Should health and care staff have to have a covid vaccine?

Mandatory COVID-19 vaccination has been approved by law makers in the United Kingdom, Italy France and Greece, and now also in NSW Australia. Medical exemptions are available. In NSW anyone who works in health care and social assistance must have their first dose of vaccine by September 30. 

 Credit: abc.net.au

A recent article in the BMJ 2021;374:n1903 presents a debate on this complicated issue. The 'Yes' argument by Michael Parker, professor of bioethics and the 'No' argument by Helen Bedford, professor of children's health, state their positions. There is an interesting 'Patient Commentary' on page 184 for a quick insight into a patient's perspective entitled Protect patients, with staff exemptions only for medical reasons.

NSW Health staff can read this via CiAP. Use your single sign on information. Problems? Contact your librarian through the Library website.

COVID-19 Resources

COVID-19 Resources

The Commission has developed and provided a range of resources to give advice on how to reduce the risk of Coronavirus (COVID-19) exposure and infection. These resources are freely available for Australian health service organisations, healthcare professionals and consumers.

The Commission supports all healthcare professionals in continuing to provide safe, high-quality care during the pandemic, with advice on infection prevention and control, risk assessment and management, managing medications and caring for people with cognitive impairment.

On the resources page find helpful information graphics, guidelines, fact sheets and brochures.

 

Mask wearing and headaches

Personal protective equipment (PPE) has become a fact of life for anyone working in health care in Australia, even those without much patient contact.

I've been asked about whether wearing a simple surgical mask can cause headaches. The answer is yes it can! The first step is make sure you are wearing an appropriately sized mask for your body size and face shape. See your manager if none of the masks supplied works for you. You may just need help with correctly fitting the masks or perhaps an alternative option can be ordered.

Combining masks with protective eyewear or a shield puts further pressure on your head and can alter your posture and putting extra pressure on soft tissue.

Tips are to make sure to take adequate breaks. Headaches are associated with wearing PPE longer than four hours at a time. Breaks are essential to preventing headaches as the mask is a physical barrier to drinking. In previous times you might have had a drink bottle handy to take sips between patients, but with the inconvenience of glove, mask and perhaps eyewear removal you just soldier on. On the other hand if you normally drink coffee, tea or caffeinated fizzy drink throughout your day, you might be drinking less because you have a mask on, which could lead to painful withdrawal headaches.

Keep your drink bottle or coffee cup in your work area as a visual reminder that you need to take a break for a drink or set a timer on your smart watch if you have one. While on your break stretch your head and neck, maybe wash your face and apply moisturiser before resuming work.

Take care people!

PRISMA 2020

If you are undertaking an systematic review you need to be aware of the updated guidelines. The Preferred Reporting Items for Systematic reviews and Meta-Analyses ( PRISMA) statement, published in 2009 has been updated. The PRISMA 202 replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. An article published in the British Medical Journal (BMJ), presents the updated 27 item checklist detailing the reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.

The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n71 (Published 29 March 2021)

                                                                                Source: norecopa.no

The PRISMA 2020 statement is also available via Open Access in PLOS Medicine and various other journals. 

Prisma 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews  BMJ 2021;372:n160. doi: 10.1136/bmj.n160 

Links to the checklist in PDF or word format can be obtained from the PRISMA website The flow diagram ready for you to use is available in word format.

If MNCLHD employees need any help accessing this information contact the Library.

AIHW Photo Competition - People's Choice Award

The Australian Institute of Health and Welfare photo competition has closed BUT the People's Choice Award is open for voting.

A $500 prize is available to the entry that is judged to be the most popular by the public.

Vote here.

Image below is one of the photos that can be voted for.

Image title: In Nancy’s Hands

Location: Cook, ACT

Suicide prevention and mental health receive $2.3 billion of funding in 2021 Australian budget

Three months of follow-up care for people discharged from hospital after a suicide attempt will be funded with $156.8 million from the federal government.

It is one of several new or expanded programs that have been promised in the budget, with $2.3 billion committed to mental health and suicide prevention over the next four years.

The budget spending on mental health has a focus on suicide prevention, but that is only one piece of the puzzle when it comes to Australia's mental health spending. The government will expand the headspace program, which focuses on youth mental health, with $278.6 million in funding going to expanding the program.

People impacted by recent bushfires will also receive specific mental health spending, with $4 million set aside to provide up to 10 free trauma and distress counselling sessions to them.

Extra support will also be funded for people with eating disorders and their families, with $26.9 million committed to establish a National Eating Disorder Research Centre and improve services.

Read the full article here on ABC News.

For more information see the following trusted websites:

Australian Government Department of Health - Budget 2021-2022

Research Australia - Budget update

                                                           Photo by Matthew Ball on Unsplash

New Australian and New Zealand Guideline for Mild to Moderate Head Injuries in Children

 An Original Research article published in Emergency Medicine Australasia Volume 33 issue 2 April 2021, by Franz E. Babl, Emma Tavender, Dustin W. Ballard et al.

Abstract

Objective: Children frequently present with head injuries to acute care settings. Although international paediatric clinical practice guidelines for head injuries exist, they do not address all considerations related to triage, imaging, observation versus admission, transfer, discharge and follow-up of mild to moderate head injuries relevant to the Australian and New Zealand context. The Paediatric Research in Emergency Departments International Collaborative (PREDICT) set out to develop an evidence-based, locally applicable, practical clinical guideline for the care of children with mild to moderate head injuries presenting to acute care settings.

Source: pexels.com

A multidisciplinary Guideline Working Group (GWG) developed 33 questions in the three key areas of triage, imaging and discharge. The results of their search and review of existing guidelines and discovered new evidence resulted in 71 recommendations relevant to the Australian and New Zealand setting. The guideline is presented as three documents; a detailed Full Guideline, a Guideline Summary and a Clinical Algorithm.

This article is available to all NSW Health employees via CiAP or by contacting your Library service. MNCLHD employees can go to the document request page.

For parents, concerning features to watch out for go to the Sydney Children’s Hospitals Network page – Head Injuries in Children. If in doubt go to emergency or see your GP. Never feel that your concern for your head injured child is wasting anyone’s time.

Curious about the COVID-19 AstraZeneca vaccine? Get your information from reliable sources!

It's easy to get confused about what is fact and what is not when guidelines change and social media is going off about recent events regarding the vaccine rollout.

The most important thing to do when making your own informed decisions about this is to get information from authoritative reliable sources.

If you like to watch and or listen to information the NSW COVID-19 update available on YouTube is work a look. A video is helpful because you can go back and repeat any information that you might not understand completely. Dr. Ketaki Sharma explains in depth the thrombosis with thrombocytopenia syndrome situation as the limited data allows. Basically it's a really rare condition. The age recommendation of 50 plus is because in younger groups being vaccinated in the UK the data on incidence shows while still rare is increasing. The panel of experts A/Prof Charlotte Hespe, A/Prof Penny Burns, Dr Kerry Chant, put questions to Dr Sharma, and ask for further clarification. 

                                       Source: University of Cambridge : Winton Centre for Risk and Evidence Communication

Despite having a history of varicose veins and a prior blood clot, I'm comfortable getting this vaccine. There is no evidence that people who have had a past history of blood clots, have an increased risk of thrombosis with thrombocytopenia syndrome (TTS). Only people that have had TTS after the first dose should not have the second dose. There have been no cases reported after the second dose.

This information will allow health professionals to confidently vaccinate their patients and explain clearly to those who have questions. The important message is to also explain the risks associated with the disease being vaccinated against, which in most age groups outweigh the risks of the vaccination.

Australian Cancer Atlas update highlights geographical disparities

 A recent Hospital & Healthcare article discusses a recent update to the Australian Cancer Atlas, an interactive online resource helping researchers, members of the community, medical professionals and policymakers understand how Australia’s cancer burden varies across geographical areas.

The recent update means the resource now includes latest national data on how cancer diagnosis and excess death rates vary by geographical area across Australia. The Atlas enables users to easily visualise these variations, offering critical insight into how the patterns of cancer and outcomes in Australia vary depending on where people live, which can be used to drive research priorities and policies going forward. This gives health agencies and policymakers a better understanding of geographic disparities and health requirements across the country.

The Atlas is a collaborative project between Cancer Council Queensland and the Queensland University of Technology (QUT).

Read the full Hospital & Healthcare article here and view the Atlas here.

                                                             image source: atlas.cancer.org.au

International Women's Day in Healthcare

What do women in health care choose to challenge this International Women’s Day?

Four inspirational women tell us what #ChooseToChallenge means to them and women in health care.

Read more at Hospital and Healthcare here.

One of the MISSIONS for IWD is "To assist women to be in a position of power to make informed decisions about their health."

Read more about the IWD missions here.

Source: IWD

The Aboriginal Health Specialty Guide is now available on CIAP!

The Aboriginal Health Specialty Guide is now available on CIAP!

The guide includes resources for clinicians, patients, researchers, Aboriginal and Torres Strait Islander workforce, and anyone interested in learning more about Aboriginal Health.

Access this and other Specialty Guides directly from the Specialty Guides page on CIAP.

Get in touch with CIAP if you’d like to become a contributor to their guide. 

MNCLHD Staff publication included in special issue of Health Promotion Journal of Australia

Health Promotion Journal of Australia Volume 32 Issue S1.

Special Issue: Equity and Health Literacy February 2021

This issue contains ground breaking work researching men in Tasmania who experience substantially poorer health outcomes and socio-economic disadvantage than most Australians.

The article is entitled "Engaging “hard‐to‐reach” men in health promotion using the OPHELIA principles: Participants' perspectives". Lead author Leigh Kinsman, Professor of Evidence Based Nursing, is especially proud of the work the team put in, as well as contributions made by some of the participants. This work was selected from many under consideration to have a "Video Short" that gives a brief pictorial introduction and overview of the research and solutions found during the research.

Source: https://onlinelibrary.wiley.com

Experiences of isolation, lack of trust in the health system, no-adherence to medication, mental health problems and long term pain were revealed. This informed the generation of ideas to to improve their health and well-being and give a better understanding of health. Specially tailored interventions were implemented including "Numeracy for Life" and "Healthy Sheds" courses. Post course interviews showed that the process contributed to a sense of worth, social support and a way to break old habits.

Scroll down in the linked article above to see the video. The article is available online. MNCLHD staff can contact the Library if they have any problems downloading it.

Congratulations Leigh Kinsman, Jan Radford, Shandell Elmer, Kathryn Ogden, Sarah Randles, Alycia Jacob, Denise Delphin, Nettie Burr, and Mick Goss on the production of a body of work that will impact on the lives of many.

What do we know about "long COVID"?

 "Long covid" is a term that is being used to describe illness those who have either recovered from covid-19 but are still reporting effects of the infection, or those who have had the usual symptoms for a far longer period of time than would be expected. A lot of people, doctors included, have been infected and have shared their anecdotal experiences on social and other media platforms. Read feature article in the BMJ "Covid-19: What do we know about long covid"? 

Professor of Infectious Diseases, Paul Garner who works at Liverpool School of Tropical Medicine, talked about his "frighteningly long" seven week experience with the virus for BMJ Opinion describing a "roller coaster of ill health, extreme emotions, and utter exhaustion". His long list of symptoms lasted for weeks and left him feeling like he was unable to function.

In the UK the Royal College of Practitioners expects GPs to see and influx of patients with "Long COVID" and has called for a rapid review for GPs to enable a streamlined approach to treatment as the approach introduced during the pandemic. A great deal of pressure is going to weigh on GPs as a direct result of covid-19.

Read evidence from a team of Italian researchers published in JAMA who reported that nine in ten patients discharged from a Rome hospital after recovery were still experiencing at least one symptom at sixty days post onset of the virus.

Currently the media is focused on two possibilities with COVID-19 either you get very sick requiring hospitalisation or you get a very mild case that is barely a sniffle. "You'll be right" just go home and isolate. The possibilities for a more chronic long term illness is not being brought to the attention of the public as it should be. Those who are considering not taking up the vaccine, thinking that because most of the population will be vaccinated, they might be protected. I think these people need to think again. 

Another article in the Pharmaceutical Journal tells the story in-depth of one patient who could not function even six months later. "Thousands of people who had been thought to have recovered are now reporting persistent or severe symptoms. Read the NSW government COVID-19 Critical Intelligence Unit's evidence check here.

Any escape of the virus to non-vaccinated members of the Australian population could have serious implications for the long term health of the people involved as well as Health System in Australia. 

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