The development and validation of a brief performance-based fall risk assessment tool for use in primary care.

Background: To report the development, external validity, reliability, and feasibility of a falls risk assessment tool for use in primary care.

Methods: Two prospective cohort studies, a test-retest reliability study, and a feasibility study were included. Seven hundred and sixty four older community-living people (mean age = 75.

Effects of a fixed combination of perindopril and indapamide in patients with type 2 diabetes and chronic kidney disease.

Aims: Individuals with diabetes and chronic kidney disease (CKD) are at high risk for cardiovascular disease. In these analyses of the ADVANCE trial, we assessed the effects of a fixed combination of perindopril-indapamide on renal and cardiovascular outcomes in patients with type 2 diabetes according to baseline CKD stage.

Methods And Results: Patients with type 2 diabetes were randomized to perindopril-indapamide (4 mg/1.

Fatal crash trends for Australian young drivers 1997-2007: geographic and socioeconomic differentials.

Background: Little has been published on changes in young driver fatality rates over time. This paper examines differences in Australian young driver fatality rates over the last decade, examining important risk factors including place of residence and socioeconomic status (SES).

Methods: Young driver (17-25years) police-recorded passenger vehicle crashes were extracted from New South Wales State records from 1997-2007.

Efficacy and safety of routine blood pressure lowering in older patients with diabetes: results from the ADVANCE trial.

Objective: The efficacy and safety of blood pressure lowering in elderly patients have not been sufficiently investigated in patients with diabetes. Using data from the Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation study, we assessed the efficacy and safety of routine blood pressure lowering to prevent major clinical outcomes in elderly patients with type 2 diabetes.

Methods: Eleven thousand one hundred and forty patients aged at least 55 years with type 2 diabetes (mean 66+/-6 years) were randomly assigned to perindopril-indapamide or placebo.

Mobility-related disability three months after aged care rehabilitation can be predicted with a simple tool: an observational study.

Questions: What is the prevalence of mobility-related disability 3 months after discharge from inpatient aged care rehabilitation? Can a clinical tool predict which individuals will experience mobility-related disability 3 months after discharge?

Design: Prospective cohort study.

Participants: 442 patients newly admitted to two large inpatient rehabilitation units.

Outcome Measures: Predictors were co-morbidities; pre-admission mobility; and discharge cognition, pain, vision, muscle strength, and mobility.

How to read a report of a randomized controlled trial.

Proper evaluation of up-to-date clinical evidence is essential for the provision of optimal patient care. Randomized controlled trials (RCTs) are the ideal study type to investigate the benefit or harm of an intervention, such as a drug therapy. RCTs aims to avoid biased assessment of clinical interventions through the even distribution of both known and unknown factors that may influence outcomes.

Effects of fibrates on cardiovascular outcomes: a systematic review and meta-analysis.

Background: Several clinical trials have reported inconsistent findings for the effect of fibrates on cardiovascular risk. We undertook a systematic review and meta-analysis to investigate the effects of fibrates on major clinical outcomes.

Methods: We systematically searched Medline, Embase, and the Cochrane Library for trials published between 1950 and March, 2010.

The second (main) phase of an open, randomised, multicentre study to investigate the effectiveness of an intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT2).

Rationale: The INTERACT pilot study demonstrated the feasibility of the protocol, safety of early intensive blood pressure lowering and effects on haematoma expansion within 6 h of onset of intracerebral haemorrhage. This article describes the design of the second, main phase, INTERACT2.

Aims: To compare the effects of a management strategy of early intensive blood pressure lowering with a more conservative guideline-based blood pressure management policy in patients with acute intracerebral hemorrhage.

Media framing of graduated licensing policy debates.

Background: The overrepresentation of young drivers in road trauma statistics produces significant media interest. Graduated licensing restrictions involving night-time curfews and restrictions on passenger numbers are prominent topics within media coverage. This was particularly apparent in Australia between January 2004 and July 2008, when various models of either restriction were introduced in four states.

Injection therapy and denervation procedures for chronic low-back pain: a systematic review.

Injection therapy and denervation procedures are commonly used in the management of chronic low-back pain (LBP) despite uncertainty regarding their effectiveness and safety. To provide an evaluation of the current evidence associated with the use of these procedures, a systematic review was performed. Existing systematic reviews were screened, and the Cochrane Back Review Group trial register was searched for randomized controlled trials (RCTs) fulfilling the inclusion criteria.

Accuracy of self-report of on-road crashes and traffic offences in a cohort of young drivers: the DRIVE study.

In order to determine the accuracy of self-report of on-road crashes and traffic offences among participants in the DRIVE study, 2991 young drivers in New South Wales, Australia who completed the follow-up questionnaire were asked whether they had been involved in an on-road crash or were convicted for a traffic offence while driving during the year prior to the survey. This information was linked to police crash data to determine the level of accuracy of self-report of on-road crashes. There was a high level of accuracy in young drivers' self-report of police recorded crashes (85.

Importance of blood pressure lowering in type 2 diabetes: focus on ADVANCE.

Routine blood pressure lowering with the fixed combination of perindopril and indapamide in 11,140 patients with type 2 diabetes was very well tolerated and produced substantial benefits in reducing all-cause and cardiovascular mortality, the primary combined outcome of macro- or microvascular events, total coronary events, and total renal events, as reported previously. We present here a wealth of evidence, most of it previously published either in journal articles or in recent abstract form, that the relative risk reductions conferred by the combination of perindopril and indapamide are broadly consistent across subgroups defined by a wide range of baseline characteristics, including blood pressure at entry, age from below 65 to above 75 years, total cardiovascular risk defined according to the European guidelines, stage of chronic disease, and cognitive function. Furthermore, we report that the absolute risk reductions are significantly greater in those with increased cardiovascular risk, with more advanced nephropathy and in older subjects.

Critical appraisal of clinical prediction rules that aim to optimize treatment selection for musculoskeletal conditions.

Background: Clinical prediction rules (CPRs) for treatment selection in musculoskeletal conditions have become increasingly popular.

Purpose: The purposes of this review are: (1) to critically appraise studies evaluating CPRs and (2) to consider the clinical utility and stage of development of each CPR.

Data Sources: Pertinent databases were searched up to April 2009.

Life events and risk of subarachnoid hemorrhage: the australasian cooperative research on subarachnoid hemorrhage study (ACROSS).

Background And Purpose: Because little evidence exists and the topic often raises concerns, we aimed to determine the relationship between life events and subarachnoid hemorrhage (SAH) in a population-based case-control setting.

Methods: In 388 SAH incident cases and 473 frequency-matched community SAH-free control subjects, information on the occurrence of 12 types of adverse life events in the preceding 1 and 2 to 12 months was obtained by interview using a questionnaire based on the Social Behavior Assessment Schedule. Analyses involved logistic regression models with adjustment for confounding variables.

Intensities of renal replacement therapy in acute kidney injury: a systematic review and meta-analysis.

Background And Objectives: Clinical trials of the intensity of renal replacement therapy (RRT) for people with acute kidney injury (AKI) have produced conflicting results. A systematic review and meta-analysis was undertaken to assess the effect of different intensities of RRT on all-cause mortality and renal recovery in AKI patients.

Design, Setting, Participants, & Measurements: MEDLINE, EMBASE, and the Cochrane Library database were systematically searched for trials published between 1950 and 2009.

International albumin use: 1995 to 2006.

Over the last ten years more reliable information regarding the risks and benefits of the use of albumin for fluid resuscitation has emerged. To determine what influence this has had on clinical practice, we sought to document albumin use (from mass of albumin supplied to hospitals) in 16 industrialised countries between 1995 and 2006. Data on national albumin and synthetic colloid use was sought from independent intensive care researchers and albumin issuers.

Urinary incontinence and quality of life among older community-dwelling Australian men: the CHAMP study.

Objective: to describe the prevalence and impact on quality of life of urinary incontinence in a population-based cohort of older community-dwelling Australian men.

Subjects: the population comprised 1,705 men aged >or=70 years participating in the Concord Health and Ageing in Men Project, a population-based study of urban older Australian men.

Methods: data were collected between January 2005 and June 2007, and the participation rate was 47%.

How little pain and disability do patients with low back pain have to experience to feel that they have recovered?

Epidemiological and clinical studies of people with low back pain (LBP) commonly measure the incidence of recovery. The pain numerical rating scale (NRS), scores from 0 to 10, and Roland Morris disability questionnaire (RMDQ), scores from 0 to 24, are two instruments often used to define recovery. On both scales higher scores indicate greater severity.

Treatment-based subgroups of low back pain: a guide to appraisal of research studies and a summary of current evidence.

There has been a recent increase in research evaluating treatment-based subgroups of non-specific low back pain. The aim of these sub-classification schemes is to identify subgroups of patients who will respond preferentially to one treatment as opposed to another. Our article provides accessible guidance on to how to interpret this research and determine its implications for clinical practice.

Secondary prevention of ischemic stroke in urban China.

Background And Purpose: We aimed to describe the uptake of proven secondary prevention strategies for ischemic stroke in urban China.

Methods: In a prospective, multicenter, hospital-based registry of 4782 cases of acute ischemic stroke in China during 2006, the use of secondary prevention regimens was evaluated before hospital discharge and 3 and 12 months after stroke. Logistic regression analysis was performed to determine associations between various baseline variables and in-hospital use of antihypertensive, antiplatelet, and lipid-lowering therapies, and to identify variables associated with their continuation at 12 months.

Cardiovascular risk perception and evidence--practice gaps in Australian general practice (the AusHEART study).

Objective: To examine the perception and management of cardiovascular disease (CVD) risk in Australian primary care.

Design, Setting And Participants: The Australian Hypertension and Absolute Risk Study (AusHEART) was a nationally representative, cluster-stratified, cross-sectional survey of 322 general practitioners. Each GP was asked to collect data on CVD risk factors and their management in 15-20 consecutive patients aged >or= 55 years who presented between April and June 2008, and to estimate each patient's absolute risk of a cardiovascular event in the next 5 years.

Evidence-based treatment for ankle injuries: a clinical perspective.

The most common ankle injuries are ankle sprain and ankle fracture. This review discusses treatments for ankle sprain (including the management of the acute sprain and chronic instability) and ankle fracture, using evidence from recent systematic reviews and randomized controlled trials. After ankle sprain, there is evidence for the use of functional support and non-steroidal anti-inflammatory drugs.

There was evidence of convergent and construct validity of Physiotherapy Evidence Database quality scale for physiotherapy trials.

Objective: To evaluate the convergent and construct validity of the Physiotherapy Evidence Database (PEDro) scale used to rate the methodological quality of randomized trials in physiotherapy.

Study Design And Setting: PEDro total scores and individual-item scores were extracted from 9,456 physiotherapy trials indexed on PEDro. Convergent validity was tested by comparing PEDro total scores with three other quality scales.

Pharmaceutical interventions for emotionalism after stroke.

Background: Antidepressants may be useful in the treatment of abnormal crying associated with stroke. This is an update of a Cochrane Review first published in 2004.

Objectives: To determine whether pharmaceutical treatment reduces the frequency of emotional displays in people with emotionalism after stroke.