Journal articles: 'Medical libraries Victoria Melbourne'

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Rood, Sarah, and Katherine Sheedy. "Frank Macfarlane Burnet." Microbiology Australia 30, no. 3 (2009): 10. http://dx.doi.org/10.1071/ma09s10.

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Sir Frank Macfarlane Burnet was born in Traralgon, Victoria, in 1899. He received his medical degree in 1924 from the University of Melbourne and performed research (1925-27) at the Lister Institute of Preventive Medicine, London. After receiving his PhD from the University of London (1928), Burnet ? usually known as Mac ? became Assistant Director of the Walter and Eliza Hall Institute of Medical Research at Royal Melbourne Hospital. From 1944-65 he was Director of the Institute and Professor of Experimental Medicine at the University of Melbourne.

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Draper, Brian. "G Vernon Davies: unsung pioneer of old age psychiatry in Victoria." Australasian Psychiatry 30, no. 2 (November 8, 2021): 203–5. http://dx.doi.org/10.1177/10398562211045085.

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Objective: To provide a biography of G Vernon Davies who took up a career in old age psychiatry in 1955 at the age of 67 at Mont Park Hospital in an era when there few psychiatrists working in the field. Conclusion: In the 1950s and 1960s, Vernon Davies worked as an old age psychiatrist and published papers containing sensible practical advice informed by contemporary research and experience, broadly applicable to both primary and secondary care, presented in a compassionate and empathetic manner. His clinical research in old age psychiatry resulted in the first doctoral degree in psychiatry awarded at the University of Melbourne at the age of 79. Before commencing old age psychiatry, he served in the Australian Army Medical Corps as a Regimental Medical Officer and received the Distinguished Service Order. He spent 3 years as a medical missionary in the New Hebrides before settling at Wangaratta where he worked as a physician for over 30 years. He contributed to his local community in a broad range of activities. Vernon Davies is an Australian pioneer of old age psychiatry.

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Gillbank, Linden. "University Botany in Colonial Victoria: Frederick McCoy's Botanical Classes and Collections at the University of Melbourne." Historical Records of Australian Science 19, no. 1 (2008): 53. http://dx.doi.org/10.1071/hr08002.

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Botany was part of the broad intellectual territory of one of the University of Melbourne's four foundation chairs. From his appointment in 1854 until his death in 1899, Frederick McCoy was the Professor of Natural Science and, for most of that time, also honorary Director of the Colony of Victoria's National Museum. McCoy gained ideas about botany and botanic gardens and museums while studying and working at the University of Cambridge, where he attended Professor John Stevens Henslow's botany lectures in 1847. With help from Henslow and Victoria's Government Botanist, Ferdinand Mueller, McCoy acquired botanical collections and developed a class (system) garden at the University of Melbourne, where he taught botany to arts and medical students from 1863 until the establishment of the science degree and arrival of the Professor of Biology in 1887 left him only a rarely-taken botanical subject.

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Hainsworth, Steven, Ann C. Lawrie, Thiru Vanniasinkam, and Danilla Grando. "Metagenomics of Toenail Onychomycosis in Three Victorian Regions of Australia." Journal of Fungi 8, no. 11 (November 14, 2022): 1198. http://dx.doi.org/10.3390/jof8111198.

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Onychomycosis is a fungal disease of the nail that is found worldwide and is difficult to diagnose accurately. This study used metagenomics to investigate the microbiology of 18 clinically diagnosed mycotic nails and two normal nails for fungi and bacteria using the ITS2 and 16S loci. Four mycotic nails were from Bass Coast, six from Melbourne Metropolitan and eight from Shepparton, Victoria, Australia. The mycotic nails were photographed and metagenomically analysed. The ITS2 sequences for T. rubrum and T. interdigitale/mentagrophytes averaged over 90% of hits in 14/18 nails. The high abundance of sequences of a single dermatophyte, compared to all other fungi in a single nail, made it the most likely infecting agents (MLIA). Trichophyton rubrum and T. interdigitale/mentagrophytes were found in Bass Coast and Shepparton while only T. interdigitale/mentagrophytes was found in Melbourne. Two nails with T. interdigitale/mentagrophytes mixed with high abundance non-dermatophyte moulds (NDMs) (Aspergillus versicolor, Acremonium sclerotigenum) were also observed. The two control nails contained chiefly Fusarium oxysporum and Malassezia slooffiae. For bacteria, Staphylococcus epidermidis was in every nail and was the most abundant, including the control nails, with an overall mean rate of 66.01%. Rothia koreensis, Corynebacterium tuberculostearicum, and Brevibacterium sediminis also featured.

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Garrett, Claire, and H. W. Gordon Baker. "A new fully automated system for the morphometric analysis of human sperm heads**Supported by grants 890959 from the National Health and Medical Research Council of Australia and 9320 from the Research Committee of the Royal Women’s Hospital, Melbourne, Victoria, Australia, and by Melbourne IVF, Melbourne, Victoria, Australia." Fertility and Sterility 63, no. 6 (June 1995): 1306–17. http://dx.doi.org/10.1016/s0015-0282(16)57616-x.

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Thomas, S. L., K. Lam, L. Piterman, A. Mijch, and P. A. Komesaroff. "Complementary medicine use among people living with HIV/AIDS in Victoria, Australia: practices, attitudes and perceptions." International Journal of STD & AIDS 18, no. 7 (July 1, 2007): 453–57. http://dx.doi.org/10.1258/095646207781147292.

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There is limited evidence suggesting the underlying reasons for the use of complementary and alternative medicines (CAMs) by people with HIV/AIDS, or individual attitudes and beliefs about the use of CAMs. Using focus groups and a survey with 151 individuals attending the HIV Clinics at The Alfred Hospital, Melbourne, we aimed to provide insights into factors that influence the use of CAMs among people living with HIV/AIDS. Roughly half (49%) of the participants had used CAMs to manage their HIV/AIDs. Users of CAMs utilized a wide range of treatments in managing their condition, but costs of the CAMs meant that users were not necessarily able to use them as much as they might have liked. Use of CAMs was based on a desire to find something beneficial rather than on being dissatisfied with conventional medicine. Further research is needed into (a) the effects of CAMs and (b) the enhancement of communication and collaboration between patients, doctors and complementary medicine practitioners.

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Guy, Rebecca, Megan S. C. Lim, Yung-Hsuan J. Wang, Nicholas Medland, Jonathan Anderson, Norman Roth, and Margaret E. Hellard. "A new surveillance system for monitoring HIV infection in Victoria, Australia." Sexual Health 4, no. 3 (2007): 195. http://dx.doi.org/10.1071/sh07011.

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Objectives: To establish a new mechanism for monitoring patterns of HIV infection, in the context of a sustained increase in HIV diagnosis among men who have sex with men (MSM) in Victoria. Methods: Between April 2004 and August 2005, a linked voluntary HIV sentinel surveillance system was implemented at five medical clinics with a high case load of MSM. Using a questionnaire, doctors collected HIV testing history, demographic and sexual risk behaviour information from all clients undergoing voluntary HIV testing. Questionnaires were linked with HIV test results. Logistic regression analysis was conducted to determine factors associated with HIV infection. Results: Of 3435 MSM tested for HIV at participating sites, 1.7%, (95% CI = 1.2–2.2) were newly diagnosed with HIV; between 2004 and 2005 the proportion increased from 1.3% (95% CI = 1.2–1.5) to 2.0% (95% CI = 1.8–2.2), P = 0.107. There was no significant change in the number of HIV tests conducted per month or in demographic characteristics, testing history and sexual behaviour characteristics between time periods. In multivariate analysis, reporting unprotected anal intercourse (UAI) with any partner, UAI with a HIV-positive partner/s and being aged 30–39 years or 40 years or greater were significantly associated with HIV infection. Conclusion: This new surveillance mechanism, based on linked testing at participating clinics, indicates that the increase in HIV notifications in 2005 was unrelated to changes in testing and data from a Melbourne sexual behavioural survey suggests the increase was more likely to be attributed to increases in transmission within the past few years. The sentinel system highlighted UAI, especially with HIV positive partner/s are important transmission factors.

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Rose, Louise, Sioban Nelson, Linda Johnston, and Jeffrey J. Presneill. "Decisions Made By Critical Care Nurses During Mechanical Ventilation and Weaning in an Australian Intensive Care Unit." American Journal of Critical Care 16, no. 5 (September 1, 2007): 434–43. http://dx.doi.org/10.4037/ajcc2007.16.5.434.

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Background Responsibilities of critical care nurses for management of mechanical ventilation may differ among countries. Organizational interventions, including weaning protocols, may have a variable impact in settings that differ in nursing autonomy and interdisciplinary collaboration. Objective To characterize the role of Australian critical care nurses in the management of mechanical ventilation. Methods A 3-month, prospective cohort study was performed. All clinical decisions related to mechanical ventilation in a 24-bed, combined medical-surgical adult intensive care unit at the Royal Melbourne Hospital, a university-affiliated teaching hospital in Melbourne, Victoria, Australia, were determined. Results Of 474 patients admitted during the 81-day study period, 319 (67%) received mechanical ventilation. Death occurred in 12.5% (40/319) of patients. Median durations of mechanical ventilation and intensive care stay were 0.9 and 1.9 days, respectively. A total of 3986 ventilation and weaning decisions (defined as any adjustment to ventilator settings, including mode change; rate or pressure support adjustment; and titration of tidal volume, positive end-expiratory pressure, or fraction of inspired oxygen) were made. Of these, 2538 decisions (64%) were made by nurses alone, 693 (17%) by medical staff, and 755 (19%) by nurses and staff in collaboration. Decisions made exclusively by nurses were less common for patients with predominantly respiratory disease or multiple organ dysfunction than for other patients. Conclusions In this unit, critical care nurses have high levels of responsibility for, and autonomy in, the management of mechanical ventilation and weaning. Revalidation of protocols for ventilation practices in other clinical contexts may be needed.

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Mulcahy, Sean Alexander, and Sean Mulcahy. "Acting Law | Law Acting: A Conversation with Dr Felix Nobis and Professor Gary Watt." Exchanges: The Interdisciplinary Research Journal 4, no. 2 (April 30, 2017): 189–200. http://dx.doi.org/10.31273/eirj.v4i2.158.

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Dr Felix Nobis is a senior lecturer with the Centre for Theatre and Performance at Monash University. He has worked as a professional actor for many years. He previously played an assistant to the Crown Prosecutor in the Australian television series, Janus, which was set in Melbourne, Victoria and based on the true story of a criminal family allegedly responsible for police shootings. He also played an advisor to a medical defence firm in the Australian television series MDA. He is a writer and professional storyteller. He has toured his one-person adaptation of Beowulf (2004) and one-person show Once Upon a Barstool (2006) internationally and has written on these experiences. His most recent work Boy Out of the Country (2016) is written in an Australian verse style and has just completed a tour of regional Victoria. Professor Gary Watt is an academic in the School of Law at the University of Warwick where his teaching includes advocacy and mooting. He also regularly leads rhetoric workshops at the Royal Shakespeare Company. He is the author of Dress, Law and Naked Truth (2013) and, most recently, Shakespeare’s Acts of Will: Law, Testament and Properties of Performance (2016), which explores rhetoric in law and theatre. He also co-wrote A Strange Eventful History, which he performed with Australian choral ensemble, The Song Company, to mark the 400th anniversary of Shakespeare’s death.

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Grundstein, Andrew, Marshall Shepherd, Paul Miller, and Stefanie Ebelt Sarnat. "The Role of Mesoscale-Convective Processes in Explaining the 21 November 2016 Epidemic Thunderstorm Asthma Event in Melbourne, Australia." Journal of Applied Meteorology and Climatology 56, no. 5 (May 2017): 1337–43. http://dx.doi.org/10.1175/jamc-d-17-0027.1.

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AbstractA major thunderstorm asthma epidemic struck Melbourne and surrounding Victoria, Australia, on 21 November 2016, which led to multiple deaths, a flood of residents seeking medical attention for respiratory problems, and an overwhelmed emergency management system. This case day had all the classic ingredients for an epidemic, including high rye grass pollen concentrations, a strong multicellular thunderstorm system moving across the region, and a large population of several million people in the vicinity of Melbourne. A particular characteristic of this event was the strong, gusty winds that likely spread the pollen grains and/or allergenic contents widely across the region to increase population exposure. This exploratory case study is the first to examine the usefulness of low-to-middle-atmospheric thermodynamic information for anticipating epidemic thunderstorm asthma outbreaks by allowing the forecast of strong downdraft winds. The authors investigated the utility of several mesoscale products derived from atmospheric soundings such as downdraft convective available potential energy (DCAPE) and indices for predicting surface wind gusts such as microburst wind speed potential index (MWPI) and a wind gust index (GUSTEX). These results indicate that DCAPE levels reached “high” to “very high” thresholds for strong downdraft winds in the lead-up to the thunderstorm, and the MWPI and GUSTEX indices accurately predicted the high maximum surface wind observations. This information may be useful for diagnostic and prognostic assessment of epidemic thunderstorm asthma and in providing an early warning to health practitioners, emergency management officials, and residents in affected areas.

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Mitchell, Paul, Jennifer Soon, Joanne Kenny, and Katherine Simons. "What do doctors value about attending multi-disciplinary cancer case discussions?" Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): e18324-e18324. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e18324.

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e18324 Background: Discussion of cancer cases at multi-disciplinary meetings (MDMs) for treatment planning is expected standard care in Australia. There has been rapid uptake of MDMs in the last 10 - 15 years and in the state of Victoria approximately 70% of cancer cases are discussed. MDMs have strong support from medical staff and we investigated their motivation in attending MDMs. Methods: Over 12 months, Austin Health in Melbourne, Victoria, hosted 452 cancer MDMs discussing 5943 patients. MDMs covered 15 tumour areas: 11 solid tumour, one lymphoma and three haematological. Over a 4-week period, medical staff attending MDMs were surveyed and asked to rank what they valued most about cancer MDMs, over and above the benefits for patients. Results: Responses were received from 84% of the 285 medical staff surveyed, which included consultants as well as trainees (registrars and fellows). For 75% of respondents the highest ranking was given to multi-disciplinary communication, 9% gave the highest ranking to quality assurance and governance, 5% ongoing learning for consultants, 5% collegiate relationships, 2% learning and teaching for non-consultant staff, 2% peer support 1% job satisfaction and 1% clinical trials engagement. Similar results were obtained for consultant staff and for registrars / fellows. For consultant medical staff, if multidisciplinary communication was excluded, 44% of respondents gave the highest ranking to quality assurance and governance, 23% to collegiate relationships, 20% ongoing learning for consultants, 10% peer support and 3% clinical trials engagement. Conclusions: When we asked doctors what they valued most about attending cancer MDMs, besides the benefits for patients, communication between disciplines was clearly the most valued aspect. The benefits for quality and governance was the next most valued, then collegiate relationships and peer support, and ongoing learning.

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Dwyer, Alison, and John McNeil. "Are Clinical Registries Actually Used? The Level of Medical Staff Participation in Clinical Registries, and Reporting within a Major Tertiary Teaching Hospital." Asia Pacific Journal of Health Management 11, no. 1 (March 16, 2016): 56–64. http://dx.doi.org/10.24083/apjhm.v11i1.245.

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Clinical Registries are established to provide a clinically credible means for monitoring and benchmarking healthcare processes and outcomes, to identify areas for improvement, and drive strategies for improving patient care. Clinical Registries are used to assess changes in clinical practice, appropriateness of care and health outcomes over time. The American Heart Association Policy Statement in April 2011 called for expanding the application for existing and future Clinical Registries, with well-designed Clinical Registry programs. Concurrently, in Australia, and similarly within the United States and United Kingdom, there has been an increased focus on performance measurement for quality and patient safety. Within Victoria, the Victorian Clinical Governance Policy Framework outlines clinical effectiveness as one of the four domains of Clinical Governance As Clinical Registries evaluate effectiveness and safety of patient care by measuring patient outcomes compared with peers, the use of Clinical Registries data to improve a health service’s quality of care seems intuitive. A mixed methods approach was utilised, involving (1) semi-structured interviews and (2) documentation audit in this study conducted at Austin Health, a major tertiary teaching hospital in North-Eastern metropolitan Melbourne, affiliated with the University of Melbourne and various research institutes within Austin LifeSciences. Although many studies have highlighted the benefits of data collected via individual Clinical Registries, [5,6] the level of voluntary medical staff participation in Clinical Registries at a health service level is yet to be established. The aim of this study was to document the level of medical staff involvement for Clinical Registries within a major tertiary teaching hospital, and the level of reporting into Quality Committees within the organisation. This study demonstrates that along with a very high level of medical staff participation in Clinical Registries, there is a lack of systematic reporting of Registries data into quality committees beyond unit level, and utilisation of such data to reflect upon practice and drive quality improvement. Abbreviations: CREPS – Centre for Excellence in Patient Safety; CSU – Clinical Services Unit; HOU – Heads of Unit; VASM – Victorian Audit of Surgical Mortality.

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Needleman, Robert, Eric P. F. Chow, Janet M. Towns, Vincent J. Cornelisse, Tim Z. T. Yang, Marcus Y. Chen, Catriona S. Bradshaw, Ria Fortune, and Christopher K. Fairley. "Access to sexual health services after the rapid roll out of the launch of pre-exposure prophylaxis for HIV in Melbourne, Australia: a retrospective cross-sectional analysis." Sexual Health 15, no. 6 (2018): 528. http://dx.doi.org/10.1071/sh17182.

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Background On 26 July 2016, Victoria began a large study of HIV pre-exposure prophylaxis, called PrEPX, that involved the creation of around 2600 appointments over 3 months across multiple sites in Melbourne, Australia. At this time, the Melbourne Sexual Health Centre (MSHC) appeared to have a larger demand on its services. The aim of the present study was to determine whether this apparent increase in demand was substantially different from other demand fluctuations. Methods: Patients presenting to the MSHC from 2014 to 2016 were reviewed. Demographic characteristics, sexual risks and sexually transmitted infection diagnoses were extracted from the clinical database. Results: There were 115522 walk-in presentations for care and a rise in presentations in the week following the launch of the PrEPX study, but at least six similar peaks occurred that year. The peak coinciding with the launch of PrEPX was only apparent for men who have sex with men. There was a substantial increase in the proportion of patients who could not be seen (i.e. triaged out), from 10% in the week before PrEPX to 22.2% in the second week after, but this was primarily due to staff absences. At the time of the PrEPX study, data were collected on the duration of symptoms for common conditions and found no significant (P>0.29) change in the average duration of symptoms compared with that seen before the PrEPX launch. Conclusions: The increase in the number of medical consultations required for the PrEPX study did not result in excessive demand for public sexual health services.

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Brijnath, Bianca, Nabita Singh, and Danielle Mazza. "Stakeholder perspectives on the new sickness certificate in Victoria: results from a mixed-methods qualitative study." Australian Health Review 40, no. 1 (2016): 27. http://dx.doi.org/10.1071/ah14136.

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Objective The aim of this study was to present the views of four stakeholder groups, namely general practitioners (GP), employers (EMP), injured workers (IW) and compensation agents (CA), about the content and usability of the draft of the new Victorian sickness certificate. Methods A cross-sectional mixed-methods qualitative study was conducted in GP clinics and community settings in Melbourne, Australia. Interviews were conducted with GPs, EMPs and IWs and one focus group discussion was completed with CAs (n = 29). Data were collected between October and December 2013. Thematic analysis was performed. Results All stakeholders viewed the new draft certificate as an improvement on the old one. GPs saw the certificate as a form of communication, whereas EMPs and CAs saw it as a therapeutic device. GPs continued to certify based on incapacity and provided little information about what IWs could do on return to work. All groups said that assessments for mental health needed more clarity and specificity. GPs, EMPs and CAs also said that the new certificates must be electronically available and integrated into existing medical software to streamline uptake. Conclusions To ensure appropriate use of the new certificate, stakeholders must share a common understanding about its purpose and the certificate must be incorporated into existing medical software. Content on mental health assessment, an area of continued difficulty, needs additional refinement. The new certificate replaced the old certificate in March 2015; after it has been established in clinical practice, an impact evaluation should be completed to determine whether GPs are certifying capacity and earlier return to work. What is known about the topic? When it comes to sickness certification, GPs tend to focus on what injured patients cannot do, rather than what they can do. The new sickness certificate aims to change GP behaviour by focusing the certificate more on capacity (i.e. what the injured patient can do). What does this paper add? Four stakeholder groups agreed that the content and usability of the new certificate has improved. However, they agreed that the assessment of mental health capacity needs further specificity. Dissonances also remain between the stakeholders on the purpose of the certificate. What are the implications for practitioners? Appropriate use of the new certificate requires a common understanding about the purpose of the certificate, training on its appropriate use, incorporation into existing medical software and clarity on mental health assessment.

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McDougall, Rosalind, Barbara Hayes, Marcus Sellars, Bridget Pratt, Anastasia Hutchinson, Mark Tacey, Karen Detering, Cade Shadbolt, and Danielle Ko. "'This is uncharted water for all of us': challenges anticipated by hospital clinicians when voluntary assisted dying becomes legal in Victoria." Australian Health Review 44, no. 3 (2020): 399. http://dx.doi.org/10.1071/ah19108.

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ObjectiveThe aim of this study was to identify the challenges anticipated by clinical staff in two Melbourne health services in relation to the legalisation of voluntary assisted dying in Victoria, Australia. MethodsA qualitative approach was used to investigate perceived challenges for clinicians. Data were collected after the law had passed but before the start date for voluntary assisted dying in Victoria. This work is part of a larger mixed-methods anonymous online survey about Victorian clinicians’ views on voluntary assisted dying. Five open-ended questions were included in order to gather text data from a large number of clinicians in diverse roles. Participants included medical, nursing and allied health staff from two services, one a metropolitan tertiary referral health service (Service 1) and the other a major metropolitan health service (Service 2). The data were analysed thematically using qualitative description. ResultsIn all, 1086 staff provided responses to one or more qualitative questions: 774 from Service 1 and 312 from Service 2. Clinicians anticipated a range of challenges, which included burdens for staff, such as emotional toll, workload and increased conflict with colleagues, patients and families. Challenges regarding organisational culture, the logistics of delivering voluntary assisted dying under the specific Victorian law and how voluntary assisted dying would fit within the hospital’s overall work were also raised. ConclusionsThe legalisation of voluntary assisted dying is anticipated to create a range of challenges for all types of clinicians in the hospital setting. Clinicians identified challenges both at the individual and system levels. What is known about the topic?Voluntary assisted dying became legal in Victoria on 19 June 2019 under the Voluntary Assisted Dying Act 2017. However there has been little Victorian data to inform implementation. What does this paper add?Victorian hospital clinicians anticipate challenges at the individual and system levels, and across all clinical disciplines. These challenges include increased conflict, emotional burden and workload. Clinicians report concerns about organisational culture, the logistics of delivering voluntary assisted dying under the specific Victorian law and effects on hospitals’ overall work. What are the implications for practitioners?Careful attention to the breadth of staff affected, alongside appropriate resourcing, will be needed to support clinicians in the context of this legislative change.

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LANTSBERG, Daniel, Yossi MIZRACHI, and Darren KATZ. "Micro-TESE Outcomes for Non-Obstructive Azoospermia — The First Australian Series." Fertility & Reproduction 04, no. 03n04 (September 2022): 140. http://dx.doi.org/10.1142/s2661318222740528.

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Background: Micro-dissection testicular sperm extraction (micro-TESE) for non-obstructive azoospermia (NOA) was shown to achieve the best sperm retrieval rate (SRR) compared to other techniques. However, to date there is no large series of published Australian data. Aim: To study the incidence and predicting factors of successful sperm extraction in men with NOA undergoing micro-TESE in Victoria. Method: We retrospectively analyzed the clinical data of all consecutive patients with confirmed NOA who were treated between August 2014 and April 2020 in a single medical centre in Melbourne, Victoria. None were excluded. Patients underwent micro-TESE and upon a successful sperm retrieval, sperm was either frozen for fertility preservation or used fresh for ICSI. Results: During the study period, 85 men with NOA underwent micro-TESE in our centre. The overall sperm retrieval rate (SRR) was 61.2% (52/85). All patients with a history of surgically treated cryptorchidism or childhood diseases had a successful sperm retrieval. Patients with Kleinfelter syndrome had a 75% SRR. Patients with Idiopathic NOA and patients with a history of chemotherapy had a 50% and 40% SRR, respectively. Among the different types of testicular pathology, the highest SRR was found in men with complete hyalinization (100%). Hypospermatogenesis was associated with a high SRR of 93.3%, while Sertoli-cell-only histology was associated with only 46.3% SRR. The SRR has significantly increased from 33.3% in 2015-2016 to 73.6% in 2019-2020 (p=0.003). On Multivariate logistic regression analysis, baseline FSH levels <20 IU and history of childhood disease or Klinefelter syndrome were significantly associated with successful sperm retrieval. The cumulative pregnancy rate was 23.7%. Conclusion: This first report from Australia indicates that micro-TESE is an effective method for the treatment of NOA with high SRR and pregnancy rate. Our results can help patient management and counseling.

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Keeves, Jemma, Belinda Gabbe, Sarah Arnup, Christina Ekegren, and Ben Beck. "Serious Injury in Metropolitan and Regional Victoria: Exploring Travel to Treatment and Utilisation of Post-Discharge Health Services by Injury Type." International Journal of Environmental Research and Public Health 19, no. 21 (October 28, 2022): 14063. http://dx.doi.org/10.3390/ijerph192114063.

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This study aimed to describe regional variations in service use and distance travelled to post-discharge health services in the first three years following hospital discharge for people with transport-related orthopaedic, brain, and spinal cord injuries. Using linked data from the Victorian State Trauma Registry (VSTR) and Transport Accident Commission (TAC), we identified 1597 people who had sustained transport-related orthopaedic, brain, or spinal cord injuries between 2006 and 2016 that met the study inclusion criteria. The adjusted odds of GP service use for regional participants were 76% higher than for metropolitan participants in the orthopaedic and traumatic brain injury (TBI) groups. People with spinal cord injury (SCI) living in regional areas had 72% lower adjusted odds of accessing mental health, 76% lower adjusted odds of accessing OT services, and 82% lower adjusted odds of accessing physical therapies compared with people living in major cities. People with a TBI living in regional areas on average travelled significantly further to access all post-discharge health services compared with people with TBI in major cities. For visits to medical services, the median trip distance for regional participants was 76.61 km (95%CI: 16.01–132.21) for orthopaedic injuries, 104.05 km (95% CI: 51.55–182.78) for TBI, and 68.70 km (95%CI: 8.34–139.84) for SCI. Disparities in service use and distance travelled to health services exist between metropolitan Melbourne and regional Victoria following serious injury.

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Seiler, Natalie, Matthew Ng, Midya Dawud, Subhash Das, Shu-Haur Ooi, and Astrid Waterdrinker. "Demographic and clinical factors associated with psychiatric inpatient admissions during the COVID-19 pandemic." Australasian Psychiatry 30, no. 2 (December 6, 2021): 229–34. http://dx.doi.org/10.1177/10398562211052903.

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Objective: The COVID-19 pandemic may cause a major mental health impact. We aimed to identify demographic or clinical factors associated with psychiatric admissions where COVID-19 was attributed to contribute to mental state, compared to admissions which did not. Methods: A retrospective cohort study was undertaken of inpatients admitted to Northern Psychiatric Unit 1, Northern Hospital in Melbourne, Victoria, Australia during 27/02/2020 to 08/07/2020. Data were extracted for participants who identified COVID-19 as a stressor compared to participants who did not. Fisher’s exact test and Mann-Whitley rank sum test were used. Results: Thirty six of 242 inpatients reported the COVID-19 pandemic contributed to mental ill health and subsequent admission. Reasons given included social isolation, generalized distress about the pandemic, barriers to support services, disruption to daily routine, impact on employment, media coverage, re-traumatization, cancelled ECT sessions, loss of loved ones, and increased drug use during the lockdown. Chronic medical conditions or psychiatric multimorbidity were positively associated and smoking status was negatively associated with reporting the COVID-19 pandemic as a contributor to mental ill health. Conclusion: Screening and identifying vulnerable populations during and after the global disaster is vital for timely and appropriate interventions to reduce the impact of the pandemic worldwide.

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Levesque, Jean-Frederic, John J. M. O'Dowd, Éidín M. Ní Shé, Jan-Willem Weenink, and Jane Gunn. "Scoping of models to support population-based regional health planning and management: comparison with the regional operating model in Victoria, Australia." Australian Health Review 41, no. 2 (2017): 162. http://dx.doi.org/10.1071/ah15198.

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Objective The aim of the present study was to try to understand the breadth and comprehensiveness of a regional operating model (ROM) developed within the Victorian Department of Health’s North West Metropolitan Region office in Melbourne, Australia. Methods A published literature search was conducted, with additional website scanning, snowballing technique and expert consultation, to identify existing operating models. An analytical grid was developed covering 16 components to evaluate the models and assess the exhaustiveness of the ROM. Results From the 34 documents scoped, 10 models were identified to act as a direct comparator to the ROM. These concerned models from Australia (n = 5) and other comparable countries (Canada, UK). The ROM was among the most exhaustive models, covering 13 of 16 components. It was one of the few models that included intersectoral actions and levers of influence. However, some models identified more precisely the planning tools, prioritisation criteria and steps, and the allocation mechanisms. Conclusions The review finds that the ROM appears to provide a wide coverage of aspects of planning and integrates into a single model some of the distinctive elements of the other models scoped. What is known about the topic? Various jurisdictions are moving towards a population-based approach to manage public services with regard to the provision of individual medical and social care. Various models have been proposed to guide the planning of services from a population health perspective. What does this paper add? This paper assesses the coverage of attributes of operating models supporting a population health planning approach to the management of services at the regional or local level. It provides a scoping of current models proposed to organise activities to ensure an integrated approach to the provision of services and compares the scoped models to a model recently implemented in Victoria, Australia. What are the implications for practitioners? This paper highlights the relative paucity of operating models describing in concrete terms how to manage medical and social services from a population perspective and encourages organisations that are accountable for securing population health to clearly articulate their own operating model. It outlines strengths and potential gaps in current models.

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Voo, Veronica Tsin Fong, Jim Stankovich, Terence J. O’Brien, Helmut Butzkueven, and Mastura Monif. "Vitamin D status in an Australian patient population: a large retrospective case series focusing on factors associated with variations in serum 25(OH)D." BMJ Open 10, no. 3 (March 2020): e032567. http://dx.doi.org/10.1136/bmjopen-2019-032567.

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ObjectivesTo investigate whether sex, age, medical specialty and seasonal variations in serum concentration of 25-hydroxy vitamin D (25(OH)D) are evident among an Australian patient population.DesignRetrospective study analysing the results of serum 25(OH)D lab tests and vitamin D supplementation from Royal Melbourne Hospital (RMH) between 2014 and 2017.SettingTertiary healthcare centre in Victoria, Australia.Participants30 023 patients (inpatient and outpatient) who had their serum 25(OH)D levels measured at RMH between 2014 and 2017.Main outcome measuresSerum 25(OH)D levels stratified according to patients’ sex, age and medical specialty admitted to, as well as the season and year (2014 to 2017) 25(OH)D level was measured.ResultsMean serum 25(OH)D level of study population was 69.9 nmol/L (95% CI 69.5 to 70.2). Only 40.2% patients in this cohort were sufficient in vitamin D (>75 nmol/L). On average, 25(OH)D levels in male patients were 6.1 units (95% CI 5.4 to 6.9) lower than in females. Linear regression analysis found that 25(OH)D levels increased by 0.16 unit (95% CI 0.14 to 0.18) for every year increase in age. One-way analysis of variance showed patients from neurology had the highest average 25(OH)D level, 76.8 nmol/L (95% CI 74.2 to 79.3) compared with other medical specialties. Mean 25(OH)D level during winter, 64.9 nmol/L (95% CI 64.2 to 65.6) was significantly lower compared with other seasons despite supplementation. Average 25(OH)D level measured in 2014, 71.5 nmol/L (95 CI% 70.8 to 72.2) was significantly higher than levels measured in 2016–2017.ConclusionsThere is a sex, age, medical specialty, seasonal and yearly variation in vitamin D status in an Australian patient population. The association between low vitamin D status and winter despite supplementation suggests other interventions are required to boost serum 25(OH)D levels.

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Lewis, Patricia R., James B. Brown, Marilyn B. Renfree, and Roger V. Short. "The resumption of ovulation and menstruation in a well-nourished population of women breastfeeding for an extended period of time**Supported by National Health and Medical Research Council grant 840200, Canberra, Australian Capital Territory, Australia; Lalor Foundation, Wilmington, Delaware; Family Health International, Research Triangle Park, North Carolina; Jack Brockoff Foundation, Melbourne, Victoria, Australia; William Buckland Foundation, Melbourne, Victoria, Australia; and Monash University Postdoctoral Fellowship." Fertility and Sterility 55, no. 3 (March 1991): 529–36. http://dx.doi.org/10.1016/s0015-0282(16)54180-6.

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Allen-Graham, Judith, Lauren Mitchell, Natalie Heriot, Roksana Armani, David Langton, Michele Levinson, Alan Young, Julian A. Smith, Tom Kotsimbos, and John W. Wilson. "Electronic health records and online medical records: an asset or a liability under current conditions?" Australian Health Review 42, no. 1 (2018): 59. http://dx.doi.org/10.1071/ah16095.

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Objective The aim of the present study was to audit the current use of medical records to determine completeness and concordance with other sources of medical information. Methods Medical records for 40 patients from each of five Melbourne major metropolitan hospitals were randomly selected (n=200). A quantitative audit was performed for detailed patient information and medical record keeping, as well as data collection, storage and utilisation. Using each hospital’s current online clinical database, scanned files and paperwork available for each patient audited, the reviewers sourced as much relevant information as possible within a 30-min time allocation from both the record and the discharge summary. Results Of all medical records audited, 82% contained medical and surgical history, allergy information and patient demographics. All audited discharge summaries lacked at least one of the following: demographics, medication allergies, medical and surgical history, medications and adverse drug event information. Only 49% of records audited showed evidence the discharge summary was sent outside the institution. Conclusions The quality of medical data captured and information management is variable across hospitals. It is recommended that medical history documentation guidelines and standardised discharge summaries be implemented in Australian healthcare services. What is known about this topic? Australia has a complex health system, the government has approved funding to develop a universal online electronic medical record system and is currently trialling this in an opt-out style in the Napean Blue Mountains (NSW) and in Northern Queensland. The system was originally named the personally controlled electronic health record but has since been changed to MyHealth Record (2016). In Victoria, there exists a wide range of electronic health records used to varying degrees, with some hospitals still relying on paper-based records and many using scanned medical records. This causes inefficiencies in the recall of patient information and can potentially lead to incidences of adverse drug events. What does this paper add? This paper supports the concept of a shared medical record system using 200 audited patient records across five Victorian metropolitan hospitals, comparing the current information systems in place for healthcare practitioners to retrieve data. This research identifies the degree of concordance between these sources of information and in doing so, areas for improvement. What are the implications for practitioners? Implications of this research are the improvements in the quality, storage and accessibility of medical data in Australian healthcare systems. This is a relevant issue in the current Australian environment where no guidelines exist across the board in medical history documentation or in the distribution of discharge summaries to other healthcare providers (general practitioners, etc).

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Lin, Sherry. "Reviewer Acknowledgements for Higher Education Studies, Vol. 8, No. 4." Higher Education Studies 8, no. 4 (November 30, 2018): 200. http://dx.doi.org/10.5539/hes.v8n4p200.

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Higher Education Studies wishes to acknowledge the following individuals for their assistance with peer review of manuscripts for this issue. Their help and contributions in maintaining the quality of the journal are greatly appreciated. Higher Education Studies is recruiting reviewers for the journal. If you are interested in becoming a reviewer, we welcome you to join us. Please find the application form and details at http://recruitment.ccsenet.org and e-mail the completed application form to hes@ccsenet.org. Reviewers for Volume 8, Number 4 Abdelaziz Mohammed, Albaha University, Saudi Arabia Anna Liduma, University of Latvia, Latvia Arbabisarjou Azizollah, Zahedan University of Medical Sciences, Iran Bahar Gün, İzmir University of Economics, Turkey Barba Patton, University of Houston-Victoria, USA Edward Lehner, Bronx Community College, City University of New York, USA Evrim Ustunluoglu, Izmir University of Economics, Turkey Gerard Hoyne, University of Notre Dame Australia, Australia Gregory S. Ching, Fu Jen Catholic University, Taiwan John Cowan, Edinburgh Napier University, United Kingdom John Rafferty, Charles Sturt University, Australia Kartheek R. Balapala, University Tunku Abdul Rahman, Malaysia Laid Fekih, University of Tlemcen Algeria, Algeria Mehmet Ersoy, Eskisehir Osmangazi University, Turkey Meric Ozgeldi, Mersin University, Turkey Michael John Maxel Okoche, Uganda Management Institute, Uganda Mirosław Kowalski, University of Zielona Góra, Poland Najia Sabir, Indiana University Bloomington, USA Nancy Maynes, Nipissing University, Schulich School of Education, Canada, Canada Philip Denton, Liverpool John Moores University, United Kingdom Qing Xie, Jiangnan University, China Sahar Ahadi, Islamic Azad University of Mashhad, Iran Savitri Bevinakoppa, Melbourne Institute of Technology, Australia Suat Capuk, Adiyaman University, Turkey Teguh Budiharso, Center of Language and Culture Studies, Indonesia Tuija A. Turunen, University of Lapland, Finland Zahra Shahsavar, Shiraz University of Medical Sciences, Iran

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Cheong, Jeanie L. Y., John D. Wark, Michael M. Cheung, Louis Irving, Alice C. Burnett, Katherine J. Lee, Suzanne M. Garland, et al. "Impact of extreme prematurity or extreme low birth weight on young adult health and well-being: the Victorian Infant Collaborative Study (VICS) 1991–1992 Longitudinal Cohort study protocol." BMJ Open 9, no. 5 (May 2019): e030345. http://dx.doi.org/10.1136/bmjopen-2019-030345.

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IntroductionInfants born extremely preterm (EP, <28 weeks’ gestation) or with extremely low birth weight (ELBW,<1000 g) in the era when surfactant has been available clinically are at high risk of health and developmental problems in childhood and adolescence. However, how their health and well-being may be affected in adulthood is not well known. This study aims to compare between EP/ELBW and normal birthweight (NBW) controls: (1) physical health, mental health and socioemotional functioning at 25 years of age and (2) trajectories of these outcomes from childhood to adulthood. In addition, this study aims to identify risk factors in pregnancy, infancy, childhood and adolescence for poor physical health and well-being in EP/ELBW young adults.Methods and analysisThe Victorian Infant Collaborative Study (VICS) is a prospective geographical cohort of all EP/ELBW survivors to 18 years of age born in the State of Victoria, Australia, from 1 January 1991 to 31 December 1992 (n=297) and contemporaneous term-born/NBW controls (n=262). Participants were recruited at birth and followed up at 2, 5, 8 and 18 years. This 25-year follow-up includes assessments of physical health (cardiovascular, respiratory and musculoskeletal), mental health and socioemotional functioning. Outcomes will be compared between the birth groups using linear and logistic regression, fitted using generalised estimating equations (GEEs). Trajectories of health outcomes from early childhood will be compared between the birth groups using linear mixed-effects models. Risk factors for adult outcomes will be assessed using linear and logistic regression (fitted using GEEs).Ethics and disseminationThis study was approved by the Human Research Ethics Committees of the Royal Women’s Hospital, Mercy Hospital for Women, Monash Medical Centre and the Royal Children’s Hospital, Melbourne. Study outcomes will be disseminated through conference presentations, peer-reviewed publications, the internet and social media.

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Fleming, Julia Ann, and Bradley David O’Connor. "Use of Lidocaine Patches for Neuropathic Pain in a Comprehensive Cancer Centre." Pain Research and Management 14, no. 5 (2009): 381–88. http://dx.doi.org/10.1155/2009/723179.

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BACKGROUND: There are few reports of the use of the lidocaine 5% patch (L5%P) for neuropathic pain (NP) in the cancer patient. Within a comprehensive cancer centre, L5%P has been prescribed by the Pain and Palliative Care Service (Peter McCallum Cancer Centre, East Melbourne, Victoria, Australia) for selected patients with NP since 2001.OBJECTIVE: To retrospectively audit the use of L5%P within a comprehensive cancer centre.METHODS: All L5%P prescriptions up to January 2009 were listed and patient medical records were searched to determine neuropathic pain syndromes treated, the presence of allodynia, previous analgesic medications, treatment duration and outcome.RESULTS: L5%P was prescribed for 97 patients, most frequently for persistent postsurgical NP (n=26), postherpetic neuralgia (n=24) and cancer-related NP (n=18). Six patients had no history of cancer and two patients never applied L5%P. Reviewers classed L5%P analgesic efficacy as ‘potent’ in 38% of patients with postherpetic neuralgia, 35% of patients with postsurgical pain, 27% of patients with NP after other treatments for cancer and 12% of patients with NP attributed to cancer alone. Allodynia featured in at least 60% of patients. Where allodynia was present, the efficacy of L5%P was assessed as ‘potent’ in 38% and ‘partial’ in 24%, but ‘ineffective’ in 26%, and ‘causing worse pain’ in 3.4% of patients. Treatment duration extended longer than one month in 52 patients, longer than two months in 29 patients and longer than one year in 13 patients. Therapy was ceased due to skin irritation in seven patients. The outcomes in relation to other reports are discussed.CONCLUSION: The present data support trials of L5%P for cancer patients with NP syndromes associated with allodynia.

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Склярова, Е. К. "LIVERPOOL IN VICTORIAN DOMESTIC POLITICS." Британские исследования, no. VII(VII) (June 1, 2022): 227–43. http://dx.doi.org/10.21267/aquilo.2022.vii.vii.001.

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В статье рассматриваются особенности социального развития Ливерпуля в контексте его роли во внутренней политике Великобритании в эпоху королевы Виктории. Крупнейший город и порт Соединённого Королевства Великобритании и Ирландии одним из первых ощутил на себе все негативные последствия промышленного переворота, урбанизации и миграции населения. Как и многие другие города Великобритании, Ливерпуль фигурировал в прессе, медицинских, статистических и парламентских отчётах, как город подвалов, центр массовой миграции, трущоб, высокой смертности населения, отсутствия санитарно-технических норм и антисанитарии. Парламентские расследования и пресса указали на Ливерпуль, а также Вулверхемптон, Глазго, Дублин, Лидс, Лондон, Манчестер, Шеффилд, как города, где необходимо первоочередное проведение социальных реформ. В середине XIX в. в эпоху королевы Виктории Ливерпуль израсходовал значительные суммы денег на решение проблемы антисанитарии, уборки и мощения города, водоснабжения и освещения, жилищную реформу, организацию прачечных, общественных бань, библиотек, парков. Пионерами муниципализации и здравоохранения Ливерпуля стали — доктор Уильям Данкен, С. Хольм, Дж. Тинн. До введения общегосударственного Закона об обеспечении общественного здравоохранения 1848 г., Ливерпуль инициировал институт инспекции и санитарных врачей, жилищную реформу, систематическое вмешательство государства в решение социальных проблем. The article examines the features of Liverpool's social development in the context of its role in the domestic politics of Great Britain in the era of Queen Victoria. The largest city and port of the United Kingdom of Great Britain and Ireland was one of the first to feel all the negative consequences of the industrial revolution, urbanization and population migration. Like many other cities in the UK, Liverpool appeared in the press, medical, statistical and parliamentary reports as a city of basements, a center of mass migration, slums, high mortality, lack of sanitary standards and unsanitary conditions. Parliamentary investigations and the press have pointed to Liverpool, as well as WolverHampton, Glasgow, Dublin, Leeds, London, Manchester, Sheffield, as cities where social reforms are needed as a priority. In the middle of the XIX century in the era of Queen Victoria, Liverpool spent significant amounts of money on solving the problem of unsanitary conditions, cleaning and paving the city, water supply and lighting, housing reform, the organization of laundries, public baths, libraries, and parks. The pioneers of municipalization and health care in Liverpool were Dr. William Duncan, S. Holm, J. Thinn. Prior to the introduction of the National Public Health Law of 1848, Liverpool initiated the Institute of inspection and sanitary doctors, housing reform, and systematic state intervention in solving social problems.

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Fisher, M., F. McRae, M. Pitcher, I. Hornung, and J. Spence. "Bridge of Support: A Collaborative Approach to a Peer Support Program." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 169s. http://dx.doi.org/10.1200/jgo.18.74600.

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Background and context: The Bridge of Support Program (BOS) is adapting a successful community based model of peer support to an acute setting, at the Sunshine Hospital Breast Clinic, to meet the cultural and socioeconomic diverse needs of women with breast cancer. This two year project was funded by LUCRF Community Partnership Trust. Aim: To improve the experience of women undergoing treatment of breast cancer at Western Health. To improve access to psych-social, emotional and practical support for women by extending the reach of CounterPart- a state-wide service of women´s Health Victoria, funded by the Victorian Department of Health and Human Services to provide peer support and information to people affected by breast or a gynecologic cancer. Program/Policy process: Peer support volunteers actively guided women to current and credible evidence-based information, support decision making and provide emotional support. Peer support volunteers are rostered once a week at Sunshine Hospital to coincide with breast clinic and include access to the day oncology unit and radiotherapy center. Detailed contact information is recorded and women receive follow-up contact (with consent) from the peer support volunteers at the CounterPart Resource Centre in Melbourne. A CounterPart staff member oversees the project and provides direct support and supervision to the volunteers on site at the hospital. Women can self refer. Outcomes: Between February and December 2016 the BOS program had 159 separate contacts with patients and their families. 82 contacts were with men and women who were new to CounterPart and 77 were follow-up contacts. 90 individuals treated for breast cancer at Western Health accessed the program, which represent 53% of the women seen by the breast service. 48% of the contacts were follow-up contacts with the CounterPart volunteers indicating that once engaged with the service many men and women continue to make contact. 38% of contacts were with women diagnosed with metastatic disease, a group who often have higher levels of unmet or more complex needs. 49% were born in a nonmain English speaking country (compared with the overall state of Victoria average of 19.6%) thus reflecting an accessible service to the non-English speaking community. What was learned: At a time when peer support is being increasingly recognized as a key part of effective supportive care in cancer services, the BOS program offers a model of integrated peer support that is respected, reliable, well supported and safe within the acute setting. This acute-community sector partnership demonstrates how the medical and social models of health care can work together to provide a connected and quality service for men and women diagnosed with breast cancer. An active research approach is enabling the project to be responsive to issues and challenges as they arise including the ongoing recruitment of women as volunteers from the local community to work within the acute setting.

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Ryland, Georgina L., Lucy C. Fox, Ella Thompson, Graham John Lieschke, David Hughes, Francoise Marie Mechinaud, Anthea Louise Greenway, et al. "Providing Diagnoses in Bone Marrow Failure Syndromes through Multimodal Comprehensive Genomic Evaluation and Multidisciplinary Care: The Melbourne Genomics Health Alliance Bone Marrow Failure Flagship." Blood 132, Supplement 1 (November 29, 2018): 3867. http://dx.doi.org/10.1182/blood-2018-99-114410.

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Abstract Background and Aims The detection of sequence variants and copy number changes can improve diagnosis, inform prognosis and guide treatment in patients with bone marrow failure syndromes (BMFS). We aimed to establish and prospectively assess the impact of comprehensive genomic evaluation on diagnostic categorisation and clinical outcomes in patients with genomically uncharacterised BMFS. Methods Eligible patients were recruited from four participating institutions across Victoria, Australia. Inclusion criteria were (i) age >3 months (ii) clinicopathological diagnosis or suspicion of either acquired aplastic anaemia (AA), inherited BMFS, hypoplastic myelodysplastic syndrome (hMDS) or a BMFS with marrow hypoplasia/aplasia not able to be definitively categorised. Patients initially underwent 90-gene targeted sequencing (Peter MacCallum Cancer Centre PanHaem and Myeloid Amplicon next generation sequencing [NGS] panels) for rapid turnaround of accredited results for clinical decision-making. In addition, whole exome sequencing (WES), whole genome copy number analysis, NGS T-cell receptor β (TRB) repertoire assessment and longitudinal monitoring of selected mutations by digital droplet PCR (ddPCR) were performed. All patients received pre-test counselling and assessment. Genomic results were reviewed in centralised multidisciplinary case conferences including the treating clinician, molecular haematopathologists, medical scientists, clinical geneticists and genetic counsellors. Results 100 patients were enrolled. Median age was 25 years (range 3 months - 80 years); 39% were under 18 years. Detection of sequence variants or copy number abnormalities led to or confirmed a diagnosis of either an inherited or acquired BMFS in 36 patients. In 17 patients a diagnosis of an inherited BMFS was positively made by detection of pathogenic sequence variants or copy number changes in FANCA(1 patient [pt]), FANCM(1 pt), FANCI(1 pt), RAD51C(1 pt), HAX1(1 pt), SBDS(1 pt), DNAJC21(1 pt), RPS19(5 pts), RPL35A(1 pt), TERT(1 pt), TINF2(1 pt) and SAMD9L(1 pt). In five patients the clinical BMFS was considered undifferentiated without a clear candidate gene suspected on phenotypic features prior to genomic evaluation. Importantly, an established diagnosis of AA was altered to an inherited BMFS by genomic characterisation in two patients (SAMD9L, FANCA). In 19 patients pathogenic sequence variants or copy number changes were detected either leading to or confirming a diagnosis of an acquired BMFS (paroxysmal nocturnal haemoglobinuria, hMDS or AA). Pathogenic sequence variants were detected in TET2(n=5), RUNX1(n=4), ASXL1(n=3), PIGA(n=3), DNMT3A(n=3),CBL(n=2), and BCOR/IDH2/SF3B1/SRSF2/TP53/U2AF1(n=1 each). Sequencing-detected copy number abnormalities included loss of chromosome 7 (n=6), losses on chromosome 5q (n=2) and copy number loss of ETV6(n=2). Longitudinal monitoring of an acquired truncating RUNX1 mutation by ddPCR resulted in one patient undergoing allogeneic bone marrow transplant for a progressively rising allelic burden. There was a trend towards more restricted TRB diversity in patients with genomically-defined acquired BMFS versus inherited BMFS (normalised Shannon index ≤0.85, 36.4% vs 0%, p=0.09). Conclusion We have established and evaluated a model of comprehensive multimodal genomic characterisation and multidisciplinary care for 100 patients with BMFS. Our results demonstrate a significant contribution to diagnostic categorisation and patient care in this area of clinical need. Disclosures Lieschke: CSL Behring Australia: Consultancy. Tam:Janssen: Honoraria, Research Funding; Gilead: Honoraria; AbbVie: Honoraria, Research Funding; Pharmacyclics: Honoraria, Travel funding; Pharmacyclics: Honoraria; Beigene: Honoraria, Other: Travel funding; Roche: Honoraria; Beigene: Honoraria, Other: Travel funding; Gilead: Honoraria; Roche: Honoraria; AbbVie: Honoraria, Research Funding.

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Sakkas, Denny, Orly Lacham, Luca Gianaroli, and Alan Trounson. "Subzonal sperm microinjection in cases of severe male factor infertility and repeated in vitro fertilization failure**Supported in part by funds from the National Health and Medical Research Council of Australia, Melbourne, Victoria, Australia, as a project grant to Alan Trounson, Ph.D." Fertility and Sterility 57, no. 6 (June 1992): 1279–88. http://dx.doi.org/10.1016/s0015-0282(16)55088-2.

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Hyne, Ross V., Alexander Stojanoff, Gary N. Clarke, Alexander Lopata, and W. Ian H. Johnston. "Pregnancy from in vitro fertilization of human eggs after separation of motile spermatozoa by density gradient centrifugation**Supported in part by National Health and Medical Research Council grants to R. V. H. and A. L. and by Pharmacia (South Seas) Pty. Ltd., Melbourne, Victoria, Australia." Fertility and Sterility 45, no. 1 (January 1986): 93–96. http://dx.doi.org/10.1016/s0015-0282(16)49103-x.

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Jones, David J. "Not to be under-estimated: Buildings, books and beyond: Mechanics’ Worldwide Conference 2004: athenaeums, endowment institutes/libraries, literary institutes, lyceums, mechanics’ institutes, mercantile libraries, philosophical societies, schools of arts and working men’s/women’s institutes: proceedings of an international conference convened by the Mechanics’ Institutes of Victoria at Swinburne University, Prahran Campus, Melbourne, Australia, 2–4 September 2004.2nd edition. Windsor, Vic: Prahran Mechanics Institute Press, 2004. 430pp. Paperback. $77.00 plus $9.00 postage (Australia) $25.00 (overseas). ISBN 0 9756 0001 X. Also available as a CD-ROM $60.00 plus $4.00 postage." Australian Library Journal 55, no. 4 (November 2006): 369–71. http://dx.doi.org/10.1080/00049670.2006.10722334.

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Andel, Joan D., H. E. Coomans, Rene Berg, James N. Sneddon, Thomas Crump, H. Beukers, M. Heins, et al. "Book Reviews." Bijdragen tot de taal-, land- en volkenkunde / Journal of the Humanities and Social Sciences of Southeast Asia 147, no. 4 (1991): 516–46. http://dx.doi.org/10.1163/22134379-90003185.

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- Joan D. van Andel, H.E. Coomans, Building up the the future from the past; Studies on the architecture and historic monuments in the Dutch Caribbean, Zutphen: De Walburg Pers, 1990, 268 pp., M.A. Newton, M. Coomans-Eustatia (eds.) - Rene van den Berg, James N. Sneddon, Studies in Sulawesi linguistics, Part I, 1989. NUSA, Linguistic studies of Indonesian and other languages in Indonesia, volume 31. Jakarta: Badan Penyelenggara Seri Nusa, Universitas Katolik Indonesia Atma Jaya. - Thomas Crump, H. Beukers, Red-hair medicine: Dutch-Japanese medical relations. Amsterdam/Atlanta, GA: Rodopi, Publications for the Netherlands Association of Japanese studies No. 5, 1991., A.M. Luyendijk-Elshout, M.E. van Opstall (eds.) - M. Heins, Kees P. Epskamp, Theatre in search of social change; The relative significance of different theatrical approaches. Den Haag: CESO Paperback no. 7, 1989. - Rudy De Iongh, Rainer Carle, Opera Batak; Das Wandertheater der Toba-Batak in Nord Sumatra. Schauspiele zur Währung kultureller Identität im nationalen Indonesischen Kontext. Veröffentlichungen des Seminars fur Indonesische und Südseesprachen der Universität Hamburg, Band 15/1 & 15/2 (2 Volumes), Berlin: Dietrich Reimer Verlag, 1990. - P.E. de Josselin de Jong, Birgit Rottger-Rossler, Rang und Ansehen bei den Makassar von Gowa (Süd-Sulawesi, Indonesien), Kölner Ethnologische Studien, Band 15. Dietrich Reimar Verlag, Berlin, 1989. 332 pp. text, notes, glossary, literature. - John Kleinen, Vo Nhan Tri, Vietnam’s economic policy since 1975. Singapore: ASEAN Economic research unit, Institute of Southeast Asian studies, 1990. xii + 295 pp. - H.M.J. Maier, David Banks, From class to culture; Social conscience in Malay novels since independence, Yale, 1987. - Th. C. van der Meij, Robyn Maxwell, Textiles of Southeast Asia; Tradition, trade and transformation. Melbourne/Oxford/Auckland/New York: Australian National Gallery/Oxford University Press. - A.E. Mills, Elinor Ochs, Culture and language development, Studies in the social and cultural foundations of language No. 6, Cambridge University Press, 227 + 10 pp. - Denis Monnerie, Frederick H. Damon, Death rituals and life in the societies of the Kula Ring, Dekalb: Northern Illinois University Press, 1989. 280 pp., maps, figs., bibliogr., Roy Wagner (eds.) - Denis Monnerie, Frederick H. Damon, From Muyuw to the Trobriands; Transformations along the northern side of the Kula ring, Tucson: The University of Arizona Press, 1990. xvi + 285 pp., maps, figs., illus., apps., bibliogr., index. - David S. Moyer, Jeremy Boissevain, Dutch dilemmas; Anthropologists look at the Netherlands, Assen/Maastricht: Van Gorcum, 1989, v + 186 pp., Jojada Verrips (eds.) - Gert Oostindie, B.H. Slicher van Bath, Indianen en Spanjaarden; Een ontmoeting tussen twee werelden, Latijns Amerika 1500-1800. Amsterdam: Bert Bakker, 1989. 301 pp. - Parakitri, C.A.M. de Jong, Kompas 1965-1985; Een algemene krant met een katholieke achtergrond binnen het religieus pluralisme van Indonesie, Kampen: Kok, 1990. - C.A. van Peursen, J. van Baal, Mysterie als openbaring. Utrecht: ISOR, 1990. - Harry A. Poeze, R.A. Longmire, Soviet relations with South-East Asia; An historical survey. London-New York: Kegan Paul International, 1989, x + 176 pp. - Harry A. Poeze, Ann Swift, The road to Madiun; The Indonesian communist uprising of 1948. Ithaca, N.Y.: Cornell Modern Indonesia Project (Monograph series 69), 1989, xii + 116 pp. - Alex van Stipriaan, Cornelis Ch. Goslinga, The Dutch in the Caribbean and in Surinam 1791/5 - 1942, Assen/Maastricht: Van Gorcum, 1990. xii + 812 pp. - A. Teeuw, Keith Foulcher, Social commitment in literature and the arts: The Indonesian ‘Institute of People’s culture’ 1950-1965, Clayton, Victoria: Southeast Asian studies, Monash University (Centre of Southeast Asian studies), 1986, vii + 234 pp. - Elly Touwen-Bouwsma, T. Friend, The blue-eyed enemy; Japan against the West in Java and Luzon, 1942-1945. New Jersey: Princeton University press, 1988, 325 pp.

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Grossniklaus, Hans E. "Recommendations for the relationship between sponsors and investigators in the design and conduct of clinical stroke trials. Donnan GA,∗∗Geoffrey A Donnan, MD, National Stroke Research Institute, Department of Neurology, Austin & Repatriation Medical Centre, Level 1, Neurosciences Building, Gate 10, Banksia Street, University of Melbourne, West Heidelberg, Victoria 3081, Australia; E-mail: donnan@austin.unimelb.edu.au Davis SM, Kaste M for the International Trial Subcommittee of the International Stroke Liaison Committee, American Stroke Association. Stroke 2003;34:1041–1045." American Journal of Ophthalmology 136, no. 3 (September 2003): 588. http://dx.doi.org/10.1016/s0002-9394(03)00648-2.

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Confino, Edmond, Richard H. Demir, Jan Friberg, and Norbert Gleicher. "The predictive value of hCG β subunit levels in pregnancies achieved by in vitro fertilization and embryo transfer: an international collaborative study**Supported by the Foundation for Reproductive Medicine, Inc., Chicago, Illinois.††The International Investigators in collaboration for this study were Benjamin G. Brackett, M.D., Ph.D., The University of Georgia College of Veterinary Medicine, Atlanta, Georgia; Jairo Garcia, M.D., Suheil Muasher, M.D., Anibal A. Acosta, M.D., Mason C. Andrews, M.D., Gary Hodgen, Ph.D., Zev Rosenwaks, M.D., Georgeanna Seegar Jones, M.D., and Howard W. Jones, Jr., M.D., Eastern Virginia Medical School, Norfolk, Virginia; Robert H. Glass, M.D., Mary C. Martin, M.D., and Pramila Dandekar, M.Sc., University of California, San Francisco, California; Vesselko Grizelj, M.D., Ph.D., University Medical School of Zagreb, Zagreb, Yugoslavia; George Henry, M.D., Jon Van Blerkom, M.D., and Barbara J. Corn, R.N., Reproductive Genetics, In Vitro, P.C., Denver, Colorado; Aarne Koskimies, M.D., and Markku Seppälä, M.D., Helsinki University Central Hospital, Helsinki, Finland; David Magyar, M.D., Robert J. Sokol, M.D., and Patricia A. Rogus, R.N., Hutzel Hospital, Wayne State University, Detroit, Michigan; H. W. Michelmann, M.D., and L. Mettler, M.D., Universitats Frauenklinik, Kiel, German Federal Republic; Jean Parinaud, Ph.D., and Georges Pontonnier, M.D., Institut National de la Santé et de la Recherche Médicale, Toulouse, France; E. van Roosendaal, M.D., and R. Schoysman, M.D., Academisch Ziekenhuis Vrije Universiteit, Brussels, Belgium; Melvin Taymor, M.D., Beth Israel Hospital and Harvard Medical School, Boston, Massachusetts; Raimund Winter, M.D., Geburtshilflich-Gynakologische Universitatsklinik Graz, Graz, Austria; Richard J. Worley, M.D., and William R. Keye, Jr., M.D., University of Utah Medical Center, Salt Lake City, Utah; and John L. Yovich, F.R.A.C.O.G., University of Western Australia, Subiaco, Perth, Western Australia, Australia.‡‡Presented at The American College of Obstetricians and Gynecologists District VI Annual Meeting, September 25 to 28, 1985, Milwaukee, Wisconsin; the 41st Annual Meeting of The American Fertility Society, September 28 to October 2, 1985, Chicago, Illinois; and the 4th World Conference on In Vitro Fertilization, November 18 to 22, 1985, Melbourne, Victoria, Australia." Fertility and Sterility 45, no. 4 (April 1986): 526–31. http://dx.doi.org/10.1016/s0015-0282(16)49282-4.

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Lee, Chung, Rami Fezai, Rachel Kluck, and Michael Toussaint. "Abstracts of the 2015 Student Paramedics Australasia Conference." Australasian Journal of Paramedicine 12, no. 4 (September 3, 2015). http://dx.doi.org/10.33151/ajp.12.4.490.

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Boyle, Malcolm, Stephen Burgess, Mark Chilton, Brian Fallows, Bill Lord, David Shugg, Brett Williams, and Andrea Wyatt. "Monash University Centre for Ambulance and Paramedic Studies (MUCAPS) Submission to the Department of Human Services (DHS), in response to the DHS Discussion Paper examining the regulation of the Health Professions in Victoria." Australasian Journal of Paramedicine 1, no. 3 (October 6, 2003). http://dx.doi.org/10.33151/ajp.1.3.208.

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This submission will primarily address the regulation of the health professions from the perspective of an education institution, and is made in response to the Discussion paper examining regulation of the health professions in Victoria, dated October 2003 which was issued by the Policy and Strategic Projects Division of the Victorian Department of Human Services, Melbourne, Victoria.

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Hotchin, Les. "Abstracts of the 2014 Australian College of Ambulance Professionals National Conference." Australasian Journal of Paramedicine 6, no. 3 (July 16, 2015). http://dx.doi.org/10.33151/ajp.6.3.465.

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These are the conferences abstracts for oral and poster presentations at the Australian College of Ambulance Professionals National Conference, Melbourne, Victoria, Australia, on 4th to 6th of September 2008.

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Haridas, Rajesh P. "John Davies Thomas: Chloroformist in London and pioneer South Australian doctor." Anaesthesia and Intensive Care, August 25, 2021, 0310057X2110315. http://dx.doi.org/10.1177/0310057x211031569.

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John Davies Thomas (1844–1893) described a two-ounce drop-bottle for chloroform in 1872 while he was a resident medical officer at University College Hospital, London. After working as a ship’s surgeon, he settled in Australia. In May 1875, Thomas presented a paper on the mortality from ether and chloroform at a meeting of the Medical Society of Victoria in Melbourne, Victoria. Surveys conducted in Europe and North America had established that the mortality from chloroform was eight to ten times higher than that from ether. At that time, chloroform was the most widely administered anaesthetic in Australia. Thomas’ paper was published in The Australian Medical Journal and reprinted by the Medical Society of Victoria for distribution to hospitals in the Colony of Victoria. Later that year, Thomas moved to Adelaide, South Australia, where he may have been influential at the Adelaide Hospital in ensuring that ether was administered more often than chloroform. It does not appear that Thomas’ papers on anaesthesia had a significant effect on the conduct of anaesthesia in Victoria or New South Wales.

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Cowell, Jane. "Managing a library service through a crisis." Library Management ahead-of-print, ahead-of-print (December 22, 2020). http://dx.doi.org/10.1108/lm-10-2020-0158.

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PurposeThe study aims to explore public libraries' ability to respond to worst-case scenarios and whether planning and scenario planning is a useful exercise to prepare library staff and library organisations for quick and agile responses to crises in the future.Design/methodology/approachPersonal viewpoint of crisis management of a library service through the experience of the library service the author manages.FindingsThis paper describes Yarra Plenty Regional Library’s (YPRL’s) response to the pandemic and lockdowns in Metro Melbourne. It offers some opinions on library services readiness to respond to crises and describes the foundations of YPRL's successful response.Originality/valueYPRL is a regional corporation governed by a board of directors and serves three councils. This is one of 10 such corporations in Victoria. The organisation's response and the development as a corporation through this crisis is something that other organisations can learn from.

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Thuma, Ev. "Australian Asthma Conference - 2004 “A fresh breath – looking to the future”." Australasian Journal of Paramedicine 1, no. 3 (October 6, 2003). http://dx.doi.org/10.33151/ajp.1.3.203.

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The Australian Asthma Conference held this year in Melbourne, was hosted by the Asthma Foundation of Victoria. The conference attracted over 300 participants from all states and internationally, and was headed by a range of keynote speakers representing national and international leaders in the various aspects of asthma management from prevention through to clinical care. Participants included the full spectrum of health professionals, with a large number of asthma educators represented.

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Hill, E., C. Szoeke, L. Dennerstein, S. Campbell, and P. Clifton. "ADHERENCE TO THE MEDITERRANEAN DIET IS NOT RELATED TO BETA-AMYLOID DEPOSITION: DATA FROM THE WOMEN’S HEALTHY AGEING PROJECT." Journal Of Prevention of Alzheimer's Disease, 2018, 1–5. http://dx.doi.org/10.14283/jpad.2018.12.

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Background: Research has indicated the neuroprotective potential of the Mediterranean diet. Adherence to the Mediterranean diet has shown preventative potential for Alzheimer’s disease incidence and prevalence, yet few studies have investigated the impact of Mediterranean diet adherence on the hallmark protein; beta-amyloid. Objectives: To investigate the association between Mediterranean diet adherence and beta-amyloid deposition in a cohort of healthy older Australian women. Design: This study was a cross-sectional investigation of participants from the longitudinal, epidemiologically sourced Women’s Healthy Ageing Project which is a follow-up of the Melbourne Women’s Midlife Health Project. Setting: Assessments were conducted at the Centre for Medical Research, Royal Melbourne Hospital in Melbourne, Australia. F-18 Florbetaben positron emission tomography scanning was conducted at the Austin Centre for PET in Victoria, Australia. Participants: One hundred and eleven Women’s Healthy Ageing Project participants were included in the study. Measurements: Mediterranean diet adherence scores for all participants were calculated from the administration of a validated food frequency questionnaire constructed by the Cancer Council of Victoria. Beta-amyloid deposition was measured using positron emission tomography standardised uptake value ratios. Results: Gamma regression analysis displayed no association between Mediterranean diet adherence and beta-amyloid deposition. This result was consistent across APOE-ε4 +/- cohorts and with the inclusion of covariates such as age, education, body mass index and cognition. Conclusions: This study found no association between adherence to the Mediterranean diet and beta-amyloid deposition in a cohort of healthy Australian women.

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Haridas, Rajesh P. "Paper trails: History of the first Australian paper on ether anaesthesia." Anaesthesia and Intensive Care, December 9, 2020, 0310057X2097749. http://dx.doi.org/10.1177/0310057x20977497.

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In September 1847, David John Thomas read a paper on etherisation at a monthly meeting of the Port Phillip Medical Association. Thomas’ paper is the earliest known presentation of a paper on etherisation in the Australian colonies. Almost half of Thomas’ 27-page manuscript was published in October 1847 in the Australian Medical Journal. The original manuscript was acquired at an unknown date by the Medical Society of Victoria. Although a full transcript of the manuscript was published in 1933, the original manuscript of Dr Thomas remained unknown to anaesthesia historians and is now held by the Medical History Museum, University of Melbourne.

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Loi, Samantha M., Mark Walterfang, Wendy Kelso, JoAnne Bevilacqua, Ramon Mocellin, and Dennis Velakoulis. "A description of the components of a specialist younger-onset dementia service: a potential model for a dementia-specific service for younger people." Australasian Psychiatry, February 24, 2021, 103985622199264. http://dx.doi.org/10.1177/1039856221992643.

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Objectives: This narrative paper describes the influences behind the development of, and key components of a specialist younger-onset dementia service located in metropolitan Victoria, Australia. Conclusion: The Melbourne Young-Onset Dementia Service was established in 2013 and provides diagnosis and ongoing care for people with younger-onset dementia and their families, through collaboration with other medical units, allied health and community services. It is potentially a model for other younger-onset dementia services nationally and internationally.

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Williams, Brett. "Removal of Invasive Devices from Deceased Persons: Forensic implications for Paramedics – a Victorian perspective." Australasian Journal of Paramedicine 3, no. 4 (July 14, 2015). http://dx.doi.org/10.33151/ajp.3.4.339.

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Professor Cordner is Professor of forensic medicine at Monash University Institutes of Health and Director of the Victorian Institute of Forensic Medicine His work in the area of forensic medicine and human rights has seen him take tours of duty in East Timor and Kosovo, as well as a year-long stint consulting to the International Committee of the Red Cross in Geneva. The following interview was conducted to invite Professor Cordner’s professional opinion in relation to practices and implications with respect to the removal of invasive clinical devices from deceased persons, as they currently apply to paramedics of Metropolitan Ambulance Service in Melbourne, and Rural Ambulance Victoria.

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Wilken, Rowan. "Peter Carey's Laptop." Cultural Studies Review 20, no. 1 (March 19, 2014). http://dx.doi.org/10.5130/csr.v20i1.3835.

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In 2001, the State Library of Victoria in Melbourne built on its holdings of Australian literary manuscripts by acquiring all the papers, drafts and other items associated with Peter Carey’s Booker Prize-winning novel, True History of the Kelly Gang. The centrepiece of this acquisition, and the focus of this article, is Carey’s Apple Mac Classic laptop computer. The argument that is developed in this article is that Carey’s laptop is a technological artefact that operates, especially at the time of its acquisition, as an important talisman in three interrelated senses. First, it was viewed by library staff as a key means of gaining access to the ‘true history’ of Carey’s own creative drive or creative unconscious. Second, its public display alongside other textual objects (mostly books) served to reinforce a reconstructed corporate image that endeavoured to reposition the library as a vital contemporary cultural site and key player in Melbourne’s institutional gallery scene. Third, it was a crucial symbolic acquisition insofar as it spoke to certain desires within library management at that time, and which responded to similar moves at major libraries elsewhere around the world, to embrace collection digitisation as the path forward.

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Ranse, Jamie. "Future Directions, Future Challenges …Beyond Tomorrow, 6th International Conference for Emergency Nurses, Melbourne, Victoria, Australia 11-13 October 2007." Australasian Journal of Paramedicine 5, no. 4 (July 16, 2015). http://dx.doi.org/10.33151/ajp.5.4.436.

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O’Brien, Kylie, Amber Moore, Peter Hartley, and David Dawson. "Lessons about work readiness from final year paramedic students in an Australian university." Australasian Journal of Paramedicine 10, no. 4 (November 4, 2013). http://dx.doi.org/10.33151/ajp.10.4.52.

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Introduction Paramedic education is changing in Australia from a post-employment model in which in-house training is provided by state-based service providers to pre-employment Bachelor degree education in universities. Little is known about how well prepared final year paramedic students nearing the end of their university course perceive themselves to be to enter the workforce. The objective of the study was to investigate perceptions of preparedness for the workforce of final year paramedic students at Victoria University, Melbourne, Australia. Methods A survey was conducted with final year paramedic students in their last semester at Victoria University, Melbourne, Australia. The survey focussed on eight dimensions relating to paramedic practice: theoretical skills, clinical skills; practical skills; interpersonal skills; communication with colleagues and other professionals; coping skills; lifelong learning; and ethics and legal responsibilities. Part 1 of the survey required participants to choose from six possible responses on how well they believe their paramedic course has prepared them in relation to 64 statements. Part 2 consisted of 5 open- ended questions. Data from part 1 was analysed to find the mean ‘preparedness scores’ on the 8 dimensions of paramedic practice. Responses from part 2 of survey were transcribed and imported into NVivo8, where each part of the questions were analysed and grouped into themes. Results Response rate was 14% (n=23). Respondents felt ‘somewhat adequately’ to ‘adequately’ prepared for the workforce. Responses to Part 2 indicated a range of perceptions in relation to preparedness to enter the paramedic workforce, ranging from feeling unprepared to put knowledge into practice, prepared in some aspects but not in others, through to feeling prepared but with a realisation that there would be much to learn on the job. Respondents comments provide paramedic educators with some clear ideas about what final year students value in terms of preparing them for practice: whilst respondents valued the clinical practice opportunities they had had, they wanted more clinical placements with more variety, for example placements in different areas of healthcare. Conclusion This small survey provides paramedic educators with some clear ideas about what final year students value in terms of preparing them for practice. As Australian paramedic education moves from a post-employment training model to a pre-employment model, further consideration is needed of how courses will best address the development of clinical and practical skills of students and meet the requirements of ambulance service employers. Collegiate dialogue between employers, educators and students will assist in addressing this.

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Kelly, H. A., K. A. Grant, H. Gidding, and K. S. Carville. "Decreased varicella and increased herpes zoster incidence at a sentinel medical deputising service in a setting of increasing varicella vaccine coverage in Victoria, Australia, 1998 to 2012." Eurosurveillance 19, no. 41 (October 16, 2014). http://dx.doi.org/10.2807/1560-7917.es2014.19.41.20926.

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We performed an ecological study using sentinel consultation data from a medical deputising service to assess the impact of increasing coverage with childhood varicella vaccine on the incidence risk of varicella and zoster in the population served by the deputising service in Victoria, Australia from 1998 to 2012. Following a successful vaccination programme, the incidence of varicella in Australia was modelled to decrease and the incidence of zoster to increase, based on a theoretical decrease in boosting of zoster immunity following a decrease in wild varicella virus circulation due to vaccination. Incidence risks (consultation proportions for varicella and zoster) were directly age-standardised to the Melbourne population in 2000, when varicella vaccine was first available. Age-standardised varicella incidence risk peaked in 2000 and halved by 2012. Age-standardised zoster incidence risk remained constant from 1998 to 2002, but had almost doubled by 2012. The increase in zoster consultations largely reflected increases in people younger than 50 years-old. Although causality cannot be inferred from ecological studies, it is generally agreed that the decrease in varicella incidence is due to increasing varicella vaccine coverage. The possible indirect effect of the vaccine on zoster incidence is less clear and ongoing monitoring of zoster is required.

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Weller, Carolina Dragica, Louise Turnour, Elizabeth Connelly, Jane Banaszak-Holl, and Victoria Team. "Clinical Coders' Perspectives on Pressure Injury Coding in Acute Care Services in Victoria, Australia." Frontiers in Public Health 10 (June 1, 2022). http://dx.doi.org/10.3389/fpubh.2022.893482.

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Pressure injuries (PIs) substantively impact quality of care during hospital stays, although only when they are severe or acquired as a result of the hospital stay are they reported as quality indicators. Globally, researchers have repeatedly highlighted the need to invest more in quality improvement, risk assessment, prevention, early detection, and care for PI to avoid the higher costs associated with treatment of PI. Coders' perspectives on quality assurance of the clinical coded PI data have never been investigated. This study aimed to explore challenges that hospital coders face in accurately coding and reporting PI data and subsequently, explore reasons why data sources may vary in their reporting of PI data. This article is based upon data collected as part of a multi-phase collaborative project to build capacity for optimizing PI prevention across Monash Partners health services. We have conducted 16 semi-structured phone interviews with clinical coders recruited from four participating health services located in Melbourne, Australia. One of the main findings was that hospital coders often lacked vital information in clinicians' records needed to code PI and report quality indicators accurately and highlighted the need for quality improvement processes for PI clinical documentation. Nursing documentation improvement is a vital component of the complex capacity building programs on PI prevention in acute care services and is relied on by coders. Coders reported the benefit of inter-professional collaborative workshops, where nurses and coders shared their perspectives. Collaborative workshops had the potential to improve coders' knowledge of PI classification and clinicians' understanding of what information should be included when documenting PI in the medical notes. Our findings identified three methods of quality assurance were important to coders to ensure accuracy of PI reporting: (1) training prior to initiation of coding activity and (2) continued education, and (3) audit and feedback communication about how to handle specific complex cases and complex documentation. From a behavioral perspective, most of the coders reported confidence in their own abilities and were open to changes in coding standards. Transitioning from paper-based to electronic records highlighted the need to improve training of both clinicians and coders.

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Valentine, Jake C., Elizabeth Gillespie, Karin M. Verspoor, Lisa Hall, and Leon J. Worth. "Performance of ICD-10-AM codes for quality improvement monitoring of hospital-acquired pneumonia in a haematology-oncology casemix in Victoria, Australia." Health Information Management Journal, November 14, 2022, 183335832211317. http://dx.doi.org/10.1177/18333583221131753.

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Background The Australian hospital-acquired complication (HAC) policy was introduced to facilitate negative funding adjustments in Australian hospitals using ICD-10-AM codes. Objective The aim of this study was to determine the positive predictive value (PPV) of the ICD-10-AM codes in the HAC framework to detect hospital-acquired pneumonia in patients with cancer and to describe any change in PPV before and after implementation of an electronic medical record (EMR) at our centre. Method A retrospective case review of all coded pneumonia episodes at the Peter MacCallum Cancer Centre in Melbourne, Australia spanning two time periods (01 July 2015 to 30 June 2017 [pre-EMR period] and 01 September 2020 to 28 February 2021 [EMR period]) was performed to determine the proportion of events satisfying standardised surveillance definitions. Results HAC-coded pneumonia occurred in 3.66% ( n = 151) of 41,260 separations during the study period. Of the 151 coded pneumonia separations, 27 satisfied consensus surveillance criteria, corresponding to an overall PPV of 0.18 (95% CI: 0.12, 0.25). The PPV was approximately three times higher following EMR implementation (0.34 [95% CI: 0.19, 0.53] versus 0.13 [95% CI: 0.08, 0.21]; p = .013). Conclusion The current HAC definition is a poor-to-moderate classifier for hospital-acquired pneumonia in patients with cancer and, therefore, may not accurately reflect hospital-level quality improvement. Implementation of an EMR did enhance case detection, and future refinements to administratively coded data in support of robust monitoring frameworks should focus on EMR systems. Implications Although ICD-10-AM data are readily available in Australian healthcare settings, these data are not sufficient for monitoring and reporting of hospital-acquired pneumonia in haematology-oncology patients.

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Journal articles on the topic 'Medical libraries Victoria Melbourne'

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