Guideline for the treatment of juvenile idiopathic arthritis

There has been an update of the 2011 American College of Rheumatology recommendations for the treatment of juvenile idiopathic arthritis: recommendations for the medical therapy of children with systemic juvenile idiopathic arthritis and tuberculosis screening among children receiving biologic medications. The guideline summary is available on the National Guideline Clearinghouse site.

 Update of the 2011 American College of Rheumatology Recommendations for the Treatment of Juvenile Idiopathic Arthritis. (2013), Arthritis and Rheumatism. Vol. 65, No. 10, October 2013, pp 2499–2512 DOI 10.1002/art.38092

PTSD and Stigma in the Australian Army

This paper by John Bale and published by the Australian Army seeks to identify the nature of the stigma attached to Post-traumatic Stress Disorder (PTSD) and other mental health conditions in the Australian Army.  It also looks at the negative implications of such a stigma on the individual, the workplace and the Army as a whole.

PTSD needs to be identified and treated early but many people fear the negative judgements of people around them so do not receive early diagnosis.  Previous reports have found that stigma surrounding mental health issues is a considerable barrier in the Australian Defence Force and particularly in the Army.  PTSD and Stigma in the Australian Army analyses Canadian, British and US initiatives and provides key recommendations to the Australian Army on how to combat stigma.

Impacts of climate change on public health in Australia

This Deeble Institute Issues Brief looks at the immediate and longer-term impacts of climate change and how it may affect Australian health and social environments.  The authors call on Federal and State Governments and agencies within the Australian public health sector to heed the information, opinions and recommendations provided here and offer them guidelines for decision-making in responding to climate change impacts.

"A new approach, based on ecological principles, will be required to navigate through the complex and interrelating health causes. The public health sector must strengthen existing approaches for effective climate change adaptation strategies, including assessing regional health risks to identify vulnerable and resilient populations, collecting enhanced surveillance data and developing monitoring indicators."

Impacts of climate change on public health in Australia: Recommendations for new policies and practices for adaptation within the public health sector.  Walter T, Stevens P, Verhoeven A & Boxall A. Deeble Institute for Health Policy Research (2014). 

Call for more generalist doctors and specialist nurses

In an article recently published in The Conversation, Professor Don Campbell from Monash University explains Why hospitals need more generalist doctors and specialist nurses.  With an ageing population with complex needs making increasing demands on our hospitals, Campbell argues that "we need to redesign the workforce so hospitals are staffed by general physicians and nurses who take on more complex roles."

Because we are living longer we are likely to develop multiple chronic diseases so need a generalist to manage our care. Nurses however need to up-skill into more specialist roles.  Examples of hospital workforce reform along these lines is given from the UK, the US and New Zealand.

Obesity in health-care settings

 Obesity-related stigma can influence how obese people interact with health-care professionals and access health care. The aim of this article was to undertake a synthesis of studies examining the views and experiences of both obese people in relation to their health-care provision and health-care professionals in providing care to obese patients.

Thirty studies were identified with all reporting obesity impacting on health-care interactions. Key themes identified were experiences of stigma and feelings of powerlessness, treatment avoidance, psycho-emotional functioning, professional attitudes, confidence and training, variations in health contact time and finally, differences in treatment options and preventative measures.

Mold, Freda, Forbes, Angus.(2013). Patients' and professionals' experiences and perspectives of obesity in health-care settings: a synthesis of current research. Health Expectations, 16(2), 119-142

The power of consoling presence

This article in the journal BMC Nursing looks at the dying person and the experience of the hospice nurse. Many nurses feel unprepared to accompany people through the process of dying and feel they don't have the skills in psychosocial and spiritual care. This can cause high levels of moral distress, grief and burnout.

Tornoe, Kirsten A. [et al] (2014). The power of consoling presence - hospice nurses’ lived experience with spiritual and existential care for the dying. BMC Nursing, 13:25.  doi:10.1186/1472-6955-13-25

Preconception interventions

The journal Reproductive Health has published a series of articles on preconception care. The importance of public health interventions during the preconceptional period on maternal and child health is recognized. "The reviews highlight our current understanding (or lack thereof) regarding how both maternal and paternal preconception health and knowledge shapes the long-term health of not only children, but of families, communities, and nations."

The complete supplement is open access and free to download. You can also read the blog related to this supplement.

2014. Preconception interventions. Reproductive Health, 11(Supp 3)

Characteristics of people using mental health services and prescription medication, 2011

The Mental Health Services-Census Data Integration project brings together data from the 2011 Census with administrative information on people accessing subsidised mental health-related Medicare Benefits Schedule (MBS) services and Pharmaceutical Benefits Scheme (PBS) prescription medication.

The proportion of the population accessing PBS subsidised mental health-related prescription medications increased with age, with over one-third (34%) of all people aged 75 years and over accessing one or more of these drugs in 2011. By comparison, a higher proportion of people aged 15-64 years accessed MBS subsidised mental health-related services compared with people younger or older than this age group.

Published by the Australian Bureau of Statistics, the report is free to download.
4329.0 - Characteristics of people using mental health services and prescription medication, 2011  

Role of allied health professionals

In a comprehensive report from QualityWatch in the UK, researchers examined the role and quality of care of allied health professionals in the NHS.  Allied health professionals: Can we measure quality of care? looks at a diverse group of 12 professions who often work across mulidisciplinary teams and across sectors of care.  

The authors of this report express concern that the contribution AHPs make to overall healthcare is undervalued.  The different AHP groups include chiropodists, dieticians, music therapists, occupational therapists, orthoptists, paramedics, physiotherapists, radiologists and speech and language therapists.  They found that AHPs made up 6% of the NHS workforce in 2013.  "We suggest that a better understanding of both the levels of care and the quality of care provided by AHPs will be increasingly important in a financially constrained NHS."

Views of Australian paediatricians on asylum seeker children

In an article published in the Medical Journal of Australia recently, Elizabeth Corbett and her colleagues report on a survey sent to all Australian paediatricians registered with the Royal Australasian College of Physicians.  Over 80% of respondents (n139) agreed with the Australian Medical Association assertion that mandatory detention of children constitutes child abuse, and disagreed with offshore processing.  Their knowledge about practical issues such as current health screening practices and Medicare eligibility showed some significant gaps, and the authors concluded that education was needed in these areas.

The article is available through CIAP for NSW Health employees, or contact your librarian if you have trouble obtaining the full text.

Australia's treatment of refugee and asylum seeker children: the views of Australian paediatricians, Elizabeth J M Corbett, Hasantha Gunasekera, Alanna Maycock and David Isaacs.

Med J Aust 2014; 201 (7): 393-398.  doi: 10.5694/mja14.00279.  

Taking a New Look at Artificial Sweeteners

Diet sodas and other treats sweetened with artificial sweeteners are often viewed as guilt-free pleasures. Because such foods are usually lower in calories than those containing natural sugars, many have considered them a good option for people who are trying to lose weight or keep their blood glucose levels in check. But some surprising new research suggests that artificial sweeteners might actually do the opposite, by changing the microbes living in our intestines.  
Read the complete blog post here.

Reposted from the NIH Director's Blog.

Australian hospital statistics 2013-14: elective surgery waiting times

Waiting times for elective surgery in Australian public hospitals have remained relatively stable between 2012-13 and 2013-14, according to a report released by the Australian Institute of Health and Welfare (AIHW). The report, Australian hospital statistics 2013-14: elective surgery waiting times, shows that national admissions for elective surgery increased by 4.2% between 2012-13 and 2013-14.

In 2013-14  about 700,000 patients were admitted to Australian public hospitals from elective surgery waiting lists and 50% of patients were admitted for their surgery within 36 days of being placed on the waiting list and 90% were admitted within 262 days.

The State of Safety and Quality in Australian Health Care

A new report released by the Australian Commission on Safety and Quality in Health Care (ACSQHC) provides an overview of a series of key topics in relation to the safety and quality of Australia's health care system. Professor Villis Marshall, Chair of ACSQHC said  “Vital Signs 2014 is structured around three important questions that members of the public may ask about their health care. Will my care be safe? Will I get the right care? Will I be a partner in my care?”  Each question is  considered in its own section using examples of key health issues in Australia and followed by two case studies.

Vital Signs 2014: The State of Safety andQuality in Australian Health Care.  Australian Commission on Safety and Quality in Health Care, Sydney: ACSQHC; 2014. 

Women With Disability After Breast Cancer - Insights from Yoga

A recent study in Canada looked at a newly developed Yoga Program for women with disability after breast cancer. Significant gaps remain in our understanding of pain, range of motion restrictions, and lymphoedema and their potentially disabling impact on women's everyday lives in relation to arm disability. Often lymphoedema is the main consideration for women, however through the course it was found that pain and range of motion restrictions are often more prevalent and continue to effect everyday life. It was also found that  the emotional burden of this illness is not only significant but also underexplored, particularly with respect to the development of supportive interventions.

Many of the women in the study felt that yoga had a positive influence on many dimensions of their lives and the study suggests that there is a need for multiple, holistic interventions such as yoga.

Insights From an Iyengar Yoga Program for Women With Disability After Breast Cancer. Holistic Nursing Practice; 28(6), 2014, p 353–361. Available on CIAP free to NSW Health Staff.              

Hip Fracture Care Clinical Guideline

The NHMRC-approved Australianand New Zealand Guideline for Hip Fracture Care - Improving Outcomes in HipFracture Management of Adults was released by the Australian and New Zealand Hip Fracture Registry (ANZHFR) Steering Group in September 2014.
This guideline is designed to help professionals providing care for people with a hip fracture to deliver consistent, effective and efficient care and is available through the Clinical Practice Guidelines Portal.