https://dora.health.qld.gov.au/qldresearchjspui/handle/1/857 2026-09-21T01:04:07Z https://dora.health.qld.gov.au/qldresearchjspui/handle/1/12365 Title: Collaborative General Practitioner Shared Care Versus Self-Directed Care Following Critical Illness in Young Children: A Pilot Hybrid Effectiveness-Implementation Randomized Controlled Trial Authors: Long, Debbie A; Tyack, Zephanie; Anthony, Lori; Dow, Belinda; Dunn, Leigh; Le Marsney, Renate; Pham, Trang M T; Best, James; Webb, Kerri-Lyn; Liley, Helen; Stocker, Christian; Thoms, Debra; Schlapbach, Luregn J; Moore, Charlotte; Lister, Paula; Bora, Samudragupta; Gibbons, Kristen Abstract: Up to one in three PICU survivors experience persistent developmental or psychologic challenges, and parents often report significant psychologic distress. Current health systems lack standardized pathways to support children and families after PICU. We aimed to assess the feasibility of a randomized controlled trial (RCT) of a collaborative general practitioner (GP) shared-care follow-up model of care intervention and the feasibility, acceptability, and appropriateness of the intervention. Multicenter, pilot, hybrid effectiveness-implementation study with parallel RCT. Trial registration: Australian and New Zealand Clinical Trials Registry, ACTRN12621000799853, June 24, 2021. Two PICUs in Queensland, Australia. Parents of children admitted to PICU from ages 2 months or older to younger than 4 years. Participants were randomized (1:1, web-based block randomization schedule) to 6 months of GP shared care (intervention) or self-directed care (active control). The primary outcome was trial feasibility. Secondary effectiveness and implementation outcomes included child neurodevelopmental vulnerability and parent psychosocial outcomes at 6 months and parental perception of the feasibility, acceptability, and appropriateness of the intervention, respectively. Between October 2021 and March 2023, 154 of 363 eligible parents (one per family) provided consent (42%); 69 were randomized to the intervention, and 72 to active control. Most parents were mothers (95%), 31-40 years old (54%), from metropolitan areas (72%). Children were predominantly male (64%), younger than 12 months old (41%), admitted for respiratory illness (39%). Retention (81%), fidelity (96%), and intervention acceptability was high (71-86%), but recruitment was low (42%) and intervention feasibility varied (35-82%). At 6 months, neurodevelopmental vulnerability rates were similar (shared care [39%] vs. active control [44%]; adjusted odds ratio (aOR), 0.72 [95% CI, 0.32-1.60]). Parenting stress was lower in the intervention group (median, 20 [interquartile range (IQR), 12-47]) vs. active control (median, 42 [IQR, 19-66]; difference, -23 [95% CI, -40 to -6]). A trial of a collaborative GP-shared-care model of care post-PICU is feasible and may reduce parenting stress. Further intervention refinement and a larger trial are warranted to evaluate clinical effectiveness, implementation, and scalability. 2026-08-26T00:00:00Z https://dora.health.qld.gov.au/qldresearchjspui/handle/1/12361 Title: Youth suicidality risk relative to ambient temperature and heatwaves across climate zones: A time series analysis of emergency department presentations in New South Wales, Australia Authors: Dey, C.; Wu, J.; Uesi, J.; Sara, G.; Dudley, M.; Knight, K.; Scott, J. G.; Jay, O.; Bowden, M.; Perkes, I. E. Abstract: OBJECTIVE: Youth suicidality prevalence continues to rise alongside hot weather severity. Links between these two variables are underexplored. We examined associations between daily temperature and emergency department suicidality presentations by young people. We assessed these associations for five regions covering New South Wales as determined by 'climate zone' and analysed for heatwave effects as well as based on demographic subgroups. METHODS: Daily emergency department presentations for suicidality by people aged 12-24 years across New South Wales, Australia, during warmer months (November to March) from 2012 to 2019 were examined in relation to daily mean temperature and heatwaves (⩾3 consecutive days ⩾ 95th percentile of long-term daily mean temperature) and by climate zone, using a generalised additive model with negative binomial distribution. Risks for age- and sex-based subgroups were also calculated. RESULTS: New South Wales youth suicidality presentation rates were significantly higher on hotter days. For every 1°C rise above average daily mean temperature, youth suicidality presentations to New South Wales emergency departments increased by 1.3%. Heatwaves did not increase presentation rates beyond single-day daily mean temperature effects. These findings were predominantly replicated across climate zones and demographic subgroups, though the association between suicidality and ambient temperature was weaker in coastal regions including Eastern Sydney. CONCLUSION: There is a positive linear association between ambient temperature and youth suicidality presentations to emergency departments. Risks are increased on single hot days, not only during heatwaves. Public health, broader societal approaches to heat and health system planning should consider impacts on youth suicidality of predicted increases in hot weather severity and frequency. 2025-01-01T00:00:00Z https://dora.health.qld.gov.au/qldresearchjspui/handle/1/12360 Title: Your C-Arm May Be Dose Optimised but Is Your Surgical Procedure? The Evaluation and Dose Optimisation of Positioning Aids Used in Paediatric Image Guided Surgery Authors: Dinham, D.; Faggotter, S.; Boughen, E.; Bonaventura, H.; Ryan, E. Abstract: INTRODUCTION: Positioning aids are frequently used in image guided surgery (IGS). This study evaluates the impact of positioning aids on radiation dose and image quality (IQ) in IGS and the potential for dose optimised imaging via the choice of positioning aid type selected for clinical use. METHODS: Foam and gel positioning aids were evaluated in this study. Anthropomorphic phantoms were used to simulate clinically relevant procedures. Patient and staff radiation exposure were estimated via incident air kerma rate and scatter dose rate measurements, respectively. Perspex phantoms were used to assess the impact of the positioning aid location within the field of view (FOV) on radiation dose, via the reference entrance point air kerma rate displayed on the C-arm. IQ was analysed objectively via contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) measurements. RESULTS: An average dose rate reduction of 24% and 27% were measured for the simulated patient and surgeon locations, respectively, when gel was replaced with foam, over all anthropomorphic phantom sizes and procedures. A maximum increase in dose rate of 3% for foam and 57% for gel were calculated with a change in positioning aid location within the FOV. In most instances, an improvement in CNR and SNR was observed with the replacement of gel with foam positioning aids. CONCLUSION: The present study demonstrates that the choice of positioning aids used in IGS can significantly impact radiation dose and IQ. With collaboration between radiographers and the perioperative team, it is recommended sites optimise their selection of positioning aids in IGS. 2025-01-01T00:00:00Z https://dora.health.qld.gov.au/qldresearchjspui/handle/1/12358 Title: "You're listening but you're not hearing": qualitative exploration of parents' lived experience of paediatric sepsis Authors: O'Keefe, M.; Crowe, L.; Lister, P.; Schlapbach, L. J.; Simons, M. Abstract: BACKGROUND: Sepsis is a life-threatening condition of significant mortality and morbidity burden in children. There is limited evidence exploring the lived experiences of parents whose children have survived or died from sepsis, nor their support needs, despite growing awareness of poor sepsis outcomes. OBJECTIVE: This study aims to understand the lived experiences of parents of children affected by sepsis, both surviving and bereaved, and identify gaps in support services to inform future interventions. METHODS: A phenomenological-hermeneutic design was used, with data collected through a focus group and individual interviews with 11 parents of children treated for paediatric sepsis in Queensland, Australia. Reflexive thematic analysis was used to analyse the data. RESULTS: Four themes were generated that present an in-depth understanding of parents' lived experiences of having a child with sepsis and what their support needs are: 1. Rupture of Life as We Knew It-parents experienced a distinct rupture between life before and after their child's sepsis diagnosis, often accompanied by trauma and grief; 2. Navigating in the Dark-parents described feeling confused and isolated, driven by a lack of awareness about sepsis, inadequate communication from healthcare providers, and limited access to specialised support; 3. The Weight of 'What If'-guilt, regret and disillusionment with the healthcare system were common among parents, particularly regarding missed early warning signs and opportunities for intervention; and 4. Call for Change-parents advocated for improved public and professional education about paediatric sepsis, trauma-informed communication from healthcare professionals, and the development of structured, specialised support networks. CONCLUSION: Parents of children affected by sepsis experience profound distress and isolation, compounded by a lack of awareness, inadequate communication, and limited specialised support services. They identified that urgent action is needed to develop paediatric sepsis-specific family support networks, enhance public and clinical education, and implement trauma-informed care to reduce the burden of sepsis on all families. 2025-01-01T00:00:00Z