Martin Goldschmidt reading on a park bench Portraits Men

Handwritten postcard addressed to Ruth Goldschmidt in Italy and dated 1937 from Zurich

Ruth Augusta Beatrice Goldschmidt with her parents Paula Goldschmidt née Harmelin and Martin Goldschmidt, walking on the street outside the Richmond Park Hotel; Karlsbad Portraits Family

Paula Goldschmidt, née Harmelin, born 1880; Martin Goldschmidt, born circa 1879; Ruth Augusta Beatrice Goldschmidt, born 1923?

Markus Dublon with his wife reading newspapers on a park bench Portraits Couples

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Geriatrician interventions on medication prescribing for frail older people in residential aged care facilities

Objective: In Australian residential aged care facilities (RACFs), the use of certain classes of high-risk medication such as antipsychotics, potent analgesics, and sedatives is high. Here, we examined the prescribed medications and subsequent changes recommended by geriatricians during comprehensive geriatric consultations provided to residents of RACFs via videoconference. Design: This is a prospective observational study. Setting: Four RACFs in Queensland, Australia, are included. Participants: A total of 153 residents referred by general practitioners for comprehensive assessment by geriatricians delivered by video-consultation. Results: Residents’ mean (standard deviation, SD) age was 83.0 (8.1) years and 64.1% were female. They had multiple comorbidities (mean 6), high levels of dependency, and were prescribed a mean (SD) of 9.6 (4.2) regular medications. Ninety-one percent of patients were taking five or more medications daily. Of total medications prescribed (n=1,469), geriatricians recommended withdrawal of 9.8% (n=145) and dose alteration of 3.5% (n=51). New medications were initiated in 47.7% (n=73) patients. Of the 10.3% (n=151) medications considered as high risk, 17.2% were stopped and dose altered in 2.6%. Conclusion: There was a moderate prevalence of potentially inappropriate high-risk medications. However, geriatricians made relatively few changes, suggesting either that, on balance, prescription of these medications was appropriate or, because of other factors, there was a reluctance to adjust medications. A structured medication review using an algorithm for withdrawing medications of high disutility might help optimize medications in frail patients. Further research, including a broader survey, is required to understand these dynamics.

Samuel Eliasberg in a park with his son Georg Eliasberg; Berlin Portraits Family

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Young Herbert Strauss (center) with four friends seated on a park bench on the Sabbath; Würzburg.

To the right of Herbert Strauss are Anne Chrenbacher and Walther Reis, to his left are Heinz Ostheim and an unidentified woman

Portrait of a family and their dog sitting in a park Portraits Family

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Prescribing for older people discharged from the acute sector to residential aged-care facilities

For frail older people, admission to hospital is an opportunity to review the indications for specific medications. This research investigates prescribing for 206 older people discharged into residential aged care facilities from 11 acute care hospitals in Australia. Patients had multiple comorbidities (mean 6), high levels of dependency, and were prescribed a mean of 7.2 regular medications at admission to hospital and 8.1 medications on discharge, with hyper-polypharmacy (≥10 drugs) increasing from 24.3% to 32.5%. Many drugs were preventive medications whose time until benefit was likely to exceed the expected lifespan. In summary, frail patients continue to be exposed to extensive polypharmacy and medications with uncertain risk–benefit ratio.

Gottschalk family in the park; Hannover, Germany. Portraits Family

Left to right: Therese Godshaw (Gottschalk) nee Molling, Walter, Freddy, Grandmother Henriette Gottschalk nee Rothschild, Ursula, Hal and Kurt

Ecological risk assessment of the East Coast Otter Trawl Fishery in the Great Barrier Reef Marine Park: Data report

An ecological risk assessment of the East Coast Otter Trawl Fishery in the Great Barrier Reef Region was undertaken in 2010 and 2011. It assessed the risks posed by this fishery to achieving fishery-related and broader ecological objectives of both the Queensland and Australian governments, including risks to the values and integrity of the Great Barrier Reef World Heritage Area. The risks assessed included direct and indirect effects on the species caught in the fishery as well as on the structure and functioning of the ecosystem. This ecosystem-based approach included an assessment of the impacts on harvested species, by-catch, species of conservation concern, marine habitats, species assemblages and ecosystem processes. The assessment took into account current management arrangements and fishing practices at the time of the assessment. The main findings of the assessment were: Current risk levels from trawling activities are generally low. Some risks from trawling remain. Risks from trawling have reduced in the Great Barrier Reef Region. Trawl fishing effort is a key driver of ecological risk. Zoning has been important in reducing risks. Reducing identified unacceptable risks requires a range of management responses. The commercial fishing industry is supportive and being proactive. Further reductions in trawl by-catch, high compliance with rules and accurate information from ongoing risk monitoring are important. Trawl fishing is just one of the sources of risk to the Great Barrier Reef.

Alfred Lichtenstein with his first wife Gerda and their daughter Sylvia seated on a park bench; Buenos Aires.

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Portrait of a family and their dog sitting in a park Portraits Family

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Dr. Guido Kisch seated outside the Park Hotel with his wife

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Unidentified man and young boy sit on park bench in Chile Portraits Women

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