24 October 2014

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 paediatriciansElizabeth J M Corbett, Hasantha Gunasekera, Alanna Maycock and David Isaacs.
Med J Aust 2014; 201 (7): 393-398.  doi: 10.5694/mja14.00279.  

21 October 2014

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.

16 October 2014

Companion animals and the health of older people

The International Federation on Ageing has published Companion animals and the health of older persons as one response to the projected costs associated with caring for ageing populations.  A literature review examined the relationship of older people living both independently and in long-term care facilities, including dementia sufferers and people with a mental illness, with their pets. The study focused on the physical, mental, emotional and social health of these people, as well as the role of animals in their perceptions of inclusion in their community.  The economic impact of animals interacting with older people was also examined and some promising initiatives explored, including one in Victoria and one in NSW.  It was acknowledged that research on this topic has been very limited.

Coeliac disease: where are we in 2014?

Published recently in Australian Family Physician by Kristin Kenrick and Andrew S Day, Coeliac disease: where are we in 2014? seeks to summarise the current knowledge and management of this autoimmune disease which affects at least one in a hundred Australians.

Coeliac disease is characterised by chronic inflammation of the small-intestinal mucosa and triggered by eating gluten. Many people with the disease remain undiagnosed because of the varied manifestations of symptoms it can produce.   The article presents up-to-date information on CD as we now understand it, with recommendations on whom to test and how to test for it, and how to manage patients once they are diagnosed.

Australian Family Physician Volume 43, No.10, October 2014 Pages 674-678.

Women, work and the menopause

According to this report, 78% of women aged between 45 and 54 participate in the Australian workforce, representing over a million women potentially experiencing menopause while at work.
Women, work and the menopause: releasing the potential of older, professional women is a report from the Australian Research Centre in Sex Health and Society at La Trobe University and authored by Gavin Jack and colleagues.  It explores:

  • Older women’s health and well-being
  • The relationship between menopause-related symptoms and work outcomes  
  • Actual and desired levels of organisational support for women experiencing menopause
  • Work-related and organisational factors that exacerbate or ameliorate women’s experiences of menopause in the workplace
  • Women’s first-hand experiences, beliefs and attitudes towards menopause at work

Mistakes made when interpreting research

Two researchers at the Australian National University have written a useful article in The Conversation, The 10 stuff-ups we all make when interpreting research.  Will J Butler and Rod Lamberts explain very simply some of the pitfalls we can easily fall into when trying to critically appraise a study.

Some of these "stuff-ups" include using the results of just one study to prove a point, confirmation bias (where we look for studies that confirm what we already believe), confusing the merits of qualitative and quantitative results and giving too much weight to significance and peer review.

Medication errors: an overview for clinicians

The Institute of Medicine in the US has estimated that medication errors cause one in 131 outpatient deaths and many more morbidities.  "Medication errors: an overview for clinicians" is an article recently published in Mayo Clinic Proceedings and its authors provide an overview of medical errors, including definitions, incidence, risk factors, avoidance strategies and legal consequences.

Medication errors can be precipitated by many factors, ranging from the confusion which may arise from the similar labeling or naming of different drugs to poor communication between health professionals.  Strategies that have been used to overcome these problems are discussed.

Wittich CM, Burkle CM, Lanier WL, Mayo Clinic proceedings.89(8):1116-25.
Contact your health library for the full text.

15 October 2014

Dying in America report

Continuing the theme of palliative care and dying, this consensus report has just been published by the US Institute of Medicine. Dying in America:  Improving quality and honoring individual preferences near the end of life argues that improving palliative care services not only enhances the quality of life of the patient, but could be more economically sustainable.

Recommendations from the report include health professionals communicating better to patients about their choices and advanced care planning, there should be more rigorous education for clinicians in the issues of palliative care and there should be greater financial incentives for people to die in their own homes.

Dying Well - Grattan report

The Grattan Institute has published Dying Well, a report by Hal Swerissen and Stephen Duckett about how we die in Australia. According to the report, 70% of Australians would like to die at home, but only 14% actually do so.  About 50% die in hospital and a third in residential care. Dying in Australia is more institutionalised than most other countries and this is linked to medical and community attitudes as well as a lack of funding for home-based care.

The report recommends more public discussion, including an education campaign, about the limits of health care as death approaches and the need to focus on end-of-life care.  It also proposes the widespread adoption of advance care plans that ensure people’s desires for the end of life are met.  “The baby boomers are growing old and in the next 25 years the number of Australians who die each year will double,” Professor Swerissen says. “We need the courage to promote a national discussion about a subject that we might dislike but cannot avoid.”

You can also read Swerisson and Duckett's article in The Conversation, A Good death:  Australians need support to die at home.  It's a good summary of their full report.

Swerissen, H and Duckett, S., 2014, Dying Well. Grattan Institute ISBN: 978-1-925015-61-

Palliative Care Services in Australia 2014

The Australian Institute of Health and Welfare has published this annual report about services available to Australians in palliative care, and changes over time.  There were over 57 600 palliative care related separations from public and private hospitals in 2011-12 and almost $4.7 million MBS payments were made for palliative medicine specialist services in 2012-13.

Detailed information is provided in the report about definitions of palliative care and who provides it.  Both GP and specialist encounters are explored, and data provided on the overall palliative workforce, medications and services and facilities.