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JournalISSN: 0025-729X

The Medical Journal of Australia 

Wiley
About: The Medical Journal of Australia is an academic journal published by Wiley. The journal publishes majorly in the area(s): Poison control & Population. It has an ISSN identifier of 0025-729X. Over the lifetime, 41213 publications have been published receiving 526873 citations. The journal is also known as: MJA.


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Journal ArticleDOI
TL;DR: To determine the morbidity and mortality from childhood Haemophilus influenzae type b (Hib) meningitis in a well defined population, a large number of cases are diagnosed with Hib.
Abstract: OBJECTIVE To determine the morbidity and mortality from childhood Haemophilus influenzae type b (Hib) meningitis in a well defined population. DESIGN Retrospective survey 1985-1987 and prospective surveillance of hospital laboratories 1989-1990. Information on outcome of meningitis was obtained from hospital records and attending physicians and, in 1989-1990, from a survey of the children's parents. SETTING Sydney Statistical Division, which had a population of children aged 0-4 years of 229,165 in 1986 and 263,758 in 1990. PATIENTS Eligible children were aged from one month to four years and had clinical and microbiological evidence of Hib meningitis on standard criteria. RESULTS There were 229 eligible children. Twelve were excluded (seven died and five had pre-existing neurological deficits). A neurological deficit was detected at the time of hospital discharge in 45 patients (21%) and persisted for 12 months or longer in 29 patients (13%). Follow-up information was available for 165 (96%) children who were normal at the time of hospital discharge and persistent deficits were recorded in 12 (7%) of these children. Forty-one children (19%) had readily recognisable neurological or hearing problems: nine (4%) had persistent severe neurological deficits and seven (3%) had severe hearing loss requiring hearing aids or a cochlear implant. Age had a significant influence on outcome. The youngest children were significantly more likely to be admitted to intensive care. Severe neurological deficits showed a significant negative trend with increasing age (P = 0.03). Severe unilateral or bilateral sensorineural loss (odds ratio [OR] 8.0, 95% confidence interval [CI] 1.5-81) and ataxia at discharge (OR 13.3, 95% CI 2.8-128) were noticeably more common in children over two years of age, with a significant positive trend (P < or = 0.001) with increasing age. Patients requiring intensive care were much more likely to have an adverse outcome, particularly if positive pressure ventilation was needed. CONCLUSIONS These data provide population-based estimates of the minimum incidence of adverse outcomes from Hib meningitis in an urban community with good access to medical services. This is important in assessing the impact of Hib vaccination, as meningitis is responsible for most of the long-term morbidity from childhood invasive Hib disease. Determination of the relationship between morbidity and age is important for assessing alternative vaccine strategies.

8,476 citations

Journal ArticleDOI
TL;DR: A review of the medical records of over 14 000 admissions to 28 hospitals in New South Wales and South Australia revealed that 16.6% of these admissions were associated with an “adverse event”, which resulted in disability or a longer hospital stay for the patient and was caused by health care management.
Abstract: A review of the medical records of over 14,000 admissions to 28 hospitals in New South Wales and South Australia revealed that 16.6% of these admissions were associated with an "adverse event", which resulted in disability or a longer hospital stay for the patient and was caused by health care management; 51% of the adverse events were considered preventable. In 77.1% the disability had resolved within 12 months, but in 13.7% the disability was permanent and in 4.9% the patient died.

2,197 citations

Journal Article

2,091 citations

Journal ArticleDOI
TL;DR: Assessment of the public's recognition of mental disorders and their beliefs about the effectiveness of various treatments (“mental health literacy”).
Abstract: Objectives To assess the public's recognition of mental disorders and their beliefs about the effectiveness of various treatments ("mental health literacy") Design A cross-sectional survey, in 1995, with structured interviews using vignettes of a person with either depression or schizophrenia Participants A representative national sample of 2031 individuals aged 18-74 years; 1010 participants were questioned about the depression vignette and 1021 about the schizophrenia vignette Results Most of the participants recognised the presence of some sort of mental disorder: 72% for the depression vignette (correctly labelled as depression by 39%) and 84% for the schizophrenia vignette (correctly labelled by 27%) When various people were rated as likely to be helpful or harmful for the person described in the vignette for depression, general practitioners (83%) and counsellors (74%) were most often rated as helpful, with psychiatrists (51%) and psychologists (49%) less so Corresponding data for the schizophrenia vignette were: counsellors (81%), GPs (74%), psychiatrists (71%) and psychologists (62%) Many standard psychiatric treatments (antidepressants, antipsychotics, electroconvulsive therapy, admission to a psychiatric ward) were more often rated as harmful than helpful, and some nonstandard treatments were rated highly (increased physical or social activity, relaxation and stress management, reading about people with similar problems) Vitamins and special diets were more often rated as helpful than were antidepressants and antipsychotics Conclusion If mental disorders are to be recognised early in the community and appropriate intervention sought, the level of mental health literacy needs to be raised Further, public understanding of psychiatric treatments can be considerably improved

1,872 citations

Journal ArticleDOI
TL;DR: The Australian College of Paediatrics has shown the way by producing a balanced and thoughtful Discussion Document, and it is to be hoped that the Human Rights Commission will see fit to take this important matter further.
Abstract: awesome responsibility must make it as they feel the patient would wish it to be made. All physicians are charged to preserve life and to relieve suffering, but it must be pointed out that these two Hippocratic ethics are not always compatible. The Australian College of Paediatrics has shown the way by producing a balanced and thoughtful Discussion Document. It is to be hoped that the Human Rights Commission will see fit to take this important matter further. DOUGLAS COHEN, Division of Surgery, Royal Alexandra Hospital for Children, Sydney. 61

1,853 citations

Performance
Metrics
No. of papers from the Journal in previous years
YearPapers
2023201
2022411
2021374
2020373
2019315
2018331