How far do you have to run to burn off sugary drinks?

A new video launched recently shows how much exercise you would need to do to burn off your sugary drink habit – 52km of running each week in some cases.  With 16 teaspoons of sugar in just one regular 600ml bottle of soft drink, you’d have to run a staggering 3km to burn it off. If you’re drinking a 600ml bottle a day, you’d have to run almost half a marathon each week just to burn off your soft drink habit!

The calculator provided lets you see exactly how far you need to walk to burn that sugar off.
http://www.rethinksugarydrink.org.au/ 

Staphylococcus aureus bacteraemia in Australian public hospitals

The Australian Institute of Health and Welfare has released a new report "Staphylococcus aureus bacteraemia in Australian publichospitals 2014-15: Australian hospital statistics".

Both the number of cases and the rates of Staphylococcus aureus bacteraemia (SAB) - or 'golden staph'-have fallen in Australian public hospitals. Overall, the majority (78%) of SAB cases were treatable with commonly used antibiotics, while the remainder (22%) were antibiotic resistant.

Download the free report: AIHWcatalogue number HSE 171   

Aboriginal and Torres Strait Islander health performance framework 2014 report

The Australian Institute of Health and Welfare has released a new web report on the latest information on how Aboriginal and Torres Strait Islander people in Australia are faring according to a range of measures of health status and outcomes, determinants of health and health system performance. Indicators are based on the Aboriginal and Torres Strait Islander Health Performance Framework. The report highlights the main areas of improvement and continuing concern.

Aboriginal and Torres Strait Islander health performance framework 2014 report: detailed analyses AIHW catalogue number IHW 167

Free from Harm: Accelerating Patient Safety Improvement

The [US] National Patient Safety Foundation convened an expert panel to reflect on the publication of the To Err Is Human report from fifteen years ago and to consider the current state of the patient safety field look to the future 15 years. The report of the panel calls for the adoption of a total systems approach and a culture of safety, and calls for action by government, regulators, health professionals, and others to place higher priority on patient safety science and implementation. The report includes eight recommendations:

1. Ensure that leaders establish and sustain a safety culture
2. Create centralized and coordinated oversight of patient safety
3. Create a common set of safety metrics that reflect meaningful outcomes
4. Increase funding for research in patient safety and implementation science
5. Address safety across the entire care continuum
6. Support the health care workforce
7. Partner with patients and families for the safest care
8. Ensure that technology is safe and optimized to improve patient safety

Free from Harm: Accelerating Patient Safety Improvement Fifteen Years After To Err Is Human. Expert Panel Convened by The National Patient Safety Foundation's Lucian Leape Institute

Boston: National Patient Safety Foundation; 2015

Managing a Deteriorating Patient

Clinical Communiqué is a newsletter written by clinicians, using a case-study approach to report on lessons learned from deaths investigated by the Coroners’ Court of Victoria. This edition explores the “challenging scenarios of managing a deteriorating patient in a rural or regional setting, and the obstacles that are faced when attempting to transfer a critically ill patient for ongoing treatment.” 

When cases of patient deaths in hospital are reviewed at mortality case review meetings or coronial inquests, there are common themes that frequently emerge. These themes are the critical elements that need to be present, or performed well, in order to provide safe and effective patient care. They include communication, documentation, awareness of one’s skills and limitations, recognising the deteriorating patient, and following guidelines, to name but a few. Failure or sub-optimal provision of even one element, inevitably leads to a failure in a system and the potential for patients to suffer preventable harm.

Clinical Communiqué. Victorian Institute of Forensic Medicine

Volume 2 Issue 4 December 2015
http://www.vifmcommuniques.org/volume-2-issue-4-december-2015/

Series of National Guidelines (SoNGs)

The Series of National Guidelines (SoNGs) have been developed in consultation with the Communicable Diseases Network Australia (CDNA) and endorsed by the Australian Health Protection Principal Committee (AHPPC). Their purpose is to provide nationally consistent advice and guidance to public health units in responding to a notifiable disease event.

Series of National Guidelines (SoNGs)

Undergraduate student clinical placements - costs and benefits

According to this review from the Sax Institute, there has been a 25.4% increase in the number of fulltime equivalent students in health related courses in Australian universities from 2009 to 2013. This has led to an increase in the need for more clinical placements, "placing additional strain on both the education provider and the health service providers where the placements may occur."

The review examined the costs and benefits of clinical placements and found only limited evidence. The obvious conclusion is that more comprehensive data collection is required and suggestions for this and further research are made.

Evidence check: the costs and benefits of providing undergraduate student clinical placements by Kelly-Ann Bowles, Terry Haines, Elizabeth Molloy, Stephen Maloney, Fiona Kent, Samantha Sevenhuysen, Joanna Tai.

Voluntary assisted death - radio podcast

Big Ideas on ABC Radio National has recently produced How We Die, an investigation into voluntary assisted death by well-known broadcaster, Andrew Denton.  Denton talks about how he watched his own father die slowly and painfully, and how he set off on a journey to find out why so many attempts to legalise voluntary assisted death have failed in Australia, despite polls showing public support. Denton listened to anti-euthanasia arguments and visited Oregon, the Netherlands and Belgium to see what happens there where laws support the practice.

Listen here to How we die or download the podcast.

Eye Health - updated statistics

The Australian Institute of Health and Welfare has updated its webpages on eye health in Australia. 

More than half of the Australian population reported having a long-term eye condition in 2011-12. There were nearly 230,000 hospitalisations for cataract extraction in 2013-14, and almost 11,000 people were employed in the eye health workforce in 2011, including over 800 ophthalmologists, around 4,000 optometrists, and over 6,000 allied ophthalmic personnel.

The site also provides links to global and national eye health policies.

Thalidomide series from The Conversation

This week The Conversation has featured a series of articles about thalidomide, "the sedative and morning sickness drug that caused thousands of miscarriages in the 50s and 60s and left more than 10,000 children severely disabled". As always, the articles are highly accessible pieces of journalism, written by experts in the field and include links to the original evidence.  Some of the articles featured so far include:

Infographic: a snapshot of the thalidomide tragedy and Timeline: key events in the history of thalidomide - both present a pictorial overview of the tragedy. 

Remind me again, what is thalidomide and how did it cause so much harm? by Arthur Daemmrich from the Smithsonian Institution. 

Could thalidomide happen again? by Sarah Ferber, University of Wollongong and Why did thalidomide's makers ignore warnings about their drug? by Garry Gray, University of Victoria answer some of the enduring questions about how this event could actually have happened.

 

Society is also to blame for thalidomiders' worsening health  by Gregor Wolbring, University of Calgary and  Why thalidomide survivors have such a tough time getting compensation by Bill Madden, Western Sydney University look at the issue from the survivors' point of view.

Psychiatric evaluation of adults - updated US guidelines

The American Psychiatric Association has released the third, updated edition of its Practice guidelines for the psychiatric evaluation of adults. Nine separate guideline modules cover:

• Review of Psychiatric Symptoms, Trauma History, and Psychiatric Treatment History
• Substance Use Assessment
• Suicide Risk Assessment
• Assessment of Risk for Aggressive Behaviors
• Assessment of Cultural Factors
• Assessment of Medical Health
• Quantitative Assessment
• Involvement of the Patient in Treatment Decisions
• Documentation of the Psychiatric Evaluation

Health outcomes following IVF pregnancies

This literature review examined the evidence for risks associated with assisted reproductive technology (ART).  The best available evidence indicates that a pregnancy after ART is often characterised by an increased risk of poorer health outcomes both for the foetus and the mothers. However these findings are confounded by multiple factors so "it is not currently known whether this is an effect of ART or of the underlying biological profile of the subfertile population".  The authors call for more focused research.

Christos A. Venetis , Georgina M. Chambers. Maternal, pregnancy and neonatal outcomes following IVF pregnancies: evidence check.  The Sax Institute.

Health of Australia's Prisoners 2015

The health of Australia's prisoners 2015, published by the AIHW, includes data from 1,011 prison entrants, 437 prison dischargees, over 9,500 prisoners who visited a prison health clinic and about 9,400 prisoners who took medications.  This report includes, for the first time, data on the smoke-free status of prisons, disabilities and long-term health conditions experienced by prisoners, and self-assessed health status.

Mental health issues and risky health behaviours, including tobacco smoking, excessive alcohol consumption and illicit use of drugs, continue to be the main areas of concern. The health of Indigenous prisoners (over-represented at 27% of the prison population) is also a continuing concern. 

Pain series from The Conversation

The Conversation has recently published a series of articles by academics, scientists and other experts about various aspects of pain. They are clearly explained with lots of links back to the evidence.  

The right words matter when talking about pain from Michael Vagg (Barwon Health) explains how to talk to people about pain and how sometimes the use of cliches can make their pain worse.  

What dictates how much pain you feel after injury? by Malcolm Hogg (University of Melbourne) explains how education levels and other social factors can effect how much pain people feel and how long it lasts.  

 

Not helping a partner with chronic pain may be the quickest road to recovery is from Toby Newton-John (University of Technology Sydney), who writes that partners who do everything for the chronic pain sufferer may actually be hindering their recovery. 

Pain drain: the economic and social costs of chronic pain by Christopher Williams (University of Newcastle) discusses our neglect of effective pain management and how this leads to an increased economic and social burden. 

Antibiotic resistance: are we all doomed?

This is the title of a recent article in Internal Medicine Journal by Peter Collignon from the Australian National University and Canberra Hospital.  It clearly summarises this important issue, which "is associated with increased deaths and suffering for people", and offers some solutions. Antimicrobials can be controlled by improved infection prevention, more diligent surveillance of usage and resistance patterns (and acting on that surveillance), ensuring that resistant microorganisms are not spread through food and water, and diligent antimicrobial stewardship.

Collignon P. Antibiotic resistance: are we all doomed?  Internal Medicine Journal. 2015;45(11):1109-15.

Women, mental health, and hormones

If you're interested in the brain, both neurologically and psychologically, ABC Radio National's program All in the Mind is worth podcasting.  Recent programs have included narcissism and domestic abuse, the use and addictive qualities of benzodiazepines, music for dementia sufferers and the science of self.

In the program, Women, mental health and hormones, guest psychiatrists, endocrinologists and women's health experts discuss why women experience twice as much depression and four times as much anxiety as men.  Biological, social and psychological factors mean that men and women experience mental illness differently and a new hormonal therapy is described as one way gender issues can be more targeted.

Mental health and human emotions - TED talks

The TED radio hour is made up of excerpts from various TED talks, including interviews with the speakers.  A recent program was called Headspace, and it examined various aspects of mental health.

Writer and psychologist, Andrew Solomon, talked about his own episodes of depression, then Alix Generous talked about how she was misdiagnosed (and mis-medicated) at a very young age with bipolar disorder. Neurobiologist David Anderson explained why psychiatric drugs don't always work and and how his own experiments with fruit flies offer a more targeted approach. Finally, psychologist Guy Winch talks about the importance of emotional hygiene and how we need to take care of our emotional wellbeing.

Listen to the program on the website, or download a podcast.  There are links to each speaker's complete talk as well.

National Health Survey: First Results, 2014-15

The 2014-15 National Health Survey is the most recent in a series of Australia-wide health surveys conducted by the Australian Bureau of Statistics. The survey was designed to collect a range of information about the health of Australians, including:

• prevalence of long-term health conditions;
• health risk factors such as smoking, overweight and obesity, alcohol consumption and exercise;
• use of health services such as consultations with health practitioners and actions people have recently taken for their health; and
• demographic and socioeconomic characteristics. 

4364.0.55.001 - National Health Survey: First Results, 2014-15 

Domestic and family violence and homelessness 2011-12 to 2013-14

This report from AIHW releases early findings on the interaction between domestic and family violence and homelessness. Nearly 200,000 adults and children sought help from homelessness services due to domestic and family violence between 2011-12 and 2013-14.  Nine in 10 adult clients (aged 18 and over) seeking assistance for domestic and family violence were female, and over one-quarter of all clients were children under the age of 15.

Domestic and family violence and homelessness 2011-12 to 2013-14  AIHWcatalogue number WEB 112         

Asthma Primer: Current Concepts in the Diagnosis and Management of Asthma

This special free issue from the journal International Forum of Allergy & Rhinology would be useful for practitioners who diagnose and treat patients with asthma. Subjects covered include epidemiology, risk factors, comorbidities, diagnosis, and treatment of asthma. 
  

Special Issue: Asthma Primer: Current Concepts in the Diagnosis and Management of Asthma. September 2015, Volume 5, Issue S1, Pages S1–S81

Australia's Health Workforce

This detailed workforce data published by the Australian Institute of Health and Welfare allows you to select the location and FTE for for each registered health profession in Australia for the years 2011-14, and to customise how the results are displayed. Results can be easily exported to other formats.

Dynamic data display: Australia's registered health workforce by location. AIHW catalogue number WEB 080   

Myopia Virtual Issue

This collection of papers reflects the advances in our understanding of the conditions which can lead to the development of myopia and the advances made in slowing its development. Some corrective approaches appear to be partially successful in slowing myopia. 

Ophthalmic and Physiological Optics Volume 35, Issue 6, pages 637–642, November 2015. 

Principles of public health interventions to support injury recovery

This review examines the evidence for the effectiveness for public health interventions and identified principles and strategies which could be used in public health interventions for injured people.

Principles of public health interventions to support injury recovery and return to productivity: a rapid review by Sandra Jones, Julien Tran, Michael Matthias, Martin McDermott,  2015. Sax Institute.

Violence against immigrant and refugee women

With White Ribbon Day receiving good media coverage this week, one timely paper recently published is from Australia's National Research Organisation for Women's Safety (ANROWS) - Promoting community-led responses to violence against immigrant and refugee women in metropolitan and regional Australia. 

This paper presents the state of national and international knowledge about family violence against immigrant and refugee women. Some of the findings include the fact that although there are similar forms of family violence for these women as other women, there are differences where women depend on perpetrators for economic security and residency rights.  There is very little evidence that mandatory arrest and pro-prosecution approaches are helpful for these women, and they may even deter them from seeking help. 

OECD review of health care quality in Australia

The OECD has also published a series of reviews of health care quality in member countries, and OECD Reviews of Health Care Quality: Australia 2015: Raising Standards  notes that the Australian system is a generally high and performs at moderate cost, despite being very complex. 

The report describes many of the quality activities being undertaken and suggests how the system could be improved, such as an enhanced federal government role in steering policy, funding and priority setting. 

Health at a glance 2015 - OECD indicators

This year's summary report on health and health care in the OECD nations, Health at a Glance 2015: OECD indicators, reports that while life expectancy continues to rise, there are still widespread differences across countries and socioeconomic groups.

The report presents the most recent comparable data on the performance of health systems in each country and also in some instances data for partner countries (Brazil, China, Colombia, Costa Rica, India, Indonesia, Latvia, Lithuania, Russian Federation and South Africa). This edition also includes a new set of dashboards of health indicators looking at the relative strengths and weaknesses of OECD countries on different key indicators of health and health system performance.  There is a special focus on the pharmaceutical sector and on health workforce migration.

Coffee consumption and mortality

A major study published in the journal Circulation has recently concluded that "Higher consumption of total coffee, caffeinated coffee, and decaffeinated coffee was associated with lower risk of total mortality."

The study, conducted by the Harvard School of Public Health was based on data gathered from three large, ongoing surveys including around 300,000 nurses and other health professionals over a 30 year period. The results indicated that people who drank three to five cups of coffee a day (either caffeinated or decaffeinated) have a reduced risk of death from heart disease, diabetes, suicide and neurological diseases.

Ding, Ming et al. Association of coffee consumption with total and cause-specific mortality in three large prospective cohorts. Cirulation AHA.115.017341 Published online before print November 16, 2015, doi: 10.1161/CIRCULATIONAHA

Why go gluten-free?

This week the ABC program, Catalyst, aired Gluten: a gut feeling, looking at why so many people who have not been diagnosed with coeliac disease are opting for a gluten-free diet. Many people say that giving up gluten in their diet has helped with gastrointestinal issues, but Professor Peter Gibson from Monash University says it could be something other than gluten that has been causing the problem. Fructans are also present in wheat and are part of a group of carbohydrates called FODMAPs. Giving up foods rich in FODMAPs would be a lot less restrictive than going gluten-free.

More information on this was published in an article recently in The Conversation: Why do people decide to go gluten- or wheat-free? by Sinead Golley from the CSIRO. She points out that "according to current Australian Dietary Guidelines, grain- and dairy-based foods are important components of a balanced diet".

Mentioned in this article was a study Golley co-authored, published earlier this year in the journal Public Health Nutrition, Motivations for avoiding wheat consumption in Australia: results from a population study.  Over 1000 randomly-selected adult Australians were surveyed and a significant number were avoiding the consumption of wheat, mainly without any medical diagnosis.

Public Health Nutr. 2015 Feb;18(3):490-9. doi: 10.1017/S1368980014000652..

Brain-eating amoeba - Naegleria fowleri

Wellcome Images

A recent episode of Australian Story on the ABC told about the tragic death of a very young boy in Northern Queensland due to the amoeba Naegleria fowleri in water from a garden hose.

More information on this amoeba and the  primary amoebic meningoencephalitis it causes can be found in the explanatory piece, "What are brain-eating amoeba and how can we reduce their harm?" published by gastroenterologist and academic, Vincent Ho, in The Conversation. Fortunately, infections of this type from Naegleria fowleri are quite rare, as opposed to another amoebic organism, Entamoeba histolytica which is estimated to result in up to 100,000 deaths per year across the world.

Are we ready for the next flu?

Lisa Jackson Pulver from the Centre for Defence and Strategic Studies at the Australian Defence College has written this briefing paper: Questions from the lab – is Australia and the near region ready for the next attack of ‘flu?

Pulver contends that the seemingly ‘common flu’ is an example of a non-traditional threat for which Australia and its near neighbours are particularly underprepared. She notes that new pathogens are always emerging and changing to resist human efforts to control them, and provides an overview of the history and current status of the influenza virus.

Sleep deprivation and starvation in hospitalised patients

The authors of this open-access opinion piece in the journal BMJ Quality and Safety highlight the neglect of quiet and nutrition in some hospitals and how, rather than helping to treat patients, they are actually harming them. "As we seek to improve quality through patient-centredness, basic human needs are important in the context of complex medical care. We should view hospitals as healing environments rather than isolated clinical spaces and design patient care accordingly.”

Xu T, Wick EC, Makary MA Sleep deprivation and starvation in hospitalised patients: how medical care can harm patients.  BMJ Qual Saf doi:10.1136/bmjqs-2015-004395

Deaths in Australia in 2013

The Australian Institute of Health and Welfare has updated its web pages to include the analysis of all 147,678 deaths registered in Australia in 2013.  Despite the slight decline in cancer mortality rates, the number of deaths due to all neoplasms was greater than the number of deaths due to circulatory diseases for the first time in 2013 (44,674 deaths and 43,603 deaths respectively).  A third of deaths were in people under 75 years of age, and the difference in death rate between males and females has lessened over time.  51% of deaths occurred among people admitted to hospital.

Find out more details about death statistics, trends, life expectancy, causes of death and more on the AIHW Deaths web pages.

Menopause: diagnosis and management

The UK’s National Institute for Health and Care Excellence (NICE) has published a new guideline on menopause.  The guideline aims to improve the consistency of support and information provided to women in menopause and is intended both for healthcare professionals who care for women in menopause and women in menopause, and their families and carers.

NICE Guideline NG23:  Menopause: diagnosis and management  November, 2015.

Stroke Riskometer app

This app has been produced with the claims that it “is a unique and easy to use tool for assessing your individual risk of a stroke in the next five or ten years and what you can do to reduce the risk. The app can also give you an indication of your risk of heart attack, dementia, and diabetes.”

In 2014, out of 100,000+ health-related apps, Stroke Riskometer™ App has been selected by leading doctors as a top health app worldwide (number 1 app in Medical Conditions category for iOS). The app won based on its medical accuracy, its utility in supporting health or healthy living goals, and usability. Stroke Riskometer™ was a finalist for New Zealand Innovators Award, category Innovation in Health & Science.

Stroke Riskometer™ 

Continuous improvement of patient safety

The UK charity the Health Foundation has published a new report on the lessons learned from their work on improving patient safety in the NHS. According to the Health Foundation’s website:

"Part I of the report illustrates why improving safety is so difficult and complex, and why current approaches need to change.

Part II looks at some of the work being done to improve safety and offers examples and insights to support practical improvements in patient safety.

In Part III, the report explains why the system needs to think differently about safety, giving policymakers an insight into how their actions can create an environment where continuous safety improvement will flourish, as well as how they can help to tackle system-wide problems that hinder local improvement."

Continuous improvement of patient safety: The case for change in the NHS. Learning report. Illingworth J., London: The Health Foundation; 2015.

Patient Experiences in Australia: Summary of Findings, 2014-15

The Australian Bureau of Statistics Patient Experience Survey is conducted annually and collects data on access and barriers to a range of health care services, including:

• general practitioners (GPs)
• medical specialists
• dental professionals
• imaging and pathology tests
• hospital admissions
• emergency department visits (ED)

It includes data from people that accessed health services in the previous 12 months, as well as from those who did not, and enables analysis of health service information in relation to particular population groups. Data are also collected on aspects of communication between patients and health professionals.

4839.0 - Patient Experiences in Australia: Summary of Findings, 2014-15 

Treatment of acute stroke: an update

About 17 million strokes occur worldwide each year and it is the second leading cause of global mortality and a major cause of neurological disability. Patients with stroke often require long-term rehabilitation following the acute phase, with ongoing support from the community and nursing home care. In this overview published in the Journal of Internal Medicine, the current strategies for specific treatment of stroke in the acute phase, focusing on intravenous thrombolysis and mechanical thrombectomy are discussed. Two important issues related to intravenous thrombolysis treatments: (i) how to shorten the delay between stroke onset and treatment and (ii) how to reduce the risk of symptomatic intracerebral haemorrhage are also considered.

This article is free online until Dec 15, 2015, after this date please contact your library.

Mikulik, R., & Wahlgren, N. (2015). Treatment of Acute Stroke: an update. Journal of Internal Medicine, 278(2), 145-165

Preventing suicide by young people

Preventing suicide by young people is a discussion paper from BoysTown, the organisation that runs the Kids Helpline. The paper reports that "In 2013, 2,522 people died by suicide in Australia. Twenty-two of these were children aged 5- 14 years, 148 were adolescents aged 15-19 years, and a further 200 were young people aged 20-24 years."  Suicide is in fact the leading cause of death in children and young people.

The paper outlines risk and protective factors against suicide for young people, looks at what's happening in preventive and early intervention in Australia, examines clinical and service interventions and discusses opportunities for improvements across the board.  There is a useful guide and summary to Apps aimed at suicide intervention as an appendix.

The evolution of impact indicators

This electronic resource by Catherine Williams (from Altmetrics) and Danielle Padula (from Scholastica) looks at the history and development of impact factors in scholarly research and publishing.  Both traditional and alternative impact indicators are examined from the perspective of research evaluation, and case studies and practical tips are provided. The authors ask, "How can impact indicators be used to determine the true impact of individual scholars’ works and the impact of individual and collective works online both within and beyond journals?"

The Evolution of Impact Indicators: From bibliometrics to altmetrics!   

Future of Antimicrobials

Read for free this recent themed issue from the British Journal of Clinical Pharmacology. The issue spotlights the need to protect antimicrobial treatments for the future. Antimicrobial resistance (AMR) constitutes one of the world's most pressing public health threats, is a major global health security risk and is very expensive, with AMR-induced GDP losses estimated at 0.4 to 1.6%. The themed section goes further to consider strategies outside the realm of traditional clinical pharmacology stewardship and infectious diseases practice that could be used to engage healthcare facility administrators, the agricultural industry and policy makers to work together to employ effective strategies for improving antimicrobial development and use.

Special Issue: Future of Antimicrobials, 2015. British Journal of Clinical Pharmacology,  79(2),  i–ii, 165–350

Hydration and Older Patients Admitted to Hospital

Older adults are susceptible to dehydration due to age-related pathophysiological changes. In this study performed at a large UK Teaching Hospital the aim was to investigate the prevalence of hyperosmolar dehydration (HD) in hospitalised older adults, aged ≥65 years, admitted to emergency and to assess the impact on short-term and long-term outcome.
HD is common in hospitalised older adults and is associated with poor outcome. The study found that coordinated efforts are necessary to develop comprehensive hydration assessment tools to implement and monitor a real change in culture and attitude towards hydration in hospitalised older adults.
The results have been published in the most recent issue of Age and Ageing.

El-Sharkawy, Ahmed M. et al. (2015). Hydration and outcome in older patients admitted to hospital (The HOOP prospective cohort study). Age and Ageing, 44(6 ), 943-947.

Issues of validity and reliability in qualitative research

Evaluating the quality of research is essential if findings are to be utilised in practice and incorporated into care delivery. The aim of this article in the journal Evidence-Based Nursing is to further the integrity in which a study is conducted, and ensure the credibility of findings in relation to qualitative research. Concepts such as reliability, validity and generalisability typically associated with quantitative research and alternative terminology will be compared in relation to their application to qualitative research. In addition, some of the strategies adopted by qualitative researchers to enhance the credibility of their research are outlined.

Noble, Helen & Smith, Joanna. (2015). Issues of validity and reliability in qualitative research. Evidence-Based Nursing, 18(2), 34-35

Stopping unnecessary use of antibiotics

This report from the Wellcome Trust UK provides an overview of how diagnostics can play an important role in the fight against antimicrobial resistance, by reducing unnecessary use, particularly outside of hospital usage. In many hospital settings the use of antimicrobial stewardship systems has allowed for more appropriate use of antibiotics. This report suggests that better and more rapid diagnostics can also aid in the more appropriate and targeted use of antimicrobials. 

Rapid Diagnostics: Stopping unnecessary use of antibiotics

Radiotherapy in Australia

This recent report from AIHW looks at national radiotherapy data from 53 service locations across Australia. The report shows that most patients who receive radiotherapy wait less than two weeks for treatment and that almost all emergency cases begin their treatment on the same or the next day. The pilot data collection shows that breast, prostate and lung cancers were the most common types of cancer among people starting courses of radiotherapy.

Download the report for free. Radiotherapy in Australia: report on a pilot data collection 2013-14  

Bipolar disorder, psychosis and schizophrenia in children and young people

This quality standard from the National Institute for Health and Care Excellence (UK) covers the recognition, early intervention and management of bipolar disorder, psychosis and schizophrenia (including related psychotic disorders such as schizoaffective disorder, schizophreniform disorder and delusional disorder) in children and young people under 18. 

NICE Quality Standard QS102  Bipolar disorder, psychosis and schizophrenia in children and young people. October 2015.

Breast Cancer in Young Women

The Australian Institute of Health and Welfare has released a new report about breast cancer in women in their 20s and 30s. Breast Cancer in Young Women is the first national report presenting key data specific to breast cancer in women in this age group. This report provides an overview of breast cancer, risk factors for young women, breast cancer detection and diagnosis methods, and key summary measures including incidence, hospitalisations, survival and mortality.

Breast cancer in young women: key facts about breast cancer in women in their 20s and 30s. October 2015; AIHW catalogue number CAN 94

Critical Care Compendium

Life in the Fast Lane (LITFL) is a medical blog and website dedicated to providing free online emergency medicine and critical care insights and education for everyone, everywhere. It is an amazing resource and the Critical Care Compendium, part of LITFL, is a comprehensive collection of pages on core topics and controversies relating to critical care. With over 1650 entries, the Compendium entries are constantly revised and improved with links to new references and online resources added daily.

The team for LITFL is headed by Mike Cadogan and Chris Nickson, and consists (mostly) of emergency physicians and intensivists based in Australia and New Zealand. Chris Nickson is the creator of the Critical Care Compendium.

New research resource for domestic violence

"The National Information Center on Health Services Research and Health Care Technology (NICHSR) of the National Library of Medicine (US) has released a new health services research resource on domestic violence. The new resource can be found on the Web portal, Health Services Research Information Central (HSR Info Central). It is intended to support health services researchers, policymakers, administrators, and practitioners involved in detection, prevention and treatment services for this under served and often unnoticed community. The scope of this “topic page” includes Intimate Partner Violence, Reproductive and Sexual Coercion, Child Abuse and Maltreatment, and Elder Abuse."
The site includes statistics, guidelines, search strategies, education and related publications.

Domestic Violence Research Resource

Patient Perspectives: Hospital care for people with cancer

The Bureau of Health Information has released a report, Patient Perspectives: Hospital care for people with cancer. This report draws on Adult Admitted Patient Survey results from almost 6,500 patients with cancer who were admitted to a NSW public hospital during the period July 2013 to July 2014. 
This is the first time a focus has been placed on the survey results of patients with cancer in NSW.

Compared with general patients, people with cancer were more positive about many aspects of care. Although patients would like more information about potential side effects of medication.

Patient Perspectives: Hospital care for people with cancer.

Dementia, Disability and Frailty in Later Life

Leading a healthier lifestyle can delay dementia, disability and frailty in later life. A recent guideline from NICE in the UK recommends National organisations and local government departments that influence public health should continue to develop and support population-level initiatives to reduce the risk of dementia, disability and frailty by making it easier for people to:

• stop smoking
• be more physically active
• reduce their alcohol consumption
• adopt a healthy diet
• achieve and/or maintain a healthy weight

NICE also recommends that organisations make physical activity, adopting a healthy diet and achieving and maintaining a healthy weight as accessible, affordable and acceptable as possible.

Dementia, disability and frailty in later life – mid-life approaches to delay or prevent onset. NICE Guidelines [NG16] October 2015  

New breast screening guidelines in the USA

The American Cancer Society has issued new guidelines which recommend women start having mammograms at 45 instead of 40, and that they don't need to have routine manual breast checks by their general practitioners.

There seems to be a few different approaches in America with the American College of Obstetricians and Gynegologists recommending regular mammograms from 40, the US Preventive Services Task Force recommends age 50, and now the American Caner Society recommends age 45.  BreastScreen Australia targets women from 50-74, but women from 40 are eligible for free screening. 

Breast Cancer Screening for Women at Average Risk : 2015 Guideline Update From the American Cancer Society is freely published in JAMA.

314(15):1599-1614. doi:10.1001/jama.2015.12783

Lancet 10,000th issue

The 10,000th issue of The Lancet has was published last month with some memories of medical milestones since their first issue in October 1823.  

See their infographic timeline to read the original articles of some celebrated research points over the last 192 years, such as Lister arguing for antiseptic practice in surgery in 1867, the first description of ultrasound in 1958 and the introduction of the Glasgow Coma Scale in 1974.

Snapshot Report: Outpatient Survey Results 2014

The Bureau of Health Information has released the first results of the NSW Outpatient Survey which looks at the experiences of more than 18,000 patients who received outpatient services in a NSW public hospital in February or March 2014. 

This is the first time information has been available about patients' experiences of care across nine different types of outpatient services, including oncology and chemotherapy, gynaecology and obstetrics, and orthopaedic surgery.

Snapshot Report: Outpatient Survey Results 2014

World report on ageing and health

With advances in medicine helping more people to live longer lives, the number of people over the age of 60 is expected to double by 2050 and will require radical societal change, according to a new report released by the World Health Organisation.

While some older people may indeed be experiencing both longer and healthier lives, these people are likely to have come from more advantaged segments of society. “People from disadvantaged backgrounds, those in poorer countries, those with the fewest opportunities and the fewest resources to call on in older age, are also likely to have the poorest health and the greatest need,” says Dr Beard, Director of the Department of Ageing and Life Course at WHO.

The Report highlights 3 key areas for action which will require a fundamental shift in the way society thinks about ageing and older people. These actions can give the older people of today and tomorrow the ability to invent new ways of living.

World report on ageing and health. WHO 2015

Type 1 Diabetes in Children

The Australian Institute of Health and Welfare has published a new report on the prevalence of type 1 diabetes among children aged 0-14 in Australia 2013. The report, based on data from the National (insulin-treated) Diabetes Register, highlights that in 2013, 6,091 children aged 0-14 had type 1 diabetes in Australia. This represented 139 cases per 100,000 population, or about 1 in 720 Australians aged 0-14. About 2 in 5 children with type 1 diabetes used an insulin pump to administer insulin. The prevalence of type 1 diabetes among children differed by age, state/territory, and residential remoteness areas.

Prevalence of type 1 diabetes among children aged 0-14 in Australia 2013 AIHW catalogue number CVD 70.

View and download the full report for free online.

e-Mental Health: A Guide for GPs

The term e-mental health refers to the use of the internet and related technologies to deliver mental health information, services and care. e-Mental health interventions are effective for use in the management of mild to moderate depression and anxiety, and can be disseminated in the primary care setting. The RACGP has developed e-Mental health: A guide for GPs to assist you in using e-mental health interventions with patients when it is safe to do so.

The Guide is designed to provide an introduction to the field of e-mental health, direct you to key online resources for you and your patients, and help you to decide how to use e-mental health in your practice.

Health of grey nomads

Health of grey nomads: On the move and under the health sector radar has been published in the Australian Journal of Rural Health recently. The term 'grey nomads' refers to older people travelling long distances around Australia and staying in caravans, tents or motor homes.  Anecdotal evidence suggests they impose a burden on rural and remote health services, but there has been very little research to support this.

Author Melissa Raven surveyed the literature and found that many grey nomads have chronic diseases and some are inadequately prepared for travelling.  She concludes that there is a need for further research to analyse the uptake of health services from this group in order to properly resource health services and optimise their well-being.  

Outcomes of Australian rural clinical schools

Outcomes of Australian rural clinical schools: a decade of success building the rural medical workforce through the education and training continuum has been published on open access in the journal, Rural and Remote Health, by Jennene Greenhill, Judi Walker and Denese Playford.

The Australian government has funded the Rural Clinical Training and Support (RCTS) program for the past decade and this article looks in detail at the successes and challenges faced by the 17 medical schools set up under this program. Through semi-structured interviews with the program directors and others with a key involvement, as well as an analysis of enrolments of students and the consequent employment characteristics of graduates, the authors conclude that the program has been an "outstanding success" with graduates finding a passion for rural health practice.

Perceptions about antibiotic resistance

Rob Brewer, flickr,com

Antibiotic resistance? Sorry, not my problem is a piece recently published in The Conversation by Amanda McCullough, Chris Del Mar and Tammy Hoffman from Bond University.  The authors discuss doctors' and patients' perceptions and understanding of antibiotic resistance and how, although it is widely recognised as a problem, very few people take individual responsibility for prescribing or consuming antibiotics.

This article refers to a paper published earlier this week in the Journal of Antimicrobial Chemotherapy by the same authors. In that article, A systematic review of the public's knowledge and beliefs about antibiotic resistance, they conclude that the public has an "incomplete understanding of antibiotic resistance and misperceptions about it and its causes and do not believe they contribute to its development".

J. Antimicrob. Chemother. (2015)doi: 10.1093/jac/dkv310First published online: October 12, 2015.  Contact your health library for the full text of this article.

State of the world's antibiotics, 2015

This report from the Center for Disease Dynamics, Economics and Policy in the US looks at the current state of antibiotic use and resistance in humans and animals globally. It examines the differences in low and middle income countries and some national strategies to combat antibiotic resistance. 

The State of the World's Antibiotics 2015 is accompanied by interactive maps that show resistance trends in 39 countries and antibiotic use in 69 countries. The maps track infections caused by 12 common and sometimes lethal bacteria, including Escherichia coli, Salmonella, and methicillin-resistant Staphylococcus aureus (MRSA).

Guide to apps promoting healthy living

VicHealth reviewed over 200 health and wellbeing apps available on Apple® and Android™ devices between May and August 2015. The selected apps were reviewed to see if they were likely to help users change their behaviour and achieve a healthier lifestyle. Each app has been given a star rating and VicHealth aims to update those ratings annually.  You can see all the reviews along with tips for choosing apps on their Healthy Living Apps website. 

Elective surgery waiting times 2014-15

The Australian Institute of Health and Welfare has released a new report on elective surgery waiting times. In 2014-15: about 700,000 patients were admitted to Australian public hospitals from elective surgery waiting lists; 50% of patients were admitted for their surgery within 35 days; fewer than 2% of patients waited more than a year for their surgery.

 Elective surgery waiting times 2014-15: Australian hospital statistics   

AIHW catalogue number HSE 166

Download the full reportfor free online. 

What really matters at the end of life - B.J. Miller

BJ Miller is a palliative care physician at Zen Hospice Project in San Francisco, and he presented this very moving TED talk earlier this year. Miller tries to create a dignified, graceful end of life for his patients, asking what do they really want?  Miller, who suffered a horrific accident as a young man and was close to death himself, says, "Let's begin at the end.  For most people it's not death that they fear - it's dying".   

Watch the TED talk, and/or read the transcript of What really matters at the end of life.  

Improving length of stay - what can hospitals do?

The Nuffield Trust in the UK has published a report, Improving length of stay: what can hospitals do?.  The authors point out that improvements in internal processes could reduce the variations in stay for patients with similar conditions.  Some of the principles of good practice that emerged from their study of the literature and insights from clinicians include:  a focus on flow, getting the basics right and ensuring active support for discharge seven days a week.

Codeine-related deaths

Almost half of codeine-related deaths in Australia from 2000 to 2013 are attributable to accidental overdose, say researchers. Deaths related to codeine, which soon could be available only on prescription, more than doubled in Australia between 2000 and 2009.

There was a jump from 3.5 to 8.7 per million population, with a 9.3 per cent rise each year, say researchers who found the increase mainly driven by accidental deaths. Almost half were attributed to accidental overdose and a third to intentional self-harm, with education about the dangers of taking too much codeine needed. The study was published in the Medical Journal of Australia in early October.

Trends and characteristics of accidental and intentional codeine overdose deaths in Australia; Amanda Roxburgh, Wayne D Hall, Lucinda Burns, Jennifer Pilgrim, Eva Saar, Suzanne Nielsen and Louisa Degenhardt. Med J Aust 2015; 203 (7): 299