Cardiac procedures in ST-segment-elevation myocardial infarction - the influence of age, geography and Aboriginality.

Background: Timely restoration of bloodflow acute ST-segment elevation myocardial infarction (STEMI) reduces myocardial damage and improves prognosis. The objective of this study was describe the association of demographic factors with hospitalisation rates for STEMI and time to angiography, Percutaneous Coronary Intervention (PCI) and Coronary Artery Bypass Graft (CABG) in New South Wales (NSW) and the Australian Capital Territory (ACT), Australia.

Methods: This was an observational cohort study using linked population health data.

The health of Hunter Valley communities in proximity to coal mining and power generation, general practice data, 1998-2010.

Aim: An analysis of general practice data for rural communities in close proximity to coal mining and coal-fired power generation in the Hunter Valley region of NSW was conducted to identify unusual patterns of illness.

Methods: Bettering the Evaluation and Care of Health general practice consultation data from the Hunter Valley region for 1998-2010 were compared with data from all other rural NSW residents.

Results: There were no significantly higher rates of problems managed or medications prescribed for Hunter Valley region residents compared with the rest of rural NSW.

Prevalence of chronic hepatitis B in South Western Sydney: evaluation of the country of birth method using maternal seroprevalence data.

Objective: To estimate the prevalence of hepatitis B infection and evaluate the country of birth (Census) method of describing hepatitis B distribution in an Australian health service with a large migrant population.

Methods: The prevalence of chronic hepatitis B in Sydney South West Area Health Service (SSWAHS, population 1.3 million) was estimated by applying the prevalence of hepatitis B surface antigen (HBsAg) in high or intermediate hepatitis B prevalence countries to SSWAHS residents from those countries, using 2006 Census data.

Influenza A testing and detection in patients admitted through emergency departments in Sydney during winter 2009: implications for rational testing.

Aim: To examine factors associated with testing and detection of influenza A in patients admitted to hospital for acute care during the winter 2009 pandemic influenza outbreak.

Design, Setting And Participants: Retrospective observational study of patients who were tested for influenza A after being admitted to hospital through emergency departments of the Sydney South West Area Health Service from 15 June to 30 August 2009.

Main Outcome Measures: The association of factors such as age, diagnosis at admission, hospital and week of admission with rates of testing and detection of influenza A.

Influenza A (H1N1) 2009 antibodies in residents of New South Wales, Australia, after the first pandemic wave in the 2009 southern hemisphere winter.

Background: The first wave of pandemic influenza A(H1N1)2009 (pH1N1) reached New South Wales (NSW), Australia in May 2009, and led to high rates of influenza-related hospital admission of infants and young to middle-aged adults, but no increase in influenza-related or all-cause mortality.

Methodology/principal Findings: To assess the population rate of pH1N1 infection in NSW residents, pH1N1-specific haemagglutination inhibition (HI) antibody prevalence was measured in specimens collected opportunistically before (2007-2008; 474 specimens) and after (August-September 2009; 1247 specimens) the 2009 winter, and before the introduction of the pH1N1 monovalent vaccine. Age- and geographically-weighted population changes in seroprevalence were calculated.

All-cause mortality during first wave of pandemic (H1N1) 2009, New South Wales, Australia, 2009.

In temperate countries, death rates increase in winter, but influenza epidemics often cause greater increases. The death rate time series that occurs without epidemic influenza can be called a seasonal baseline. Differentiating observed death rates from the seasonally oscillating baseline provides estimated influenza-associated death rates.

Pandemic (H1N1) 2009 influenza in NSW: an overview of the public health response.

In April 2009, a new influenza A virus, pandemic (H1N1) 2009 influenza, was identified in Mexico and the United States of America. The NSW response was co-ordinated by the Public Health Emergency Operations Centre through an incident control structure that included planning, operations and logistics teams with designated roles and responsibilities for the public health response. The emphasis of public health action changed as the pandemic moved through three response phases: DELAY, CONTAIN and PROTECT.

Ensuring safe drinking water in regional NSW: the role of regulation.

In regional and rural areas of NSW, drinking water is provided by 107 local water utilities serving a total population of some 1.7 million and operating 323 water supply systems. NSW Health exercises public health oversight of these regional water utilities through the NSW Health Drinking Water Monitoring Program, which provides guidance to water utilities on implementing elements of the Australian Drinking Water Guidelines 2004, including drinking water monitoring.

General practice management of overweight and obesity in children and adolescents in Australia.

Background: Childhood obesity is rapidly increasing in prevalence worldwide, but healthcare capacity to address this problem seems limited.

Objective: The purpose of this study was to describe the prevalence and rate of management of childhood overweight and obesity in Australian general practice.

Subjects: A cross-sectional study consisting of 3978 general practitioners (GPs), randomly selected using Medicare Australia claims, who recorded 42,515 encounters with children age 2-17 including 12,925 sub-sampled encounters with self or carer-reported height and weight collected.

Documentation of clinical review and vital signs after major surgery.

Objective: To describe the quality of postoperative documentation of vital signs and of medical and nursing review and to identify the patient and hospital factors associated with incomplete documentation.

Design, Setting And Participants: Retrospective audit of medical records of 211 adult patients following major surgery in five Australian hospitals, August 2003--July 2005.

Main Outcome Measures: Proportion of patients with complete documentation of medical review (each day) and nursing review and vital signs (heart rate, blood pressure, respiratory rate, temperature and oxygen saturation) (each nursing shift), and the proportion of available opportunities for medical and nursing review where documentation was incomplete.

Respiratory rate: the neglected vital sign.

The level of documentation of vital signs in many hospitals is extremely poor, and respiratory rate, in particular, is often not recorded. There is substantial evidence that an abnormal respiratory rate is a predictor of potentially serious clinical events. Nurses and doctors need to be more aware of the importance of an abnormal respiratory rate as a marker of serious illness.

Mitigating the health impacts of a natural disaster--the June 2007 long-weekend storm in the Hunter region of New South Wales.

A severe storm that began on Thursday, 7 June 2007 brought heavy rains and gale-force winds to Newcastle, Gosford, Wyong, Sydney, and the Hunter Valley region of New South Wales. The storm caused widespread flooding and damage to houses, businesses, schools and health care facilities, and damaged critical infrastructure. Ten people died as a result of the storm, and approximately 6000 residents were evacuated.

The effectiveness of implementation of the medical emergency team (MET) system and factors associated with use during the MERIT study.

Objective: The potential of the medical emergency team (MET) system to reduce adverse events may depend on the effectiveness of its implementation. We aimed to evaluate the effectiveness of the implementation of the MET system during the MERIT (Medical Early Response, Intervention and Therapy) study and to determine factors associated with the level of MET system utilisation.

Methods: Surveys were conducted on the nursing staff from the general adult wards of all 12 MERIT study intervention hospitals after the 4-month implementation period and again after the 6-month study period.

Planning for pandemic influenza surveillance in NSW.

Early detection of a novel strain (genotype) of influenza virus in the NSW population is the key to controlling a pandemic. If this occurs, ongoing surveillance will help determine the epidemiology and risk factors of the virus as well as its impact on essential services. Important components of surveillance preparedness in NSW include: border surveillance; hospital-based screening for suspected cases; protocols for efficient transport and testing of viral specimens; flexible, robust electronic tools for rapid surveillance data collection; management and reporting; and creation of surveillance surge capacity.