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"Diagnosis is not the end, but the beginning of practice."
Martin H. Fischer

 

Gastro-oesophageal reflux disease: new guideline

In this latest guideline, NICE recommends that parents and carers are given advice about gastro-oesophageal reflux (GOR) and are reassured that in well infants, effortless regurgitation of feeds is very common, usually begins before the infant is 8 weeks old, but will become less frequent with time and does not usually need further investigation or treatment. Health professionals should support and advise families on the difference between GOR and GORD. NICE recommends that health professionals look for 'red flag' symptoms which may suggest disorders other than GOR and investigate further or refer.

Source: National Institute for Health and Care Excellence 2015

 

CriSTAL – screening tool for end-of-life decision making

Criteria for Screening and Triaging to Appropriate aLternative care (CriSTAL) has been developed by University of NSW to identify elderly patients who are likely to die within a 3 month period, in order to avoid potentially harmful and futile treatments. CriSTAL will be trialled in selected hospital emergency departments in Sydney this year and will include communication training for clinicians.

Source: BMJ supportive & palliative care Jan 2015, Online first

 

End-stage renal disease facilities – educational toolkit

This tool kit developed by the US Agency for Healthcare Research and Quality is intended to help prevent infection in people with end-stage renal disease. Dialysis clinics can use this toolkit to prevent healthcare-associated infections in their patients. Available at no charge, the toolkit helps clinicians and other health care workers follow clinical best practices, create a culture of safety, use checklists and other audit tools, and engage patients and their families in infection prevention practices.

Source: US Agency for Healthcare Research and Quality Toolkit 2015

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CVD, diabetes and CKD: morbidity – hospital care in Australia

This report presents up-to-date statistics on cardiovascular disease, diabetes and chronic kidney disease in Australia, as well as trends on hospitalisations from these chronic diseases acting alone or together.

How many hospitalisations occur for CVD, diabetes and CKD?

  • In 2012-13, CVD, diabetes and CKD were associated with around 1.8 million hospitalisations, around 20% of all hospitalisations in Australia.
  • Over 1.2 million hospitalisations were associated with CVD, and around half had CVD as the principal diagnosis-12.8% of all hospitalisations in 2012-13. Coronary heart disease (CHD) accounted for 148,950 hospitalisations (28% of all cardiovascular disease hospitalisations), heart failure 57,450 (11%) and stroke 36,390 (7%).
  • Diabetes was recorded in around 840,000 hospitalisations- 8.9% of all hospitalisations in 2012-13. Of these, 738,300 (88%) were associated with type 2 diabetes, 52,900 (6.3%) with type 1 diabetes and 31,900 (3.8%) hospitalisations with gestational diabetes.
  • In 2012-13, there were 1.5 million hospitalisations associated with CKD. Regular dialysis (generally a day procedure where a person is discharged on the same or following day) accounted for the overwhelming majority-almost 1.3 million hospitalisations-and was the most common reason for hospitalisation in Australia.

Source: AIHW 22 Dec 2014

 

Group decision-making: implications for patient safety

Traditionally we consider collaborative problem solving leads to better thinking and better solutions for patients. In this paper the authors "problematise this assumption" by describing how group decision-making can have its own biases and risks, "be imperfect and result in organisational and clinical errors". Four systematic biases are explored arising from group decision-making in clinical settings - 'groupthink', 'social loafing', 'group polarization' and 'escalation of commitment'. With each bias the authors describe its antecedents, how it can impair group decisions, and outline possible remedial strategies. Cultures that value openness, transparency, learning and mindfulness may be better positioned to avoid the risks of these biases.

Source: International journal for quality in health care 2014: 26(6) 606-612

 

Interventions for reducing sitting at work

"Physical inactivity at work has increased in recent years throughout the world increasing the risk of obesity, heart disease, stroke and diabetes. It is unclear whether interventions that aim to reduce sitting, such as desks at which you can work while standing up (sit-stand desks), are effective at reducing the amount of time spent sitting." Authors

Source: Cochrane Database of Systematic Reviews 2015 Workplace interventions for reducing sitting at work

 

Mental health risk doubles in teens with asthma

As around 10% of Australian young people (12-25 years) have asthma, there is a great public health interest in improving their quality of life, health status and health outcomes. This survey identifies the current issues and opportunities in the health and wellbeing of young people with asthma.

Source: National Young People and Asthma Survey, 2014

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Journals spotlight

These links provide access to the the current issue.

Annals of emergency medicine
Breast
British journal of occupational therapy
Clinical rehabilitation
Evidence-based nursing
Gut
Infection control and hospital epidemiology
Journal of clinical pathology
Journal of emergency nursing
Journal of medical ethics
Journal of urology
Topics in stroke rehabilitation

Looking for the latest journal issues?
All our journal titles with electronic access are available via the A-Z Journal List
(outside the Austin Health network use your Library barcode no. & PIN for access)

If you require an article from a journal that is not on the A-Z Journal List, please use our online document delivery form.

Journals received in print-only format this week:

Infant, Vol. 11, no. 1, January 2015.

Journal of sexual medicine, Vol. 11, no. 12, December  2014.

Nature, Vol. 517, no. 7532; Vol. 517, no. 7534, 15 January 2015.

 

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