Antimicrobial Resistance Website

The Government has launched an online resource for industry and the community as part of ongoing work to tackle the rise of antimicrobial resistance.
The main cause of antibiotic resistance is antibiotic use, the more we use antibiotics, the more chance bacteria have to develop resistance to them. As a result of antibiotic resistance, standard medical and veterinary treatments may become ineffective and infections may persist and spread to others. Australia is one of the developed world’s highest users of antibiotics – one of the main causes of AMR.

The new AMR website has information for the community, health professionals, animal health professionals, farmers, animal owners and the broader agriculture industry.

Using appreciative inquiry as a framework to enhance the patient experience

The following case depicts the journey of a non-profit hospital in the US and its attempts to turn around suffering patient experience. The Hospital turned to the theories of Appreciative Inquiry and the power of a strengths-based approach to create a framework to support the patient experience initiatives. Hospital leadership led the formation of a Patient Experience Team to implement ten initiatives in order increase the top box score in the domain of willingness to recommend the hospital, as that was selected as a global measure of success for the overall improvement project.

Moorer, Kerry [et al] (2017). Using appreciative inquiry as a framework to enhance the
patient experience, Patient Experience Journal,  4(3), Article 18. 

A productive workplace is built on teamwork and a shared vision

An interesting blog post from Jane Collins on the KingsFund blog where the author considers how managers and clinicians can work together to improve productivity and reduce waste in healthcare. Although the post relates to the NHS, improving productivity in the UK has become a national priority as it is in Australia.

Collins, Jane (2017) 'A productive workplace is built on teamwork and a shared vision', 8 November. Available at: https://www.kingsfund.org.uk/blog/2017/11/productive-workplace-teamwork-shared-vision? (Accessed 27 December 2017)

Hospital care for Australian sports injury 2012-13

This report focuses on acute care services provided by hospitals for sports injuries treated in Australian hospitals in 2012-13. Cases of sports injury are examined in terms of the body region injured with ten types of injury are described in some detail. 7500 people were hospitalised for sport-related head injury and 5500 for knee injury.

Hospital care for Australian sports injury 2012–13, AIHW 2017.  

Work-related hospitalised injuries, Australia 2006-07 to 2013-14

AIHW has recently published a report on work related injuries requiring hospitalisation. There were 617,755 hospitalised cases funded by workers' compensation in Australia in the period from 2006-07 to 2013-14, with 72% being male and 96% aged 15-64. Almost 38% of these cases were hospitalised primarily due to a musculoskeletal-related condition while 32% were hospitalised primarily due to injury and poisoning. There were 234,104 hospitalised cases reported as work related over this period, with 61% being funded by workers' compensation.

Download report: Work-related hospitalised injuries, Australia 2006-07 to 2013-14  

Strengthening safety statistics: How to make hospital safety data more useful

Australia needs to reform how it collects and uses information about patient safety, to reduce the risk of more scandals and tragedies in our hospitals, according to Grattan Institute’s latest report, Strenghtening safety statistics: How to make hospital safety data more useful. The system is awash with data, but the information is poorly collated, not shared with patients, and often not given to doctors, explains Health Program Director Stephen Duckett in this podcast. Inexcusably, private hospitals are left outside state safety monitoring of hospitals. The performance of private hospitals should be analysed in the same way as public hospitals, and the results fed back to them and reported widely.
To ensure hospital safety data is more useful, it must be more trustworthy, relevant and accessible. The many different data sets should be linked, and the information should be presented more clearly so doctors can act on it and patients can understand it.

You can listen to the podcast or download the report here. 

Yoga for Improving Health and Well-being

This Cochrane Library Special Collection of systematic reviews on yoga focuses on reviews evaluating the effectiveness of yoga for improving physical or mental symptoms and quality of life in a range of health conditions. It has been developed to bring the best available evidence on the health-related effects of yoga to the attention of the general public, patients, health professionals, and other decision makers, and to inform choices on the use of yoga to improve health and well-being.

Yoga for improving health and well-being. Cochrane Library Special Collection. Nov. 2017. 

Opioid Dependence in Older Adults

A literature review of relevant material was conducted in November 2015 to assess current outcome research among older adults treated for opioid dependence. Most research conducted on older adults involves alcohol and prescription medications. Older drug users are growing in number and have a unique profile, with many presenting for treatment for the first time aged 50–70 years. Findings reveal that opioid treatment numbers are decreasing, however the average age of treatment admissions is increasing, older clients achieve better treatment outcomes than younger counterparts, and older women achieve better treatment outcomes than men.
Addiction and healthcare services must anticipate and prepare for increased demand by this group.

Carew, A.M., Comiskey, C. M. (2018).Treatment for opioid use and outcomes in older adults: a systematic literature review. Drug and Alcohol Dependence, 182(Jan), 48-57. [open access]  

How is my Local Hospital Performing?

The Bureau of Health Information is a board-governed organisation that publishes independent reports about the performance of the NSW public healthcare system. Just released is the Healthcare Quarterly report showing how hospitals and ambulance services performed in the April to June 2017 quarter.

Check the performance of your local hospital here.  

Link between health and academic achievement

A study published in CDC’s September 8^th issue of the Morbidity and Mortality Weekly Report (MMWR) consolidates the association between student health and academic grades. The study confirms that high school students who lack physical activity and inadequate nutrition, also reported lower academic marks.

 Using information gathered from the 2015 Youth Risk Behavior Survey (YRBS), in the United States, researchers in CDC’s Healthy Schools investigated the relationships between 10 dietary, physical activity, and sedentary risk behaviors and one measure of academic achievement. Grades surveyed were 9-12.

Researchers found that students who reported higher grades are more likely to engage in physical activity for at least 60 minutes a day on 5 or more days and play on at least one sports team. They were also less likely to watch television or play video games for 3 or more hours per day.

Morbidity and Mortality Weekly Report.

Social participation and successful aging

"Social participation consists of three inter-related concepts most informatively labelled Social Connections, Informal Social Participation, and Volunteering." Regardless of the measure of health that was used, the literature review undertaken in this study, indicated that each concept shared a positive relationship with health in older adults. Cognitive function, depression, and even a reduced incidence of falls were some on the health outcomes shown to improve.
This article in Australian Health Review overviews the three concepts of social participation, their methods of measurement and their associations with health in older adults.

Douglas Heather, Georgiou Andrew, Westbrook Johanna (2016) Social participation as an indicator of successful aging: an overview of concepts and their associations with health. Australian Health Review 41(4), 455-462. (Open access)

A Trip to Healthcare

David Matz, as the patient writes; "This narrative shares how my experience with two colonoscopies and three surgeries in one year taught me that I am not so good at engaging in treatment decisions. I thought I was." Follow his story in Patient Experience Journal, find out where he thinks he made mistakes and how hospitals possibly made decision making harder.

Matz, David E. (2017) A trip to healthcare. Patient Experience Journal, 4(2), Article 3.
(you can also read the full Special Issue: Patient Involvement here)

Mindfulness articles

In Buddhist tradition, mindfulness is a way of being and seeing which involves the conscious awareness of one's body, speech, feelings and thoughts, observing their emergent nature without placing any attachment or judgement to them. The skill is to raise awareness of negative thoughts, emotions or physical sensations and to respond in a more flexible, rather than reactive way.
Wiley has given free access to a large number of articles on mindfulness until October 31, 2017. Impact on behaviour, impact on cognitive function, impact on mental health, impact on physical health and mindfulness in the workplace are topics all covered in this collection.

Mindfulness Day Collection.

BJS Open

BJSOpen is a new open access journal from the British Journal of Surgery). BJS Open reflects the views of the British Journal of Surgery Society. In terms of content, BJS Open is a true general surgical journal designed to have international appeal as global surgical problems become increasingly evident. A mixture of editorials, systematic reviews, randomized trials and other types of original articles will characterize the content over the first few years.

Articles include:

• Surgery for massive splenomegaly.
• Natural orifice transluminal endoscopic surgery for colorectal cancer.   

Choose Physio Website

This site is part of a campaign from the Australian Physiotherapy Association to increase consumer awareness of what physiotherapy encompasses and why physiotherapy could be chosen ahead of other treatment options. You can easily look up different injuries and learn more as well.

Choose Physio website.    

GEN: Aged Care Data

A new Australian Institute of Health and Welfare website, GEN, was recently launched. GEN is a comprehensive "one-stop shop" for data and information about aged care services in Australia. It reports on capacity and activity in the aged care system focusing on the people, their care assessments and the services they use.

www.gen-agedcaredata.gov.au  

Use of Emergency Department and GP Services in 2015-16

Updated information is available for in-hours and after-hours emergency department attendances, with GP attendances for the same times of day. Maps (available in the Resources section) show results side by side for all Australian capital cities except Canberra. To break down to the North Coast section, you will need to open the Excel file.

Web update: Use of emergency department and GP services in 2015–16. AIHW  

Clinical Guidelines for Stroke Management 2017

The Clinical Guidelines for Stroke Management 2017 updates and supersedes the Clinical Guidelines for Stroke Management 2010. The Clinical Guidelines cover the whole continuum of stroke care, across 8 chapters, with each chapter of the new guideline downloadable as a pdf.

Stroke: No Postcode Untouched

This report from the Stroke Foundation demonstrates the cities and towns where stroke is having its biggest impact, where the need for stroke survivor support is most urgent and where the future stroke hotspots are located. It contains federal electorate breakdowns of key information including the number of strokes, the number of stroke survivors living in the community and the leading risk factors for preventable stroke.

Also by looking at the No Postcode Untouched website you can see that the Cowper Electorate has 5000 people, nearly double the national average of people living with stroke. In 2017, 522 people within the electorate suffered a stroke.

No Postcode Untouched: Stroke in Australia 2017 (download the report here)

Mental Health and the Older Person Virtual Issue

The International Journal of Mental Health Nursing has published a virtual issue on mental health and older people. Topics include the impact of falls on mental health, family carers' experiences, restraint use, suicide and delirium.
Read all the articles for free here.

Year of the Healthy Nurse

Nurses make up more than half of the health workforce and are responsible for providing the majority of health care worldwide. Current shortages in the availability of nurses are predicted to worsen, in part due to nurses having corresponding aging and chronic disease development in common with the populations they serve. Loss of productivity in the nursing workforce would substantially affect the availability and quality of health care globally.

The Journal of Advanced Nursing has published a virtual issue titled Year of the Healthy Nurse. Articles are free online until November 12, 2017.

Australia's Hospitals at a Glance 2015-16

Australia's hospitals 2015-16 at a glance provides summary information on Australia's public and private hospitals.
   * In 2015-16, there were 10.6 million hospitalisations (6.3 million in public hospitals, 4.3 million in private hospitals).
   * The average length of stay was over 5 days (5.7 days in public hospitals; 5.2 days in private hospitals).
   * 1 in 4 hospitalisations involved a surgical procedure.
   * 27% were emergency admissions.
   * 149,000 hospitalisations involved a stay in intensive care.    
Download report: Australia's hospitals at a glance 2015–16

Better Caring Website

Better Caring is an Australian-first online marketplace linking independent care and support workers with clients.
Individuals can search and contact care workers directly, choose rates, hours and services, and manage and pay for the care online. There are no waiting lists and no cash handling. NDIS  funding can be used to create your own team of support.

www.bettercaring.com.au   

Changes in Portion Sizes

 New research from The George Institute for Global Health has revealed Australians are eating ever bigger portions of foods laden in fat, sugar, and salt. Researchers compared data from 1995 to 2012 and found portion sizes for a large proportion of Australia’s most commonly consumed junk foods had risen significantly. An average slice of cake has increased in size so much it now contains almost 1000 kilojoules more than it did two decades ago.

Zheng, M., Rangan, A., Meertens, B., & Wu, J. H. (2017). Changes in Typical Portion Sizes of Commonly Consumed Discretionary Foods among Australian Adults from 1995 to 2011–2012. Nutrients, 9(6), 577. (open access)  

Changing the Narrative in Aboriginal and Torres Strait Islander Health Research

 Changing the Narrative outlines the journey and the successes of the Lowitja Institute and the Cooperative Research Centres (CRCs).The book, has been prepared in partnership with the Australian Institute of Aboriginal and Torres Strait Islander Studies, showcasing how the combined efforts have pioneered a new way of doing health research in Aboriginal and Torres Strait Islander communities, and maps the evolution of a new, collaborative and culturally appropriate approach driven by Aboriginal and Torres Strait Islander cultures, knowledge and leadership.    

Australian Institute of Aboriginal and Torres Strait Islander Studies & The Lowitja Institute 2017, Changing the Narrative in Aboriginal and Torres Strait Islander Health Research: Four Cooperative Research Centres and the Lowitja Institute: The story so far, The Lowitja Institute, Melbourne.

Beyond Clinical Priority: Unplanned Surgical Cases

This paper in Australian Health Review describes the perceptions of operating theatre staff in Australia and The Netherlands regarding the influence of logistical or operational reasons that may affect the scheduling of unplanned surgical cases.

A questionnaire was developed and targeted anaesthetists, managers, nurses and surgeons. The survey found there were significant differences in perceptions of logistics delay factors across different professional groups when patients were waiting for unplanned surgery. "Queue positions of patients waiting for unplanned surgery, or emergency surgery, are determined by medical clinicians according  
to clinicians’ indication of clinical priority."

Fitzgerald, Anneke and Wu, Yong. (2017). Beyond clinical priority: what matters when making operational decisions about emergency surgical queues?  Australian Health Review, 41(4) 384-393.  (open access)

Planning and Evaluating Palliative Care Services in NSW

Local Health Districts (LHDs) provide palliative care services in settings such as homes, hospitals and clinics to patients with varying needs. There are several care providers that can be involved. This audit assessed whether NSW Health is effectively planning and evaluating palliative care services, in the context of rising demand, increasingly complex needs, and the diversity of service providers.

The audit found there is no overall policy framework for palliative and end-of-life care, nor is there comprehensive monitoring and reporting on services and outcomes. Local Health Districts’ ability to plan, deliver and improve their services is hindered by:

• multiple disjointed information systems and manual data collection
• not universally using a program which collects data on patient outcomes for benchmarking and quality improvement.

New South Wales Auditor-General’s Report: Performance Audit

Planning and Evaluating Palliative Care Services in NSW; NSW Health, 2017 

Influenza Surveillance Reports

It is confirmed that 2017 is already its worst year for flu, and people are being warned that due to different strains circulating the country there’s a chance they could get a second dose.
Notifications data shows numerous strains are currently circulating the country, including three strains of influenza A, and influenza B. 
The current vaccine covers strains A (H1N1), A (H3N2), the B Brisbane strain and B Phuket strain.

Download the weekly Influenza surveillance reports here.   

Hospital Health Check

The Hospital Health Check was conducted by the Australian Medical Association and the Australian Salaried Medical Officers' Federation. The survey questioned more than 1,000 junior medical officers (JMOs) over rostering, access to leave, wellbeing, training, morale and hospital culture.
The report showed 71 per cent reported they were concerned about making clinical errors because of fatigue.

Download the Alliance NSW Hospital Health Check Survey Report here. 

Quality improvement in mental health

The UK charity The King’s Fund has published this report examining how a systematic approach to quality improvement can enhance the quality of care in mental health. The report’s findings show that where providers have introduced a quality improvement approach reduced lengths of stay in inpatient care, improved staff morale and reduced absence, reductions in violent incidents involving staff, and shorter waiting times have been achieved. Guidance is provided for for mental health leaders wanting to embed quality improvement in their organisations, and seek to engage and empower frontline teams, service users and carers to develop solutions collaboratively.

Download the report for free here.    

Animated infographic about diabetic retinopathy

The Australian Indigenous HealthInfoNet has a new resource on its eye health section. To support the health workforce, a new animated infographic about diabetic retinopathy (DR) has been produced to add to the key fact sheets about this condition. This short animated 4-minute video has been designed by the HealthInfoNet and the Fred Hollows Foundation. It provides visually engaging evidence-based information to assist health care providers in their everyday practice.  Also included on the website is a key factsheet.

Diabetic retinopathy among Aboriginal and Torres Strait Islander people video 

Cannabis use in patients with first-episode psychosis

Cannabis use following the onset of first-episode psychosis has been linked to both increased risk of relapse and non-adherence with antipsychotic medication. Whether poor outcome associated with cannabis use is mediated through an adverse effect of cannabis on medication adherence is unclear.
This study published in Lancet Psychiatry examines medication adherence as a mediator of the association between continued cannabis use following illness onset and relapse, as indexed by admission to hospital, in patients with first-episode psychosis.

Schoeler, T. (et al)  (2017). Poor medication adherence and risk of relapse associated with continued cannabis use in patients with first-episode psychosis: a prospective analysis. 

The Lancet Psychiatry , 4 (8),  627 - 633 Open access

#hellomynameis

The “hello my name is” campaign was created by Dr Kate Granger MBE, a doctor in the UK who had terminal cancer. Together, with her husband Chris Pointon, Dr Granger asked frontline NHS staff to make a pledge to introduce themselves in future to their patients. She used social media to help kick start the campaign and created the hashtag #hellomynameis.

As a patient  Kate observed that many staff looking after her did not introduce themselves before delivering her care. It felt incredibly wrong that such a basic step in communication was missing and as a result, the campaign continues long after Kate has passed away. Kate believed it is not just about common courtesy, but it runs much deeper. Introductions are about making a human connection between one human being who is suffering and vulnerable, and another human being who wishes to help.

Read more about this campaign here.  

Adult Admitted Patient Survey

The third year of AdultAdmitted Patient Survey results from 28,000 patients in NSW is available on the interactive data portal, Healthcare Observer on the Bureau of Health Information (BHI) website. The Adult Admitted Patient Survey asks for feedback from people who have recently been admitted to a NSW public hospital. 
Results are available at a NSW, local health district, peer group and hospital level with an easy search option to find particular hospitals. 
BHI is a board-governed organisation that publishes independent reports about the performance of the NSW public healthcare system.

Adolescents, young adults and cancer: what GPs need to know

Although cancer in the adolescent and young adult age group is rare, a cancer diagnosis is the most common cause of death in this age group after accidents, murders and suicides. Being familiar with potential medical and psychosocial complications and providing support to families are essential in the primary care of adolescents and young adults with cancer. 

GPs have an important role in providing care for adolescents and young adults (AYAs) with cancer, and their role should be encouraged, even for patients with complex needs.

 Ng, M.,  Forsyth, V., Trahair, T., Carrington, N., Anazodo, A. (2017, August).  Adolescents, young adults and cancer: what GPs need to know. Medicine Today, 18(8). 14-22.

 

Australian Women Against Violence

The Australian Women Against Violence Alliance (AWAVA) was established in March 2010 as one of five National Women’s Alliances funded by the Australian Government. AWAVA ensures that women’s voices, particularly marginalised women’s voices, are heard by Government.
The website under the Resources link includes a information on family violence, child protection and ending violence against women.
Australian Women Against Violence Alliance 

Combatting the Burnout Epidemic

AHRQ has been funding research on physicians’ working conditions to determine what causes burnout and explore interventions to combat it. Causes of burnout can include a lack of control over work conditions, time pressures, chaotic workplaces, and a lack of alignment of values between providers and their leaders. This blog post by Dr Gopal Khanna  & Dr. Arlene S. Bierman from the Agency for Healthcare Research and Quality looks at these issues and the professional and personal consequences for clinicians.

Combatting the Burnout Epidemic. AHRQ Views Blog. July 2017.  

Flooded with evidence: improving research implementation in nursing practice

The object of the study in this article was to identify barriers to implementing evidence-based practice initiatives in small to medium sub-acute facilities in Queensland. Three themes emerged which described the needs of clinicians when evidence-based practice initiatives were being implemented: (1) valuing evidence; (2) risk prioritisation; and (3) controlling the flow of evidence. A ‘Spillway Model’
was used as a mechanism for targeting clinical priorities using integrated risk management.

Moloney, C., Ralph, N., Taylor, M. (2017). Flooded with evidence: using a 'spillway' model
to improve research implementation in nursing practice. Australian Journal of Advanced Nursing, 34(1)  

New Approaches to Value in Health and Care

New Aproaches to Value in Health and Care was written for those seeking to add value to people’s lives and mobilise the value that people and communities themselves can create for health and wellbeing. Although this is a UK initiative, it is of value in that it bases core national outcomes on the health and wellbeing outcomes that are most important to people and communities.
Written as part of the Realising the Value program, the report makes a series of calls to action to ensure that the approach to understanding, capturing, measuring and assessing value in health and care takes full account of value.

Redding, Don. New approaches to value in health and care. The Health Foundation, 2016  

McMaster Optimal Aging Portal

The McMaster Optimal Aging Portal’s (Portal) professional bibliographic database contains high quality scientific evidence about optimal aging specifically targeted to clinicians, public health professionals and policymakers.
The objective of this work was to provide easy access to reliable health information based on good quality research that will help health care professionals to learn what works best for seniors to stay as healthy as possible, manage health conditions and build supportive health systems. The Portal is continually updated, freely accessible online, easily searchable, and provides email-based alerts when new records are added.
Access the McMaster University Optimal Aging Portal here.  

Heart Failure

The journal Clinical Pharmacology & Therapeutics has published a virtual issue on heart failure.
These articles are free to access for the month of August and after this date contact your library.
Access the virtual issue here.  

Health Care Access, Mental Health, and Preventative Health; Health Priority Survey Findings for People in the Bush

This report published by the Royal Flying Doctor Service, is from a collaboration between the National Farmers' Federation and the Country Women's Association of Australia. A survey of over 450 country people drawn from every state and territory, saw one-third of responses (32.5%) name doctor and medical specialist access as their key priority. 

The five most important issues identified by respondents overall were access to medical services; mental health; drugs and alcohol; cancer; and cardiovascular health. The areas of health that respondents identified money should be spent on included: access to medical services; mental health; health promotion and prevention activities; cancer; aged care; and travel and accommodation support for people needing to access health care outside of their community.
Download the report here.  

The Burden of Musculoskeletal Conditions in Australia

This report from AIHW presents findings from the Australian Burden of Disease Study 2011 on the burden of musculoskeletal conditions in Australia. Musculoskeletal conditions were the fourth leading contributor to total burden of disease in Australia, with back pain and problems, osteoarthritis and rheumatoid arthritis being the greatest contributors to the musculoskeletal burden.

Download report: The burden of musculoskeletal conditions in Australia: a detailed analysis of the Australian Burden of Disease Study 2011
ISSN 2204-4108 (PDF) 2006-4508 (Print); ISBN 978-1-76054-150-7; Cat. no. BOD 14; 28p.

Respiratory Conditions in Australia

This report published by AIHW presents information on the disease burden of chronic respiratory conditions using data from the Australian Burden of Disease Study 2011. Respiratory conditions were the sixth leading contributor to total burden of disease in Australia, with chronic obstructive pulmonary disease (COPD), asthma and upper respiratory conditions being the greatest contributors to the respiratory burden.

Download report: The burden of chronic respiratory conditions in Australia: a detailed analysis of theAustralian Burden of Disease Study 2011
N 2204-4108 (PDF) 2006-4508 (Print); ISBN 978-1-76054-152-1; Cat. no. BOD 15; 32pp.  

Evidence Check

A Sax Institute Evidence Check involves conducting a rapid review of existing research and evidence that is tailored to  a policy agency’s individual needs. An Evidence Check review is a synthesis, summary and analysis of the best and most relevant research evidence to inform policy making
and program development. Evidence Check is used by a range of agencies, including government and statutory agencies, non-government organisations, and other policy making agencies.
Click here to read what is involved in an Evidence Check.

Health IT-Related Patient Safety Incidents

A new report, Literature Review and Environmental Scan on Approaches to the Review and Investigation of Health IT-Related Patient Safety Incidents, has been published by the Australian Commission on Safety and Quality in Health Care.

The Australian Institute of Health Innovation (AIHI) at Macquarie University performed a literature review and environmental scan on investigating health IT-related patient safety incidents . The subsequent report identifies methods for monitoring hazards affecting health IT systems, and for investigating incidents resulting from the use of these systems.

Download the report here.  

Potentially Preventable Hospitalisations in 2015-16

This web update provides the latest rates of potentially preventable hospitalisations for Australia's 31 Primary Health Network areas and more than 300 smaller local areas.
It updates information for 22 conditions where hospitalisation may have been prevented by timely and appropriate provision of primary or community-based health care.
Results are highlighted for five conditions that contribute most to the number of days spent in hospital for potentially preventable hospitalisations: 
       - chronic obstructive pulmonary disease,
       - diabetes complications,
       - congestive heart failure,
       - cellulitis, and
       - kidney and urinary tract infections. 
This web update is accompanied by an interactive tool allowing users to explore the data in depth for their area and compare with other local communities.

AIHW. (2017). Web update: Potentially preventable hospitalisations in 2015–16

Childhood obesity quadruples risk of type 2 diabetes

The growing rate of childhood obesity is fuelling an increase in type 2 diabetes among UK children, say researchers who have found a fourfold greater risk of diabetes in obese children. A retrospective cohort study of 369,362 children aged 2 to 15 years between 1994 and 2013 identified 654 incident cases of type 2 diabetes, and 1318 cases of type 1 diabetes.
The study, published in the Journal of the Endocrine Society, found an increasing incidence in both type 1 and type 2 diabetes over the study period. However, only type 2 diabetes was shown to have a linear association with obesity.

Ali Abbasi, Dorota Juszczyk, Cornelia H. M. van Jaarsveld, Martin C. Gulliford; Body Mass Index and Incident Type 1 and Type 2 Diabetes in Children and Young Adults: A Retrospective Cohort Study. J. Endocr. Soc. 2017; 1 (5): 524-537. doi: 10.1210/js.2017-00044
(if you cannot access the full text via the link, please contact your library)

Palliative Radiation Therapy for Bone Metastases

The American Society for Radiation Oncology has published "Palliative radiation therapy for bone metastases: update of an ASTRO evidence-based guideline". 

Interventions and practices considered include;
1. External beam radiotherapy (EBRT)
2. Single- versus multiple-fraction radiation schedules

3. Repeat radiotherapy 

4. Stereotactic body radiotherapy (considered but not recommended as primary treatment outside of clinical trials).

Download the full guideline here.

Effective Care for High-Need Patients

This special publication from the National Academey of Medicine is the result of 3 workshops on how to better manage the care of the high-need patient population. The report states; “the top 1 percent of patients account for more than 20 percent of health care expenditures, and the top 5 percent account for nearly half of the nation’s spending on health care”.  

The Academy argues that “Improving care for high-need patients is not only possible–it also contributes to a more sustainable health system".

Effective Care for High-Need Patients: Opportunities for Improving Outcomes, Value, and Health. Long P, Abrams M, Milstein A, Anderson G, Lewis Apton K, Lund Dahlberg M, et al., editors. Washington D. C.: National Academy of Medicine; 2017.   

Cost of Cancer to the Patient

The articles in the latest issue of Cancer Forum provide a valuable overview of the research into the cost of cancer to the patient and their families. Although healthcare in Australia is largely publicly funded, there are out-of-pocket costs associated with diagnosis, treatment and survival, even in the public system. In Australia, people with cancer report relatively high out-of-pocket health costs and a heavy burden of out-of-pocket costs relative to income.
 Unemployment and reduced employment after a cancer diagnosis is associated with reduced financial reserves, impaired quality of life, and possibly reduced survival.

Cancer Forum,Vol 41 (2), 2017   

When Patient Centred is no Longer Enough

Michael Millenson has written an essay on the changes to patient centred care, with technological, economic and social changes in health creating new networks of collaboration. There are three core principles to collaborative health stated by the author;

• Shared information
• Shared engagement
• Shared accountability.

When “patient centred” is no longer enough: the challenge of collaborative health: an essay by Michael L Millenson. (Published 05 July 2017)  BMJ 2017;358:j3048  

Medication Safety in Mental Health

This study undertaken by the University of South Australia, focused on medication safety issues in mental health in hospital and community settings.
The study found that existing medication safety practices and strategies may not be in widespread use across mental health services in Australia.  Consumers and carers want more personalised information about their medications, a need to be more engaged in shared decision making around treatment options and monitoring of side effects of medications has found to be inadequate.

University of South Australia. (2017) Medication Safety in Mental Health.   

Improving Documentation at Transistions of Care

In Australia there are an increasing number of people who have complex and chronic healthcare needs, and it is common for their care to be provided by a number of different clinicians and health providers, across many different settings. This includes care delivery across hospitals, private rooms, general practices and other locations.
The points of handover when patients move between clinicians are known as ‘transitions of care’, and these are recognised as times of high risk for patients as there is an increased risk of information being miscommunicated or lost.
There is strong evidence that poor documentation of information at transitions of care is a key safety and quality issue for patients.

Australian Commission on Safety and Quality in Health Care (2017). Improving Documentation at Transitions of Care for Complex Patients. 

Psoriasis: British Journal of Dermatology free issue

A special issue on Psoriasis from the British Journal of Dermatology is now available to download for free. Articles include identifying biomarkers, quality of life instruments and therapies.

British Journal of Dermatology, March 2017. Volume 176, Issue 3

Domestic and Family Violence and Parenting

This paper examines the current state of knowledge on the impact of domestic and family violence (DFV) on parenting. The research captures the experiences and impacts on fathers, mothers, and children at varying ages and stages of development and independence. It considers how often DFV occurs among parents; the impact of DFV on parenting; the methods and behaviours used by perpetrators to disrupt the mother-child relationship; and interventions used to strengthen and support a healthy mother-child relationship.

Domestic and family violence and parenting: mixed method insights into impact and support needs - final report.  2017. Australia's National Research Organisation for Women's Safety. 

Question Builder

The Australian Commission on Safety and Quality in Health Care and Healthdirect Australia have jointly launched the Question Builder, a free web-based tool to help people prepare for their medical appointment and make the best use of the time with their doctor.

Question Builder helps people create a list of questions they might like to ask their doctor, prepare for the questions their doctor may ask them, and allows them to print out or email the question list so they can use it in their appointment.  

Link to Question Builder here.