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Medical Education - Research Publications
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ItemNo Preview AvailableCommunity engagement programs and socially accountable medical educationJones, R ; Lavercombe, M ; Schwarz, J ; Lew, S ; Toussaint, J (The Australian & New Zealand Association for Health Professional Educators, 2016)
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ItemNo Preview AvailablePrescribing oxygen: An audit of prescribing and delivery practices at two tertiary hospitals in Melbourne, AustraliaRoberts, J ; Lavercombe, M (Wiley Online Library, 2021)Background and Aims: Over-oxygenation in COPD patients can result in adverse outcomes. The use of specific oxygen saturation targets in COPD has been associated with less acidosis, a lower requirement for assisted ventilation, and reduced mortality. Our study reviews current practices of both oxygen prescription and delivery for patients admitted at two tertiary hospitals with an exacerbation of COPD. Methods: This retrospective audit included all admissions at two tertiary hospitals with a primary diagnosis of exacerbation of COPD over 6 months (April to September 2020). Medical records were reviewed to determine how many had documented target SpO2 ranges and how concordant these were with the Thoracic Society of Australia and New Zealand guidelines (SpO2 range 88% to 92% in COPD). For those with documented SpO2 ranges, we determined the percentage of recorded SpO2 levels that were below, above and within the target range. Results: 312 admissions for exacerbation of COPD were reviewed. Target SpO2 goals were documented for 57% of admissions (N=178), of which 77% (N=137) were consistent with current guidelines. Of those with a documented SpO2 range, only 75.4% of recorded SpO2 readings were within range, with 2.3% falling below and 22.3% above range. Conclusions: Our results highlight underutilisation of SpO2 targets in patients with COPD, as well as frequent over-oxygenation despite documented targets.
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ItemNo Preview AvailableUtility of the stop and stop-bang questionnaires in a pre-screened population presenting for overnight polysomnographyLavercombe, M ; Hocking, V ; Clarence, M ; Thien, F (Wiley, 2009)Obstructive Sleep Apnoea (OSA) is a common condition, the diagnosis of which is often delayed by prolonged waiting lists at the point of referral or in the sleep laboratory. Clinical prediction tools may become useful in triaging assessment and management of this condition.Recent publications have proposed and validated two new pre-opera-tive screening tools for Obstructive Sleep Apnoea (OSA) in surgical patients (STOP and STOP-BANG). These screening tools have not been examined in a general sleep population.Methods: All patients attending for in-laboratory polysomnography at Box Hill Hospital during the study period were asked to complete the STOP questionnaire, and sleep scientists recorded the biometric data required for the BANG component. Polysomnography proceeded with sleep staging and event scoring performed according to the Chicago Criteria.Risk stratification by the STOP and STOP-BANG tools was combined with total Respiratory Disturbance Index from polysomnogram reports.Results: 69 patients have been recruited, although data continues to be collected. As expected, there is a predominance of moderate and severe OSA in this cohort (45/69, 65%).The STOP-BANG tool maintains higher sensitivity, negative predic-tive value and odds ratios than the STOP tool at each degree of OSA severity examined. Receiver operating characteristic curves demonstrate superiority of the STOP-BANG tool for RDI > 15, when compared with STOP-BANG for RDI > 30 and STOP at both RDI cut-offs.Conclusions: With ongoing data collection we hope to confirm trends seen in predictive values with these tools. Removal of less discrimina-tory criteria may improve their statistical usefulness, perhaps allowing development into risk stratification tools that will assist in triaging investigation and management of patients with suspected OSA.
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ItemNo Preview AvailableTheory into Practice: Scholarship and the Clinician-EducatorLavercombe, M (Australian & New Zealand Association for Health Professional Educators, 2023-06-06)
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ItemNo Preview AvailableIn-hospital hyperglycaemia but not diabetes mellitus alone is associated with increased in-hospital mortality in community-acquired pneumonia (CAP): a systematic review and meta-analysisBarmanray, R ; Cheuk, N ; Fourlanos, S ; Greenberg, P ; Colman, P ; Worth, L (University of Melbourne, 2022)
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ItemNo Preview AvailablePregnancy planning in a woman with diabetes secondary to familial partial lipodystrophy due to a rare PPAR gamma gene variantGong, J ; Barmanray, R ; Nankervis, A ; Price, S ; Trainer, A ; Conn, J (International Association of the Diabetes and Pregnancy Study Groups, 2022)
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ItemNo Preview AvailableDiabetes Digital Phenotyping to Improve Documentation of Diabetes in Hospital InpatientsBarmanray, R ; Fazio, T ; Sharma, A ; Grundy, L ; KITT-THOMPSON, T ; Coote, A ; Bode, G ; PLUMB, S (Australian Diabetes Society, 2022)
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ItemNo Preview AvailableThe Specialist Treatment of Inpatients: Caring for Diabetes (STOIC-D) Surgery Randomised Controlled Trial – Proactive Electronic-based Care Reduces Glucose and Healthcare-Associated InfectionsBarmanray, R ; Kyi, M ; Colman, P ; Rowan, L ; Raviskanthan, M ; Collins, L ; Donaldson, L ; Tsan, J ; Sun, E ; Le, M ; Worth, L ; Fourlanos, S (Australian Diabetes Society, 2022)
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ItemNo Preview AvailableThe Diabetes IN hospital – Glucose and Outcomes in the COVID-19 pandemic (DINGO COVID-19) study: the 2020 Melbourne hospital experience prior to vaccination programs and the delta variantBarmanray, R ; Gong, J ; Kyi, M ; Kevat, D ; Islam, M ; Galligan, A ; Manos, G ; Perera, N ; Adams, N ; Nursing, A ; Warren, A ; Hamblin, P ; MacIsaac, R ; Ekinci, E ; Krishnamurthy, B ; Nair, I ; Karunajeewa, H ; Buising, K ; Visvanathan, K ; Kay, T ; Fourlanos, S (Australian Diabetes Society, 2022)
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ItemNo Preview AvailableOvernight hospital admission is associated with healthcare-associated infection but not adverse glycaemia in patients undergoing glucose monitoring in the DINGO studySun, E ; Hazara, A ; Barmanray, R ; Kyi, M ; Fourlanos, S (Australian Diabetes Society, 2022)