Centres In Melbourne Research Articles

What are Gastric Banding Patients Eating One Year Post-Surgery?

There is a paucity of evidence-based dietary management guidelines for patients post-laparoscopic adjustable gastric banding, including no consensus recommendations for macronutrient intake. We examined the macronutrient intake across a multi-centre cohort of post-bariatric surgery patients and compared these intakes to post-bariatric surgery and population-based dietary guidelines. Two hundred and fifteen patients from three bariatric surgery centres in Melbourne, Australia were invited to complete a validated Food Frequency Questionnaire 12 months post-operatively. Energy intakes of the 52 participants ranged from 1,140 to 13,200 kJ/day, with an average of 4,890 kJ/day (±2,360 kJ/day). Many patients did not meet minimum population recommendations for macronutrients. The average fibre intake was only 14 g/day (compared to the recommendations of 25 g for women and 30 g for men). The average diet 1 year post-operatively was 36% total fat compared to the recommendations of 20-25%, with 14% of intake from saturated fat. Patients' dietary intakes vary significantly 1 year post-laparoscopic adjustable band surgery, with many patients not meeting recommendations. These results suggest that patients decrease their total energy intake; however, eating habits may not improve as they consume a diet high in saturated fat. It is recommended that all patients receive dietary education about diet quality post-laparoscopic adjustable gastric band surgery to assist them in improving their diet quality as well as quantity for optimal health and weight loss. Specific international guidelines for nutrient intakes for people undergoing bariatric surgery are needed.

Challenges developing evidence-based algorithms for the trauma reception and resuscitation project

A project based at the Alfred Emergency and Trauma Centre in Melbourne, Australia aimed to standardise trauma resuscitation, documentation and interventions by developing best practice algorithms. The primary study objective was to demonstrate a reduction in management errors using a real-time computer based algorithm (the study group) compared to the control group in an open randomised controlled interventional study. A baseline control group was also used for comparison with usual (current) practice. In order to examine the existing evidence and algorithms in trauma care, nine teams of emergency nurses and doctors were formed. Specific literature searches performed by each team revealed a paucity of evidence supporting clinical practice in the trauma setting for procedures. Subsequently, the multidisciplinary teams worked together and developed algorithms based on best practice. The process revealed three main areas of challenges in the development of algorithms: (i) clinical, (ii) research and (iii) nursing challenges. The completion of the project demonstrated benefits in the real-time computer based algorithm with a reduction in the error rate per patient from the baseline control group to the intervention study group (2.30 vs. 2.13, p=0.04) and error-free resuscitations increasing from 16% to 21.8% (p=.049). This project supported the implementation of a real-time computer based algorithm system with improved protocol compliance and reduced errors and morbidity.

Adrenal Injuries and Incidentalomas in Trauma Patients at an Urban Trauma Centre

Background: Trauma patients are frequently evaluated by abdominal computed tomography. The prevalence of adrenal incidentalomas is 4% of the general population, increasing with age. The aim of this study was to examine the incidence and follow-up of adrenal lesions in an adult trauma centre. Methods: A retrospective review was performed of all trauma admissions to an urban trauma centre in Melbourne, Australia between August 2000 and October 2009 with a discharge diagnosis including adrenal injury, mass, or adenoma. Results: From August 2000 through October 2009, there were 45,576 patients admitted to the Alfred Hospital Trauma Unit, 142 (0.31%) patients had adrenal injuries and 26 (0.06%) patients had adrenal incidentalomas. Of the patients with adrenal injuries, the male-to-female ratio was 3:1. Blunt trauma was responsible in 99% of patients. Right-sided injuries were commoner (73%). Left-sided lesions were present in 19%, and bilateral injuries in 5% (P < 0.0001). Adrenal injury was identified as haemorrhage or haematoma in 95%. In the adrenal injury group, there was the 13% mortality. Follow-up imaging was not performed in 50% of patients; while another 30% only had imaging within 2 weeks, while still hospitalised. Of the 26 patients with incidentalomas, the male-to-female ratio was 1.6:1. All were blunt trauma patients, 69% of identified masses were left-sided lesions, 23% right-sided, and 7.7% were bilateral. Repeat imaging was obtained in 58% of patients, while the remainder was lost to follow-up. Biochemical investigations were performed in 54%. One patient had phaeochromocytoma, and 13 patients had benign incidentalomas. Three patients underwent adrenalectomy: one at the time of trauma laparotomy (benign cortical adenoma); one 5 months post-trauma (phaeochromocytoma); and the final patient 3 months post-trauma (benign vascular epithelial cyst). Conclusions: With increased use of abdominal CT in the evaluation of trauma patients, adrenal lesions are increasingly likely to be found. Follow-up of these lesions in this series has been variable. The development of a protocol for adrenal lesions in trauma patients may improve follow-up care. doi: http://dx.doi.org/10.4021/ jcs108w

Editorial introductions

Current Opinion in Infectious Diseases was launched in 1988. It is part of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of infectious diseases is divided into 11 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Section Editors for this issue. Section Editors Monica SlavinMonica SlavinDr Monica Slavin has been Head of the Department of Infectious Diseases at the Peter MacCallum Cancer Centre in Melbourne, Australia since 2000. She is an Associate Professor in the Department of Medicine at the University of Melbourne and a Research Associate at the Macfarlane Burnet Centre for Medical Research and Public Health. She received her medical degree from the University of Melbourne and after completing training in Infectious Diseases in Melbourne, worked for 3 years in the Program in Infectious Diseases at Fred Hutchison Cancer Research Center in Seattle, USA. She has been an Infectious Diseases physician since 1993 with a major interest in infections in immunocompromised especially patients with cancer and undergoing stem cell transplantation. Her current research focus is prevention and early treatment of invasive fungal infections in haematology patients. She has served on national steering committees for the development of antifungal and fever and neutropenia treatment guidelines and for the conduct of Australia-wide studies of the epidemiology of fungal infection. Simon CroftSimon CroftSimon Croft is Professor of Parasitology in the Faculty of Infectious and Tropical Diseases at the London School of Hygiene & Tropical Medicine, London, UK. He gained a PhD at the Liverpool School of Tropical Medicine and, after post-doctoral periods working in the laboratory on parasite ultrastructure and biochemistry and overseas on the transmission of African trypanosomiasis, he moved to research on anti-protozoal chemotherapy. His expertise and knowledge on anti-protozoal chemotherapy was developed while working with the Wellcome Research Laboratories, Beckenham, UK in the 1980 s. Following his return to academia, Simon focused his research on the identification and evaluation of novel drugs and formulations for the treatment of leishmaniasis, malaria, human African trypanosomiasis (sleeping sickness) and South American trypanosomiasis (Chagas disease). This work included projects on miltefosine, AmBisome and topical paromomycin, all of which reached clinical trials for the treatment of leishmaniasis. Other current research interests include the drug – immune response interaction and pharmacokinetics and drug delivery of antiprotozols. From 2004 to 2007 he was the Research and Development Director at the Drugs for Neglected Diseases Initiative (DNDi), Geneva. Deenan PillayDeenan PillayFollowing a PhD in Biochemistry, Dr Pillay studied Medicine in Newcastle upon Tyne and undertook postgraduate training in medical virology at St Thomas's Hospital and Royal Free Hospital, London. He was then a visiting NIH Fellow in the laboratory of Dr Doug Richman, University of California, San Diego, where he developed an interest in HIV Drug Resistance. On his return to the UK, Dr Pillay took up the post of Consultant Medical Virologist, Birmingham Public Health Laboratory and in 1996 became Director of the National PHLS Reference Laboratory for antiviral drug resistance. In 2003 he moved to University College London, with a joint appointment at the Central Public Health Laboratory, Colindale, where he is pursuing academic and epidemiological studies on drug resistance, with particular reference to HIV. Dr Pillay's main areas of interest are the treatment of viral infections and laboratory monitoring of such treatment. His current research is focused on clinical correlates of antiviral drug resistance, viral informatic approaches to antiviral drug resistance data, and epidemiology of drug resistance.

Five-minute heart rate variability can predict obstructive angiographic coronary disease

ObjectiveObstructive coronary artery disease (CAD) is evident in only half of patients referred for diagnostic angiography. Five-minute heart rate variability (HRV) is a non-invasive marker for autonomic control of the...

Economic burden of obesity in primary total knee arthroplasty

To compare the hospital inpatient costs between nonobese and obese patients and estimate the economic burden of obesity in primary total knee arthroplasty (TKA). A cost identification study was conducted in a consecutive cohort of 530 patients who underwent TKA between 2006 and 2007 at a university-affiliated tertiary referral center in Melbourne, Australia. Total hospital inpatient costs incurred at the study institution associated with the index surgery and subsequent related emergency presentations and readmissions during the episode of care were captured. Predictor variables of interest were obesity and body mass index (BMI), and the outcomes of interest were total hospital inpatient costs for the index surgery and episode of care, defined as the first 12 months following TKA. Multivariate linear regression techniques were used to examine the association between the predictors of interest and hospital costs, adjusting for clinically relevant variables. Economic data were analyzed in 521 patients, of which 317 (60.8%) were obese. Obesity was associated with higher inpatient index surgery costs (+$1,226.89 [95% confidence interval (95% CI) $82.25, $2,371.52]; P = 0.036) and episode of care costs (+$1,821.36 [95% CI $244.93, $3,397.79]; P = 0.024). Each unit increase in BMI was also associated with higher inpatient index surgery costs ($128.91 [95% CI $34.53, $223.28]; P = 0.008) and total episode of care costs ($158.79 [95% CI $28.54, $289.05]; P = 0.017). The estimated significant additional annual obesity-related expenditure reported in this study establishes a rationale to trial and evaluate interventions that target weight loss in obese patients undergoing TKA from both a quality of life and economic perspective.

Primary caregivers’ satisfaction with clinicians’ response to them as informal carers of young people with first‐episode psychosis: a qualitative study

To explore first-time primary caregivers' experience of the way mental health nurses and other mental health clinicians respond to them as carers of young people with first-episode psychosis. Caregivers have a key role in supporting family members/relatives with mental illness, but their contribution is undervalued frequently by mental health nurses and other mental health clinicians. Design. Qualitative interpretative phenomenological analysis. A qualitative interpretative design was undertaken, using semi-structured, audio-recorded interviews. Twenty primary caregivers were recruited through Orygen Youth Health, a first-episode psychosis centre in Melbourne. Interpretative phenomenological analysis was used to identify themes in the data. Two competing themes were identified in the data, highlighting caregivers' contrasting experience with mental health nurses and other mental health clinicians. First, most clinical staff were approachable and supportive. Second, several carers felt their contribution was undervalued by some clinical staff. This was as a consequence of being excluded from clinical deliberations because of clinical staffs' concerns and young people's requests about maintaining confidentiality regarding treatment, as well as carers feeling their role was not taken seriously by clinical staff. First-time primary carers have positive and negative experiences with first-episode psychosis mental health nurses and other clinicians, and these competing events are interrelated. Experiences are affected directly by the manner they are treated by clinical staff and this may, in turn, affect carers' commitment to caring, the way they engage with clinical staff on subsequent occasions and towards the first-episode psychosis service generally. Greater appreciation is needed of the contribution, experience and difficulties caregivers encounter in their role and in engaging with mental health nurses and other clinicians. Additional training is required for clinical staff in family interventions and to familiarise them with legislation and mental health policies relating to carers.

An Exploration Into the Coping Strategies of Preschoolers: Implications for Professional Practice

This study aims to explore the coping strategies of preschoolers, by asking 4-year-old children (N = 46) at an early learning centre in Melbourne to describe their coping strategies when dealing with seven age-appropriate challenging situations. The interviews were recorded, transcribed and thematically analysed. The results indicated that preschoolers could articulate coping strategies that are theoretically clustered into productive and nonproductive coping styles. The capacity to identify a range of coping strategies related to specific situations has implications not only for theory development, but also for the design of effective prevention and intervention programs to help children more effectively deal with life challenges.

Right to the City, Desire for the Suburb?

The 2000s have been a lively decade for cities. The Worldwatch Institute estimated that 2007 was the first year in human history that more people worldwide lived in cities than the countryside. Globalisation and new digital media technologies have generated the seemingly paradoxical outcome that spatial location came to be more rather than less important, as combinations of firms, industries, cultural activities and creative talents have increasingly clustered around a select node of what have been termed “creative cities,” that are in turn highly networked into global circuits of economic capital, political power and entertainment media. Intellectually, the period has seen what the UCLA geographer Ed Soja refers to as the spatial turn in social theory, where “whatever your interests may be, they can be significantly advanced by adopting a critical spatial perspective”. This is related to the dynamic properties of socially constructed space itself, or what Soja terms “the powerful forces that arise from socially produced spaces such as urban agglomerations and cohesive regional economies,” with the result that “what can be called the stimulus of socio-spatial agglomeration is today being assertively described as the primary cause of economic development, technological innovation, and cultural creativity”

Trauma Resuscitation Errors and Computer-assisted Decision Support

This prospective, randomized, controlled interventional study evaluated the effect of real-time, computer-prompted, evidence-based decision and action algorithms on error occurrence during initial resuscitation of trauma patients between January 24, 2006 and February 25, 2008 at a level I adult trauma center in Melbourne, Australia. There, four trauma resuscitation bays were equipped with identical resuscitation equipment, layout, and trauma teams. Two of the trauma rooms (the study arm) were equipped with computerized equipment that provided aid in decisions and management.

The relationship between personality disorders and mental health, substance use severity and quality of life among injecting drug users

To determine the relationship between personality disorders (PDs) and substance use severity, mental health symptoms and disorders and quality of life (QoL) among injecting drug users (IDUs). A cross-sectional study of 103IDUs accessing a needle and syringe program and a primary health centre in Melbourne, Australia. Presence of PDs was assessed using the International Personality Disorder Examination ICD-10Screener. Axis I mental health disorders, psychological distress and QoL were also assessed. Ninety per cent of participants scored positive for one or more PD. Having a Cluster A or Cluster B PD was associated with greater severity of substance use. The presence of a current mental health disorder was associated with all types of PD except dissocial PD. Only Cluster C PDs were associated with self-reported levels of psychological distress. Cluster C PDs were more strongly associated with substance use, mental health and QoL variables than Cluster A or B, although the number of PDs present had the strongest associations with these variables. IDUs had high rates of PD symptoms, which were associated with the presence of concurrent mental health disorders, more severe levels of psychological distress and substance use and low perceived QoL. IDUs require comprehensive models of care, including access to mental health practitioners with expertise in co-occurring disorders.

Outcome in early-onset schizophrenia revisited: Findings from the Early Psychosis Prevention and Intervention Centre long-term follow-up study

Objective To compare the long-term outcome in individuals with early-onset (before age 18) and adult-onset schizophrenia spectrum disorder who were initially diagnosed and treated in the same clinical center. Method A prospective follow-up study of 723 consecutive first-episode psychosis patients (age range 14 to 30 years) on average 7.4 years after initial presentation to an early psychosis service, the Early Psychosis Prevention and Intervention Centre in Melbourne, Australia. The outcome measures included the Brief Psychiatric Rating Scale, the Schedule for the Assessment of Negative Symptoms, the Beck Depression Inventory, the Global Assessment of Functioning Scale, the Social and Occupational Functioning Assessment Scale, and the Quality of Life Scale. Results Follow-up interviews were conducted on 66.9% (484/723) individuals, of whom 75.6% (366/484) received a schizophrenia spectrum disorder diagnosis at baseline. Early-onset schizophrenia spectrum disorder was observed in 11.2% (41/366). At follow-up, individuals with early-onset reported significantly fewer positive symptoms and were characterised by significantly superior functioning on measures assessing global functioning, social-occupational functioning, and community functioning than individuals with adult-onset. The early-onset group also achieved significantly better vocational outcomes and had a more favourable course of illness with fewer psychotic episodes over the last two years prior to follow-up. Finally, when investigated as a continuous variable, younger age at onset significantly correlated with better symptomatic and functional outcomes. Conclusions These results question the assumption that early-onset schizophrenia typically has a poor outcome. Early detection and specialised treatment for the first psychotic episode appear to be more effective at improving long-term functional outcomes in people with early-onset schizophrenia as in those with adult-onset schizophrenia. This possibility and the reasons for it need further investigation.

Validity of outcome measures used to assess one and six month outcomes in orthopaedic trauma patients

Introduction To evaluate the validity of the 12-item Short Form Health Survey (SF-12), Sickness Impact Profile (SIP) and the Short Musculoskeletal Functional Assessment Questionnaire (SMFA) for use in an orthopaedic trauma population. Materials and methods A prospective validation trial was completed at a Level 1 adult trauma centre in Melbourne, Australia. One hundred and fifty four patients with orthopaedic trauma managed or followed-up by an orthopaedic unit were prospectively recruited. Patients with pathological fractures related to metastatic disease and/or an isolated orthopaedic injury, a documented history of mental illness or dementia or those for whom follow-up was likely to be difficult were excluded. The SF-12, SIP and SMFA were administered by a trained interviewer at one and six months. Each questionnaire was scored for the physical and mental components and then compared for content and construct validity at each time point. Results Complete data were collected for 134 patients at one and six months. The one and six month component scores correlated strongly between the SF-12 physical, SIP physical ( r = 0.513–0.669) and SMFA dysfunction ( r = 0.529–0.778); the SF-12 mental, SIP mental ( r = 0.643–0.719) and SMFA bother ( r = 0.564–0.602) components. The strength of association was greater for the six month time point compared to the one month measure. The SF-12 demonstrated no ceiling or floor effects, and provided a lower time burden on participants and researchers when compared to the SIP and SMFA. Conclusions For large population-based surveillance research into orthopaedic injury the SF-12 provides a valid and versatile tool.

Using internet enabled mobile devices and social networking technologies to promote exercise as an intervention for young first episode psychosis patients

BackgroundYoung people with first episode psychosis are at an increased risk for a range of poor health outcomes. In contrast to the growing body of evidence that suggests that exercise therapy may benefit the physical and mental health of people diagnosed with schizophrenia, there are no studies to date that have sought to extend the use of exercise therapy among patients with first episode psychosis. The aim of the study is to test the feasibility and acceptability of an exercise program that will be delivered via internet enabled mobile devices and social networking technologies among young people with first episode psychosis.Methods/DesignThis study is a qualitative pilot study being conducted at Orygen Youth Health Research Centre in Melbourne, Australia. Participants are young people aged 15-24 who are receiving clinical care at a specialist first episode psychosis treatment centre. Participants will also comprise young people from the general population. The exercise intervention is a 9-week running program, designed to gradually build a person's level of fitness to be able to run 5 kilometres (3 miles) towards the end of the program. The program will be delivered via an internet enabled mobile device. Participants will be asked to post messages about their running experiences on the social networking website, and will also be asked to attend three face-to-face interviews.DiscussionThis paper describes the development of a qualitative study to pilot a running program coupled with the use of internet enabled mobile devices among young people with first episode psychosis. If the program is found to be feasible and acceptable to patients, it is hoped that further rigorous evaluations will ultimately lead to the introduction of exercise therapy as part of an evidence-based, multidisciplinary approach in routine clinical care.

‘I feel myself to be a world citizen’: negotiating Turkish and Alevi identity in Melbourne

The complexity and heterogeneity of modern multicultural societies can both highlight and obscure the diversity which exists within identity groups. Whilst the majority of the Turkish community in Melbourne are Sunni Muslim, significant groups of ethnically, religiously and linguistically different communities also exist. Recent research with women who participate in activities at the Alevi community centre in Melbourne has brought to light many of the issues which are faced by individuals who are doubly excluded from the mainstream of Australian life and culture as migrants and from the mainstream of Turkish diasporic life through a non-Sunni Islamic religious orientation. For some, but not all of these women there is also an added dimension of difference through embracing their Kurdish ethnicity and linguistic background. Both first and second generation Alevi women use a range of strategies to locate themselves within what one respondent called the ‘rose garden’ of Australia since the advent of immigrant diversity.

Cannabis use disorder and age at onset of psychosis — A study in first-episode patients

Introduction Age at onset of psychosis (AAO) may be younger in patients with cannabis use disorders (CUD) compared to those without CUD (NCUD). Previous studies included CUD co-morbid with other substance use disorders (SUD), and many did not control for confounders. Methods Controlling for relevant confounders, differences in AAO between patients with and without CUD excluding those with any other SUD were analyzed in a large representative file audit of 625 first-episode psychosis (FEP) patients (age 14 to 29 years) admitted to the Early Psychosis Prevention and Intervention Centre in Melbourne, Australia. Results Three quarters of the 625 FEP patients had a CUD. Cannabis use started before psychosis onset in 87.6% of patients. AAO was not significantly different between CUD (without other SUD, n = 201) and NCUD (n = 157). However, AAO was younger in those with early CUD (starting age 14 or younger) compared to NCUD (F(1) = 5.2; p = 0.024; partial η 2 = 0.026). Earlier age at onset of cannabis use predicted earlier age at onset of psychosis (β = − 0.49, R 2-change = 0.25, p < 0.001). Conclusion Only CUD starting age 14 or younger was associated with an earlier AAO at a small effect size. These findings suggest that CUD may exert an indirect effect on brain maturation resulting in earlier AAO potentially only in cannabis sensitive subjects.

Mitochondrial Function Linked to Autism

Back to table of contents Previous article Next article Clinical & Research NewsFull AccessMitochondrial Function Linked to AutismJoan Arehart-TreichelJoan Arehart-TreichelSearch for more papers by this authorPublished Online:18 Mar 2011https://doi.org/10.1176/pn.46.6.psychnews_46_6_18_1AbstractMight mitochondria—the little packets inside cells that make energy for both brain and body—play a role in autism?Perhaps in some cases of the disorder, two researchers believe. They are Daniel Rossignol, M.D., a primary care physician affiliated with the International Child Development Resource Center in Melbourne, Fla., and Richard Frye, M.D., Ph.D., of the University of Texas Health Science Center at Houston. Mitochondria are best known for producing energy for the cell from oxygen and food. Because of mitochondria's role in energy production, children with mitochondrial disease have some level of dysfunction in high-energy organs such as the brain. Children with mitochondrial disease can have either normal intelligence, mental retardation, or developmental delay. On the basis of a review of 65 studies, Rossignol and Frye concluded in a report in the January 25 Molecular Psychiatry that 1 in 20 children with autism has mitochondrial disease, which is much higher than the incidence in the general population, which is about 1 in 10,000 children. Moreover, they compared children with both autism and mitochondrial disease with children who had autism without mitochondrial disease and with nonautistic children with mitochondrial disease and uncovered some interesting findings. For example, children who had both autism and mitochondrial disease were significantly more likely than children with autism but no mitochondrial disease to develop normally early in life and then to lose some previously acquired skills. Furthermore, children who had both autism and mitochondrial disease were significantly more likely to experience seizures and gastrointestinal abnormalities than were children with autism but no mitochondrial disease and children with mitochondrial disease but no autism. "Overall, this evidence supports the notion that mitochondrial dysfunction is associated with autism spectrum disorders," the researchers concluded, but they added that more studies are required before the role that mitochondrial dysfunction plays in autism can be defined. But if there is a causal effect, then the question is: Could treating mitochondrial disease improve the health of children who have both autism and mitochondrial disease? Rossignol believes that to be the case, he told Psychiatric News. "[Some] studies reported improvements with antioxidants such as carnitine, coenzyme Q10, and B vitamins. We also see improvements in children with autism and mitochondrial disease when we use these in clinical practice." The research was funded by the Autism Research Institute and the Jane Botsford Johnson Foundation. Both Rossignol and Frye noted a possible conflict of interest in their paper. Rossignol has two children with autism and treats autistic children with both standard and integrative treatments. Frye provides expert testimony for children with mitochondrial disorders who may have been injured from vaccines. ("In our review," Rossignol told Psychiatric News, "there were several published cases of regression into autism and mitochondrial disorder that were associated temporally with vaccination, often in association with fever. However, there is very little published research on this subject.") "Numerous studies have now documented the presence of mitochondrial dysfunction in a subset of patients with autism spectrum disorders," David Fassler, M.D., a child and adolescent psychiatrist and a clinical professor of psychiatry at the University of Vermont, told Psychiatric News. "The results of the current meta-analysis are consistent with such previous reports … . The authors readily acknowledge the limitations of their study, including reliance on small sample sizes and possible referral and/or publication bias. However, I would certainly concur with their conclusion that this is a promising area for future research. Hopefully, such efforts will ultimately enhance our ability to diagnose and treat children, adolescents, and adults with autism spectrum disorders." An abstract of "Mitochondrial Dysfunction in Autism Spectrum Disorders: A Systematic Review and Meta-analysis" is posted at <www.nature.com/mp/journal/vaop/ncurrent/full/mp2010136a.html>. ISSUES NewArchived

Does an intervention that improves infant sleep also improve overweight at age 6? Follow-up of a randomised trial

ObjectiveShort sleep duration may contribute to childhood obesity. Amenable to intervention, sleep thus provides a potential path for prevention. The authors aimed to determine the impact of a behavioural intervention...

A national, one-day, consumer-oriented telephone drug information project in Australia

Abstract The design and execution of a nationwide, one-day telephone drug information service for the general public are described and data collected during the project analysed. The Australian public was provided with access to a toll-free telephone service on September 4, 1992, for seeking direct information about medication from a team of pharmacists and medical practitioners based at a temporary telecommunications centre in Melbourne. Details of the project had been agreed by a multidisciplinary steering group. Over 2,000 calls were connected to the centre, averaging 167 calls per hour (range nine to 215). Calls were processed through central triage lines prior to referral to appropriate personnel. Information was gathered from 1,650 calls using a standard data collection form, and the details of a sample of 895 of these were analysed using Epi-info 5.01a (public domain) software for epidemiology and disease surveillance. The success of this project, as well as that of other similar telephone information services in other countries, indicates a high level of interest among the public. In the future, information gained in this type of data collection process may be of benefit to clinicians in assisting them to provide information to patients about their drug therapy.

Smoke Alarm Maintenance in an Australian Community Sample

Australia has a high rate of smoke alarm ownership, with compulsory installation requirements across all states. Although this is pleasing, it is not correct to assume that a smoke alarm will be in functional order without appropriate maintenance. Procedures to optimise smoke alarm performance include yearly replacement of the battery, and monthly testing of the alarm sounder and cleaning of the unit with a vacuum cleaner. The current study interviewed 500 people randomly selected from shopping centres in Melbourne, Australia, about the maintenance of their smoke alarm. Overall it was found that 17 % of people reported never changing the battery. Most people who reported never changing their smoke alarm battery owned hardwired alarms. Only 57 % reported cleaning their alarms, and of these, 75 % did so less often than recommended. Lower numbers still reported cleaning their smoke alarm (21 %), and only 15 % of these people reported following the correct cleaning procedure. Implications are discussed in relation to targeting community information campaigns.