Australasian Medical Journal
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Risks of Alcohol-Attributable Hospitalisation and Death in Australia Over Time.
Get PDFBackgroundPast reports on trends of alcohol consumption and related harm have generally been descriptive in nature and have not provided evidence of whether changes over time are significant. AimsWe investigated whether: (i) the risk of alcohol-attributable hospitalisation and death between 1994 and 2005 for three different age groups changed significantly across all Australian jurisdictions; and (ii) the relative rates of hospitalisation for males and females changed over time. Method Estimates of alcohol-attributable hospitalisations and deaths were calculated using the aetiologic fraction method. Hospitalisations and deaths were grouped by age: 15-29 years, 30-44 years and 45+ years. Risk estimates and risk differences were analysed using Poisson regression. ResultsRisk of alcohol-attributable hospital separations increased nationally and across most jurisdictions throughout the study period. Male and female rates converged over time. Alcohol-attributable deaths decreased nationally across the three age groups and across several jurisdictions beginning in the mid-1990s.ConclusionNationally, alcohol-attributable deaths declined while hospitalisations rose. However, states with higher population density tended to drive national rates, with considerable variation by jurisdiction. The conditions which dominated hospitalisations (e.g. alcohol dependence, falls) differed substantially from those underlying alcohol-attributable deaths (e.g. alcoholic liver cirrhosis, road crashes). Jurisdictional variation in death and hospitalisations rates as well as changes over time may be partly due to differences in: regulation of alcohol supply; patterns and levels of alcohol consumption; the nature and effectiveness of law enforcement; demographic characteristics of general and sub-populations; and medical health services and screening for chronic conditions
Acute Ischaemic Stroke Prediction from Physiological Time Series Patterns
Get PDFBackgroundStroke is one of the major diseases with human mortality. Recent clinical research has indicated that early changes in common physiological variables represent a potential therapeutic target, thus the manipulation of these variables may eventually yield an effective way to optimise stroke recovery.AimsWe examined correlations between physiological parameters of patients during the first 48 hours after a stroke, and their stroke outcomes after 3 months. We wanted to discover physiological determinants that could be used to improve health outcomes by supporting the medical decisions that need to be made early on a patient’s stroke experience.Method We applied regression-based machine learning techniques to build a prediction algorithm that can forecast 3-month outcomes from initial physiological time series data during the first 48 hours after stroke. In our method, not only did we use statistical characteristics as traditional prediction features, but also we adopted trend patterns of time series data as new key features.ResultsWe tested our prediction method on a real physiological data set of stroke patients. The experiment results revealed an average high precision rate: 90%. We also tested prediction methods only considering statistical characteristics of physiological data, and concluded an average precision rate: 71%.ConclusionWe demonstrated that using trend pattern features in prediction methods improved the accuracy of stroke outcome prediction. Therefore, trend patterns of physiological time series data have an important role in the early treatment of patients with acute ischaemic stroke
Bacterial Contamination of Unused, Disposable Non-sterile Gloves on a Hospital Orthopaedic Ward
Get PDFBackgroundNon-sterile disposable gloves are used on large hospital wards, however their potential role as a vehicle for pathogen transmission has not been explored in this setting. AimsThis study investigates glove use on a hospital orthopaedic ward to examine whether pathogen contamination occurs prior to contact with patients.Method Glove samples were aseptically removed from boxes on a hospital orthopaedic ward on opening and days 3, 6 and 9 thereafter. Following elution of bacteria and viable counts, glove isolates were identified by standard techniques and 16s rDNA sequencing. Methicillin resistance of staphylococci was determined by disc diffusion,Epsilon tests and PCR. Gloves were inoculated to determine two isolate survival rates.ResultsTotal bacterial counts ranged from 0 to 9.6 x 103 cfu/glove. Environmental bacteria, particularly Bacillus species, were present on 31/38 (81.6%) of samples. Half (19/38) the samples were contaminated with skin commensals; coagulase negative staphylococci were predominant. Enterococcus faecalis, Klebsiella pneumoniae, Pseudomonas sp. or methicillin susceptible Staphylococcus aureus were recovered from 5/38 (13.2%) of samples. Significantly more skin commensals and pathogens were recovered from samples from days 3, 6, 9 than box-opening samples. Staphylococcus epidermidis and Klebsiella pneumoniae inoculated onto gloves remained viable for several days but counts decreased. ConclusionHealth-care workers introduced skin commensals and pathogenic bacteria into glove boxes indicating that unused, non-sterile gloves are potential pathogen transmission vehicles in hospitals. Findings highlight adherence to hand-washing guidelines, common glove retrieval practice, and glove-box design as targets for decreasing bacteria transmission via gloves on hospital wards
‘I mean I expect that it’s pretty safe’: Perceptions of food trust in pregnancy – implications for primary health care practice
Get PDFBackgroundPregnancy is a time in which food choice is of particular importance. Trust in the food supply and those who regulate it is receiving greater acknowledgement because of the influence of trust on food choice. No prior investigation into pregnant women and food trust has been conducted.AimsThis paper identifies factors that determine the nature and extent of pregnant women’s trust in food; sources of information which influence pregnant women’s food choices; and how trust impacts on pregnant women’s food choices. MethodIn-depth interviews were conducted with 13 pregnant women; nine were pregnant with their first child and four were in their second or subsequent pregnancy.ResultsFood choices of pregnant women were predominantly influenced by nutrition and perceived quality of food. Risk-taking behaviour, such as the consumption of foods considered high risk during pregnancy, was common amongst participants. The sample was characterised by a dependence on expert information, limited reflexivity in relation to food safety, and contradictory practice such as risk-taking behaviours in regard to high risk foods were observed. ConclusionFurther research is needed to confirm findings in this study. Research into consumption of high-risk foods and the information received from healthcare providers would be useful in creating a clearer understanding of whether provision of information is sufficient in communicating risks and promoting a healthy pregnancy.
Efficacy of podcasts as a supplementary teaching aid and assessment of its perceived utility in first year dental students
No full textBackgroundThe advent of newer technology and students’ growing familiarity with it has enabled information providers to introduce newer teaching methods such as audio podcasting in education. Inclusion of audio podcasts as a teaching aid for undergraduate medical or dental students could serve as a useful supplement to make reviewing more convenient and to enhance understanding and recall of the subject matter. Aims1. To assess the efficacy of podcasts as a supplementary teaching and learning aid for first-year dental students of Manipal. 2. To study students’ attitudes towards audio podcasts and perceived utility of podcasts.MethodThis study was conducted at the Manipal College of Dental Sciences, India. The participants were first-year dental students. Live lecture classes were conducted for the students (n=80). The students were then divided randomly into two equal groups of 40 each. Group 1 students (n=40) had a study session followed by a multiple choice question (MCQ) test. This was followed by a podcasting session. Group 2 students had a study session along with an opportunity to listen to a podcast, followed by the test. Following this both groups completed a feedback form intended to assess their perceived utility and attitude towards podcasts. The performance score was analysed using SPSS and an independent sample t test was used to test the significance of differences in the mean score between the two groups.ResultsOur analysis revealed a significant difference (p = 0.000) in the mean score between the two groups. Group 1 scored a mean of 7.95 out of 13 and group 2 scored a mean of 6.05 out of 13. Analysis of the feedback forms showed that 91.3 per cent of the students found the podcasts useful, as they could listen to lecture content repeatedly and at their own convenience. Sixty-three per cent of the students, however, felt that the absence of images and diagrams in podcasts was a disadvantage.ConclusionStudents benefited when podcasts were used to supplement live lectures and textbook content. This was indicated by better student performance in the podcast group. Also, students showed a favourable attitude for podcasts being used as a supplementary teaching and learning aid
Life Threatening Rhabdomyolysis Following the Interaction of two Commonly Prescribed Medications
Get PDFWe report an interaction between erythromycin and simvastatin resulting in life-threatening rhabdomyolysis in an elderly patient. Drugs that inhibit CYP3A4 enzyme can cause elevated serum levels of statins which amplifies the risk of statin-induced rhabdomyolysis. Physicians should be aware of potential drug interactions of statins, which are widely used in the community
Physician’s Preparedness for Tobacco Cessation Service in India
Get PDFBackgroundA total of 275 million tobacco users live throughout India and are in need of tobacco cessation services. However, the preparation of physicians to deliver this service at primary care health facilities remains unknown.AimsThe study aimed to examine the primary care physicians’ preparedness to deliver tobacco cessation services in two Indian states.Method Researchers surveyed physicians working in primary care public health facilities, primarily in rural areas using a semi-structured interview schedule. Physicians’ preparedness was defined in the study as those possessing knowledge of tobacco cessation methods and exhibiting a positive attitude towards the benefits of tobacco cessation counselling as well as being willing to be part of tobacco prevention or cessation program.ResultsOverall only 17% of physicians demonstrated adequate preparation to provide tobacco cessation services at primary care health facilities in both the States. The findings revealed minimal tobacco cessation training during formal medical education (21.3%) and on-the-job training (18.9%). Factors, like sex and age of service provider, type of health facility, location of health facility and number of patients attended by the service provider, failed to show significance during bivariate and regression analysis. Preparedness was significantly predicted by state health system.ConclusionThe study highlights a lack of preparedness of primary care physicians to deliver tobacco cessation services. Both the curriculum in medical school and on-the-job training require an addition of a learning component on tobacco cessation. The addition of this component will enable existing primary care facilities to deliver tobacco cessation services