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Journal articles on the topic 'Trauma centers – New South Wales'

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Published: 4 June 2021

Last updated: 11 February 2022

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1

Oliver, Matthew, Michael M. Dinh, Kate Curtis, Royce Paschkewitz, Oran Rigby, and Zsolt J. Balogh. "Trends in Procedures at Major Trauma Centres in New South Wales, Australia: An Analysis of State-Wide Trauma Data." World Journal of Surgery 41, no. 8 (March 27, 2017): 2000–2005. http://dx.doi.org/10.1007/s00268-017-3993-8.

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2

Curtis, Kate, Mary Lam, Rebecca Mitchell, Cara Dickson, and Karon McDonnell. "Major trauma: the unseen financial burden to trauma centres, a descriptive multicentre analysis." Australian Health Review 38, no. 1 (2014): 30. http://dx.doi.org/10.1071/ah13061.

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Objective This research examines the existing funding model for in-hospital trauma patient episodes in New South Wales (NSW), Australia and identifies factors that cause above-average treatment costs. Accurate information on the treatment costs of injury is needed to guide health-funding strategy and prevent inadvertent underfunding of specialist trauma centres, which treat a high trauma casemix. Methods Admitted trauma patient data provided by 12 trauma centres were linked with financial data for 2008–09. Actual costs incurred by each hospital were compared with state-wide Australian Refined Diagnostic Related Groups (AR-DRG) average costs. Patient episodes where actual cost was higher than AR-DRG cost allocation were examined. Results There were 16 693 patients at a total cost of AU$178.7 million. The total costs incurred by trauma centres were $14.7 million above the NSW peer-group average cost estimates. There were 10 AR-DRG where the total cost variance was greater than $500 000. The AR-DRG with the largest proportion of patients were the upper limb injury categories, many of whom had multiple body regions injured and/or a traumatic brain injury (P < 0.001). Conclusions AR-DRG classifications do not adequately describe the trauma patient episode and are not commensurate with the expense of trauma treatment. A revision of AR-DRG used for trauma is needed. What is known about this topic? Severely injured trauma patients often have multiple injuries, in more than one body region and the determination of appropriate AR-DRG can be difficult. Pilot research suggests that the AR-DRG do not accurately represent the care that is required for these patients. What does this paper add? This is the first multicentre analysis of treatment costs and coding variance for major trauma in Australia. This research identifies the limitations of the current AR-DRGS and those that are particularly problematic. The value of linking trauma registry and financial data within each trauma centre is demonstrated. What are the implications for practitioners? Further work should be conducted between trauma services, clinical coding and finance departments to improve the accuracy of clinical coding, review funding models and ensure that AR-DRG allocation is commensurate with the expense of trauma treatment.

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3

Beuran, M. "TRAUMA CARE: HIGHLY DEMANDING, TREMENDOUS BENEFITS." Journal of Surgical Sciences 2, no. 3 (July 1, 2015): 111–14. http://dx.doi.org/10.33695/jss.v2i3.117.

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From its beginning, mankind suffered injuries through falling, fire, drowning and human aggression [1]. Although the frequency and the kinetics modifiy over millennia, trauma continues to represent an important cause of morbidity and mortality even in the modern society [1]. Significant progresses in the trauma surgery were due to military conflicts, which next to social sufferance came with important steps in injuries’ management, further applied in civilian hospitals. The foundation of modern trauma systems was started by Dominique Jean Larrey (1766-1842) during the Napoleonic Rin military campaign from 1792. The wounded who remained on the battlefield till the end of the battle to receive medical care, usually more than 24 hours, from that moment were transported during the conflict with flying ambulances to mobile hospitals. Starting with the First World War, through the usage of antiseptics, blood transfusions, and fracture management, the mortality decreased from 39% in the Crimean War (1853–1856) to 10%. One of the most preeminent figures of the Second World War was Michael DeBakey, who created the Mobile Army Surgical Hospitals (MASH), concept very similar to the Larrey’s unit. In 1941, in England, Birmingham Accident Hospital was opened, specially designed for injured people, this being the first trauma center worldwide. During the Golf War (1990–1991) the MASH were used for the last time, being replaced by Forward Surgical Teams, very mobile units satisfying the necessities of the nowadays infantry [1]. Nowadays, trauma meets the pandemic criteria, everyday 16,000 people worldwide are dying, injuries representing one of the first five causes of mortality for all the age groups below 60 [2]. A recent 12-month analysis of trauma pattern in the Emergency Hospital of Bucharest revealed 141 patients, 72.3% males, with a mean age of 43.52 ± 19 years, and a mean New Injury Severity Score (NISS) of 27.58 ± 11.32 [3]. The etiology was traffic related in 101 (71.6%), falls in 28 (19.9%) and crushing in 7 (5%) cases. The overall mortality was as high as 30%, for patients with a mean NISS of 37.63 [3]. At the scene, early recognition of severe injuries and a high index of suspicion according to trauma kinetics may allow a correct triage of patients [4]. A functional trauma system should continuously evaluate the rate of over- and under-triage [5]. The over-triage represents the transfer to a very severe patient to a center without necessary resources, while under-triage means a low injured patient referred to a highly specialized center. If under-triage generates preventable deaths, the over-triage comes with a high financial and personal burden for the already overloaded tertiary centers [5]. To maximize the chance for survival, the major trauma patients should be transported as rapid as possible to a trauma center [6]. The initial resuscitation of trauma patients was divided into two time intervals: ten platinum minutes and golden hour [6]. During the ten platinum minutes the airways should be managed, the exsanguinating bleeding should be stopped, and the critical patients should be transported from the scene. During the golden hour all the life-threatening lesions should be addressed, but unfortunately many patients spend this time in the prehospital setting [6]. These time intervals came from Trunkey’s concept of trimodal distribution of mortality secondary to trauma, proposed in 1983 [7]. This trimodal distribution of mortality remains a milestone in the trauma education and research, and is still actual for development but inconsistent for efficient trauma systems [8]. The concept of patients’ management in the prehospital setting covered a continuous interval, with two extremities: stay and play/treat then transfer or scoop and run/ load and go. Stay and play, usually used in Europe, implies airways securing and endotracheal intubation, pleurostomy tube insertion, and intravenous lines with volemic replacement therapy. During scoop and run, used in the Unites States, the patient is immediately transported to a trauma center, addressing the immediate life-threating injuries during transportation. In the emergency department of the corresponding trauma center, the resuscitation of the injured patients should be done by a trauma team, after an orchestrated protocol based on Advanced Trauma Life Support (ATLS). The modern trauma teams include five to ten specialists: general surgeons trained in trauma care, emergency medicine physicians, intensive care physicians, orthopedic surgeons, neurosurgeons, radiologists, interventional radiologists, and nurses. In the specially designed trauma centers, the leader of the trauma team should be the general surgeon, while in the lower level centers this role may be taken over by the emergency physicians. The implementation of a trauma system is a very difficult task, and should be tailored to the needs of the local population. For example, in Europe the majority of injuries are by blunt trauma, while in the United States or South Africa they are secondary to penetrating injuries. In an effort to analyse at a national level the performance of trauma care, we have proposed a national registry of major trauma patients [9]. For this registry we have defined major trauma as a New Injury Severity Score higher than 15. The maintenance of such registry requires significant human and financial resources, while only a permanent audit may decrease the rate of preventable deaths in the Romanian trauma care (Figure 1) [10]. Figure 1 - The website of Romanian Major Trauma Registry (http://www.registrutraume.ro). USA - In the United States of America there are 203 level I centers, 265 level II centers, 205 level III or II centers and only 32 level I or II pediatric centers, according to the 2014 report of National Trauma Databank [11]. USA were the first which recognized trauma as a public health problem, and proceeded to a national strategy for injury prevention, emergency medical care and trauma research. In 1966, the US National Academy of Sciences and the National Research Council noted that ‘’public apathy to the mounting toll from accidents must be transformed into an action program under strong leadership’’ [12]. Considerable national efforts were made in 1970s, when standards of trauma care were released and in 1990s when ‘’The model trauma care system plan’’[13] was generated. The American College of Surgeons introduced the concept of a national trauma registry in 1989. The National Trauma Databank became functional seven years later, in 2006 being registered over 1 million patients from 600 trauma centers [14]. Mortality from unintentional injury in the United States decreased from 55 to 37.7 per 100,000 population, in 1965 and 2004, respectively [15]. Due to this national efforts, 84.1% of all Americans have access within one hour from injury to a dedicated trauma care [16]. Canada - A survey from 2010 revealed that 32 trauma centers across Canada, 16 Level I and 16 Level II, provide definitive trauma care [18]. All these centers have provincial designation, and funding to serve as definitive or referral hospital. Only 18 (56%) centers were accredited by an external agency, such as the Trauma Association of Canada. The three busiest centers in Canada had between 798–1103 admissions with an Injury Severity Score over 12 in 2008 [18]. Australia - Australia is an island continent, the fifth largest country in the world, with over 23 million people distributed on this large area, a little less than the United States. With the majority of these citizens concentrated in large urban areas, access to the medical care for the minority of inhabitants distributed through the territory is quite difficult. The widespread citizens cannot be reached by helicopter, restricted to near-urban regions, but with the fixed wing aircraft of the Royal Flying Doctor Service, within two hours [13]. In urban centers, the trauma care is similar to the most developed countries, while for people sparse on large territories the trauma care is far from being managed in the ‘’golden hour’’, often extending to the ‘’Golden day’’ [19]. Germany - One of the most efficient European trauma system is in Germany. Created in 1975 on the basis of the Austrian trauma care, this system allowed an over 50% decreasing of mortality, despite the increased number of injuries. According to the 2014 annual report of the Trauma Register of German Trauma Society (DGU), there are 614 hospitals submitting data, with 34.878 patients registered in 2013 [20]. The total number of cases documented in the Trauma Register DGU is now 159.449, of which 93% were collected since 2002. In the 2014 report, from 26.444 patients with a mean age of 49.5% and a mean ISS of 16.9, the observed mortality was 10% [20]. The United Kingdom - In 1988, a report of the Royal College of Surgeons of England, analyzing major injuries concluded that one third of deaths were preventable [21]. In 2000, a joint report from the Royal College of Surgeons of England and of the British Orthopedic Association was very suggestive entitled "Better Care for the Severely Injured" [22]. Nowadays the Trauma Audit Research network (TARN) is an independent monitor of trauma care in England and Wales [23]. TARN collects data from hospitals for all major trauma patients, defined as those with a hospital stay longer than 72 hours, those who require intensive care, or in-hospital death. A recent analysis of TARN data, looking at the cost of major trauma patients revealed that the total cost of initial hospital inpatient care was £19.770 per patient, of which 62% was attributable to ventilation, intensive care and wards stays, 16% to surgery, and 12% to blood transfusions [24]. Global health care models Countries where is applied Functioning concept Total healthcare costs from GDP Bismarck model Germany Privatized insurance companies (approx. 180 nonprofit sickness funds). Half of the national trauma beds are publicly funded trauma centers; the remaining are non-profit and for-profit private centers. 11.1% Beveridge model United Kingdom Insurance companies are non-existent. All hospitals are nationalized. 9.3% National health insurance Canada, Australia, Taiwan Fusion of Bismarck and Beveridge models. Hospitals are privatized, but the insurance program is single and government-run. 11.2% for Canada The out-of-pocket model India, Pakistan, Cambodia The poorest countries, with undeveloped health care payment systems. Patients are paying for more than 75% of medical costs. 3.9% for India GDP – gross domestic product Table 1 - Global health care models with major consequences on trauma care [17]. Traumas continue to be a major healthcare problem, and no less important than cancer and cardiovascular diseases, and access to dedicated and timely intervention maximizes the patients’ chance for survival and minimizes the long-term morbidities. We should remember that one size does not fit in all trauma care. The Romanian National Trauma Program should tailor its resources to the matched demands of the specific Romanian urban and rural areas.

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4

Eyland, Simon, Simon Corben, and Jenny Barton. "Suicide Prevention in New South Wales Correctional Centres." Crisis 18, no. 4 (July 1997): 163–69. http://dx.doi.org/10.1027/0227-5910.18.4.163.

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The New South Wales Department of Corrective Services has introduced a number of suicide prevention measures in order to deal with the problem of inmate suicides. This article describes the measures. The article also shows that the characteristics of the incarcerated population differ greatly from those in the community. Findings from the self-harm database 1991-1995 show that, nevertheless, there are some unique characteristics of the group of self-harmers and fatal self-harmers. These findings are discussed in relation to the preventive measures that are introduced in the NSW correctional centers.

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5

Wong, Kenneth, and Jeffrey Petchell. "Resources for managing trauma in rural New South Wales, Australia." ANZ Journal of Surgery 74, no. 9 (September 2004): 760–65. http://dx.doi.org/10.1111/j.1445-1433.2004.03138.x.

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6

Yusof Vessey, Johan, Ganeshwaran Shivapathasundram, Nevenka Francis, and Mark Sheridan. "Is neurotrauma training in rural New South Wales still required following the implementation of the New South Wales State Trauma Plan?" ANZ Journal of Surgery 91, no. 9 (July 5, 2021): 1881–85. http://dx.doi.org/10.1111/ans.16978.

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7

Gaskin, C. "Mental health and trauma in young offenders – A new South Wales perspective." Neuropsychiatrie de l'Enfance et de l'Adolescence 60, no. 5 (July 2012): S138. http://dx.doi.org/10.1016/j.neurenf.2012.04.104.

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8

Adams, Susan E., Andrew Holland, and Julie Brown. "Management of paediatric splenic injury in the New South Wales trauma system." Injury 48, no. 1 (January 2017): 106–13. http://dx.doi.org/10.1016/j.injury.2016.11.005.

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9

Gomez, David, Kristian Larsen, Brian J. Burns, Michael Dinh, and Jeremy Hsu. "Optimizing access and configuration of trauma centre care in New South Wales." Injury 50, no. 5 (May 2019): 1105–10. http://dx.doi.org/10.1016/j.injury.2019.02.018.

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10

Nocera, Nadia. "Hubs, spokes and trauma nurse coordinators: New South Wales' model of optimal trauma care — Part I." Australian Emergency Nursing Journal 6, no. 1 (April 2003): 5–9. http://dx.doi.org/10.1016/s1328-2743(03)80003-2.

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11

Nocera, Nadia. "Hubs, spokes and trauma nurse coordinators: New South Wales' model of optimal trauma care — Part II." Australian Emergency Nursing Journal 6, no. 2 (January 2004): 5–8. http://dx.doi.org/10.1016/s1328-2743(04)80108-1.

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12

Mitchell, Rebecca J., Kate Curtis, Shanley Chong, Andrew J. A. Holland, S. V. S. Soundappan, Kellie L. Wilson, and Daniel T. Cass. "Comparative analysis of trends in paediatric trauma outcomes in New South Wales, Australia." Injury 44, no. 1 (January 2013): 97–103. http://dx.doi.org/10.1016/j.injury.2011.11.012.

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13

Dinh, Michael M., Zsolt J. Balogh, Glenn Sisson, and Jean‐Frederic Levesque. "The New South Wales Trauma Quality Improvement Program: Structure, process, outcomes and the role of trauma verification." ANZ Journal of Surgery 91, no. 7-8 (July 2021): 1331–32. http://dx.doi.org/10.1111/ans.16988.

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14

Kendall, Sacha, Stacey Lighton, Juanita Sherwood, Eileen Baldry, and Elizabeth Sullivan. "Holistic Conceptualizations of Health by Incarcerated Aboriginal Women in New South Wales, Australia." Qualitative Health Research 29, no. 11 (May 13, 2019): 1549–65. http://dx.doi.org/10.1177/1049732319846162.

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While there has been extensive research on the health and social and emotional well-being (SEWB) of Aboriginal women in prison, there are few qualitative studies where incarcerated Aboriginal women have been directly asked about their health, SEWB, and health care experiences. Using an Indigenous research methodology and SEWB framework, this article presents the findings of 43 interviews with incarcerated Aboriginal women in New South Wales, Australia. Drawing on the interviews, we found that Aboriginal women have holistic conceptualizations of their health and SEWB that intersect with the SEWB of family and community. Women experience clusters of health problems that intersect with intergenerational trauma, perpetuated and compounded by ongoing colonial trauma including removal of children. Women are pro-active about their health but encounter numerous challenges in accessing appropriate health care. These rarely explored perspectives can inform a reframing of health and social support needs of incarcerated Aboriginal women establishing pathways for healing.

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15

KARANOVIC, IVANA. "A new Candonopsini (Ostracoda) genus from subterranean waters of New South Wales (Australia)." Zootaxa 4379, no. 2 (February 13, 2018): 247. http://dx.doi.org/10.11646/zootaxa.4379.2.6.

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The Australian Candonidae ostracod fauna has few surface water representatives, despite Australia being one of the principal centers of Candonidae biodiversity. The majority of Australian species live in subterranean waters, with most genera and one tribe being endemic to the continent. Species in Australia show Tethyan and Gondwana connections, with relatives living in European and Central/South American subterranean waters. I describe Hancockcandonopsis gen. nov. from boreholes in the alluvial aquifers of the Peel River and Hunter Valley, which at present contains five species, of which three are named, H. inachos sp. nov., H. io sp. nov., and H. tamworthi sp. nov., and two are left on the open nomenclature. All species are allopatric and short range endemics. The genus belongs to the almost cosmopolitan Candonopsini tribe, and the major generic autapomorphy is a hook-shaped h3-seta on the cleaning leg. Characters on the prehensile palps and hemipenis of Hancockcandonopsis indicate a close relationship with the Queensland genus Pioneercandonopsis Karanovic, 2005 and two West Indies genera, Cubacandona Danielopol, 1978 and Caribecandona Broodbaker, 1983. A cladistic analysis, based on 32 Candonopsini species and 24 morphological characters, is used to test phylogenetic relationships among Candonopsini genera globally. Several hypotheses about the historical biogeography of this tribe are discussed.

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Curtis, Kate A., Rebecca J. Mitchell, Shanley S. Chong, Zsolt J. Balogh, Duncan J. Reed, Peter T. Clark, Scott D'Amours, et al. "Injury trends and mortality in adult patients with major trauma in New South Wales." Medical Journal of Australia 197, no. 4 (August 2012): 233–37. http://dx.doi.org/10.5694/mja11.11351.

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Stapleton, Stuart G., Rod O. Bishop, and James L. Mallows. "Injury trends and mortality in adult patients with major trauma in New South Wales." Medical Journal of Australia 198, no. 9 (May 2013): 480–81. http://dx.doi.org/10.5694/mja12.11485.

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Curtis*, Kate A. "Injury trends and mortality in adult patients with major trauma in New South Wales." Medical Journal of Australia 198, no. 9 (May 2013): 481. http://dx.doi.org/10.5694/mja12.11623.

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19

Curtis, Kate, Rebecca Mitchell, Cara Dickson, Deborah Black, and Mary Lam. "Do AR-DRGs Adequately Describe the Trauma Patient Episode in New South Wales, Australia?" Health Information Management Journal 40, no. 1 (March 2011): 7–13. http://dx.doi.org/10.1177/183335831104000102.

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20

Wong, Kenneth, and Jeffrey Petchell. "SEVERE TRAUMA CAUSED BY STABBING AND FIREARMS IN METROPOLITAN SYDNEY, NEW SOUTH WALES, AUSTRALIA." ANZ Journal of Surgery 75, no. 4 (April 2005): 225–30. http://dx.doi.org/10.1111/j.1445-2197.2005.03333.x.

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21

Dinh, Michael M., Matthew Oliver, Kendall J. Bein, Susan Roncal, and Christopher M. Byrne. "Performance of the New South Wales Ambulance Service major trauma transport protocol (T1) at an inner city trauma centre." Emergency Medicine Australasia 24, no. 4 (April 4, 2012): 401–7. http://dx.doi.org/10.1111/j.1742-6723.2012.01559.x.

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22

Curtis, Kate, Mary Lam, Rebecca Mitchell, Deborah Black, Colman Taylor, Cara Dickson, Stephen Jan, Cameron S. Palmer, Mary Langcake, and John Myburgh. "Acute costs and predictors of higher treatment costs of trauma in New South Wales, Australia." Injury 45, no. 1 (January 2014): 279–84. http://dx.doi.org/10.1016/j.injury.2012.10.002.

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23

Reid, Janice C., and Timothy Strong. "Rehabilitation of refugee victims of torture and trauma: principles and service provision in New South Wales." Medical Journal of Australia 148, no. 7 (April 1988): 340–46. http://dx.doi.org/10.5694/j.1326-5377.1988.tb133735.x.

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24

Amaranath, Jeevaka E., Mahesh Ramanan, Jessica Reagh, Eilen Saekang, Narayan Prasad, Raymond Chaseling, and Sannappa Soundappan. "Epidemiology of traumatic head injury from a major paediatric trauma centre in New South Wales, Australia." ANZ Journal of Surgery 84, no. 6 (January 9, 2014): 424–28. http://dx.doi.org/10.1111/ans.12445.

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Curtis, Kate, Daniel Leonard Chan, Mary Kit Lam, Rebecca Mitchell, Kate King, Liz Leonard, Scott D'Amours, and Deborah Black. "The injury profile and acute treatment costs of major trauma in older people in New South Wales." Australasian Journal on Ageing 33, no. 4 (June 17, 2013): 264–70. http://dx.doi.org/10.1111/ajag.12059.

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26

Newman, Claire, Michelle Eason, and Grant Kinghorn. "Incidence of Vicarious Trauma in Correctional Health and Forensic Mental Health Staff in New South Wales, Australia." Journal of Forensic Nursing 15, no. 3 (2019): 183–92. http://dx.doi.org/10.1097/jfn.0000000000000245.

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27

Mitchell, Rebecca J., Kate Curtis, Andrew JA Holland, Zsolt J. Balogh, Julie Evans, and Kellie L. Wilson. "Acute costs and predictors of higher treatment costs for major paediatric trauma in New South Wales, Australia." Journal of Paediatrics and Child Health 49, no. 7 (June 12, 2013): 557–63. http://dx.doi.org/10.1111/jpc.12280.

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28

Bhardwaj, Gaurav, James Elder, Frank Martin, Mark Jacobs, and Minas T. Coroneo. "Re: Epidemiology of traumatic head injury from a major paediatric trauma centre in New South Wales, Australia." ANZ Journal of Surgery 84, no. 12 (December 2014): 995. http://dx.doi.org/10.1111/ans.12873.

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29

Sharwood, Lisa N., Holger Möller, Jesse T. Young, Bharat Vaikuntam, Rebecca Q. Ivers, Tim Driscoll, and James W. Middleton. "The Nature and Cost of Readmissions after Work-Related Traumatic Spinal Injuries in New South Wales, Australia." International Journal of Environmental Research and Public Health 16, no. 9 (April 29, 2019): 1509. http://dx.doi.org/10.3390/ijerph16091509.

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This study aimed to measure the subsequent health and health service cost burden of a cohort of workers hospitalised after sustaining work-related traumatic spinal injuries (TSI) across New South Wales, Australia. A record-linkage study (June 2013–June 2016) of hospitalised cases of work-related spinal injury (ICD10-AM code U73.0 or workers compensation) was conducted. Of the 824 individuals injured during this time, 740 had sufficient follow-up data to analyse readmissions ≤90 days post-acute hospital discharge. Individuals with TSI were predominantly male (86.2%), mean age 46.6 years. Around 8% (n = 61) experienced 119 unplanned readmission episodes within 28 days from discharge, over half with the primary diagnosis being for care involving rehabilitation. Other readmissions involved device complications/infections (7.5%), genitourinary or respiratory infections (10%) or mental health needs (4.3%). The mean ± SD readmission cost was $6946 ± $14,532 per patient. Unplanned readmissions shortly post-discharge for TSI indicate unresolved issues within acute-care, or poor support services organisation in discharge planning. This study offers evidence of unmet needs after acute TSI and can assist trauma care-coordinators’ comprehensive assessments of these patients prior to discharge. Improved quantification of the ongoing personal and health service after work-related injury is a vital part of the information needed to improve recovery after major work-related trauma.

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Duffield, Christine, and Finlay MacNeil. "The role of the Advanced Casualty Management Team in St John Ambulance Australia (New SouthWales District)." Australian Health Review 23, no. 1 (2000): 90. http://dx.doi.org/10.1071/ah000090.

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St John Ambulance is a household name synonymous with the teaching and provision of firstaid. Recently the organisation has developed pre-hospital emergency care services through theintroduction of the St- John Ambulance Australia Advanced Casualty Management Team inNew South Wales. The Advanced Casualty Management Team represents a move away fromthe practice of first aid by lay personnel and is a natural extension of the traditional workand principles of St John Ambulance. This article provides an overview of the AdvancedCasualty Management Team and discusses its contribution to pre-hospital trauma caredelivery.

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31

Manage, Nadeeka Parana, Natalie Lockart, Garry Willgoose, George Kuczera, Anthony S. Kiem, AFM Kamal Chowdhury, Lanying Zhang, and Callum Twomey. "Statistical testing of dynamically downscaled rainfall data for the Upper Hunter region, New South Wales, Australia." Journal of Southern Hemisphere Earth Systems Science 66, no. 2 (2016): 203. http://dx.doi.org/10.1071/es16016.

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This study tests the statistical properties of downscaled climate data, concentrating on the rainfall which is required for hydrology predictions used in water supply reservoir simulations. The datasets used in this study have been produced by the New South Wales (NSW) / Australian Capital Territory (ACT) Regional Climate Modelling (NARCliM) project which provides a dynamically downscaled climate dataset for southeast Australia at 10 km resolution. In this paper, we present an evaluation of the downscaled NARCliM National Centers for Environmental Prediction (NCEP) / National Center for Atmospheric Research (NCAR) reanalysis simulations. The validation has been performed in the Goulburn River catchment in the Upper Hunter region of New South Wales, Australia. The analysis compared time series of the downscaled NARCliM rain-fall data with ground based measurements for selected Bureau of Meteorology rainfall stations and 5 km gridded data from the Australian Water Availability Project (AWAP). The initial testing of the rainfall was focused on autocorrelations as persistence is an important factor in hydrological and water availability analysis. Additionally, a cross-correlation analysis was performed at daily, fort-nightly, monthly and annually averaged time resolutions. The spatial variability of these statistics were calculated and plotted at the catchment scale. The auto-correlation analysis shows that the seasonal cycle in the NARCliM data is stronger than the seasonal cycle present in the ground based measurements and AWAP data. The cross-correlation analysis also shows a poor agreement between NARCliM data, and AWAP and ground based measurements. The spatial variability plots show a possible link between these discrepancies and orography at the catchment scale.

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32

Mitchell, Rebecca J., Mike R. Bambach, David Muscatello, Kirsten McKenzie, and Zsolt J. Balogh. "Can SNOMED CT as Implemented in New South Wales, Australia Be Used for Road Trauma Injury Surveillance in Emergency Departments?" Health Information Management Journal 42, no. 2 (June 2013): 4–8. http://dx.doi.org/10.1177/183335831304200201.

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33

Davies, Bronwyn. "Encounters with Difference and the Entangled Enlivening of Being." Departures in Critical Qualitative Research 7, no. 4 (2018): 30–48. http://dx.doi.org/10.1525/dcqr.2018.7.4.30.

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This essay explores the encounters through which individuals and their communities are territorialized and deterritorialized. Thinking through Henri Bergson's lines of ascent and descent, this article looks at migration and seeking refuge. It makes links between the colonization of New South Wales, Australia, and its people in the late 1700s, and the treatment of present-day refugees caught indefinitely in Australian offshore detention centers. It draws on stories of the author's own territorialization as a child and seeks new ways of understanding encounters with difference, and movement across borders.

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Mitchell, Rebecca, Wendy L. Watson, Kate Curtis, Ian Harris, and Patricia McDougall. "Difficulties in establishing long-term trauma outcomes data collections. Could trauma outcomes be routinely monitored in New South Wales, Australia: Piloting a 3 month follow-up?" Injury 43, no. 1 (January 2012): 96–102. http://dx.doi.org/10.1016/j.injury.2011.01.006.

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Ferry, Brian. "Enhancing Environmental Experiences through Effective Partnerships among Teacher Educators, Field Study Centers, and Schools." Journal of Experiential Education 18, no. 3 (December 1995): 133–37. http://dx.doi.org/10.1177/105382599501800304.

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Few teacher educators would dispute that preservice teachers benefit from active participation in planning, implementing, and evaluating experiential learning activities in natural environments. Such experiences help them to understand how environmental education can be successfully woven into a teaching program rather than just an added “frill” presented in isolation. However, it is difficult to find efficient ways of organising these experiences in tertiary institutions. This paper discusses a partnership formed among teacher educators, schools, and field study centers in New South Wales, Australia. It was devised to enhance the experiences in environmental education for all participants, and at the same time make efficient use of human resources.

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Gomez, David, Pooria Sarrami, Hardeep Singh, Zsolt J. Balogh, Michael Dinh, and Jeremy Hsu. "External benchmarking of trauma services in New South Wales: Risk-adjusted mortality after moderate to severe injury from 2012 to 2016." Injury 50, no. 1 (January 2019): 178–85. http://dx.doi.org/10.1016/j.injury.2018.09.037.

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Mitchell, Rebecca J., Kate Curtis, Shanley Chong, Andrew J. A. Holland, S. V. S. Soundappan, Kellie L. Wilson, and Daniel T. Cass. "Erratum to “Comparative analysis of trends in paediatric trauma outcomes in New South Wales, Australia” [Injury 44 (1) (2013) 97–103]." Injury 44, no. 10 (October 2013): 1375. http://dx.doi.org/10.1016/j.injury.2013.07.003.

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Mitra, Biswadev, Stephen Bernard, Dashiell Gantner, Brian Burns, Michael C. Reade, Lynnette Murray, Tony Trapani, et al. "Protocol for a multicentre prehospital randomised controlled trial investigating tranexamic acid in severe trauma: the PATCH-Trauma trial." BMJ Open 11, no. 3 (March 2021): e046522. http://dx.doi.org/10.1136/bmjopen-2020-046522.

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IntroductionHaemorrhage causes most preventable prehospital trauma deaths and about a third of in-hospital trauma deaths. Tranexamic acid (TXA), administered soon after hospital arrival in certain trauma systems, is an effective therapy in preventing or managing acute traumatic coagulopathy. However, delayed administration of TXA appears to be ineffective or harmful. The effectiveness of prehospital TXA, incidence of thrombotic complications, benefit versus risk in advanced trauma systems and the mechanism of benefit remain uncertain.Methods and analysisThe Pre-hospital Anti-fibrinolytics for Traumatic Coagulopathy and Haemorrhage (The PATCH-Trauma study) is comparing TXA, initiated prehospital and continued in hospital over 8 hours, with placebo in patients with severe trauma at risk of acute traumatic coagulopathy. We present the trial protocol and an overview of the statistical analysis plan. There will be 1316 patients recruited by prehospital clinicians in Australia, New Zealand and Germany. The primary outcome will be the eight-level Glasgow Outcome Scale Extended (GOSE) at 6 months after injury, dichotomised to favourable (GOSE 5–8) and unfavourable (GOSE 1–4) outcomes, analysed using an intention-to-treat (ITT) approach. Secondary outcomes will include mortality at hospital discharge and at 6 months, blood product usage, quality of life and the incidence of predefined adverse events.Ethics and disseminationThe study was approved by The Alfred Hospital Research and Ethics Committee in Victoria and also approved in New South Wales, Queensland, South Australia, Tasmania and the Northern Territory. In New Zealand, Northern A Health and Disability Ethics Committee provided approval. In Germany, Witten/Herdecke University has provided ethics approval. The PATCH-Trauma study aims to provide definitive evidence of the effectiveness of prehospital TXA, when used in conjunction with current advanced trauma care, in improving outcomes after severe injury.Trial registration numberNCT02187120.

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Monk, Amy, Mark Tracy, Maralyn Foureur, Celia Grigg, and Sally Tracy. "Evaluating Midwifery Units (EMU): a prospective cohort study of freestanding midwifery units in New South Wales, Australia." BMJ Open 4, no. 10 (October 2014): e006252. http://dx.doi.org/10.1136/bmjopen-2014-006252.

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ObjectiveTo compare maternal and neonatal birth outcomes and morbidities associated with the intention to give birth in two freestanding midwifery units and two tertiary-level maternity units in New South Wales, Australia.DesignProspective cohort study.Participants494 women who intended to give birth at freestanding midwifery units and 3157 women who intended to give birth at tertiary-level maternity units. Participants had low risk, singleton pregnancies and were at less than 28+0 weeks gestation at the time of booking.Primary and secondary outcome measuresPrimary outcomes were mode of birth, Apgar score of less than 7 at 5 min and admission to the neonatal intensive care unit or special care nursery. Secondary outcomes were onset of labour, analgesia, blood loss, management of third stage of labour, perineal trauma, transfer, neonatal resuscitation, breastfeeding, gestational age at birth, birth weight, severe morbidity and mortality.ResultsWomen who planned to give birth at a freestanding midwifery unit were significantly more likely to have a spontaneous vaginal birth (AOR 1.57; 95% CI 1.20 to 2.06) and significantly less likely to have a caesarean section (AOR 0.65; 95% CI 0.48 to 0.88). There was no significant difference in the AOR of 5 min Apgar scores, however, babies from the freestanding midwifery unit group were significantly less likely to be admitted to neonatal intensive care or special care nursery (AOR 0.60; 95% CI 0.39 to 0.91). Analysis of secondary outcomes indicated that planning to give birth in a freestanding midwifery unit was associated with similar or reduced odds of intrapartum interventions and similar or improved odds of indicators of neonatal well-being.ConclusionsThe results of this study support the provision of care in freestanding midwifery units as an alternative to tertiary-level maternity units for women with low risk pregnancies at the time of booking.

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Reid, Janice, Derrick Silove, and Ruth Tarn. "The Development of the New South Wales Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (Startts): The First Year." Australian & New Zealand Journal of Psychiatry 24, no. 4 (December 1990): 486–95. http://dx.doi.org/10.3109/00048679009062904.

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Many immigrants to Australia are refugees, some of whom have experienced acute stress and trauma, including torture, prior to or during their escape from their home countries. In response to a growing recognition that the health care services may not be meeting the needs of these people the NSW Department of Health funded the establishment of a community-based rehabilitation service for traumatised refugees. This paper provides an overview of the recent history of the service, some of the organisational and staffing issues faced during its first year, some characteristics of the first 200 clients, principles of treatment, clinical, nosological and therapeutic issues and relationships with other agencies.

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Malalasekera, Ashanya, Prunella L. Blinman, Haryana M. Dhillon, Natalie A. Stefanic, Peter Grimison, Ankit Jain, Mario D’Souza, Steven C. Kao, and Janette L. Vardy. "Times to Diagnosis and Treatment of Lung Cancer in New South Wales, Australia: A Multicenter, Medicare Data Linkage Study." Journal of Oncology Practice 14, no. 10 (October 2018): e621-e630. http://dx.doi.org/10.1200/jop.18.00125.

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Introduction: Earlier access to lung cancer specialist (LCS) care improves survival. We examined times to diagnosis and treatment of patients with lung cancer in rural and metropolitan New South Wales (NSW) Australia, benchmarked against recent timeframe recommendations. Materials and Methods: Semistructured interviews of recently diagnosed patients with lung cancer from five NSW cancer centers were used to determine standardized time intervals to diagnosis and treatment, triangulated with Medicare data linkage and medical records. We used descriptive statistics to evaluate the primary end points of median time intervals from general practitioner (GP) referral to first LCS visit (GP-LCS interval) and to treatment start (Secondary Care interval). Univariable and multivariable analyses were used to study associations with delays in end points. Post hoc survival analyses were performed. Results: Data linkage was performed for 125 patients (68% stage IV; 69% metropolitan), with 108 interviewed. The median GP-LCS interval was 4 days, with 83% of patients seeing an LCS within the recommended 14 days. The median Secondary Care interval was 42 days (52% within 42 days). There were no significant differences between time intervals faced by rural and metropolitan patients overall, although metropolitan patients took 18 days less than rural counterparts to commence radiation/chemoradiation (95% CI, −33.2 to −2.54; P = .02). One third of patients perceived delays. Delays did not affect survival. Conclusion: Rural and metropolitan NSW patients face comparable time lines to diagnosis and treatment of lung cancer. Most patients are seen by an LCS within recommended timeframes, but transition through Secondary Care and addressing patient expectations could be improved.

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Westaway, Michael, Douglas Williams, Richard Wright, Rachel Wood, Jon Olley, Jaime Swift, Sarah Martin, Justine Kemp, Shane Rolton, and William Bates. "The death of Kaakutja: a case of peri-mortem weapon trauma in an Aboriginal man from north-western New South Wales, Australia." Antiquity 90, no. 353 (September 15, 2016): 1318–33. http://dx.doi.org/10.15184/aqy.2016.173.

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Kwok, Alan B. C., Ron Haering, Samantha K. Travers, and Peter Stathis. "Trends in wildlife rehabilitation rescues and animal fate across a six-year period in New South Wales, Australia." PLOS ONE 16, no. 9 (September 10, 2021): e0257209. http://dx.doi.org/10.1371/journal.pone.0257209.

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Globally, millions of animals are rescued and rehabilitated by wildlife carers each year. Information gathered in this process is useful for uncovering threats to native wildlife, particularly those from anthropogenic causes. However, few studies using rehabilitation data include a diverse range of fauna, cover large geographical areas, and consider long-term trends. Furthermore, few studies have statistically modelled causes of why animals come into care, and what are their chances of survival. This study draws on 469,553 rescues reported over six years by wildlife rehabilitators for 688 species of bird, reptile, and mammal from New South Wales, Australia. For birds and mammals, ‘abandoned/orphaned’ and ‘collisions with vehicles’ were the dominant causes for rescue, however for reptiles this was ‘unsuitable environment’. Overall rescue numbers were lowest in winter, and highest in spring, with six-times more ‘abandoned/orphaned’ individuals in spring than winter. Of the 364,461 rescues for which the fate of an animal was known, 92% fell within two categories: ‘dead’, ‘died or euthanased’ (54.8% of rescues with known fate) and animals that recovered and were subsequently released (37.1% of rescues with known fate). Modelling of the fate of animals indicated that the likelihood of animal survival (i.e. chance of: being released, left and observed, or permanent care), was related to the cause for rescue. In general, causes for rescue involving physical trauma (collisions, attacks, etc.) had a much lower likelihood of animals surviving than other causes such as ‘unsuitable environment’, ‘abandoned/orphaned’, and this also showed some dependence upon whether the animal was a bird, reptile, or mammal. This suggests rehabilitation efforts could be focused on particular threats or taxa to maximise success, depending on the desired outcomes. The results illustrate the sheer volume of work undertaken by rehabilitation volunteers and professionals toward both animal welfare and to the improvement of wildlife rehabilitation in the future.

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Dinh, Michael M., Hardeep Singh, Pooria Sarrami, and Jean-Frederic Levesque. "Correlating injury severity scores and major trauma volume using a state-wide in-patient administrative dataset linked to trauma registry data—A retrospective analysis from New South Wales Australia." Injury 51, no. 1 (January 2020): 109–13. http://dx.doi.org/10.1016/j.injury.2019.09.022.

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Aldous, David E. "Perspectives on Horticultural Therapy in Australia." HortTechnology 10, no. 1 (January 2000): 18–23. http://dx.doi.org/10.21273/horttech.10.1.18.

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Human awareness of plants in Australia goes back 50,000 years when the aboriginal first began using plants to treat, clothe and feed themselves. The European influence came in 1778 with the First Fleet landing in New South Wales. Australia's earliest records of using horticulture for therapy and rehabilitation were in institutions for people with intellectual disabilities or who were incarcerated. Eventually, legislation created greater awareness in the government and community for the needs of persons with disabilities, and many worthwhile projects, programs and organizations were established or gained greater recognition. Horticultural therapy programs may be found in nursing homes, rehabilitation centers, adult training support services, hospitals, day centers, community centers and gardens, educational institutions, supported employment, and the prisons system. This article reviews the history and development of Australian horticulture as a therapy in the treatment of disabilities and social disadvantaged groups, and includes an overview of programs offered for special populations and of Australia's horticultural therapy associations. It also discusses opportunities for research, teaching and extension for horticultural therapy in Australia.

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Dahlen, Hannah, Holly Priddis, Virginia Schmied, Anne Sneddon, Christine Kettle, Chris Brown, and Charlene Thornton. "Trends and risk factors for severe perineal trauma during childbirth in New South Wales between 2000 and 2008: a population-based data study." BMJ Open 3, no. 5 (2013): e002824. http://dx.doi.org/10.1136/bmjopen-2013-002824.

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Costa, Deborah A. "Transforming Traumatised Children within NSW Department of Education Schools: One School Counsellor's Model for Practise – REWIRE." Children Australia 42, no. 2 (June 2017): 113–26. http://dx.doi.org/10.1017/cha.2017.14.

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Adequately supporting the needs of maltreated and traumatised children within New South Wales (NSW) public education system schools is often frustrated by poor perception of the impact of developmental trauma on children's school-based functioning and the need for additional, specialist support; the push for, and provision of, behaviour diagnoses for these children to fund basic assistance and supervision; competing demands on an overextended School Counselling resource impacting capacity for school-based trauma informed psychological services, and seemingly stretched capacity of government/non-government agencies to reliably provide effective support. This is accompanied by a lack of understanding of behavioural signals of distress children display and underreporting to agencies; persistent, simplistic behaviourist views of children's behaviours within schools and low-level collaboration between schools and external agencies. Facilitating a trauma sensitive environment within NSW schools can ameliorate these frustrations and attend to these inadequacies in a pragmatic, achievable way. This practice paper presents a School Counsellor-led model (REWIRE) for achieving this.

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Pacey, Adam, Jamie J. Wilkinson, and David R. Cooke. "Chlorite and Epidote Mineral Chemistry in Porphyry Ore Systems: A Case Study of the Northparkes District, New South Wales, Australia." Economic Geology 115, no. 4 (June 1, 2020): 701–27. http://dx.doi.org/10.5382/econgeo.4700.

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Abstract Propylitic alteration, characterized by the occurrence of chlorite and epidote, is typically the most extensive and peripheral alteration facies developed around porphyry ore deposits. However, exploration within this alteration domain is particularly challenging, commonly owing to weak or nonexistent whole-rock geochemical gradients and the fact that similar assemblages can be developed in other geologic settings, particularly during low-grade metamorphism. We document and interpret systematic spatial trends in the chemistry of chlorite and epidote from propylitic alteration around the E48 and E26 porphyry Cu-Au deposits of the Northparkes district, New South Wales, Australia. These trends vary as a function of both distance from hydrothermal centers and alteration paragenesis. The spatial trends identified in porphyry-related chlorite and epidote at Northparkes include (1) a deposit-proximal increase in Ti, As, Sb, and V in epidote and Ti in chlorite, (2) a deposit-distal increase in Co and Li in chlorite and Ba in epidote, and (3) a pronounced halo around deposits in which Mn and Zn in chlorite, as well as Mn, Zn, Pb, and Mg in epidote, are elevated. Chlorite Al/Si ratios and epidote Al/Fe ratios may show behavior similar to that of Mn-Zn or may simply decrease outward, and V and Ni concentrations in chlorite are lowest in the peak Mn-Zn zone. In comparison to porphyry-related samples, chlorite from the regional metamorphic assemblage in the district contains far higher concentrations of Li, Ca, Ba, Pb, and Cu but much less Ti. Similarly, metamorphic epidote contains higher concentrations of Sr, Pb, As, and Sb but less Bi and Ti. These chlorite and epidote compositional trends are the net result of fluid-mineral partitioning under variable physicochemical conditions within a porphyry magmatic-hydrothermal system. They are most easily explained by the contribution of spent magmatic-derived ore fluid(s) into the propylitic domain. It is envisaged that such fluids experience progressive cooling and reduction in fs2 during outward infiltration into surrounding country rocks, with their pH controlled by the extent of rock-buffering experienced along the fluid pathway.

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Marchetti, Elena, and Debbie Bargallie. "Life as an Australian Aboriginal and Torres Strait Islander Male Prisoner: Poems of Grief, Trauma, Hope, and Resistance." Canadian Journal of Law and Society / Revue Canadienne Droit et Société 35, no. 3 (December 2020): 499–519. http://dx.doi.org/10.1017/cls.2020.25.

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AbstractFor Australia’s Aboriginal and Torres Strait Islander people, writing is predominantly about articulating their cultural belonging and identity. Published creative writing, which is a relatively new art form among Aboriginal and Torres Strait Islander prisoners, has not been used as an outlet to the same extent as other forms of art. This is, however, changing as more Aboriginal and Torres Strait Islander rappers and story-writers emerge, and as creative writing is used as a way to express Aboriginal and Torres Strait Islander empowerment and resistance against discriminatory and oppressive government policies. This article explores the use of poetry and stories written by Aboriginal and Torres Strait Islander male prisoners in a correctional facility located in southern New South Wales, Australia, to understand how justice is perceived by people who are (and have been) surrounded by hardships, discrimination, racism, and grief over the loss of their culture, families, and freedom.

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Dinh, Michael M., Saartje Berendsen Russell, Kendall J. Bein, Kirsten Vallmuur, David Muscatello, Dane Chalkley, and Rebecca Ivers. "Age-related trends in injury and injury severity presenting to emergency departments in New South Wales Australia: Implications for major injury surveillance and trauma systems." Injury 48, no. 1 (January 2017): 171–76. http://dx.doi.org/10.1016/j.injury.2016.08.005.

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