Gold Coast Health

The burden of patient harm from unsafe care is disproportionately high in low-income countries, particularly in intensive care units (ICUs). Despite this, there is limited empirical evidence explaining the underlying challenges that make patient safety difficult to achieve in resource-limited ICUs. To explore the barriers to patient safety and incident-reporting in ICUs at Ethiopian university hospital. An exploratory qualitative descriptive study was conducted using in-depth interviews guided by a semi-structured protocol and informed by the Theoretical Domains Framework (TDF). Participants were purposively selected, and sample size was determined based on principles of data sufficiency. Reflexive thematic analysis with inductive orientation was employed following Braun and Clarke's approach. Thirty-nine healthcare professionals participated: 23 (59%) nurses, 13 (33%) physicians, and 3 (8%) clinical pharmacists. The mean age of participants was 32±5 years. Three overarching themes captured the barriers to patient safety and incident reporting in ICUs: (i) Fragile systems: Governance failure and resource constraints; (ii) Normalisation of deviance: teaching-hospital dynamics and clinical oversight, normalised communication lapses, and weak teamwork and relational context; and (iii) Silence trap: Fear in punitive and blame-oriented culture and lack of incident-reporting systems. Patient safety in Ethiopian ICUs is undermined by systemic, operational, and clinician-related obstacles. Structural and cultural barriers further hinder incident-reporting creating a vicious cycle where unsafe care remains hidden and opportunities for learning and improvements are lost. Breaking this cycle requires strong governance, coordinated resource investment, enhancing just culture, strengthening teamwork, establishing robust incident-reporting systems, and ongoing professional development focused on patient safety. Identifying barriers to patient safety and incident reporting in ICUs may enables targeted interventions that reduce preventable harm, improve care quality, and promote incident reporting and learning to sustain safe clinical practice.

Obstructive sleep apnoea (OSA) is common in Australia but underexamined among First Nations peoples. We conducted a retrospective cross-sectional analysis of 1563 adult sleep studies in South East Queensland (2022-2023). Thirty-eight participants (2.4%) identified as First Nations, of whom 74% had OSA. Comorbidities were more frequent among the First Nations cohort, though small sample size limited certainty. These findings reveal both under-identification of First Nations status and a substantial OSA burden, emphasising the need for culturally informed, community-led approaches to OSA care in Queensland.

Cell fate determination is controlled by a complex network of cell signalling pathways. The process of osteoblasts transforming into osteocytes can be described as several distinct stages: from osteoblasts to early osteocytes, then to mature osteocytes, deeply embedded in the bone matrix within spaces called lacunae and canaliculi. During this transition, the committed osteoblast undergoes significant changes, including loss of proliferative capacity, the extension of multiple slender processes, and the secretion of minerals onto the collagenous scaffold. These osteocytes are arranged in an ordered manner with respect to neighbouring cells, suggesting that osteoblast-to-osteocyte transition is a tightly regulated developmental event. In this review, we summarise recent findings on Notch expression during osteoblast-to-osteocyte transition and propose a regulatory role for Notch in coordinating adjacent osteoblast activity during this process. We further discuss the implications of Notch signalling in the alveolar bone, as emerging data indicate that Notch participates in the osteogenic commitment of periodontal and alveolar progenitor cells, modulates force-driven remodelling, contributes to inflammatory osteolysis in periodontitis, and presents opportunities for biomaterial-guided alveolar bone regeneration and improved osseointegration around dental implants. This review highlights Notch as a potential master regulator of alveolar bone biology, suggesting that precise spatial and temporal control of Notch signalling may offer new therapeutic avenues to maintain alveolar bone homeostasis.

Participatory grantmaking (PGM) applies participatory principles directly to funding, involving communities in determining priorities and allocations. Despite its growing use, empirical evidence on PGM implementation remains limited. This process evaluation examined a PGM pilot implemented by Healthy North Coast, a regional primary health commissioning body in New South Wales, Australia. Using a qualitative process evaluation, semi-structured interviews were conducted with implementation and delivery stakeholders involved in the design, facilitation, observation and governance of the pilot. Data were analysed using reflexive thematic analysis, guided by an evaluative framework focussing on feasibility, fairness and legitimacy, equity of participation, and contribution to learning. Five themes were identified: (1) value of participatory design; (2) funding allocation tensions; (3) emotional impact of peer competition; (4) challenges in achieving equity; and (6) capability-building and collaboration opportunities. Findings reveal inherent tensions between participatory ideals and institutional commissioning realities. While the pilot enhanced legitimacy and organisational learning, competitive elements constrained equity and substantive power redistribution. The study contributes empirical evidence on PGM in practice and offers methodological insights for evaluating participatory funding interventions, emphasising the need to assess power, equity, relational impacts and emotional dimensions alongside procedural fidelity.

To map the current literature on the characteristics of nurse-related medication errors in perioperative healthcare settings. A scoping review. This scoping review used the five-stage framework developed by Arksey and O'Malley (2005). The five stages are: (1) Identifying the Research Question; (2) Identifying Relevant Studies; (3) Study Selection; (4) Charting the Data; and (5) Collating, Summarising, and Reporting the Results. Findings were synthesised using the PAGER framework. An Ishikawa diagram was used to illustrate contributing factors of nurse-related medication errors. In October 2024, using key search terms, five databases (Scopus, EBSCO Cumulative Index to Nursing and Allied Health Literature, OVID Embase, EBSCO Medline, EBSCO PsycInfo) and two grey literature platforms (opengrey, Policy commons) were searched. The articles were imported to the Covidence database from Endnote after removing duplicate literature. Selected article titles and abstracts, and subsequently full-text articles, were screened by two trained reviewers based on a priori inclusion and exclusion criteria. Data were extracted from the included full-text articles by one author, checked by another, and analysed descriptively. Of the 967 articles identified through the searches, 7 full-text articles were included. The incidence of nurse-related medication errors in perioperative settings ranged from 6.4% to 33.7%, with errors including incorrect medication routes, missed or delayed doses, and miscommunication-related overdoses. Contributing factors were multifaceted, involving workload pressures, communication failures, system flaws, and organisational influences such as leadership and safety culture. Medication errors in the perioperative setting pose a significant threat to patient safety yet remain underexplored compared to other healthcare contexts. A holistic approach incorporating human factors frameworks, improved communication, workload management, and leadership can help address the complex causes of these errors and guide targeted interventions to enhance perioperative safety and patient outcomes. Scoping Reviews (PRISMA-ScR) checklist. No Patient or Public Contribution. Open science Framework Website. Registration DOI https://doi.org/10.17605/OSF.IO/EXT8C.

Introduction: Disasters are increasing globally, in both frequency and severity. Rural and remote areas are disproportionately exposed to disasters, with unequal resources and a significantly reduced health workforce and infrastructure. Nurses play an important role in assisting with and responding to disasters; however, in rural and remote settings, there is limited literature describing nurses’ roles or experiences in these events. This study aimed to uncover what it is like for rural and remote nurses when assisting in disasters using a phenomenological approach. Methods: Sixteen nurses from rural or remote Australia were interviewed about their experiences assisting during a disaster. A phenomenological approach underpinned the study, with descriptive thematic analysis of the data uncovering moments of disaster. These moments provide a shared history across participants, disaster subtypes, and locations. Results: Eight moments were identified during the nurses’ experience assisting in a disaster. These moments consisted of a Prelude, Being notified, Making a decision, Preparing, Initial evaluation of the scene, Stepping into Action, Stepping down, and Lessons through reflection. Within each of the moments, rural and remote nurses tell us how events occurred, how the moments stood out in their singularity, and how they transitioned into another moment, highlighting the uniqueness of each activity and interaction within each moment. Conclusion: Rural and remote nurses played a significant role in assisting in disasters either in their community or at their place of work. This study highlighted the nuances of their work’s geographical location and the activities they are engaged in. It also shows the innate knowledge required of rural and remote nurses in disaster situations. This study provides an in-depth insight into what these nurses do and their experiences, which will help increase disaster awareness, particularly in rural and remote contexts.

The clinical application of acoustic swallowing sound parameters collected from digital cervical auscultation is limited because of the time-consuming manual segmentation required by trained experts. The automated identification of swallowing sounds in children and adults from swallowing sound audio wavefiles using machine learning have accuracies between 76-95%. No data exists in preterm neonates. To determine if applying automated machine learning using a transfer learning approach could accurately identify and segment swallows from swallowing sounds collected in preterm neonates. Thin fluid swallow sounds were collected from 78 preterm neonates, median birth age 34weeks gestation (range 25-36weeks, 52.6% males) across 3 Australian special care nurseries. For the base machine learning model, a deep convolutional neural network (DCNN) pre-trained for audio event classification was used. With raw swallow audio data as input, embedding vectors from the base DCNN were generated and used to train a feedforward neural network to determine the presence of a swallow within an audio segment. The model showed high overall accuracy (94%) in identifying preterm swallows. Better model performance on bottle feeding swallows (Sensitivity, 95%; and specificity, 96%) was seen compared with breastfeeding swallows (sensitivity, 95%, specificity 92%). Interpretation: Our novel study demonstrates the successful use of transfer learning to accurately identify and segment digital swallowing sounds in preterm neonates. Application of this model could support the development of a digital CA app to automatically classify swallow sounds and improve objectivity for CA use in clinical practice within special care nurseries.