Local birthing services for rural women: Adaptation of a rural New South Wales maternity service.

Objective: To describe the outcomes of a public hospital maternity unit in rural New South Wales (NSW) following the adaptation of the service from an obstetrician and general practitioner-obstetrician (GPO)-led birthing service to a low-risk midwifery group practice (MGP) model of care with a planned caesarean section service (PCS).

Design: A retrospective descriptive study using quantitative methodology.

Setting: Maternity unit in a small public hospital in rural New South Wales, Australia.

Population-based study shows that resuscitating apparently stillborn extremely preterm babies is associated with poor outcomes.

Aim: This population-based study determined the delivery room management and outcomes of extremely preterm infants born with Apgar scores of 0.

Methods: We linked birth, neonatal intensive care unit (NICU) and death records for babies who were born between 22 + 0 and 27 + 6 weeks of gestation with a one-minute Apgar score of 0, in New South Wales, Australia, between 1998 and 2011.

Results: We classified 2173/2262 (96%) of infants with a one-minute Apgar score of 0 as stillborn.

A structured framework improves clinical patient assessment and nontechnical skills of early career emergency nurses: a pre-post study using full immersion simulation.

Aims And Objectives: The aim of this study was to evaluate the effect of the new evidence-informed nursing assessment framework HIRAID (History, Identify Red flags, Assessment, Interventions, Diagnostics, reassessment and communication) on the quality of patient assessment and fundamental nontechnical skills including communication, decision making, task management and situational awareness.

Background: Assessment is a core component of nursing practice and underpins clinical decisions and the safe delivery of patient care. Yet there is no universal or validated system used to teach emergency nurses how to comprehensively assess and care for patients.

Designing and implementing full immersion simulation as a research tool.

Simulation is a valuable research tool used to evaluate the clinical performance of devices, people and systems. The simulated setting may address concerns unique to complex clinical environments such as the Emergency Department, which make the conduct of research challenging. There is limited evidence available to inform the development of simulated clinical scenarios for the purpose of evaluating practice in research studies, with the majority of literature focused on designing simulated clinical scenarios for education and training.

Epidemiological Evidence for a Decreasing Incidence of Neonatal Abstinence Syndrome, 2000-11.

Background: This study analyses the incidence of Neonatal Abstinence Syndrome (NAS) in a large geographically defined population in Australia.

Method: Database linkage analysis of all births between 2000 and 2011 in New South Wales (NSW), Australia. The diagnosis of NAS was derived from hospital coding P96.

AHI Outcomes Are Superior after Upper Airway Reconstructive Surgery in Adult CPAP Failure Patients.

Objective: This study aims to evaluate Apnea-Hypopnea Index (AHI) outcomes of upper airway adult obstructive sleep apnea (OSA) reconstructive surgery, as compared with outcomes of suboptimal continuous positive airway pressure (CPAP) therapy, in response to reviews claiming unreliable surgical AHI reduction.

Study Design: Prospective cohort study.

Setting: Single-surgeon series at medical centers within Wollongong, Australia.

Reasons for Rehospitalization in Children Who Had Neonatal Abstinence Syndrome.

Background And Objectives: Neonatal abstinence syndrome (NAS) occurs after in utero exposure to opioids, but outcomes after the postnatal period are unclear. Our objectives were to characterize childhood hospitalization after NAS.

Methods: Population-based linkage study of births, hospitalization, and death records of all children registered in New South Wales (NSW), Australia, between 2000 and 2011 to a maximum of 13 years.

The impact of HIRAID on emergency nurses' self-efficacy, anxiety and perceived control: A simulated study.

Introduction: Emergency nurses must perform accurate and complete comprehensive patient assessments to establish patient treatment needs and expedite care.

Aim: To evaluate the impact of a structured approach to emergency nursing assessment following triage, on novice emergency nurses' anxiety, self-efficacy and perceptions of control.

Methods: Thirty eight early career emergency nurses from five Australian hospitals performed an initial patient assessment in an immersive clinical simulated scenario, before and after undertaking training in HIRAID, an evidence-informed patient assessment framework for emergency nurses.

Prostatic urethral lift: A minimally invasive treatment for benign prostatic hyperplasia.

Prostatic urethral lift (PUL) is a minimally invasive procedure for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia. The procedure may be performed under local, spinal, or general anesthesia. The PUL procedure involves the delivery of implants that retract obstructing prostate lobes.

HIRAID: An evidence-informed emergency nursing assessment framework.

Introduction: Emergency nurses must be highly skilled at performing accurate and comprehensive patient assessments. In 2008, the inaugural emergency nursing assessment framework (ENAF) was devised at Sydney Nursing School, to provide emergency nurses with a systematic approach to initial patient assessment. In 2014 the assessment framework was re-developed to reflect the most recent evidence.

Measuring the clinical learning environment in anaesthesia.

The learning environment describes the way that trainees perceive the culture of their workplace. We audited the learning environment for trainees throughout Australia and New Zealand in the early stages of curriculum reform. A questionnaire was developed and sent electronically to a large random sample of Australian and New Zealand College of Anaesthetists trainees, with a 26% final response rate.

Meropenem versus piperacillin-tazobactam for definitive treatment of bloodstream infections due to ceftriaxone non-susceptible Escherichia coli and Klebsiella spp (the MERINO trial): study protocol for a randomised controlled trial.

Background: Gram-negative bacteria such as Escherichia coli or Klebsiella spp. frequently cause bloodstream infections. There has been a worldwide increase in resistance in these species to antibiotics such as third generation cephalosporins, largely driven by the acquisition of extended-spectrum beta-lactamase or plasmid-mediated AmpC enzymes.

Do maternal opioids reduce neonatal regional brain volumes? A pilot study.

Objective: A substantial number of children exposed to gestational opioids have neurodevelopmental, behavioral and cognitive problems. Opioids are not neuroteratogens but whether they affect the developing brain in more subtle ways (for example, volume loss) is unclear. We aimed to determine the feasibility of using magnetic resonance imaging (MRI) to assess volumetric changes in healthy opioid-exposed infants.

Total hip replacement: a systematic review and meta-analysis on mid-term quality of life.

Objective: Total hip replacement (THR) is one of the most successful and frequently performed operations worldwide. Health-related quality of life (HRQOL) is a key outcome measure of surgery. We investigated mid-term HRQOL after THR in patients with osteoarthritis (OA).

Three cases of presumed pneumocystis pneumonia in patients receiving bortezomib therapy for multiple myeloma.

Introduction: This paper presents three probable cases of pneumocystis pneumonia in patients receiving bortezomib therapy for multiple myeloma.

Presentation Of Cases: Three patients receiving bortezomib therapy for multiple myeloma presented with dyspnoea, non-productive cough, and fevers. These patients deteriorated despite receiving broad-spectrum antibiotic therapy with piperacillin + tazobactam and azithromycin and an assortment of other antimicrobials but promptly responded to sulfamethoxazole + trimethoprim therapy.

Beyond uvulopalatopharyngoplasty for obstructive sleep apnoea: single surgeon case series of contemporary airway reconstruction.

Objective: Adult patients with obstructive sleep apnoea can be a therapeutic surgical challenge if other treatments fail or are rejected. We report the outcomes of a series of 17 patients for whom standard device-based treatments failed or could not be used. These patients were considered unsuitable for a lesser operation and therefore underwent multilevel upper airway reconstruction.

Coblation-assisted Lewis and MacKay operation (CobLAMO): new technique for tongue reduction in sleep apnoea surgery.

Background: Obstructive sleep apnoea is a common condition that is unfortunately associated with a high rate of patient non-compliance regarding device use. Newer surgical interventions have focused on procedures at the palate level, using variants of palatoplasty and transpalatal advancement. However, the extent of tongue reduction surgery required remains controversial.

The impact structured patient assessment frameworks have on patient care: an integrative review.

Aims And Objectives: To evaluate structured patient assessment frameworks' impact on patient care.

Background: Accurate patient assessment is imperative to determine the status and needs of the patient and the delivery of appropriate patient care. Nurses must be highly skilled in conducting timely and accurate patient assessments to overcome environmental obstacles and deliver quality and safe patient care.

Novel antimicrobial agents against multi-drug-resistant gram-negative bacteria: an overview.

No novel antimicrobial agents against multi-drug-resistant Gram-negative bacteria have been available to daily clinical practice during the last 5 years. On the other hand, resistance rates and mechanisms of those pathogens are increasing worldwide. Pan-resistant (against which none of the currently available antibiotics is effective) strains of Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa have been described.

Novel antimicrobial agents against multi-drug-resistant gram-positive bacteria: an overview.

Antimicrobial resistance threatens to compromise the treatment of bacterial infectious diseases. Strains resistant to most (if not all) antibiotics available have emerged. Gram-positive such representatives include strains of Methicillinresistant Staphylococcus aureus (MRSA), Vancomycin-resistant Enterococci (VRE) and highly-resistant to penicillin Streptococcus pneumoniae.