Matthew H R Anstey

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BACKGROUND Immobilisation predicts adverse outcomes in patients in the surgical intensive care unit (SICU). Attempts to mobilise critically ill patients early after surgery are frequently restricted, but we tested whether early mobilisation leads to improved mobility, decreased SICU length of stay, and increased functional independence of patients at(More)
INTRODUCTION Increased demand for expensive intensive care unit (ICU) services may contribute to rising health-care costs. A focus on appropriate use may offer a clinically meaningful way of finding the balance. We aimed to determine the extent and characteristics of perceived inappropriate treatment among ICU doctors and nurses, defined as an imbalance(More)
Intensive care is one of the main contributors to rising inpatient hospital costs due to frequent use of expensive diagnostics and therapies. With successful track records of team- and protocol-based care, intensive care units are ideal sites to take the lead in reducing overuse and misuse of diagnostic tests and prescribing. We offer a framework for(More)
OBJECTIVES We quantified the 28-day mortality effect of preexisting do-not-resuscitate orders in ICUs. DESIGN Longitudinal, retrospective study of patients admitted to five ICUs at a tertiary university medical center (Beth Israel Deaconess Medical Center, BIDMC, Boston, MA) between 2001 and 2008. INTERVENTION None. PATIENTS Two cohorts were defined:(More)
BACKGROUND Delirium is a common occurrence in patients undergoing major cardiac surgery and is associated with a number of adverse consequences for the individual, their family and the health system. Current approaches to the prevention of delirium include identifying those at risk together with various non-pharmacological and pharmacological strategies,(More)
The scientific consensus is that global warming is occurring and is largely the result of greenhouse gas emissions from human activity. This paper examines the health implications of global warming, the current socio-political attitudes towards action on climate change and highlight the health co-benefits of reducing greenhouse gas emissions. In addition,(More)
OBJECTIVE To determine the effect of spending time as an outlier (ie, an inpatient who spends time away from his or her "home" ward) on the frequency of emergency calls for patients admitted to a tertiary referral hospital. DESIGN, SETTING AND PATIENTS Observational cohort study of all patients admitted to a university-affiliated tertiary referral(More)
One of the elements of the health reform plan, as agreed to by Australian state and federal governments, is to introduce a 4-h National Access Target, to reduce emergency department (ED) waiting times. This article highlights the flawed rationale behind the 4-h rule, the UK experience of this rule and discusses the potential dangers it poses to Australian(More)
The provision of health services in Australia currently is primarily financed by a unique interaction of public and private insurers. This commentary looks at a loophole in this framework, namely that private insurers have to date been able to avoid funding healthcare for some of their policy holders, as it is not a requirement to use private insurance when(More)
Perhaps Functional Grammar’s most distinctive feature is its extensive use of the so-called layered structure of the clause (LSC). The LSC is used as both a descriptive and explanatory construct, dividing the linguistic world into various hierarchically related layers, each with concomitant operators and satellites. Since Hengeveld’s original Layers and(More)