134125 research outputs found
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Does policy and practice for peripheral intravenous catheters match clinical standards? A point prevalence study
No full textBackground Peripheral intravenous catheters (PIVCs) face complications from inadequate care, posing patient safety risks. The Australian ‘Management of Peripheral Intravenous Catheters Clinical Care Standard’ sets an expected level-of-care, but current adoption of the Standard into policy and practice is unknown. Methods A multi-site point prevalence study was conducted in 134 acute hospital wards across 21 hospitals in 8 health services in one Australian state. Patients with ≥1 PIVC were included. Adherence to the Standard's 10 Quality Statements (QSs) was measured against the Standard's 13 structural and process indicators, and 6 additional study measures. Overall binary adherence for each QS was achieved when all indicators were met. Results Adherence with Standard structural indicators ranged from 19 % to 43 %, while additional structural measures met 57.9 %–100 % adherence. For process indicators, 788 patients were included. Most had PIVCs used for a therapeutic purpose since insertion (91 %), and in the last 24-h (81 %), could identify the reason for their PIVC (86 %), and had clean, dry, secure PIVC dressings (81 %). Fewer had PIVCs inserted on the first attempt (70 %), had a documented insertion indication (80 %), or documented assessment of ongoing PIVC need (61 %). Notably, 53 % had PIVCs in an area-of-flexion and 42 % had documented PIVC inspections at least 8-hourly. Overall binary adherence was met for 2/10 (20 %) Standard QSs. Conclusions Despite a clear level of expected care for PIVCs, much unwarranted variation exists in policy and practice. Reform of local guidelines, policies, and processes to standardise PIVC care across hospitals and strategies to improve Standard adherence are needed.Full Tex
Safety decision making cues of Queensland's volunteer firefighters
No full textThis research examines how Queensland's rural volunteer firefighters interpret their initial decision cues during wildfire responses. Building on Klein's naturalistic decision making and recognition primed decision model, it emphasises the role of environmental cues, pattern recognition and experiential knowledge in high pressure situations. Using a qualitative approach, the study participants include eight first officers' and examines the cognitive processes through recollections of memorable fires. The analysis identifies four themes: knowing your patch, pattern matching, sizing up the scene and resource planning that form a cohesive framework for effective decision making. The findings highlight how environmental familiarity and situational assessment enable rapid, intuitive responses, discussed within existing decision models. Practical implications include developing targeted training to enhance recognition and adaptive decision making, promoting regional knowledge sharing and decentralised command structures to strengthen wildfire response and community safety amid Australia's escalating fire threat.Thesis (Masters)Master of Arts ResearchSchool of Humanities, Languages and Social ScienceArts, Education and LawFull Tex
Factors Associated With Digital Confidence and Use of Technology Among Older Queenslanders
No full textOBJECTIVE: Digital technology increasingly plays an important role in supporting older adults to live longer and healthier lives. However, research consistently identifies barriers to technology usage for some older adults, particularly as they age. This study draws on data from a survey of older adults (aged 65 years and older) to improve our understanding of the role that confidence with technology plays in older adults' technology acceptance. METHODS: We analysed technology usage and acceptance data from 547 Queensland older adults (53% male, 47% female) gathered as part of a larger survey examining how technology may assist the development of an in-home heat early warning system for older Queenslanders. Respondents fell within five age range groups, 65-69 years (24%), 70-74 years (29%), 75-79 years (28%), 80-84 years (12%) and 85+ (7%). RESULTS: Respondents from the highest age range groups were more apprehensive about, and were slower to adopt, new technologies. Moreover, overall use of technology also declined with age, implying the need to consider ageing cohorts when considering technology acceptance. When looking at digital confidence, our results highlight that age was the only independent variable that predicted (inversely) digital confidence, and somewhat counterintuitively, frustration with technology. This may suggest that older cohorts avoid using new technology to avoid the risk of frustration. CONCLUSIONS: Results from the survey data add to our knowledge of the patterns of technology usage and acceptance by older adults. Our analysis underscores the need to consider variables such as confidence or frustration with technology when considering whether cutting-edge technologies will benefit older users.No Full Tex
Nursing student reflections on a research internship: A reflective discussion following the Gibbs' reflective cycle
Get PDFBackground: Evidence-based practice underscores the importance of utilising research-based skills in the delivery of care. However, entry-to-practice nursing curriculums in Australia currently do not provide students with practical research opportunities. Acknowledging this gap, an Australian university initiated a two-month summer research internship that aim to expose undergraduate nursing students to clinical research under the mentorship of a nursing academic. Aim: To understand the opportunities and challenges of a research internship and its contribution to developing research knowledge and skills for future nursing practice and leadership. Design: A reflective discussion following the six stages of the Gibbs' Reflective Cycle. Settings: A two-month research internship at an Australian University was held over the summer. Participants: Two successful nursing students (FO and BM) who were both students in the Master of Nursing (Graduate Entry) program. Methods: Following the Gibbs' Reflective Cycle, a description of the internship experience was outlined, alongside feelings encountered. The opportunities and challenges of the internship are explored, evaluated, and analysed with related literature to inform an overall conclusion. To support other nursing students pursuing similar research endeavours during their professional transition, an action plan was developed. Results: The optional summer research internship proved to be a valuable experience for participating nursing students. FO and BM were granted co-authorship on their respective research projects, providing opportunities at international nursing and midwifery conferences and several avenues for career advancement. Conclusions: Nursing research internships contribute to students' personal and professional development. This paper highlights the need for universities to provide innovative educational opportunities to students that enrich evidence-based nursing practice and inspire further opportunities.Full Tex
Watch Out, it Bites! An Examination of Threat Information Transmission from Parents to Young Children with Specific Phobias
Get PDFSpecific phobias are highly prevalent and onset as young as 3 years of age. Evidence suggests children learn fear beliefs and avoidance after being provided negative/threatening information. Little is currently known, however, about the role of information transmission in clinical samples. This study explores the role of information transmission in early onset specific phobias, as proposed by Rachman (1977), by comparing a clinical group of forty-two parents of children (aged 3 to 6 years) with specific phobia and a non-clinical group including seventeen parents of age-matched children. Parents completed a diagnostic telephone interview and parent psychopathology questionnaire, followed by an in-person novel animal task to ascertain the frequency of information they attend to and putatively provide to their children under three valence conditions (positive, negative, ambiguous). Parents of children with specific phobia putatively provided significantly more negative information to their children than parents of non-clinical children, under ambiguous conditions. The amount of negative information provided within this sample was not related to parent’s own anxiety. The findings of this study extend upon previous research showing that it is normative for children to acquire fears after receiving negative/threatening information, providing support for the role of negative/threatening information transmission in pathological fears, with a clinical sample at the time of onset.Full Tex
The impact of referral wait times on high-risk medication usage in patients with chronic pain: a tertiary pain clinic retrospective chart audit
No full textBackground
Increasing demand for specialist pain clinics for patients with chronic non-cancer pain has led to longer wait times. The shift towards multimodal analgesia has raised significant safety concerns, particularly in vulnerable populations, yet remains unexplored.
Aim
This study aimed to investigate changes in medication use for opioids, gabapentinoids, and benzodiazepines among patients waiting for an initial appointment at a tertiary pain clinic, and to determine the effect of waitlist duration on opioid doses.
Method
A retrospective audit of patients referred to a pain clinic between January 2022–December 2023 was conducted at a public tertiary hospital, located in Queensland, Australia. Data from general practitioner referrals and first appointments were analysed. Negative binomial regression examined the relationship between waitlist duration and opioid dosages. This project was exempt due to the local policy requirements that constitute research by the Metro South Health Human Research Ethics Committee (Reference no: EX/2023/QMS/98214). The justification for this exemption was as follows: the project only utilised anonymised data collected as part of routine clinical practice, presented minimal patient risk, and conforms with the National Health and Medical Research Council Ethical considerations in quality assistance and evaluation activities.
Results
The study included 500 patients with complete data, of whom 82% reported using prescribed opioids at referral, 42% reporting using gabapentinoids, and 25% reported using benzodiazepines. Concomitant use was common, with 43% of patients on opioids plus at least one other medication class at referral. The median waitlist duration was 320 days. After adjusting for covariates, there was no effect of waitlist duration on opioid doses at first appointment. Referral opioid dose was the strongest predictor of first appointment opioid dose (odds ratio 1.01, 95% confidence interval 1.009–1.012, p < 0.001).
Conclusion
Despite no effect of waitlist duration on opioid doses, high rates of concurrent medication use highlight the need for improved triage systems and management strategies to reduce risks and optimise care.Full Tex
Government funding for healthcare infection prevention research: A scoping review of the past decade
Get PDFBackground: Healthcare infection prevention and control (IPC) programs are recognised globally as a system-wide strategy to support patient and staff safety. Research evidence is essential to underpin these programs, however it is unclear the level of national research funding invested into healthcare IPC in the past decade. Methods: Scoping review using Arksey and O'Malley's framework. A systematic search of national category 1 grants awarded between 2014 and 2023 on healthcare IPC was undertaken. Grants were eligible if they were focused on healthcare IPC, we excluded preclinical studies and vaccine development studies. Two independent reviewers screened and extracted data, result were summarised narratively. Results: We identified 10,394 grants, amounting to 37.11M was provided for 23 IPC research projects/programs (median per grant $1.10M, interquartile range 335k to 2.44M). Accounted for approximately 0.19 % of the total government health research funding in Australia from 2014 to 2023. No healthcare IPC related grants were awarded in 2020, the peak of the pandemic. Conclusion: IPC research funding in Australia remains disproportionately low relative to infection health and economic burden.Full Tex
Quantum state smoothing when Alice assumes the wrong type of monitoring by Bob
No full textAn open quantum system leaks information into its environment. We are interested in physical situations where an observer, say Alice, can recover some of that information, as a classical measurement record. The optimal way for Alice to estimate the quantum state at time t from the record before t is known as quantum filtering. Recently, a version of quantum smoothing, in which Alice estimates the state at time t using her record on both sides of t, has been developed. It requires Alice to make optimal inferences about the pre-t record of a second observer, say Bob, who recovers whatever information Alice does not. But for Alice to make this inference, she needs to know Bob's measurement setup. In this paper we consider what happens if Alice is mistaken in her assumption about Bob's setup. We show that the accuracy --- as measured by the Trace-Squared-Deviation, of Alice's estimate of the true state (i.e., the state conditioned on her and Bob's pre-t records) --- depends strongly on her setup, Bob's actual setup, and the wrongly assumed setup. Using resonance fluorescence as a model system, we show numerically that in some cases the wrong smoothing is almost as accurate as the right smoothing, but in other cases much less accurate, even being less accurate than Alice's filtered estimate. Curiously, in some of the latter cases the fidelity of Alice's wrong estimate with the true state is actually higher than that of her right estimate. We explain this, and other features we observe numerically, by some simple analytical arguments.Full Tex
Challenging Assumptions: Per- and Polyfluoroalkyl Substances Detected in Deep Groundwater across Southeastern Australia
No full textPer- and polyfluoroalkyl substances (PFAS) are increasingly detected in groundwater globally, yet their occurrence in deep or confined aquifers remains poorly characterized. We conducted the first regional-scale survey of PFAS in groundwater systems across southeastern Australia, encompassing 54 bores from four locations to establish baseline concentrations. Fifteen PFAS were detected in both shallow and deep wells, with ∑PFAS concentrations ranging from below detection to 78.8 ng/L. PFOS and PFOA were the most frequently detected legacy compounds, including bores screened at >50 m depth and up to 106 m. PFAS were found across a range of land uses, including sites without known contamination sources, indicating potential long-range lateral transport, vertical migration through bore infrastructure or diffuse legacy inputs. These findings provide chemically based evidence that supports the hypothesis of modern groundwater reaching deeper aquifers, previously thought to be isolated from surface contamination. Random forests modeling identified dissolved organic carbon and nutrient concentrations as key predictors of PFAS presence, suggesting links between geochemical conditions and contaminant occurrence. This baseline data set contributes new evidence that deep groundwater systems are not immune to PFAS intrusion and underscores the need to incorporate subsurface transport processes into monitoring and management strategies, particularly for groundwater-dependent ecosystems and water security planning, worldwide.No Full Tex
Working with, and for, our communities: bringing visions for music to life
No full textOne of the challenges that music teachers face is that of isolation within schools and within communities. This is compounded when teachers feel overworked and stressed. We know, however, that one of the ways to counteract the effects of burnout and isolation is to work towards creating and participating in communities. This workshop works with and for teachers to help them establish a working plan for engaging more effectively in their communities, harnessing the myriad resources that may be underused. The latest National Cultural Policy offers an alternative and whole-of-government advocacy platform. The pillars of First Nations First, providing a place for every story, centring artists, enhancing cultural infrastructure, and engaging audiences can provide guiding principles in crafting our collective vision for music education. Following a policy analysis, workshop participants will collaboratively work through a process of identification, analysis, planning and action items in order to leave the workshop with workable strategies for community building and policy responses to use within their own context. This workshop will be led by members of the Access to Music Education for Inclusion and Equity (AMIE) Network, a collective of scholars and music professionals from around Australia working to ensure that the lives of all children and young people, no matter their background, ability, or circumstance, are enriched by a creative and culturally responsive music education.No Full Tex