Research

A cross-sectional survey of Tasmanian students aged 8–13 years finds that mandatory iodine fortification of bread appears to have achieved the goal of significantly improving iodine status in this population. However, further research is needed to assess the effects of mandatory fortification in pregnant and breastfeeding women.

Kate M DePaoli BSc(Hons)(Diet) · Judy A Seal BAppSci, GradDipDiet, MPH · John R Burgess FRACP, MD, PhD · Roscoe Taylor MB BS, FAFPHM, GradDipEpid

A survey of Royal Australasian College of Surgeons trainees suggests that although many trainees are interested in pursuing part-time surgical training, very few have obtained accredited positions to do so. In a related commentary, the RACS censor-in-chief acknowledges the desire of trainees for flexible training, and describes what the College is doing to help meet this need.

Rachel E McDonald BSc · Amy E Jeeves MB BS, BMedSci(Hons), FRACS(Plast) · Carolyn E Vasey MB BS, BMedSci · Deborah M Wright BMedSc, MB ChB · Gregory O’Grady BHB, MB ChB, PhD

Establishing part-time surgical training posts may be difficult, but evidence suggests it is possible and increasingly necessaryThe study by McDonald and colleagues confirms previous reports in Australia and elsewhere that there is a significant difference between the number of trainees who are undertaking some of their surgical training part-time and those who would be interested in doing so.1 It cannot be denied that doctors entering a ...

Simon A Williams MB BS, FRACS, FAOrthA

Objective: To assess the current frequency of sunburn, a preventable risk factor for skin cancer, among Queensland adults.Design and setting: Cross-sectional population-based surveys of 16 473 residents aged ≥ 18 years across Queensland in 2009 and 2010.Main outcome measures: Proportion of the adult population reporting sunburn (skin reddening lasting 12 hours or more) during the previous weekend, by age, sex and other risk factors.Results: ...

Adèle C Green MB BS, PhD, FAAPHM · Louise Marquart BSc, BEcon, BAppSc(Hons) · Susan L Clemens BA, MPH · Catherine M Harper BSc, MPH · Peter K O’Rourke BSc(Hons), BA(Hons), PhD

A 14-year study of patients with M. ulcerans disease treated with surgery alone in a Victorian hospital found that the disease recurred in about a third of patients, with recurrence most often associated with immunosuppression or positive histological margins on excised lesions.

Daniel P O’Brien MB BS, FRACP · Aaron Walton MD, FRACP · Andrew J Hughes MB BS, FRACP · N Deborah Friedman MB BS, FRACP, MD · Anthony McDonald MB BS, FRACS · Peter Callan MB BS, FRACS · Richard Rhadon MB BS, FRACS · Ian Holten MB BS, FRACS · Eugene Athan MB BS, FRACP, MPH

This study suggests that recent media reports and public concern about concussion sustained during sport are valid, as the frequency of hospitalisation for concussed players in Victoria increased significantly between 2002–03 and 2010–11, with substantial associated economic costs.

Caroline F Finch BSc(Hons), MSc, PhD, · Angela J Clapperton M(Counsel), GradDipEdPsych, BSc(Behav) · Paul McCrory MB BS, PhD, FRACP

Although only a small proportion of cases of influenza in hospitalised patients in 2010–2011 were nosocomial, the outcomes could be severe. All nosocomial cases occurred in patients with chronic comorbidities for whom influenza vaccination is recommended, but two-thirds of patients had not been vaccinated.

on behalf of the FluCAN investigators

A NSW study found low rates of self-reported influenza vaccine uptake in pregnant women. Women who had received a recommendation to have the vaccine were 20 times more likely to have been vaccinated, but less than half recalled receiving such a recommendation. Most of the women who expressed safety concerns about the vaccine indicated they would have the vaccine if their doctor recommended it.

Kerrie E Wiley MScMed(ClinEpid) · Peter D Massey DrPH, GCPH, RN · Spring C Cooper BS, PhD · Nicholas J Wood MB BS, FRACP, PhD · Jane Ho BMed, FRACP, MPH · Helen E Quinn BSc(Hons), MAppEpid, PhD · Julie Leask PhD, MPH

The custodial environment poses challenges for infectious disease management. This study examines the prevalence of susceptibility to measles, mumps, rubella, varicella and hepatitis B virus among people entering prisons in NSW.

Sarah Larney BA, BSc(Hons), PhD · Denise L Monkley BNSc(Hons), MPH · Devon Indig PhD, MPH, BSc · Stephen E Hampton MB BS, MPH, FRACGP

The results of this 12-month assessment provide a compelling rationale that more needs to be done to improve diet and nutrition in remote communities.

Julie K Brimblecombe GradDipNut · Megan M Ferguson BSc, GradDipNut · Selma C Liberato GradDipNut · Kerin O’Dea BSc, PhD

Research into the likelihood of in-flight measles transmission enables an assessment of the effectiveness of current contact-tracing guidelines.

Veronica C Hoad MB BS, MPH · Bridget A O’Connor BAppSc, MPH, MAppEpid · Andrew J Langley MB BS, FAFOEM, FAFPHM · Gary K Dowse MB BS, MScEpid, FAFPHM

A cohort comparison of colorectal cancer patient data from the National Bowel Cancer Screening Program register and the South Australian Cancer Registry found that cancers were diagnosed at a significantly earlier stage in people invited to the screening program compared with those who were not invited. A further shift towards earlier stage was seen in those who participated in screening and those with positive test results compared with the rest of the study population.

Stephen R Cole BSc, MPH · Graeme R Tucker BSc · Joanne M Osborne MPH · Susan E Byrne BN · Peter A Bampton MD, FRACP, AGAF · Robert J L Fraser MB BS, FRACP, PhD · Graeme P Young MD, FRACP, FTSE

About 50% of medical graduates who completed their degrees between 2006 and 2010 undertook international medical electives, of which more than half were in developing countries. The authors highlight that formal predeparture training and postelective debriefing (offered by 12 and eight of the 16 medical schools involved in the study, respectively) should be scaled up to help students make the most of these experiences.

Iain R Law BSc, MSc · Paul S Worley MB BS, PhD, FACRRM · Freya J Langham BMedSci(Hons)

An antibiotic stewardship program in a tertiary referral hospital immediately reduced use of broad-spectrum antibiotics but will it stand the test of time?

Kelly A Cairns BPharm, GradDipClinPharm · Adam W J Jenney MB BS, FRACP, FRCPA · Iain J Abbott MB BS · Matthew J Skinner MB BS, FRACP · Joseph S Doyle MB BS, MSc, FRACP · Michael Dooley BPharm · Allen C Cheng MPH, PhD, FRACP

After the detection of four clusters of gram-negative bacteria harbouring the MBL gene blaIMP-4 in an intensive care unit, an epidemiological investigation uncovered an environmental reservoir of the organisms that proved difficult to clean up.

Despina Kotsanas BSc(Hons), MClinEpi · W R P L I Wijesooriya MB BS, MD, MPhil · Tony M Korman MB BS, FRACP, FRCPA · Elizabeth E Gillespie BN, MPubHlth · Louise Wright BN · Kylie Snook BN · Natalie Williams BN · Jan M Bell BSc · Hua Y Li MMed · Rhonda L Stuart MB BS, PhD, FRACP

Objectives: To determine research priorities of infectious diseases physicians for clinician-initiated randomised controlled trials (RCTs).Design, setting and participants: Online survey of infectious diseases physicians in Australia and New Zealand.Main outcome measures: Research priorities for, and perceived barriers to, clinician-initiated RCTs.Results: 122/550 infectious diseases physicians (22%) responded to the survey. The five highest ranked proposals for clinician-initiated RCTs were ...

on behalf of the Steering Group of the Australasian Society for Infectious Diseases Clinical Research Network*

Eight years after the first Bali bombing, a cross-sectional study of Australians who were directly affected by the attacks found that they tended to have good physical health but high rates of psychological distress.

Garry J Stevens BSc(Hons), MClinPsych, MAPS · Julie C Dunsmore BSc(Psych)(Hons), MPH, MAPS · Kingsley E Agho BSc(Hons), PhD, MPH · Melanie R Taylor BSc(Hons), PhD, CPsychol · Alison L Jones MD, FRCP, FRCPE · Jason J van Ritten BSc(Hons), GradCertSRM · Beverley Raphael MB BS, MD, FRANZCP

A retrospective study shows that microbiologically confirmed hookworm infection is now a rare event in the NT, persisting mainly in adults outside the target group of the community children’s deworming program.

Jane Davies* MB BS, MRCP(UK), DTM · Suman S Majumdar* BMed, MPHTM, MRCP(UK) · Robert T M Forbes BM BS, BSc, MSc · Pam Smith BSc · Bart J Currie FRACP, FAFPHM, DTM · Robert W Baird MB BS, FRACP, FRCPA

A study designed to measure the effect of introducing a new electronic medical record system in a public hospital emergency department reveals deterioration in a number of key performance indicators following the introduction of the new system.

Murugabalaji K Mohan MB BS · Rod O Bishop MB BS, MPH(Hons), FACEM · James L Mallows MB BS, FACEM

First and foremost, do no harm. Second, do some goodOne of the key issues for high-volume, high-risk workplaces like hospital emergency departments (EDs) is the struggle of conflicting aims. While hospital managers need information systems for data collection and storage, clinicians need efficient clinical documentation, data retrieval and order-entry systems that save time rather than steal it from the patient. The work of clinicians is ...

Jon D Patrick PhD, MSc, BSc · Susan Ieraci MB BS, FACEM

Objectives: To examine the rate of detection of alprazolam among cases of heroin-related death (HRD) in Victoria, including the relationship between alprazolam supply and HRDs.Design and setting: Population-based study of community alprazolam supply in Victoria and HRDs reported to the Victorian coroner from January 1990 to December 2010.Main outcome measures: Number of prescriptions for alprazolam supplied; defined daily dose (DDD) ...

Angela C Rintoul BA, MSocSci · Malcolm D H Dobbin MB BS, PhD, MPH · Suzanne Nielsen BPharm, BPharmSc, PhD · Louisa Degenhardt BA(Hons), MPsychology(Clinical), PhD · Olaf H Drummer PhD(Med), BAppSc(Chem), FRCPA

In a survey of HIV-positive men with newly acquired hepatitis C (HCV), novel risk factors for HCV transmission (non-injecting drug use, sexual practices with increased likelihood of trauma, and presence of genital ulcers) were identified. These novel transmission routes and a limited knowledge of the risks of HCV are emerging as important risk factors in this group.

Andrew A Mahony MB BS, FRACP · Ellen J Donnan MAppEpid, MPH, BNurs · Rosemary A Lester MB BS, MPH, FAFPHM · Joseph S Doyle MB BS, MSc, FRACP · James Knox MB BS, BSc, DTMH · Samantha L Tracy BSc · Scott Bowden PhD · Joseph J Sasadeusz MB BS, FRACP, PhD

A cross-sectional study finds that symptoms and spirometric evidence of chronic obstructive pulmonary disease are common among people aged 40 years or older in Australia, and increase with age.

Brett G Toelle PhD · Wei Xuan PhD · Tessa E Bird RN · Michael J Abramson MB BS, PhD, FAFPHM · David N Atkinson MB BS, MPH · Deborah L Burton PhD · Alan L James MD, FRACP · Christine R Jenkins MB BS, MD, FRACP · David P Johns PhD · Graeme P Maguire MB BS, FRACP, PhD · A W (Bill) Musk MB BS, MD, FRACP · E Haydn Walters MA, DM, FRACP · Richard Wood-Baker DM, FRCP, FRACP · Michael L Hunter PhD · Bruce J Graham BSc, MEd, PhD · Phillipa J Southwell BMedSc(Hons) · William M Vollmer PhD · A Sonia Buist MD · Guy B Marks MB BS, PhD, FRACP

A qualitative study explores the experiences of patients treated for trauma in Victoria, revealing gaps in communication, information provision and post-discharge care.

Belinda J Gabbe MAppSc, MBiostat, PhD · Jude S Sleney BSc(Hons), MSc · Cameron M Gosling BAppSc(HM), GradDip(ExRehab), MAppSc · Krystle Wilson BN(Hons) · Melissa J Hart RN, Orth Cert, BEd, · Ann M Sutherland RN, AdvCertM’ment, GradDipOHE · Nicola Christie BA, PhD