MNCLHD

MNCLHD

Monday, March 31, 2014

Climate change and health - IPCC Report

The Intergovernmental Panel on Climate Change brought out its Fifth Assessment Report today.  The IPCC is the international body for assessing the science related to climate change and was set up in 1988 by the World Meteorological Organization (WMO) and United Nations Environment Program (UNEP) to provide policymakers with regular assessments of the scientific basis of climate change, its impacts and future risks.

The human health chapter in the second (“Impacts”) volume of the IPCC’s Fifth Assessment Report concludes that the impact of climate change on our health is increasing significantly.  In the next few decades, the largest impacts will occur in poorer and vulnerable populations and communities where illnesses such as under-nutrition and diarrhoeal disease are already high – thus widening further the world’s health disparities.  A good summary of the health impacts described by the report can be found in The Conversation today, Climate change and health:  IPCC reports emerging risks, emerging consensus.

Elder abuse - current Australian legal situation

Australia’s ageing population is growing and so too is the number of older persons who experience abuse.  A recent article in the Sydney Law Review, Neglectful to the point of cruelty? Elder abuse and the rights of older persons in Australia, outlines the factors that can heighten a person’s vulnerability to abuse and describes the complexity of addressing elder abuse from a legal and policy perspective.  Case examples are provided, and the author examines the current legal situation in Australia.  Recognising that elder abuse involves the denial of a person’s basic human rights, this article calls for a national inquiry into elder abuse by the Australian Human Rights Commission.

Lacey W. (2014). Sydney Law Review, 36(1), 99-130

Thursday, March 27, 2014

The Essential Role of the Rehabilitation Nurse in Facilitating Care Transitions

Rehabilitation NursingFacilitating effective care transitions is incredibly important given the longevity of people today, and the increasing prevalence of chronic illnesses. "There is a need for clinicians with the necessary knowledge and skills to advocate and facilitate transitions that result in the greatest value to the patients, their families, and the healthcare delivery system. A review of the literature reveals significant problems with transitions to postacute care (PAC) settings. Care is fragmented, disorganized, and guided by factors unrelated to the quality of care or patient outcomes. Studies have demonstrated that the selection of a PAC setting for patients is influenced by multiple factors". Although the article is American, it still may be applicable to the rehabilitation nurse in Australia.
  In the January-February issue of Rehabilitation Nursing  you can read the article, “The Essential Role of the Rehabilitation Nurse in Facilitating Care Transitions: A White Paper by the Association of Rehabilitation Nurses”.   There is free access to this paper throughout 2014.  

Drug-resistant Tuberculosis

"Tuberculosis, or consumption as it used to be known, sounds like a disease that we've managed to fight off for good. But a drug-resistant strain of the bacteria that causes it is making a comeback, and it’s wreaking havoc where it can do most damage." The problem continues to be that there are increasing numbers of drug-resistant tuberculosis infections, with nearly 60% of these occurring in the Asia Pacific region.
This article, published on The Conversation. is freely available.

Time to turn back the tide of drug-resistant tuberculosisby Justin Denholm, Ben Marais, Jo Chandler and Suman Majumdar. 

Causes of Death, Australia, 2012

This Australian Bureau of Statistics publication presents statistics on the number of deaths for reference year by state or territory of Australia, sex, selected age groups, and causes of death classified to the WHO's International Statistical Classification of Diseases and Health Related Problems (ICD). Causes of death data are a significant and important input to health and social policy formulation and planning as well as health related research and analysis.

In Australia, causes of death statistics are recorded as both underlying cause and multiple cause. The underlying cause is the disease or injury which initiated the train of morbid events leading directly to death. Multiple causes are all causes and conditions reported on the death certificate that contributed to, were associated with or were the underlying cause of the death.

3303.0 - Causes of Death, Australia, 2012                                                              

Push for Young Doctors to Go Rural


landscape: a gum tree in a farm paddockA rural Not for Profit network is teaming up with Rural Health Workforce Australia to get more young doctors and medical students into rural areas. The Go Rural campaign, will showcase the professional and lifestyle rewards of rural medicine, including access to some of the best training experiences in the country.

10 things that can raise your blood pressure

Doctor checks man's blood pressure.Around one in three Australians has high blood pressure (although only half of them know it) - a major risk factor for heart attacks and strokes. There's no way of telling from the outside if you have high blood pressure. You can feel perfectly well and yet the force of blood pressing against the walls of your arteries can be high enough to be slowly causing damage that increases your risk of heart disease, strokes and kidney failure.

ABC Health and Wellbeing has presented this feature on the 10 things that can raise your blood pressure.

Cognitive Changes In Diabetes Related to Proliferative Retinopathy

Increasing evidence shows that adult type 1 diabetes mellitus (T1DM) is associated with gaps in mental efficiency that are accompanied by structural and functional cerebral compromise. Alterations in the brain are typically seen in patients with peripheral complications, such as proliferative retinopathy, which is considered to be a marker of chronic hyperglycemia. The authors of this controlled study used neuropsychological tests for cognitive function and magnetic resonance imaging (MRI) for white matter integrity. They found that subclinical macroangiopathy may be a factor in the development of diabetes-related cognitive changes in uncomplicated T1DM. In patients with advanced T1DM, proliferative retinopathy may be the driving force behind cerebral compromise.
Differential impact of subclinical carotid artery diseaseon cerebral structure and functioning in type 1 diabetes patients with versus thosewithout proliferative retinopathyCardiovascular Diabetology | Mar 12, 2014 (FREE FULL TEXT)

Creating nationally-consistent health information

In a health system dispersed across the states and territories by the Australian Government, strong governance arrangements are needed to ensure that health information, collected under different health administrations, are consistent and therefore accurate and useful for policy, planning and program management.

This document provides guidance on engaging with the national processes responsible for health information and data standards. In particular, it describes how those developing data about some aspect of health can obtain assistance with, and/or endorsement of, their data development work.

Creating nationally-consistent health information: engaging with the national health information committees, AIHW, Mar. 2014

Health expenditure Australia 2011-12: analysis by sector

This report from AIHW explores expenditure on particular categories of health goods and services, including hospitals, primary health care, other recurrent health expenditure and capital expenditure.
To download click here.

Friday, March 21, 2014

BMC Obesity - new open access journal

BMC Obesity (from BioMed Central) has recently been launched.  It is an open access, peer-reviewed journal concentrating on all aspects of human obesity across the lifecourse.  It is broadly scoped and mulidisciplinary and includes articles on the prevention, causes, treatment, management, and implications of obesity, incorporating lifestyle, epidemiology, policy and community/environmental interventions, related approaches for weight loss and the prevention of weight gain, management of the condition including the use of drugs and surgery, and basic science relating to the causes and effects of obesity.  

Ending newborn deaths - Save the Children report

In 2012, 2.9 million newborn babies died within 28 days worldwide. A third of these babies died on their first day of life. The Save the Children Organisation urges action as "there is a real danger that progress in reducing child deaths will stall, and we will fail in our ambition to be the generation that can end all preventable child deaths." 

Their report, Ending Newborn Deaths sets out an agenda to tackle the crisis and identifies the essential interventions around birth that a properly skilled midwife or other trained health worker can deliver to save newborn lives and prevent stillbirths during labour.  The authors call on governments, world leaders and the private sector to ensure access to properly trained and equipped health workers at birth and universal health coverage for the poorest and hardest-to-reach communities.  

Grey Matters - evidence search tool

Grey literature is any information that has not been formally published in books or journals, and as such it can be very difficult to find.  Many government and organisational reports which could be useful and authoritative fall into this category.  The Canadian Agency for Drugs and Technologies in Health (CADTH) has published a tool for finding health technology assessment grey literature from organisations across the world.

Grey Matters: a practical search tool for evidence based medicine provides a checklist to "ensure the retrieval of all relevant health technology assessment (HTA), government, and evidence-based agency reports that may not be indexed in bibliographic databases such as MEDLINE"

Wednesday, March 19, 2014

"At 150 kg you can't run" - men's weight loss stories

This study, published in Health Psychology and Behavioral Medicine, explores men's weight loss stories published in the popular magazine Men's Health between 2009 and 2012 and considers the appropriateness of the proposed strategies in light of clinical practice guidelines and current evidence for overweight and obesity management.

The Australian authors reported, "Our findings indicate that most of the men reportedly used some form of behavioural strategies to assist them in their behaviour change efforts. The weight loss methods used were consistent with clinical practice guidelines, with the exception of some dietary practices."  They concluded that these narratives could be useful in promoting weight loss to men.

Danielle Couch, Gil-Soo Han, Priscilla Robinson & Paul Komesaroff, “At 150 kg, you can't run” men's weight loss stories in a popular health magazine provide appropriate examples of good health practice" Health Psychology and Behavioral Medicine, 2(1), 2014 : 252-27.  (Open access article).

Helping Measure Person Centred care

The Health Foundation (UK) has published Helping Measure Person Centred Care as a review of the evidence about commonly used approaches and tools.  The reviewers aimed to find out how person-centred care was being measured, where and by whom. 

According to the Health Foundation’s website, the “review shows that, while a large number of tools are available to measure person-centred care, there is no agreement about which tools are most worthwhile".  Also available is a searchable spreadsheet listing 160 of the most commonly researched measurement tools. Links to the abstracts of examples of research using each tool are also provided.

Alzheimer's Disease Risk Index - ANU tool


The Australian National University has published a tool aimed at assessing individual exposure to risk factors known to be associated with an increased risk of developing Alzheimer's disease in late-life.
The ANU-ADRI (Alzheimer's Disease Risk Index) is an evidence-based, validated, tool which provides a systematic individualised assessment, useful for people who wish to know their risk profile and how they can reduce their risk. It may also be useful to clinicians who would like their patients to record their current risk profile for discussion at their next medical appointment.  
This ANU website links to the test, which takes about twenty minutes to complete.  There is also useful current facts and figures related to Alzheimer's and dementia in general.

Research priorities in suicide - Australian study

A recent study published in the Australian Health Review shows that despite suicide being a priority in Australia for some time, rates of suicide and related behaviours remain high.  In Research priorities in suicide prevention: an examination of Australian-based research 2007-11, the authors, Robinson and Pirkis, examine research into suicide that has been conducted during that time, in order to see whether research that can guide best practice is being prioritised.  They found that most studies (particularly focusing on youth) were epidemiological and that there was a disappointing lack of intervention studies.

Australian Health Review 38(1) 18-24 http://dx.doi.org/10.1071/AH13058.  Contact your health library for full text of the article.

Dental and oral health in Australia

This snapshot of the state of dental and oral health in Australia has just been updated by the Australian Institute of Health and Welfare.

Check here for the most recent statistics on both dental health and dental visiting patterns.  The information provided shows clearly that both are affected by remoteness and socioeconomic status.  The proportion of people with untreated decay is greater in remote and very remote areas (38%) than in major cities (24%).

Wednesday, March 12, 2014

Hippotherapy and Therapeutic Horse Riding


VIHippotherapy (from the Greek hippos [horse]) is a form of physical therapy in which a licensed therapist uses the characteristic movements of a horse as a therapeutic intervention or tool. Therapeutic horse riding (where specific horse riding skills are taught) is conducted by non-therapist riding instructors and assistants who select target objectives based on the person’s individual physical and social needs.

There is some research evidence of observable benefits in terms of motor ability, balance, and postural adjustment. Horseback riding is particularly popular and addition to its appeal as a fun activity in which horse and rider establish a close relationship, it has the ability to engage people with a wide range of physical difficulties (e.g. cerebral palsy with Gross Motor Function Classification System levels I–V) and social/communication and cognitive difficulties (e.g. autism and intellectual disability).

The journal Developmental Medicine & Child Neurology presents five free articles on the subject including two review articles (one a meta-analysis) which illustrate the existing levels of evidence and also the challenges involved in conducting studies in the field. 

Virtual issue:  Hippotherapy and therapeutic horseriding

Clinical Anatomy of the Cranial Nerves

Clinical Anatomy of the Cranial NervesThe journal Clinical Anatomy has made free a virtual issue focusing on the anatomy of the cranial nerves. Some of the papers include the naming of the nerves, clinical examination, MRI and CT, arterial supply and surgery.

Special Issue: Special Issue on the Clinical Anatomy of the Cranial Nerves; Clinical Anatomy, January 2014. Volume 27, Issue 1, Pages 1–144

To gain access to the free full text articles click here.

Fluid Withdrawal During Dialysis Improves Prognosis

Fluid overload and alterations in the autonomic nervous system are known risk factors for cardiovascular morbidity and mortality in patients on chronic hemodialysis. This small observational study published in BMC Nephrology found a significant correlation between heart rate variability indices and fluid overload, suggesting that appropriate management of fluid withdrawal during dialysis can translate into a better prognosis. 
The results suggested that depressed HRV is associated with fluid overload and that normalization of hydration status is accompanied by improved HRV.

Effects of fluid overload on heart rate variability in chronic kidney disease patients on hemodialysis; BMC Nephrology 2014, 15:26  doi:10.1186/1471-2369-15-26


Ending Newborn Deaths

Newborn ReportSave The Children has published a report on child mortality, which shows one half of first day deaths around the world could be prevented if the mother and baby had access to free health care and a skilled midwife. Since 1990, the number of children who die every year before the age of five has almost halved – from 12.6 million to 6.6 million....  This reduction in child mortality has been achieved through action on immunisation, family planning, nutrition and treatment of childhood illnesses, as well as improving economies. The research also found an additional 1.2 million babies are stillborn each year, their heartbeats stopping during labor because of childbirth complications, maternal infections and hypertension.

This report shows that, in 2012, 2.9 million babies died within 28 days of being born: two out of every five child deaths. Of these, 1 million babies died within 24 hours, their first – and only – day of life. Causes of these deaths include premature birth, complications during birth and  infections.
Download the report. 

Thursday, March 06, 2014

National breast cancer and cervical screening participation

The latest national participation data for Australia’s breast and cervical cancer screening programs are for 2011 and 2012, and have been released ahead of other cancer screening data to provide early access to this information. Detailed analyses are provided annually in comprehensive monitoring reports, scheduled for release in May 2014 (National Cervical Screening Program) and October 2014 (BreastScreen Australia).You can read the web update "National breast cancer and cervical screening participation" here.

Low-dose Opioids Safe for Severe COPD

Lower-dose opioids are not associated with increased hospital admissions or deaths in patients with very severe chronic obstructive pulmonary disease (COPD) and might be safe for symptom reduction in severe respiratory disease. However, benzodiazepines and opioids in higher doses might increase mortality, according to a recent study. The authors state this study further supports the safety of regular low-dose systemic opioids to reduce breathlessness in severely ill patients with respiratory compromise and for those patients who have an immense need for relief of symptoms.
Safety of benzodiazepines and opioids in very severerespiratory disease: national prospective study.
British Medical Journal | Jan 30, 2014 (FREE FULL TEXT)

Your Liver Delivers: Protect It From Harm


Your liver works hard to protect your health. But alcohol, drugs, viruses, and excess weight can damage your liver. The US National Institute of Health has produced a feature on the health of your liver with Resources and Wise Choices listed.  

Your Liver Delivers Protect It From Harm                                                                                            

Patient Decision Aids

Decision aids are intended to help people participate in decisions that involve weighing the benefits and harms of treatment options often with scientific uncertainty. A recent Cochrane Review "Decision Aids for people facing health treatment or screening decisions",  found that there is  high-quality evidence that decision aids compared to usual care improve people's knowledge regarding options, and reduce conflict related to feeling uninformed and unclear about their personal values.
The Health Knowledge Network has also published an Evidence Bulletin on the same topic.

Clinical Supervision in Psychiatry

This selection of papers was presented at the NSW Institute of Psychiatry (NSWIOP) Advances in Clinical Supervision Conference.
You can download a copy of the papers for free.