https://dora.health.qld.gov.au/qldresearchjspui/handle/1/858 2026-04-13T05:22:57Z 2026-04-13T05:22:57Z Abbot, Hagen George, Adam R. McCarron, Luke Graham, David J. Sivakumar, Brahman https://dora.health.qld.gov.au/qldresearchjspui/handle/1/7598 2025-05-27T05:00:22Z 2024-01-01T00:00:00Z

Title: Intramedullary Screw Fixation of Proximal Phalangeal Fractures: Short- to Medium-term Outcomes Authors: Abbot, Hagen; George, Adam R.; McCarron, Luke; Graham, David J.; Sivakumar, Brahman Abstract: Background: Intramedullary screw fixation of phalangeal and metacarpal fractures has gained popularity as a method of providing rigid internal fixation with minimum tendon disturbance, allowing early mobilization and rehabilitation. Despite this, the literature on outcomes using this technique is limited. Thus, the aim of this study was to assess the short-term to medium-term outcomes of intramedullary screw fixation for proximal phalangeal fracture fixation in an Australian setting.; Methods: A retrospective analysis of consecutive patients with a fracture(s) of the proximal phalanx fixated using intramedullary screws between January 2020 and March 2023 was conducted via telehealth.; Results: Forty-six phalangeal fractures from 37 patients were included in this study. Mean Quick Disabilities of the Arm, Shoulder, and Hand score of 6.2 (range: 0-61.4, median: 0), mean pain visual analogue scale score of 1.8 (range: 1-7, median: 1), and mean total active motion of 231° (range: 132-282) were noted. A total of 4.4% of fractures sustained a major complication, and 94.6% of patients reported willingness to undergo intramedullary screw fixation again.; Conclusion: This study concurs with the prior literature that intramedullary screw fixation is a safe and effective method of stabilizing extra-articular proximal phalangeal fractures in the short to medium term. Superior clinical outcomes, as well as cost-effectiveness and time-effectiveness, render it a viable alternative to plate fixation in this setting.; Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

2024-01-01T00:00:00Z Abell, Bridget Rodwell, David Eagleson, Karen J. Auld, Ben Bora, Samudragupta Kasparian, Nadine A. Justo, Robert Parsonage, William McPhail, Steven M. https://dora.health.qld.gov.au/qldresearchjspui/handle/1/7597 2025-05-27T05:00:42Z 2024-01-01T00:00:00Z

Title: Neurodevelopmental follow-up care pathways and processes for children with congenital heart disease in Australia Authors: Abell, Bridget; Rodwell, David; Eagleson, Karen J.; Auld, Ben; Bora, Samudragupta; Kasparian, Nadine A.; Justo, Robert; Parsonage, William; McPhail, Steven M. Abstract: Background: International consensus exists for neurodevelopmental follow-up care of children with congenital heart disease (CHD) to support timely intervention for developmental delays. Yet, documentation of how this care is implemented in Australia is lacking. This study aimed to identify, categorise, and understand care pathways and services supporting neurodevelopmental follow-up of Australian children with CHD.; Methods: A qualitative study, using semi-structured virtual interviews with healthcare professionals across Australia involved in neurodevelopmental care of children with CHD (n = 52) was conducted. Data was analysed using a rapid qualitative approach including structured templates, data reduction, and inductive-deductive analysis of matrices to synthesise data.; Results: Most neurodevelopmental follow-up was delivered as pathways through existing healthcare services rather than centre-based cardiac programmes. Service availability and accessibility varied across the country. Community-based primary care services, paediatric clinics, child development services, neonatal follow-up programmes, and allied health providers were commonly accessed pathway components. However, participants reported a lack of formal structures to coordinate care pathways.; Conclusions: The study identifies how cardiac neurodevelopmental follow-up in Australia can be embedded into existing services and adapted to meet local needs and contexts. Future approaches will benefit from integrating, leveraging, and growing existing services, although adoption of new models may be needed.; Impact: This study found neurodevelopmental follow-up care for children with CHD in Australia to be delivered as pathways through existing services rather than the centre-based cardiac follow-up programmes common in North America. Our study describes alternate options, including providers in community settings, that can be used for follow-up care delivery and how these can adapted to local context. Future approaches will benefit from integrating, leveraging, and growing existing services, although adoption of new models may be needed. Greater systematic coordination of care pathways is still required to optimise service delivery, inform planning, and support implementation of national standards of care.; Competing Interests: Competing interests: The authors declare no competing interests. Consent statement: Consistent with our ethical approval, informed verbal consent was obtained from every participant prior to starting each interview. (© 2024. The Author(s).)

2024-01-01T00:00:00Z Abell, Bridget Rodwell, David Eagleson, Karen J. Parsonage, William Auld, Ben Bora, Samudragupta Kasparian, Nadine A. Justo, Robert McPhail, Steven M. https://dora.health.qld.gov.au/qldresearchjspui/handle/1/7596 2025-05-27T05:00:21Z 2024-01-01T00:00:00Z

Title: "It's more than just a conversation about the heart": exploring barriers, enablers, and opportunities for improving the delivery and uptake of cardiac neurodevelopmental follow-up care Authors: Abell, Bridget; Rodwell, David; Eagleson, Karen J.; Parsonage, William; Auld, Ben; Bora, Samudragupta; Kasparian, Nadine A.; Justo, Robert; McPhail, Steven M. Abstract: Introduction: Surveillance, screening, and evaluation for neurodevelopmental delays is a pivotal component of post-surgical care for children with congenital heart disease (CHD). However, challenges exist in implementing such neurodevelopmental follow-up care in international practice. This study aimed to characterise key barriers, enablers, and opportunities for implementing and delivering outpatient cardiac neurodevelopmental follow-up care in Australia.; Methods: an exploratory descriptive qualitative study was conducted with healthcare professionals across Australia who had lived experience of designing, implementing, or delivering neurodevelopmental care for children with CHD. Online semi-structured interviews were conducted using a guide informed by the Consolidated Framework for Implementation Research to explore contextual influences. Interview transcripts were analysed using a rapid qualitative approach including templated summaries and hybrid deductive-inductive matrix analysis.; Results: fifty-two participants were interviewed. Perceived barriers and enablers were organised into six higher-order themes: factors in the broader environmental, economic, and political context; healthcare system factors; organisational-level factors; provider factors; patient and family factors; and care model factors. The largest number of barriers occurred at the healthcare system level (service accessibility, fragmentation, funding, workforce), while service providers demonstrated the most enabling factors (interprofessional relationships, skilled teams, personal characteristics). Strategies to improve practice included building partnerships; generating evidence; increasing funding; adapting for family-centred care; and integrating systems and data.; Discussion: Australia shares many similar barriers and enablers to cardiac neurodevelopmental care with other international contexts. However, due to unique geographical and health-system factors, care models and implementation strategies will require adaption to the local context to improve service provision.; Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2024 Abell, Rodwell, Eagleson, Parsonage, Auld, Bora, Kasparian, Justo and McPhail.)

2024-01-01T00:00:00Z Abell, Bridget R. Eagleson, Karen Auld, Benjamin Bora, Samudragupta Justo, Robert Parsonage, William Sharma, Pakhi Kularatna, Sanjeewa McPhail, Steven M. https://dora.health.qld.gov.au/qldresearchjspui/handle/1/7595 2025-05-27T05:01:34Z 2024-01-01T00:00:00Z

Title: Implementing neurodevelopmental follow‐up care for children with congenital heart disease: A scoping review with evidence mapping Authors: Abell, Bridget R.; Eagleson, Karen; Auld, Benjamin; Bora, Samudragupta; Justo, Robert; Parsonage, William; Sharma, Pakhi; Kularatna, Sanjeewa; McPhail, Steven M. Abstract: Aim: To identify and map evidence describing components of neurodevelopmental follow-up care for children with congenital heart disease (CHD). Method: This was a scoping review of studies reporting components of neurodevelopmental follow-up programmes/pathways for children with CHD. Eligible publications were identified through database searches, citation tracking, and expert recommendations. Two independent reviewers screened studies and extracted data. An evidence matrix was developed to visualize common characteristics of care pathways. Qualitative content analysis identified implementation barriers and enablers. Results: The review included 33 studies. Twenty-one described individual care pathways across the USA (n = 14), Canada (n = 4), Australia (n = 2), and France (n = 1). The remainder reported surveys of clinical practice across multiple geographical regions. While heterogeneity in care existed across studies, common attributes included enrolment of children at high-risk of neurodevelopmental delay; centralized clinics in children's hospitals; referral before discharge; periodic follow-up at fixed ages; standardized developmental assessment; and involvement of multidisciplinary teams. Implementation barriers included service cost/resourcing, patient burden, and lack of knowledge/awareness. Multi-level stakeholder engagement and integration with other services were key drivers of success. Interpretation: Defining components of effective neurodevelopmental follow-up programmes and care pathways, along with enhancing and expanding guideline-based care across regions and into new contexts, should continue to be priorities. (PsycInfo Database Record (c) 2024 APA, all rights reserved)

2024-01-01T00:00:00Z