Evaluation of interventions for trauma care in older adults: a consensus study.

Background: Trauma care of older adults is an important and growing public health issue. Countries such as the United States and United Kingdom have published best-practice guidelines on the management of older trauma patients. In Australia, there are no such guidelines.

A scoping review of models of care for the management of older trauma patients.

Introduction: The number of older people hospitalised with major trauma is rapidly increasing. New models of care have emerged, such as co-management, and trauma centres dedicated to delivering geriatric trauma care. The aim of this scoping review was to explore in-hospital models of care for older adults who experience physical trauma.

A qualitative descriptive study exploring clinicians' perspectives of the management of older trauma care in rural Australia.

Background: For older trauma patients who sustain trauma in rural areas, the risk of adverse outcomes associated with advancing age, is compounded by the challenges encountered in rural healthcare such as geographic isolation, lack of resources, and accessibility. Little is known of the experience and challenges faced by rural clinicians who manage trauma in older adults. An understanding of stakeholders' views is paramount to the effective development and implementation of a trauma system inclusive of rural communities.

Older trauma patients with isolated chest injuries have low rates of complications.

Introduction: The number of older adults hospitalised for injury is growing rapidly. The population-adjusted incidence of isolated thoracic injuries in older adults is also growing. While some older adults are at high risk of post-traumatic complications, not all older adults will need treatment in a major trauma service (MTS).

Injury profiles and clinical management of older patients with major trauma.

Objectives: This study aimed to characterise the most common injury profiles and interventions in older major trauma patients, and how they change with age.

Methods: This is a retrospective review of interventions, injury profiles and outcomes of major trauma patients aged 65 years and older from 2007 to 2018, using data from the Victorian State Trauma Registry. A latent class analysis (LCA) was used to identify homogenous injury groups.

Evaluating the need for an integrated geriatric service in older general surgery patients.

Background: Despite the success of an orthogeriatric model in improving outcomes of older patients, there is a paucity of evidence in general surgical disciplines. The aim of this project was to assess the viability of acute kidney injury (AKI) as an indicator of the care of older patients admitted under general surgery.

Methods: A retrospective review of the medical records of patients aged 75 years and older admitted under general surgery between 1 July 2015 and 30 June 2018 at the Royal Hobart Hospital was conducted.

Weekend Carotid Endarterectomies are Not Associated with a Greater Risk of Stroke and/or Death in Australia and New Zealand.

Background: Data from multiple surgical studies and settings have reported an increase in adverse events in patients admitted or treated on weekends. The aim of this study was to investigate short-term outcomes for patients undergoing carotid endarterectomy (CEA) in Australia and New Zealand based on the day of surgery.

Methods: This is a retrospective observational cohort study.

Ageing population has changed the nature of major thoracic injury.

Introduction: An increasing proportion of the major trauma population are older persons. The pattern of injury is different in this age group and serious chest injuries represent a significant subgroup, with implications for trauma system design. The aim of this study was to examine trends in thoracic injuries among major trauma patients in an inclusive trauma system.

Rural centres do not have a higher prevalence of post-operative complications than urban centres: a retrospective analysis of a mortality audit.

Background: The trend towards centralization of surgical care from rural to high-volume centres is based on studies showing better outcomes for patients requiring complex surgical procedures. However, evidence that this also applies to less complex procedures is lacking. This study therefore aimed to determine whether there was a relationship between geographic location (rural versus urban) of surgical procedures of varying complexity and post-operative complications.

Trends in the Nature and Management of Serious Abdominal Trauma.

Background: There have been recommendations for increased non-operative management (NOM) of abdominal trauma in adults. To assess the impact of this trend and changes in the epidemiology of trauma, we examined the management of serious abdominal injuries and mortality, in Victorian major trauma patients 16 years or older, between 2007 and 2016.

Methods: Using data from the population-based Victorian Trauma Registry, characteristics of patients who underwent laparotomy, embolisation, laparotomy and embolisation, or NOM, were compared with the Chi-square test.

A review of coronial investigations into medication-related deaths in residential aged care.

Background: Residential aged care is a complex and challenging clinical setting where medication errors continue to occur despite efforts to improve medication safety. No studies have sought to review and synthesize coronial investigations into medication-related deaths in Australian residential aged care facilities (RACFs).

Objective: To review coronial investigations into medication-related deaths in Australian RACFs.

Post-operative Complications Following Emergency Operations Performed by Trainee Surgeons: A Retrospective Analysis of Surgical Deaths.

Background: Adequate surgical care of patients and concurrent training of residents is achieved in elective procedures through careful case selection and adequate supervision. Whether this applies when trainees are involved in emergency operations remains equivocal. The aim of this study was therefore to compare the risk of post-operative complications following emergency procedures performed by senior operators compared with supervised trainees.

A greater risk of premature death in residential respite care: a national cohort study.

Background: the demand for residential respite care for older persons is high yet little is known about the occurrence of harm, including death in this care setting.

Objective: to compare the prevalence and nature of deaths among residential respite to permanent nursing home residents.

Design: retrospective cohort study.

Optimising residential respite care in nursing homes: Current problems and solutions for a better future.

Aim: To examine whether residential respite care increases the risk of harm to older people and suggest directions for future research and policy.

Background: Respite care is a vital part of the aged care system that supports dependent older people and their caregivers to continue residing in the community. There is little research determining whether an older person experiences harm from residential respite.

Death Following Recent Admission Into Nursing Home From Community Living: A Systematic Review Into the Transition Process.

Objective: This study examines the impact of the transition process on the mortality of elderly individuals following their first admission to nursing home from the community at 1, 3, and 6 months postadmission, and causes and risk factors for death.

Method: A systematic review of relevant studies published between 2000 and 2015 was conducted using key search terms: first admission, death, and nursing homes.

Results: Eleven cohort studies met the inclusion criteria.

Mortality in Nursing Homes Following Emergency Evacuation: A Systematic Review.

Objectives: To determine the risk associated with mortality among nursing home residents within 6 months following an evacuation because of man-made or natural disasters.

Design: A systematic review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Statement.

Setting: All peer-reviewed studies published in English, French, German, or Spanish between January 1, 2000 and December 31, 2015, examining mortality within 6 months of disaster evacuation from a nursing home.

Systematic Review of the Prevalence of Medication Errors Resulting in Hospitalization and Death of Nursing Home Residents.

Medication errors (MEs) result in preventable harm to nursing home (NH) residents and pose a significant financial burden. Institutionalized older people are particularly vulnerable because of various organizational and individual factors. This systematic review reports the prevalence of MEs leading to hospitalization and death in NH residents and the factors associated with risk of death and hospitalization.

Review of the causes and management of chronic gastrointestinal symptoms in returned travellers referred to an Australian infectious diseases service.

Background: Thirty to seventy per cent of overseas travellers experience traveller's diarrhoea (TD), a potential cause of serious gastrointestinal (GI) sequelae. However, there is limited evidence on the optimal management of TD.

Objective: The objectives of this article are to characterise the aetiologies and management of returned travellers with ongoing GI symptoms referred to a specialist infectious diseases service.

The utility of medico-legal databases for public health research: a systematic review of peer-reviewed publications using the National Coronial Information System.

Background: Medico-legal death investigations are a recognised data source for public health endeavours and its accessibility has increased following the development of electronic data systems. Despite time and cost savings, the strengths and limitations of this method and impact on research findings remain untested. This study examines this issue using the National Coronial Information System (NCIS).

Resident-to-resident physical aggression leading to injury in nursing homes: a systematic review.

Background: resident-to-resident aggression (RRA) is an understudied form of elder abuse in nursing homes.

Objective: the purpose of this systematic review was to examine the published research on the frequency, nature, contributing factors and outcomes of RRA in nursing homes.

Methods: in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement, this review examined all original, peer-reviewed research published in English, French, German, Italian or Spanish between 1st January 1949 and 31st December 2013 describing incidents of RRA in nursing homes.

The forest or the trees: preference for global over local image processing is reversed by prior experience in honeybees.

Traditional models of insect vision have assumed that insects are only capable of low-level analysis of local cues and are incapable of global, holistic perception. However, recent studies on honeybee (Apis mellifera) vision have refuted this view by showing that this insect also processes complex visual information by using spatial configurations or relational rules. In the light of these findings, we asked whether bees prioritize global configurations or local cues by setting these two levels of image analysis in competition.