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Objective Studies of Australian health workforce demographics tend to be limited to single professions, a set geographic area, or based on incomplete data. This study aims to comprehensively describe changes to the demographic characteristics of Australia’s regulated health professions over 6 years. Methods Data were sourced from the Australian Health Practitioner Regulation Agency (Ahpra) registration database, and a retrospective analysis of 15 of the 16 regulated health professions between 1 July 2015 and 30 June 2021 was conducted. Variables including profession, age, gender and state/territory locations for the practitioners’ principal places of practice were analysed descriptively and via appropriate statistical tests. Results Changes in age, gender representation, and place of practice varied significantly and in different ways across the 15 professions. The total number of registered health practitioners increased by 141 161 (22%) from 2016 to 2021. The number of registered health practitioners per 100 000 population increased by 14% from 2016, with considerable variation across the professions. In 2021, women accounted for 76.3% of health practitioners across the 15 health professions, a significant increase of 0.5% points since 2016. Conclusions Changes to demographics, especially in ageing workforces and feminising professions, can have implications for workforce planning and sustainability. Future research could build on this demographic trend data by investigating causes or undertaking workforce supply or demand modelling.

The National Coronial Information System (NCIS) is the world's first national Internet-based database of coronial information. It was established in Australia following the recognition by coroners that their mandate for public health and safety could be improved if they could identify previous similar deaths. The NCIS is funded from state, territory, and commonwealth government agencies and overseen by the NCIS Board of Management. A team of ten staff manage the day-to-day operation of the system. The NCIS enables the rapid identification of up-to-date information on deaths investigated by the coroners' jurisdictions in Australia (from July 2000) and New Zealand (from July 2007). It is accessible to death investigators (coroners; forensic, medical, and scientific staff; and police) to assist with death investigation and approved third parties (e.g., researchers). The NCIS contains demographic information about the deceased, contextual information about the circumstances in which the death occurred, the cause and manner of death, and four full text reports generated during the investigation. The NCIS contains information on over 328 000 completed coroners' death investigations across Australia and New Zealand. Approximately 350 death investigators are registered to access the data for their ongoing death investigations, and 235 third party users are registered to utilize the data set in their research. In addition to the utility of the NCIS, this paper describes the rationale and governance structure of the NCIS, the information technology infrastructure, data set, quality assurance framework, and contribution to death and injury prevention.

ObjectivesTo determine whether sharing of routinely collected health service performance data could have predicted a critical safety failure at an Australian maternity service.DesignObservational quantitative descriptive study.SettingA public hospital maternity service in Victoria, Australia.Data sourcesA public health service; the Victorian state health quality and safety office—Safer Care Victoria; the Health Complaints Commission; Victorian Managed Insurance Authority; Consultative Council on Obstetric and Paediatric Mortality and Morbidity; Paediatric Infant Perinatal Emergency Retrieval; Australian Health Practitioner Regulation Agency.Main outcome measuresNumbers and rates for events (activity, deaths, complaints, litigation, practitioner notifications). Correlation coefficients.ResultsBetween 2000 and 2014 annual birth numbers at the index hospital more than doubled with no change in bed capacity, to be significantly busier than similar services as determined using an independent samples t-test (pr2=0.18, p=0.003). Independent samples t-tests demonstrated that the rates of emergency neonatal and perinatal transfer were both significantly lower than similar services (both pConclusionWhile clinical activity data and direct-to-service patient complaints appear to offer promise as potential predictors of health service stress, complaints to regulators and medicolegal activity are less promising as predictors of system failure. Significant changes to how all data are handled would be required to progress such an approach to predicting health service failure.

Oxycodone is one of the most abused prescription drugs. Iatrogenic factors that lead to oxycodone-related death, such as mis-prescribing, present an opportunity for death prevention if identified early. This study investigated deaths involving oxycodone in Australia to explore potentially inappropriate prescribing and the coroner’s investigation. The National Coronial Information System identified cases from 2001 to 2011 where oxycodone was detected by toxicological analysis. There were 806 oxycodone-related deaths, with a significant increase in the 11-year period, from 21 deaths in 2001, up almost sevenfold in 2011 (139 deaths). Most deaths were caused by combined drug toxicity (63.4 %) or oxycodone toxicity alone (11.8 %). Most individuals were male (59.1 %), aged 35–44 years (26.7 %), who died unintentionally (56.4 %), with mental illness (52.1 %) and/or a history of acute or chronic pain (46.2 %). 312 cases (39 %) described a legitimate prescription for oxycodone, of which most involved non-cancer related chronic pain. About three quarters of the indications were deemed appropriate. There were at least 43 different indications treated with oxycodone that were inappropriate. The majority of oxycodone-related cases involved minor to no description of the drugs involved (n = 600; 74.4 %). A moderate description of oxycodone involvement was given in 162 cases (20.1 %), while only 44 cases (5.5 %) involved a thorough examination and recommendations from the coroners on oxycodone and other drugs involved in death. This study emphasized the need for medical practitioners to exercise caution when prescribing oxycodone and for coroners to provide more consistent and detailed information regarding drug use, in order to identify and implement preventive strategies.

The National Coronial Information System (NCIS) database contains information about every death reported to an Australian coroner from July 2000 up to today, making it an invaluable source of information for coroners and death investigators alike. With over 80 current research projects across Australia, covering a broad range of public health topics, the database is recognised as an essential national statistical …

The post mortem redistribution of ten commonly prescribed antipsychotic drugs (APs) was investigated. Femoral blood was collected from 273 cases at admission to mortuary (AD) and at post-mortem (PM). The PM samples were collected at various times up to nine days after admission and the sample pairs analysed using LC-MS/MS. The drugs included in this study were 9OH-risperidone (paliperidone), amisulpride, chlorpromazine, clozapine, haloperidol, olanzapine, promethazine, quetiapine, risperidone, and zuclopenthixol. Haloperidol, quetiapine and risperidone showed minimal changes between AD and PM specimens, whereas the majority of drugs showed significant changes between the sample pairs collected at different time points post mortem (p

Olanzapine (OLZ) is amongst the most commonly prescribed antipsychotic drugs and is associated with substantial instability. The aim of this study was to investigate the instability of OLZ and to identify the degradants formed from its breakdown. Three experiments were conducted to monitor the degradation of OLZ and the formation of degradants in blood (1), water (2), and post-extraction at 4 °C (3). All three sample sets were analysed in duplicate and repeated in the absence (A) and presence (B) of 0.25% ascorbic acid. One degradant was identified in sample sets 2A and 3A with m/z 329 and confirmed as 2-hydroxymethyl-OLZ (2-OH-OLZ) using LC-MS techniques. The addition of 0.25% ascorbic acid slowed the degradation of OLZ down in all three experiments and inhibited the formation of 2-OH-OLZ in sample sets 2A and 3A. To investigate the influence of oxygen on the degradation of OLZ and the formation of 2-OH-OLZ in water, an additional experiment (4) was conducted. Sample sets were prepared containing different vortexing or sonication steps in order to alter the oxygen content in the samples. Statistical analysis confirmed that degradation increased significantly following vortexing for 1 min while sonication did not affect the rate of degradation of OLZ further suggesting the involvement of oxygen in the degradative processes. 2-OH-OLZ was only identified as a degradant of OLZ in aqueous solutions. It also degrades over time but its product is currently unknown and is under investigation.

Antipsychotic drugs (APs) are prescribed for a wide range of psychotic illnesses. With more than 35 APs currently available worldwide, this drug class has rapidly gained importance in both clinical and forensic settings. On account of their chemical properties, many APs are present in human specimens at very low concentrations, which complicate their detection using standard gas chromatography–mass spectrometry (GC-MS) procedures that often cannot provide the required sensitivity. Recent advances in liquid chromatography-(tandem) mass spectrometry LC-MS(/MS) technology have enabled accurate detection and quantification of these compounds in various human specimens, indicated by the increasing number of published methods. Method validation has been a particular focus of analytical chemistry in recent times. Recommendations set by several guidance documents are now widely accepted by the toxicology community, as reflected by the guidelines drafted by leading toxicological societies. This review provides a critical review of single-stage and tandem LC-MS procedures for the detection and quantification of APs, with a particular emphasis on appropriate method validation. The quality of published methods is inconsistent throughout the literature. While the majority of authors incorporate some validation experiments in their respective method development, a large number of published methods lack essential components of method validation, which are considered mandatory according to the guidelines. If adapting a method for the detection of APs for use in a laboratory, analysts should ensure successful validation experiments for appropriateness and completeness have been conducted, and perform additional experiments when indicated. Copyright © 2012 John Wiley & Sons, Ltd.

Antipsychotic drugs are frequently associated with sudden death investigations. Detection of these drugs is necessary to establish their use and possible contribution to the death. LC-MS(MS) methods are common; however accurate and precise quantification is assured by using validated methods. This study compared extraction efficiency and matrix effects using common liquid-liquid and solid-phase extraction procedures in both ante-mortem and post-mortem specimen using LC-MS-MS. Extraction efficiencies and matrix effects were determined in five different blank blood specimens of each blood type. The samples were extracted using a number of different liquid-liquid extraction methods and compared with a standard mixed-mode solid-phase extraction method. Matrix effects were determined using a post-extraction addition approach-the blank blood specimens were extracted as described above and the extracts were reconstituted in mobile phase containing a known amount of analytes. The extraction comparison of ante-mortem and post-mortem blood showed considerable differences, in particular the extraction efficiency was quite different between ante-mortem and post-mortem blood. Quantitative methods used for determination of antipsychotic drugs in post-mortem blood should establish that there are no differences in extraction efficiency and matrix effects, particularly if using ante-mortem blood as calibrator.

The aim of this study was to develop an LC-MS/MS based screening technique that covers a broad range of acidic and neutral drugs and poisons by combining a small sample volume and efficient extraction technique with simple automated data processing. After protein precipitation of 100μL of whole blood, 132 common acidic and neutral drugs and poisons including non-steroidal anti-inflammatory drugs, barbiturates, anticonvulsants, antidiabetics, muscle relaxants, diuretics and superwarfarin rodenticides (47 quantitated, 85 reported as detected) were separated using a Shimadzu Prominence HPLC system with a C18 separation column (Kinetex XB-C18, 4.6mm×150mm, 5μm), using gradient elution with a mobile phase of 25mM ammonium acetate buffer (pH 7.5)/acetonitrile. The drugs were detected using an ABSciex(®) API 2000 LC-MS/MS system (ESI+ and -, MRM mode, two transitions per analyte). The method was fully validated in accordance with international guidelines. Quantification data obtained using one-point calibration compared favorably to that using multiple calibrants. The presented LC-MS/MS assay has proven to be applicable for determination of the analytes in blood. The fast and reliable extraction method combined with automated processing gives the opportunity for high throughput and fast turnaround times for forensic and clinical toxicology.

Over the last 60 years extensive development has occurred in the ­pharmacological treatment of mental illnesses with currently over 40 different ­compounds being prescribed.

The stability of 30 common antipsychotics (APs) in spiked whole blood was investigated over ten weeks in a preliminary experiment (designated "P experiment"). Pools of blank blood spiked with drugs at two different therapeutic levels were stored at four different temperatures: 20 °C, 4 °C, -20 °C, and -60 °C and extracted once weekly in duplicate, using a previously published method. A loss of >15% of the initial drug concentration was considered to indicate possible instability and the respective drugs were selected for further investigation in a final experiment (designated "F experiment"). Eight APs (chlorpromazine, chlorprothixene, fluspirilene, droperidol, olanzapine, thioridazine, triflupromazine, and ziprasidone) were incorporated into the F experiment. The same conditions were used in both experiments, however only a high therapeutic drug concentration was chosen for the F experiment and the storage time was extended to 20 weeks. All drugs of interest in the F experiment showed significant losses after 20 weeks of storage under at least one storage condition. The most notable results involved olanzapine, where losses of almost 100% in all storage temperatures were observed. Drug degradation in fluspirilene samples was significant after 20 weeks under all storage conditions. Overall, extensive degradation was seen with approximately 80% drug loss when stored at 20 °C and 4 °C with samples also seriously affected by degradation of up to 50% when stored at -20 °C and -60 °C, respectively. Ziprasidone remained stable when stored at 4 °C, -20 °C, and -60 °C over 9 weeks, however significant degradation was observed when stored at 20 °C, with a loss of almost 100% after 20 weeks of storage. The time period and temperature of storage of biological samples can have a significant influence on the stability of several APs. It is therefore important to be aware of potential changes in drug concentrations during storage when interpreting analytical results.

Over the last decade, the prescription rates of antipsychotic (AP) drugs have increased worldwide. Studies have shown that the risk of sudden cardiac death is threefold higher among patients treated with APs. To investigate the presence of APs in postmortem cases, a liquid chromatography (LC)-MS/MS method was developed using only 0.1 ml of blood sample with 10 microl of internal standard (IS) (haloperidol-d(4), 1 microg/ml). After the addition of 0.2 ml of Trizma buffer, the blood sample was extracted using liquid-liquid extraction (LLE) with 1 ml of 1-chlorobutane for 5 min on a shaker at 1500 rpm. After centrifugation at 12,000 rpm for 1 min, the separated solvent layer was transferred to an autosampler vial and evaporated to dryness under N(2). The residue was reconstituted in 0.05 ml acetonitrile containing 0.1% formic acid, vortexed for 30 s and an additional 0.45 ml of 50 mmol/l ammonium formate pH 3.5 was added and the sample vortexed; 0.1 ml of the final extract was injected into a Shimadzu Prominence HPLC system, with detection of drugs achieved using an Applied Biosystems 3200 Q-TRAP LC-MS/MS system equipped with a Turbo V ion source [electron spray ionization (ESI), multiple reaction monitoring (MRM) mode]. The method has been validated according to international guidelines and was found to be selective for all tested compounds. Calibration was satisfactory for all drugs, except olanzapine, from subtherapeutic to toxic concentrations. The lower limits of quantifications (LLOQs) corresponded to the lowest concentrations used for the calibration curves. With the exception of the lowest concentrations of bromperidol, buspirone and perphenazine, accuracy data were within the acceptance interval of +/- 15% (+/- 20% at LLOQ) of the nominal values for all drugs. The method has been proven to be useful for the routine analysis of APs in postmortem blood samples.

In our publication we present a fingerprint watermark for the compressed video formats MPEG1/2 to ensure customer identification. The basic customer information is a watermark, which was developed for still images. We transfer it into the video area and adjust it to the special facts of MPEG video to be resistant against coalition attacks.

Digitale Wasserzeichenverfahren stellen eine Technologie zur Verfugung, die den Nachweis der Urheberschaft von geschutzten Datenmaterial und die Ruckverfolgung illegaler Kopien zum Kopierer ermoglichen. Das Einbringen von eindeutigen kundenspezifischen Markierungen in das Datenmaterial als Wasserzeichen wird als digitaler Fingerabdruck (digital fingerprinting) bezeichnet und erlaubt die Ruckverfolgung einer illegalen Kopie zum Verursacher der Urheberrechtsverletzung. Wasserzeichen mussen den Urheber oder den rechtmasigen Kunden eindeutig identifizieren und die eingebrachte Kennzeichnung darf nur sehr schwer und unter Zerstorung der relevanten Eigenschaften des Werkes entfernbar sein. Das Einbringen von Fingerabdrucken zur kundenspezifischen Kennzeichnung des Datenmaterials mittels Wasserzeichenverfahren eroffnet das Problem, das unterschiedliche Kopien des Datenmaterials erzeugt werden. Angreifer, die die Markierung zerstoren wollen, um eine Verfolgung der illegalen Kopien unmoglich zu machen, konnen ihre unterschiedlichen Kopien vergleichen und die gefundenen Unterschiede manipulieren. In den meisten Fallen wird dadurch die eingebrachte Information zerstort. In diesem Beitrag beschreiben wir die Moglichkeit der Erstellung von kollisions-sicheren Fingerabdrucken basierend auf endlichen Geometrien und einen Wasserzeichenalgorithmus mit speziellen Markierungspositionen, in denen die generierten Fingerabdrucke als kundenspezifische Kennzeichnung eingebracht werden. Bei einem Vergleichsangriff auf mehrere kundenspezifische Kopien konnen die Angreifer nur die Unterschiede in den Markierungspunkten feststellen, in denen der eingebrachte Fingerabdruck nicht identisch ist. Die verbleibende Schnittmenge der Fingerabdrucke bleibt erhalten und liefert Informationen uber die Angreiferkunden. Die vorgestellte Technik zur Erzeugung von kundenspezifischen Fingerabdrucken kann bis zu d Piraten aus der Schnittmenge von maximal d Fingerabdrucken identifizieren.

In response to personal correspondence with Robert J. Flanagan, the authors would like to make the following correction to the abovepaper:When investigating the post-mortem redistribution of orally administered clozapine in the domestic pig, Flanagan and colleagues [1]observed an increase of drug blood concentration over 48 h post sacrifice in central and peripheral vessels. We stated incorrectly in ourpublication that followingan initialincrease inconcentration,the bloodconcentrationsshowed a decrease24 hpost-dose,withclozapineno longer detectable in one of the investigated pigs – this in fact referred to studies in living pigs.The decrease in clozapine in our study was only seen after four days, well after the maximum time studied by Flanagan et al.The authors would like to apologise for any inconvenience caused.Reference

Annotatsioon. Luudi keel on uks vahem uuritud ja dokumenteeritud ning samal ajal uks ohustatumaid laanemeresoome keeli. Artikkel esitab ulevaate 2012. aastal keskluudi alal toimunud Tartu Ulikooli keeleteadlaste valitoode tulemustest ning on suunatud eelkoige keeleteadlastele, kuid ka ajaloolastele, etnoloogidele ning keelesotsioloogidele. Artikli esimeses osas esitatakse hinnang keskluudi murde konelejaskonna suuruse kohta tanapaeval. Teine osa sisaldab keelelist analuusi, mis keskendub haabuva murde nuudisaegsele struktuurile – peamiselt fonoloogiale ja morfoloogiale. Toodud andmed taiendavad seniseid teadmisi keskluudi murde sisemisest liigendusest. Eraldi tahelepanu puhendatakse ka keelekontakti ilmingutele murdegrammatikas, eelkoige sellistele, mis on teoreetiliselt valjakutsuvad. Artiklis lopus esitatakse vaadeldava murdeala keelenaiteid. Votmesonad: deskriptiivne keeleteadus, ohustatud keeled, keelekontaktid, keele dokumenteerimine, luudi keel, fonoloogia, morfoloogia

To examine trends in codeine-related mortality rates in Australia, and the clinical and toxicological characteristics of codeine-related deaths.Analysis of prospectively collected data from the National Coronial Information System on deaths where codeine toxicity was determined to be an underlying or contributory cause of death. The study period was 2000-2013.Population-adjusted numbers (per million persons) of (1) codeine-related deaths, classified by intent (accidental or intentional); and (2) heroin- and Schedule 8 opioid-related deaths (as a comparator).The overall rate of codeine-related deaths increased from 3.5 per million in 2000 to 8.7 per million in 2009. Deaths attributed to accidental overdoses were more common (48.8%) than intentional deaths (34.7%), and their proportion increased during the study period. High rates of prior comorbid mental health (53.6%), substance use (36.1%) and chronic pain (35.8%) problems were recorded for these deaths. For every two Schedule 8 opioid-related deaths in 2009, there was one codeine-related death. Most codeine-related deaths (83.7%) were the result of multiple drug toxicity.Codeine-related deaths (with and without other drug toxicity) are increasing as the consumption of codeine-based products increases. Educational messages are needed to better inform the public about the potential harms of chronic codeine use, especially in the context of polypharmacy.