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Page 1 of 3

  • 8 - Mental healthcare for children and adolescents

  • from Part C - Nursing children and young people
  • Edited by Jennifer Fraser, University of Sydney, Donna Waters, University of Sydney, Elizabeth Forster, Griffith University, Queensland, Nicola Brown
  • Book:
    Paediatric Nursing in Australia and New Zealand
    Published online:
    05 January 2022
    Print publication:
    05 January 2022, pp 193-218

  • Summary

    The focus of this chapter is the role of the nurse in optimising child and youth mental health. An overview of mental disorders experienced during childhood and adolescence is followed by a discussion of mental health promotion for children and young people. Although the lifetime prevalence of eating disorders is very low, they are common, and nurses play an important role in the care of those affected children and young people admitted to hospital for treatment. The chapter looks specifically at how nurses can help support children and young people with eating disorders, and also considers the effects of digital technologies on the mental health of young people growing up in today's society. The importance of working closely with the parents and families of children and young people disabled by mental illness and the services available to them is emphasised throughout the chapter.

Paediatric Nursing in Australia and New Zealand
  • 3rd edition
  • Edited by Jennifer Fraser, Donna Waters, Elizabeth Forster, Nicola Brown
  • Published online:
    05 January 2022
    Print publication:
    05 January 2022
  • The health of babies, children and young people is fundamentally different from that of adults, so their healthcare must reflect their unique needs and engage their parents, family members and communities. Paediatric Nursing in Australia and New Zealand introduces nursing students to the care of infants, children, young people and their families in a range of clinical and community settings across Australasia. This third edition includes New Zealand content and an increased focus on families. New chapters cover health services available for Aboriginal, Torres Strait Islander and Māori children, the transition to parenthood for new families, children's sleep patterns and behaviour, and paediatric health in school settings. Case studies and reflective questions encourage students to develop critical thinking and problem-solving skills. Written by an expert team, Paediatric Nursing in Australia and New Zealand equips future nurses with the knowledge and skills to provide evidence-based care to babies, children and their families.

  • 2 - Child rights in Australia and New Zealand

  • from Part A - Contexts of nursing care
  • Edited by Jennifer Fraser, University of Sydney, Donna Waters, University of Sydney, Elizabeth Forster, Griffith University, Queensland, Nicola Brown
  • Book:
    Paediatric Nursing in Australia and New Zealand
    Published online:
    05 January 2022
    Print publication:
    05 January 2022, pp 32-52

  • Summary

    This chapter provides a basis for nursing students to understand the ways in which children and young people’s rights are upheld in Australia and New Zealand, particularly within the healthcare systems. It provides insight into the ways in which human rights, and particularly child rights, inform paediatric nursing policy and practice. It begins by looking at the international agreements and covenants regarding the protection of child rights that have been endorsed by Australia and New Zealand, before moving on to examine the national legislation and the implications for health and social support systems. The second part of the chapter looks at some of the ethical challenges regarding child and family rights that you will consider as a paediatric nurse. In particular, we look at issues surrounding access to family, advocacy and consent to treatment of specific diseases in some situations. It provides a basis for understanding the way in which children and young people’s rights – including the right to be protected from all forms of violence and neglect – are upheld in Australia and New Zealand, particularly within the health and welfare systems.

  • 9 - Child and family: Psychosocial considerations and response to illness

  • from Part C - Nursing children and young people
  • Edited by Jennifer Fraser, University of Sydney, Donna Waters, University of Sydney, Elizabeth Forster, Griffith University, Queensland, Nicola Brown
  • Book:
    Paediatric Nursing in Australia and New Zealand
    Published online:
    05 January 2022
    Print publication:
    05 January 2022, pp 219-254

  • Summary

    This chapter presents guidelines and recommendations for managing emotional and behavioural responses related to children’s experiences of illness. It provides an overview of psychosocial development to best illustrate the relationship between child development and response and adaptation to illness. The relationship is bidirectional – that is, responses are shaped according to the psychodevelopmental stage of the child or young person, and at the same time developmental outcomes are impacted by the experiences and challenges of both acute and chronic illness. The family is also impacted when a child or young person is experiencing illness. Families are central to the care of children – in fact, the paediatric patient and their wider family provide the focus for care. This chapter therefore also explores what it means to be a family and family-centred care, and presents frameworks that can be used to assess and consider the psychosocial needs of families when a child is experiencing illness.

  • Rendering Inuit cancer “visible”: Geography, pathology, and nosology in Arctic cancer research

  • Jennifer Fraser
  • Journal:
    Science in Context / Volume 33 / Issue 3 / September 2020
    Published online by Cambridge University Press:
    07 June 2021, pp. 195-225
    Print publication:
    September 2020

  • In August of 1977, Australian pathologist David W. Buntine delivered a presentation at the Annual Meeting of the Royal College of Pathologists of Australia in Melbourne, Victoria. In this presentation, he used the diagnostic category of “Eskimoma,” to describe a unique set of salivary gland tumors he had observed over the past five years within Winnipeg’s Health Sciences Center. Only found amongst Inuit patients, these tumors were said to have unique histological, clinical, and epidemiological features and were unlike any other disease category that had ever been encountered before. To understand where this nosological category came from, and its long-term impact, this paper traces the historical trajectory of the “Eskimoma.” In addition to discussing the methods and infrastructures that were essential to making the idea of Inuit cancer “visible,” to the pathologist, the epidemiologist, and to society at large, this paper discusses how Inuit tissue samples obtained, stored, and analyzed in Winnipeg, Manitoba, came to be codified into a new, racially based disease category – one that has guided Canadian and international understandings of circumpolar cancer trends and shaped northern healthcare service delivery for the past sixty years.

  • Postdischarge antibiotic use for prophylaxis following spinal fusion

  • David K. Warren, Katelin B. Nickel, Jennifer H. Han, Pam Tolomeo, Christopher J. Hostler, Katherine Foy, Ian R. Banks, Victoria J. Fraser, Margaret A. Olsen, for the CDC Prevention Epicenter Program
  • Journal:
    Infection Control & Hospital Epidemiology / Volume 41 / Issue 7 / July 2020
    Published online by Cambridge University Press:
    05 May 2020, pp. 789-798
    Print publication:
    July 2020
  • Objective:

    Despite recommendations to discontinue prophylactic antibiotics after incision closure or <24 hours after surgery, prophylactic antibiotics are continued after discharge by some clinicians. The objective of this study was to determine the prevalence and factors associated with postdischarge prophylactic antibiotic use after spinal fusion.

    Design:

    Multicenter retrospective cohort study.

    Patients:

    This study included patients aged ≥18 years undergoing spinal fusion or refusion between July 2011 and June 2015 at 3 sites. Patients with an infection during the surgical admission were excluded.

    Methods:

    Prophylactic antibiotics were identified at discharge. Factors associated with postdischarge prophylactic antibiotic use were identified using hierarchical generalized linear models.

    Results:

    In total, 8,652 spinal fusion admissions were included. Antibiotics were prescribed at discharge in 289 admissions (3.3%). The most commonly prescribed antibiotics were trimethoprim/sulfamethoxazole (22.1%), cephalexin (18.8%), and ciprofloxacin (17.1%). Adjusted for study site, significant factors associated with prophylactic discharge antibiotics included American Society of Anesthesiologists (ASA) class ≥3 (odds ratio [OR], 1.31; 95% CI, 1.00–1.70), lymphoma (OR, 2.57; 95% CI, 1.11–5.98), solid tumor (OR, 3.63; 95% CI, 1.62–8.14), morbid obesity (OR, 1.64; 95% CI, 1.09–2.47), paralysis (OR, 2.38; 95% CI, 1.30–4.37), hematoma/seroma (OR, 2.93; 95% CI, 1.17–7.33), thoracic surgery (OR, 1.39; 95% CI, 1.01–1.93), longer length of stay, and intraoperative antibiotics.

    Conclusions:

    Postdischarge prophylactic antibiotics were uncommon after spinal fusion. Patient and perioperative factors were associated with continuation of prophylactic antibiotics after hospital discharge.

  • The Weighting of Cues to Upright Following Stroke With and Without a History of Pushing

  • Lindsey E. Fraser, Avril Mansfield, Laurence R. Harris, Daniel M. Merino, Svetlana Knorr, Jennifer L. Campos
  • Journal:
    Canadian Journal of Neurological Sciences / Volume 45 / Issue 4 / July 2018
    Published online by Cambridge University Press:
    21 June 2018, pp. 405-414
    • Article
      • You have access
      • Open access
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  • Objective: Perceived upright depends on three main factors: vision, graviception, and the internal representation of the long axis of the body. We assessed the relative contributions of these factors in individuals with sub-acute and chronic stroke and controls using a novel tool; the Oriented Character Recognition Test (OCHART). We also considered whether individuals who displayed active pushing or had a history of pushing behaviours had different weightings than those with no signs of pushing. Method: Three participants experienced a stroke <3 months before the experiment: one with active pushing. In total, 14 participants experienced a stroke >6 months prior: eight with a history of pushing. In total, 12 participants served as healthy aged-matched controls. Visual and graviceptive cues were dissociated by orienting the visual background left, right, or upright relative to the body, or by orienting the body left, right, or upright relative to gravity. A three-vector model was used to quantify the weightings of vision, graviception, and the body to the perceptual upright. Results: The control group showed weightings of 13% vision, 25% graviception, and 62% body. Some individuals with stroke showed a similar pattern; others, particularly those with recent stroke, showed different patterns, for example, being unaffected by one of the three factors. The participant with active pushing behaviour displayed an ipsilesional perceptual bias (>30°) and was not affected by visual cues to upright. Conclusion: The results of OCHART may be used to quantify the weightings of multisensory inputs in individuals post-stroke and may help characterize perceptual sources of pushing behaviours.

  • Comparative Antimicrobial Efficacy of Two Hand Sanitizers in Intensive Care Units Common Areas: A Randomized, Controlled Trial

  • Abhishek Deshpande, Jacqueline Fox, Ken Koon Wong, Jennifer L. Cadnum, Thriveen Sankar, Annette Jencson, Sarah Schramm, Thomas G. Fraser, Curtis J. Donskey, Steven Gordon
  • Journal:
    Infection Control & Hospital Epidemiology / Volume 39 / Issue 3 / March 2018
    Published online by Cambridge University Press:
    31 January 2018, pp. 267-271
    Print publication:
    March 2018
  • OBJECTIVE

    Contaminated hands of healthcare workers (HCWs) are an important source of transmission of healthcare-associated infections. Alcohol-based hand sanitizers, while effective, do not provide sustained antimicrobial activity. The objective of this study was to compare the immediate and persistent activity of 2 hand hygiene products (ethanol [61% w/v] plus chlorhexidine gluconate [CHG; 1.0% solution] and ethanol only [70% v/v]) when used in an intensive care unit (ICU).

    DESIGN

    Prospective, randomized, double-blinded, crossover study

    SETTING

    Three ICUs at a large teaching hospital

    PARTICIPANTS

    In total, 51 HCWs involved in direct patient care were enrolled in and completed the study.

    METHODS

    All HCWs were randomized 1:1 to either product. Hand prints were obtained immediately after the product was applied and again after spending 4–7 minutes in the ICU common areas prior to entering a patient room or leaving the area. The numbers of aerobic colony-forming units (CFU) were compared for the 2 groups after log transformation. Each participant tested the alternative product after a 3-day washout period.

    RESULTS

    On bare hands, use of ethanol plus CHG was associated with significantly lower recovery of aerobic CFU, both immediately after use (0.27 ± 0.05 and 0.88 ± 0.08 log10 CFU; P = .035) and after spending time in ICU common areas (1.81 ± 0.07 and 2.17 ± 0.05 log10 CFU; P<.0001). Both the antiseptics were well tolerated by HCWs.

    CONCLUSIONS

    In comparison to the ethanol-only product, the ethanol plus CHG sanitizer was associated with significantly lower aerobic bacterial counts on hands of HCWs, both immediately after use and after spending time in ICU common areas.

    CLINICAL TRIAL IDENTIFIER

    Clinicaltrials.gov identifier NCT02258412

    Infect Control Hosp Epidemiol 2018;39:267–271

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