Publications by authors named "Marsh N"

Background: New catheter materials for peripherally inserted central catheters (PICCs) may reduce the risk of device failure due to infectious, thrombotic, and catheter occlusion events. However, data from randomized trials comparing these catheters are lacking.

Methods: We conducted a randomized, controlled, superiority trial in three Australian tertiary hospitals.

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Background/objectives: The Parents' Evaluation of Developmental Status (PEDS) and Developmental Milestones (PEDS:DM) are cost-effective, self-report tools that can be conveniently utilized in low- and middle-income countries to screen for developmental delays in children. This study assessed the diagnostic accuracy of PEDS and PEDS:DM in distinguishing children with typical development (TD) from those with developmental disabilities (DD). It also examined the relationship between parents' general concerns and specific developmental concerns about their children.

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Background: Approximately 25% of hospitalised adults require an indwelling urinary catheter (IDC) during their hospital stay. IDCs expose patients to risks of infectious and non-infectious complications.

Aims: To identify IDC prevalence, assess adherence to clinical practice guidelines and patient-reported involvement in IDC care for adult hospital inpatients.

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Purpose: Patients receiving treatment for solid tumours and haematological malignancies, among other acute and chronic health conditions, are highly dependent upon central venous access devices (CVADs) for administering chemotherapy and other complex therapies; thus, CVADs can meaningfully impact their health outcomes and experiences. This systematic review aimed to identify and critique patient-reported outcome measure (PROM) and patient-reported experience measure (PREM) instruments related to CVADs.

Methods: A systematic review was undertaken, commencing with an electronic search of health databases (April 2022).

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Inter-kingdom communication through small molecules is essential to the coexistence of organisms in an ecosystem. In soil communities, the plant root is a nexus of interactions for a remarkable number of fungi and is a source of small-molecule plant hormones that shape fungal compositions. Although hormone signaling pathways are established in plants, how fungi perceive and respond to molecules is unclear because many plant-associated fungi are recalcitrant to experimentation.

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Background: An evidence and consensus-based instrument is needed to classify central venous access device-associated skin impairments.

Aim: The aim of this study was to design and evaluate the central venous access device-associated skin impairment classification tool.

Design: A two-phase modified Delphi study.

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Background: A quarter of patients who present to emergency departments (EDs) have difficult intravenous access (DIVA), making it challenging for clinicians to successfully place a peripheral intravenous catheter (PIVC). Some literature suggests that guidewire PIVC improves first-insertion success rate.

Aim: The aim was to determine the clinical and cost-effectiveness of a novel long PIVC (5.

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Background: Access to arterial circulation through arterial catheters (ACs) is crucial for monitoring and decision-making in intensive care units (ICU) but carries the risk of complications including bloodstream infection (BSI).

Methods: We conducted a secondary analysis of data from four randomised controlled trials in Australian ICUs, investigating the efficacy of different AC interventions. De-identified data were combined into a single dataset, and per-patient outcomes analysed.

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Article Synopsis
  • Early identification of patients at high risk for PIVC-related phlebitis is crucial to prevent complications associated with medical devices.
  • The study developed and validated four machine learning models to predict phlebitis incidence in critically ill patients, using a large dataset of 3429 PIVCs.
  • Results showed that the Random Survival Forest (RSF) model had the best performance for predicting phlebitis, while key predictive factors included insertion site, catheter material, age, and medication use.
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Article Synopsis
  • The study investigates how different settings and strategies affect the selection of alternative materials and designs for peripherally inserted central catheters (PICC).
  • Qualitative interviews were conducted with 23 stakeholders, revealing key themes such as the importance of intervention adaptability, staff involvement, and adequate funding in successfully implementing changes.
  • Ultimately, while trial evidence is vital, the research emphasizes the need to consider local healthcare contexts and resources when making decisions regarding PICC materials and designs.
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Article Synopsis
  • Vascular access devices are crucial for patient care in the emergency department, and randomized controlled trials (RCTs) are the most authoritative source for evaluating their effectiveness.
  • The study aims to gather and analyze findings from RCTs focused on different types of vascular access devices used in the ED over the last decade.
  • The scoping review will highlight existing research gaps in this area, helping clinicians and researchers identify future study opportunities and enhance evidence-based practices.
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Introduction: Peripheral intravenous catheters (PIVCs) are the most commonly used vascular access device in hospitalised patients. Yet PIVCs may be complicated by local or systemic infections leading to increased healthcare costs. Chlorhexidine gluconate (CHG)-impregnated dressings may help reduce PIVC-related infectious complications but have not yet been evaluated.

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Article Synopsis
  • Metabolic adaptations are crucial for survival, with the mitochondrial calcium uniporter playing a key role in managing energy supply by regulating mitochondrial functions and calcium signaling.
  • The study investigates the effects of uniporter loss and gain on metabolic pathways, revealing that loss of function increases proteins involved in branched-chain amino acid (BCAA) catabolism, while specifically suppressing this pathway in liver cancer cells with high mitochondrial calcium levels.
  • The research also highlights the upregulation of the transcription factor KLF15 due to uniporter loss, linking it to changes in liver metabolism and potential complications like hyperammonemia in cancer patients.
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Background: Central venous access devices (CVADs) allow intravenous therapy, haemodynamic monitoring and blood sampling but many fail before therapy completion.

Objective: To quantify CVAD failure and complications; and identify risk factors.

Designs, Settings, And Participants: Secondary analysis of multicentre randomised controlled trial including patients aged ≥16 years with a non-tunnelled CVAD (NTCVAD), peripherally-inserted central catheter (PICC) or tunnelled CVAD (TCVAD).

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Objectives: To identify the prevalence and type of central venous access device-associated skin complications for adult cancer patients, describe central venous access device management practices, and identify clinical and demographic characteristics associated with risk of central venous access device-associated skin complications.

Methods: A prospective cohort study of 369 patients (626 central venous access devices; 7,682 catheter days) was undertaken between March 2017 and March 2018 across two cancer care in-patient units in a large teaching hospital.

Results: Twenty-seven percent (n = 168) of participants had a central venous access device-associated skin complication.

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Introduction: First-insertion success rates for peripheral vascular access devices (PVADs) in patients with difficult venous access (DIVA) are low, which negatively affects staff workload, patient experience, and organizational cost. There is mixed evidence regarding the impact of a peripheral vascular access device with retractable coiled tip guidewire (GW; AccuCath™, BD) on the first-insertion success rate. The aim of this study is to investigate whether the use of long GW-PVADs, compared with standard PVADs, reduces the risk of first-time insertion failure, in patients admitted to emergency departments (EDs).

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Relations among attention-deficit/hyperactivity disorder (ADHD), sleep, and substance-related negative consequences are largely unknown. In this cross-sectional study, we examined associations among ADHD diagnosis, sleep, and alcohol-related consequences. We also evaluated the independent and interactive effects of sleep and ADHD on alcohol-related negative consequences, above and beyond levels of alcohol use.

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Background: Hospitals frequently introduce new medical devices. However, the process of clinicians adapting to these new vascular access devices has not been well explored. The study aims to explore clinicians' experience with the insertion of a new guidewire peripheral intravenous catheter (PIVC) introduced in the emergency department (ED) setting.

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Background: Irrigation is used to minimize infection of open wounds. Sterile saline is preferred, but potable water is becoming more widely accepted. However, the large volumes of water that are recommended are usually not available in austere environments.

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Introduction: Labor is both a physiological and physical activity that requires energy expenditure by the woman. Despite this, women are often fasted in labor, with hydration requirements addressed predominantly by intravenous therapy. Little is known about how best to manage this in nulliparous women undergoing induction of labor, who can be prone to lengthy labors.

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Objectives: Arterial catheters (ACs) are critical for haemodynamic monitoring and blood sampling but are prone to complications. We investigated the incidence and risk factors of AC failure.

Methods: Secondary analysis of a multi-centre randomised controlled trial (ACTRN 12610000505000).

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Background: Healthcare consumers require diverse resources to assist their navigation of complex healthcare interactions, however, these resources need to be fit for purpose.

Aim: In this study, we evaluated the utility, usability and feasibility of children, families and adults requiring long-term intravenous therapy using a recently developed mobile health application (App), intravenous (IV) Passport.

Design: Multi-site, parallel, multi-method, prospective cohort study.

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Purpose: Children with chronic and complex health conditions frequently need intravenous devices. The current approach to intravenous device selection, insertion, and monitoring is inconsistent, and healthcare consumers are often negatively affected by siloed health information, and poor future planning. Despite child- and family-centred care being recognised as a pillar of paediatric nursing care, limited implementation for vascular access device planning and management is evident.

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