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  1. Article ; Online: The Southern Health system's Community Health Council: establishment and processes to engage with communities, whānau and patients.

    Derrett, Sarah / Adank, Charlotte / Browne, Karen / Takurua, Kelly

    The New Zealand medical journal

    2022  Volume 135, Issue 1554, Page(s) 63–72

    Abstract: Aims: This paper aims to: describe steps to establish the Southern Health system's Community Health Council (CHC) and its associated advisors; discuss support for the CHC, advisors and staff; and reflect on engagement activities, what has worked well, ... ...

    Abstract Aims: This paper aims to: describe steps to establish the Southern Health system's Community Health Council (CHC) and its associated advisors; discuss support for the CHC, advisors and staff; and reflect on engagement activities, what has worked well, and opportunities for development.
    Method: Prompts for establishing the CHC came from the Health Quality & Safety Commission and previous commissioners of the Southern District Health Board (SDHB). Following support from the Iwi Governance Committee and SDHB and WellSouth Primary Health Organisation (PHO) chief executives and their leadership teams, advertisements called for people interested in joining the CHC. After group interviews, the CHC was established in 2017.
    Results: It became evident that an 11 member CHC could not support all requests for engagement throughout the Southern Health system. Consequently, the CHC developed a framework for engagement, a large team of CHC advisors, and a Roadmap to support engagement activities.
    Conclusions: The CHC has supported over 120 CHC members and advisors working on over 95 engagement projects throughout the Southern Health system. It is hoped that the processes described will be useful to the establishment of robust community, whānau and patient forums intended to sit at the centre of Aotearoa New Zealand's restructured health system.
    MeSH term(s) Humans ; Leadership ; New Zealand ; Public Health
    Language English
    Publishing date 2022-05-06
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 390590-1
    ISSN 1175-8716 ; 0028-8446 ; 0110-7704
    ISSN (online) 1175-8716
    ISSN 0028-8446 ; 0110-7704
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  2. Article ; Online: Adhesive-Free, Stretchable, and Permeable Multiplex Wound Care Platform.

    Brown, Matthew S / Browne, Karen / Kirchner, Nancy / Koh, Ahyeon

    ACS sensors

    2022  Volume 7, Issue 7, Page(s) 1996–2005

    Abstract: The wound healing process remains a poorly understood biological mechanism. The high morbidity and mortality rates associated with chronic wounds are a critical concern to the health care industry. Although assessments and treatment options exist, these ... ...

    Abstract The wound healing process remains a poorly understood biological mechanism. The high morbidity and mortality rates associated with chronic wounds are a critical concern to the health care industry. Although assessments and treatment options exist, these strategies have primarily relied on static wound dressings that do not consider the dynamic physicochemical microenvironment and can often create additional complications through the frequent dressing changing procedure. Inspired by the need for engineering "smart" bandages, this study resulted in a multifaceted approach to developing an adhesive-free, permeable, and multiplex sensor system. The electronic-extracellular matrix (e-ECM) platform is capable of noninvasively monitoring chemical and physical changes in real-time on a flexible, stretchable, and permeable biointegrated platform. The multiplex sensors are constructed atop a soft, thin, and microfibrous substrate of silicone to yield a conformal, adhesive-free, convective, or diffusive wound exudate flow, and passive gas transfer for increased cellular epithelization and unobstructed physical and chemical sensor monitoring at the wound site. This platform emulates the native epidermal mechanics and physical extracellular matrix architecture for intimate bio-integration. The multiple biosensor array can continuously examine inflammatory biomarker such as lactate, glucose, pH, oxygen, and wound temperature that correlates to the wound healing status. Additionally, a heating element was incorporated to maintain the optimal thermal conditions at the wound bed. The e-ECM electrochemical biosensors were tested in vitro, within phosphate-buffered saline, and ex vivo, within wound exudate. The "smart" wound bandage combines biocompatible materials, treatments, and monitoring modalities on a microfibrous platform for complex wound dynamic control and analysis.
    MeSH term(s) Adhesives ; Bandages ; Biosensing Techniques ; Wound Healing
    Chemical Substances Adhesives
    Language English
    Publishing date 2022-07-07
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2379-3694
    ISSN (online) 2379-3694
    DOI 10.1021/acssensors.2c00787
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  3. Article ; Online: Clinical benefits of prone positioning in the treatment of non-intubated patients with acute hypoxic respiratory failure: a rapid systematic review.

    Richards, Hayden / Robins-Browne, Karen / O'Brien, Troy / Wilson, Greer / Furyk, Jeremy

    Emergency medicine journal : EMJ

    2021  Volume 38, Issue 8, Page(s) 594–599

    Abstract: Background: The COVID-19 pandemic has led to a surge in critically unwell patients with type 1 respiratory failure. In an attempt to reduce the number of patients requiring mechanical ventilation, prone positioning (PP) of non-intubated patients has ... ...

    Abstract Background: The COVID-19 pandemic has led to a surge in critically unwell patients with type 1 respiratory failure. In an attempt to reduce the number of patients requiring mechanical ventilation, prone positioning (PP) of non-intubated patients has been added to many hospital guidelines around the world. We set out to conduct a systematic review of the evidence relating to PP in the non-intubated patient with type 1 respiratory failure secondary to COVID-19 and other causes.
    Methods: The review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. A literature search of major databases and grey sources was conducted. Studies were assessed for inclusion by two authors according to prespecified criteria. Data collection processes, analysis and risk of bias assessment were planned.
    Results: 31 studies were included for analysis. These consisted of prospective and retrospective case series, cohort studies and case reports. None of the studies included a comparison group. No statistical analysis was performed. Descriptive data of included studies and narrative synthesis are presented.
    Conclusions: No high-quality randomised controlled trials were found and thus evidence in relation to PP as a treatment for non-intubated patients with type 1 respiratory failure is lacking.
    MeSH term(s) COVID-19/therapy ; Humans ; Pneumonia, Viral/therapy ; Pneumonia, Viral/virology ; Prone Position ; Respiratory Insufficiency/therapy ; Respiratory Insufficiency/virology ; SARS-CoV-2
    Language English
    Publishing date 2021-06-23
    Publishing country England
    Document type Journal Article ; Systematic Review
    ZDB-ID 2040124-3
    ISSN 1472-0213 ; 1472-0205
    ISSN (online) 1472-0213
    ISSN 1472-0205
    DOI 10.1136/emermed-2020-210586
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  4. Article ; Online: The characteristics of SARS-CoV-2-positive children in Australian hospitals: a PREDICT network study.

    Ibrahim, Laila / Wilson, Catherine / Tham, Doris / Corden, Mark / Jani, Shefali / Zhang, Michael / Kochar, Amit / Tan, Ker Fern / George, Shane / Phillips, Natalie T / Buntine, Paul / Robins-Browne, Karen / Chong, Vimuthi / Georgeson, Thomas / Lithgow, Anna / Davidson, Sarah / O'Brien, Sharon / Tran, Viet / Babl, Franz E

    The Medical journal of Australia

    2023  Volume 218, Issue 10, Page(s) 460–466

    Abstract: Objectives: To examine the clinical characteristics and short term outcomes for children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections who presented to Australian hospitals during 2020 and 2021.: Design, setting: ... ...

    Abstract Objectives: To examine the clinical characteristics and short term outcomes for children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections who presented to Australian hospitals during 2020 and 2021.
    Design, setting: Retrospective case review study in nineteen hospitals of the Paediatric Research in Emergency Departments International Collaborative (PREDICT) network from all Australian states and territories, including seven major paediatric tertiary centres and eight Victorian hospitals.
    Participants: SARS-CoV-2-positive people under 18 years of age who attended emergency departments or were admitted to hospital during 1 February 2020 - 31 December 2021.
    Main outcome measures: Epidemiological and clinical characteristics, by hospital care type (emergency department [ED] or inpatient care).
    Results: A total of 1193 SARS-CoV-2-positive children and adolescents (527 girls, 44%) attended the participating hospitals (107 in 2020, 1086 in 2021). Their median age was 3.8 years (interquartile range [IQR], 0.8-11.4 years); 63 were Aboriginal or Torres Strait Islander people (5%). Other medical conditions were recorded for 293 children (25%), including asthma (86, 7%) and premature birth (68, 6%). Medical interventions were not required during 795 of 1181 ED presentations (67%); children were discharged directly home in 764 cases (65%) and admitted to hospital in 282 (24%; sixteen to intensive care units). The 384 admissions to hospital (including 102 direct admissions) of 341 children (25 infants under one month of age) included 23 to intensive care (6%); the median length of stay was three days (IQR, 1-9 days). Medical interventions were not required during 261 admissions (68%); 44 children received respiratory support (11%) and 21 COVID-19-specific treatments, including antiviral and biologic agents (5%). Being under three months of age (v one year to less than six years: odds ratio [OR], 2.6; 95% confidence interval [CI], 1.7-4.0) and pre-existing medical conditions (OR, 2.5; 95% CI, 1.9-3.2) were the major predictors of hospital admission. Two children died, including one without a known pre-existing medical condition.
    Conclusion: During 2020 and 2021, most SARS-CoV-2-positive children and adolescents who presented to participating hospitals could be managed as outpatients. Outcomes were generally good, including for those admitted to hospital.
    MeSH term(s) Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Australia/epidemiology ; COVID-19/epidemiology ; COVID-19/therapy ; Emergency Service, Hospital ; Hospitals ; Retrospective Studies ; SARS-CoV-2 ; Male
    Language English
    Publishing date 2023-04-22
    Publishing country Australia
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 186082-3
    ISSN 1326-5377 ; 0025-729X
    ISSN (online) 1326-5377
    ISSN 0025-729X
    DOI 10.5694/mja2.51934
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  5. Article ; Online: The characteristics of SARS-CoV-2-positive children who presented to Australian hospitals during 2020: a PREDICT network study.

    Ibrahim, Laila F / Tham, Doris / Chong, Vimuthi / Corden, Mark / Craig, Simon / Buntine, Paul / Jani, Shefali / Zhang, Michael / George, Shane / Kochar, Amit / O'Brien, Sharon / Robins-Browne, Karen / Tosif, Shidan / Daley, Andrew / McNab, Sarah / Crawford, Nigel W / Wilson, Catherine / Babl, Franz E

    The Medical journal of Australia

    2021  Volume 215, Issue 5, Page(s) 217–221

    Abstract: Objectives: To examine the epidemiological and clinical characteristics of SARS-CoV-2-positive children in Australia during 2020.: Design, setting: Multicentre retrospective study in 16 hospitals of the Paediatric Research in Emergency Departments ... ...

    Abstract Objectives: To examine the epidemiological and clinical characteristics of SARS-CoV-2-positive children in Australia during 2020.
    Design, setting: Multicentre retrospective study in 16 hospitals of the Paediatric Research in Emergency Departments International Collaborative (PREDICT) network; eleven in Victoria, five in four other Australian states.
    Participants: Children aged 0-17 years who presented to hospital-based COVID-19 testing clinics, hospital wards, or emergency departments during 1 February - 30 September 2020 and who were positive for SARS-CoV-2.
    Main outcome measures: Epidemiological and clinical characteristics of children positive for SARS-CoV-2.
    Results: A total of 393 SARS-CoV-2-positive children (181 girls, 46%) presented to the participating hospitals (426 presentations, including 131 to emergency departments [31%]), the first on 3 February 2020. Thirty-three children presented more than once (8%), including two who were transferred to participating tertiary centres (0.5%). The median age of the children was 5.3 years (IQR, 1.9-12.0 years; range, 10 days to 17.9 years). Hospital admissions followed 51 of 426 presentations (12%; 44 children), including 17 patients who were managed remotely by hospital in the home. Only 16 of the 426 presentations led to hospital medical interventions (4%). Two children (0.5%) were diagnosed with the paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS).
    Conclusion: The clinical course for most SARS-CoV-2-positive children who presented to Australian hospitals was mild, and did not require medical intervention.
    MeSH term(s) Adolescent ; Ambulatory Care Facilities/statistics & numerical data ; Australia ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19 Testing/statistics & numerical data ; Child ; Child, Preschool ; Emergency Service, Hospital/statistics & numerical data ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Retrospective Studies ; Symptom Assessment ; Systemic Inflammatory Response Syndrome/diagnosis ; Systemic Inflammatory Response Syndrome/epidemiology
    Language English
    Publishing date 2021-08-13
    Publishing country Australia
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 186082-3
    ISSN 1326-5377 ; 0025-729X
    ISSN (online) 1326-5377
    ISSN 0025-729X
    DOI 10.5694/mja2.51207
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  6. Article ; Online: The SMART-COP score performs well for pneumonia risk stratification in Australia's Tropical Northern Territory: a prospective cohort study.

    Robins-Browne, Karen L / Cheng, Allen C / Thomas, Kathleen A S / Palmer, Didier J / Currie, Bart J / Davis, Joshua S

    Tropical medicine & international health : TM & IH

    2012  Volume 17, Issue 7, Page(s) 914–919

    Abstract: Objective: To prospectively compare a modified pneumonia severity scoring system, SMARTACOP, with other severity scores in patients presenting with pneumonia to the emergency department (ED) of a tertiary referral hospital in tropical Australia.: ... ...

    Abstract Objective: To prospectively compare a modified pneumonia severity scoring system, SMARTACOP, with other severity scores in patients presenting with pneumonia to the emergency department (ED) of a tertiary referral hospital in tropical Australia.
    Methods: We conducted a prospective observational study of adult patients presenting with radiologically confirmed pneumonia over a 12-month period. The sensitivity of risk stratification scores were assessed against the need for intensive respiratory or vasopressor support (IRVS).
    Results: There were 367 ED attendances for pneumonia of whom 77.1% were admitted to hospital, 10% required intensive respiratory or vasopressor support and 2.8% died. Mean age was 50.0 years, 52% were men and 59% were Indigenous. The sensitivity of a SMART-COP score ≥3, a SMARTACOP score ≥3 and a pneumonia severity index (PSI) class ≥3 for predicting IRVS was 97%, 97% and 78% respectively.
    Conclusions: We found no significant advantage of the SMARTACOP over the SMART-COP score for the prediction of intensive respiratory or vasopressor support, but both scores significantly outperformed PSI. The SMART-COP score should replace the PSI in tropical Australia and should be assessed in other tropical areas for pneumonia risk stratification in emergency departments.
    MeSH term(s) Adult ; Cohort Studies ; Community-Acquired Infections/diagnosis ; Emergency Service, Hospital ; Female ; Humans ; Male ; Middle Aged ; Northern Territory ; Pneumonia/diagnosis ; Predictive Value of Tests ; Prospective Studies ; Risk Assessment ; Severity of Illness Index
    Language English
    Publishing date 2012-07
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1314080-2
    ISSN 1365-3156 ; 1360-2276
    ISSN (online) 1365-3156
    ISSN 1360-2276
    DOI 10.1111/j.1365-3156.2012.03006.x
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