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9. Care of older people and people requiring palliative care with COVID-19: guidance from the Australian National COVID-19 Clinical Evidence Taskforce

Author

Cheyne, S, Lindley, R, Smallwood, N, Tendal, B, Chapman, M, Navarro, DF, Good, PD, Jenkin, P, McDonald, S, Morgan, D, Murano, M, Millard, T, Naganathan, V, Srikanth, V, Tuffin, P, Vogel, J, White, H, Chakraborty, SP, Whiting, E, William, L, Yates, PM, Callary, M, Elliott, J, Agar, MR, Cheyne, S, Lindley, R, Smallwood, N, Tendal, B, Chapman, M, Navarro, DF, Good, PD, Jenkin, P, McDonald, S, Morgan, D, Murano, M, Millard, T, Naganathan, V, Srikanth, V, Tuffin, P, Vogel, J, White, H, Chakraborty, SP, Whiting, E, William, L, Yates, PM, Callary, M, Elliott, J, and Agar, MR

Abstract

INTRODUCTION: Older people living with frailty and/or cognitive impairment who have coronavirus disease 2019 (COVID-19) experience higher rates of critical illness. There are also people who become critically ill with COVID-19 for whom a decision is made to take a palliative approach to their care. The need for clinical guidance in these two populations resulted in the formation of the Care of Older People and Palliative Care Panel of the National COVID-19 Clinical Evidence Taskforce in June 2020. This specialist panel consists of nursing, medical, pharmacy and allied health experts in geriatrics and palliative care from across Australia. MAIN RECOMMENDATIONS: The panel was tasked with developing two clinical flow charts for the management of people with COVID-19 who are i) older and living with frailty and/or cognitive impairment, and ii) receiving palliative care for COVID-19 or other underlying illnesses. The flow charts focus on goals of care, communication, medication management, escalation of care, active disease-directed care, and managing symptoms such as delirium, anxiety, agitation, breathlessness or cough. The Taskforce also developed living guideline recommendations for the care of adults with COVID-19, including a commentary to discuss special considerations when caring for older people and those requiring palliative care. CHANGES IN MANAGEMENT AS RESULT OF THE GUIDELINE: The practice points in the flow charts emphasise quality clinical care, with a focus on addressing the most important challenges when caring for older individuals and people with COVID-19 requiring palliative care. The adult recommendations contain additional considerations for the care of older people and those requiring palliative care.

Published
2022

11. Care of older people and people requiring palliative care with COVID-19: guidance from the Australian National COVID-19 Clinical Evidence Taskforce

Author

Cheyne, S., Lindley, R.I., Smallwood, N., Tendal, B., Chapman, M., Fraile, Navarro, D., Good, P.D., Jenkin, P., McDonald, S., Morgan, D., Murano, M., Millard, T., Naganathan, V., Srikanth, V., Tuffin, P., Vogel, J., White, H., Chakraborty, S.P., Whiting, E., William, L., Yates, P.M., Callary, M., Elliott, J., Agar, M.R., and for, the, National, COVID-19, Clinical, Evidence, Taskforce

Subjects
Coronavirus, 11 Medical and Health Sciences, 17 Psychology and Cognitive Sciences, General & Internal Medicine, Palliative Care, Australia, COVID-19, Humans, General Medicine, Aged
Abstract

Introduction: Older people living with frailty and/or cognitive impairment who have coronavirus disease 2019 (COVID-19) experience higher rates of critical illness. There are also people who become critically ill with COVID-19 for whom a decision is made to take a palliative approach to their care. The need for clinical guidance in these two populations resulted in the formation of the Care of Older People and Palliative Care Panel of the National COVID-19 Clinical Evidence Taskforce in June 2020. This specialist panel consists of nursing, medical, pharmacy and allied health experts in geriatrics and palliative care from across Australia. Main recommendations: The panel was tasked with developing two clinical flow charts for the management of people with COVID-19 who are i) older and living with frailty and/or cognitive impairment, and ii) receiving palliative care for COVID-19 or other underlying illnesses. The flow charts focus on goals of care, communication, medication management, escalation of care, active disease-directed care, and managing symptoms such as delirium, anxiety, agitation, breathlessness or cough. The Taskforce also developed living guideline recommendations for the care of adults with COVID-19, including a commentary to discuss special considerations when caring for older people and those requiring palliative care. Changes in management as result of the guideline: The practice points in the flow charts emphasise quality clinical care, with a focus on addressing the most important challenges when caring for older individuals and people with COVID-19 requiring palliative care. The adult recommendations contain additional considerations for the care of older people and those requiring palliative care.

Published
2021

14. Clinical care of pregnant and postpartum women with COVID-19: Living recommendations from the National COVID-19 Clinical Evidence Taskforce

Author

Vogel, JP, Tendal, B, Giles, M, Whitehead, C, Burton, W, Chakraborty, S, Cheyne, S, Downton, T, Fraile Navarro, D, Gleeson, G, Gordon, A, Hunt, J, Kitschke, J, McDonald, S, McDonnell, N, Middleton, P, Millard, T, Murano, M, Oats, J, Tate, R, White, H, Elliott, J, Roach, V, Homer, CSE, and National COVID-19 Clinical Evidence Taskforce

Subjects
Pregnancy, SARS-CoV-2, Postpartum Period, Australia, Humans, COVID-19, Prenatal Care, Female, 1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services, Pregnancy Complications, Infectious, Obstetrics & Reproductive Medicine
Abstract

To date, 18 living recommendations for the clinical care of pregnant and postpartum women with COVID-19 have been issued by the National COVID-19 Clinical Evidence Taskforce. This includes recommendations on mode of birth, delayed umbilical cord clamping, skin-to-skin contact, breastfeeding, rooming-in, antenatal corticosteroids, angiotensin-converting enzyme inhibitors, disease-modifying treatments (including dexamethasone, remdesivir and hydroxychloroquine), venous thromboembolism prophylaxis and advanced respiratory support interventions (prone positioning and extracorporeal membrane oxygenation). Through continuous evidence surveillance, these living recommendations are updated in near real-time to ensure clinicians in Australia have reliable, evidence-based guidelines for clinical decision-making. Please visit https://covid19evidence.net.au/ for the latest recommendation updates.

Published
2020

15. Clinical care of pregnant and postpartum women with COVID-19: Living recommendations from the National COVID-19 Clinical Evidence Taskforce.

Author

Burgess P., Morphet J., Nou S., Russo P., Sarson M., Young A., Norris S., Morris-Donovan B., Gurry S., Hudson E., Hurley S., Primmer D., Timms S., Whicker S., Mukherjee S., Booth K., Cameron P., Cooper M., Cheng A., Fowler P., Frydenberg M., McGloughlin S., McPhee E., Mitchell B., O'Donnell C., Parr M., Phillips J., Varndell W., Whyte I., Randall R., Brightwell R., Condon L., Deshpande A., Ehm A., Ferrie M., Muller J., Pullin L., Robinson E., Witt A., Larkins S., Morgan M., Taylor G., Agostino J., Douglas K., Ewald B., Fornasier D., Knight S., Nelson C., Peachey L., Peiris D., Driel M., Walters L., Weaver I., Burr L., Hendel S., Shekar K., Avard B., Cairns K., Glanville A., Gilroy N., Myles P., O'Sullivan R., Robinson O., Sharland C., McCarthy S., Wark P., McGoughlin S., Hodgson C., Ankravs M., Hansen K., Huckson S., Iredell J., Janerka C., Jaspers R., Litton E., Macdonald S., Peake S., Bowen A., McMullan B., Tingay D., Vasilunas N., Anderson L., Best J., Burns P., Erickson S., Fancourt N., Goff Z., Kapuya V., Keyte C., Malyon L., Wurzel D., Agar M., Lindley R., Smallwood N., Callary M., Chapman M., Good P., Jenkin P., Morgan D., Naganathan V., Srikanth V., Tuffin P., Whiting E., William L., Yates P., Barber B., Davies J., Davis J., Gwee A., Leder K., Matthews G., McMahon J., Peel T., Raftery C., Rees M., Roberts J., Seppelt I., Wibrow B., Baker R., Curnow J., Cutts B., Enjeti A., Forbes A., Ho P., Holyoak A., Liley H., McFadyen J., McQuilten Z., Merriman E., Savoia H., Tan C.W., Tran H., Ward C., Williams K., Ballard N., Bendall S., Bhanderi N., Byers L., Craig S., Ellis D., Ewald D., Fairley C., Hoggard B., Cong M.L., Morley P., Nair P., Pearce A., Turner T., Callesen H., Campbell S., Ring J., Wilson A., Henry D., Pearson S., Boyle D., Chidwick K., Chapman W., French C., Pearce C., Snelling T., Bero L., Grundy Q., Lexchin J., Mintzes B., Vogel J.P., Tendal B., Giles M., Whitehead C., Burton W., Chakraborty S., Cheyne S., Downton T., Fraile Navarro D., Gleeson G., Gordon A., Hunt J., Kitschke J., McDonald S., McDonnell N., Middleton P., Millard T., Murano M., Oats J., Tate R., White H., Elliott J., Roach V., Homer C.S.E., McGowan S., Ballenden N., Barrett T.-L., Beavis V., Saunders J.B., Buchanan T., Buchanan-Grey M., Casey D., Cowie M., Doyle J., Gnjidic D., Green S., Greenland R., Griffin K., Groombridge S., Hardy L., Hodak A., Holley A., Jovanovska V., Michaels K., Burgess P., Morphet J., Nou S., Russo P., Sarson M., Young A., Norris S., Morris-Donovan B., Gurry S., Hudson E., Hurley S., Primmer D., Timms S., Whicker S., Mukherjee S., Booth K., Cameron P., Cooper M., Cheng A., Fowler P., Frydenberg M., McGloughlin S., McPhee E., Mitchell B., O'Donnell C., Parr M., Phillips J., Varndell W., Whyte I., Randall R., Brightwell R., Condon L., Deshpande A., Ehm A., Ferrie M., Muller J., Pullin L., Robinson E., Witt A., Larkins S., Morgan M., Taylor G., Agostino J., Douglas K., Ewald B., Fornasier D., Knight S., Nelson C., Peachey L., Peiris D., Driel M., Walters L., Weaver I., Burr L., Hendel S., Shekar K., Avard B., Cairns K., Glanville A., Gilroy N., Myles P., O'Sullivan R., Robinson O., Sharland C., McCarthy S., Wark P., McGoughlin S., Hodgson C., Ankravs M., Hansen K., Huckson S., Iredell J., Janerka C., Jaspers R., Litton E., Macdonald S., Peake S., Bowen A., McMullan B., Tingay D., Vasilunas N., Anderson L., Best J., Burns P., Erickson S., Fancourt N., Goff Z., Kapuya V., Keyte C., Malyon L., Wurzel D., Agar M., Lindley R., Smallwood N., Callary M., Chapman M., Good P., Jenkin P., Morgan D., Naganathan V., Srikanth V., Tuffin P., Whiting E., William L., Yates P., Barber B., Davies J., Davis J., Gwee A., Leder K., Matthews G., McMahon J., Peel T., Raftery C., Rees M., Roberts J., Seppelt I., Wibrow B., Baker R., Curnow J., Cutts B., Enjeti A., Forbes A., Ho P., Holyoak A., Liley H., McFadyen J., McQuilten Z., Merriman E., Savoia H., Tan C.W., Tran H., Ward C., Williams K., Ballard N., Bendall S., Bhanderi N., Byers L., Craig S., Ellis D., Ewald D., Fairley C., Hoggard B., Cong M.L., Morley P., Nair P., Pearce A., Turner T., Callesen H., Campbell S., Ring J., Wilson A., Henry D., Pearson S., Boyle D., Chidwick K., Chapman W., French C., Pearce C., Snelling T., Bero L., Grundy Q., Lexchin J., Mintzes B., Vogel J.P., Tendal B., Giles M., Whitehead C., Burton W., Chakraborty S., Cheyne S., Downton T., Fraile Navarro D., Gleeson G., Gordon A., Hunt J., Kitschke J., McDonald S., McDonnell N., Middleton P., Millard T., Murano M., Oats J., Tate R., White H., Elliott J., Roach V., Homer C.S.E., McGowan S., Ballenden N., Barrett T.-L., Beavis V., Saunders J.B., Buchanan T., Buchanan-Grey M., Casey D., Cowie M., Doyle J., Gnjidic D., Green S., Greenland R., Griffin K., Groombridge S., Hardy L., Hodak A., Holley A., Jovanovska V., and Michaels K.

Abstract

To date, 18 living recommendations for the clinical care of pregnant and postpartum women with COVID-19 have been issued by the National COVID-19 Clinical Evidence Taskforce. This includes recommendations on mode of birth, delayed umbilical cord clamping, skin-to-skin contact, breastfeeding, rooming-in, antenatal corticosteroids, angiotensin-converting enzyme inhibitors, disease-modifying treatments (including dexamethasone, remdesivir and hydroxychloroquine), venous thromboembolism prophylaxis and advanced respiratory support interventions (prone positioning and extracorporeal membrane oxygenation). Through continuous evidence surveillance, these living recommendations are updated in near real-time to ensure clinicians in Australia have reliable, evidence-based guidelines for clinical decision-making. Please visit https://covid19evidence.net.au/ for the latest recommendation updates.Copyright © 2020 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists

Published
2021

16. Weekly updates of national living evidence-based guidelines: methods for the Australian living guidelines for care of people with COVID-19

Author

Tendal, B, Vogel, JP, McDonald, S, Norris, S, Cumpston, M, White, H, Leder, K, Navarro, DF, Cheyne, S, Chakraborty, S, Murano, M, Millard, T, Callesen, HE, Islam, RM, Elliott, J, Turner, T, Tendal, B, Vogel, JP, McDonald, S, Norris, S, Cumpston, M, White, H, Leder, K, Navarro, DF, Cheyne, S, Chakraborty, S, Murano, M, Millard, T, Callesen, HE, Islam, RM, Elliott, J, and Turner, T

Abstract

BACKGROUND AND OBJECTIVES: The Australian National COVID-19 Clinical Evidence Taskforce is a consortium of 31 Australian health professional organisations developing living, evidence-based guidelines for care of people with COVID-19, which are updated weekly. This article describes the methods used to develop and maintain the guidelines. METHODS: The guidelines use the GRADE methods and are designed to meet Australian NHMRC standards. Each week, new evidence is reviewed, current recommendations are revised, and new recommendations made. These are published in MAGIC and disseminated through traditional and social media. Relevant new questions to be addressed are continually sought from stakeholders and practitioners. For prioritized questions, the evidence is actively monitored and updated. Evidence surveillance combines horizon scans and targeted searches. An evidence team appraises and synthesizes evidence and prepares evidence-to-decision frameworks to inform development of recommendations. A guidelines leadership group oversees the development of recommendations by multidisciplinary guidelines panels and is advised by a consumer panel. RESULTS: The Taskforce formed in March 2020, and the first recommendations were published 2 weeks later. The guidelines have been revised and republished on a weekly basis for 24 weeks, and as of October 2020, contain over 90 treatment recommendations, suggesting that living methods are feasible in this context. CONCLUSIONS: The Australian guidelines for care of people with COVID-19 provide an example of the feasibility of living guidelines and an opportunity to test and improve living evidence methods.

Published
2021

17. Care of older people and people requiring palliative care with COVID-19: guidance from the Australian National COVID-19 Clinical Evidence Taskforce.

Author

Cheyne, S, Lindley, RI, Smallwood, N, Tendal, B, Chapman, M, Fraile Navarro, D, Good, PD, Jenkin, P, McDonald, S, Morgan, D, Murano, M, Millard, T, Naganathan, V, Srikanth, V, Tuffin, P, Vogel, J, White, H, Chakraborty, SP, Whiting, E, William, L, Yates, PM, Callary, M, Elliott, J, Agar, MR, National COVID-19 Clinical Evidence Taskforce, Cheyne, S, Lindley, RI, Smallwood, N, Tendal, B, Chapman, M, Fraile Navarro, D, Good, PD, Jenkin, P, McDonald, S, Morgan, D, Murano, M, Millard, T, Naganathan, V, Srikanth, V, Tuffin, P, Vogel, J, White, H, Chakraborty, SP, Whiting, E, William, L, Yates, PM, Callary, M, Elliott, J, Agar, MR, and National COVID-19 Clinical Evidence Taskforce

Abstract

INTRODUCTION: Older people living with frailty and/or cognitive impairment who have coronavirus disease 2019 (COVID-19) experience higher rates of critical illness. There are also people who become critically ill with COVID-19 for whom a decision is made to take a palliative approach to their care. The need for clinical guidance in these two populations resulted in the formation of the Care of Older People and Palliative Care Panel of the National COVID-19 Clinical Evidence Taskforce in June 2020. This specialist panel consists of nursing, medical, pharmacy and allied health experts in geriatrics and palliative care from across Australia. MAIN RECOMMENDATIONS: The panel was tasked with developing two clinical flow charts for the management of people with COVID-19 who are i) older and living with frailty and/or cognitive impairment, and ii) receiving palliative care for COVID-19 or other underlying illnesses. The flow charts focus on goals of care, communication, medication management, escalation of care, active disease-directed care, and managing symptoms such as delirium, anxiety, agitation, breathlessness or cough. The Taskforce also developed living guideline recommendations for the care of adults with COVID-19, including a commentary to discuss special considerations when caring for older people and those requiring palliative care. CHANGES IN MANAGEMENT AS RESULT OF THE GUIDELINE: The practice points in the flow charts emphasise quality clinical care, with a focus on addressing the most important challenges when caring for older individuals and people with COVID-19 requiring palliative care. The adult recommendations contain additional considerations for the care of older people and those requiring palliative care.

Published
2021

26. POP’s exposition in Swedish fishermen: effect on sperm quality

Author

Stronati, A., Medi, G., Proietti, E., Manes, S., Antonucci, N., Corradetti, B., Murano, M., Jönsson, B. A. G., Rignell Hydbom, A., Rylander, L., Giwercman, A., Toft, G., Bonde, J. P., Bonefeld Jorgensen, E. C., Manicardi, Gian Carlo, and Bizzaro, D.

Subjects
human fertility, Sperm DNA, POP’s exposition, INUENDO
Published
2008

36. New Results in Comprehensive Calculations of Heavy-Ion Interactions.

Author

Cerutti, F., Clivio, A., Gadioli, E., Murano, M., Ballarini, F., Battistoni, G., Ferrari, A., Ottolenghi, A., Ranft, J., and Sala, P. R.

Subjects
ION bombardment, COLLISIONS (Nuclear physics), PARTICLES (Nuclear physics), QUANTUM theory, NUCLEAR reactions, NUCLEAR physics
Abstract

We present results concerning the study of reactions between light nuclei and quasi-symmetric reactions between medium-heavy nuclei at low energies, and relativistic quantum molecular-dynamics calculations of heavy-nucleus reactions at intermediate energies. © 2005 American Institute of Physics [ABSTRACT FROM AUTHOR]

Published
2005
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45. In vivo trial of a driving system for a self-propelling capsule endoscope using a magnetic field (with video)

Author

Morita E, Ohtsuka N, Shindo Y, Nouda S, Kuramoto T, Inoue T, Murano M, Umegaki E, and Higuchi K

Abstract

Background: A capsule endoscope does not allow the examiner to observe a lesion from the desired direction in real time. Objective: To develop a driving system for a self-propelling capsule endoscope (SPCE) by using a magnetic field. Setting: Experimental endoscopic study in a live dog model. Design and Interventions: A microactuator was developed with the aim of remote-control operation. We developed a driving system for SPCE by attaching a capsule endoscope to this medical microactuator and performed the following experiments. (1) We operated this SPCE by remote control in the stomach of a dog under sedation and obtained endoscopic images using a real-time monitoring system only. (2) We placed a hemostatic clip on the gastric mucosa and recorded images of this clip with the SPCE. (3) We also placed clips at 2 other sites in the stomach and asked the SPCE operator, who was unaware of the location of the clips, to identify the site, number, and color of the clips. Main Outcome Measurements: Evaluation of performance of a driving system for SPCE. Results: The operator was able to obtain endoscopic images with the SPCE in the stomach of a dog in vivo, in any desired direction, by remote control. SPCE produced clear images of the clips placed in the stomach. The operator was able to easily identify the site, number, and color of the clips. Limitations: Animal model. Conclusions: Our trial suggests the possibility of clinical application of the driving system for an SPCE using a magnetic field. [ABSTRACT FROM AUTHOR]

Published
2010
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46. Enprostil, a Prostaglandin-E2 Analogue, Inhibits Interleukin-8 Production of Human Colonic Epithelial Cell Lines.

Author

Toshina, K., Hirata, I., Maemura, K., Sasaki, S., Murano, M., Nitta, M., Yamauchi, H., Nishikawa, T., Hamamoto, N., and Katsu, K.

Subjects
COLITIS treatment, COLON cancer, CELL lines
Abstract

We previously reported that intracolonic administration of enprostil, a prostaglandin-E2 (PGE2) analogue, had therapeutic effects on acute colitis induced in rodents by dextran sulfate sodium (DSS). In addition, production of growth-regulated gene product/cytokine-induced neutrophil chemoattractant-1 [GRO/CINC-1; an interleukin(IL)-8 like cytokine] was suppressed in the inflamed tissues. In the present study we used a human colon cancer cell line (HT-29) to investigate enprostil effects on the IL-8 production of intestinal epithelial cells stimulated by various stimulants. In a MTT assay, concentrations of enprostil >10-5M had cytotoxitic effects on HT-29 cells. Furthermore, 10-6 M enprostil suppressed IL-8 production in HT-29 cells, SW620 and CaCo2 stimulated with interleukin-1β (IL-1β) or lipopolysaccharide (LPS), but did not suppress this response when cells were stimulated with tumour necrosis factor (TNF)-α. These results suggest that enprostil affects a point in the pathway between the IL-1 receptor or LPS receptor and nuclear factor-κB(NF-κB), without affecting the pathway between the TNF receptor and NF-κB, with the latter factor being required for the IL-8 gene transcription. The therapeutic effect of exogenous enprostil on DSS colitis may involve the inhibition of IL-8 production in colonic epithelial cells stimulated by IL-1β or LPS. [ABSTRACT FROM AUTHOR]

Published
2000
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47. Mating behavior of the marine copepod Oithona davisae.

Author

Uchima, M. and Murano, M.

Subjects
COPEPODA, OITHONA, SEMICONDUCTOR doping, EXTRUSION process, SPERMATOPHORES
Abstract

Oithona davisae Ferrari and Orsi were collected from the innermost region of Tokyo Bay, Japan, in 1980 and 1981. The mating behavior of this marine cyclopoid copepod consists of several steps, starting with the paddling of the male in random search of a mate. This behavior is followed by a spiraling movement in pursuance of a mate. Next is the copulatory grasp during which the male grasps the fourth swimming legs of the female partner by means of his first antennae. Whilst in this position, the male's urosome vibrates to allow the spermatophores to extrude from his genital openings. The mating behavior then culminates in the spermatophore transfer. Males do not grasp the uro-some or caudal setae of the mating partner before proper copulatory grasp. The specialized setae of the female's fourth legs may help the male to grasp her legs firmly. Spiraling occurs when the male approaches or traverses the trail of a female that is ready to copulate and that presumably emits a sex-attractant pheromone. The turning radius reduces gradually from more than 1 mm to ca. 0.25 mm as the male approaches the mate female. Females may register spiraling as a mate (male)-approaching signal. Spiraling may lead the male to locate a pheromone source more accurately, and to promote diffusion of the pheromone to prevent other males from pursuing the source. This swimming strategy can increase the copulatory chance of mature virgin females. [ABSTRACT FROM AUTHOR]

Published
1988
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