirium in adults with acute burns was conducted using PRISMA guidelines and PROSPERO protocol CRD42021283055. The Newcastle-Ottawa Scale …

A Differential Response To Antihypertensive Therapy In African Men And Women: Insights From The Creole Trial, Dike B. Ojji, Gabriel L. Shedul, Mahmoud Sani, Okechukwu S. Ogah, Anastase Dzudie, Felix Barasa, Charles Mondo, Prossie M. Ingabire, Erika S.W. Jones, Brian Rayner, Damasceno Albertino, Elijah Ogola, Wynand Smythe, Nicky Hickman, Veronica Francis, Pandie Shahiemah, Grace Shedul, Akinyemi Aje, Karen Sliwa, Simon Stewart, For The Creole Investigators

IHR Papers and Journal Articles

Background: We sought to address the paucity of data to support the evidence-based management of hypertension to achieve optimal blood pressure (BP) control on a sex-specific basis in Africa.

Methods: We undertook a post hoc analysis of the multicenter, randomized CREOLE (Comparison of Three Combination Therapies in Lowering Blood Pressure in Black Africans) Trial to test the hypothesis that there would be clinically important differences in office BP control between African men and women. We compared the BP levels of 397 and 238 hypertensive women (63%, 50.9 ± 10.5 years) and men (51.2 ± 11.3 years) from 10 sites across …

Nurses’ Perceptions Of Using Volunteer Support In Health Care Settings: A Systematic Scoping Review, Kate Crookes, Rosemary Saunders, Vivien Kemp, Olivia Gallagher, Manonita Ghosh, Caroline Bulsara, Karen Gullick, Bev O'Connell

IHR Papers and Journal Articles

Aims

To understand nurses’ perceptions of volunteer support in health care settings.

Background

Increasingly, volunteers provide specialised support to health care service users, requiring volunteers and nurses to work closely together. However, little is known about nurses’ perceptions of volunteer support.

Methods

A scoping review was conducted following the PRISMA-ScR checklist. A mixed-methods convergent integrative approach was taken guided by the JBI framework. Quantitative data were transformed into qualitative data for synthesis and descriptive thematic analysis. Six databases were searched (CINHAL+, EMBASE, PubMed, Scopus, PsycInfo, ProQuest Health and Medical Collection) on 24 January 2022 using terms related to nurses, perceptions, …

Improving Care For Older Patients Visiting Emergency Departments. Are They Receiving Falls Prevention Guideline Care?, Melinda Williamson, Annette Barton, Deborah Edwards, Claire Morrisby, Angela Jacques, Kristie J. Harper

IHR Papers and Journal Articles

Background: The primary objective was to examine whether the Emergency Department (ED) treatment of older adults who fall in Australia is concordant with falls prevention and management clinical guideline care recommendations.

Methods: A retrospective medical records audit was completed for patients 65years and older, who at-tended the ED with a fall and were discharged home. An audit tool was developed from local, national, and international falls clinical guidelines.

Results: One thousand and twenty-seven patients presented following a fall throughout 2020. One hundred and seven patient medical records were audited. Assessment of cognition (94%), medication review (76%) and …

Characteristics Of Quality Activities In A Tertiary Teaching Hospital In Western Australia, Qun Catherine Li, Jonathan Karnon, Simon Towler, James Codde

IHR Papers and Journal Articles

Objective: This study aims to describe the characteristics of quality activities in a tertiary quaternary hospital in Western Australia.

Methods: Data from the study hospital’s electronic quality management system Governance, Evidence, Knowledge and Outcome between 1 January 2015 and 31 December 2019 was analysed by using descriptive and thematic methods.

Results: Quality assurance (QA) accounted for 68.3% of all quality activities in the study hospital. Principal investigators of activities were mostly in clinical roles and relatively senior in their profession. Collaboration within the same profession and same team was common, but much less so across departments. The median quality cycle …

Modulators Of Change-Of-Direction Economy After Repeated Sprints In Elite Soccer Players, Filippo Dolci, Andrew E. Kilding, Tania Spiteri, Paola Chivers, Ben Piggott, Andrew Maiorana, Nicolas H. Hart

IHR Papers and Journal Articles

Purpose: To investigate the acute effect of repeated-sprint activity (RSA) on change-of-direction economy (assessed using shuttle running economy [SRE]) in soccer players and explore neuromuscular and cardiorespiratory characteristics that may modulate this effect.

Methods: Eleven young elite male soccer players (18.5 [1.4] y old) were tested on 2 different days during a 2-week period in their preseason. On day 1, lower-body stiffness, power and force were assessed via countermovement jumps, followed by an incremental treadmill test to exhaustion to measure maximal aerobic capacity. On day 2, 2 SRE tests were performed before and after a repeated-sprint protocol with …

Is There An Association Between The Vaginal Microbiome And First Trimester Miscarriage? A Prospective Observational Study, Monica Shahid, Julie A. Quinlivan, George Mendz, Michael Peek, Natalia Castaño-Rodríguez

IHR Papers and Journal Articles

Aim

To examine whether there are differences in the vaginal microbiome of women who miscarry compared to those who have normal pregnancy outcomes.

Methods

Prospective observational study conducted at the Canberra Hospital, Australia, with 24 participant women in the first trimester of pregnancy. The vaginal microbiomes of the 24 women were characterized using sequencing analysis of the V4 region of the 16S rRNA gene employing an Illumina MiSeq instrument with QIAGEN reagents. Vaginal microbiome data were correlated with pregnancy clinical metadata.

Results

Ordination plots showed differences in the composition of microbiomes of women who miscarried and controls. In nulliparous women, …

Reducing Hospital Discharges Back Into Homelessness, Jake Turvey, Isaac Wood, Lisa Wood, Amanda Stafford

IHR Papers and Journal Articles

No abstract provided.

A Prospective Pilot Study Of The Energy Balance Profiles In Acute Non-Severe Burn Patients, Tyler Osborne, Dale Edgar, Paul Gittings, Fiona Wood, Thomas Le Huray, Brodie Allan, Brendan R. Scott, Bradley Wall

IHR Papers and Journal Articles

Background:Major burn patients have been shown to exhibit a hyper-metabolic state of activity which can persist for up to two years after burn. The relationship between total body surface area (TBSA) and resting metabolic rate (RMR) has been investigated in larger burns (≥20% TBSA), however not in non-severe burns (≤15% TBSA). The primary aim of this observational study was to examine the association between the acute effects of burns

Methods: The study included data from 39 participants (82% male), all admitted to the State Adult Burn Unit at Fiona Stanley Hospital. Each patient was recruited upon admission and RMR …

Exploring The Association Between Stroke And Acute Myocardial Infarction And Statins Adherence Following A Medicines Co-Payment Increase, Karla L. Seaman, Max K. Bulsara, Frank M. Sanfilippo, Anna Kemp-Casey, Elizabeth E. Roughead, Caroline Bulsara, Gerald F. Watts, David B. Preen

IHR Papers and Journal Articles

Objectives: Patient contributions (co-payments) for one months’ supply of a publicly-subsidised medicine in Australia were increased by 21% in January 2005 (US$2.73-$3.31 for social security recipients and $17.05- $20.58 for others). This study investigates the relationship between patients’ use of statin medication and hospitalisation for acute coronary syndrome and stroke, following this large increase in co-payments.

Methods: We designed a retrospective cohort study of all patients in Western Australia who were dispensed statin medication between 2004 and 05. Data for the cohort was obtained from State and Federal linked databases. We divided the cohort into those who discontinued, reduced or …

Olfactory Dysfunction At Six Months After Coronavirus Disease 2019 Infection, S R. Leedman, M Sheeraz, P G. Sanfilippo, Dale W. Edgar, G V. D'Aulerio, D M. Robb, T Richards, C C. Blyth, D A. Mackey

IHR Papers and Journal Articles

Objective: This study aimed to assess olfactory dysfunction in patients at six months after confirmed coronavirus disease 2019 infection.

Methods: Coronavirus disease 2019 positive patients were assessed six months following diagnosis. Patient data were recoded as part of the adapted International Severe Acute Respiratory and Emerging Infection Consortium Protocol. Olfactory dysfunction was assessed using the University of Pennsylvania Smell Identification Test.

Results: Fifty-six patients were included. At six months after coronavirus disease 2019 diagnosis, 64.3 per cent of patients (n = 36) were normosmic, 28.6 per cent (n = 16) had mild to moderate microsmia and 7 per …

Starting A New Anti-Seizure Medication In Drug-Resistant Epilepsy: Add-On Or Substitute?, Mubeen Janmohamed, Nicholas Lawn, Katrina Spilsbury, Josephine Chan, John Dunne

IHR Papers and Journal Articles

Objectives: Randomized studies in drug-resistant epilepsy (DRE) typically involve addition of a new anti-seizure medication (ASM). However, in clinical practice, if the patient is already taking multiple ASMs, then substitution of one of the current ASMs commonly occurs, despite little evidence supporting this approach.

Methods: Longitudinal prospective study of seizure outcome after commencing a previously untried ASM in patients with DRE. Multivariable time-to-event and logistic regression models were used to evaluate outcomes by whether the new ASM was introduced by addition or substitution.

Results: A total of 816 ASM changes in 436 adult patients with DRE between 2010 and 2018 …

Quantification Of The Negative Impact Of Sedation And Inotropic Support On Achieving Early Mobility In Burn Patients In Icu: A Single Center Observational Study, Lauren Bright, Lisa Van Der Lee, Dana Hince, Fiona M. Wood, Dale W. Edgar

IHR Papers and Journal Articles

Introduction: Early rehabilitation for burns survivors in the intensive care unit (ICU) is arguably more challenging than the general population. Early achievement of functional verticality milestones (FVMs) has the potential to ameliorate the detrimental effects of bed rest and immobility observed in ICU patients and reduce healthcare costs. However, the time to achieving FVMs after burn injury is influenced by factors such as sedation practices, cardiovascular stability, mechanical ventilation, acute skin reconstruction and length of stay (LOS) during the acute intensive care period.

Objectives/Aims: The aims of this study were to identify the association between early achievement of FVMs and …

Situationism, Capacities And Culpability, Adam Piovarchy

IHR Papers and Journal Articles

The situationist experiments demonstrate that most people’s behaviour is influenced by environmental factors much more than we expect, and that ordinary people can be led to behave very immorally. A number of philosophers have investigated whether these experiments demonstrate that subjects’ responsibility-relevant capacities are impeded. This paper considers how, in practice, we can assess when agents have a reduced capacity to avoid wrongdoing. It critiques some previously offered strategies including appeals to the reasonable person standard, appeals to counterfactuals and understandability of behaviour, and appeals to base rates of wrongdoing. It then proposes we should think a certain factor impeded …

Post-Stroke Lateropulsion And Rehabilitation Outcomes: A Retrospective Analysis, Jessica Nolan, Erin Godecke, Katrina Spilsbury, Barbara Singer

IHR Papers and Journal Articles

Purpose: A person with post-stroke lateropulsion actively pushes themselves toward their hemiplegic side, or resists moving onto their non-hemiplegic side. This study aimed to determine the association of lateropulsion severity with: • Change in function (Functional Independence Measure – FIM) and lateropulsion severity (Four-Point Pusher Score – 4PPS) during inpatient rehabilitation; • Inpatient rehabilitation length of stay (LOS); • Discharge destination from inpatient rehabilitation.

Methods: Retrospective data for 1,087 participants (aged ≥65 years) admitted to a stroke rehabilitation unit (2005–2018) were analysed using multivariable regression models.

Results: Complete resolution of lateropulsion was seen in 69.4% of those with mild lateropulsion …

Do Peers Increase Older Adults' Participation In Strength Training? Pilot Randomized Trial, Elissa Burton, Karen Levit, Jim Codde, Keith D. Hill, Anne-Marie Hill

IHR Papers and Journal Articles

Fewer than 20% of older adults participate in strength training (ST). Barriers to ST participation include not knowing where to go or not having someone to go with. To address these barriers, the authors provided older adults with a peer (older person already participating in ST) to support their engagement. The aim of this pilot randomized controlled trial was to determine whether older adults who were provided with a peer when participating in ST were more likely to be participating in ST 4 weeks postintervention, compared with those receiving ST alone. Fifty-one ST participants were recruited; 40 completed the intervention …

Self-Report Motor Competence In Adolescents Aged 12-18 Years In Regional And Rural Victoria (Australia), Mandy S. Plumb, Beth Hands, Fleur Mcintyre, Amanda Timler

IHR Papers and Journal Articles

Background: Poor motor skills are an increasing issue for adolescents in our local communities. In regional Victoria, almost 20% of children starting school in 2018 were considered at risk or developmentally vulnerable in the domain of physical health and wellbeing.

Purpose: The aim of the current study was to examine factors (how adolescents perceive their fine and gross motor skills, activities of daily living, comparison to peers) of motor competence that may be important to adolescents in regional Victoria, Australia, using the Adolescent Motor Competence Questionnaire (AMCQ).

Methods: A sample of 183 Australian adolescents ([138 females ( …

Fatherhood Too Soon. Anxiety, Depression And Quality Of Life In Fathers Of Preterm And Term Babies: A Longitudinal Study, Ingrid Beatrice Petersen, Julie Anne Quinlivan

IHR Papers and Journal Articles

Introduction: Fathers are increasingly recognized as playing a critical role in the family unit and emotional development of children. The birth of a preterm baby can be confronting, yet there is limited research that explores how preterm birth might impact on father’s emotional wellbeing and quality of life. The aim of the study was to monitor quality of life and psychological wellbeing in a group of fathers to explore if a preterm birth altered outcomes in these two domains.

Methods: Institutional ethics committee approval was obtained. Australian men (N = 1000) were recruited in the antenatal period via their …