Gabor Mihala's research while affiliated with Griffith University and other places

Publications (99)

Article
Background: One-third of peripheral intravenous catheters (PIVCs) fail from inflammatory or infectious complications, causing substantial treatment interruption and replacement procedures. Objectives: We aimed to compare complications between integrated PIVCs (inbuilt extension sets, wings, and flattened bases) and traditional nonintegrated PIVC...
Article
Background: Noroviruses are a leading cause of acute gastroenteritis across all age groups in Australia. We explored the epidemiology of symptomatic and asymptomatic norovirus infection and assessed risk factors and the related healthcare burden in Australian children during their first 2 years of life. Methods: Participants in the Observational...
Article
Introduction Peripheral venous catheters (PVCs) are used to administer antimicrobials, but many fail prior to completion of therapy. While some antimicrobials are known to increase PVC failure, risk profiles for many are unclear. Objective To synthesise data from prospective PVC studies conducted between 2013–2019, to determine associations betwee...
Article
Objective The objective of this study was to audit current patient blood management practice in children throughout cardiac surgery and paediatric intensive care unit (PICU) admission. Design This was a prospective observational cohort study. Setting This was a single-centre study in the cardiac operating room (OR) and PICU in a major tertiary ch...
Article
Background: Acute diarrheal illness (ADI) causes a substantial disease burden in high-income countries. We investigated associations between potentially pathogenic organisms in stools and ADI by polymerase chain reaction (PCR) in Australian children aged <2 years. Methods: Children in a community-based birth cohort had gastrointestinal symptoms...
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Synbiotics have emerged as a therapeutic strategy for modulating the gut microbiome and targeting novel cardiovascular risk factors, including uremic toxins indoxyl sulfate (IS) and p-cresyl sulfate (PCS). This study aims to evaluate the feasibility of a trial of long-term synbiotic supplementation in adults with stage 3–4 chronic kidney disease (C...
Article
Objective This study aims to explore the associations between diet quality, uraemic toxins, and gastrointestinal microbiota in the chronic kidney disease (CKD) population. Methods This is a baseline cross-sectional study of adults with CKD participating in a randomized controlled trial of prebiotic and probiotic supplementation. Dietary intake was...
Article
The timing and nature of initial infections by potentially vaccine-preventable gastrointestinal viruses (group-F adenoviruses, classic human astrovirus, norovirus I/II, and sapovirus I/II/IV/V) was investigated in a community-based birth cohort. Weekly stool samples were collected from 158 children aged <2 years in an Australian subtropical city. M...
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Introduction: The Australian Gold Coast Integrated Care programme trialled a model of care targeting those with chronic and complex conditions at highest risk of hospitalisation with the goal of producing the best patient outcomes at no additional cost to the healthcare system. This paper reports the economic findings of the trial. Methods: A pr...
Article
Background Peripheral intravenous catheters are an essential medical device which are prone to complications and failure. Objectives Identify patient, provider and device risk factors associated with all-cause peripheral intravenous catheter failure as well as individual complications: phlebitis, infiltration/occlusion, and dislodgement to improve...
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Background: The optimal intravenous device for antibiotic administration for children with respiratory disease is uncertain. We assessed the feasibility of a randomized controlled trial (RCT) comparing midline catheters with peripherally inserted central catheters (PICCs). Methods: Prospective, 2-arm, feasibility RCT in an Australian tertiary, p...
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Background and Aims Individuals with chronic kidney disease (CKD) have significantly increased risk of cardiovascular mortality which is only partially explained by Framingham risk factors. There is a growing body of evidence linking the gut-derived uraemic toxins indoxyl sulphate (IS) and p-cresyl sulphate (PCS) with accelerated kidney disease pro...
Article
Background and Aims Synbiotics, co-administered prebiotics and probiotics, have emerged over the last decade as an innocuous intervention targeting the microbial generation of the uraemic toxins, indoxyl sulphate (IS) and p-cresyl sulphate (PCS). However, most trials to date are of short duration (2-24 weeks). In order to inform translation into cl...
Article
Background: Peripherally inserted central catheters (PICCs) are commonly placed with the assistance of fluoroscopy or medical imaging, ultrasound, electrocardiogram guidance, or all the above. Innovative ultrasound technologies continue to emerge; however, the impact upon clinical outcomes is not well understood. In this study, we aimed to compare...
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en Aims The aim of this systematic review and meta‐analysis was to summarize and quantify peripheral intravenous catheter‐related complications. Design This systematic review is reported by means of the Cochrane process for randomized controlled trials and the Meta‐analysis of Observation Studies in Epidemiology for cohort studies. Data sources...
Article
Introduction Peripheral intravenous catheters (PIVCs) are widely used, but failure is unacceptably common with up to 69% failing before treatment is complete. PIVC securement reduces failure, but the optimal way to achieve this is unclear. Tapes and supplementary securement products are widely used, however rigorous testing of these to reduce PIVC...
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Background: Peripheral intravenous catheters (PIVCs) are ubiquitous medical devices, crucial to providing essential fluids and drugs. However, post-insertion PIVC failure occurs frequently, likely due to inconsistent maintenance practice such as flushing. The aim of this implementation study was to evaluate the impact a multifaceted intervention c...
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Background: To evaluate the feasibility of an efficacy trial comparing a hydrophobic polyurethane peripherally inserted central catheter (PICC) with a standard polyurethane PICC. Methods: This pilot randomised controlled trial (RCT) was conducted between May 2017 and February 2018. Adult participants (n = 111) were assigned to hydrophobic polyur...
Article
Aim This study sought to describe the burden of acute diarrhoeal illness (ADI) in an Australian subtropical urban setting following rotavirus vaccine introduction and to investigate the associations between child/family characteristics and ADI. Methods Parents of 154 children from the Observational Research in Childhood Infectious Diseases birth c...
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Pilot randomized controlled trial (180 patients) of needleless connector decontamination. Central line-associated bloodstream infection occurred in 2% (1/61) of 70% isopropyl alcohol (IPA) wipe, 2% (1/59) of 70% IPA cap, and zero (0/58) infections in 2% chlorhexidine gluconate in 70% IPA wipe patients. Larger definitive trials are feasible and need...
Article
Background Critically ill patients in an intensive care setting often require arterial catheters for blood pressure monitoring and arterial blood collection. Arterial catheter failure, which manifests in both mechanical and infective forms, remains common. Dressing and securement inadequacies may impact this failure; however, the best method for dr...
Article
Aim Evaluate the feasibility of an efficacy randomised control trial (RCT) of paediatric peripheral intravenous catheter (PIVC) securement to prevent failure without resultant skin damage. Methods A 3-arm, pilot RCT in an XX paediatric hospital. Random assignment of 330 children to receive (i) bordered polyurethane dressing (BPU) + non-sterile foa...
Article
Estimates of acute gastroenteritis (AGE) burden are difficult to compare between studies because of inconsistent definitions describing this illness. AGE definitions used in prospective, community-based childhood cohort studies were identified by searching databases for studies that collected daily observations of AGE symptoms. Disease definitions...
Article
Introduction: Central venous access devices (CVADs) are a vital medical device for intensive care (ICU) patients; however, complications and failure are common, yet potentially prevented through effective dressings and securement. Objectives/aims: The objective of this study was to test the feasibility of a randomised controlled trial (RCT) comp...
Article
Worldwide, there has been a shift in health care delivery, with an increasing emphasis on avoiding hospital admissions and providing treatment such as intravenous antibiotics for patients at home, using peripherally inserted central catheters (PICCs). However, there is inadequate data to demonstrate if rates of PICC failure are similar for hospital...
Article
Background: With over 2 billion peripheral intravenous catheters used globally each year, avoiding complications is crucial for patients and healthcare organisations. Effective catheter dressing and securement is a key nursing strategy to reduce catheter failure and resultant patient harm. Objectives: To describe global catheter dressing and sec...
Article
Aim: To describe practice evolution, complications and risk factors for multiple insertion attempts and device failure in paediatric central venous access devices (CVADs). Methods: A paediatric retrospective cohort study using prospectively collected data from CVAD database 2012-2014. Data included were patient (i.e. age, condition), insertion (...
Article
Objectives: Central venous access devices enable many treatments during critical illness; however, 25% of pediatric central venous access devices fail before completion of treatment due to infection, thrombosis, dislodgement, and occlusion. This is frequently attributed to inadequate securement and dressing of the device; however, high-quality res...
Article
Aim To test the feasibility of an efficacy trial comparing different flushing frequencies and volumes to reduce peripheral intravenous cannula (PIVC) failure in paediatric inpatients. Methods Pilot, 2 × 2 factorial, randomised controlled trial comparing PIVC flushing techniques in intervention pairs: (i) low volume (3 mL) versus high volume (10 mL...
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Aim To improve paediatric peripheral intravenous catheter (PIVC) care through the implementation of care bundles. Methods A pre–post study using mixed methods (clinical audit, staff survey, parent interviews) in 2016 at a tertiary paediatric hospital in Brisbane was conducted to evaluate the effectiveness of a PIVC insertion and maintenance bundle...
Article
Objectives: To examine the proportion and rate of central venous access device failure and complications across central venous access device types in adult intensive care. Data sources: A systematic search was undertaken in the electronic databases Cochrane Central Register of Controlled Trials (CENTRAL), Embase, U.S. National Library of Medicin...
Article
Background: Vascular access devices are widely used in healthcare settings worldwide. The insertion of a vascular access device creates a wound, vulnerable to irritation, injury and infection. Vascular access-associated skin complications are frequently reported in the literature, however very little evidence is available regarding the incidence an...
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Prevalence of asthma in Australian children is amongst the highest in the world. Although breastfeeding positively influences infant immunity, early introduction of Milk Other than Breast Milk (MOTBM) may also play an important role in the development of Asthma. The aim of this study was to investigate the association between the introduction of MO...
Article
Background: Skin microorganisms may contribute to the development of vascular access device (VAD) infections. Baseline skin microorganism type and quantity vary between body sites, yet there is little evidence to inform choice of VAD site selection. Objective: To compare microorganisms present at different body sites used for VAD insertions and...
Article
Aim To describe the relationship between emergency department (ED) diagnosis of infectious disease and immunisation status in children ≤5 years. We also aimed to demonstrate feasibility of proof‐of‐concept linkage between disparate databases. Methods Data from a cohort of 3404 children born in Southeast Queensland/Far North New South Wales between...
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Background The reported incidence of peripheral intravenous catheter (PIV) failure has been as high as 69%. This is in part due to inadequate stabilisation or securement to the skin, which allows micro-motion of the catheter within the vein. Methods A pilot open randomised controlled trial of 300 patients was conducted in the medical and surgical...
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Background Peripheral intravenous catheters (PVCs) are essential invasive devices, with 2 billion PVCs sold each year. The comparative efficacy of expert versus generalist inserter models for successful PVC insertion and subsequent reliable vascular access is unknown. Methods A single-centre, parallel-group, pilot randomised controlled trial (RCT)...
Preprint
Prevalence of asthma in Australian children is amongst the highest in the world. Although breastfeeding positively influences infants’ immunity, early introduction of Milk Other than Breast Milk (MOTBM) may also play an important role in the development of Asthma. The aim of this study was to investigate the association between the introduction of...
Article
This study was undertaken to calculate the incidence of 8 signs and symptoms used for the diagnosis of phlebitis with peripheral intravenous catheters, or short peripheral catheters, and the level of correlation between them. A total of 22 789 daily observations of 6 signs (swelling, erythema, leakage, palpable venous cord, purulent discharge, and...
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Background: To measure rates of parental-report of allergic disorders and ED presentations for allergic disorders in children, and to describe factors associated with either. Methods: An existing cohort of 3404 children born between 2006 and 2011 (Environments for Healthy Living) with prospectively collected pre-natal, perinatal and follow-up da...
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This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To compare the effectiveness of dressings and securement devices for peripheral arterial catheters.
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Introduction Peripheral intravenous catheters (PIVCs) are frequently used in hospitals. However, PIVC complications are common, with failures leading to treatment delays, additional procedures, patient pain and discomfort, increased clinician workload and substantially increased healthcare costs. Recent evidence suggests integrated PIVC systems may...
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Background: Most people admitted to hospitals worldwide require a vascular access device (VAD). Hundreds of millions of VADs are inserted annually in the USA with reports of over a billion peripheral intravenous catheters used annually worldwide. Numerous reports suggest that a team approach for the assessment, insertion, and maintenance of VADs i...
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Background: Despite the popularity of peripherally inserted central catheters (PICCs), recent literature highlights their potential injurious complications. Innovative PICC materials have been developed to prevent thrombosis and infection formation (Endexo®) and antireflux valves to prevent occlusion (pressure-activated safety valve®). No large ra...
Article
Issue addressed Stigma and discrimination can have a significant impact on successful mental health recovery. This research evaluated the effectiveness of a web‐based mental health promotion intervention on stigma and discrimination in community pharmacies via assessment of staff attitudes, confidence and skills. Methods Guided by the intervention...
Article
Background: Almost 70% of hospitalized patients require a peripheral intravenous catheter (PIV), yet up to 69% of PIVs fail prior to completion of therapy. Objective: To identify risk factors associated with PIV failure. Design: A single center, prospective, cohort study. Setting: Medical and surgical wards of a tertiary hospital located in...
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Background Peripherally inserted central catheters (PICCs) are commonly used for delivering intravenous therapy. PICC failure is unacceptably high (up to 40%) due to mechanical, infectious and thrombotic complications. Poor securement potentiates all complication types. This randomised controlled trial (RCT) aimed to examine the feasibility of a la...
Article
Full-text available
Background Central venous access device (CVAD) associated complications are a preventable source of patient harm, frequently resulting in morbidity and delays to vital treatment. Dressing and securement products are used to prevent infectious and mechanical complications, however current complication rates suggest customary practices are inadequate...
Article
Introduction This study examined the effect of a telehealth intervention on the control of type 2 diabetes and subsequent potential cost-savings to the health system. Methods This prospective randomised controlled trial randomised adults with type 2 diabetes to the intervention (diabetes program) or control (usual care) arm. Key eligibility criter...
Article
Financial hardship may affect up to 30% of cancer survivors, however, little research has addressed the effect of employment change on financial hardship. This study compared the self-reported financial hardship of middle-aged (45–64 years) colorectal cancer survivors (n = 187) at 6 and 12 months following diagnosis with that of a matched general p...
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Background: Mental illness is a worldwide health priority. As medication is commonly used to treat mental illness, community pharmacy staff is well placed to assist consumers. Aim: To evaluate the effectiveness of a multifaceted, community pharmacy medication support service for mental health consumers. Method: Pharmacists and pharmacy support staf...
Article
Aim: Infants under 12 months of age are disproportionately represented amongst emergency department (ED) presentations, and infants are more likely to be frequent ED users. This study aimed to describe and identify psychosocial predictors of ED presentation in infants. Methods: A prospective birth cohort from Queensland and New South Wales (Envi...
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Introduction Chronic diseases are the leading cause of illness, disability and death in Australia. The prevalence and associated health expenditure are projected to soar. There is no ‘whole system’ approach to healthcare in Australia. To overcome this fragmentation, the Gold Coast Hospital and Health Service (GCHHS) is developing a new model known...
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Background Antipsychotics are recognised as a critical intervention for schizophrenia and bipolar disorder. Guidelines globally endorse the routine practice of antipsychotic monotherapy, at the minimum effective dose. Even in treatment-resistant schizophrenia, clozapine use is endorsed before combining antipsychotics.This aim of this study was to r...
Article
Aim: To estimate the cost-effectiveness of the Mitii training system for improvements in upper limb function for children with unilateral cerebral palsy (CP). Mitii is a web-based programme delivered at home with set-up and monitoring by therapists. Method: A randomized controlled trial was conducted comparing the Mitii training programme to usu...