Establishing trust in emergency telehealth consultations.

Over recent years, emergency telehealth has developed rapidly in Australasia. From the patient's perspective, establishing trust with a healthcare provider is uniquely challenging when using the audio and video modalities commonly used in telehealth. It is crucial to consider how we may improve the delivery of care through this emerging pathway if high-quality care is to be delivered.

Implementing AI-Driven Bed Sensors: Perspectives from Interdisciplinary Teams in Geriatric Care.

Sleep is a crucial aspect of geriatric assessment for hospitalized older adults, and implementing AI-driven technology for sleep monitoring can significantly enhance the rehabilitation process. Sleepsense, an AI-driven sleep-tracking device, provides real-time data and insights, enabling healthcare professionals to tailor interventions and improve sleep quality. This study explores the perspectives of an interdisciplinary hospital team on implementing Sleepsense in geriatric hospital care.

From concept to reality: A comprehensive exploration into the development and evolution of a virtual emergency department.

Emergency department (ED) overcrowding remains a persistent challenge in global public health, leading to detrimental outcomes for patients and healthcare professionals. Traditional approaches to improve this issue have been insufficient, prompting exploration of novel strategies such as virtual care interventions. Our team developed the first comprehensive statewide virtual ED in Australia, the Victorian Virtual Emergency Department, offering an alternative to in-person care for non-life-threatening emergencies.

Potential bed-day savings and caregiver perspectives of transitioning hospital-level management of infants with bronchiolitis to the home: a mixed-methods study.

Objective: Home management of infants admitted to hospital with bronchiolitis would alleviate pressure on hospital beds. We aim to understand the proportion of children requiring active care interventions (ie, oxygen, fluids), caregiver perspectives and potential impact of transitioning hospital-level care of infants with bronchiolitis to home.

Methods: This is a mixed-methods study in an Australian tertiary paediatric hospital.

Reducing unwarranted chest x-rays in bronchiolitis: Importance of a robust analysis.

Aim: Bronchiolitis is the commonest reason for hospitalisation amongst infants and is often a target for low-value care (LVC) reduction. We aimed to assess the impact of a multifaceted intervention (clinician education, parent engagement, audit-feedback) on rates of chest x-rays (CXR) in bronchiolitis.

Methods: Longitudinal study of CXRs ordered in infants (1-12 months) diagnosed with bronchiolitis in the Emergency Department (ED) of an Australian paediatric hospital between May 2016 and February 2023.

Retrospective analysis of the impact of electronic medical record alerts on low value care in a pediatric hospital.

Objectives: Hospital costs continue to rise unsustainably. Up to 20% of care is wasteful including low value care (LVC). This study aimed to understand whether electronic medical record (EMR) alerts are effective at reducing pediatric LVC and measure the impact on hospital costs.

Discharge criteria for inpatient paediatric asthma: a narrative systematic review.

Introduction: Criteria-led discharges (CLDs) and inpatient care pathways (ICPs) aim to standardise care and improve efficiency by allowing patients to be discharged on fulfilment of discharge criteria. This narrative systematic review aims to summarise the evidence for use of CLDs and discharge criteria in ICPs for paediatric inpatients with asthma, and summarise the evidence for each discharge criterion used.

Methods: Database search using keywords was performed using Medline, Embase and PubMed for studies published until 9 June 2022.

Impact of an Intervention to Reduce Bronchodilator Use in Bronchiolitis - A Time Series Analysis.

Background And Objectives: International guidelines recommend against the use of bronchodilators in bronchiolitis. Despite attempts to address low value care practices in pediatrics, the literature is still evolving regarding which interventions are most effective in low value care reduction. We aim to assess the impact of a multifaceted intervention on rates of bronchodilator prescription in bronchiolitis.

Hospital bed replacement for acute care of children at home during the COVID-19 pandemic through a Hospital-in-the-Home programme.

Objectives: During the COVID-19 pandemic, we expanded our Hospital-in-the-Home (HITH) programme to increase capacity and manage COVID-19-positive children. We aimed to assess impact on overall HITH activity and COVID-19-positive outcomes.

Design: Prospective comparative cohort study.

Home Care for Bronchiolitis: A Systematic Review.

Context: Bronchiolitis is the leading cause of pediatric hospital admissions. Hospital-at-Home (HAH) delivers hospital-level care at home, relieving pressure on the hospital system.

Objectives: We aimed to review the feasibility, acceptability, and safety of HAH for bronchiolitis, and assess the cost-impact to hospitals and society.

Improving Asthma Care Documentation with a Digital Tool-Experience in a Pediatric Institution.

Background: Asthma affects approximately 10% of Australian children. Electronic medical record (EMR) systems and clinical decision support initiatives have been shown to improve the delivery of asthma care. Our institution implemented an EMR-based asthma "hub," which collates asthma-related information to a central location within a patient's record, provides a template to collect relevant clinical information, allows clinicians to evaluate a patient's history and presentation in a systematic manner and prompts relevant actions.

Virtual health care for children: Parental willingness to adopt virtual health-care technologies.

Aim: To understand parental awareness and appetite for virtual health modalities, including asynchronous communication and remote monitoring. To understand which socio-demographic characteristics are associated with greater awareness and appetite for virtual health.

Methods: Nationally representative survey of Australian parents, recruited via an online panel in February 2021 as part of the Royal Children's Hospital National Child Health Poll.

Opportunistic influenza vaccination in the home: broadening access in isolated times.

Background: Influenza is a vaccine-preventable infection that causes serious illness. The mandate to prevent an influenza epidemic has increased with the COVID-19 pandemic. However, isolation restrictions have reduced interactions with healthcare professionals.

In situ deteriorating patient simulation in general practice.

Background: GP practices have limited access to medical emergency training and basic life support is often taught out of context as a skills-based event.

Aim: To develop and evaluate a whole team integrated simulation-based education, to enhance learning, change behaviours and provide safer care.

Method: Phase 1: 10 practices piloted a 3-hour programme delivering 40 minutes BLS and AED skills and 2-hour deteriorating patient simulation.

Bronchiolitis at a specialist paediatric centre: The electronic medical record helps to evaluate low-value care.

Aim: Low-value care (LVC) is common. We aimed, using infants presenting to a major tertiary paediatric hospital with bronchiolitis between April 2016 and July 2018, to: (i) assess rates of chest X-ray (CXR) and medication use; (ii) identify associated factors; and (iii) measure the harm of not performing these practices.

Methods: We extracted data from the electronic medical record for all children aged 1-12 months given a diagnosis of bronchiolitis in the emergency department.

Acute rheumatic fever and rheumatic heart disease: incidence and progression in the Northern Territory of Australia, 1997 to 2010.

Background: Although acute rheumatic fever (ARF) and its sequel, rheumatic heart disease (RHD), continue to cause a large burden of morbidity and mortality in disadvantaged populations, most studies investigating the effectiveness of control programs date from the 1950s. A control program, including a disease register, in the Northern Territory of Australia where the Indigenous population has high rates of ARF and RHD allowed us to examine current disease incidence and progression.

Methods And Results: ARF and RHD incidence rates, ARF recurrence rates, progression rates from ARF to RHD to heart failure, and RHD survival and mortality rates were calculated for Northern Territory residents from 1997 to 2010.

Centaurin-alpha 1, an ADP-ribosylation factor 6 GTPase activating protein, inhibits beta 2-adrenoceptor internalization.

The small GTP-binding protein ADP ribosylation factor 6 (ARF6) has recently been implicated in the internalization of G protein-coupled receptors (GPCRs), although its precise molecular mechanism in this process remains unclear. We have recently identified centaurin alpha(1) as a GTPase activating protein (GAP) for ARF6. In the current study, we characterized the effects of centaurin alpha(1) on the agonist-induced internalization of the beta(2)-adrenoceptor transiently expressed in human embryonic kidney (HEK) 293 cells.

Centaurin-alpha1 is an in vivo phosphatidylinositol 3,4,5-trisphosphate-dependent GTPase-activating protein for ARF6 that is involved in actin cytoskeleton organization.

The ADP-ribosylation factor (ARF) 6 small GTPase regulates vesicle trafficking and cytoskeletal actin reorganization. The GTPase-activating proteins (GAPs) catalyze the formation of inactive ARF6GDP. Centaurin-alpha1 contains an ARF GAP and two pleckstrin homology (PH) domains, which bind the second messenger phosphatidylinositol 3,4,5-trisphosphate (PIP3).