Global Surgery and Trauma Research
An estimated 11–32% of the global disease burden is due to surgically correctable illnesses. Lancet Commission on Global Surgery estimated that 5 billion people do not have adequate access to safe affordable surgical care when needed. Contrary to belief, investing in surgical services in low- and middle-income countries (LMICs) is affordable, saves lives, and promotes economic growth. Global Surgery is defined as an area of study, research, practice, and advocacy that seeks to improve health outcomes and achieve health equity for all people who need surgical and anaesthesia care, with a special emphasis on underserved populations and populations in crisis. Among these surgically treatable diseases, trauma causes over four million deaths annually, predominantly in LMICs and is an important aspect of Global surgery. Cancer, similarly, is the second most lethal noncommunicable disease after cardiovascular disease and accounted for about 9.9 million deaths, globally in 2020. Around 9% of all cancer death
Shop-to-Stop Hypertension: A public screening campaign to detect and manage raised blood pressure in Australian adults
Background
Worldwide the leading risk factor for death is raised blood pressure (BP), accounting for ~30,000 deaths daily.1 In Australia, high BP is responsible for 43% of coronary heart disease, 41% of stroke, 65% of the burden of hypertensive heart disease, 38% of chronic kidney disease, 32% of atrial fibrillation and flutter and 3.6% of dementia.2 Better BP control could save more lives than any other single treatment intervention.3 In Australia, BP control rates have stagnated since 2011 at ~32%,4, 5 leading to a 2022 call to action to improve uncontrolled BP in Australia.5
Hypertension (the condition you have from high BP) is called the "silent killer" because most people who have raised BP do not have any symptoms.6 In Australia, 34% of adults have hypertension,4 but millions remain unaware and undiagnosed.6, 7 Only one in two people detected to have high BP are aware of their condition.8 Innovative strategies to target wider and high-risk populations,
PREVENTion with SGLT-2 inhibition of Acute Kidney Injury in intensive care (PREVENTS-AKI)
Background
Acute Kidney Injury (AKI) affects up to 1 in 2 patients treated in the ICU, and is associated with poorer survival, reductions in long term kidney function and greater cost of treatment. There are no treatments proven to reduce these impacts of AKI but there is a growing evidence base suggesting that inhibitors of the sodium-glucose transport protein 2 (SGLT-2 inhibitors) in the kidney tubule may protect against AKI.
SGLT-2 inhibitors were originally developed as a treatment for type 2 diabetes but have been proven in recent clinical trials to significantly improve outcomes for patients with heart disease and/or kidney impairment - with fewer patients progressing to dialysis, needing hospital care or dying. Later examination of these trials has also shown lower rates of AKI in participants receiving SGLT-2 treatment but, as these results were not the main outcome of the studies, these findings are not enough to change patient treatment.
Aim
To conduct a prospective, multi-centre, parall
The wider benefits of SGLT2 inhibitors
Policy & Practice Report
Gender-responsive Research and Advocacy through CEDAW (GRACE) in India, Indonesia, South Africa, and Kenya
Background
Women who have survived violence experience negative consequences on their sexual and reproductive health, unsafe abortions, sexually transmitted infections, traumatic fistulas, and are twice as likely to be diagnosed with cervical cancer. They also experience anxiety, depression, and alcohol use disorders. Rates of violence against women and gender based discrimination continue to remain high despite legislative action by governments. With COVID-19 pandemic, the situation has become alarming demanding ever more serious action in protecting the rights of women and addressing Gender Based Violence (GBV) and discrimination across the globe.
The United Nations (UN) Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW) has been considered as an important instrument towards encouraging governments to take action towards protecting the rights of women and addressing gender based discrimination through legal reforms. It has been 40 years since the United Nations (UN) Con
Health Star Rating system
Policy & Practice Report
Post-Sepsis Care: Co-designed models of support (SEPSIS SUPPORT)
Background:
Sepsis is the bodies life-threatening response to an infection, that affects 49 million people globally each year.In 2022–23, there were over 84,000 sepsis-related hospitalisations in Australia, far exceeding previous estimates of 55,000 cases annually, with one in four adults admitted to intensive care unit (ICU) and one in seven cases resulting in death. In 2017, approximately 25% of paediatric ICU deaths in Australia and New Zealand were related to severe infections.
Survivorship after sepsis is a global health care priority. Sepsis survivors face significant long-term morbidity, with between 30% - 50% of adults experiencing new limitations to usual activities or exacerbation of pre-existing chronic conditions resulting in reduced quality of life. For children, up to 40% experience ongoing impacts to physical and psychosocial development, education, family functioning and reduced quality of life. Consequently, post-sepsis hospital readmission rates are high, with as many as 70
The RENAL LIFECYCLE Trial: Assessing the effect of dapagliflozin on patients with severe chronic kidney disease
BackgroundSGLT2 inhibitors are a relatively new class of agents, originally developed as oral antihyperglycemic drugs. SGLT2 inhibitors are clinically available since 2012 for the treatment of patients with diabetes mellitus type 2. Later, SGLT2 inhibitors appeared to also have specific reno- and cardioprotective effects. Notably, the trials that have been performed thus far have excluded patients with an eGFR below 25 mL/min/1.73m2 at inclusion, prevalent dialysis patients, and kidney transplant recipients. These patients are at greater risk of developing kidney failure requiring dialysis, cardiovascular complications and mortality, however currently there are only a few proven effective therapies for these conditions. There is emerging evidence from experimental studies and post hoc-analyses of randomised clinical trials that SGLT2 inhibitors may also be effective in preventing cardiovascular and mortality outcomes in patients with severe CKD, including patients receiving dialysis or living with a
Snakes, the ecosystem, and us: it’s time we change
Policy & Practice Report
Community Coordinated Burn Care
Background
There are very few healthcare services in NSW with the cultural safety or expertise needed for aftercare and recovery of burn injury for Aboriginal and Torres Strait Islander children. However, Aboriginal Community Controlled Health Services (ACCHS) are well placed to provide best practice, comprehensive and culturally safe care.
Burn injuries can have long-term physical, emotional and social impacts on children and their families. For optimal recovery, burn injuries need to be treated with immediate first aid and appropriate ongoing care and aftercare to minimise initial injury and optimise long-term outcomes.
Aboriginal and Torres Strait Islander children are admitted to hospitals with an acute burn injury at a rate three times greater than other Australian children1. Additionally, their length of stay in hospital is approximately 4 days longer compared to other Australian children.
In partnership with ACCHS, the NSW Statewide Burn Injury Service and The Children's Hospital at Westmead,
Understanding and preventing child drowning in the Sundarbans, West Bengal
Drowning is emerging as an important global health issue. In 2018, the World Health Organization reported 320,000 drowning deaths globally, with an estimated 90% of drownings occurring in low-and middle-income countries (LMICs). 62,000 deaths, or almost one fifth of the burden, is in India. Children aged 1-9 are most at risk of drowning.
Children in some coastal regions of India such as the Sundarbans in the northern state of West Bengal are at a high risk of drowning, due to poor infrastructure, rurality, presence of unregulated open water, lack of safety awareness and inadequate health systems.
The World Health Organization has recommended four community-based interventions in rural LMIC settings to reduce drowning in young children. These interventions are: the installing barriers controlling access to water (such as playpens and fencing), the provision of safe spaces away from children with capable child care, teaching school-aged children basic swimming and rescue skills and training adult bystande
Meaningful progress or empty promises? An analysis of how gender features in NCD action plans
Policy & Practice Report