Hospital costs and factors associated with days alive and at home after surgery (DAH ).

Objective: To assess the relationships of patient and surgical factors and hospital costs with the number of days alive and at home during the 30 days following surgery (DAH ).

Design: Retrospective cohort study; analysis of Medibank Private health insurance hospital claims data, Australia, 1 January 2016 - 31 December 2017.

Setting, Participants: Admissions of adults (18 years or older) to hospitals for elective or emergency inpatient surgery with anaesthesia covered by private health insurance, Australia, 1 January 2016 - 31 December 2017.

Effect of Dapagliflozin on Cardiovascular Outcomes According to Baseline Kidney Function and Albuminuria Status in Patients With Type 2 Diabetes: A Prespecified Secondary Analysis of a Randomized Clinical Trial.

Importance: Sodium-glucose cotransporter 2 inhibitors, such as dapagliflozin, promote renal glucose excretion and reduce cardiovascular (CV) deaths and hospitalizations for heart failure (HHF) among patients with type 2 diabetes. The relative CV efficacy and safety of dapagliflozin according to baseline kidney function and albuminuria status are unknown.

Objective: To assess the CV efficacy and safety of dapagliflozin according to baseline estimated glomerular filtration rate (eGFR) and urinary albumin to creatinine ratio (UACR).

Reducing cardiovascular disease risk in diabetes: a randomised controlled trial of a quality improvement initiative.

Objectives: To describe the management of cardiovascular disease (CVD) risk in Australian patients with diabetes; to compare the effectiveness of a quality improvement initiative for people with and without diabetes.

Research Design And Methods: Subgroup analyses of patients with and without diabetes participating in a cluster randomised trial.

Setting And Participants: Indigenous people (≥ 35 years old) and non-Indigenous people (≥ 45 years old) who had attended one of 60 Australian primary health care services at least three times during the preceding 24 months and at least once during the past 6 months.

Shared Genetic Risk Factors of Intracranial, Abdominal, and Thoracic Aneurysms.

Background: Intracranial aneurysms (IAs), abdominal aortic aneurysms (AAAs), and thoracic aortic aneurysms (TAAs) all have a familial predisposition. Given that aneurysm types are known to co-occur, we hypothesized that there may be shared genetic risk factors for IAs, AAAs, and TAAs.

Methods And Results: We performed a mega-analysis of 1000 Genomes Project-imputed genome-wide association study (GWAS) data of 4 previously published aneurysm cohorts: 2 IA cohorts (in total 1516 cases, 4305 controls), 1 AAA cohort (818 cases, 3004 controls), and 1 TAA cohort (760 cases, 2212 controls), and observed associations of 4 known IA, AAA, and/or TAA risk loci (9p21, 18q11, 15q21, and 2q33) with consistent effect directions in all 4 cohorts.

Oxygenation targets, monitoring in the critically ill: a point prevalence study of clinical practice in Australia and New Zealand.

Background: Many critically ill patients require supplemental oxygen. However, the optimal oxygen saturation measured by pulse oximetry (SpO₂) in intensive care unit patients is unknown.

Objective: To evaluate clinical practice in Australia and New Zealand ICUs in relation to SpO₂monitoring, prescription of SpO₂targets by doctors, and upper and lower limits of tolerance of high and low SpO₂levels by ICU bedside nurses.

Prediction of the effect of atrasentan on renal and heart failure outcomes based on short-term changes in multiple risk markers.

Background: A recent phase II clinical trial (Reducing Residual Albuminuria in Subjects with Diabetes and Nephropathy with AtRasentan trial and an identical trial in Japan (RADAR/JAPAN)) showed that the endothelin A receptor antagonist atrasentan lowers albuminuria, blood pressure, cholesterol, hemoglobin, and increases body weight in patients with type 2 diabetes and nephropathy. We previously developed an algorithm, the Parameter Response Efficacy (PRE) score, which translates short-term drug effects into predictions of long-term effects on clinical outcomes.

Design: We used the PRE score on data from the RADAR/JAPAN study to predict the effect of atrasentan on renal and heart failure outcomes.

Coordinated care versus standard care in hospital admissions of people with chronic illness: a randomised controlled trial.

Objective: To determine whether Care Navigation (CN), a nurse-led hospital-based coordinated care intervention, reduced the use of hospital services and improved quality of life for patients with chronic illness.

Design: Randomised controlled trial; participants were allocated to CN or standard care.

Participants And Setting: Patients with chronic illness presenting to the emergency department of Nepean Hospital, Sydney, New South Wales.

Clinical guidelines on hyperlipidaemia: recent developments, future challenges and the need for an Australian review.

Large reductions in cardiovascular disease (CVD) mortality have been achieved over the last 50 years in developed countries. The health policies that have contributed so much to this success have largely been coordinated by means of expert guidelines for the management of the classic modifiable risk factors such as blood pressure, diabetes and blood lipids. National and international guidelines for lipid management have demonstrated a high degree of consistency between numerous sets of recommendations.

Effectiveness of a multifactorial intervention on preventing development of frailty in pre-frail older people: study protocol for a randomised controlled trial.

Introduction: Frailty is a major concern due to its costly and widespread consequences, yet evidence of effective interventions to delay or reduce frailty is lacking. Our previous study found that a multifactorial intervention was feasible and effective in reducing frailty in older people who were already frail. Identifying and treating people in the pre-frail state may be an effective means to prevent or delay frailty.

Prognostic factors of remission in myasthenia gravis after thymectomy.

Thymectomy has become an increasingly popular procedure for myasthenia gravis. Knowledge of factors associated with a good outcome (remission) or those most likely to benefit from surgery can help clinical decision-making. A systematic review search was conducted in Medline and Embase for English language studies from 1985 through to February 2014.

Patient selection and volume in the era surrounding implementation of Medicare conditions of participation for transplant programs.

Objective: To evaluate evidence of practice changes affecting kidney transplant program volumes, and donor, recipient and candidate selection in the era surrounding the introduction of Centers for Medicare and Medicaid Services (CMS) conditions of participation (CoPs) for organ transplant programs.

Data: Scientific Registry of Transplant Recipients; CMS ESRD and Medicare claims databases.

Design: Retrospective analysis of national registry data.

Influence of migration on characteristics of type 2 diabetes in sub-Saharan Africans.

Aim: This study compared the clinical and biochemical characteristics and microvascular complications found in three groups of type 2 diabetes (T2D) patients: Africans living in Africa; African immigrants living in France; and Caucasians living in France.

Methods: Diagnosed T2D Africans living in Cameroon (n=100) were compared with 98 African migrants diagnosed with T2D after having moved to France, and a group of 199 T2D Caucasian patients living in France. All underwent clinical and biochemical evaluations, and all were assessed for microvascular complications.

Primary care provision by volunteer medical brigades in Honduras: a health record review of more than 2,500 patients over three years.

The weak health system in Honduras contributes to poor health indicators. To improve population health, a number of volunteer medical brigades from developed countries provide health services in Honduras. To date, there is little information on the brigades' activities and impact.

A systematic overview of prospective cohort studies of cardiovascular disease in sub-Saharan Africa.

Background: Cardiovascular diseases (CVDs) are becoming increasingly significant in sub-Saharan Africa (SSA). Reliable measures of the contribution of major determinants are essential for informing health services and policy solutions.

Objective: To perform a systematic review of all longitudinal studies of CVDs and related risk factors that have been conducted in SSA.

Restraint use and seating position among child car passengers: an observational study in Shanghai.

Child passenger restraint practices in China are poorly characterized and few direct observational studies have been performed. This study aims to describe child passenger restraint use and to investigate factors influencing the restraint practices. A cross-sectional observational study was conducted at toll-gates in Shanghai during an 11-day period in June in 2009.

Public reporting of hospital outcomes: a challenging road ahead.

Public reporting of patient outcomes following hospitalisation in Australia is limited compared with other countries. This will change, given recent commitments by state and federal governments to an Australian reporting program as part of health reform. There are numerous challenges in the design and implementation of such a program, including strategic decisions, statistical methods, and preventing risk aversion and perverse behaviour.

Contemporary model for cardiovascular risk prediction in people with type 2 diabetes.

Background: Existing cardiovascular risk prediction equations perform non-optimally in different populations with diabetes. Thus, there is a continuing need to develop new equations that will reliably estimate cardiovascular disease (CVD) risk and offer flexibility for adaptation in various settings. This report presents a contemporary model for predicting cardiovascular risk in people with type 2 diabetes mellitus.

Prevalence of sleep disturbance in patients with low back pain.

Low back pain (LBP) is a common health condition that is often associated with disability, psychological distress and work loss. Worldwide, billions of dollars are expended each year trying to manage LBP, often with limited success. Recently, some researchers have reported that LBP patients also report sleep disturbance as a result of their LBP.

Robust data to close the gap: current vascular and maternal/newborn indicators as measures of progress in Aboriginal health in New South Wales.

Objective: Focussing on maternal/newborn health and vascular diseases, to review NSW Health's reporting, by Aboriginal status, against national performance indicators relevant to preventable chronic diseases.

Methods: We reviewed seven indicator documents and the Australian Institute of Health and Welfare Chronic Disease Indicator Database to identify national indicators. Indicators from six NSW Health reports were then compared with these national indicators to assess reporting by Aboriginal status and region.

Prevalence rates of helmet use among motorcycle riders in a developed region in China.

This study aimed to determine the prevalence rates of helmet use, and of correct helmet use (chinstrap firmly fastened) among motorcycle riders and their passengers in Zhongshan, Guangdong Province, China. A cross-sectional survey involving direct observation of motorcycle riders was conducted at 20 randomly selected intersections. A total of 13,410 motorcycles were observed during a 10-day period in February 2009.

Cardiovascular outcomes in type 2 diabetes: the impact of preventative therapies.

The world is facing an unprecedented increase in type 2 diabetes. Most disability and premature mortality experienced by people with diabetes is related to cardiovascular disease. This review summarizes recent evidence about approaches for managing cardiovascular risk in patients with type 2 diabetes.

Association between Supervisory Driver Offences and Novice Driver Crashes Post-Licensure.

This research explore associations between driving offences of learner supervisory drivers and subsequent crashes as novice independent drivers in a prospective cohort of 20,822 drivers aged 17-24 in New South Wales, Australia, on their first independent driver licence. Information on demographics, primary supervisory drivers, and various risk factors was collected via an online questionnaire and subsequently linked to police-reported crashes two years later. Poisson regression determined that the unadjusted relative risk of crash was 1.

Economic evaluation of a combined microfinance and gender training intervention for the prevention of intimate partner violence in rural South Africa.

Objective: Assess the cost-effectiveness of an intervention combining microfinance with gender and HIV training for the prevention of intimate partner violence (IPV) in South Africa.

Methods: We performed a cost-effectiveness analysis alongside a cluster-randomized trial. We assessed the cost-effectiveness of the intervention in both the trial and initial scale-up phase.

Does psychological distress increase the risk for motor vehicle crashes in young people? findings from the DRIVE study.

Purpose: Earlier research demonstrates increased and decreased risk of crash related to psychological distress; however, previous literature has almost entirely used retrospective study designs and has not been able to adequately control for important confounders such as exposure to driving, alcohol and drug use, or having had a previous crash. This study aimed to assess the relationship between psychological distress and risk of motor vehicle crashes.

Methods: The DRIVE study is a prospective cohort study of 20,822 novice drivers aged 17-24 years in Australia.