ResearchOnline@ND (University of Notre Dame)
Not a member yet
7734 research outputs found
Sort by
Coronary artery bypass grafting in octogenarians: An Australian experience
No full textBackground: The aims of this study were to describe early and mid-term morbidity and mortality in octogenarian patients undergoing CABG, to determine if outcomes are comparable to younger patients undergoing the same procedure.
Methods: We conducted a retrospective analysis of the first 901 patients who underwent cardiac surgery at a large newly established tertiary hospital in Western Australia from February 2015 to September 2019. Inclusion criteria involved all patients undergoing coronary artery bypass grafting. Exclusion criteria included patients who underwent concomitant valve or aortic procedure.
Results: From a cohort of 901 patients, 37 octogenarian patients underwent CABG. Octogenarian patients had a higher rate of post-operative transfusion 35.1% versus 21.4%(P = 0.048), a higher rate of post-op acute kidney injury 40.5% versus 17.2% (P \u3c 0.0001),a higher rate of post-operative atrial arrythmia requiring treatment 40.5% versus22.5% (P = 0.011) and higher rate of return to theatre (13.5% versus 4.7%,P = 0.018), with bleeding/tamponade being the most likely reason (10.8% versus2.7%). Octogenarian patients had a longer post-operative length of stay (LOS) with a median LOS of 10 versus 7 days (P \u3c 0.0001). There was no increase in hospital readmission rate, in-hospital mortality or 1 year mortality in octogenarian patients.24-month and 36-month survivals were 95.2% and 89.6% in octogenarians and 95.3%and 91.5% in the younger group.
Conclusions: Despite an increase in post-operative morbidity and LOS, there was no difference in hospital readmission, in-hospital mortality or 1 year mortality in octogenarian patients who underwent CABG. CABG is safe and remains an important management option for these patients
Maternal performance after childbirth and its predictors: a cross sectional study
No full textBackground and Objectives: Birthing parents need to use specialized skills as the frst caregiver of the newborn. Several factors may afect performance. Yet there is a paucity of research in this area, and evidence remains inconsist‑ ent. Consequently, this study aimed to determine maternal performance after childbirth and its predictors.
Methods: This cross-sectional study was conducted with those (n=450) who had given birth (
Results: The mean age of the participants was 26.78 and the mean total score of maternal performance was 91.04 (0—120). The highest and lowest scores related to the ‘maternal competence’ and the ‘maternal needs’ domains, with mean score calculated at 77.51 and 72.81 respectively. ‘Childbirth experience’ and‘maternal self-efcacy’ domains had a statistically signifcant relationship with maternal performance (P\u3c0.05). Among the predictive factors of mater‑ nal performance, the results of our linear regression demonstrated the variables of birth experience (B=0.63), mater‑ nal self-efcacy (B=1.53), spouse’s employment status (B=5.78 for worker level, B=3.99 for employee level), the num‑ ber of previous childbirth experiences (B= -8.46), frequency of receiving antenatal care (B= -6.68), length of stay in the birth suite (B= -2.22) and length of stay in the hospital (B=2.84) remained in the model. 53.2% of changes in maternal performance can be explained by these independent variables.
Conclusion: The promotion of evidence-based, person-centered, and respectful perinatal care during pregnancy and childbirth are of paramount importance. Strategies to improve the experience of childbirth and self-efcacy are especially required to improve maternal performance in the postpartum period. Prenatal care aimed at improving maternal function after childbirth will be important in achieving this overall
Identifying priorities for Australian disability research using Q methodology
No full textBackground Globally, there are over an estimated one billion people with disability. Research priorities with a focus on diagnosis and treatment of conditions or policy and service initiatives, traditionally decided by researchers, may not align with priorities of those with lived experience of disability. Objective To explore and inform disability research for Australia, including perspectives of people with disability. Methods As part of a research program, we used Q methodology to explore “what should guide the Australian research agenda?” People with disability, their families, community organizations and researchers were purposively recruited and sorted 25 statements, developed iteratively using data collated from systematic research mapping and a prior consultation process. The sorting grid ranged from −4 to +4, according to “Which topics should guide disability research the least to the most?” Factor analysis revealed four distinct but interrelated participant viewpoints. Results 52 participants (65 % female, aged 18–65+ years, 37 % people living with disability), sorted the statements. Viewpoint 1 – design and delivery of services across the lifespan. Viewpoint 2 – understanding the diverse experience of those with disability. Viewpoint 3 – designing systems to address impacts of disability for the individual, their families and society. Viewpoint 4 – addressing mental health for those with disability no matter where they live. Conclusion These viewpoints focused on design and delivery of services to address the impacts of disabling environments and attitudes on individuals living with impairments, their families and society. The four viewpoints provide a framework for future disability research in consultation with those with lived experience
Reflections on navigating community protocols with awareness and respect
Get PDFIndigenous communities in the Kimberley, and across Australia, hold different protocols and expectations when it comes to how outsiders (including researchers) ought to behave and engage.
Historically, researchers active in the Kimberley have not always conducted themselves in respectful ways, which can disrupt trusting relationships and diminish the research endeavour; many Indigenous people are suspicious of researchers, and for good reason.
This conversation will seek to elucidate the kinds of place-based protocols that researchers need to be mindful of, and to advise on how researchers might slow down, step carefully and engage meaningfully with Indigenous people
Tending to the machine: The impact of intrapartum fetal surveillance on women in Australia
No full textQualitative research about women and birthing people’s experiences of fetal monitoring during labour and birth is scant. Labour and birth is often impacted by wearable or invasive monitoring devices, however, most published research about fetal monitoring is focused on the wellbeing of the fetus. This manuscript is derived from a larger mixed methods study, ‘WOmen’s Experiences of Monitoring Baby (The WOMB Study)’, aiming to increase understanding of the experiences of women and birthing people in Australia, of being monitored; and about the information they received about fetal monitoring devices during pregnancy. We constructed a national cross-sectional survey that was distributed via social media in May and June, 2022. Responses were received from 861 participants. As far as we are aware, this is the first survey of the experiences of women and birthing people of intrapartum fetal monitoring conducted in Australia. This paper comprises the analysis of the free text survey responses, using qualitative and inductive content analysis. Two categories were constructed, Tending to the machine, which explores participants’ perceptions of the way in which clinicians interacted with fetal monitoring technologies; and Impressions of the machine, which explores the direct impact of fetal monitoring devices upon the labour and birth experience of women and birthing people. The findings suggest that some clinicians need to reflect upon the information they provide to women and birthing people about monitoring. For example, freedom of movement is an important aspect of supporting the physiology of labour and managing pain. If freedom of movement is important, the physical restriction created by a wired cardiotocograph is inappropriate. Many participants noticed that clinicians focused their attention primarily on the technology. Prioritising the individual needs of the woman or birthing person is key to providing high quality woman-centred intrapartum care. Women should be provided with adequate information regarding the risks and benefits of different forms of fetal monitoring including how the form of monitoring might impact her labour experience
Connecting the threads: the role of multiplicative thinking in algebraic, geometrical, and statistical reasoning
No full textMaking connections within and between different aspects of mathematics is recognised as fundamental to learning mathematics with understanding. However, exactly what these connections are and how they serve the goal of learning mathematics is rarely made explicit in curriculum documents with the result that mathematics tends to be presented as a set of discrete, disconnected topics. Interest in establishing a more coherent approach to the teaching and learning of school mathematics has led to a focus on big ideas. That is, networks of related concepts, skills and ways of thinking that facilitate learning mathematics with understanding. Research on learning progressions has helped identify what these big ideas are and how they serve to build connections within and between different aspects of mathematics. This paper draws on research that provides an evidenced-based learning progression for multiplicative reasoning to illustrate the connective role of multiplicative thinking in the development of algebraic, geometrical, and statistical reasoning