The Medical journal of Australia
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Multicenter Study Comparative Study
Late mortality after severe traumatic brain injury in New South Wales: a multicentre study.
To determine the long-term mortality pattern of adults with severe traumatic brain injury (TBI), and to identify the risk factors associated with death in this group. ⋯ People who survive to discharge from inpatient rehabilitation following a severe TBI were found to have a sustained increase in risk of death for eight years post discharge. Various demographic and injury-related variables selectively increase mortality risk and may be modifiable in order to reduce the observed increase in mortality.
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Multicenter Study
Prevalence of antimicrobial-resistant organisms in residential aged care facilities.
To assess the frequency of, and risk factors for, colonisation with vancomycin-resistant enterococci (VRE), Clostridium difficile and extended-spectrum β-lactamase (ESBL)-producing organisms in residential aged care facilities (RACFs). ⋯ We found a high prevalence of multiresistant ESBL-producing E. coli in RACF residents. A clonal relatedness of isolates suggests possible transmission within the facility. RACFs should have programs emphasising processes that will limit spread of these organisms, namely good hand hygiene compliance, enhanced environmental cleaning and dedicated antimicrobial stewardship programs.
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Randomized Controlled Trial Multicenter Study Comparative Study
Predictors of accuracy of diagnosis of chronic obstructive pulmonary disease in general practice.
To compare the clinical diagnosis of chronic obstructive pulmonary disease (COPD) with results of post-bronchodilator spirometry in general practice, and examine practitioner, practice and patient characteristics associated with agreement between clinical and spirometric diagnoses. ⋯ A substantial proportion of patients clinically identified as having COPD in general practice do not have the condition according to spirometric criteria, with inaccurate diagnosis more common in patients with comorbidities. Policy and practice change is needed to support the use of spirometry in primary care.
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Randomized Controlled Trial Multicenter Study
Clinician-assisted computerised versus therapist-delivered treatment for depressive and addictive disorders: a randomised controlled trial.
To compare computer-delivered and therapist-delivered treatments for people with depression and comorbid addictive disorders. ⋯ Over a 3-month period, CBT/MI was associated with a better treatment response than supportive counselling. CAC therapy was associated with greater reduction in alcohol use than therapist-delivered treatment.
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Multicenter Study
Aseptic insertion of central venous lines to reduce bacteraemia.
To reduce the rate of central line-associated bacteraemia (CLAB). ⋯ Compliance with all aspects of aseptic CVL insertion significantly reduces the risk of CLAB. A difficulty we experienced was that most ICUs lacked the organisation and staff to support quality improvement and audit.