Is Your Steptember Team Ready?

Yes it's that time again!

Last year MNCLHD had 113 and 413 participants in the Steptember challenge that raised over $15K for the Cerebral Palsy Alliance.

https://www.steptember.org.au/home

You need to rally up your team of 4, nominate a captain and go to to www.steptember.org.au and register NOW using our unique free registration code sent in an MNCLHD-ALLsite e-mail on 22/7/2020.  Enter Mid North Coast LHD as our organisation name when prompted.

Mental health and relationships during the COVID-19 Pandemic

In partnership with the Australian National University (ANU), the Australian Institute of Health and Welfare (AIHW) worked to add a range of questions to the Life in Australia panel survey to explore the impact of COVID-19 on mental health, housing, alcohol consumption and service use. The most recent report referenced below focuses on mental health and relationships.

The authors found that there is a very strong relationship between changes in outcomes and psychological distress, even when allowing for pre-COVID mental health outcomes. A particularly strong relationship between changes in stress, loneliness, relationships and mental health outcomes was found. We have been very fortunate in Australia with low rates of COVID-19 infections and mortality rates. However there have been large negative effects on outcomes with young Australians notably in need of support.

The Australian Medical Association recognises the anxiety and stress that financial, employment and family issues cause during this time and have provided resources and online support links on their website. Remember to consult your GP if you need specific personalised mental health advice.

https://healthdirect.gov.au

Link through to the full article here:

Mental Health and Relationships during the COVID-19 Pandemic
ANU Centre for Social Research and Methods
Professor Nicholas Biddle; Associate Professor Ben Edwards; Professor Matthew Gray; and
Kate Sollis.
July 2020

Abstract
The aim of this paper is to explore the relationship between mental health outcomes and
relationship quality during the COVID-19 period. We find that after a significant worsening in
mental health outcomes between February 2017 and April 2020, there was strong evidence
for improvements between April and May and weaker evidence for a further improvement
between May and the end of June/start of July. However, for those Australians under the age
of 45, psychological distress is still at a higher level than it was prior to the spread of COVID-
19. We find that a number of people have reported negative changes to their subjective
circumstances. Only 22.5 per cent of the population are estimated to have not experienced
any of the negative changes during the COVID-19 period from our dataset compared to 51.6
per cent who reported no improvements in the same measures. The majority of respondents
reported no change in relationship quality, and for those who did report a change, there was
a net improvement. We find a very strong relationship between self-reported changes in
outcomes and psychological distress, with a particularly strong relationship between changes
in stress, loneliness and relationships and mental health outcomes.

New MNCLHD Staff Publications

Congratulations to all staff (highlighted) involved in the publication of the following articles.

Source: youthtoday.org

Diab, J., A. Bannan and T. Pollitt (2020). "Necrotising fasciitis." BMJ 369: m1428.

John, S., D. Schmidt and J. Rowley (2020). "Decision-making capacity assessment for confused patients in a regional hospital: A before and after study." Australian Journal of Rural Health 28(2): 132-140.

Lieng, H., A. Kneebone, A. J. Hayden, D. R. H. Christie, B. J. Davis, T. N. Eade, L. Emmett, T. Holt, G. Hruby, D. Pryor, M. Sidhom, M. Skala, J. Yaxley and T. P. Shakespeare (2019). "Radiotherapy for node-positive prostate cancer: 2019 Recommendations of the Australian and New Zealand Radiation Oncology Genito-Urinary group." Radiotherapy & Oncology 140: 68-75.

Shakespeare, T. P., E. Eggert, M. Wood, J. Westhuyzen, K. Turnbull, N. Rutherford and N. Aherne (2019). "PSMA-PET guided dose-escalated volumetric arc therapy (VMAT) for newly diagnosed lymph node positive prostate cancer: Efficacy and toxicity outcomes at two years." Radiotherapy & Oncology 141: 188-191.

Toby, J., T. Shakespeare, N. Aherne, C. Brown, L. Guo, M. Hoffmann, G. Hruby, A. Kneebone and T. Eade (2019). "Validation of the prognostic ability of the five-tiered ISUP grade groups for prostate cancer treated with definitive dose-escalated external beam radiation treatment in a contemporary Australian population." Journal of Medical Imaging and Radiation Oncology 63 (Supplement 1): 96.

Wen, S., L. Manuel, M. Doolan, J. Westhuyzen, T. P. Shakespeare and N. J. Aherne (2020). "Effect of clinical and treatment factors on survival outcomes of triple negative breast cancer patients." Breast Cancer: Targets and Therapy 12: 27-35.

MNCLHD Staff Publications Database – Maintained & updated by PMBH Health Services Library.

Please contact the PMBH Library if you are a member of MNCLHD and your publication has been missed.

Medicines for COVID-19

The Australian Commission on Safety and Quality in Health Care is working hard to help clinicians and health service organisations to have access to evidence-based information on medicines for the  potential treatment of COVID-19.

Source: psa.org.au

Resources are available on their website and are linked below.

While there is no cure, a summary of antiretroviral and other therapies being looked into for the potential treatment of COVID-19.

Information about the safe and quality use of medications that may be utilised in the management of COVID-19 is presented in a series of position statements that will be invaluable to practitioners on the ground.

For further information a list of links to COVID-19 guidance from Australia and the global community is also available.

All this a more is available on the Australian Commission on Safety and Quality in Health Care website.

Caring for People with Cognitive Impairment During COVID-19

The Australian Commission on Safety and Quality in Health Care (ACSQHC) have developed new resources to support health service organisations to provide safe care for patients with cognitive impairment during COVID-19. Remember that the environment around cognitively has changed due to COVID-19 so they may find hospital even more frightening than ever before. The increased use of personal protective equipment by staff and find the principles of social distancing difficult to understand and follow.

healthdirect.gov.au

The resources are a fact sheet for clinicians and a poster. These provide important reminders of key actions in the National Safety and Quality Health Services (NSQHS) Standards that remain essential at this time. These include:

• Goals of care discussions with the patient, support person or, if required, the substitute decision maker
• The involvement of carers
• Delirium prevention strategies, and
• The use of antipsychotics only as a last resort.

As a harm reduction measure clinicians should continue to use the strategies of their hospital or health service organisation to keep their patients with cognitive impairment safe.

For reliable information on Coronavirus disease (COVID-19) infection prevention and control and medicines go to the ACSQHC website.

New Mid-North Coast Staff Publications

New Staff Publications  January - March 2020

Congratulations to the below highlighted Mid-North Coast staff on the publication of their articles.

Callander, D., T. Cook, P. Read, M. E. Hellard, C. K. Fairley, J. M. Kaldor, E. Vlahakis, A. Pollack, C. Bourne, D. B. Russell, R. J. Guy and B. Donovan (2019). "Sexually transmissible infections among transgender men and women attending Australian sexual health clinics." Medical Journal of Australia 211(9): 406-411.

Carroll, V., M. Bramble, A. Wong, D. Schwebel and R. Rossiter (2019). "Cost-effectiveness of a Parkinson's nurse specialist position in rural and regional Australia: A pilot retrospective analysis." Journal of Parkinson's Disease 9 (1): 260.

Malfitano, A. P. S., G. Whiteford and M. Molineux (2019). "Transcending the individual: The promise and potential of collectivist approaches in occupational therapy." Scandinavian journal of occupational therapy: 1-13.

Marks, S. and M. Olenski (2019). "Q fever in the first trimester: A case report from northern rural New South Wales." Tropical Medicine and Infectious Disease 4 (2) (no pagination)(90).

Oliffe, M., E. Thompson, J. Johnston, D. Freeman, H. Bagga and P. K. K. Wong (2019). "Assessing the readability and patient comprehension of rheumatology medicine information sheets: a cross-sectional Health Literacy Study." BMJ Open 9(2): e024582.

Parnell, T., G. Whiteford and C. Wilding (2019). "Differentiating occupational decision-making and occupational choice." Journal of Occupational Science 26(3): 442-448.

Peadon, R., J. Hurley and M. Hutchinson (2020). "Hierarchy and medical error: Speaking up when witnessing an error." Safety Science 125: 104648.

Pereira, R. B., G. Whiteford, N. Hyett, G. Weekes, A. Di Tommaso and J. Naismith (2020). "Capabilities, Opportunities, Resources and Environments (CORE): Using the CORE approach for inclusive, occupation-centred practice." Australian occupational therapy journal. 19.

Thompson, D., C. Thompson, N. Nassar and A. Katelaris (2019). "Additional qualifications of trainees in specialist training programs in Australia." BMC Medical Education 19(1): 247.

Walder, K., M. Molineux, M. Bissett and G. Whiteford (2019). "Occupational adaptation - analyzing the maturity and understanding of the concept through concept analysis." Scandinavian journal of occupational therapy: 1-15.

Whiteford, G., K. Jones, G. Weekes, N. Ndlovu, C. Long, D. Perkes and S. Brindle (2019). "Combatting occupational deprivation and advancing occupational justice in institutional settings: Using a practice-based enquiry approach for service transformation." British Journal of Occupational Therapy 83(1): 52-61.

Whiteford, G. E. (2019). "Sylvia docker memorial lecture: Together we go further—Service co-design, knowledge co-production and radical solidarity." Australian Occupational Therapy Journal 66(6): 682-689.

Zecchin, R., D. Candelaria, C. Ferry, L. A. Ladak, D. McIvor, K. Wilcox, A. Bennett, S. Bowen, B. Carr, S. Randall and R. Gallagher (2019). "Development of Quality Indicators for Cardiac Rehabilitation in Australia: A Modified Delphi Method and Pilot Test." Heart, Lung & Circulation 28(11): 1622-1630.

Bowel Cancer Awareness Month

June is Bowel Cancer awareness month.

Source: bowelcanceraustralia.org

103 Australians die every week as a result of bowl cancer, that's 5375 people every year, but bowel cancer is one of the most treatable cancers if diagnosed early. The risk of bowel cancer does increase with age but it does affect both men and women, young and old. Over 15,000 people are diagnosed with bowel cancer every year - 300 per week!

You can support Bowel Cancer awareness month by purchasing a virtual ribbon that you can buy for yourself or send to a friend. You might also want to dedicate the ribbon to someone you know who has or had bowel cancer. Go to Bowel Cancer Australia's website to learn more about Bowel Cancer including prevention, early detection and treatment, as well as finding sources of support.

Update of COVID 19 Pandemic

BMJ Best Practice - Update

Globally, 179,112 cases and 7426 deaths have been reported as of 17 March 2020.

Many countries are moving from the containment phase to delay and mitigation phases in order to reduce the peak impact of the virus and slow its spread, as well as reduce the anticipated surge in healthcare use. This includes travel bans and restrictions, and social distancing strategies such as restrictions on public gatherings; closures of schools and universities; closures of cafes, bars, restaurants, and other businesses; and encouraging people to work from home and not to leave the house. Some cities and countries are currently in 'lockdown'.

The World Health Organization (WHO) formally declared the COVID-19 outbreak a pandemic on 11 March 2020. "WHO has been assessing this outbreak around the clock and we are deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction," said WHO chief Tedros Adhanom Ghebreyesus during a press briefing. "We have therefore made the assessment that COVID-19 can be characterized as a pandemic. Describing the situation as a pandemic does not change WHO’s assessment of the threat posed by this virus. It doesn’t change what WHO is doing, and it doesn’t change what countries should do," he said. This is the first pandemic to be caused by a coronavirus. It is expected that the number of cases, deaths, and affected countries will increase in the weeks ahead.

                                                                                                    Source: bestpractice.bmj.com

The situation is evolving rapidly with global case counts and deaths increasing each day. 

The World Health Organization has declared the COVID-19 outbreak a pandemic and rates the global risk assessment as very high.

Community transmission is occurring in many countries, but it is uncertain how easily the virus spreads between people. Clinical trials and investigations to learn more about the virus, its origin, and how it affects humans are ongoing.

Definition

Coronavirus disease 2019 (COVID-19) is a potentially severe acute respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus was identified as the cause of an outbreak of pneumonia of unknown cause in Wuhan City, Hubei Province, China, in December 2019.[1]Ren LL, Wang YM, Wu ZQ, et al. Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study. Chin Med J (Engl). 2020 Jan 30 [Epub ahead of print]. http://www.ncbi.nlm.nih.gov/pubmed/32004165?tool=bestpractice.com 32004165 Fulltext The clinical presentation is that of a respiratory infection with a symptom severity ranging from a mild common cold-like illness, to a severe viral pneumonia leading to acute respiratory distress syndrome that is potentially fatal. (Source: BMJ Best Practice).

MNCLHD staff should use CIAP (BMJ Best Practice is on the Quick Links)or contact their librarian at PMBH or CHHC for a full-text PDF of this update.  The site includes guidelines and patient information.

Elsevier’s free health and medical research on Novel Coronavirus

In Elsevier's Novel Coronavirus Information Center you will find expert information for the research and health community on Novel Coronavirus (also referred to as COVID-19 and its temporary title 2019-nCoV).

Their aim for this website is to open resources to help public health authorities, researchers and clinicians contain and manage this disease. Their resources cover scientific and medical journals and textbooks, educational products, and a variety of other resources, like travel precautions from the CDC and media posts of interest to the community. They have also created a interactive global map of experts based on Scopus data.

All resources are free to access and include guidelines for clinicians and patients.

"MERS Coronavirus Particles" by National Institutes of Health (NIH) is licensed under CC BY-NC 2.0

February is Ovarian Cancer Awareness Month

Every year over 1,510 women in Australia will be diagnosed with ovarian cancer.

In the last 30 years, other cancers have been able to find fabulous improvements in awareness, funding and survival rates. The same hope is held for women with ovarian cancer. Some progress has been made but there is still a long way to go.

For the position of ovarian cancer and it's sufferers to improve, major changes are needed in awareness, treatment and funding. It's Ovarian Cancer's time to be in the spotlight. Ovarian Cancer Australia are asking ALL Australians to stand with them and take action.

                                                           Source: https://ovariancancer.net.au/

Find information on the Ovarian Cancer Australia website on the signs and symptoms as well as risk factors for ovarian cancer. 

Find out how you can get involved by giving, helping to fundraise, volunteering an more here. If you need help find that out too.

Start investigating today to spread the word.

Novel Coronavirus - Information and Answers

Coronaviruses are a large family of viruses that are found world wide in humans and animals. These viruses cause illnesses ranging from the common cold to more severe disease such as Sever Acute Respiratory Syndrome (SARS).

A Novel Coronavirus (CoV) is a new strain of coronavirus that has not been previously identified in humans.

                                                                   Credit: Getty Images/iStockphoto

• What is known and unknown about this virus?
• What you need to do if you have been exposed to a person who has been confirmed as having the virus?
• Do you need to take any action following a recent return from China?
• How can you best look after yourself, your family and your community?
  
  To find these answers and much more go to the NSW Government Ministry of Health website
  Novel coronavirus - Frequently asked questions also provided is a basic Chinese version for those that require it. Read about the history of CoV since it was identified in China in late 2019 here.

More information is available from the World Health Organization and information and resources for health professionals from NSW Health is available here.

MNCLHD Staff Publications

Congratulations to the highlighted MNCLHD staff on their recent publications. Please contact the Library if you would like to read any of these publications.

New Staff Publications December 2019 -January 2020

Ball, R., R. Vaschak, A. Bailey, G. Whiteford, T. L. Burrows, K. Duncanson and C. E. Collins (2019). "Study Protocol of the Parents in Child Nutrition Informing Community (PICNIC) Peer Education Cohort Study to Improve Child Feeding and Dietary Intake of Children Aged Six Months to Three Years Old." Children (Basel) 7(1).

Davis, I. D., A. J. Martin, M. R. Stockler, S. Begbie, K. N. Chi, S. Chowdhury, X. Coskinas, M. Frydenberg, W. E. Hague, L. G. Horvath, A. M. Joshua, N. J. Lawrence, G. Marx, J. McCaffrey, R. McDermott, M. McJannett, S. A. North, F. Parnis, W. Parulekar, D. W. Pook, M. N. Reaume, S. K. Sandhu, A. Tan, T. H. Tan, A. Thomson, E. Tu, F. Vera-Badillo, S. G. Williams, S. Yip, A. Y. Zhang, R. R. Zielinski, C. J. Sweeney, E. T. Investigators, A. the, U. New Zealand and G. Prostate Cancer Trials (2019). "Enzalutamide with Standard First-Line Therapy in Metastatic Prostate Cancer." New England Journal of Medicine 381(2): 121-131.

Dwyer, M., G. Peterson, S. Gall, L. Kinsman, K. Francis, K. Ford, H. Castley, A. Kitsos, T. Hilliard and J. English (2019). "Regional differences in access to acute ischaemic stroke care and patient outcomes." Intern Med J.

Dwyer, M., S. Rehman, T. Ottavi, J. Stankovich, S. Gall, G. Peterson, K. Ford and L. Kinsman (2019). "Urban-rural differences in the care and outcomes of acute stroke patients: Systematic review." Journal of the Neurological Sciences 397: 63-74.

Hallenstein, L. and C. Sorensen (2019). "The ins and outs of a regional cancer genetics service; Review of referral handling and triage processes." Twin Research and Human Genetics 22 (5): 392.

Mersiades, A. J., A. Tognela, P. S. Haber, M. Stockler, N. Lintzeris, J. Simes, I. McGregor, I. Olver, D. J. Allsop, C. Gedye, A. C. Kirby, R. L. Morton, P. Fox, S. Clarke, K. Briscoe, M. Aghmesheh, N. Wong, A. Walsh, C. Hahn and P. Grimison (2018). "Oral cannabinoid-rich THC/CBD cannabis extract for secondary prevention of chemotherapy-induced nausea and vomiting: a study protocol for a pilot and definitive randomised double-blind placebo-controlled trial (CannabisCINV)." BMJ Open 8(9): e020745.

Mesman, J., K. Walsh, L. Kinsman, K. Ford and D. Bywaters (2019). "Blending Video-Reflexive Ethnography With Solution-Focused Approach: A Strengths-Based Approach to Practice Improvement in Health Care." International Journal of Qualitative Methods 18: 1609406919875277.

Moloney, G., M. Sutherland, M. Norton, A. Bowling and I. Walker (2019). "Increasing registrations on the Australian Organ Donor Register." Medical Journal of Australia 210(3): 143-143.e141.

Sutherland, R., A. Brown, N. Nathan, L. Janssen, R. Reynolds, A. Walton, N. Hudson, A. Chooi, S. Yoong, J. Wiggers, A. Bailey, N. Evans, K. Gillham, C. Oldmeadow, A. Searles, P. Reeves, C. Rissel, M. Davies, K. Reilly, B. Cohen, T. McCallum and L. Wolfenden (2019). "Protocol for an effectiveness- implementation hybrid trial to assess the effectiveness and cost-effectiveness of an m-health intervention to decrease the consumption of discretionary foods packed in school lunchboxes: the 'SWAP IT' trial." BMC Public Health 19(1): 1510.

Valiukas, S., M. Pickering, T. Hall, N. Seneviratne, A. Aitken, F. John-Leader and S. W. Pit (2019). "Sexting and Mental Health Among Young Australians Attending a Musical Festival: A Cross Sext-ional Study." Cyberpsychology, behavior and social networking 22(8): 521-528.

Wong, P. K. K. and P. Hanrahan (2018). "Management of vaccination in rheumatic disease." Best Practice & Research in Clinical Rheumatology 32(6): 720-734.

MNCLHD Staff Publications Database – Maintained & updated by HMCN Health Services Library.

Article Alert : Patient-focused Information on Emergency Department Discharge

Awareness of diagnosis and follow up care after discharge from the emergency department
Leamy K, Thompson J, Mitra B
Australasian Emergency Care. 2019;22(4):221-226.

This Australian study looked at whether providing emergency department (ED) patients with more detailed information – a simplified discharge card – increased their understanding. It is standard for patients to receive a discharge summary after an ED visit, but the authors of this paper sought to see if a simplified discharge information card could improve patients’ awareness of their discharge diagnosis and follow-up requirements.

This was a prospective pre-post design interventional study with 112 patients in the pre-intervention group and 117 in the post-intervention group. The authors concluded that the patient-focused communication, in the form of a discharge information card, improved the patients' awareness of discharge diagnoses and follow-up requirements.

MNCLHD employees can find this article in full text on CIAP or request it from the Library.

Bushfires and your health - Reliable advice and evidence based information

Bushfires can severely affect your health, physically and mentally. Read below for some accurate and reliable information regarding bushfires and your health. 

• "Bushfires have always been a part of the Australian ecology, but now that ecology is changing." Doctors for the environment Australia provide information sheets that detail the impact of the current bushfire crisis in Australia on our health and how to reduce the risks.

Find the information sheets here.

• The Australian Medical Association is warning of "new health threats for people affected by the escalating bushfire crisis."

Read the AMA recommendations here.

• "NSW Health is assisting residents and their families affected by the bushfire emergency to look after their physical and mental health."

Read about the services available here.

And for more health information for the NSW bushfires here.

• The Heart Foundation warns that "bushfire smoke contains harmful gases such as carbon monoxide, and very small particles that can penetrate deep into the lungs."

Read their advice here.

• Unicef Australia offers advice on "how to talk to your children about Australia's bushfire emergency."

Read their recommendations here.

• Climate and Health Alliance advocates an evidence based factsheet developed by the Centre for Air Pollution which outlines what the "health impacts are to bushfire smoke, which groups are most vulnerable and what we can do to minimise exposure."

Read the factsheet here. 

                                                           Image by Daniel Zuflucht/pixabay.com

New CiAP JMO Specialty Guide for NSW Health

CIAP has created a new Specialty Guide to assist junior doctors through the trials and tribulations of those first few years on the job.

The JMO Guide will act as a quick access portal to some favourite sites like UpToDate and MEDLINE . It will also link to a variety of other useful resources like well-being links such as Fitness Passport and JMO Health.

Check out the complete guide here