Cairns, Australia
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Hayes B.,Cairns Base Hospital | Bonnet A.,Charles Sturt University
Journal of Renal Care | Year: 2010

Job dissatisfaction, stress and burnout are linked to high rates of nurses leaving the profession, poor morale and poor patient outcomes. Haemodialysis (HD) nursing is uniquely characterised by the intense-prolonged interaction with patients who require complex technological care. A review of nine papers found that factors affecting job satisfaction were aspects of nursing care, organisational factors and length of time that a nurse has been working in nephrology nursing. Factors affecting job stress and burnout were due to interpersonal relationships with physicians, patient care activities, violence and abuse from patients, organisational factors and a lack of access to ongoing education. © 2010 European Dialysis and Transplant Nurses Association/European Renal Care Association.


Rojek A.,Royal Brisbane and Womens Hospital | Little M.,Cairns Base Hospital
EMA - Emergency Medicine Australasia | Year: 2013

The creation of hospitals safe from disaster is an area of increasing public policy. The vulnerability of hospitals to damage and destruction during an event has profound implications for the health of a community. Although hospital evacuations do occur in Australia, their prevalence is unknown and what leads to a successful evacuation is poorly understood. This article reviewed the worldwide hospital evacuation literature to determine the prevalence of hospital evacuations and common precipitants for evacuation. Factors leading to safe evacuation and areas of ongoing challenge were identified. The findings highlight the need for more structured and detailed reporting of hospital responses to disaster. A number of lessons can be learned from hospitals that have experienced evacuation. Most critically, all hospitals must have a practised, detailed hospital evacuation plan existing before an impending threat. There are also areas for improvement in the areas of assessing the risk to the facility, communications, leadership, logistics, staffing and planning. These lessons should be included into comprehensive, detailed evacuation plans for all Australian hospitals, supported by a national framework that standardises planning and response. © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.


Bonner A.,Queensland University of Technology | Caltabiano M.,James Cook University | Berlund L.,Cairns Base Hospital
Nursing and Health Sciences | Year: 2013

In this study we investigated the relationship between health-related quality of life, fatigue, and activity levels of people with anemia secondary to chronic kidney disease over a 12 month period following the introduction of an erythropoietin-stimulating agent. Using a longitudinal repeated-measure design, 28 people with chronic kidney disease completed the Short Form-36 Health Survey, Human Activity Profile and Fatigue Severity Scale at the commencement of an erythropoietin-stimulating agent, and then at 3, 6, and 12 months. Over a 12 month period, a significant change was found for health-related quality of life in relation to role-physical, vitality, mental health/emotional well-being, and overall mental health. However, activity levels did not significantly improve during that time. Renal nurses in dialysis units and chronic kidney disease outpatient clinics have repeated and frequent contact with people with chronic kidney disease over long periods of time, and are in an ideal position to routinely assess fatigue and activity levels and to institute timely interventions to optimize health-related quality of life and independent activity. © 2013 Wiley Publishing Asia Pty Ltd.


Fielding J.R.,Cairns Base Hospital
Australian Journal of Medical Science | Year: 2013

Aberration in iron homeostasis can be clinically significant and extreme effects manifest as either iron deficiency anaemia or iron toxicity. Many patients suffering from iron deficiency (ID) or anaemia of chronic disease (ACD) will present with complex medical conditions including inflammation, infection or malignancy. Iron status in disease may be classified as early ID, iron deficiency anaemia (IDA), functional iron deficiency (FID), ACD or iron deficiency anaemia combined with ACD (IDA/ACD). It is important to differentiate between these clinical entities as the treatment regime will vary. A failure to diagnose anaemia or inappropriate treatment may lead to poorer clinical outcomes particularly in the newborn. The bone marrow iron stain was the initial standard for diagnosing iron deficiency but is impractical as a screening test. This test was superseded by the serum ferritin which is a very good indicator of iron status when inflammation is absent. Alternative or supplementary tests proposed to improve the diagnosis of IDA and ACD include serum transferrin receptor, reticulocyte haemoglobin content/equivalent, C-reactive protein and the Ferritin Index. Cut-off points for these tests may vary with different clinical presentations and a single reference range for such tests reduces their diagnostic effectiveness. The recently identified iron regulatory proteins like hepcidin are still research subjects but offer the potential for novel therapeutic agents in addition to better diagnosis of iron status. Those who are most at risk of IDA and/or ACD often reside in less developed or remote locations and would benefit from a more clinically effective diagnostic test such as a point-of-care (POC) test.


Bendall A.,Cairns Base Hospital | De Costa C.,James Cook University | Woods C.,James Cook University | Howat P.,Cairns Base Hospital
Australian and New Zealand Journal of Obstetrics and Gynaecology | Year: 2012

Serum concentrations of vitamin D were measured in pregnant women booking for antenatal care in Cairns Base Hospital, Queensland. Of 116 women, none was found to be vitamin D deficient. With a threshold of 50 nmol/L, no woman demonstrated vitamin D insufficiency; with a threshold of 75 nmol/L, 6.9% would have mild insufficiency. Further investigation into vitamin D concentrations of women living in northern Australia is required before recommendations are made for universal vitamin D screening of all pregnant women in Australia. © 2012 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.


Eschertzhuber S.,Innsbruck Medical University | Brimacombe J.,Cairns Base Hospital | Kaufmann M.,Innsbruck Medical University | Keller C.,Schulthess Klinik | Tiefenthaler W.,Innsbruck Medical University
Anaesthesia | Year: 2012

The i-gel TM and LMA Supreme TM are extraglottic airway devices with non-inflatable and inflatable cuffs, respectively. We hypothesised that directly measured mucosal pressures would differ between these devices in anesthetised paralysed patients. Thirty patients were randomly allocated to receive one of these two devices. Four pressure sensors were attached to all airway devices used to measure mucosal pressure at the base of the tongue, the distal oropharynx, the hypopharynx and the pyriform fossa. At these four places, median (IQR [range]) i-gel mucosal pressures were 8.0 (2.7-10.7 [0-26.7]), 5.0 (2.7-7 [1.0-37.3]), 9.3 (2.7-13.3 [0-22.7] and 8.0 (2.7-10.7 [0-25.3]) cmH 2O, respectively, and for the LMA Supreme, these were 5.0 (0.5-8.0 [0-33]), 4.0 (1.3-9.3 [0-24]), 10.7 (4-17.3 [0-26.7]) and 8.0 (0-10.7 [0-36]) cmH 2O, respectively. Mucosal pressures were low and similar for both devices. The LMA Supreme mucosal pressures were higher in the hypopharynx than in the distal oropharynx (p = 0.04) and base of the tongue (p = 0.011). There were no pressure differences between the locations for the i-gel. © 2012 The Association of Anaesthetists of Great Britain and Ireland.


Boyce Z.,Cairns Base Hospital | Collins N.,Cairns Dermatology
Australasian Journal of Dermatology | Year: 2015

Scedosporium apiospermum is a fungus emerging as a rare but important cause of both localised and disseminated infections in immunocompromised patients. Most cutaneous lesions present as mycetoma, however a review of the literature revealed an increasing number of cases worldwide presenting with lymphocutaneous spread resembling sporotrichosis. An 85-year-old man with an extensive medical history including type II diabetes mellitus and meningioma presented with crusted haemorrhagic areas on the dorsum of his left foot and multiple crusted nodules extending proximally along his leg in a sporotrichoid-like lymphocutaneous pattern. A mycological examination and culture of the cutaneous tissue found the fungus, Scedosporium apiospermum. © 2013 The Australasian College of Dermatologists.


Hayes B.,Cairns Base Hospital
Renal Society of Australasia Journal | Year: 2011

This paper describes one nurse's story of the evacuation of patients in Queensland during theevent of a major category 5 cyclone inFebruary 2011. The lessons learned include the importance ofcommunication, both manual and electronic records, clothing, medication and personal requirements,accommodation and transport needs, and the need for extensive culturally appropriate emotional andfamily support.


Jayaratnam S.,Cairns Base Hospital | De Costa C.,James Cook University | Howat P.,Cairns Base Hospital
Australian and New Zealand Journal of Obstetrics and Gynaecology | Year: 2011

Background: Maternal mortality is now a rare event in the developed world and its measurement is no longer a useful way of assessing obstetric care. Examination of cases of women who nearly died but survived a severe complication of pregnancy or childbirth - maternal 'near-misses' - is increasingly being recognised as potentially more useful, although severe maternal morbidity is much less easy to define and quantify than maternal death. Aim: To identify and assess prospectively cases of severe maternal morbidity presenting to Cairns Base Hospital (CBH), to define cases as near-misses and thereby develop a tool for future assessment of obstetric care in CBH and elsewhere. Methods: Based on approaches recommended by the recent WHO working group on Maternal Mortality and Morbidity classifications, a data collection form was constructed using a combination of named morbidities and specific interventions. Over 1 year data from all cases of severe maternal morbidity was collected and analysed both prospectively and retrospectively to identify true near-misses. Results: Seventeen cases of true near-misses were identified, giving a near-miss rate of six per 1000 live births for CBH in the study period; 64% of cases were attributable to obstetric causes and 36% to non-obstetric causes. Conclusions: Collection of near-miss data has the potential to become a useful tool for the assessment of obstetric care in both in CBH and in other Australian hospitals but is time-consuming and requires continuous surveillance by medical staff if cases are not to be overlooked. © 2011 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.


News Article | February 19, 2017
Site: news.yahoo.com

KUALA LUMPUR, Malaysia (AP) — Malaysia performed a second autopsy on the estranged half brother of North Korea's leader because the first procedure was inconclusive, piling on the intrigue surrounding what appeared to be a well-executed assassination at an airport in Kuala Lumpur, an official said Saturday. Police arrested a fourth suspect, identified as a North Korean man. The second autopsy clearly enraged North Korea, which has vowed to reject the results of any post-mortem and demanded that Malaysia turn over the body immediately. Speaking to reporters outside the morgue late Friday, Pyongyang's ambassador said Malaysian officials may be "trying to conceal something" and "colluding with hostile forces." Malaysian police have announced the arrest of a fourth suspect, a North Korean, in the death of the half brother of the North Korean leader. A police statement says the man identified as Ri Jong Chol was arrested on Friday in Selangor near Kuala Lumpur. It gave no other details. Two women, one of them Indonesian and the other traveling on a Vietnamese passport, and a boyfriend of one of them, have been arrested earlier on suspicion of involvement in the death of Kim Jong Nam. South Korea has accused its enemies in North Korea of dispatching a hit squad to kill Kim Jong Nam at the airport in Kuala Lumpur, saying two female assassins poisoned him and then fled in a taxi. SEOUL, South Korea (AP) — As Malaysian police continue their inquiry into the death of Kim Jong Nam, the outcast half brother of North Korean leader Kim Jong Un, there's plenty of speculation surrounding what seems one of the stranger killings the world has recently seen. North Korea killed Kim Jong Nam because he planned to create an exile government around defectors, says one rumor. Kim Jong Un was furious after learning about secret Chinese plans to enthrone his estranged sibling in Pyongyang if something happens to him, says another. Or maybe Pyongyang wasn't involved at all. Perhaps, Kim Jong Nam, known for his carefree lifestyle and gambling habits, angered crime organizations over money problems and that got him killed, say some online arguments. BRISBANE, Australia (AP) — A man was critically injured when he was attacked by a shark on Saturday while spear fishing on Australia's Great Barrier Reef, an official said. The 26-year-old was bitten repeatedly on a leg as he dived near Hinchinbrook Island off the coast of Queensland state, Queensland Ambulance Service Supervisor Ange Timmins said. His friends brought him by boat to the town of Cardwell where ambulance officers stopped his bleeding and stabilized his condition, Timmins said. He was flown by helicopter in a critical condition 150 kilometers (90 miles) north to the Cairns Base Hospital, she said. His friends thought the man was attacked by a bull or tiger shark, Timmins said. ISLAMABAD (AP) — A brutal attack on a beloved Sufi shrine that killed 88 people raised fears that the Islamic State group has become emboldened in Pakistan, aided by an army of homegrown militants benefiting from hideouts in neighboring Afghanistan, analysts and officials said Friday. Pakistani security forces have carried out sweeping country-wide raids following Thursday's bombing of the shrine in Pakistan's southern Sindh province that also wounded 343 people. The military's public relations wing reported on its official twitter account that more than 100 suspected "terrorists" were killed in the raids, while government officials lashed out at Kabul accusing the Afghan government of ignoring earlier pleas to crackdown on militant hideouts. MILAN (AP) — Italian media says the Bank of China has agreed to pay a 600,000-euro ($640,000) fine as part of a plea deal in a 4.5-billion-euro money laundering probe. The news agency ANSA reported that at a preliminary hearing on Friday, a judge also convicted four bank officials of money-laundering, while dropping an aggravating charge of employing Mafia methods, and handed down suspended two-year sentences. The judge also ordered the seizure of 980,000 euros, ANSA said, a sum equal to what prosecutors say were the bank's profits in the scheme. The Bank of China said the plea deal was aimed at "avoiding a long trial and allowing the Milan branch to concentrate on developing its own business." It said the Milan branch had respected national and international laws. SEOUL, South Korea (AP) — A desolate but lovely volcano on the North Korea-China border could be the key to unraveling the sudden, mysterious death of an exiled scion of North Korean royalty. South Korea's spy agency believes that Kim Jong Nam was assassinated this week in a Malaysian airport as part of a five-year plot by North Korean leader Kim Jong Un to kill a brother he reportedly never met. If this is right, the motive likely has more to do with their shared bloodlines — and that volcano — than any specific transgression. Here's why: The volcano — Mount Paektu, which is topped with a deep crater lake — is at the heart of North Korea's foundation myth, and is used to legitimize the Kim family's three generations of power. KABUL, Afghanistan (AP) — The Islamic State group launched an attack on Afghan security posts killing 17 soldiers, an Afghan official said Friday. Ahmad Ali Hazrat, chief of the provincial council in the province, said the attack Thursday night took place in the Dih Bala district in eastern Nangarhar province. Hazrat said IS fighters attacked Army security posts from three directions and after several hours of heavy fighting, 17 army soldiers were dead. General Doulat Waziri , spokesman for the Ministry of Defense, said soldiers killed 21 IS fighters. Also on Friday, an Afghan provincial official said Taliban forces stormed several Afghan security posts in eastern Kunar province, killing five police officers. Pakistan's highest ranking foreign ministry official says neighbor Afghanistan has ignored repeated demands to take action against militants targeting Pakistan from sanctuaries on its soil following a horrific attack on a shrine that killed dozens. The Islamic State took responsibility and on Friday and Sartaj Aziz called Afghanistan's National Security Adviser Hanif Atmar to complain of inaction against Pakistani insurgents operating on its territory. Meanwhile, Pakistan says its paramilitary Frontier Corps came under fire by militants in Afghanistan and they retaliated with heavy artillery fire. Afghan officials say the artillery barrage wounded two children and forced scores of families to flee their homes. ISLAMABAD (AP) — Militant attacks in Pakistan have killed hundreds of people over the past three years, including many women and children. On Friday, security forces carried out sweeping raids, gunning down and arresting dozens, a day after a massive suicide bombing killed 88 worshippers at a Sufi shrine in the country's south. The attack, claimed by an Islamic State affiliate in Pakistan, raised questions about the ability of the authorities to rein in militant groups despite several recent offensives targeting insurgents. Here are some of the deadliest attacks in Pakistan in the last three years: 2017: __Feb. 16: An Islamic State suicide bomber strikes inside a famed Sufi shrine in southern Sindh province, killing 88 worshippers as they were performing a devotional dance known as "dhamal." __Feb.

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