Burn injury as a result of interpersonal violence in the Northern Territory Top End.

Aim: To describe the demographics, circumstances, burn wound characteristics and current tertiary centre management of interpersonal violence (IPV) burn victims in the Northern Territory Top End. It is anticipated that such knowledge gained will be of benefit to key stakeholders across the spectrum of injury prevention and management in this region.

Methods: All adult admissions to the Royal Darwin Hospital (RDH) during 2010-2015 were identified through the Burns Registry of Australia and New Zealand.

3,3'-Disubstituted 5,5'-Bi(1,2,4-triazine) Derivatives with Potent in Vitro and in Vivo Antimalarial Activity.

A series of 3,3'-disubstituted 5,5'-bi(1,2,4-triazine) derivatives was synthesized and screened against the erythrocytic stage of Plasmodium falciparum 3D7 line. The most potent dimer, 6k, with an IC (50% inhibitory concentration) of 0.008 μM, had high in vitro potency against P.

Incorporating indigenous knowledge in health services: a consumer partnership framework.

Objectives: Healthcare policy and planning should be informed by a partnership between healthcare services and healthcare users. This is critical for people who access care frequently such as indigenous Australians who have a high burden of chronic kidney disease. This study aimed to explore the most appropriate ways of enhancing services by incorporating renal patients' expectations and satisfaction of care in Australia's Northern Territory.

The cost-effectiveness of a 20% price discount on fruit, vegetables, diet drinks and water, trialled in remote Australia to improve Indigenous health.

This paper estimates the cost-effectiveness of a 20% price discount on healthy food and beverages with and without consumer nutrition education, as trialled in remote Northern Australia. Changes in actual store sales, from the pre-discount baseline period, were analysed for population impact on consumption of fruit and vegetables, water and artificially sweetened soft drinks, in addition with total dietary weight (grams), energy (Mega Joules), and sodium (milligrams). Disability Adjusted Life Years (DALYs), arising from changes in dietary risk factor prevalence in the population, were estimated as the primary health outcome in a multi health-state Markov model.

Mediators and moderators of nutrition intervention effects in remote Indigenous Australia.

We conducted a longitudinal dietary intervention study to assess the impact of a store-based intervention on mediators and moderators and consequent dietary behaviour in Indigenous communities in remote Australia. We assessed dietary intake of fruit, vegetable, water and sweetened soft drink, mediators and moderators among 148, eighty-five and seventy-three adult participants (92 % women) at baseline (T1), end of intervention (T2) and at 24 weeks post intervention (T3), respectively. Mediators included perceived affordability and self-efficacy.

Takotsubo Cardiomyopathy Associated With Work-Place Bullying.

Background: Takotsubo cardiomyopathy (TC) is a condition of transient left ventricular dysfunction precipitated by acute physical or emotional stress. The pathogenesis of TC is not well understood, but it is known to predominantly affect postmenopausal women in the context of physical or emotional triggers.

Aims: To describe a case of TC with an association to a never previously described work place stressor of bullying.

A systematic review of adherence in Indigenous Australians: an opportunity to improve chronic condition management.

Background: Indigenous Australians experience high rates of chronic conditions. It is often asserted Indigenous Australians have low adherence to medication; however there has not been a comprehensive examination of the evidence. This systematic literature review presents data from studies of Indigenous Australians on adherence rates and identifies supporting factors and impediments from the perspective of health professionals and patients.

Effect of a price discount and consumer education strategy on food and beverage purchases in remote Indigenous Australia: a stepped-wedge randomised controlled trial.

Background: Evidence is mounting that price discounts can be effective in improving diet. This study examined the effectiveness of a 20% price discount on food and drink purchases with and without consumer education in remote Indigenous Australia.

Methods: A 20% discount on fruit, vegetables, water, and artificially sweetened soft drinks was applied for 24 weeks in 20 communities in remote Indigenous Australia where the community store was managed by the Arnhem Land Progress Aboriginal Corporation (ALPA) or Outback Stores (OBS) in a stepped-wedge randomised trial.

Probiotic Modulation of Innate Cell Pathogen Sensing and Signaling Events.

There is a growing body of evidence documenting probiotic bacteria to have a beneficial effect to the host through their ability to modulate the mucosal immune system. Many probiotic bacteria can be considered to act as either immune activators or immune suppressors, which have appreciable influence on homeostasis, inflammatory- and suppressive-immunopathology. What is becoming apparent is the ability of these probiotics to modulate innate immune responses via direct or indirect effects on the signaling pathways that drive these activatory or suppressive/tolerogenic mechanisms.

Reducing early career general practitioners' antibiotic prescribing for respiratory tract infections: a pragmatic prospective non-randomised controlled trial.

Background: Inappropriate antibiotic prescription and consequent antibacterial resistance is a major threat to healthcare.

Objectives: To evaluate the efficacy of a multifaceted intervention in reducing early career general practitioners' (GPs') antibiotic prescribing for upper respiratory tract infections (URTIs) and acute bronchitis/bronchiolitis.

Methods: A pragmatic non-randomized trial employing a non-equivalent control group design nested within an existing cohort study of GP registrars' (trainees') clinical practice.

Realising the potential of health needs assessments.

Population-level assessment and planning has traditionally been the role of public health departments but in establishing Primary Health Networks (PHNs), the Australian Government has instituted a new mechanism for identifying community needs and commissioning services to meet those needs. If PHNs are to achieve the vision of nimble organisations capable of identifying and addressing local health needs via integrated health and social services, several things need to occur. First, PHN funding schedules must become more flexible.

Safety and Efficacy of Warfarin Therapy in Remote Communities of the Top End of Northern Australia.

Background: Warfarin remains a widely used anticoagulant but application in the remote context is not well documented. This study aimed to assess in more detail whether warfarin is being utilised effectively in Australia's most isolated and remote areas.

Methods: Retrospective cohort analysis of 2013 captured international normalised ratio (INR) results from people engaged in long term warfarin usage within a number of remote Northern Australian communities.

Echocardiographic Screening for Rheumatic Heart Disease in Indigenous Australian Children: A Cost-Utility Analysis.

Background: Rheumatic heart disease (RHD) remains a leading cause of cardiovascular morbidity and mortality in children and young adults in disadvantaged populations. The emergence of echocardiographic screening provides the opportunity for early disease detection and intervention. Using our own multistate model of RHD progression derived from Australian RHD register data, we performed a cost-utility analysis of echocardiographic screening in indigenous Australian children, with the dual aims of informing policy decisions in Australia and providing a model that could be adapted in other countries.

Rheumatic Heart Disease Severity, Progression and Outcomes: A Multi-State Model.

Background: Rheumatic heart disease (RHD) remains a disease of international importance, yet little has been published about disease progression in a contemporary patient cohort. Multi-state models provide a well-established method of estimating rates of transition between disease states, and can be used to evaluate the cost-effectiveness of potential interventions. We aimed to create a multi-state model for RHD progression using serial clinical data from a cohort of Australian patients.

Changes in early-career family physicians' antibiotic prescribing for upper respiratory tract infection and acute bronchitis: a multicentre longitudinal study.

Background: Inappropriate antibiotic prescription and subsequent antibacterial resistance are major threats to health worldwide.

Objectives: We aimed to establish whether early-career 'apprenticeship-model' experience in family practice influences antibiotic prescribing for respiratory tract infections and to also establish other associations of antibiotic prescribing changes during this early-career experience.

Methods: A longitudinal analysis (2010-2014) of a cohort study of Australian GP registrars' (vocational trainees') consultations.

Detection of 12.5% and 25% Salt Reduction in Bread in a Remote Indigenous Australian Community.

Food reformulation is an important strategy to reduce the excess salt intake observed in remote Indigenous Australia. We aimed to examine whether 12.5% and 25% salt reduction in bread is detectable, and, if so, whether acceptability is changed, in a sample of adults living in a remote Indigenous community in the Northern Territory of Australia.

Inhaled non-steroid anti-inflammatories for children and adults with bronchiectasis.

Background: Chronic neutrophilic inflammation, in both the presence and absence of infection, is a feature of bronchiectasis in adults and children. The anti-inflammatory properties of non-steroid anti-inflammatory drugs (NSAIDs) may be beneficial in reducing airway inflammation, thus potentially improving lung function and quality of life in patients with bronchiectasis.

Objectives: To evaluate the efficacy of inhaled NSAIDs in the management of non-cystic fibrosis bronchiectasis in children and adults:• during stable bronchiectasis; and• for reduction of:∘ severity and frequency of acute respiratory exacerbations; and∘ long-term pulmonary decline.

Epidemiological investigation of an outbreak of cutaneous sporotrichosis, Northern Territory, Australia.

Background: An outbreak of cutaneous sporotrichosis occurred in the Darwin region of the Northern Territory (NT) in 2014. We aimed to determine the source and risk factors associated with the outbreak and describe the clinical spectrum of cases seen.

Methods: Epidemiological investigation of cases of cutaneous sporotrichosis identified through the Royal Darwin Hospital was undertaken to investigate risk factors and potential sources of infection.

The short-term impact of each primary dose of pneumococcal conjugate vaccine on nasopharyngeal carriage: Systematic review and meta-analyses of randomised controlled trials.

Background: Early onset of persistent otitis media is a priority issue for Australian Indigenous populations. The objective is to determine the direct and short-term impact of one, two and three doses of any pneumococcal conjugate vaccine (PCV) formulation on nasopharyngeal (NP) carriage of Streptococcus pneumoniae (Spn) and non-typeable Haemophilus influenzae (NTHi), the otopathogens targeted by current PCVs.

Methods: We searched MEDLINE (PubMed) and CENTRAL (Cochrane Library) to 29 September 2015.

Can a community of practice equip public health nutritionists to work with remote retail to improve the food supply?

Introduction: This study aimed to determine the influence on practice of a community of practice designed for public health nutritionists who work with retail stores in remote Indigenous communities in Australia.

Methods: A descriptive evaluation of the community of practice participants' perspectives using the most significant change technique and individual in-depth interviews was conducted. Data were analysed using thematic and content analysis with a focus on answering the evaluation questions.

HIV testing rate increased following recommendation of routine screening of acute medical admissions at Royal Darwin Hospital.

Unlabelled: Background To improve HIV detection, Royal Darwin Hospital implemented a guideline in 2012 recommending routine HIV testing for all adult acute medical admissions. This study aimed to determine the uptake, point prevalence and impact on late diagnosis of HIV screening following guideline implementation.

Methods: Data on the number of HIV tests and number of acute medical admissions over the 8 months prior and post guideline implementation were extracted from hospital databases.

Prevalence and clinical impact of magnesium disorders in end-stage renal disease: a protocol for a systematic review.

Background: Magnesium plays a key role in maintaining internal homeostasis through actions in the musculoskeletal, nervous, endocrine and cellular messenger systems. Renal excretion is the major route of magnesium elimination from the body. A positive magnesium balance would be expected in renal failure.

Inflammation, high ferritin, and erythropoietin resistance in indigenous maintenance hemodialysis patients from the Top End of Northern Australia.

Use of erythropoiesis-stimulating agents (ESAs) has improved the management of anemia in patients on maintenance hemodialysis (MHD). Iron deficiency and inflammation cause ESAs resistance and are both common among indigenous people of Northern Australia. As part of quality assurance in our Renal Anaemia Management program, we observed that there was use of higher doses of ESAs and adjuvant iron therapy in our MHD patients.