Research

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

A 3-year whole-of-hospital clinical service redesign program in a tertiary paediatric hospital in Western Australia finds that the introduction of a 4-hour-rule program for discharge or admission from the emergency department improves timeliness of care for patients throughout the hospital, with no adverse impact on the quality and safety of clinical care.

Liana Maumill RN, BN, PGDip(Paed Nsg) · Mia Zic BHlthSc, MIPH · Amanda A Esson BHlthSc · Gary C Geelhoed MB BS, FRACP, FACEM · Meredith M Borland MB BS, FACEM · Christopher Johnson MB BS, ANZCA · Philip Aylward BBA · Andrew C Martin MB BS, FRACP, MD

A study comparing single-field fundus photography with expert clinical examination finds the former is a valid tool in detecting diabetic retinopathy in Indigenous people in remote communities of Central Australia.

Janice J-Y Ku MB BS · John Landers PhD, FRANZCO · Tim Henderson MB, ChB, FRANZCO · Jamie E Craig DPhil, FRANZCO

A small exploratory study finds that most patients with diabetes attending for routine blood monitoring are willing to undergo non-mydriatic retinal photography administered by pathology collection staff.

Melanie F Larizza BBSc, GradDip(Sec) · Lauren A Hodgson BSc(Hons) · Eva K Fenwick MA, BA(Hons) · Ryo Kawasaki PhD, MD, MPH · Ralph Audehm MB BS · Jie Jin Wang PhD, MB BS, MMed(OphthalPath) · Tien Y Wong PhD, FRCEEd, MMed · Ecosse L Lamoureux PhD, BEd, MApplSci

A retrospective audit of patients referred for venous thromboembolism-related imaging reveals that the availability of new screening and diagnostic tests may have led to overdiagnosis of clinically insignificant pulmonary embolism.

Tatiana Segard MD · William B G Macdonald MB BS, MPH, FRACP

The authors explore the reasons for barriers to discharge from inpatient rehabilitation and whether these can be predicted by demographic or clinical variables.

Peter W New MB BS, MClinEpi, FAFRM(RACP) · Damien J Jolley MSc(Epidemiol), MSc, A Stat · Peter A Cameron MB BS, MD, FACEM · John H Olver MB BS, MD, FAFRM(RACP) · Johannes U Stoelwinder MB BS, MD, FRACMA

In a cohort of 65 boys aged 12–16 years at recruitment, treatment for more than 3 years with stimulant medication was associated with a slower rate of physical development during puberty, compared with boys not taking stimulants.

Alison S Poulton MA, MB BChir, MD · Elaine Melzer RN, RM, OAM · Paul R Tait MB BS, FRACP · Sarah P Garnett BSc, MNutrDiet, PhD · Chris T Cowell MB BS, FRACP · Louise A Baur MB BS, PhD, FRACP · Simon Clarke MB BS, FRACP, FCP

A study of help-seeking behaviours, reproductive disorders and rates of testing for prostate problems in Aboriginal and Torres Strait Islander men from urban, rural and remote communities in the Northern Territory and Queensland.

Michael J Adams BSW, MA, PhD · Veronica R Collins BSc, MSc(Epidemiol), PhD · Michael P Dunne BA(Hons), PhD · David M de Kretser MB BS, MD, FRACP · Carol A Holden BSc(Hons), PhD, MPH

Objectives: To report on the prevalence and implications of overweight and obesity in a rural maternity cohort.Design, setting and participants: A retrospective 6-year cohort of 6138 pregnancies managed in a rural Victorian maternity service from 1 January 2005 to 31 December 2010.Main outcome measures: Maternal body mass index (BMI), prevalence of overweight and obesity, prevalence of pregnancy complications and their association with BMI ...

Chris E Cunningham MSc, BLit, BA · Glyn R Teale MRCP, MRCOG, FRANZCOG

A review of clinical records of patients treated in Canberra and Sydney identified 10 patients who were likely to have suffered “deathcap” mushroom poisoning between 1999 and 2012. Despite treatment according to current standards, including use of the purported antidote silibinin, eight developed significant hepatotoxicity and four died.

Darren M Roberts PhD, FRACP · Michael J Hall FACEM · Morna M Falkland BPharm · Simone I Strasser MD, FRACP · Nick A Buckley MD, FRACP