Search

Given the lack of evidence-based guidelines for hypothermic infants, providers may be inclined to use febrile infant decision-making tools to guide management decisions. Our objective was to assess the diagnostic performance of febrile infant decision tools for identifying hypothermic infants at low risk of bacterial infection.We conducted a secondary analysis of a retrospective cohort study of hypothermic (≤36.0 C) infants ≤90 days of age presenting to the emergency department or inpatient unit among 9 participating sites between September 1, 2016 and May 5, 2021. Well-appearing infants evaluated for bacterial infections via laboratory testing were included. Infants with complex chronic conditions or premature birth were excluded. Performance characteristics for detecting serious bacterial infection (SBI; urinary tract infection, bacteremia, bacterial meningitis) and invasive bacterial infection (IBI; bacteremia, bacterial meningitis) were calculated for each tool.Overall, 314 infants met the general inclusion criteria, including 14 cases of SBI (4.5%) and 7 cases of IBI (2.2%). The median age was 5 days, and 68.1% of the infants (214/314) underwent a full sepsis evaluation. The Philadelphia, Boston, IBI Score, and American Academy of Pediatrics Clinical Practice Guideline did not misclassify any SBI or IBI as low risk; however, they had low specificity and positive predictive value. Rochester and Pediatric Emergency Care Applied Research Network tools misclassified infants with bacterial infections.Several febrile infant decision tools were highly sensitive, minimizing missed SBIs and IBIs in hypothermic infants. However, the low specificity of these decision tools may lead to unnecessary testing, antimicrobial exposure, and hospitalization.

Numerous decision tools have emerged to guide management of febrile infants, but limited data exist to guide the care of young infants presenting with hypothermia. We evaluated the variation in care for well-appearing hypothermic young infants in the hospital and/or emergency department setting between participating sites.This is a retrospective cohort study of well-appearing infants ≤90 days old across 9 academic medical centers from September 1, 2016 to May 5, 2021. Infants were identified via billing codes for hypothermia or an initial temperature ≤36.0°C with manual chart review performed. Primary outcomes included assessment of variation in diagnostic evaluation, disposition, empirical antimicrobial therapy, and length of stay.Of 14 278 infants originally identified, 739 met inclusion criteria. Significant interhospital variation occurred across all primary outcomes. Across sites, a full serious bacterial illness evaluation was done in 12% to 76% of hypothermic infants. Empirical antibiotics were administered 20% to 87% of the time. Performance of herpes simplex viral testing ranged from 7% to 84%, and acyclovir was empirically started 8% to 82% of the time. Hospital admission rates ranged from 45% to 100% of patients.Considerable variation across multiple aspects of care exists for well-appearing young infants presenting with hypothermia. An improved understanding of hypothermic young infants and their risk of infection can lead to the development of clinical decision tools to guide appropriate evaluation and management.

Despite native grasses occupying a large area of land in Australia, there has been limited work on the responses of these species to the addition of phosphorus (P). The main objective of this study was to investigate the effect of the addition of P to create a range of P contents in the soil on the productivity and morphology of two native grasses at two times of harvests. Two contrasting perennial native grasses, namely kangaroo grass (Themeda triandra Forssk. syn. T. australis R. Br. Stapf) and weeping grass [Microlaena stipoides var. stipoides (Labill.) R. Br.] were grown in a glasshouse with the addition of P to create five contents of P in the soil (7, 17, 32, 107 and 307mgkg-1 soil) using a completely randomised design with four replicates per treatment. Grasses were harvested to 5cm above the substrate surface, and the number of tillers and leaf area were recorded on Day 84 (harvest 1) and Day 112 (harvest 2) of the experiment. Dry matter production for kangaroo and weeping grass increased with P contents of the soil of 32mg and ≥107mgPkg-1 soil, respectively. Increased dry matter production for both species was the result of increased leaf area, tiller number and root growth. These results provide data that help to understand the disappearance sequence of kangaroo grass from more fertile soils and an increase in weeping grass, particularly in soils with greater fertility. Further research is required to determine if these results hold for other grass ecotypes.

This paper reports the results of an initial evaluation of a large collection of Australian perennial native grasses. The overall aim of the research was to identify accessions that may be useful for pastoral purposes and for controlling land degradation on hill-lands in the high (>500 mm) rainfall zone of south-eastern Australia. Accessions (807) representing 37 target species were established in spaced plant nurseries at Rutherglen and Wagga Wagga. Dactylis glomerata L. cv. Porto and Eragrostis curvula (Schrad) Nees. Complex cv. Consol were established as comparator (control) species. A range of attributes was observed over a 2-year period (1990—1992), including persistence, vigour, productivity, palatability, morphology, and characteristics related to seed production. Accessions were initially culled on the basis of their persistence. Data for a range of attributes were separately analysed using pattern analysis to provide a broad overview of the performance and characteristics of the remaining accessions. A number of selection criteria were applied which resulted in selection of a promising group of 20 accessions (12 species from 8 genera). The promising group of accessions will be evaluated further at field sites typical of hilly landscapes in the 500—600 mm rainfall zone of south-eastern Australia. Additional keywords: Australian native grasses, dryland salinity, germplasm evaluation.

This paper reports on the collection phase of a research program which aimed to identify Australian native grasses that may be useful for pastoral purposes and for controlling land degradation on hill-lands in the high (>500 mm) rainfall zone of south-eastern Australia. Live plants of 37 target species were collected along a number of transects, and at specific locations, in New South Wales and Victoria. The collection sites were generally along public roads, and were chosen for their vegetation diversity. Each collection site was marked on a 1: 250000 topographic map, and detailed notes were taken of the native vegetation, geology, soil types, land use, and other features. Surface (0—10 cm) soil samples were collected at most sites and analysed for phosphorus, pH CaCl 2 , electrical conductivity, and particle size distribution. A total of 807 accessions were collected from 210 locations. At most collection sites, soils were acidic (median pH 5.6); soil phosphorus (Olsen) was in the low range (<8.5 mg/kg); and the target genera occurred with a low frequency (half of the sites yielded 3 accessions or less). Although genera collected in the study could be ranked on the basis of the mean pH of their collection sites, they all tolerated a considerable soil pH range (of about 2—5 pH units). Allowing root and shoot growth to recommence by growing collected plants for a short period in coarse sand considerably improved establishment success. Accessions collected in this study will be further evaluated. Additional keywords: Australian native grasses, dryland salinity, plant collection strategies.

This review covers research carried out on native grass pastures in moist temperate Australia. Such pastures extend from southern Queensland through New South Wales and Victoria to south-eastern South Australia. Other areas occur in Tasmania and south-western Western Australia. Changes to the original composition resulting from agricultural practices are briefly described. Research on native grasses and native grass pastures in various regions since 1990 is reviewed in detail. Research currently in progress is outlined and suggestions are made for future research on native grasses. The need to correct the imbalance between research on exotic and native pasture species is emphasised.