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South Brisbane, Australia

Dalton S.,The Childrens Hospital at Westmead | Cheng N.,The Childrens Hospital at Westmead | Jay G.,Gold Coast Hospital | Keijers G.,Gold Coast Hospital | And 11 more authors.
EMA - Emergency Medicine Australasia

Objectives: To describe current practice in managing children with possible acute appendicitis in EDs in Australia and New Zealand as the basis for a clinical practice guideline (CPG). Methods: An anonymous survey was distributed to consultant emergency physicians working at PREDICT (Paediatric Research in Emergency Departments International Collaborative) sites in Australia and New Zealand in April 2013. A second, site-based survey was distributed to the PREDICT representatives at each of the 13 sites. Results: The response rate was 100% (13/13) for the site-based survey and 82% (145/176) for the physician survey. Most respondents agreed that right lower quadrant (RLQ) tenderness (94%), anorexia (92%), migration of abdominal pain to the RLQ (86%), rebound tenderness in the RLQ (60%) and RLQ tenderness produced on coughing, hopping or percussion (63%) were valuable symptoms and signs in diagnosing appendicitis. The responses regarding nausea and vomiting and fever were less consistent. Less than 50% regarded blood tests (C-reactive protein, white cell count) as relevant for the diagnosis of appendicitis. Most physicians (61%) agreed there was a role for a validated CPG for possible appendicitis in children, although only 3/13 sites reported use of such a CPG. Conclusions: This survey of senior emergency physicians across Australia and New Zealand demonstrated congruence in several clinical markers and disagreements in others in the approach to diagnosing children with possible appendicitis. Whereas emergency physicians would like a validated CPG, this survey has highlighted some critical issues. Particularly, the low regard for blood tests, integral to published diagnostic scoring systems, will be a challenge for the development and introduction of such a CPG in Australia and New Zealand. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine. Source

Terrill P.I.,Queensland University of Technology | Suresh S.,The Materials Childrens Hospital | Wilson S.J.,Queensland University of Technology | Cooper D.M.,The Materials Childrens Hospital
Sleep and Biological Rhythms

The ALICE5 software package provides a commercially available automated sleep staging system designed for infants. This study aims to evaluate the accuracy of this sleep staging system in healthy infants. Polysomnograms from 32 healthy infants were obtained from the CHIME dataset. Sleep staging was performed using the Pneumo mode of the ALICE5 package. Each polysomnogram was then re-staged by an experienced pediatric sleep physician. The agreement rate and the kappa agreement rate between the manual sleep scoring and the automated sleep scoring were calculated. The mean agreement rate was 74.6% (SD = 10%), and the kappa agreement rate was κ= 0.558 (SD = 0.17). While the mean agreement rates are comparable with agreement rates between human scorers, the intra-subject variability in performance means that the ALICE5-generated automated sleep staging should be manually validated. © 2011 The Authors. Sleep and Biological Rhythms © 2011 Japanese Society of Sleep Research. Source

Terrill P.I.,Queensland University of Technology | Wilson S.J.,Queensland University of Technology | Suresh S.,The Materials Childrens Hospital | Cooper D.M.,The Materials Childrens Hospital | Dakin C.,The Materials Childrens Hospital
Computers in Biology and Medicine

Breathing dynamics vary between infant sleep states, and are likely to exhibit non-linear behaviour. This study applied the non-linear analytical tool recurrence quantification analysis (RQA) to 400 breath interval periods of REM and N-REM sleep, and then using an overlapping moving window. The RQA variables were different between sleep states, with REM radius 150% greater than N-REM radius, and REM laminarity 79% greater than N-REM laminarity. RQA allowed the observation of temporal variations in non-linear breathing dynamics across a night's sleep at 30. s resolution, and provides a basis for quantifying changes in complex breathing dynamics with physiology and pathology. © 2013 Elsevier Ltd. Source

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