Prospective observational study of emergent endotracheal intubation practice in the intensive care unit and emergency department of an Australian regional tertiary hospital

Objective: The present study aimed to describe the characteristics and outcomes of intubation occurring in the ICU and ED of an Australian tertiary teaching hospital. Methods: This was a prospective observational study of intubation practice across the Geelong Hospital over a 6 month period from 1 August 2012 to 31 January 2013. Data were entered by the intubating team through an online data collection form. Results: There were 119 patients intubated and 134 attempts at intubation in the ED and ICU over a 6 month period. The first-pass success rate was 104/119 (87.4%), and all but a single patient was intubated by the second attempt. Propofol, fentanyl, midazolam and suxamethonium were the most common drugs used in rapid sequence induction. AEs were reported in 44/134 (32.8%) of intubation attempts, with transient hypoxia and hypotension being the most common. A significant adverse outcome, namely aspiration pneumonitis, occurred in one patient. There were no peri-intubation deaths. Conclusion: The majority of airways are managed by ICU and ED consultants and trainees, with success rates and AE rates comparable with other published studies. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Psychosocial factors impacting on life transitions among young adults with type 2 diabetes : an Australian - Danish qualitative study

BACKGROUND: Type 2 diabetes (T2DM) prevalence is increasing rapidly worldwide with a significant increase in young adults. There is limited information about psychosocial and service needs of this group. AIM: To explore similarities and differences in how psychosocial factors impact on Australian and Danish young adults with T2DM and to identify unmet support needs during life transitions. METHOD: A qualitative approach was adopted using thematic content analysis of 26 in-depth semi-structured interviews. An inductive descriptive content analysis was undertaken using a comparative coding system. FINDINGS: Eligible participants were from Australia (12) and Denmark (14), aged 19-42 years who had T2DM for more than 10 months. In general, they reported diabetes management was difficult during transitions and diabetes self-care routines had to change to accommodate life changes. The underpinning sense of 'uncertainty' initiated by life transitions caused guilt that often resulted in low self-worth, anxiety and depression, which in turn had a negative impact on social and professional relationships. The participants emphasised the importance of connectedness to social networks, particularly with T2DM peers, and the need for flexible access to health professionals, age-specific tailored support and lower costs for Australians. Australian participants were more concerned than Danish participants about the cost associated with diabetes care and their ability to stay employed; hence, they were reluctant to disclose diabetes at work. CONCLUSION: T2DM had a similar impact on life transitions of Australian and Danish young adults with T2DM, suggesting health care needs to encompass managing life transitions. Participants had to cope with uncertainty and the impact of people's responses to diabetes, particularly at work and in relationships. Health professionals are urged to integrate these factors in care plans and education, which must be individualised and focus on the psychosocial aspects that operate during life transitions.

The lived experience of Australian retirees: 'I'm retired, what do i do now?'

Introduction: The purpose of this qualitative study was to explore the lived experience of retirement in a context where it is not compulsory, and to understand consequent changes in roles, identity and occupational adaptation from the perspective of Australian retirees. Method: Five people aged between 61 and 68 years, who had retired during the previous 18 months, were interviewed. Data analysis included transcription and coding of data, data aggregation and identification of themes. Findings: The themes that emerged from the data analysis were related to time structure and meaningful occupations, ageing and performance capacity, role changes, emotional adjustment to retirement and preparation for retirement. Conclusion: The findings suggest that engagement in meaningful occupations and valued roles, along with the emergence of grandparenting as a significant role, the development of new interests and engagement in retirement planning activities, and support in restructuring the use of time are essential to maintain a positive identity and to adapt successfully to retirement. © The College of Occupational Therapists Ltd.

The prevalence and characteristics associated with excessive daytime sleepiness among Australian workers

OBJECTIVE: To estimate the prevalence of excessive daytime sleepiness (EDS) and its associated factors in a mixed population of employed Australian workers. METHODS: Study participants (n = 707) were volunteers from various Melbourne workplaces, participating in a workplace physical activity program in 2008. Daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS), with EDS defined as ESS scores >10. RESULTS: In this population of adult employees (40.0% male; mean age 40.2 ± 10.4 years), prevalence of EDS was 16.0%. Characteristics associated with EDS and higher ESS scores were age, higher body mass index, markers of poorer diet, and markers of poorer mental health. CONCLUSIONS: Excessive daytime sleepiness is potentially an important contributor to lower productivity and poorer mental health in the workplace. Our finding suggests that workplace health programs aimed at improving diet and body weight may also help alleviate EDS.

Book review: Review of 'John Connor, Anzac and Empire: George Foster Pearce and the Foundations of Australian Defence' (Melbourne: Cambridge University Press), 2011. ISBN10 1107009502 (Hb) pp. 248. $59.95, cloth.

Anzac and Empire is the remarkable story of George Foster Pearce – a carpenter who became one Australia's most influential politicians, and the man central to how Australia planned for, and fought in, World War I. The nation's longest-serving defence minister – holding the portfolio before, during and after the Great War – Pearce saw no contradiction in being both a fierce Australian nationalist, and also a loyal subject of the British Empire.Anzac and Empire is the first full-length biography of this extraordinary Australian. Written by one of Australia's leading military historians, this book shows that to understand Australia in the Great War, you must understand the man behind it.

Does the poor quality of Australian health education documentation undermine the message? A review of documents informing pregnant women about alcohol

Background. The advice given to pregnant women about alcohol consumption during pregnancy is variable across countries and within countries.Aim. The aim of this study was to review the content and design of existing Australian health education documentation regarding alcohol consumption in pregnancy that is available to pregnant women. Methods. A documentary analysis was conducted. This involved the identification and collection of a range of health education documents, which were then systematically analysed. The thematic and symbolic elements of each document were compared and contrasted using a modified version of the DISCERN instrument. Findings. A total of 32 documents were retrieved via general and targeted internet searching. Documents varied considerably in their purpose, language levels, accessibility, and quality. The majority of documents scored as low to moderate quality. Implications. Although there are many and varied existing documents relating to alcohol consumption during pregnancy in Australia, these are not of high quality and could be substantially improved by including publication dates, using simple language, and providing sources of information. This may result in a more effective public health message and so help to reduce the number of pregnant women who continue to drink during pregnancy.