https://novaprd-lb.newcastle.edu.au/vital/access/manager/Index ${session.getAttribute("locale")} 5 https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:34089 Wed 31 Aug 2022 13:37:51 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:30030 Wed 27 Apr 2022 14:49:17 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:32803 Wed 23 Feb 2022 16:05:34 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:27841 Wed 23 Feb 2022 16:03:54 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:33102 15 mL, mismatch ratio > 1.8, baseline ischemic core < 70 mL, and volume of severely hypoperfused tissue < 100 mL). Patients meeting target mismatch criteria were analyzed as a subgroup to identify whether they had different treatment responses from the pooled group. Results: Of 146 pooled patients, 71 received alteplase and 75 received tenecteplase. Tenecteplase-Treated patients had greater early clinical improvement (median National Institutes of Health Stroke Scale score change: Tenecteplase, 7; alteplase, 2; P=0.018) and less parenchymal hematoma (2 of 75 versus 10 of 71; P=0.02). The pooled group did not show improved patient outcomes when treated with tenecteplase (modified Rankin scale score 0-1: odds ratio, 1.77; 95% confidence interval, 0.89-3.51; P=0.102) compared with alteplase therapy. However, in patients with target mismatch (33 tenecteplase, 35 alteplase), treatment with tenecteplase was associated with greater early clinical improvement (median National Institutes of Health Stroke Scale score change: Tenecteplase, 6; alteplase, 1; P < 0.001) and better late independent recovery (modified Rankin scale score 0-1: odds ratio, 2.33; 95% confidence interval, 1.13-5.94; P=0.032) than those treated with alteplase. Conclusions: Tenecteplase may offer an improved efficacy and safety profile compared with alteplase, benefits possibly exaggerated in patients with baseline computed tomography perfusion-defined target mismatch. Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01472926. URL: https://www.anzctr.org.au. Unique identifier: ACTRN12608000466347.]]> Wed 19 Jan 2022 15:18:46 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:31501 2 ) was recorded continuously using a portable metabolic system. The average VO₂ during each 30-second epoch was determined. VO₂ ≥10.5 mL/kg/min was categorised as ≥moderate intensity. Findings: Participants exercised at VO₂ ≥10.5 mL/kg/min for the majority of the time on the workstations [functional: 369/472 epochs (78%), ergometer: 170/204 epochs (83%)]. Most (69%) participants exercised for ≥30 minutes. No serious adverse events occurred. Conclusions: Applying interval training principles to a circuit of functional and ergometer workstations enabled ambulant participants to exercise at an intensity and for a duration that can improve cardiorespiratory fitness. The training approach appears feasible, safe and a promising way to incorporate both cardiorespiratory fitness and functional training into post-stroke management.]]> Wed 19 Jan 2022 15:16:20 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:48936 Wed 19 Apr 2023 14:55:13 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:30006 Wed 17 Nov 2021 16:29:49 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:29929 FEver, hyperglycaemia (Sugar) and Swallowing (the FeSS protocols) in stroke, previously demonstrated in the Quality in Acute Stroke Care (QASC) trial to decrease 90-day death and dependency, into all stroke services in New South Wales (NSW), Australia's most populous state. Design: Pre-test/post-test prospective study. Setting: 36 NSW stroke services. Methods: Our clinical translational initiative, the QASC Implementation Project (QASCIP), targeted stroke services to embed 3 nurse-led clinical protocols (the FeSS protocols) into routine practice. Clinical champions attended a 1-day multidisciplinary training workshop and received standardised educational resources and ongoing support. Using the National Stroke Foundation audit collection tool and processes, patient data from retrospective medical record self-reported audits for 40 consecutive patients with stroke per site pre-QASCIP (1 July 2012 to 31 December 2012) were compared with prospective self-reported data from 40 consecutive patients with stroke per site post-QASCIP (1 November 2013 to 28 February 2014). Inter-rater reliability was substantial for 10 of 12 variables. Primary outcome measures: Proportion of patients receiving care according to the FeSS protocols pre-QASCIP to post-QASCIP. Results: All 36 (100%) NSW stroke services participated, nominating 100 site champions who attended our educational workshops. The time from start of intervention to completion of post-QASCIP data collection was 8 months. All (n=36, 100%) sites provided medical record audit data for 2144 patients (n=1062 pre-QASCIP; n=1082 post-QASCIP). Pre-QASCIP to post-QASCIP, proportions of patients receiving the 3 targeted clinical behaviours increased significantly: management of fever (pre: 69%; post: 78%; p=0.003), hyperglycaemia (pre: 23%; post: 34%; p=0.0085) and swallowing (pre: 42%; post: 51%; p=0.033). Conclusions: We obtained unprecedented statewide scale-up and spread to all NSW stroke services of a nurse-led intervention previously proven to improve long-term patient outcomes. As clinical leaders search for strategies to improve quality of care, our initiative is replicable and feasible in other acute care settings.]]> Wed 15 Dec 2021 16:10:19 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:20399 Wed 11 Apr 2018 18:07:28 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:15732 Wed 11 Apr 2018 17:05:14 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:15057 Wed 11 Apr 2018 16:51:17 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:25866 Wed 11 Apr 2018 16:20:25 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:22662 Wed 11 Apr 2018 15:55:35 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:19406 Wed 11 Apr 2018 15:19:32 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:14025 Wed 11 Apr 2018 15:14:26 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:16544 Wed 11 Apr 2018 14:53:25 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:18673 Wed 11 Apr 2018 14:31:33 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:20481 Wed 11 Apr 2018 14:29:37 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:15068 Wed 11 Apr 2018 13:50:10 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:14828 Wed 11 Apr 2018 13:41:35 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:26221 Wed 11 Apr 2018 13:11:20 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:13912 Wed 11 Apr 2018 12:56:56 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:21012 60 Gy) with curative intent, will be recruited from radiotherapy departments at 5 Australian sites. Assessments will be conducted at 4 time points (first and final week of radiotherapy, 4 and 12 weeks postradiotherapy). The primary outcome will be a nutritional status assessment. ETHICS AND DISSEMINATION: Ethics approval from all relevant bodies has been granted. Study findings will be disseminated widely through peer-reviewed publications and conference presentations.]]> Wed 11 Apr 2018 12:47:57 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:24184 Wed 11 Apr 2018 12:25:08 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:30108 Wed 11 Apr 2018 12:12:57 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:14418 Wed 11 Apr 2018 12:08:06 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:13689 Wed 11 Apr 2018 12:02:09 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:22521 Wed 11 Apr 2018 11:21:06 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:19521 Wed 11 Apr 2018 10:38:42 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:28923 Wed 11 Apr 2018 10:33:05 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:13769 Wed 11 Apr 2018 10:20:22 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:21671 Wed 11 Apr 2018 10:03:48 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:15729 Wed 11 Apr 2018 09:44:30 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:29961 Wed 11 Apr 2018 09:38:40 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:16780 Wed 11 Apr 2018 09:14:25 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:34570 Wed 04 Sep 2019 09:48:31 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:45662 20 g/day was associated with a 13% (95% CI = 7–20%) increase in the risk of total mortality. Comparable findings were observed for cardiovascular (CV) deaths. With regard to cancer, drinking up to 10 g/day was not associated with either mortality risk reduction or increase, while alcohol intake > 20 g/day was associated with a 22% (95% CI = 10–35%) increased risk of mortality. The association of alcohol with fatal outcomes was similar in men and women, differed somewhat between countries and was more apparent in individuals preferring wine, suggesting that benefits may not be due to ethanol but other ingredients. Mediation analysis showed that high-density lipoprotein cholesterol explained 2.9 and 18.7% of the association between low alcohol intake and total as well as CV mortality, respectively. Conclusions: In comparison with life-time abstainers, consuming less than one drink per day (nadir at 5 g/day) was associated with a reduced risk of total, cardiovascular and other causes mortality, except cancer. Intake of more than two drinks per day was associated with an increased risk of total, cardiovascular and especially cancer mortality.]]> Wed 02 Nov 2022 15:52:10 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:19319 55 years) with obstructive airway disease and healthy controls (N=56) underwent inhaler technique assessment, skin allergy testing, venepuncture, fractional exhaled nitric oxide (FENO) and gas diffusion measurement, exercise testing, sputum induction, and questionnaire assessment. They then completed an assessment burden questionnaire across five domains: difficulty, discomfort, pain, symptoms and test duration. Results: Test perception was generally favourable. Induced sputum had the greatest test burden perceived as being more difficult (mean 0.83, P=0.001), associated with more discomfort (mean 1.3, P<0.001), more painful (0.46, P=0.019), longer test duration (0.84, P<0.001) and worsening symptoms (0.55, P=0.001) than the questionnaires. FENO had a more favourable assessment but was assessed to be difficult to perform. Inhaler technique received the most favourable assessment. Conclusions: Older adults hold favourable perceptions to a range of tests that they might encounter in the course of their care for airway disease. The newer tests of sputum induction and FENO have some observed difficulties, in particular sputum induction. The results of this study can inform current practice by including details of the test and its associated adverse effects when conducting the test, as well as providing clear explanations of the utility of tests and how the results might aid in patient care.]]> Tue 26 Jun 2018 11:28:14 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:21441 Tue 24 Aug 2021 14:28:19 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:48570 Tue 21 Mar 2023 18:40:40 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:41945 Tue 16 Aug 2022 14:24:17 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:36392 Tue 07 Apr 2020 15:18:29 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:35768 Tue 06 Jun 2023 13:29:56 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:40149 v 45.9%), the proportion of patients who died in hospital was lower (0.3% v 1.4%), and re-admission within 28 days was less frequent (2.3% v 3.6%). The 50 DRGs with greatest HIH activity encompassed 65 811 HIH admissions (82.1%), or 8.4% (95% CI, 8.4–8.5%) of all admissions in these DRGs. HIH admission numbers grew more rapidly than non-HIH admissions, but the difference was not statistically significant. Conclusions: HIH care is most frequently provided to patients requiring hospital treatment related to infections, venous thromboembolism, or post-surgical care. Its use could be expanded in clinical areas where it is currently used, and extended to others where it is not. HIH activity is growing. It should be systematically monitored and reported to allow better overview of its use and outcomes.]]> Tue 05 Jul 2022 15:56:43 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:30581 Tue 01 May 2018 08:51:40 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:24160 Thu 30 Mar 2023 17:25:22 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:29962 Thu 28 Oct 2021 12:37:27 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:23099 Thu 28 Oct 2021 12:36:55 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:29916 Thu 27 Jan 2022 15:56:37 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:26803 Thu 14 Apr 2022 11:02:21 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:34090 Thu 09 Dec 2021 11:02:37 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:34659 20%), but this was only statistically significant in adjusted analyses (unadjusted hazard ratio [HR], 0.79; 95% confidence interval [CI] , 0.58-1.07; P=0.13; adjusted HR, 0.77; 95% CI, 0.59-0.99; P=0.045). Older age (75-84 years; HR, 4.9; 95% CI, 2.8-8.7; P < 0.001) and increasing stroke severity (HR, 1.5; 95% CI, 1.3-1.9; P < 0.001) were associated with increased mortality, while being married (HR, 0.70; 95% CI, 0.49-0.99; P=0.042) was associated with increased likelihood of survival. Cardiovascular disease (including stroke) was listed either as the primary or secondary cause of death in 80% (211/264) of all deaths. Conclusions: Our results demonstrate the potential long-term and sustained benefit of nurse-initiated multidisciplinary protocols for management of fever, hyperglycemia, and swallowing dysfunction. These protocols should be a routine part of acute stroke care.]]> Thu 03 Feb 2022 12:20:16 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:13795 13 on the Beck Depression Inventory-II (BDI-II) received a single-session brief intervention. They were then block randomised to either six sessions of group CBT (n = 25) or no further intervention (BI; n = 32). All were re-assessed at 2, 6 and 12 months. Differences between treatment groups in the primary (BDI-II) and secondary [rates of depression; anxiety symptoms, as measured by the Hospital Anxiety and Depression Scale-Anxiety (HADS-A)] outcomes were examined using generalised linear mixed models with a random intercept term for the individual. Results: Significant improvements were seen for the total group from baseline to 12 months on BDI-II and HADS-A scores. However, no differences were found between the CBT and BI conditions on change in BDI-II score, rates of major depressive episode or HADS-A score. Post hoc analysis on the total group found 12-month symptom non-remission was associated with higher baseline BDI-II score (p = 0.03), more visits to health professionals 12 months prior to baseline (p = 0.05) and a greater likelihood of either drinking alcohol over recommended levels or smoking at baseline (p = 0.01). Conclusions: Group CBT of up to six sessions did not result in greater reductions in depression or anxiety symptoms compared with a single-session brief intervention. Further work should focus on the efficacy and role of brief interventions, and addressing smoking and alcohol misuse in cardiac patients with depression.]]> Sat 24 Mar 2018 10:40:34 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:13753 Sat 24 Mar 2018 10:39:17 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:12896 Sat 24 Mar 2018 10:36:56 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:15334 Sat 24 Mar 2018 08:26:45 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:14102 Sat 24 Mar 2018 08:24:01 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:20453 Sat 24 Mar 2018 08:06:58 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:20942 p = 0.020) and then further elevated after surgery (1 hour postoperative, 17.8 ± 2.0 U vs. preoperative, 13.8 ± 1.4 U, p = 0.008). Polytrauma patients were more hypercoagulable than nonpolytrauma at the preoperative sample time (17.7 ± 2.6 U vs. 10.7 ± 1.2 U, p = 0.040) and postoperative period (24.3 ± 3.4 U vs. 11.9 ± 1.4 U, p = 0.006). The OHP for patients undergoing open pelvic surgery (28.3 ± 3.0 U) was higher than both intramedullary nailing (16.2 ± 2.0 U) and percutaneous pelvic surgery (17.0 ± 1.7 U) on Day 5 (p < 0.05). Patients demonstrated a higher OHP than controls did at all time points, except at 6 weeks (patients, 10.8 ± 1.7 U vs. controls, 8.1 ± 0.5 U; p = 0.400). CONCLUSION: The OHP assay detected the hypercoagulable state following major orthopedic trauma and surgical intervention, which was present for 10 days postoperatively. The extent of hypercoagulability could be associated with polytrauma and the type of surgical intervention; however, further studies are needed to confirm this.]]> Sat 24 Mar 2018 08:06:06 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:20818 Sat 24 Mar 2018 08:05:53 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:16723 Sat 24 Mar 2018 08:05:31 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:18764 Sat 24 Mar 2018 08:02:46 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:16881 Sat 24 Mar 2018 08:00:47 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:20740 Sat 24 Mar 2018 08:00:24 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:20257 Sat 24 Mar 2018 07:59:56 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:16904 Sat 24 Mar 2018 07:59:52 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:20482 Sat 24 Mar 2018 07:59:07 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:16916 Sat 24 Mar 2018 07:58:44 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:19935 Sat 24 Mar 2018 07:58:30 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:19122 Sat 24 Mar 2018 07:55:56 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:19135 Sat 24 Mar 2018 07:55:55 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:21853 Sat 24 Mar 2018 07:55:30 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:21364 11 mmol/L). We also recorded swallow screening and assessment during the first 24 h of admission. Results: Data for 718 (98%) patients were available; 138 (19%) had four hourly or more temperature readings and 204 patients (29%) had a fever, with 44 (22%) receiving paracetamol. A quarter of patients (n = 102/412, 25%) had six hourly or more glucose readings and 23% (95/412) had hyperglycemia, with 31% (29/95) of these treated with insulin. The majority of patients received a swallow assessment (n = 562, 78%) by a speech pathologist in the first instance rather than a swallow screen by a nonspeech pathologist (n = 156, 22%). Of those who passed a screen (n = 108 of 156, 69%), 68% (n = 73) were reassessed by a speech pathologist and 97% (n = 71) were reconfirmed to be able to swallow safely. Conclusions: Our results showed that acute stroke patients were: undermonitored and undertreated for fever and hyperglycemia; and underscreened for swallowing dysfunction and unnecessarily reassessed by a speech pathologist, indicating the need for urgent behavior change.]]> Sat 24 Mar 2018 07:51:25 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:26805 0.25) compared with increases observed in 20- to 21-year-old Maori males. For Maori females, estimates were more variable, but overall, there was no evidence of the hypothesised effect (incidence rate ratios between 0.60 and 1.09; P values >0.07). Discussion and Conclusions: Overall, we find no evidence that lowering the minimum alcohol purchasing age increased weekend hospitalised assaults among young Maori. Inferences are compromised by lack of statistical power which underlines the importance of planning for evaluation of important policies well before they are implemented, particularly with a view to meeting obligations to Maori arising from the Treaty of Waitangi.]]> Sat 24 Mar 2018 07:36:27 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:25578 Sat 24 Mar 2018 07:35:13 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:26588 Sat 24 Mar 2018 07:34:02 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:30928 Sat 24 Mar 2018 07:33:38 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:27027 Sat 24 Mar 2018 07:30:15 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:28120 Sat 24 Mar 2018 07:24:57 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:26235 Sat 24 Mar 2018 07:24:04 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:28777 11 mmol/l), and swallowing dysfunction in intervention stroke units. Results: Data from 1804 patients (718 preintervention; 1086 postintervention) showed that significantly more patients admitted to hospitals allocated to the intervention group received care according to the fever (n = 186 of 603, 31% vs. n = 74 of 483, 15%, P < 0·001), hyperglycemia (n = 22 of 603, 3·7% vs. n = 3 of 483, 0·6%, P = 0·01), and swallowing dysfunction protocols (n = 241 of 603, 40% vs. n = 19 of 483, 4·0%, P ≤ 0·001). Significantly more patients in these intervention stroke units received four-hourly temperature monitoring (n = 222 of 603, 37% vs. n = 90 of 483, 19%, P < 0·001) and six-hourly glucose monitoring (194 of 603, 32% vs. 46 of 483, 9·5%, P < 0·001) within 72 hours of admission to a stroke unit, and a swallowing screen (242 of 522, 46% vs. 24 of 350, 6·8%, P ≤ 0·0001) within the first 24 hours of admission to hospital. There was no difference between the groups in the treatment of patients with fever with paracetamol (22 of 105, 21% vs. 38 of 131, 29%, P = 0·78) or their hyperglycemia with insulin (40 of 100, 40% vs. 17 of 57, 30%, P = 0·49). Interpretation Our intervention resulted in better protocol adherence in intervention stroke units, which explains our main trial findings of improved patient 90-day outcomes. Although monitoring practices significantly improved, there was no difference between the groups in the treatment of fever and hyperglycemia following acute stroke. A significant link between improved treatment practices and improved outcomes would have explained further the success of our intervention, and we are still unable to explain definitively the large improvements in death and dependency found in the main trial results. One potential explanation is that improved monitoring may have led to better overall surveillance of deteriorating patients and faster initiation of treatments not measured as part of the main trial.]]> Sat 24 Mar 2018 07:23:45 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:22233 Sat 24 Mar 2018 07:17:38 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:23691 Sat 24 Mar 2018 07:13:26 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:24697 F0 = 0.017) and 3 months (Pr>F = 0.006), indicating more consistent and predictable improvement in motor outcomes. Conclusion: Early, more-intensive, UL training was associated with greater changes in activation in putative motor (supplementary motor area and cerebellum) and attention (anterior cingulate) regions, providing support for the role of these regions and functions in early recovery poststroke.]]> Sat 24 Mar 2018 07:10:53 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:39001 P < .001), thus resulting in a median increase in costs (in Australian dollars) of $33,338 (confidence interval, $21,943-$38,415). Several baseline characteristics were strongly associated with a bleeding event. Conclusions: The impact of a bleeding event on the cost of cardiac surgery is substantial. This study identified a set of risk factors for bleeding that could be used to identify patients for discussion at the heart team level, where measures to minimize the risk of transfusion may be initiated.]]> Mon 29 Jan 2024 17:47:12 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:53418 20 g/d had 1% (HR = 1.01; 0.82–1.25), 10% (HR = 1.10; 1.02–1.19) and 17% (HR = 1.17; 1.09–1.26) higher rate of death. The association of alcohol consumption with all-cause mortality was nonlinear, with a different J-shape by EL levels. It was consistent across both sexes and in various approaches of measuring alcohol consumption, including combining quantity and frequency and it was more evident when the beverage of preference was wine. We observed that drinking in moderation (≤ 10 g/d) is associated with lower mortality rate more evidently in individuals with higher EL than in people with lower EL, while heavy drinking is associated with higher mortality rate more evidently in individuals with lower EL than in people with higher EL, suggesting that advice on reducing alcohol intake should especially target individuals of low EL.]]> Mon 27 Nov 2023 11:18:45 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:44785 1). Logistic regression models were used to examine the relationship between ICU strain and hospital mortality. Results: 57,844 ICU admissions were analysed, with the majority (64.4%) admitted to medium-strain ICUs. Those admitted to high-strain ICUs spent longer in hospital prior to ICU than medium-strain or low-strain ICUs. After adjusting for confounders those admitted to high-strain ICUs [OR 1.24 (95%CI 1.14–1.35)] or medium-strain ICUs [OR 1.18 (95%CI 1.09–1.27)], (p < 0.001) had a higher risk of death compared low-strain ICUs. Conclusion: ICU strain is associated with longer times in hospital prior to ICU admission and was associated with increased risk of death in patients admitted from ward.]]> Mon 24 Oct 2022 09:17:40 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:21232 Mon 23 Sep 2019 14:20:10 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:37711 Mon 22 Mar 2021 14:54:58 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:55170 Mon 22 Apr 2024 11:22:23 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:18704 Mon 20 Jul 2015 17:48:19 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:22755 1.8 and volume >15 ml, core <70 ml). In a second analysis, we compared outcomes of the perfusion computed tomography-selected rtPA-treated patients to an Australian historical cohort of non-contrast computed tomography-selected rtPA-treated patients. Of 635 patients with acute ischaemic stroke eligible for rtPA by standard criteria, thrombolysis was given to 366 patients, with 269 excluded based on visual real-time perfusion computed tomography assessment. After off-line quantitative perfusion computed tomography classification: 253 treated patients and 83 untreated patients had 'target' mismatch, 56 treated and 31 untreated patients had a large ischaemic core, and 57 treated and 155 untreated patients had no target mismatch. In the primary analysis, only in the target mismatch subgroup did rtPA-treated patients have significantly better outcomes (odds ratio for 3-month, modified Rankin Scale 0-2 = 13.8, P < 0.001). With respect to the perfusion computed tomography selected rtPA-treated patients (n = 366) versus the clinical/non-contrast computed tomography selected rtPA-treated patients (n = 396), the perfusion computed tomography selected group had higher adjusted odds of excellent outcome (modified Rankin Scale 0-1 odds ratio 1.59, P = 0.009) and lower mortality (odds ratio 0.56, P = 0.021). Although based on observational data sets, our analyses provide support for the hypothesis that perfusion computed tomography improves the identification of patients likely to respond to thrombolysis, and also those in whom natural history may be difficult to modify with treatment.]]> Mon 11 Mar 2019 12:14:50 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:46474 N = 220) with current depressive symptoms and alcohol misuse were recruited from the DAISI project, a randomised controlled trial with four treatment arms. PTSD symptoms were assessed at baseline by the Posttraumatic Stress Diagnostic Scale and again at the 3-month assessment. Results: McNemars t-test assessed for changes in PTSD symptom severity and PTSD symptom clusters at the 3-month assessment. Repeated measures multivariate analysis of variance assessed for changes in PTSD symptoms, by DAISI treatment allocation. At the 3-month assessment, participants with PTSD reported significant reductions in PTSD symptoms (except intrusion) and a lower rate of PTSD, and responded better to integrated depression-alcohol misuse CBT than to the alcohol/depression single-focussed or brief interventions. Conclusion: Integrated depression and alcohol misuse CBT may be effective for PTSD symptoms, but intrusions may need to be addressed specifically.]]> Fri 25 Nov 2022 15:45:27 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:32802 Fri 22 Apr 2022 10:24:54 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:33265 Fri 21 Sep 2018 14:23:24 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:48914 Fri 14 Apr 2023 18:21:18 AEST ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:45592 1c) assessment and notification of diabetes services about patients at intervention hospitals with blood glucose levels of 14 mmol/L or more. Main outcome measure: New diagnoses of diabetes and documented follow‐up plans for patients with admission blood glucose levels of 14 mmol/L or more. Results: Blood glucose was measured in 133 837 patients admitted to hospital from an ED. The numbers of new diabetes diagnoses with documented follow‐up plans for patients with blood glucose levels of 14 mmol/L or more were similar in intervention (83/506 patients, 16%) and control hospitals (73/278, 26%; adjusted odds ratio [aOR], 0.83; 95% CI 0.42–1.7; P = 0.61), as were new diabetes diagnoses with or without plans (intervention, 157/506, 31%; control, 86/278, 31%; aOR, 1.51; 95% CI, 0.83–2.80; P = 0.18). 30‐day re‐admission (31% v 22%; aOR, 1.34; 95% CI, 0.86–2.09; P = 0.21) and post‐hospital mortality rates (24% v 22%; aOR, 1.07; 95% CI, 0.74–1.55; P = 0.72) were also similar for patients in intervention and control hospitals. Conclusion: Glucose and Hb_1c screening of patients admitted to hospital from EDs does not alone increase detection of previously unidentified diabetes. Adequate resourcing and effective management pathways for patients with newly detected hyperglycaemia and diabetes are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12611001007921.]]> Fri 04 Nov 2022 08:55:50 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:47867 Fri 03 Feb 2023 14:14:59 AEDT ]]> https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:30100 p = 0.022) and did not have different rates of mRS 0 to 2 (72% treated patients vs 77% untreated; RR, 0.93; 95% CI, 0.82-1.95; p = 0.23). Interpretation: This large observational cohort suggests that a portion of ischemic stroke patients clinically eligible for alteplase therapy with a small perfusion lesion have a good natural history and may not benefit from treatment.]]> Fri 01 Apr 2022 09:25:36 AEDT ]]>