The Medical journal of Australia
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Randomized Controlled Trial
A new model of care and in-house general practitioners for residential aged care facilities: a stepped wedge, cluster randomised trial.
To evaluate whether an alternative model of care in aged care facilities, including in-house general practitioners, influenced health outcomes for residents. ⋯ Recruiting GPs to work directly in residential aged care facilities is difficult, but may reduce the burden of unplanned presentations to hospitals and increase the reporting of adverse events.
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To estimate the carbon footprint of five common hospital pathology tests: full blood examination; urea and electrolyte levels; coagulation profile; C-reactive protein concentration; and arterial blood gases. ⋯ The carbon footprint of common pathology tests was dominated by those of sample collection and phlebotomy. Although the carbon footprints were small, millions of tests are performed each year in Australia, and reducing unnecessary testing will be the most effective approach to reducing the carbon footprint of pathology. Together with the detrimental health and economic effects of unnecessary testing, our environmental findings should further motivate clinicians to test wisely.
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Chronic fatigue syndrome (CFS) is a prevalent condition affecting about one in 100 patients attending primary care. There is no diagnostic test, validated biomarker, clear pathophysiology or curative treatment. The core symptom of fatigue affects both physical and cognitive activities, and features a prolonged post-activity exacerbation triggered by tasks previously achieved without difficulty. ⋯ There is clear evidence for a genetic contribution to CFS from family and twin studies, suggesting that a large scale genome-wide association study is warranted. Despite the many unknowns in relation to CFS, there is significant room for improvement in provision of the diagnosis and supportive care. This may be facilitated via clinician education.
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To assess progress in Australia toward the 2030 WHO hepatitis C elimination targets two years after the introduction of highly effective direct-acting antiviral (DAA) treatments. ⋯ Hepatitis C elimination programs in Australia should focus on increasing testing rates and linkage with care to maintain adequate levels of treatment.
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Observational Study
Corticosteroid treatment of patients with coronavirus disease 2019 (COVID-19).
To assess the efficacy of corticosteroid treatment of patients with coronavirus disease 2019 (COVID-19). ⋯ Corticosteroids are widely used when treating patients with COVID-19, but we found no association between therapy and outcomes in patients without acute respiratory distress syndrome. An existing HBV infection may delay SARS-CoV-2 clearance, and this association should be further investigated.