Are patients with concussion getting optimal discharge advice at a regional emergency department?
- Authors: Brown, Ashlee , Twomey, Dara , Wong Shee, Anna
- Date: 2018
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 26, no. 2 (2018), p. 134-135
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- Description: Mild traumatic brain injury (mTBI), known as concussion, is receiving increasing global attention. Growing concerns about the potential long-term effects of mTBI have highlighted the need for good management and follow- up care.1 Given that regional emergency departments (EDs) experience higher rates of mTBI presentations compared with metropolitan EDs and are often the first point of contact, the provision of evidence-based care in these settings is crucial for positive patient outcomes.2 Followup after mTBI has shown promising results in reducing the number and severity of symptoms.
Comparison of two fall risk assessment tools (FRATs) targeting falls prevention in sub-acute care
- Authors: Wong Shee, Anna , Phillips, Bev , Hill, Keith
- Date: 2012
- Type: Text , Journal article
- Relation: Archives of Gerontology and Geriatrics Vol. 55, no. 3 (November 2012 2012), p. 653-659
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- Description: FRATs are designed to identify both persons at high risk of falls and to allow for cost-effective targeting of fall prevention strategies. This study compares two FRATs (BHS FRAT and TNH-STRATIFY) for accuracy of predicting falls and targeting of fall prevention strategies in a sub-acute hospital. Comparisons of retrospective audit data over two periods (use of the BHS-FRAT; post TNH-STRATIFY implementation) were used in the evaluation (n=362). Inter-rater reliability of the TNH-STRATIFY was evaluated from independent assessment by two nurses for 30 sub-acute patients and using intraclass correlation coefficient (ICC2,1). Event rate (ER) and standard measures of predictive accuracy were calculated for both FRATs. The proportions of patients with documented fall prevention strategies addressing identified fall risk factors were compared between audit phases. The TNH-STRATIFY had high inter-rater reliability (ICC2,1=0.96). The BHS-FRAT and TNH-STRATIFY demonstrated poor predictive accuracy using recommended high risk cut-off scores, with low specificityER (0.07 and 0.13 respectively) and very low Youden IndexER (0.04 and 0.07 respectively), although these measures improved using modified cut-off scores. Positive and negative predictive values were moderate for the BHS-FRAT (0.51, 0.64) and TNH-STRATIFY (0.52, 0.61). The falls rate and proportion of recurrent fallers did not change between audit phases. Implementation rates for prevention strategies for key risk factors were higher following implementation of the TNH-STRATIFY. The results indicated that the TNH-STRATIFY, combined with associated nursing care plan falls documentation, improved the targeting of prevention strategies for key risk factors such as cognitive impairment, incontinence and mobility impairment.
- Description: C1
High-intensity interval training improves cardiorespiratory fitness in cancer patients and survivors : a meta-analysis
- Authors: Wallen, Matthew , Hennessy, Declan , Brown, Stephen , Evans, Luke , Rawstorn, Jonathan , Wong Shee, Anna , Hall, Adrian
- Date: 2020
- Type: Text , Journal article , Review
- Relation: European Journal of Cancer Care Vol. 29, no. 4 (2020), p.
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- Description: Objective: The primary objective of this systematic review and meta-analysis was to compare the effects of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) and usual care (UC) on cardiorespiratory fitness (peak V̇O2) in cancer patients and survivors. Secondary objectives were to compare the effects of HIIT versus MICT and UC on other cardiopulmonary exercise testing (CPET) indices. Safety and adherence to HIIT were also evaluated. Methods: A systematic review and meta-analysis of controlled trials were undertaken using eligible studies from electronic database searching (inception—December 2019). Mean differences (MD) with 95% confidence intervals (CI) were compared and heterogeneity assessed using Cochran's Q and I2 statistic. Results: Twelve eligible studies included 516 participants with post-intervention CPET data. No serious adverse events occurred. Adherence to HIIT ranged between 71.2% and 95.6%. HIIT had significantly higher peak V̇O2 compared with UC (MD = 2.11 ml kg−1 min−1, 95% CI 0.75–3.47, p =.002). No significant difference was found between HIIT and MICT (MD = 2.03 ml kg−1 min−1, 95%CI −0.75–4.83, p =.15). HIIT was more effective than UC to improve peak oxygen pulse (MD = 1.59 ml/beat, 95%CI 0.06–3.12, p =.04). Conclusions: Quantitative assessment of HIIT studies indicates good compliance, with a significant effect on peak V̇O2 and peak oxygen pulse compared with UC in cancer patients and survivors. HIIT demonstrates a comparable effect with MICT to improve peak V̇O2. © 2020 John Wiley & Sons Ltd
- Description: Western Alliance Academic Health Science Centre , WA-739501
Increasing trend in the frequency of sports injuries treated at an Australian regional hospital
- Authors: Wong Shee, Anna , Clapperton, Angela , Finch, Caroline
- Date: 2016
- Type: Text , Journal article
- Relation: The Australian Journal of Rural Health Vol. 25, no. 2 (2016), p. 125-127
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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Independent appraiser assessment of the quality, methodological rigour and transparency of the development of the 2008 international consensus statement on concussion in sport
- Authors: White, Peta , Wong Shee, Anna , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 48, no. 2 (2014), p. 130-134
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Aim: In recent years, considerable effort has been devoted to the development and revisions to an international consensus statement on concussion in sport (ICSCS). The aim of this study was to obtain expert views on the methodological rigour and transparency with which the 2008 ICSCS was developed, as a precursor to the development of the 2012 update. Methods: Delegates registered for the 2012 fourth International Conference on Concussion in Sport, selected local concussion researchers not involved in any prior international consensus meetings, and all authors of the 2008 ICSCS published paper were invited to assess the methodological rigour and transparency with which the 2008 ICSCS was developed. The online Appraisal of Guidelines for Research and Evaluation (AGREE) II assessment tool, with six quality domains, was used and domain scores were expressed as a percentage of the maximum possible score for that domain. Results: 18 appraisers completed the online AGREE II assessment. Ten appraisers said they would recommend the 2008 ICSCS for use (without modification) and seven said they would recommend its use with some modification. The 'scope and purpose' and 'clarity of presentation' were rated highest, both scoring 78%. The lowest scoring domain was 'applicability' with a score of 55%. Conclusions: The quality of the ICSCS is important because it is used to guide return-to-play decisions and the management of sport-related concussions. This appraisal of the 2008 ICSCS suggests that a greater focus is needed on the actual implementation of future ICSCS and the relationship between implementation and desired health outcomes.