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Constantinides F, Orr N, Nash K, Evans JR, McMahon CM, Gunasekera H, Harkus S, Clague L, Cross C, Halvorsen L, Lumby N, Coates H, Macniven R. Examining relationships between parent-reported factors and recurring ear symptoms among Aboriginal and Torres Strait Islander children. Health Promot J Austr 2024; 35:225-234. [PMID: 36961054 DOI: 10.1002/hpja.719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 02/14/2023] [Accepted: 03/20/2023] [Indexed: 03/25/2023] Open
Abstract
ISSUE ADDRESSED Aboriginal and Torres Strait Islander child ear health is complex and multiple. We examined relationships between parent-reported sociodemographic, child health, health service access factors and ear symptoms among Aboriginal and Torres Strait Islander children aged 3 to 7 years. METHODS The Longitudinal Study of Indigenous Children is a large child cohort study with annual parent-reported data collection. Generalised linear mixed model analyses examined Wave 1 (1309 children 0-5 years; 2008) predictors of being free of parent-reported ear symptoms in both Waves 2 and 3. RESULTS A total of 1030 (78.7%) had no reported ear symptoms in either Wave 2 or 3. In the fully adjusted model, children who had been hospitalised in the past year (aOR = 2.16; 95% CI 1.19-3.93) and those with no ear symptoms (aOR = 2.94; 95% CI, 1.59-5.46) at Wave 1 had higher odds of no ear symptoms in both the subsequent waves. There were also relationships between parent main source of income-government pension or allowance as well as parents who reported no history of their own ear symptoms and higher odds of no ear symptoms in Waves 2 and 3 after partial adjustment for sociodemographic factors. CONCLUSION These findings suggest relationships between different sociodemographic and health factors and parent-reported ear symptoms among Aboriginal and Torres Strait Islander children that warrant further investigation. So what? Children with parent-reported ear symptoms during the early years need holistic support to prevent future ear symptoms that impact health, social and educational life trajectories.
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Affiliation(s)
- Fina Constantinides
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Neil Orr
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Kai Nash
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - John Robert Evans
- Moondani Toombadool Centre, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Catherine M McMahon
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Hasantha Gunasekera
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Children's Hospital Westmead Clinical School, Sydney, New South Wales, Australia
| | - Samantha Harkus
- National Acoustic Laboratories, Macquarie University, Sydney, New South Wales, Australia
| | - Liesa Clague
- School of Nursing and Midwifery, University of Notre Dame, Sydney, New South Wales, Australia
| | - Cara Cross
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Luke Halvorsen
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Noeleen Lumby
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Harvey Coates
- School of Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Rona Macniven
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
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DeLacy J, Burgess L, Cutmore M, Sherriff S, Woolfenden S, Falster K, Banks E, Purcell A, Kong K, Coates H, Curotta J, Douglas M, Slater K, Thompson A, Stephens J, Sherwood J, McIntyre P, Tsembis J, Dickson M, Craig J, Gunasekera H. Ear health and hearing in urban Aboriginal children. Aust N Z J Public Health 2023; 47:100075. [PMID: 37517360 DOI: 10.1016/j.anzjph.2023.100075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/17/2023] [Accepted: 06/13/2023] [Indexed: 08/01/2023] Open
Abstract
OBJECTIVE Evaluate ear health and hearing among urban Aboriginal children and quantify relationships with child, family and social factors. METHODS Baseline questionnaire and ear health examinations from 1430 children with diagnoses (0.5-18 years) attending Aboriginal Health Services enrolled in SEARCH. Ear health outcomes were Otitis Media (OM), and hearing loss (three-frequency average hearing loss >20dB) diagnosed using pneumatic otoscopy, tympanometry, and audiometry. RESULTS Half the children 0.5-3 years had OM (51.5%, 136/264). One third 0.5-18 years (30.4%; 435/1430) had OM, including 1.8% (26/1430) with perforation (0.8% chronic suppurative OM, 0.6% dry perforation and 0.4% acute OM with perforation). One quarter 0.5-18 years (25.7%; 279/1087) had hearing loss; 12.4% unilateral, 13.2% bilateral (70.6% with bilateral loss had concurrent OM). OM was associated with: younger age (0.5-<3 years versus 6-18 years) age-sex-site; adjusted prevalence ratio (aPR)=2.64, 95%, 2.18-3.19); attending childcare/preschool (aPR=1.24, 95%CI, 1.04-1.49); foster care (aPR=1.40, 95%CI, 1.10-1.79); previous ear infection/s (aPR=1.68, 95%CI, 1.42-1.98); and ≥2 people/bedroom (aPR=1.66, 95%CI, 1.24-2.21). Hearing impairment was associated with younger age (0.5-<6 years vs. ≥6 years aPR=1.89, 95%CI, 1.40-2.55) and previous ear infection (aPR=1.87, 95%CI, 1.31-2.68). CONCLUSIONS Half the urban Aboriginal children in this cohort had OM and two-thirds with hearing impairment had OM. IMPLICATIONS FOR PUBLIC HEALTH Findings highlight importance of early detection and support for ear health, particularly in pre-school-aged children with risk factors.
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Affiliation(s)
- Jack DeLacy
- The University of Sydney, Sydney, NSW, Australia; Children's Hospital at Westmead, Sydney, NSW, Australia; The Sax Institute, Sydney, NSW, Australia.
| | | | | | - Simone Sherriff
- The University of Sydney, Sydney, NSW, Australia; The Sax Institute, Sydney, NSW, Australia
| | | | | | - Emily Banks
- Australian National University, Canberra, ACT, Australia
| | | | - Kelvin Kong
- Newcastle Private Medical Suites, Newcastle, NSW, Australia
| | - Harvey Coates
- University of Western Australia, Perth, WA, Australia
| | | | | | - Kym Slater
- Tharawal Aboriginal Corporation, Sydney, NSW, Australia
| | - Aleathia Thompson
- Riverina Medical and Dental Aboriginal Corporation, Wagga Wagga, NSW, Australia
| | | | | | | | | | | | | | - Hasantha Gunasekera
- The University of Sydney, Sydney, NSW, Australia; Children's Hospital at Westmead, Sydney, NSW, Australia
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Nash K, Macniven R, Clague L, Coates H, Fitzpatrick M, Gunasekera H, Gwynne K, Halvorsen L, Harkus S, Holt L, Lumby N, Neal K, Orr N, Pellicano E, Rambaldini B, McMahon C. Ear and hearing care programs for First Nations children: a scoping review. BMC Health Serv Res 2023; 23:380. [PMID: 37076841 PMCID: PMC10116763 DOI: 10.1186/s12913-023-09338-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/24/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Ear and hearing care programs are critical to early detection and management of otitis media (or middle ear disease). Otitis media and associated hearing loss disproportionately impacts First Nations children. This affects speech and language development, social and cognitive development and, in turn, education and life outcomes. This scoping review aimed to better understand how ear and hearing care programs for First Nations children in high-income colonial-settler countries aimed to reduce the burden of otitis media and increase equitable access to care. Specifically, the review aimed to chart program strategies, map the focus of each program against 4 parts of a care pathway (prevention, detection, diagnosis/management, rehabilitation), and to identify the factors that indicated the longer-term sustainability and success of programs. METHOD A database search was conducted in March 2021 using Medline, Embase, Global Health, APA PsycInfo, CINAHL, Web of Science Core Collection, Scopus, and Academic Search Premier. Programs were eligible or inclusion if they had either been developed or run at any time between January 2010 to March 2021. Search terms encompassed terms such as First Nations children, ear and hearing care, and health programs, initiatives, campaigns, and services. RESULTS Twenty-seven articles met the criteria to be included in the review and described a total of twenty-one ear and hearing care programs. Programs employed strategies to: (i) connect patients to specialist services, (ii) improve cultural safety of services, and (iii) increase access to ear and hearing care services. However, program evaluation measures were limited to outputs or the evaluation of service-level outcome, rather than patient-based outcomes. Factors which contributed to program sustainability included funding and community involvement although these were limited in many cases. CONCLUSION The result of this study highlighted that programs primarily operate at two points along the care pathway-detection and diagnosis/management, presumably where the greatest need lies. Targeted strategies were used to address these, some which were limited in their approach. The success of many programs are evaluated as outputs, and many programs rely on funding sources which can potentially limit longer-term sustainability. Finally, the involvement of First Nations people and communities typically only occurred during implementation rather than across the development of the program. Future programs should be embedded within a connected system of care and tied to existing policies and funding streams to ensure long term viability. Programs should be governed and evaluated by First Nations communities to further ensure programs are sustainable and are designed to meet community needs.
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Affiliation(s)
- Kai Nash
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia.
| | - Rona Macniven
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Liesa Clague
- Thurru Indigenous Unit, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Harvey Coates
- The University of Western Australia, Perth, Australia
| | | | | | - Kylie Gwynne
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | - Luke Halvorsen
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | | | - Leanne Holt
- Department of Indigenous Studies, Macquarie University, Sydney, Australia
| | - Noeleen Lumby
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | | | - Neil Orr
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | | | - Boe Rambaldini
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | - Catherine McMahon
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
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Hearsey D, Bamford K, Hutton M, Wade L, Coates H, Ramsay E, Alberts BA, Powell N. P03 Identification of intervention opportunities through assessment of the appropriateness of antibiotic prescribing in surgical patients in a UK hospital using a national audit tool: a single centre retrospective audit. JAC Antimicrob Resist 2023. [DOI: 10.1093/jacamr/dlac133.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Abstract
Background
Identifying opportunities to safely reduce antibiotic prescribing is necessary for prescribers and antibiotic stewardship teams to minimize unwarranted antibiotic use. We aimed to quantify excess antibiotic use in General Surgery.
Methods
We retrospectively audited the antibiotic prescribing for patients discharged from the General Surgery specialty in an acute hospital in the south-west of England between 01/08/21 and 31/08/21 using an audit tool developed by Public Health England. The appropriateness of prescribing was determined for each patient at three antibiotic decision time-points: at initiation, the pre-72h antibiotic review, and treatment duration. Two infection specialists and a general surgeon reviewed each patient. Indication and excess days of therapy (DOTs) were calculated at each decision time-point and expressed as a proportion of total DOTs.
Results
Eighty-six patients were prescribed 1162 DOTs; 192 (16.5%) excess DOTs were prescribed in 38 patients (44%), with zero excess days identified in the remaining 48 patients (56%). Seventy-five of 192 (39%) excess DOTs occurred at initiation; 55/192 (29%) after the pre-72hour antibiotic review; and 62/192 (32%) due to protracted antibiotic courses. There was concordance between the general surgeon and infection specialist for the majority of apportioned excess DOTs. However, the surgeon apportioned fewer excess DOTs 160/1162 (13.8%). Overall IV antibiotics accounted for 53.4% of total DOTs. Seventy-two of 86 (83.7%) patients received 620 intravenous DOTs; of these, 79 (12.7%) IV DOTS were unnecessary.
Conclusions
We have identified excess antibiotic prescribing in General surgery with comparable excess DOTs at all three time-points.
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Affiliation(s)
- D Hearsey
- Pharmacy Department, Royal Cornwall Hospital , Truro, TR1 3LJ
| | - K Bamford
- Medical Microbiology, Royal Cornwall Hospital , Truro, TR1 3LJ
| | - M Hutton
- General Surgery Department, Royal Cornwall Hospital , Truro, TR1 3LJ
| | - L Wade
- Pharmacy Department, Royal Cornwall Hospital , Truro, TR1 3LJ
| | - H Coates
- Royal Cornwall Hospital , Truro, TR1 3LJ
| | - E Ramsay
- Royal Cornwall Hospital , Truro, TR1 3LJ
| | | | - N Powell
- Pharmacy Department, Royal Cornwall Hospital , Truro, TR1 3LJ
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Clark SL, Seppanen EJ, Kirkham LAS, Novotny LA, Bakaletz LO, Cripps AW, Corscadden K, Coates H, Vijayasekaran S, Richmond PC, Thornton RB. Australian Aboriginal Otitis-Prone Children Produce High-Quality Serum IgG to Putative Nontypeable Haemophilus influenzae Vaccine Antigens at Lower Titres Compared to Non-Aboriginal Children. Front Cell Infect Microbiol 2022; 12:767083. [PMID: 35463651 PMCID: PMC9022120 DOI: 10.3389/fcimb.2022.767083] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 03/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background Nontypeable Haemophilus influenzae (NTHi) is the most common bacterial otopathogen associated with otitis media (OM). NTHi persists in biofilms within the middle ears of children with chronic and recurrent OM. Australian Aboriginal children suffer exceptionally high rates of chronic and recurrent OM compared to non-Aboriginal children. NTHi protein vaccines comprised of antigens associated with both adhesion and persistence in a biofilm are under development and could be beneficial for children with chronic and recurrent OM. Understanding the ontogeny of natural antibody development to these antigens provides insight into the value of vaccinating with particular antigens. Methods An in-house multiplex fluorescent bead immunoassay was used to measure serum IgG titres and avidity for three putative vaccine antigens: recombinant soluble PilA (rsPilA), ChimV4, and outer membrane protein 26 (OMP26) in sera from Australian Aboriginal otitis-prone children (n=77), non-Aboriginal otitis-prone children (n=70) and non-otitis-prone children (n=36). Serum IgG titres were adjusted for age, and geometric mean concentrations (GMCs) were compared between groups using a univariate analysis model. Antibody avidity was calculated as a relative avidity index and compared between groups using ANOVA. Results Australian Aboriginal otitis-prone children had lower serum IgG titres to rsPilA and ChimV4 than non-Aboriginal otitis-prone children (p<0.001), and non-otitis-prone children (p<0.020). No differences were observed between serum IgG titres from non-Aboriginal otitis-prone children and non-otitis-prone children. There were also no differences in the proportion of high avidity IgG specific for these antigens between these groups. Serum IgG titres to OMP26 were similar between all groups (p>0.670) although otitis-prone children had a higher proportion of high avidity antibodies to this antigen. Conclusions Australian Aboriginal otitis-prone children had lower serum IgG titres to 2/3 major NTHi vaccine candidate antigens, suggesting these children are unable to develop persistent IgG responses due to repeated NTHi exposure. These reduced IgG titres may relate to earlier and more frequent exposure to diverse NTHi strains in Aboriginal children through carriage or infection. These data suggest that Aboriginal children may benefit from immunisation with vaccines containing these antigens to increase titres of protective antibodies.
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Affiliation(s)
- Sharon L. Clark
- School of Medicine, The University of Western Australia, Perth, WA, Australia,Wesfarmers Centre of Vaccines & Infectious Disease, Telethon Kids Institute, Perth, WA, Australia
| | - Elke J. Seppanen
- Wesfarmers Centre of Vaccines & Infectious Disease, Telethon Kids Institute, Perth, WA, Australia
| | - Lea-Ann S. Kirkham
- Wesfarmers Centre of Vaccines & Infectious Disease, Telethon Kids Institute, Perth, WA, Australia,Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - Laura A. Novotny
- Centre for Microbial Pathogenesis, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, United States
| | - Lauren O. Bakaletz
- Centre for Microbial Pathogenesis, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, United States
| | - Allan W. Cripps
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
| | - Karli Corscadden
- Wesfarmers Centre of Vaccines & Infectious Disease, Telethon Kids Institute, Perth, WA, Australia
| | - Harvey Coates
- School of Medicine, The University of Western Australia, Perth, WA, Australia
| | - Shyan Vijayasekaran
- School of Medicine, The University of Western Australia, Perth, WA, Australia,Perth Children's Hospital (PCH), Perth, WA, Australia
| | - Peter C. Richmond
- School of Medicine, The University of Western Australia, Perth, WA, Australia,Wesfarmers Centre of Vaccines & Infectious Disease, Telethon Kids Institute, Perth, WA, Australia,Perth Children's Hospital (PCH), Perth, WA, Australia
| | - Ruth B. Thornton
- Wesfarmers Centre of Vaccines & Infectious Disease, Telethon Kids Institute, Perth, WA, Australia,Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia,*Correspondence: Ruth B. Thornton,
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Mateus T, Seppanen EJ, de Gier C, Clark S, Coates H, Vijayasekaran S, Prosser K, Wiertsema SP, Fuery A, Kirkham LAS, Richmond PC, Thornton RB. Sleep Disordered Breathing and Recurrent Tonsillitis Are Associated With Polymicrobial Bacterial Biofilm Infections Suggesting a Role for Anti-Biofilm Therapies. Front Cell Infect Microbiol 2022; 12:831887. [PMID: 35295756 PMCID: PMC8918577 DOI: 10.3389/fcimb.2022.831887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe underlying pathogenesis of pediatric obstructive sleep disordered breathing (SDB) and recurrent tonsillitis (RT) are poorly understood but need to be elucidated to develop less invasive treatment and prevention strategies.MethodsChildren aged between 1- and 16-years undergoing adenoidectomy, tonsillectomy or adenotonsillectomy for SDB (n=40), RT alone (n=18), or both SDB and RT (SDB+RT) (n=17) were recruited with age-matched healthy controls (n=33). Total bacterial load and species-specific densities of nontypeable Haemophilus influenzae (NTHi), Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae and Moraxella catarrhalis were measured by qPCR in nasopharyngeal swabs, oropharyngeal swabs, adenoid and tonsillar tissue from children with SDB, SDB+RT and RT, and in naso- and oro- pharyngeal swabs from healthy children. A subset of tonsil biopsies were examined for biofilms using 16S rRNA FISH (n=3/group).ResultsThe 5 bacterial species were detected in naso- and oro- pharyngeal samples from all children. These species were frequently detected in adenotonsillar tissue (except S. aureus, which was absent in adenoids) from children with SDB, SDB+RT and RT. NTHi and S. aureus were observed in tonsils from 66.7-88.2% and 33.3-58.8% of children respectively. Similar total and species-specific bacterial densities were observed in adenotonsillar tissue from children with SDB, SDB+RT or RT. Nasopharyngeal and oropharyngeal swabs were more likely to have multiple bacterial species co-detected than adenotonsillar tissue where one or two targeted species predominated. Polymicrobial biofilms and intracellular bacteria were observed in tonsils from children with adenotonsillar disease.ConclusionsAntimicrobials, particularly anti-biofilm therapies, may be a strategy for managing children with SDB.
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Affiliation(s)
- Tulia Mateus
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Elke J. Seppanen
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Camilla de Gier
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Sharon Clark
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Harvey Coates
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Shyan Vijayasekaran
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Perth Children’s Hospital, Perth, WA, Australia
| | | | - Selma P. Wiertsema
- School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Angela Fuery
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Lea-Ann S. Kirkham
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
- Centre for Child Health Research, University of Western Australia, Perth, WA, Australia
| | - Peter C. Richmond
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
- Perth Children’s Hospital, Perth, WA, Australia
- Centre for Child Health Research, University of Western Australia, Perth, WA, Australia
| | - Ruth B. Thornton
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
- Centre for Child Health Research, University of Western Australia, Perth, WA, Australia
- *Correspondence: Ruth B. Thornton,
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Ross PM, Scanes E, Poronnik P, Coates H, Locke W. Understanding STEM academics' responses and resilience to educational reform of academic roles in higher education. Int J STEM Educ 2022; 9:11. [PMID: 35127335 PMCID: PMC8796749 DOI: 10.1186/s40594-022-00327-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/11/2022] [Indexed: 05/04/2023]
Abstract
BACKGROUND Across the globe, there have been significant reforms to improve STEM education at all levels. A significant part of this has been teacher reform. While the responses and resilience of STEM teachers to educational reforms in secondary education have received significant attention, the responses and resilience of STEM teachers in higher education remains understudied. In higher education, educational reforms of academic roles have seen increasing numbers of STEM academics focussed on education. Responses of STEM academics to education reform of the academic role have some parallels with teacher resilience, but there are also potential misalignments within a culture which values and prioritises science disciplinary research. This study examined the responses of STEM academics in higher education to educational reform of the academic role using the theoretical construct of resilience and Bronfenbrenner's socio-ecological model. This was a 2-year case study of 32 academics and senior educational leaders in higher education in STEM. Data collection included semi-structured interviews which were theme coded and inductively analysed. RESULTS The responses and resilience of STEM academics focussed on education appeared to be dependent on interactions between individual disposition in the microsystem and influences of the exosystem and the external macrosystem. Five major themes emerged about the value and quality, scholarship and expertise, progress and mobility, status and identity and community and culture of STEM academics focussed on education. The exosystem was a significant unidirectional influence on STEM academics where judgements were made concerning academic performance, awards, and promotion. Responses of senior leaders in the exosystem were influenced by the macrosystem and culture of science. Academics focussed on research, rather than education were more valued and more likely to be both financially rewarded and promoted. CONCLUSION During this pressured decade, where COVID-19 has intensified stress, more attention on the direction and reciprocal relationships in the socio-ecological model of higher education is needed in order for educational reform in higher education STEM to be effective. Resilience of STEM academics to educational reform in higher education is a dynamic quality, and the capacity to "bounce back", learn from challenges, and realise expectations of educational reform will depend on an understanding of resilience and support of Bronfenbrenner's spheres of influence.
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Affiliation(s)
- Pauline Mary Ross
- Melbourne Centre for the Study of Higher Education (Melbourne–CSHE), University of Melbourne, Melbourne, VIC Australia
- The University of Sydney of School Life and Environmental Science, Sydney, NSW Australia
| | - E. Scanes
- The University of Sydney of School Life and Environmental Science, Sydney, NSW Australia
- Climate Change Cluster, University of Technology, Sydney, NSW Australia
| | - P. Poronnik
- The University of Sydney, School of Medical Sciences, Sydney, NSW Australia
| | - H. Coates
- Institute of Education, Tsinghua University, Haidian District, Beijing, China
| | - W. Locke
- Melbourne Centre for the Study of Higher Education (Melbourne–CSHE), University of Melbourne, Melbourne, VIC Australia
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Wigger C, Leach AJ, Beissbarth J, Oguoma V, Lennox R, Nelson S, Patel H, Chatfield M, Currie K, Coates H, Edwards K, Smith-Vaughan H, Hare K, Torzillo P, Tong S, Morris P. Povidone-iodine ear wash and oral cotrimoxazole for chronic suppurative otitis media in Australian aboriginal children: study protocol for factorial design randomised controlled trial. BMC Pharmacol Toxicol 2019; 20:46. [PMID: 31351491 PMCID: PMC6660704 DOI: 10.1186/s40360-019-0322-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 07/09/2019] [Indexed: 11/10/2022] Open
Abstract
Background Chronic suppurative otitis media (CSOM) is a significant health issue affecting Aboriginal Australians. Long-term hearing loss can cause communication problems, educational disadvantage, and social isolation. Current standard treatment for CSOM in our region is twice daily dry mopping of the pus from the ear canal followed by instillation of ciprofloxacin antibiotic ear drops for up to 16 weeks, or until the discharge resolves for a period of 3 days. The treatment is long, laborious and fails to resolve ear discharge in 70% of cases in remote communities. Bacterial pathogens also persist. Povidone-iodine ear wash is the preferred method of clearing ear discharge in Western Australia. However, evidence of its effectiveness is lacking. In systematic reviews, topical antibiotics (ciprofloxacin) have been shown to be more effective than oral antibiotics or topical antiseptics. Currently, it is unclear whether there are any benefits of combining these treatments. Methods This protocol describes a 2 × 2 factorial randomised controlled trial of two different interventions (povidone-iodine ear wash and oral cotrimoxazole), given as adjunctive therapy to standard treatment for CSOM. 280 children, between 2 months and 17 years of age, Indigenous or non-Indigenous, living in participating Northern Territory (NT) communities are randomised to standard treatment (dry mopping and ciprofloxacin drops) plus one of two topical treatments (dilute povidone-iodine ear wash or no wash) and one of two oral medication treatments (16 weeks of cotrimoxazole or placebo). Discussion Current treatment of CSOM in our region shows that eradication of bacterial pathogens from the middle ear space and dry ears is often not achieved. This trial will evaluate the efficacy of adjunctive treatments of antiseptic ear washes and oral antibiotics. Clinical, microbiological and hearing outcomes will be reported. Trial registration This trial (ACTRN12614000234617) was registered with ANZCTR on 05 April 2014.
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Affiliation(s)
- Christine Wigger
- Menzies School of Health Research, PO Box 41096, Casuarina, Darwin, NT, 0812, Australia.
| | - Amanda Jane Leach
- Menzies School of Health Research, PO Box 41096, Casuarina, Darwin, NT, 0812, Australia
| | - Jemima Beissbarth
- Menzies School of Health Research, PO Box 41096, Casuarina, Darwin, NT, 0812, Australia
| | - Victor Oguoma
- Menzies School of Health Research, PO Box 41096, Casuarina, Darwin, NT, 0812, Australia
| | - Ruth Lennox
- Menzies School of Health Research, PO Box 41096, Casuarina, Darwin, NT, 0812, Australia
| | - Sandra Nelson
- Top End Health Services, Darwin, Northern Territory, Australia
| | - Hemi Patel
- Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Mark Chatfield
- University of Queensland, Brisbane, Queensland, Australia
| | - Kathy Currie
- Northern Territory Department of Health, Darwin, Northern Territory, Australia
| | - Harvey Coates
- University of Western Australia, Perth, Western Australia, Australia
| | - Keith Edwards
- Top End Health Services, Darwin, Northern Territory, Australia
| | - Heidi Smith-Vaughan
- Menzies School of Health Research, PO Box 41096, Casuarina, Darwin, NT, 0812, Australia
| | - Kim Hare
- Menzies School of Health Research, PO Box 41096, Casuarina, Darwin, NT, 0812, Australia
| | - Paul Torzillo
- Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Steven Tong
- Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Peter Morris
- Royal Darwin Hospital, and Menzies School of Health Research, Darwin, Northern Territory, Australia
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9
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Sibthorpe B, Agostino J, Coates H, Weeks S, Lehmann D, Wood M, Lannigan F, McAullay D. Indicators for continuous quality improvement for otitis media in primary health care for Aboriginal and Torres Strait Islander children. Aust J Prim Health 2019; 23:1-9. [PMID: 28088980 DOI: 10.1071/py16096] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 11/24/2016] [Indexed: 11/23/2022]
Abstract
Otitis media is a common, generally self-limiting childhood illness that can progress to severe disease and have lifelong sequelae, including hearing loss and developmental delays. Severe disease is disproportionately prevalent among Aboriginal and Torres Strait Islander children. Primary health care is at the frontline of appropriate prevention and treatment. Continuous quality improvement in the prevention and management of important causes of morbidity in client populations is accepted best practice in primary health care and now a requirement of Australian Government funding to services providing care for Aboriginal and Torres Strait Islander children. To date, there have been no indicators for continuous quality improvement in the prevention and management of otitis media and its sequelae in primary health care. Through an expert group consensus process, seven evidence-based indicators, potentially extractable from electronic health records, have been developed. The development process and indicators are described.
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Affiliation(s)
| | - Jason Agostino
- Academic Unit of General Practice, Australian National University, PO Box 11, Woden, ACT 2606, Australia
| | - Harvey Coates
- School of Paediatrics and Child Health, University of Western Australia, GPO Box D184, Perth, WA 6840, Australia
| | - Sharon Weeks
- Telethon Kids Institute, University of Western Australia, PO Box 855, WA 6872, Australia
| | - Deborah Lehmann
- Telethon Kids Institute, University of Western Australia, PO Box 855, WA 6872, Australia
| | - Marianne Wood
- Aboriginal Health Council of Western Australia, 450 Beaufort Street, Highgate, WA 6003, Australia
| | - Francis Lannigan
- School of Paediatrics and Child Health, University of Western Australia, GPO Box D184, Perth, WA 6840, Australia
| | - Daniel McAullay
- Edith Cowan University, 2 Bradfield Street, Mount Lawley, WA 6050, Australia
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10
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Lappan R, Imbrogno K, Sikazwe C, Anderson D, Mok D, Coates H, Vijayasekaran S, Bumbak P, Blyth CC, Jamieson SE, Peacock CS. A microbiome case-control study of recurrent acute otitis media identified potentially protective bacterial genera. BMC Microbiol 2018; 18:13. [PMID: 29458340 PMCID: PMC5819196 DOI: 10.1186/s12866-018-1154-3] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 02/08/2018] [Indexed: 12/15/2022] Open
Abstract
Background Recurrent acute otitis media (rAOM, recurrent ear infection) is a common childhood disease caused by bacteria termed otopathogens, for which current treatments have limited effectiveness. Generic probiotic therapies have shown promise, but seem to lack specificity. We hypothesised that healthy children with no history of AOM carry protective commensal bacteria that could be translated into a specific probiotic therapy to break the cycle of re-infection. We characterised the nasopharyngeal microbiome of these children (controls) in comparison to children with rAOM (cases) to identify potentially protective bacteria. As some children with rAOM do not appear to carry any of the known otopathogens, we also hypothesised that characterisation of the middle ear microbiome could identify novel otopathogens, which may also guide the development of more effective therapies. Results Middle ear fluids, middle ear rinses and ear canal swabs from the cases and nasopharyngeal swabs from both groups underwent 16S rRNA gene sequencing. The nasopharyngeal microbiomes of cases and controls were distinct. We observed a significantly higher abundance of Corynebacterium and Dolosigranulum in the nasopharynx of controls. Alloiococcus, Staphylococcus and Turicella were abundant in the middle ear and ear canal of cases, but were uncommon in the nasopharynx of both groups. Gemella and Neisseria were characteristic of the case nasopharynx, but were not prevalent in the middle ear. Conclusions Corynebacterium and Dolosigranulum are characteristic of a healthy nasopharyngeal microbiome. Alloiococcus, Staphylococcus and Turicella are possible novel otopathogens, though their rarity in the nasopharynx and prevalence in the ear canal means that their role as normal aural flora cannot be ruled out. Gemella and Neisseria are unlikely to be novel otopathogens as they do not appear to colonise the middle ear in children with rAOM. Electronic supplementary material The online version of this article (10.1186/s12866-018-1154-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rachael Lappan
- The Marshall Centre for Infectious Diseases Research and Training, School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia. .,Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.
| | - Kara Imbrogno
- The Marshall Centre for Infectious Diseases Research and Training, School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Chisha Sikazwe
- Department of Microbiology, PathWest, Perth, WA, Australia
| | - Denise Anderson
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Danny Mok
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Harvey Coates
- School of Medicine, The University of Western Australia, Perth, WA, Australia
| | - Shyan Vijayasekaran
- School of Medicine, The University of Western Australia, Perth, WA, Australia.,Princess Margaret Hospital for Children, Perth, WA, Australia
| | - Paul Bumbak
- School of Medicine, The University of Western Australia, Perth, WA, Australia.,Princess Margaret Hospital for Children, Perth, WA, Australia
| | - Christopher C Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.,Department of Microbiology, PathWest, Perth, WA, Australia.,School of Medicine, The University of Western Australia, Perth, WA, Australia.,Princess Margaret Hospital for Children, Perth, WA, Australia
| | - Sarra E Jamieson
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Christopher S Peacock
- The Marshall Centre for Infectious Diseases Research and Training, School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia. .,Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.
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11
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Kuthubutheen J, Joglekar S, Smith L, Friesen L, Smilsky K, Millman T, Ng A, Shipp D, Coates H, Arnoldner C, Nedzelski J, Chen J, Lin V. The Role of Preoperative Steroids for Hearing Preservation Cochlear Implantation: Results of a Randomized Controlled Trial. Audiol Neurootol 2018; 22:292-302. [DOI: 10.1159/000485310] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 11/14/2017] [Indexed: 12/22/2022] Open
Abstract
Objectives: To determine whether preoperative steroids can improve hearing outcomes in cochlear implantation (CI). Methods: This is a randomized controlled trial involving 30 postlingual deaf CI patients. Subjects had preoperative thresholds of better than or equal to 80 dB at 125 and 250 Hz, and better than or equal to 90 dB at 500 and 1,000 Hz. The subjects were randomized to a control group, an oral steroid group (receiving 1 mg/kg/day of prednisolone for 6 days prior to surgery), or a transtympanic steroid group (receiving a single dose of 0.5 mL of 10 mg/mL dexamethasone at 24 h prior to surgery). Results: The subjects receiving transtympanic steroids had a significant decrease in the pure tone average over 3 months compared to the control and oral steroid group, which persisted over 12 months (p < 0.05). Conclusion: A single dose of preoperative transtympanic steroids prior to CI appears to have a beneficial effect, at least in the short term, with minimal effects seen in the longer term.
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12
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Schilder AGM, Marom T, Bhutta MF, Casselbrant ML, Coates H, Gisselsson-Solén M, Hall AJ, Marchisio P, Ruohola A, Venekamp RP, Mandel EM. Panel 7: Otitis Media: Treatment and Complications. Otolaryngol Head Neck Surg 2017; 156:S88-S105. [PMID: 28372534 DOI: 10.1177/0194599816633697] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective We aimed to summarize key articles published between 2011 and 2015 on the treatment of (recurrent) acute otitis media, otitis media with effusion, tympanostomy tube otorrhea, chronic suppurative otitis media and complications of otitis media, and their implications for clinical practice. Data Sources PubMed, Ovid Medline, the Cochrane Library, and Clinical Evidence (BMJ Publishing). Review Methods All types of articles related to otitis media treatment and complications between June 2011 and March 2015 were identified. A total of 1122 potential related articles were reviewed by the panel members; 118 relevant articles were ultimately included in this summary. Conclusions Recent literature and guidelines emphasize accurate diagnosis of acute otitis media and optimal management of ear pain. Watchful waiting is optional in mild to moderate acute otitis media; antibiotics do shorten symptoms and duration of middle ear effusion. The additive benefit of adenoidectomy to tympanostomy tubes in recurrent acute otitis media and otitis media with effusion is controversial and age dependent. Topical antibiotic is the treatment of choice in acute tube otorrhea. Symptomatic hearing loss due to persistent otitis media with effusion is best treated with tympanostomy tubes. Novel molecular and biomaterial treatments as adjuvants to surgical closure of eardrum perforations seem promising. There is insufficient evidence to support the use of complementary and alternative treatments. Implications for Practice Emphasis on accurate diagnosis of otitis media, in its various forms, is important to reduce overdiagnosis, overtreatment, and antibiotic resistance. Children at risk for otitis media and its complications deserve special attention.
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Affiliation(s)
- Anne G M Schilder
- 1 evidENT, Ear Institute, University College London, London, United Kingdom.,2 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Tal Marom
- 3 Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Faculty of Medicine, Tel Aviv University, Zerifin, Israel
| | - Mahmood F Bhutta
- 4 Royal National Throat Nose and Ear Hospital, London, United Kingdom
| | - Margaretha L Casselbrant
- 5 Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of UPMC, Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Harvey Coates
- 6 Department of Otolaryngology, School of Paediatrics and Child Health, The University of Western Australia, Nedlands, WA, Australia
| | - Marie Gisselsson-Solén
- 7 Department of Clinical Sciences, Division of Otorhinolaryngology, Head and Neck Surgery, Lund University Hospital, Lund, Sweden
| | - Amanda J Hall
- 8 University Hospitals Bristol NHS Foundation Trust and School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Paola Marchisio
- 9 Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Aino Ruohola
- 10 Department of Pediatrics, University of Turku, Turku, Finland
| | - Roderick P Venekamp
- 2 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Ellen M Mandel
- 5 Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of UPMC, Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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13
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Acharya AN, Coates H, Tavora-Vieira D, Rajan GP. Response to the Letter to the Editor regarding "A pilot study investigating basic fibroblast growth factor for the repair of chronic tympanic membrane perforations in pediatric patients". Int J Pediatr Otorhinolaryngol 2016; 86:247-8. [PMID: 27132194 DOI: 10.1016/j.ijporl.2016.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 04/15/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Aanand N Acharya
- Department of Otolaryngology, Fiona Stanley Hospital, Murdoch Drive, Murdoch, Western Australia 6150, Australia.
| | - Harvey Coates
- Department of Otolaryngology, Princess Margaret Hospital for Children, Roberts Road, Perth, Western Australia 6008, Australia; Otolaryngology, Head & Neck Surgery, School of Surgery, Department of Otolaryngology, University of Western Australia, 35 Stirling Highway, Perth, Western Australia 6009, Australia
| | - Dayse Tavora-Vieira
- Department of Otolaryngology, Fiona Stanley Hospital, Murdoch Drive, Murdoch, Western Australia 6150, Australia
| | - Gunesh P Rajan
- Department of Otolaryngology, Fiona Stanley Hospital, Murdoch Drive, Murdoch, Western Australia 6150, Australia; Department of Otolaryngology, Princess Margaret Hospital for Children, Roberts Road, Perth, Western Australia 6008, Australia; Otolaryngology, Head & Neck Surgery, School of Surgery, Department of Otolaryngology, University of Western Australia, 35 Stirling Highway, Perth, Western Australia 6009, Australia
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14
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Kuthubutheen J, Coates H, Rowsell C, Nedzelski J, Chen JM, Lin V. The role of extended preoperative steroids in hearing preservation cochlear implantation. Hear Res 2015; 327:257-64. [PMID: 26117408 DOI: 10.1016/j.heares.2015.06.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 05/03/2015] [Accepted: 06/12/2015] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Steroids have been shown to reduce the hearing threshold shifts associated with cochlear implantation. Previous studies have examined only the administration of steroids just prior to surgery. The aim of this study is to examine the role of extended preoperative systemic steroids in hearing preservation cochlear implantation. METHODS An animal model of cochlear implantation was used. 24 Hartley strain guinea pigs with a mean weight of 768 g and normal hearing were randomised into a control group, a second group receiving a single dose of systemic dexamethasone one day prior to surgery, and a third group receiving a daily dose of systemic dexamethasone for 5 days prior to surgery. A specially designed cochlear implant electrode by Med-EL (Innsbruck) was inserted through a dorsolateral approach to an insertion depth of 5 mm and left in-situ. Auditory brain stem responses at 8 kHz, 16 kHz and 32 kHz were measured preoperatively, and 1 week, 1 month and 2 months postoperatively. Cochlear histopathology was examined at the conclusion of the study. RESULTS At 1-week post operative, both groups receiving dexamethasone prior to implantation had smaller threshold shifts across all frequencies and which was significant at 32 kHz (p < 0.05). There were no differences among the three groups in the area of electrode related fibrosis. Spiral ganglion neuron (SGN) density was significantly higher in the group receiving steroids for 5 days, but only in the basal cochlear turn. DISCUSSION This is study demonstrates the benefits of extended preoperative systemic steroids on hearing outcomes and SGN density in an animal model of cochlear implantation surgery.
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Affiliation(s)
- Jafri Kuthubutheen
- Department of Otolaryngology - Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada; School of Surgery, University of Western Australia, Perth, Western Australia, Australia.
| | - Harvey Coates
- School of Surgery, University of Western Australia, Perth, Western Australia, Australia
| | - Corwyn Rowsell
- Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Julian Nedzelski
- Department of Otolaryngology - Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Joseph M Chen
- Department of Otolaryngology - Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Vincent Lin
- Department of Otolaryngology - Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
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15
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Barber C, Ille S, Vergison A, Coates H. Acute otitis media in young children - what do parents say? Int J Pediatr Otorhinolaryngol 2014; 78:300-6. [PMID: 24374143 DOI: 10.1016/j.ijporl.2013.11.030] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 11/21/2013] [Accepted: 11/24/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The Ear infections Attitudes Research study investigated parental attitudes and awareness towards acute otitis media (AOM) and evaluated the burden of AOM for affected children, their families, and parental work capabilities. METHODS This study, conducted via online interviews in October-November 2010, included parents (N=2867) from 12 countries, whose children aged ≤3.5 years had experienced ≥1 professionally diagnosed AOM episode in the last 6 months (AOM-experienced group; N=1438) or had never experienced any professionally diagnosed AOM episode (non AOM-experienced group; N=1429). The interviews consisted of questions with multiple-choice, five-point scaled or free-text answers. Answers to multiple-choice questions were presented as frequencies of particular responses and those to scaled questions as mean values or percentages of parents considering each aspect as applicable. RESULTS Parents considered that the main AOM burdens for affected children were pain (mean values on five-point scales: 4.4 and 4.5), disturbed sleep (4.3 and 4.3) and irritability (4.2 and 4.0) and for their families, sleepless nights (4.2 and 3.8) and worries about the child's recovery (4.1 and 4.3) and about potential long-term implications (4.0 and 4.3) in the AOM-experienced and non AOM-experienced groups, respectively. During their child's most recent AOM episode, 95% of parents in the AOM-experienced group used antibiotics, 76% reported that their doctors prescribed antibiotics for immediate use, 13% were advised to return for antibiotic prescription if symptoms did not abate and 9% received a prescription for antibiotics to use if symptoms did not improve. Both reported prescription and usage rates for antibiotics were higher than expected. When their child had AOM, 73% of parents had to be absent from work or rearrange their working hours. Among those who took leave from work, 67% stayed at home for 2-7 days. CONCLUSIONS Parents perceive AOM to be a burden for their child and families, particularly the pain and disturbed sleep due to AOM, and this disease had a significant effect on parents' ability to attend work. Given how common AOM is, this loss of workdays may lead to substantial financial burden for families and the society. Antibiotics were almost invariably used in all countries despite current guidelines.
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Affiliation(s)
- Colin Barber
- Department of Paediatric Otolaryngology, Starship Hospital, 2 Park Road, Grafton, Auckland 1023, New Zealand.
| | | | - Anne Vergison
- Department of Paediatric Infectious Diseases, Infection Control and Epidemiology Unit, ULB-Hopital Universitaire Des Enfants, J.J. Crocq 15, 1020 Brussels (Laken), Belgium.
| | - Harvey Coates
- School of Paediatrics and Child Health, The University of Western Australia, Perth, 208 Hampden Road, Nedlands, Western Australia 6009, Australia.
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Ogilvie F, Earwicker R, Petrokofsky C, Wynne P, Jenkins S, Coates H. PP76 Exploring Barriers and Solutions to take up of Interventions to Address Fuel Poverty: A Health Impact Assessment of Fuel Poverty Policy in England. Br J Soc Med 2013. [DOI: 10.1136/jech-2013-203126.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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17
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Vijayasekaran S, Coates H, Thornton RB, Wiertsema SP, Kirkham LAS, Jamieson SE, Rye M, Richmond PC. New findings in the pathogenesis of otitis media. Laryngoscope 2013; 122 Suppl 4:S61-2. [PMID: 23254605 DOI: 10.1002/lary.23817] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 09/06/2012] [Indexed: 12/30/2022]
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18
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Sun W, Jacoby P, Riley TV, Bowman J, Leach AJ, Coates H, Weeks S, Cripps A, Lehmann D. Association between early bacterial carriage and otitis media in Aboriginal and non-Aboriginal children in a semi-arid area of Western Australia: a cohort study. BMC Infect Dis 2012; 12:366. [PMID: 23256870 PMCID: PMC3546895 DOI: 10.1186/1471-2334-12-366] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 12/17/2012] [Indexed: 11/16/2022] Open
Abstract
Background Streptococcus pneumoniae (Pnc), nontypeable Haemophilus influenzae (NTHi) and Moraxella catarrhalis (Mcat) are the most important bacterial pathogens associated with otitis media (OM). Previous studies have suggested that early upper respiratory tract (URT) bacterial carriage may increase risk of subsequent OM. We investigated associations between early onset of URT bacterial carriage and subsequent diagnosis of OM in Aboriginal and non-Aboriginal children living in the Kalgoorlie-Boulder region located in a semi-arid zone of Western Australia. Methods Aboriginal and non-Aboriginal children who had nasopharyngeal aspirates collected at age 1- < 3 months and at least one clinical examination for OM by an ear, nose and throat specialist before age 2 years were included in this analysis. Tympanometry to detect middle ear effusion was also performed at 2- to 6-monthly scheduled field visits from age 3 months. Multivariate regression models were used to investigate the relationship between early carriage and subsequent diagnosis of OM controlling for environmental factors. Results Carriage rates of Pnc, NTHi and Mcat at age 1- < 3 months were 45%, 29% and 48%, respectively, in 66 Aboriginal children and 14%, 5% and 18% in 146 non-Aboriginal children. OM was diagnosed at least once in 71% of Aboriginal children and 43% of non-Aboriginal children. After controlling for age, sex, presence of other bacteria and environmental factors, early nasopharyngeal carriage of NTHi increased the risk of subsequent OM (odds ratio = 3.70, 95% CI 1.22-11.23) in Aboriginal children, while Mcat increased the risk of OM in non-Aboriginal children (odds ratio = 2.63, 95% CI 1.32-5.23). Early carriage of Pnc was not associated with increased risk of OM. Conclusion Early NTHi carriage in Aboriginal children and Mcat in non-Aboriginal children is associated with increased risk of OM independent of environmental factors. In addition to addressing environmental risk factors for carriage such as overcrowding and exposure to environmental tobacco smoke, early administration of pneumococcal-Haemophilus influenzae D protein conjugate vaccine to reduce bacterial carriage in infants, may be beneficial for Aboriginal children; such an approach is currently being evaluated in Australia.
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Affiliation(s)
- Wenxing Sun
- Division of Population Sciences, Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, PO Box 855, West Perth, WA 6872, Australia
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Coates H, Vijayasekaran S. Bacterial biofilm in chronic suppurative otitis media. Otolaryngol Head Neck Surg 2010; 142:778; author reply 778. [PMID: 20416478 DOI: 10.1016/j.otohns.2010.01.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Accepted: 01/19/2010] [Indexed: 11/25/2022]
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20
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Thornton R, Richmond P, Vijayasekaran S, Rigby P, Wiertsema S, Coates H. A New Disease Paradigm - Mucosal and stromal intracellular bacteria in the upper respiratory tract. Laryngoscope 2009. [DOI: 10.1002/lary.21588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Lehmann D, Weeks S, Jacoby P, Elsbury D, Finucane J, Stokes A, Monck R, Coates H. Absent otoacoustic emissions predict otitis media in young Aboriginal children: a birth cohort study in Aboriginal and non-Aboriginal children in an arid zone of Western Australia. BMC Pediatr 2008; 8:32. [PMID: 18755038 PMCID: PMC2538518 DOI: 10.1186/1471-2431-8-32] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Accepted: 08/28/2008] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Otitis media (OM) is the most common paediatric illness for which antibiotics are prescribed. In Australian Aboriginal children OM is frequently asymptomatic and starts at a younger age, is more common and more likely to result in hearing loss than in non-Aboriginal children. Absent transient evoked otoacoustic emissions (TEOAEs) may predict subsequent risk of OM. METHODS 100 Aboriginal and 180 non-Aboriginal children in a semi-arid zone of Western Australia were followed regularly from birth to age 2 years. Tympanometry was conducted at routine field follow-up from age 3 months. Routine clinical examination by an ENT specialist was to be done 3 times and hearing assessment by an audiologist twice. TEOAEs were measured at ages <1 and 1-2 months. Cox proportional hazards model was used to investigate the association between absent TEOAEs and subsequent risk of OM. RESULTS At routine ENT specialist clinics, OM was detected in 55% of 184 examinations in Aboriginal children and 26% of 392 examinations in non-Aboriginal children; peak prevalence was 72% at age 5-9 months in Aboriginal children and 40% at 10-14 months in non-Aboriginal children. Moderate-severe hearing loss was present in 32% of 47 Aboriginal children and 7% of 120 non-Aboriginal children aged 12 months or more. TEOAE responses were present in 90% (46/51) of Aboriginal children and 99% (120/121) of non-Aboriginal children aged <1 month and in 62% (21/34) and 93% (108/116), respectively, in Aboriginal and non-Aboriginal children at age 1-2 months. Aboriginal children who failed TEOAE at age 1-2 months were 2.6 times more likely to develop OM subsequently than those who passed. Overall prevalence of type B tympanograms at field follow-up was 50% (n = 78) in Aboriginal children and 20% (n = 95) in non-Aboriginal children. CONCLUSION The burden of middle ear disease is high in all children, but particularly in Aboriginal children, one-third of whom suffer from moderate-severe hearing loss. In view of the frequently silent nature of OM, every opportunity must be taken to screen for OM. Measurement of TEOAEs at age 1-2 months to identify children at risk of developing OM should be evaluated in a routine health service setting.
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Affiliation(s)
- Deborah Lehmann
- Telethon Institute for Child Health Research, Centre for Child Health Research, the University of Western Australia, Australia
| | - Sharon Weeks
- Professional Hearing Services, South Perth, Western Australia, Australia
| | - Peter Jacoby
- Telethon Institute for Child Health Research, Centre for Child Health Research, the University of Western Australia, Australia
| | - Dimity Elsbury
- Telethon Institute for Child Health Research, Centre for Child Health Research, the University of Western Australia, Australia
| | - Janine Finucane
- Telethon Institute for Child Health Research, Centre for Child Health Research, the University of Western Australia, Australia
| | - Annette Stokes
- Telethon Institute for Child Health Research, Centre for Child Health Research, the University of Western Australia, Australia
| | - Ruth Monck
- Telethon Institute for Child Health Research, Centre for Child Health Research, the University of Western Australia, Australia
| | - Harvey Coates
- School of Paediatrics and Child Health, the University of Western Australia, Australia
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Lehmann D, Arumugaswamy A, Elsbury D, Finucane J, Stokes A, Monck R, Jeffries‐Stokes C, McAullay D, Coates H, Stanley FJ. The Kalgoorlie Otitis Media Research Project: rationale, methods, population characteristics and ethical considerations. Paediatr Perinat Epidemiol 2008; 22:60-71. [PMID: 18173785 PMCID: PMC7168013 DOI: 10.1111/j.1365-3016.2007.00891.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Otitis media (OM) is one of the most common paediatric illnesses for which medical advice is sought in developed countries. Australian Aboriginal children suffer high rates of OM from early infancy. The resultant hearing loss can affect education and quality of life. As numerous factors contribute to the burden of OM, interventions aimed at reducing the impact of single risk factors are likely to fail. To identify key risk factors and understand how they interact in complex causal pathways, we followed 100 Aboriginal and 180 non-Aboriginal children from birth to age 2 years in a semi-arid zone of Western Australia. We collected demographic, obstetric, socio-economic and environmental data, breast milk once, and nasopharyngeal samples and saliva on seven occasions. Ear health was assessed by clinical examination, tympanometry, transient evoked otoacoustic emissions and audiometry. We considered the conduct of our study in relation to national ethical guidelines for research in Aboriginal and Torres Strait Islander health. After 1 year of community consultation, the study was endorsed by local committees and ethical approval granted. Fieldwork was tailored to minimise disruption to people's lives and we provided regular feedback to the community. We saw 81% of non-Aboriginal and 65% of Aboriginal children at age 12 months. OM was diagnosed on 55% and 26% of routine clinical examinations in Aboriginal and non-Aboriginal children respectively. Aboriginal mothers were younger and less educated, fewer were employed and they lived in more crowded conditions than non-Aboriginal mothers. Sixty-four per cent of Aboriginal and 40% of non-Aboriginal babies were exposed to environmental tobacco smoke. Early consultation, provision of a service while undertaking research, inclusion of Aboriginal people as active members of a research team and appropriate acknowledgement will assist in ensuring successful completion of the research.
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Affiliation(s)
- Deborah Lehmann
- Telethon Institute for Child Health Research, Centre for Child Health Research, the University of Western Australia, West Perth, WA, Australia.
| | - Ashwini Arumugaswamy
- Telethon Institute for Child Health Research, Centre for Child Health Research, the University of Western Australia, West Perth, and
| | - Dimity Elsbury
- Telethon Institute for Child Health Research, Centre for Child Health Research, the University of Western Australia, West Perth, and
| | - Janine Finucane
- Telethon Institute for Child Health Research, Centre for Child Health Research, the University of Western Australia, West Perth, and
| | - Annette Stokes
- Telethon Institute for Child Health Research, Centre for Child Health Research, the University of Western Australia, West Perth, and
| | - Ruth Monck
- Telethon Institute for Child Health Research, Centre for Child Health Research, the University of Western Australia, West Perth, and
| | - Christine Jeffries‐Stokes
- Telethon Institute for Child Health Research, Centre for Child Health Research, the University of Western Australia, West Perth, and
| | - Daniel McAullay
- Telethon Institute for Child Health Research, Centre for Child Health Research, the University of Western Australia, West Perth, and
| | - Harvey Coates
- Princess Margaret Hospital for Children, Subiaco, WA, Australia
| | - Fiona J. Stanley
- Telethon Institute for Child Health Research, Centre for Child Health Research, the University of Western Australia, West Perth, and
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Abstract
BACKGROUND Systemic ototoxicity is a significant cause of vestibulocochlear morbidity in sub-Saharan Africa. It may result in permanent hearing impairment and/or balance problems. OBJECTIVES To review the literature pertaining to the ototoxic potential of three frequently prescribed systemic medications in the sub-Saharan setting; quinine, furosemide and aminoglycoside antibiotics. The pathophysiology, clinical manifestations and risk factors and risk minimisation strategies regarding the ototoxicity associated with these drugs are presented in order to highlight this problem and reduce the incidence of adverse outcomes. DATA SOURCES The biomedical literature was systematically reviewed. This included a search of the National Library of Medicine's PubMed database (http://www.ncbi.nlm.nih.gov/ entrez/query.fcgi?db=PubMed). The search was limited to the English language literature and used the following search terms: ototoxicity; aminoglycosides; quinine; furosemide; gentamicin; vestibular toxicity; auditory toxicity; and Africa. STUDY SELECTION Studies and reviews directly addressing clinical ototoxicity, experimental studies and studies regarding ototoxicity in sub-Saharan Africa were reviewed. The authors formed a consensus opinion regarding the most relevant articles considering factors including evidence level. DATA EXTRACTION Systematic data extraction was undertaken from relevant studies. CONCLUSIONS Quinine, furosemide and aminoglycosides are potentially ototoxic. High doses, prolonged treatment and intravenous administration increase this risk. The clinical condition of the patient may further predispose patients to ototoxic damage. Lack of monitoring facilities and efficacious, cost effective alternatives increase the risks of ototoxicity in the African setting. Clinicians must be aware of these risks and those patients at increased risk, and be vigilant in recognising their clinical manifestations.
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Affiliation(s)
- N P Shine
- Department of Paediatric Otolaryngology, Princess Margaret Hospital, Subiaco WA 6008, Perth, Western Australia
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Shine NP, Sader C, Coates H. Cervicofacial emphysema and pneumomediastinum following pediatric adenotonsillectomy: a rare complication. Int J Pediatr Otorhinolaryngol 2005; 69:1579-82. [PMID: 15939486 DOI: 10.1016/j.ijporl.2005.04.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2005] [Accepted: 04/18/2005] [Indexed: 12/16/2022]
Abstract
Cervicofacial emphysema and pneumomediastinum are rarely observed sequelae of surgical intervention in the upper aerodigestive tract. It is a potentially life-threatening condition but the majority of cases are self-limiting and benign. Symptoms include chest pain, neck pain, dyspnea and odynophagia. A case occurring after adenotonsillar surgery in a 7-year-old child is presented. This report highlights this unusual complication and its potential to delay the postoperative recovery following adenotonsillectomy.
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Affiliation(s)
- Neville Patrick Shine
- Department of Pediatric Otolaryngology, Princess Margaret Hospital, Roberts Road, 20 Jarrad Street, Subiaco, Cottesloe, WA 6011, Australia.
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Abstract
Until recently the only available antibiotic eardrops for treatment of the discharging middle ear and mastoid cavity have been potentially ototoxic. With the advent of non-ototoxic fluoroquinolone eardrops, consensus panels in the USA, Canada and the UK have advocated the preferential use of these agents in the open middle ear. However, in Australia, no fluoroquinolone topical agent is approved for use with tympanic membrane perforations, and when used as an 'off label' eardrop, none is on the Pharmaceutical Benefits Scheme. This creates an ethical dilemma, particularly with best practice management of chronic suppurative otitis media in indigenous children. Despite concerns regarding resistance issues with ototopical use of systemic antibiotics, bacterial resistance has not been documented in major studies. For equity and ethical reasons, Australian regulatory authorities should consider approving a sterile non-ototoxic eardrop for use in the open middle ear.
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Affiliation(s)
- Harvey Coates
- Department of Pediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.
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Mak D, MacKendrick A, Bulsara M, Coates H, Lannigan F, Lehmann D, Leidwinger L, Weeks S. Outcomes of myringoplasty in Australian Aboriginal children and factors associated with success: a prospective case series. ACTA ACUST UNITED AC 2004; 29:606-11. [PMID: 15533146 DOI: 10.1111/j.1365-2273.2004.00896.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The objective of this study was to assess the outcomes of myringoplasties in Aboriginal children and to identify factors associated with a successful outcome with the use of prospective case series from primary health care clinics and hospitals in four rural and remote regions of Western Australia. All 58 Aboriginal children, aged 5-15 years, who underwent 78 myringoplasties between 1 January 2000 and 30 June 2001 were included in the study. Complete postoperative (post-op) follow-up was achieved following 78% of myringoplasties. The main outcome measures were (a) success, i.e. an intact tympanic membrane and normal hearing six or more months post-op in the operated ear, (b) closure of the perforation, (c) Post-op hearing improvement. Forty-nine per cent of myringoplasties were successful, 72% resulted in closure or reduction in the size of the perforation and 51% resulted in hearing improvement. After controlling for age, sex, clustering and number of previous myringoplasties, no association was observed between success or hearing improvement and perforation size, or the presence of serous aural discharge at the time of surgery. Myringoplasty resulted in hearing improvement and/or perforation closure in a significant proportion of children. Thus, primary school-aged Aboriginal children in whom conservative management of chronic suppurative otitis media has been unsuccessful should have access to myringoplasty because of the positive impact on their socialization, language and learning that results from improved hearing.
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Affiliation(s)
- D Mak
- Kimberley Public Health Unit, Derby, and School of Population Health, The University of Western Australia, Perth, Australia.
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Coates H. Treatment of otologic disease in Australian Aboriginal children. Ear Nose Throat J 2004; 83:23-4. [PMID: 15543840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Affiliation(s)
- Harvey Coates
- Department of Otolaryngology, The University of Western Australia, Perth
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Coates H. Treatment of Otologic Disease in Australian Aboriginal Children. Ear Nose Throat J 2004. [DOI: 10.1177/01455613040839s409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Mak DB, MacKendrick A, Bulsara MK, Weeks S, Leidwinger L, Coates H, Lannigan FJ, Lehmann D. Long-term outcomes of middle-ear surgery in Aboriginal children. Med J Aust 2003; 179:324-5. [PMID: 12964918 DOI: 10.5694/j.1326-5377.2003.tb05559.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2003] [Accepted: 07/31/2003] [Indexed: 11/17/2022]
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Lehmann D, Tennant MT, Silva DT, McAullay D, Lannigan F, Coates H, Stanley FJ. Benefits of swimming pools in two remote Aboriginal communities in Western Australia: intervention study. BMJ 2003; 327:415-9. [PMID: 12933727 PMCID: PMC181254 DOI: 10.1136/bmj.327.7412.415] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To determine the health impact of swimming pools built with the aim of improving quality of life and reducing high rates of pyoderma and otitis media. DESIGN Intervention study assessing prevalence of ear disease and skin infections before and at six monthly intervals after opening of swimming pools. SETTING Two remote Aboriginal communities in Western Australia. PARTICIPANTS 84 boys and 78 girls aged < 17 years. MAIN OUTCOME MEASURES Changes in prevalence and severity of pyoderma and perforation of tympanic membranes with or without otorrhoea over 18 months after opening of pools. RESULTS In community A, 61 children were seen before the pool was opened, and 41, 46, and 33 children were seen at the second, third, and fourth surveys. Equivalent figures for community B were 60, 35, 39, and 45. Prevalence of pyoderma declined significantly from 62% to 18% in community A and from 70% to 20% in community B during the 18 months after the pools opened. Over the same period, prevalence of severe pyoderma fell from 30% to 15% in community A and from 48% to 0% in community B. Prevalence of perforations of the tympanic membrane fell from 32% in both communities to 13% in community A and 18% in community B. School attendance improved in community A. CONCLUSION Swimming pools in remote communities were associated with reduction in prevalence of pyoderma and tympanic membrane perforations, which could result in long term benefits through reduction in chronic disease burden and improved educational and social outcomes.
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Affiliation(s)
- Deborah Lehmann
- Centre for Child Health Research, University of Western Australia, Telethon Institute for Child Health Research, PO Box 855, West Perth, WA 6872, Australia.
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Coates H, Hawke M, Manning SC, Vesterhauge S, Haynes DS, Deitmer T. Strategies for managing granulation tissue. Ear Nose Throat J 2003; 82:21-4. [PMID: 12974055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Affiliation(s)
- Harvey Coates
- Department of Otolaryngology, University of Western Australia, Perth
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Coates H. Topical treatment of chronic suppurative otitis media in Aboriginal children. Ear Nose Throat J 2003; 82:13. [PMID: 12974052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Affiliation(s)
- Harvey Coates
- Department of Otolaryngology, University of Western Australia, Perth
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Abstract
Ligneous conjunctivitis is a rare condition that can involve the mucous membranes of the upper and lower airways and temporal bone extensively. This can lead to life threatening airway obstruction. Involvement of the middle ear and mastoid may cause significant conductive hearing loss. This is the first reported case with temporal bone sections of ligneous conjunctivitis, and awareness of the associated obstructive hydrocephalus may prevent death in this condition. Evidence suggests that plasminogen deficiency may be a causative factor in ligneous conjunctivitis, and this finding may offer new prospects for management.
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Affiliation(s)
- Francis Chai
- Department of Otorhinolaryngology, Head and Neck Surgery, Princess Margaret Hospital for Children, Level 1, 51 Colin Street, West Perth, Perth, Western Australia 6005, Australia.
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Coates H. Post-tympanostomy tube otorrhea in children: a clinical overview. Ear Nose Throat J 2002; 81:3-5. [PMID: 12199187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Affiliation(s)
- Harvey Coates
- Princess Margaret Hospital for Children, Perth, Western Australia
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Coates H. Chronic suppurative otitis media in indigenous populations: the Australian aborigine. Ear Nose Throat J 2002; 81:11-2. [PMID: 12199180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Affiliation(s)
- Harvey Coates
- Princess Margaret Hospital for Children, Perth, Western Australia
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Abstract
The neonate is a preferential nasal breather; therefore, nasal obstruction in the neonatal period may cause significant sequelae. Although the uncommon choanal atresia is the main condition to be excluded, many other possible causes exist. A systematic approach to the workings of nasal obstruction in the neonate and infant is outlined so that appropriate management can be instituted.
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Affiliation(s)
- H Coates
- Princess Margaret Hospital for Children, Perth, Western Australia
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Kroeber MJ, Gray LP, Coates H. Tonsillectomy - current concepts and nursing care. Aust Nurses J 1980; 9:37-40, 49. [PMID: 6902648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Abstract
The blood pressures (BP) in 418 vegetarian Seventh-day Adventist (SDA) volunteers in Western Australia were compared with those in 290 non-vegetarian volunteers in Narrogin, a Western Australian country town. The mean systolic and diastolic BPs in the SDAs, adjusted for age, sex, height and weight (128.7/76.2 mm of mercury) were significantly less than those in the Narrogin residents (139.3/84.5). It appeared unlikely that these differences could be explained by differences in alcohol, tobacco, tea, coffee or egg consumption, socioeconomic status or physical activity. There was, however, a gradient toward increasing BP with increasing egg intake in SDAs, and SDAs who drank tea or coffee had a higher mean diastolic BP than those who did not (mean difference of 4.2 mm of mercury). The possibility that selective bias or unmeasured environmental differences might explain the difference in BP between the two groups is discussed.
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Coates H, Borsos T, Foard M, Bang FB. Pathogenesis of Rous sarcoma virus in the chick embryo with particular reference to vascular lesions. Int J Cancer 1968; 3:424-39. [PMID: 4300774 DOI: 10.1002/ijc.2910030403] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Cline GB, Coates H, Anderson NG, Chanock RM, Harris WW. Respiratory syncytial virus isolation by combined continuous flow-isopycnic banding centrifugation. J Virol 1967; 1:659-64. [PMID: 5621468 PMCID: PMC375332 DOI: 10.1128/jvi.1.4.659-664.1967] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
A new zonal centrifuge rotor (B-IX) which combines continuous sample flow centrifugation with isopycnic banding has been used to isolate and concentrate respiratory syncytial virus from liter volumes of culture fluid. This isolation technique utilizes a sucrose density gradient to trap and isopycnically band the virus particles, and permits recovery of the particles from the rotor in an unaggregated condition.
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Coates H, Cook AH, Heilbron IM, Hey DH, Lambert A, Lewis FB. 106. New therapeutic agents of the quinoline series. Introduction and Part I. Monopyridylquinolines. ACTA ACUST UNITED AC 1943. [DOI: 10.1039/jr9430000401] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Coates H, Cook AH, Heilbron IM, Hey DH, Lambert A, Lewis FB. 108. New therapeutic agents of the quinoline series. Part III. Methoxy-, hydroxy-, and alkyl-pyridylquinolines. ACTA ACUST UNITED AC 1943. [DOI: 10.1039/jr9430000406] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Coates H. The Temperance Question. West J Med 1898. [DOI: 10.1136/bmj.1.1943.862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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