30 November 2016

Sugary drinks tax - report

The Grattan Institute's report, A sugary drinks tax: recovering the community costs of obesity, strongly supports the imposition of an excise tax of 40 cents per 100 grams of sugar on all non-alcoholic, water-based drinks containing added sugar. "Such a tax would increase the price of a two-litre bottle of soft drink by about 80 cents, raise about $500 million a year, and generate a fall of about 15 per cent in the consumption of sugar-sweetened beverages."

The report provides obesity statistics and costings in Australia, and cites other countries which already have, or are planning to have, a tax on soft drinks - France, Belgium, Hungary, Finland, Chile, the UK, Ireland, South Africa, and parts of the US.

Drug-caused deaths in Australian health professionals

A study recently published in the journal Addiction, looked at the risk of substance abuse and its associated premature death in health professionals.  404 drug-caused deaths reported to a coroner between 2003 and 2013 from this cohort were examined.  The researchers found that the most common drug-caused deaths involving health professionals at this time were females in their mid-40s with a diagnosis of mental illness.

Pilgrim, J. L., Dorward, R., and Drummer, O. H. (2016) Drug-caused deaths in Australian medical practitioners and health-care professionals. Addiction, doi: 10.1111/add.13619.  (Access is available via CIAP for NSW Health staff)

HIV, viral hepatitis and STIs

HIV, viral hepatitis and sexually transmissible infections in Australia: Annual surveillance report 2016 has been published by the Kirby Institute at the University of NSW.

This analysis includes estimates of incidence and prevalence of HIV and viral hepatitis, by demographic and risk groups, patterns of treatment for HIV and viral hepatitis infection, and behavioural risk factors for HIV and Hepatitis C infection. This annual report has been published every year since 1997. Among the many findings in this year's report are:
  • The number of HIV notifications newly diagnosed in Australia has remained stable for the past four years
  • At 0.1%, the prevalence or overall proportion of people in Australia who are living with HIV is low compared to other high income countries, and countries in the region.
  • In 2015 there were 10,790 notifications of hepatitis C, with the highest rates in the 25 – 39 year age group.
  • Chlamydia was the second most frequently reported notifiable condition in Australia in 2015, with a total of 66 033 notifications.
You can also access the Kirby Institute's interactive surveillance data website, which provides the report information in graphs and other useful visuals.

Equality and Diversity in Psycho-Oncology

A Special Issue of the journal Psycho-Oncology focussing on inequalities in cancer has been published. Concerns are raised relating to what is known about the experience of cancer treatment and cancer treatment outcomes in adults with dementia.

Findings indicate that, when compared with other cancer patients, those with dementia are diagnosed at a later stage, receive less treatment, are more likely to experience complications from treatment and have poorer survival. 

Special Issue: Equality and Diversity in Psycho-Oncology, (2016). Psycho-Oncology. 25(10), 1121-1249

Safety Monitoring and Reporting in Clinical Trials

The National Health and Medical Research Council (NHMRC) has issued new Guidance on safety monitoring and reporting in clinical trials. This Guidance will replace the existing 2009 Australian Human Ethics Committee Position Statement: Safety Monitoring and Reporting in Clinical Trials Involving Therapeutic Goods.
This guidance specifically addresses the monitoring, collection and reporting of adverse events and adverse reactions that occur in clinical trials involving investigational medicinal products (IMPs) and investigational medical devices (IMDs) for trials conducted under the Clinical Trial Exemption (CTX) or Clinical Trial Notification (CTN) schemes. The Guidance is also broadly applicable to all clinical trials involving therapeutic goods.
Guidance for Safety Monitoring and Reporting in Clinical Trials; involving therapeutic goods, (2016)

Does quality improvement improve quality?

The authors of this article in Future Hospital Journal describe the issue of quality improvement; “Although quality improvement (QI) is frequently advocated as a way of addressing the problems with healthcare, evidence of its effectiveness has remained very mixed. QI work is often pursued through time-limited, small-scale projects, led by professionals who may lack the expertise, power or resources to instigate the changes required. There is insufficient attention to rigorous evaluation of improvement and to sharing the lessons of successes and failures. Too many QI interventions are seen as ‘magic bullets’ that will produce improvement in any situation, regardless of context. Too much improvement work is undertaken in isolation at a local level, failing to pool resources and develop collective solutions, and introducing new hazards in the process.”

Dixon-Woods, Mary, Martin, Graham. (2016). Does Quality Improvement Improve Quality. Future Hospital Journal, 3(3), 191-194

Shared Decision Making through Reflective Practice

This article in the journal MedSurg Nursing focuses on competencies of shared decision making with examples of the knowledge, behaviors, and attitudes needed if shared decision making is to be realized. It also demonstrates how self-reflective questioning assists the clinical nurse to integrate these competencies in practice. This is Part II in a series of articles on shared decision making. Part I of this series reviewed background literature and considered descriptions of shared decision making, including the process and outcomes.

Truglio-Londrigan, M. (2016). Shared Decision Making through Reflective Practice: Part II
Medsurg Nursing, 25(5), 341-345,350.
MNCLHD staff can access this article free full text via the e-journal site or ask your library staff.

Getting Australia's Health on Track

A new report "Getting Australia’s Health on Track" presents 10 priority policy actions that, together, will help get Australia on track to reach the 2025 targets and significantly reduce preventable illness and disability in the population. It has been produced by a national collaboration of Australia’s leading chronic disease experts and organisations.

Its focus is upon interventions to reduce the consumption of sugar, salt and alcohol, and to tackle junk food marketing. It also recommends actions to reduce smoking, particularly by Aboriginal and Torres Strait Islander people and by people with mental illness.

Getting Australia's health on track—a policy report for a healthier Australia. Australian Health Policy Collaboration, 2016

25 November 2016

Busting the cranberry myth

A recent program on ABC's Health Report titled Busting the Cranberry Myth, looked at a randomised trial which showed no significant difference in women in nursing homes who took cranberry capsules for urinary tract infections, compared to a control group who took a placebo. The lead author of the paper, published in JAMA, Manisha Juthani-Mehta, was interviewed on the program and explained her findings. She did say that cranberries probably help ease the symptoms of urinary tract infections, but could not find evidence that they can treat the problem.

Manisha Juthani-Mehta et al. Effect of Cranberry Capsules on Bacteriuria Plus Pyuria Among Older Women in Nursing Homes: A Randomized Clinical Trial. JAMA. 2016;316(18):1879-1887. doi:10.1001/jama.2016.16141

Medical students and patient-centredness

A study of medical students in Victoria found that while their confidence increased over the course of two years of clinical training, their attitudes to patient centredness did not change.  They had positive attitudes throughout and "noted its importance in contributing to quality care".

The article, published in BMC Medical Education aimed to compare students' attitudes to these two important outcomes of medical education, and to see how the setting of their clinical placement influenced them.  The authors concluded that "a new generation of doctors with a strong patient-centred focus is emerging".  Patient centredness was encouraged and supported within their clinical placements and influenced by role modelling.

Ruth McNair, Leonie Griffiths, Katharine Reid, Hannah Sloan. (2016). Medical students developing confidence and patient centredness in diverse clinical settings: A longitudinal survey study BMC Medical Education, 16:176  

Eye Health web resource

The Australian Indigenous HealthInfo Net has set up an Eye Health Web Resource for Aboriginal and Torres Strait Islander people.

The tools and information on this page are set up to support health professionals and students of eye health in this group.  They include links to programs and projects, reviews of the literature, relevant policies, health promotion resources and information about the workforce in this field - training, conferences and job opportunities.

24 November 2016

Emergency department care 2015-16

The Australian Institute of Health and Welfare has published a new report on emergency department care. In 2015-16, there were 7.5 million presentations to public hospital emergency departments across Australia (excluding the Australian Capital Territory), or more than 20,000 presentations each day.
  • 74% of patients received treatment within an appropriate time for their urgency (triage) category;
  • 73% of patients spent 4 hours or less in the emergency department;
  • 2.2 million patients were admitted to hospital from the emergency department, and 49% of these were admitted within 4 hours.
Download the report for free: Emergency department care 2015-16: Australian hospital  statistics. AIHW catalogue number [HSE 182].

Sharing of Trial Results

It is interesting the number of drug trials that are not published. Clinical trials are the best way we have of testing whether a medicine is safe and effective. They can involve thousands of people, patients and healthy volunteers, and take years to complete, but trials with negative results are twice as likely to remain unreported as those with positive results. This means that patients and doctors don't have the full information about the benefits and risks of treatments. 
The link to the trials tracker, built by the Evidence-Based Medicine Data Lab at University of Oxford is here:   

Review Issue on Viruses and Disease

The reviews assembled in this free virtual issue of the Journal of Pathology focus on the interface between virology and pathology and encompass aspects of both the clinical pathology of viral disease and the underlying disease mechanisms.

(2015). Journal of Pathology. Special Issue: Viruses and Disease, 235(2)  

Occupational Therapy Practice Guidelines

The American Occupational Therapy Association has updated 2 guidelines;