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  • Publication
    Journal Article
  • Person
    Oz, Tugba
  • Publication
    Journal Article
    Nutrition delivery across hospitalisation in critically ill patients with COVID-19: An observational study of the Australian experience.
    (2024-05-01)
    Chapple, Lee-Anne S
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    Ridley, Emma J
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    Ainscough, Kate
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    Ballantyne, Lauren
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    Burrell, Aidan
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    Dux, Claire
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    Ferrie, Suzie
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    Fetterplace, Kate
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    Fox, Virginia
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    Jamei, Matin
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    King, Victoria
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    Serpa Neto, Ary
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    Nichol, Alistair
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    Osland, Emma
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    Paul, Eldho
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    Summers, Matthew J
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    Marshall, Andrea P
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    Udy, Andrew
    Data on nutrition delivery over the whole hospital admission in critically ill patients with COVID-19 are scarce, particularly in the Australian setting.The objective of this study was to describe nutrition delivery in critically ill patients admitted to Australian intensive care units (ICUs) with coronavirus disease 2019 (COVID-19), with a focus on post-ICU nutrition practices.A multicentre observational study conducted at nine sites included adult patients with a positive COVID-19 diagnosis admitted to the ICU for >24 h and discharged to an acute ward over a 12-month recruitment period from 1 March 2020. Data were extracted on baseline characteristics and clinical outcomes. Nutrition practice data from the ICU and weekly in the post-ICU ward (up to week four) included route of feeding, presence of nutrition-impacting symptoms, and nutrition support received.A total of 103 patients were included (71% male, age: 58 ± 14 years, body mass index: 30±7 kg/m), of whom 41.7% (n = 43) received mechanical ventilation within 14 days of ICU admission. While oral nutrition was received by more patients at any time point in the ICU (n = 93, 91.2% of patients) than enteral nutrition (EN) (n = 43, 42.2%) or parenteral nutrition (PN) (n = 2, 2.0%), EN was delivered for a greater duration of time (69.6% feeding days) than oral and PN (29.7% and 0.7%, respectively). More patients received oral intake than the other modes in the post-ICU ward (n = 95, 95.0%), and 40.0% (n = 38/95) of patients were receiving oral nutrition supplements. In the week after ICU discharge, 51.0% of patients (n = 51) had at least one nutrition-impacting symptom, most commonly a reduced appetite (n = 25; 24.5%) or dysphagia (n = 16; 15.7%).Critically ill patients during the COVID-19 pandemic in Australia were more likely to receive oral nutrition than artificial nutrition support at any time point both in the ICU and in the post-ICU ward, whereas EN was provided for a greater duration when it was prescribed. Nutrition-impacting symptoms were common.
  • Publication
    Journal Article
    The first confirmed human case of rabies, Timor-Leste, 2024.
    (2024-05-01)
    Amaral Mali, Marcelo
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    Machado, Filipe de Neri
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    Moniz, Filomeno Pinto
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    Bosco Alves Dos Santos, Frederico
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    Laot, Perpetua Ana Mery Estela
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    Pereira Tilman, Ari Jayanti
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    Florindo, Tanizio Ebryes
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    Barros, Cristovao de Alexandria
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    Barbosa, Adriano
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    Oliveira Lima, Jose A
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    Goncalves, Joao Paulo
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    Borges, Francisco
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    Hornay, Elisabeth
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    Moises, Joanico
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    de Jesus Neto, Osmenia
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    Varela, Liliana
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    da Costa, Agapito
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    Francis, Joshua R
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    Monteiro, Merita Antonio A
    In March 2024, the first ever human case of rabies, following a dog bite, was detected in Timor-Leste. This paper briefly discusses the circumstances of transmission, clinical presentation, palliative care of the case and public health measures taken. Timor-Leste was previously considered rabies-free. Any person who is bitten or scratched by an animal that could potentially transmit rabies virus (especially dogs, bats, monkeys or cats) in Timor-Leste should be assessed for consideration of provision of rabies post-exposure prophylaxis.
  • Publication
    Journal Article
    Reducing intravenous antibiotics in neonates born ≥35 weeks' gestation: A quality improvement study.
    (2024-05-02) ;
    Jayakumar, Nilarni
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    Cooper, Celia
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    Andersen, Chad
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    Callander, Emily
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    Gomersall, Judith
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    Rumbold, Alice
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    Keir, Amy
    To assess the impact of the Early Onset Sepsis (EOS) calculator, implemented as a quality improvement study, to reduce the rate of unnecessary antibiotics in neonates born ≥35 weeks' gestation.An audit of routinely collected hospital data from January 2008 to March 2014 (retrospective) and from January 2018 to September 2019 (prospective) determined baseline incidence of EOS intravenous antibiotic use in neonates born ≥35 weeks' gestation in a tertiary level perinatal centre. Plan-do-study-act (PDSA) cycles were applied to implement the EOS calculator. Statistical process control methodology and time series analysis assessments were used to assess the potential impact of the PDSA cycles on the rate of intravenous antibiotics, blood culture collection, EOS, length of stay and health care costs (not adjusted for potential confounders).In the study population, from January 2008 to March 2014, the baseline incidence of intravenous antibiotic use was 10.49% (2970/28290), whilst only 0.067% (19/28290) neonates had culture proven EOS. From January 2018 to October 2019, prior to implementation of the EOS calculator, 13.3% (1119/8411) neonates were treated with intravenous antibiotic and the use decreased to 8.3% (61/734) post-implementation. The rate of blood culture collection decreased from 14.4% (1211/8411) to 11.9% (87/734). There were no cases of missed EOS. Length of stay decreased from 2.68 to 2.39 days, with an estimated cost saving of $366 per patient per admission.Implementing the EOS calculator in a tertiary hospital setting reduced invasive investigations for EOS and intravenous antibiotic use among neonates ≥35 weeks' gestation. This can result in reduced length of neonatal hospital stays, and associated health care cost savings and may reduce separation of mother and baby.
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