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Objectives: To investigate the admission characteristics and hospital outcomes for Indigenous and non-Indigenous patients admitted to intensive units (ICUs) after major trauma.Design, Setting: Retrospective analysis of Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database data from 92 Australian ICUs for the 6-year period, 2010-2015.Participants: Patients older than 17 years of age admitted to public hospital ICUs with a primary diagnosis of trauma.Main Outcome Measures: ICU and overall hospital lengths of stay, hospital discharge destination, and ICU and overall hospital mortality rates for Indigenous and non-Indigenous patients.Results: 23 804 people were admitted to Australian public hospital ICUs after major trauma; 1754 (7.4%) were Indigenous Australians. The population-standardised incidence of admissions was consistently higher for Indigenous Australians than for non-Indigenous Australians (847 per million v 251 per million population; incidence ratio, 3.37; 95% CI, 3.19-3.57). Overall hospital mortality rates were similar for Indigenous and non-Indigenous patients (adjusted odds ratio [aOR], 1.04; 95% CI, 0.82-1.31). Indigenous patients were more likely than non-Indigenous patients to be discharged to another hospital (non-Indigenous v Indigenous: aOR, 0.84; 95% CI, 0.72-0.96) less likely to be discharged home (non-Indigenous v Indigenous: aOR, 1.17; 95% CI, 1.04-1.31).Conclusion: The population rate of trauma-related ICU admissions was substantially higher for Indigenous than non-Indigenous patients, but hospital mortality rates after ICU admission were similar. Indigenous patients were more likely to be discharged to a another hospital and less likely to be discharged home than non-Indigenous patients. [ABSTRACT FROM AUTHOR]

Objective: To estimate rates of respiratory syncytial virus (RSV)-associated hospitalisation across the age spectrum, and to identify groups at particular risk of serious RSV-associated disease.Design, Setting and Participants: Retrospective review of National Hospital Morbidity Database data for all RSV-associated hospitalisations in Australia, 2006-2015.Main Outcomes and Measures: RSV-coded hospitalisation rates by age, sex, Indigenous status, jurisdiction, and seasonality (month and year); hospital length of stay; in-hospital deaths.Results: During 2006-2015, there were 63 814 hospitalisations with an RSV-specific principal diagnostic code; 60 551 (94.9%) were of children under 5 years of age. The hospitalisation rate for children under 5 years was 418 per 100 000 population; for children under 6 months of age it was 2224 per 100 000 population; the highest rate was for infants aged 0-2 months (2778 per 100 000 population). RSV-coded hospitalisation rates were higher for adults aged 65 or more than for people aged 5-64 years (incidence rate ratio [IRR], 6.6; 95% CI, 6.2-7.1), and were also higher for Indigenous Australians than other Australians (IRR, 3.3; 95% CI, 3.2-3.5). A total of 138 in-hospital deaths were recorded, including 82 of adults aged 65 years or more (59%).Conclusions: Prevention strategies targeting infants, such as maternal or early infant vaccination, would probably have the greatest impact in reducing RSV disease rates. Further characterisation of RSV disease epidemiology, particularly in older adults and Indigenous Australians, is needed to inform health care strategies. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the incidence and demographic features of anterior cruciate ligament (ACL) reconstructions in Australia by age and sex, and to determine whether the incidence has changed during the past 15 years.Design and Setting: Descriptive epidemiological analysis of longitudinal data on ACL reconstructions (July 2000 - June 2015) in the National Hospital Morbidity Database.Main Outcome Measures: Population ACL reconstruction rates, by age group and sex.Results: 197 557 primary ACL reconstructions were performed during the study period; the annual incidence increased by 43% (from 54.0 to 77.4 per 100 000 population), and by 74% among those under 25 years of age (from 52.6 to 91.4 per 100 000 population). In males, the peak incidence in 2014-15 was for 20-24-year-olds (283 per 100 000 population); for females, it was for 15-19-year-olds (164 per 100 000 population). Annual growth in incidence was greatest in the 5-14-year-old age group (boys, 7.7%; girls, 8.8%). Direct hospital costs of ACL reconstruction surgery in 2014-15 were estimated to be $142 million. The annual incidence of revision ACL reconstructions increased from 2.49 (2000-01) to 5.65 per 100 000 population (2014-15), or by 5.6% per year; revisions as a proportion of all ACL reconstruction increased from 4.4% to 6.8%.Conclusions: The increasing incidence of ACL reconstructions in young Australians over 15 years is worrying. The individuals at greatest risk are men aged 20-24 years and women aged 15-19 years; the rate of reconstruction is increasing most rapidly among those aged 5-14 years. Revision rates are increasing more rapidly than those of primary reconstructions. [ABSTRACT FROM AUTHOR]

Keywords: Abortion; induced EN Abortion induced 375 376 2 10/19/21 20211015 NES 211015 It is difficult to estimate the abortion rate in Australia, as most states do not routinely report abortion data, and published national data have been incomplete.1 Consequently, some clinicians and academics have been accused of inflating reported rates for political reasons.2 National data have not been published in the peer-reviewed literature since 2005.3 However, "abortion with operating room procedure" (65 451 procedures) was reported to be the third most frequent surgical procedure in Victorian hospitals during January 2014 - December 2016.4 Prompted by this report, we sought to provide an updated estimate of the national abortion rate for women in Australia. Surgical abortion is a common medical procedure in Australia, but the rate has declined by 5.1% per year since the PBS listing of combination mifepristone/misoprostol. [Extracted from the article]

The article discusses a study of the effect of the national rotavirus vaccination (RV) program on hospitalization rates for rotavirus and acute gastroenteritis (AGE) in Australia. The researchers performed a retrospective assessment of the Australian Institute of Health and Welfare's National Hospital Morbidity database of AGE and rotavirus hospitalization records between July 1, 2001 and June 30, 2010. They found a decline in the number of rotavirus and AGE hospitalizations after RV.

The article discusses a study that seeks to investigate the portrayal of psychiatric genetics in Australian print news media published between 1996 and 2009. A total of 406 eligible items about the genetics of psychiatric disorders were systematically identified on the Factiva database and analyzed noting causal attributions. Results show the implications of excessive optimism in the power of genetic technology on psychiatric health care and perceived clinical benefits.

The article offers information on a study that deals with the scope, rationales, and evaluation foci of indigenous health curricula included in university-based professional training of health care service providers. The study gathered information from the Australian Medical Index, Aboriginal and Torres Strait Islander Health Bibliography, Medline, Scopus version 4,and Web of Science databases. It discovered evidence of efforts towards evaluating learner outcomes.

The article discusses the national emergency department data reference set developed based on Systematized Nomenclature of Medicine -- Clinical Terms (SNOMED CT) database. In particular, a purpose-built terminology for emergency departments (ED) and its impact on data collection in ED information systems is described. It stresses the importance of communication in patient safety within health care environments. It compares SNOMED CT with the codes of the International Classification of Diseases, 10th revision, Australian modification (ICD-10-AM).

Keywords: Poison control centers; Obesity; Legislation, drug; Poisoning EN Poison control centers Obesity Legislation, drug Poisoning 434 434 1 05/19/20 20200530 NES 200530 To the Editor: Rising obesity rates in high income countries have resulted in a growing demand for weight-loss products.[1] Unfortunately, drugs that increase energy expenditure often have severe adverse effects. 2,4-Dinitrophenol (DNP) uncouples oxidative phosphorylation, inducing a hyper-metabolic state. Russian roulette with unlicensed fat-burner drug 2,4-dinitrophenol (DNP): evidence from a multidisciplinary study of the internet, bodybuilding supplements and DNP users. [Extracted from the article]

The authors comment on the single entry and exit point model for a national intern allocation system in Australia. They cite the factors contributing to the increasing consistency among internship programs across Australia despite minor historical variations between states and territories. The single entry and exit point model involves the development of an online portal where internship applications can be submitted based on an agreed minimum set of data.

The article discusses of the benefits of and barriers to sharing health-services data in Australia. Data sharing refers to the process of facilitating access to data by research groups and other stakeholders who were not part of gathering the original data. A joint statement was signed by 17 funders of research from around the world to encourage data sharing from the research that they finance. These include several health-services databases in Australia that are kept by different groups.

The article discusses a review on a pathology department's electronic database for patients admitted with community-acquired pneumonia (CAP) to a tertiary referral center and two suburban teaching hospitals between May 1, 2007 and April 30, 2008. The review was done to study the usefulness of microbiological diagnostic testing for CAP and adopted Australia's CAP criteria for aetiology. The findings showed that aetiology can be established in up to 55% of patients and management changes can be done with the use of a combination of diagnostic tests.

Objective: To conduct a systematic review of the literature to identify existing online primary care quality improvement tools and resources to support organisational improvement related to the seven elements in the Primary Care Practice Improvement Tool (PC-PIT), with the identified tools and resources to progress to a Delphi study for further assessment of relevance and utility.Study Design: Systematic review of the international published and grey literature.Data Sources: CINAHL, Embase and PubMed databases were searched in March 2014 for articles published between January 2004 and December 2013. GreyNet International and other relevant websites and repositories were also searched in March-April 2014 for documents dated between 1992 and 2012.Study Selection: All citations were imported into a bibliographic database. Published and unpublished tools and resources were included in the review if they were in English, related to primary care quality improvement and addressed any of the seven PC-PIT elements of a high-performing practice. Tools and resources that met the eligibility criteria were then evaluated for their accessibility, relevance, utility and comprehensiveness using a four-criteria appraisal framework.Data Extraction and Synthesis: We used a data extraction template to systematically extract information from eligible tools and resources. A content analysis approach was used to explore the tools and resources and collate relevant information: name of the tool or resource, year and country of development, author, name of the organisation that provided access and its URL, accessibility information or problems, overview of each tool or resource and the quality improvement element(s) it addresses. If available, a copy of the tool or resource was downloaded into the bibliographic database, along with supporting evidence (published or unpublished) on its use in primary care.Conclusions: This systematic review identified 53 tools and resources that can potentially be provided as part of a suite of tools and resources to support primary care practices in improving the quality of their practice, to achieve improved health outcomes. [ABSTRACT FROM AUTHOR]