MNCLHD

MNCLHD

Wednesday, September 30, 2009

New reviews of surgical procedures

The Australian Safety and Efficacy Register of New Interventional Procedures - Surgical (ASERNIP-S), conducts systematic literature reviews on the safety and effectiveness of new surgical techniques. They also conduct clinical and research audits or studies, identify and assess new and emerging techniques, and provide input into the production of clinical practice guidelines. The latest reviews published by ASERNIP-S include:
Systematic literature reviews
• Permanent and semi-permanent dermal fillers
• The effect of fatigue on surgeon performance
• Treatments for varicose veins
Rapid reviews
• Clinical treatments for wrist ganglia
• Diagnostic arthroscopy for conditions of the knee
• Male non-therapeutic circumcision
• Treatments for varicose veins
• Upper airway surgery for the treatment of adult obstructive sleep apnoea

The full range of ASERNIP-S reviews is accessible through the publications page of ASERNIP-S on the Australian College of Surgeons website.

Towards national Indicators of Safety and Quality in Health Care

This report sets out recommendations for a set of 55 national indicators of safety and quality of clinical care provided to patients across the Australian health care system. Thirteen indicators apply to primary and community health services, 25 to hospitals, six to specialised health services, and five to residential aged care. Eleven indicators apply to multiple or all types of health services.
The Australian Institute of Health and Welfare suggests that public reporting on these indicators could serve two main purposes: to provide transparency and to inform decision-making about overall priorities and system-level strategies for safety and quality improvement; and to inform quality improvement activities of service providers. The indicators cover the national health priority areas and major burden of disease and injury groups. Download here for free.

Health expenditure Australia 2007-08

Health expenditure Australia 2007–08 is the latest in the Australian Institute of Health and
Welfare’s long-running series of reports on Australia’s National Health Accounts. Health expenditure in Australia in 2007-08 reached $104 billion and as a percentage of GDP it was 9.1%, the same level as in 2006-07. The area of health expenditure showing the highest growth was public health expenditure which grew by 21% in real terms, mostly due to extra spending on immunisation. Health expenditure Australia 2007-08 examines expenditure on different types of health goods and services in the decade to 2007-08. It describes funding by the Australian and State governments, private health insurance and individuals; compares health expenditures in the different states and territories and compares Australia's spending with other countries. Download part or all of the report here.

Monday, September 28, 2009

Faster Detection of TB May Be on the Horizon

FRIDAY, Sept. 25 (HealthDay News) -- A new test can rapidly identify active tuberculosis in people who've had negative sputum tests, say European researchers. In about half of all people with active TB, the disease-causing bacterium can't be identified using sputum tests. Because of this, new diagnostic tests are needed to help control the spread of TB, the researchers said. "In this study, we showed that a differentiation between active pulmonary tuberculosis and [latent TB infection] is possible by the ELISpot test," Dr. Christoph Lange, principal investigator of the Tuberculosis Network European Trials group study, said in a news release from the American Thoracic Society. The study is published in the Oct. 1 issue of the American Journal of Respiratory and Critical Care Medicine.(From: Healthfinder Weekend Health News 27/9)

Thursday, September 24, 2009

World Alzheimer Report


On 21 September, World Alzheimer's Day, Alzheimer's Disease International released the World Alzheimer Report 2009, which presents a comprehensive global prevalence study of dementia, looking at levels of mortality, disability, strain on carers and dependency. Frighteningly, the report estimates that 35.6 million people worldwide will be living with a form of dementia in 2010 and that this number is estimated to nearly double every 20 years, to 65.7 million in 2030, and 115.4 million in 2050.

The report also offers examples of good national dementia plans and information on health service responses. It includes eight recommendations that will provide a global framework for action on dementia, the first of which is that The World Health Organization (WHO) should declare dementia a world health priority.

Cardiovascular risk factors and life expectancy

The British Medical Journal has just published the results of a major long-term study by Robert Clarke et al, Life expectancy in relation to cardiovascular risk factors: 38 year follow-up of 19 000 men in the Whitehall study .

18 863 men aged 40-69 employed in the civil service in London, were examined in 1967-70 and followed for 38 years. 13 501 have died and 4811 were re-examined in 1997. At entry, 42% of the men were current smokers, 39% had high blood pressure, and 51% had high cholesterol. Even though these risk factors changed over time (for example, many gave up smoking), baseline differences in risk factors were associated with 10 to 15 year shorter life expectancy from age 50.


Monday, September 21, 2009

Paediatric Emergency Guidelines



A statewide, web-based, Paediatric Clinical Practice Guidelines e-learning package, based on the 12 current guidelines, has been launched. The interactive modules promote as well as test understanding of the key clinical principles behind the CPGs and also facilitates monitoring of the clinician engagement across the health system.
The package is available here online and enables access from anywhere in the state by internet or local intranet. It is free to register.

WHO Issues Guidelines for Antiviral Treatment of H1N1 and Other Influenza

The new guidelines published on 20th August are titled "WHO Guidelines for Pharmacological Management of Pandemic (H1N1) 2009 Influenza and other Influenza Viruses". The purpose of the new recommendations is to provide a basis for advice to clinicians regarding the use of the currently available antivirals for patients presenting with illness caused by influenza virus infection, as well as considerations regarding potential use of these antiviral medications for chemoprophylaxis. (From: Medscape News CME dated 19th September 2009)

Women’s Health Topics

A new website has been launched on the US National Library of Medicine site as part of the Specialized Information Services Website. It lists Women's Health Resources - covering the following Women’s Health Topics: General topics; Alcohol, Tobacco and Substance Abuse; Autoimmune Diseases; Bone and Joint Health; Cancer; Complementary and Alternative Medicine (CAM); Diabetes; Exercise and Fitness; Heart Disease; HIV/AIDS; Menopausal Hormone Therapy; Mental Health; Nutrition; Reproductive Health; Safety and Wellness; Sexually Transmitted Diseases (STD); Violence and Abuse (From NLM Weekly Announcements for the week beginning 14th September 2009)

Thursday, September 17, 2009

Top 10 Internet Search Tips

Melissa S. Barker, author of Internet Research Illustrated 5th Edition, has listed her top 10 tips to search the internet.
The invisible or deep Web is the vast reservoir of information stored in databases, estimated to be 500 times larger than the visible web and inaccessable to search engines. Find ways with this 5 page summary to improve your searching.

OncologySTAT

If you need to keep up with latest oncology information, use OncologySTAT to stay current, save time and make informed evidence-based decisions. Sign up for free and have a look at some of the following features.

Screening on SBS by the Rural Health Education Foundation

SBS Television will be broadcasting three Rural Health Education Foundation documentary programs on the following dates:
It Takes a Village - Monday 28 September at 5.30pm
Stay Strong - Monday 5 October at 5.30pm
Strong and Deadly - Monday 12 October at 5.30pm
These 3 programs focus on community development and Aboriginal and Torres Strait Islander Health.
The Foundation's live Type 2 Diabetes Mellitus (T2DM) Four-part Guidelines Television series continues on September 22nd, October 13th and November 10th.
The series is available as a free CD-Rom set to Australian health professionals. Contact the RHEF on their website or email rhef@rhef.com.au .

Wednesday, September 16, 2009

Antibiotics Bought Easily on the Internet

TUESDAY, Sept. 15 (HealthDay News) -- Consumers who decide on their own that they need antibiotics can easily find and buy the medications on the Internet, without the benefit of a prescription, new research shows. The practice is illegal, the study authors said, and could contribute to an overuse of antibiotics that is known to create resistant bacteria which, in turn, can cause life-threatening infections. One expert agreed the trend has troubling implications.

"The expanded and uncontrolled use of antibiotics is a public health hazard because of the impact on creating multiple drug-resistant bacteria," said Dr. Robert Schwartz, chair of the department of family medicine and community health at the University of Miami Miller School of Medicine. "We already have a problem in our country with physicians overprescribing antibiotics . . . Allowing individuals in society unrestricted access to antibiotics is a set-up for a public health disaster." Most previous research and attention has focused on overprescribing by doctors, said Arch G. Mainous III, lead author of a paper appearing in the September/October issue of the Annals of Family Medicine. "Unfortunately, it's misleading to make the assumption that that's only where antibiotics are available," he noted. "Consumers should consult with their primary-care providers first before ordering antibiotics and ask for advice," Schwartz recommended. "Many people will take antibiotics for viral infections, which of course are useless and have potential negative side effects -- destroying normal gut flora, allowing potentially harmful bacteria that are stable under normal conditions to become pathogenic or harmful. They should save their money." (From Healthfinder 16/9/09)

Tuesday, September 15, 2009

University of California, San Francisco: Drug Industry Document Archive

This archive is one that will be of particular importance to those with an interest in public health, public policy, and the general activities of pharmaceutical companies. The Drug Industry Document Archive (DIDA) was created by the University of California, San Francisco (UCSF) and it contains over 1500 documents related to pharmaceutical industry clinical trials, publication of study results, pricing, marketing, and relations with physicians. Many of these documents were previously secret, and were only made public as a result of lawsuits filed against a number of prominent pharmaceutical companies. First-time visitors may wish to start by clicking on "The Documents" link on the homepage. Here they can read about some of the crucial lawsuits that generated the documents featured in this archive. [KMG] (From The Scout Report via ALIAHealth elist)

Monday, September 14, 2009

Diabetes Type 2 Guidelines

The NHMRC has recently released four new guidelines for Type 2 Diabetes:

The Diabetes Australia website has several more best practice guidelines for health professionals.

Chocolate is good for your heart

An 8-year study published in the Journal of Internal Medicine this month by Imre Janszky, et al. has strongly linked chocolate consumption two or more times weekly to 66% less risk of dying from heart disease.

Chocolate consumption and mortality following a first acute myocardial infarction: The Stockholm Heart Epidemiology Program was a population-based inception cohort study, following 1,169 non-diabetic patients hospitalized with a confirmed first acute myocardial infarction and self-reporting of chocolate consumption over time. While chocolate consumption had a strong inverse association with cardiac mortality, the eating of other sweets had no statistical bearing on any type of mortality. The researchers conclude that "confirmation of this strong inverse relationship from other observational studies or large-scale, long-term, controlled randomized trials is needed."

Thursday, September 10, 2009

The hidden cost of genetic screening

Is uptake of genetic testing for colorectal cancer influenced by knowledge of insurance implications? MJA 2009; 191 (5): 255-258.
Louise Keogh has authored this study, which looks at the causes of colorectal cancer. It found that people are choosing not to obtain genetic information because of how it will affect their eligibility for insurance, despite the fact that early screening can prevent cancer from progressing.

Emergency services and legal implications after Katrina

Strained by Katrina, a Hospital Faced Deadly Choices by Sheri Fink was published in the New York Times Magazine recently. This is the story of an emergency doctor and the nurses assisting her who were arrested after allegedly euthenasing some gravely ill patients when their hospital was completely stranded by Hurricane Katrina. The doctor, Anna Pou, has since helped write and pass three laws in Louisiana that offer immunity to health care professionals from most civil lawsuits — though not in cases of willful misconduct — for their work in future disasters, from hurricanes to terrorist attacks to pandemic influenza. In this article, Fink uncovers new evidence which suggests that 17 patients were killed by Pou and that she still has many questions to answer.
A fascinating read for anyone interested in emergency preparedness, altered states of care and medical immunity.

Wednesday, September 09, 2009

Exhausted Australian doctors told to drink more coffee

Exhausted doctors in Australia's northeastern state of Queensland have been advised by the government to drink more coffee.

A 102-page "fatigue management strategy" developed by Queensland Health, has recommended that the "strategic use of caffeine" could be beneficial to extremely tired doctors.
The document suggested medics should consume 400 milligrams of caffeine, which is equivalent to six cups of coffee, to stay awake on the job.
As such a high coffee intake was "not always feasible or realistic", the report said doctors could take caffeine tablets or energy drinks as an alternative.
"Compared with other psychoactive drugs, for example, modafinil (a prescription-only narcolepsy treatment), caffeine is supported in its use as it is more readily available and less expensive," the document said.
The recommendation comes after 88 per cent of doctors in a survey of 113 state hospitals said they experienced dangerous fatigue while working.
A union representing Queensland doctors also warned that public hospital patients were dying because dangerously tired medics were being forced to work up to 80 hours without a break.
However, the suggestion that coffee was the solution to the staffing crisis has been greeted with disdain by Australian doctors.
Susannah McAuliffe, of Salaried Doctor's Queensland, said the strategy was "absolutely ridiculous" and would put patients in further danger.
Andrew Pesce, chairman of the Australian Medical Association, said the real answer to fatigue management was sensible rostering.
"It would be hard for me to be convinced that caffeine that makes you feel less tired is going to necessarily improve your performance," he said.
"I think at the end of the day, we should be focusing on a fundamentally safe rostering system and an acknowledgement that certain minimum number of hours of sleep is what is necessary to maximise performance."
Paul Lucas, Queensland's health minister, said the state was aiming to train more doctors and cap hospital shifts at 12 hours over the next two years, but had no immediate solution to fatigue and staff shortages.
"If the doctors are not there, we can't do it," he said. "We can't say we'd rather not have it as it is and create doctors out of the air."
Australia's federal government is currently under pressure to seize control of the nation's ailing public hospital system, which is currently managed by state governments.
Kevin Rudd, the prime minister, made repairing the health system a campaign promise in 2007 and has warned that a full takeover of public hospitals was still on the cards.

Tuesday, September 08, 2009

Let Orthopedic Surgery Wait Until Morning When Possible

MONDAY, Sept. 7 (HealthDay News) Scheduling a prime daytime slot to undergo an orthopedic procedure may lower your risk of an unplanned follow-up surgery later on, a new study has found. The study, published in the September issue of The Journal of Bone and Joint Surgery, found little difference otherwise for healing, recovery time and major complication rates between certain orthopedic surgeries done during the day (between 6 a.m. and 4 p.m.) and those done after hours (4 p.m. to 6 a.m.). "Although everyone wants to be treated immediately, it may be in a patient's best interest to wait until morning. The reality is that the on-call night surgical team may not be well rested, as it is likely they had just finished a normal day shift," study lead author Dr. William M. Ricci, chief of the Orthopaedic Trauma Service at the Washington University School of Medicine in St. Louis, said in a news release issued by the American Academy of Orthopaedic Surgeons. (From: Healthfinder Sept 7, 2009)

Sleep Apnoea Raises Risk of Death, Especially for Men: Report

Sleep-disordered breathing is a common condition associated with adverse health outcomes including hypertension and cardiovascular disease. The overall objective of this study was to determine whether sleep-disordered breathing and its sequelae of intermittent hypoxemia and recurrent arousals are associated with mortality in a community sample of adults aged 40 years or older. Sleep-disordered breathing is associated with all-cause mortality and specifically that due to coronary artery disease, particularly in men aged 40–70 y with severe sleep-disordered breathing. Punjabi and his colleagues published their findings in the August 18 issue of PLoS Medicine . (From: Healthfinder 19/8/09)

Monday, September 07, 2009

Josie's Story Teaches Hospitals How to Become Safer

Almost 10 years ago, the healthcare industry found that it might not be as safe as it thought. It was then that the Institute of Medicine released To Err Is Human, which noted that each year a million or more hospitalized patients are injured and as many as 98,000 die as a result of errors in their care.

Janice Simmons, for HealthLeaders Media, September 3, 2009

Read the whole article: http://www.healthleadersmedia.com/content/238442/topic/WS_HLM2_QUA/Josies-Story-Teaches-Hospitals-How-to-Become-Safer.html

Tuesday, September 01, 2009

Disaster Glossaries on the US National Library of Medicine Website

Standard and concise disaster terminology for all members of the disaster risk reduction and emergency management community enables professionals to collaborate effectively. Professionals need to be able to find and access different disaster-related glossaries as a step toward creating more uniform terminology, especially for use in international disaster research and publications. This list of glossaries may be helpful in developing a scholarly consensus on such disaster and emergency terms. (From the NLM Weekly Announcements)

Updated Files on the National Library of Medicine Website

MedlinePlus, part of the US National Library of Medicine, has some updated Health Topics which may be of interest. (From the NLM Weekly Announcements)

*MedlinePlus: Amyloidosis
http://www.nlm.nih.gov/medlineplus/amyloidosis.html
*MedlinePlus: Tongue Disorders
http://www.nlm.nih.gov/medlineplus/tonguedisorders.html
*MedlinePlus: Intestinal Obstruction
http://www.nlm.nih.gov/medlineplus/intestinalobstruction.html
*MedlinePlus: Hair Loss
http://www.nlm.nih.gov/medlineplus/hairloss.html