- Childhood maltreatment and adulthood poor sleep quality: a longitudinal study. [Journal Article]
- IMIntern Med J 2017 Apr 19
- CONCLUSIONS: Childhood maltreatment does not appear to predict young adult poor sleep quality, with the exception of physical abuse for males. While childhood maltreatment has been found to predict a range of mental health problems, childhood maltreatment does not appear to predict young adult occurring sleep problems. Poor sleep quality was accounted for by concurrent social disadvantage, cigarette smoking and internalising.
- The benefits of clinical facilitators on improving stroke care in acute hospitals: a new program for Australia. [Journal Article]
- IMIntern Med J 2017 Apr 19
- CONCLUSIONS: Fixed-term employment of Facilitators was effective in positively influencing stroke care in hospitals through a range of change management strategies where stroke-specific expertise had been previously limited.
- The use of resuscitation plans at a tertiary Australian hospital: room for improvement. [Journal Article]
- IMIntern Med J 2017 Apr 19
- CONCLUSIONS: More patients had resuscitation plans after introducing the ARP. However, patients and senior physicians were often remote from the consultation process and an ARP was not present for many patients likely to have a poor outcome from cardiopulmonary arrest.
- Plug-assisted retrograde transvenous obliteration of splenorenal shunts for refractory hepatic encephalopathy. [Letter]
- IMIntern Med J 2017; 47(4):470-471
- The genomic potential of the Aspirin in Reducing Events in the Elderly and Statins in Reducing Events in the Elderly studies. [Journal Article]
- IMIntern Med J 2017; 47(4):461-463
- Human genetic studies are continuing to increase in size and scale, but the availability of well-phenotyped longitudinal cohorts remains rare. Significant infrastructure, investment and effort are re...
Human genetic studies are continuing to increase in size and scale, but the availability of well-phenotyped longitudinal cohorts remains rare. Significant infrastructure, investment and effort are required to establish and maintain high-quality cohorts with biobanking, genetic consent and repeated clinical data measurements. Australia currently has two such cohorts established by Monash University as part of community-based clinical trials in the elderly. Both studies involve capture of demographic, mood, cognitive performance, physical function, neuroimaging, audiometry and various clinical data types over an average of 5 years. The ASPirin in Reducing Events in the Elderly (ASPREE) cohort is comprised of 16 703 Australians aged over 70 years and 2411 Americans aged over 65 years - recruited and randomised to either daily low-dose aspirin or placebo to examine the preventative benefit of aspirin on a range of clinical outcomes. The STAtins in Reducing Events in the Elderly (STAREE) study uses a similar model, and is currently recruiting 10 000 men and women aged over 70 years across Australia randomised to either low-dose statins or placebo. Both cohorts involve biobanking and consent for genetic research, with recruitment through a network of general practitioners in the community. A combination of whole-genome and targeted sequencing approaches will allow gene-phenotype relationships to be explored within the context of detailed longitudinal data. Genetic risk factors for late-onset high-burden conditions, such as cardiovascular disease and dementia will be investigated, plus research into other areas, such as healthy ageing and disease resilience will be possible due to unique phenotypes of health.
- Advance Care Planning and Advance Care Directives: ideas whose time has passed? [Editorial]
- IMIntern Med J 2017; 47(4):359-360
- Advance Care Planning: is quality end of life care really that simple? [Journal Article]
- IMIntern Med J 2017; 47(4):390-394
- The routine implementation of Advance Care Planning (ACP) is now a prominent feature of policy directed at improving end of life care in Australia. However, while complex ACP interventions may modest...
The routine implementation of Advance Care Planning (ACP) is now a prominent feature of policy directed at improving end of life care in Australia. However, while complex ACP interventions may modestly reduce medical care at the end of life and enable more people to die at home or outside of acute hospital settings, existing legal, organisational, cultural and conceptual barriers limit the implementation and utility of ACP. We suggest that meaningful improvements in end of life care will not result from the institutionalisation of ACP but from more significant changes to the design and delivery of care.
- The clinical academic workforce in Australia and New Zealand: report on the second binational summit to implement a sustainable training pathway. [Journal Article]
- IMIntern Med J 2017; 47(4):394-399
- There has been a decline in the proportion of clinical academics compared with full-time clinicians, since 2004. A Working Party was established to help develop and implement a model for the training...
There has been a decline in the proportion of clinical academics compared with full-time clinicians, since 2004. A Working Party was established to help develop and implement a model for the training of clinical academics. After a highly successful first summit in 2014 that summarised the challenges faced by clinical academics in Australia and New Zealand, a second summit was convened late in 2015 to report on progress and to identify key areas for further action. The second summit provided survey results that identified the varied training pathways currently offered to clinical academics and the institutions willing to be involved in developing improved pathways. A literature review also described the contributions that clinical academics make to the health sector and the challenges faced by this workforce sector. Current training pathways created for clinical academics by Australasian institutions were presented as examples of what can be done. The perspectives of government and research organisations presented at the summit helped define how key stakeholders can contribute. Following the summit, there was a strong commitment to continue to work towards developing a sustainable and defined training pathway for clinical academics. The need for a coordinated and integrated approach was highlighted. Some key objectives were agreed upon for the next phase, including identifying and engaging key advocates within government and leading institutions; publishing and profiling the contributions of successful clinical academics to healthcare outcomes; defining the stages of a clinical academic training pathway; and establishing a mentoring programme for training clinical academics.
- Double fire tachycardia induced cardiomyopathy: first ever reported case in Australia. [Letter]
- IMIntern Med J 2017; 47(4):468-470
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- Medical colleges: whose purpose, if any, do they serve? A response. [Editorial]
- IMIntern Med J 2017; 47(4):355-358