Papers by Daniel Seller
American journal of respiratory and critical care medicine, May 19, 2024
American Journal of Respiratory and Critical Care Medicine, 2014
Journal of Clinical Medicine, Mar 9, 2023
Background: Moderate-to high-certainty evidence supports the benefits of pre-and postoperative ex... more Background: Moderate-to high-certainty evidence supports the benefits of pre-and postoperative exercise for people undergoing surgical resection for lung cancer. Despite this, exercise programs are not commonly provided. Previous data regarding exercise practices are a decade old. Therefore, this study aimed to understand current exercise practices in surgical lung cancer care in Australia and New Zealand. Methods: An online cross-sectional survey of Australian and New Zealand allied health professionals specialising in exercise-based interventions was carried out. Survey development and reporting adhered to CHERRIES and CROSS checklists. Institutions with thoracic surgery departments were invited to participate via email, and additional responses were sought via snowballing. Results: The response rate was 81%, with a total of 70 health services responding. A total of 18 (26%) pre-operative services, 59 (84%) inpatient post-operative services, and 39 (55%) community/outpatient post-operative services were identified. Only eight (11%) services provided a pre-operative exercise program. Half of the respondents referred less than 25% of patients to community/outpatient exercise programs on hospital discharge. Respondents reported that their clinical management was predominantly influenced by established workplace practices and personal experience rather than evidence. Conclusions: The availability and uptake of pre-and postoperative exercise remain low, and work should continue to make pre/post-operative exercise training usual practice.
Journal of Clinical Medicine
Background: Moderate- to high-certainty evidence supports the benefits of pre- and post-operative... more Background: Moderate- to high-certainty evidence supports the benefits of pre- and post-operative exercise for people undergoing surgical resection for lung cancer. Despite this, exercise programs are not commonly provided. Previous data regarding exercise practices are a decade old. Therefore, this study aimed to understand current exercise practices in surgical lung cancer care in Australia and New Zealand. Methods: An online cross-sectional survey of Australian and New Zealand allied health professionals specialising in exercise-based interventions was carried out. Survey development and reporting adhered to CHERRIES and CROSS checklists. Institutions with thoracic surgery departments were invited to participate via email, and additional responses were sought via snowballing. Results: The response rate was 81%, with a total of 70 health services responding. A total of 18 (26%) pre-operative services, 59 (84%) inpatient post-operative services, and 39 (55%) community/outpatient po...
New Zealand Journal of Physiotherapy, 2014
A learning needs analysis was performed using an online survey to establish the most appropriate ... more A learning needs analysis was performed using an online survey to establish the most appropriate curriculum for a simulation-based intensive care training programme for junior physiotherapists. Perceptions were compared between an intensive care-naïve ‘novice’ group of rotational physiotherapists from a single tertiary teaching hospital in Melbourne, Australia, and an ‘expert’ group of senior intensive care physiotherapists from across Australia. The learning needs analysis survey involved two questions. Question one required participants to rank assessment topics for perceived training importance from 1 (greatest) to 6 (least). Question two required participants to select which treatment topics from a list (total 15) they felt important for further training. 14/15 (93%) of the novice group, and 15/16 (94%) of the expert group completed the surveys. The highest ranked assessment topics for both groups were assessing intubated, ventilated patients and assessment of haemodynamically u...
A A bout 10% of Australia's approximately 110,000 people with Type 1 Diabetes Mellitus (T1DM) use... more A A bout 10% of Australia's approximately 110,000 people with Type 1 Diabetes Mellitus (T1DM) use continuous subcutaneous insulin infusion (CSII) therapy ("insulin pumps") rather than multiple daily injections (MDI) to deliver their essential insulin (1). As T1DM is a condition which often starts in childhood, almost half of Australian insulin pump users are under 25 years old (1). One of the major potential benefits of insulin pump use, which makes it so attractive for children and young adults, is the increased flexibility of lifestyle compared to multiple daily injection (MDI) insulin regimens (1-3), enabling them to live a more normal life. A holistic program which also aims to empower children with T1DM to live a more normal life is the diabetes camp. Camps specifically for children with T1DM have been running since the late 1920s (4), and in Australia since 1938. While there are many practical differences between the individual programs, one of their overarching aims is to empower children and adolescents to manage their lives with T1DM better (4). Paralleling the increasing number of insulin pump users in Australia, there has also been an increase in the number of children on insulin pumps attending diabetes camps. While there are many opportunities which accompany the growing prevalence of insulin pumps on diabetes camps, this growth has also brought many challenges.
ABSTRACT Hyperinflation of the lungs is a technique commonly employed by physiotherapists in the ... more ABSTRACT Hyperinflation of the lungs is a technique commonly employed by physiotherapists in the intensive care setting, Whilst there is extensive evidence to support the use of manual hyperinflation, there is limited evidence regarding the efficacy of ventilator hyperinflation, The aim of this study was to investigate the current physiotherapy practice of ventilator hyperinflation throughout Australia and New Zealand, A purpose-designed postal survey was distributed to senior physiotherapists in all intensive care units throughout Australia and New Zealand (n=189). A response rate of 87% was obtained (n=165). A minority of respondents (21 %, n=35/165) performed ventilator hyperinflation, A lack of training in ventilator hyperinflation was cited as the main barrier to use (44%, n=46/105). Ventilator hyperinflation was most commonly performed by a senior physiotherapist in a tertiary intensive care unit. When performed, ventilator hyperinflation was used as an alternative to manual hyperinflation, to allow improved monitoring and control of ventilator parameters (74%, n=25/34) and maintain positive end expiratory pressure (59%, n=20134). Ventilator hyperinflation is not commonly used by physiotherapists in intensive care units throughout Australia and New Zealand and considerable variability was found in its application between respondents, Further studies are required to define optimal parameters for ventilator hyperinflation and promote standardised delivery of this technique.
R R esearch studies have demonstrated that people with Type 1 diabetes derive greater glycaemic b... more R R esearch studies have demonstrated that people with Type 1 diabetes derive greater glycaemic benefit, specifically lower HbA1c levels, and possibly less hypoglycaemia, with use of real-time Continuous Glucose Monitoring (RT-CGM) to facilitate insulin dosing delivered by either continuous subcutaneous insulin infusion (CSII) therapy or multiple daily injections (MDI) (1-5). However glycaemic benefit, at least in clinical trials, relates to the number of days per week the person with diabetes uses RT-CGM, usually with 60-70% or more time wearing and reacting to the RT-CGM system being required to derive significant benefit (1,2). In the JDRF-CGM Study, significant predictors of HbA1c reduction after 6-months RT-CGM use were adulthood, high RT-CGM usage time when first commenced on the technology and frequent pre-CGM-study blood glucose monitoring (3). Although people with recurrent severe hypoglycaemia have often been excluded from RT-CGM-trials, RT-CGM is also associated with at least a trend to less severe hypoglycaemia (2) and less time with low interstitial fluid glucose (5). While there is strong clinical trial evidence indicating that continuous RT-CGM use is likely to improve glycaemia, because there are no subsidies for RT-CGM devices or sensors in our region (Australia), the few people with diabetes who use RT-CGM often do so episodically. However, we believe that a situation in which episodic RT-CGM use could be of benefit to people with Type 1 diabetes is for prolonged exercise such as long-distance running or cycling, and for safety critical situations in recreation (e.g. mountaineering, flying) or work (e.g. high altitude work or long-distance truck driving). There are few reports of such RT-CGM use, no clinical trials of which we are aware, and few recommendations available for such use of RT-CGM.
Annals of the American Thoracic Society, 2015
Rationale Patients surviving acute respiratory distress syndrome suffer decrements in physical fu... more Rationale Patients surviving acute respiratory distress syndrome suffer decrements in physical function and health-related quality of life (HR-QoL) however it is unclear whether HR-QoL is disproportionately affected in those with H1N1 influenza. Objectives The objective was to compare the HR-QoL of patients with a diagnosis of H1N1 influenza who were mechanically ventilated, twelve months following ICU with healthy population data and ICU survivor data. Methods A prospective, observational, binational, multi-centre cohort study was conducted in eleven ICUs in Australia and New Zealand during June-September, 2009. Eligible participants were mechanically ventilated in the ICU with a confirmed diagnosis of H1N1 influenza. People were excluded if aged < 18 years or could not speak English. Two validated HR-QoL questionnaires (Short Form-36 Version 2 (SF-36); the Assessment of Quality of Life (AQoL)) were administered one year following ICU. Measurements and main results Sixty-two patients (48% male) had median (IQR) age 42 (29 to 53) years, APACHE II score 18.0 (14 to 20); ventilation days 10.0 (4 to 23); ICU and hospital LOS 12.5 (7 - 27) and 20.0 (15 - 38) days respectively. Hospital mortality was 7% and 31% of the cohort received a tracheostomy. The mean (SD) health utility score at one year was 0.68 (0.30) compared to the healthy age-matched population (0.81 (0.23)). The mean (SD) SF-36 physical and mental component summary scores were within population normal ranges at 44.4 (12.3) and 45.5 (12.5) respectively. Conclusions Health-related quality of life of Australasian survivors of severe H1N1 influenza was comparable to the healthy population one year following ICU discharge. Consensus should be sought on standardization of follow-up time points and outcome measurement. Clinical trial registration The trial was registered with the Australian and New Zealand Clinical Trials Registry available at www.anzctr.org ACTRN12609001037291. Registered December 4th 2009.
Australian Health Review, 2015
Allied health professions have developed specialised advanced and extended scope roles over the p... more Allied health professions have developed specialised advanced and extended scope roles over the past decade, for the benefit of patient outcomes, allied health professionals’ satisfaction and to meet labour and workforce demands. There is an essential need for formalised, widely recognised training to support these roles, and significant challenges to the delivery of such training exist. Many of these roles function in the absence of specifically defined standards of clinical practice and it is unclear where the responsibility for training provision lies. In a case example of physiotherapy practice in the intensive care unit, clinical placements and independence of practice are not core components of undergraduate physiotherapy degrees. Universities face barriers to the delivery of postgraduate specialised training and, although hospital physiotherapy departments are ideally placed, resources for training are lacking and education is not traditionally considered part of healthcare s...
A learning needs analysis was performed using an online survey to establish the most appropriate ... more A learning needs analysis was performed using an online survey to establish the most appropriate curriculum for a simulation-based intensive care training programme for junior physiotherapists. Perceptions were compared between an intensive care-naïve ‘novice’ group of rotational physiotherapists from a single tertiary teaching hospital in Melbourne, Australia, and an ‘expert’ group of senior intensive care physiotherapists from across Australia. The learning needs analysis survey involved two questions. Question one required participants to rank assessment topics for perceived training importance from 1 (greatest) to 6 (least). Question two required participants to select which treatment topics from a list (total 15) they felt important for further training. 14/15 (93%) of the novice group, and 15/16 (94%) of the expert group completed the surveys. The highest ranked assessment topics for both groups were assessing intubated, ventilated patients and assessment of haemodynamically unstable patients. The highest rated treatment topics for both groups were lung hyperinflation, and rehabilitation. Based on these results and practical considerations, the subsequently developed simulation-based intensive care training programme comprised four modules: general assessment of an intensive care unit patient, assessment of haemodynamically unstable patients, positioning, and lung hyperinflation.
Infusystems Asia, Oct 18, 2013
Hyperinflation of the lungs is a technique commonly employed by physiotherapists in the intensive... more Hyperinflation of the lungs is a technique commonly employed by physiotherapists in the intensive care setting. Whilst there is extensive evidence to support the use of manual hyperinflation, there is limited evidence regarding the efficacy of ventilator hyperinflation. The aim of this study was to investigate the current physiotherapy practice of ventilator hyperinflation throughout Australia and New Zealand. A purpose-designed postal survey was distributed to senior physiotherapists in all intensive care units throughout Australia and New Zealand (n=189). A response rate of 87% was obtained (n=165). A minority of respondents (21%, n=35/165) performed ventilator hyperinflation. A lack of training in ventilator hyperinflation was cited as the main barrier to use (44%, n=46/105). Ventilator hyperinflation was most commonly performed by a senior physiotherapist in a tertiary intensive care unit. When performed, ventilator hyperinflation was used as an alternative to manual hyperinflation, to allow improved monitoring and control of ventilator parameters (74%, n=25/34) and maintain positive end expiratory pressure (59%, n=20/34). Ventilator hyperinflation is not commonly used by physiotherapists in intensive care units throughout Australia and New Zealand and considerable variability was found in its application between respondents. Further studies are required to define optimal parameters for ventilator hyperinflation and promote standardised delivery of this technique.
Conference Presentations by Daniel Seller
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Papers by Daniel Seller
Conference Presentations by Daniel Seller