Psychological distress in three Australian communities living with environmental per- and polyfluoroalkyl substances contamination.

Background: Environmental chemical contamination is a recognised risk factor for psychological distress, but has been seldom studied in the context of per- and polyfluoroalkyl substances (PFAS) contamination. We examined psychological distress in a cross-sectional study of three Australian communities exposed to PFAS from the historical use of aqueous film-forming foam in firefighting activities, and three comparison communities without environmental contamination.

Methods: Participation was voluntary following recruitment from a PFAS blood-testing program (exposed) or random selection (comparison).

Interventional radiology in obstetric patients: A population-based record linkage study of use and outcomes.

Introduction: Interventional radiology (IR) is a technique for controlling hemorrhage and preserving fertility for women with serious obstetric conditions such as placenta accreta spectrum (PAS) or postpartum hemorrhage. This study examined maternal, pregnancy and hospital characteristics and outcomes for women receiving IR in pregnancy and postpartum.

Material And Methods: A population-based record linkage study was conducted, including all women who gave birth in hospital in New South Wales or the major tertiary hospital in the neighboring Australian Capital Territory, Australia, between 2003 and 2019.

Interaction effects of multimorbidity and frailty on adverse health outcomes in elderly hospitalised patients.

We quantified the interaction of multimorbidity and frailty and their impact on adverse health outcomes in the hospital setting. Using aretrospective cohort study of persons aged ≥ 75 years, admitted to hospital during 2010-2012 in New South Wales, Australia, and linked with mortality data, we constructed multimorbidity, frailty risk and outcomes: prolonged length of stay (LOS), 30-day mortality and 30-day unplanned readmissions. Relative risks (RR) of outcomes were obtained using Poisson models with random intercept for hospital.

Differences in the pre-hospital management of women and men with stroke by emergency medical services in New South Wales.

Objectives: To examine whether pre-hospital emergency medical service care differs for women and men subsequently admitted to hospital with stroke.

Design, Setting, Participants: Population-based cohort study; analysis of linked Admitted Patient Data Collection and NSW Ambulance data for people admitted to New South Wales hospitals with a principal diagnosis of stroke at separation, 1 July 2005 - 31 December 2018.

Main Outcome Measures: Emergency medical service assessments, protocols, and management for patients subsequently diagnosed with stroke, by sex.

Maternal factors and risk of spontaneous preterm birth due to high ambient temperatures in New South Wales, Australia.

Background: Exposure to high ambient temperatures has been shown to increase the risk of spontaneous preterm birth. Determining which maternal factors increase or decrease this risk will inform climate adaptation strategies.

Objectives: This study aims to assess the risk of spontaneous preterm birth associated with exposure to ambient temperature and differences in this relationship between mothers with different health and demographic characteristics.

Sex differences in emergency medical services management of patients with myocardial infarction: analysis of routinely collected data for over 110,000 patients.

Emergency medical services (EMS) activation is an integral component in managing individuals with myocardial infarction (MI). EMS play a crucial role in early MI symptom recognition, prompt transport to percutaneous coronary intervention centres and timely administration of management. The objective of this study was to examine sex differences in prehospital EMS care of patients hospitalized with Ml using data from a retrospective population-based cohort study of linked health administrative data for people with a hospital diagnosis of MI in Australia (2001-18).

Are newly introduced criteria for the diagnosis of gestational diabetes mellitus associated with improved pregnancy outcomes and/or increased interventions in New South Wales, Australia? A population-based data linkage study.

Introduction: The incidence of gestational diabetes mellitus (GDM) is increasing in Australia, influenced by changed diagnostic criteria. We aimed to identify whether the diagnostic change was associated with improved outcomes and/or increased obstetric interventions using state-wide data in New South Wales (NSW), Australia.

Research Design And Methods: Perinatal and hospital data were linked for singleton births, 33-41 weeks' gestation, 2006-2015, NSW.

Predicting outcomes in older patients undergoing vascular surgery using the Hospital Frailty Risk Score.

Background: Frailty may explain why some older patients having vascular surgery are at high risk of adverse outcomes. The Hospital Frailty Risk Score (HFRS) has been designed specifically for use with administrative data and has three categories of frailty risk (low, intermediate and high). The aim of this study was to evaluate the HFRS in predicting mortality, and hospital use in older patients undergoing vascular surgery.

Simplified management of epistaxis.

Primary care, urgent care, and emergency department providers periodically treat epistaxis, either as recurrent nosebleed or an acute persistent episode. Silver nitrate application to the decongested and anesthetized nasal mucosa addresses the former in most cases. The plethora of commercial nasal packing devices testifies to the discomfort, technical difficulty, and frustration associated with traditional gauze-packing methods.

Current Indications for Tonsillectomy and Adenoidectomy.

This paper reviews current indications for otolaryngology consultation for tonsillectomy and adenoidectomy (T&A). Despite often being performed concurrently, these procedures should be considered separate surgeries done for different indications. The American Academy of Otolaryngology - Head and Neck Surgery published tonsillectomy guidelines for children in 2019.

Multiple Peri-Operative Complications are Associated with Reduced Long Term Amputation Free Survival Following Revascularisation for Lower Limb Peripheral Artery Disease: A Population Based Linked Data Study.

Objective: To determine, in a population based linked data study, the relationship between peri-operative multiple complications and longer term outcomes, specifically the combined outcome of two year amputation or death, after lower limb revascularisation for peripheral artery disease (PAD).

Methods: State wide health administrative data and death records were probabilistically linked for all patients who had lower limb artery surgery between 2010 and 2012 in New South Wales, Australia. Multivariable Cox regression modelled the impact of medical and surgical complications on the combined outcome of amputation or death two years after discharge.

Gestational age, morbidity and mortality among twin births in New South Wales, Australia 2003-2014: A cohort study.

Background: Evidence suggests that the trend toward early planned births observed among singletons may be evident among twin pregnancies.

Aims: To describe trends in gestational age at birth, pregnancy characteristics, neonatal morbidity and mortality among twin pregnancies.

Materials And Methods: Population-based data linkage study of twin births of ≥30 weeks of gestation without a major congenital anomaly born in 2003-2014 in New South Wales (NSW), Australia.

Surface-Atmosphere Coupling Scale, the Fate of Water, and Ecophysiological Function in a Brazilian Forest.

Tropical South America plays a central role in global climate. Bowen ratio teleconnects to circulation and precipitation processes far afield, and the global CO growth rate is strongly influenced by carbon cycle processes in South America. However, quantification of basin-wide seasonality of flux partitioning between latent and sensible heat, the response to anomalies around climatic norms, and understanding of the processes and mechanisms that control the carbon cycle remains elusive.

The association between haemoglobin levels in the first 20 weeks of pregnancy and pregnancy outcomes.

Background: Low haemoglobin has been linked to adverse pregnancy outcomes. Our study aimed to assess the association of haemoglobin (Hb) in the first 20 weeks of pregnancy, and restoration of low Hb levels, with pregnancy outcomes in Australia.

Methods: Clinical data for singleton pregnancies from two tertiary public hospitals in New South Wales were extracted for 2011-2015.

Haemoglobin trajectories during pregnancy and associated outcomes using pooled maternity and hospitalization data from two tertiary hospitals.

Background And Objectives: This study aimed to describe how haemoglobin trajectories in pregnant Australian women were associated with subsequent postpartum haemorrhage, blood transfusion and other outcomes.

Materials And Methods: The study was conducted in two tertiary public hospitals in Australia, using routinely collected maternity and hospital data on singleton pregnancies (2011-2015). Latent class growth modelling defined trajectories among those with at least one haemoglobin in each of three antenatal time periods (0-15, 16-30 and 31+ weeks; n = 7104).

Mortality and hospital readmissions in the first year of life after intra-uterine and neonatal blood product transfusions: A population data linkage study.

Aim: Blood product transfusions are a potentially life-saving therapy for fetal and neonatal anaemia, but there is limited population-based research on outcomes. We aimed to describe mortality, readmission and average hospital stay in the first year of life for infants with or without intra-uterine or neonatal blood product transfusions.

Methods: Linked birth, hospital and deaths data from New South Wales, Australia (January 2002-June 2014) were used to identify singleton infants (≥23 weeks' gestation, surviving to 29 days; n = 1 089 750) with intra-uterine or neonatal transfusion or no transfusion.

Launching into interprofessional education: graduate students learning and growing together.

Interprofessional education (IPE) is vital in university clinical settings to prepare graduate students to engage in today's health care system. However, few university programs have successfully implemented IPE into existing clinical programs. The purpose of this pilot study was to evaluate the effectiveness of an interprofessional (IP) training and clinical experience on graduate students' and caregivers perceptions on quality of care in a pre-existing clinical program.