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"Cultural differences should not separate us from each other, but rather cultural diversity brings a collective strength that can benefit all of humanity."
Robert Alan

 

Impact of alcohol related presentations in ED

Recent Australian & New Zealand research indicates that 1 in 8 presentations to ED are now alcohol related. Authors have found this has resulted in the rise of verbal and physical aggression towards clinical staff, and is having a negative impact on the waiting times and care of other patients. ED nurses (92% reported) felt unsafe because of the behaviour of these patients.

Source: MJA 2016; 204(4): 155

 

Clinical practice guidelines - dementia

"Approximately 9% of Australians aged 65 and over have a diagnosis of dementia; in people aged 85 years and older this figure rises to 30 per cent.  As Australia's population ages, the number of people with dementia is expected to increase. These Clinical Practice Guidelines and Principles of Care for people with dementia are written primarily for health and aged care staff (doctors, nurses, allied health and care workers) who work with people with dementia in community, residential and hospital settings."

Source: Clinical Practice Guidelines and Principles of Care for people with dementia. NHMRC Partnership Centre for Dealing with Cognitive and Related Functional Decline in Older People, 2016

Further reading

Is dementia in decline? Historical trends and future trajectories
"Using surveillance data collected from the Framingham Heart Study from 1975 to the present, researchers found a 20% decrease in dementia incidence each decade, even as average body-mass index, diabetes prevalence, and population age have increased. Can we now conclude that the tide has turned in the dementia epidemic? The potential decline of dementia, seen in light of the rise and fall of other major diseases, raises an even more tantalizing prospect: Can we control our burden of disease?"
Source: NEJM 2016; 374(6): 523-32

Alzheimer's Australia - Key facts and statistics 2016

The Dementia Enabling Environment Project (DEEP) Virtual Information Centre provides practical tips, guides and resources to help develop an enabling environment for a person living with dementia.

 

A positive side of negative results - cancer clinical trials

In the context of positive phase III cancer clinical trials, researchers report that while positive trials indicate clinical advances, the negative trials also provided "sizeable scientific impact by generating important scientific observations and new hypotheses and by showing what new treatments should not be used." With research into cancer drugs authors hope that their findings "will comfort and encourage both patients and researchers, since findings indicate that contributing to a trial, regardless how it turns out, is crucial to cancer research."

Source: JAMA Oncology 2016; Online first: 10 March
Full text available for Austin & MHW Heidelberg staff via document delivery

 

Central venous catheter-related infections - ICU

This recent Cochrane Review on Catheter impregnation, coating or bonding for reducing central venous catheter-related infections in adults confirms the effectiveness of "antimicrobial CVCs in reducing rates of CRBSI and catheter colonization". It was found the magnitude of benefits regarding catheter colonization varied according to setting, with significant benefits only in studies conducted in ICUs. A comparatively smaller body of evidence suggests that antimicrobial CVCs do not appear to reduce clinically diagnosed sepsis or mortality significantly."

Source: Cochrane Intervention Review March 2016

 

Patient-centred care interventions in CHF

This new review focuses on collaborative goal setting between patients and their healthcare professionals. Noting that the strength of evidence is poor, the authors report that patient-centred care "has been shown to reduce symptom burden, improve health-related quality of life, reduce readmission rates and enhance patient engagement for patients with CHF".

Source: Heart Failure Reviews 2015; 20(6): 673-87

Further reading

NSQHS work on Patient & Consumer Centred Care

 

Better births - improving maternity services outcomes in UK

This report was part of a review into the future of maternity services in England. The authors found that despite the increases in the number of births and the increasing complexity of cases, the quality and outcomes of maternity services in England have improved significantly over the last decade. However, the review also found variations across the country, and identified opportunities to improve safety and reduce still births. Key priorities to drive improvement include:

  1. personalised care
  2. continuity of carer
  3. safer care
  4. better postnatal and perinatal mental health care
  5. multi-professional working - breaking down the barriers
  6. working across boundaries to provide safety & choice
  7. a payment system that fairly compensates providers for high quality care

Source: National Maternity Review report 2016. Better births: improving outcomes of maternity services in England: a five year forward view for maternity care

Further reading

NHS England Maternity Review overview 2016

 

Cultural Diversity Week

"The concept of diversity is one of inclusiveness and respect and includes many things that make us unique such as culture, language, ethnicity, gender, sexual orientation, age or literacy level."
Dr. Brendan Murphy - Austin Health Diversity Plan 2015-2020

An explanation and analysis of how world religions formulate their ethical decisions on withdrawing treatment and determining death
This paper explores definitions of death from the perspectives of several world religions. It aims to increase cultural competency in practitioners by demonstrating the reasoning process religions use to derive their conclusions for end of life decisions.
Source: Philosophy, Ethics and Humanities in Medicine 2015; 10(6)

Cultural competency books

Caring for women cross-culturally / edited by Patricia F. St. Hill, Juliene G. Lipson, Afaf Ibrahim Meleis - F.A. Davis, 2003.

Caring for Hindu patients / edited by Diviash Thakrar, Rasamandala Das and Aziz Sheikh - Radcliffe Publishing, 2008.

Caring for Muslim patients / edited by Aziz Sheikh and Abdul Rshid Gatrad - Radcliff Publishing, 2000.

Cultural awareness in nursing and health care : an introductory text / Karen Holland & Christine Hogg - 2nded., Hodder Arnold, 2010.

The soul of medicine : spiritual perspectives and clinical practice / edited by John R. Peteet and Michael N. D'Ambra - John Hopkins University Press, 2011.

Communication for patients : talking with patients / Lisa Kennedy Sheldon, Janice B. Foust - 3rd ed., Jones & Bartlett, 2014.

Cultural competence in health care / Wen-Shing Tseng, Jon Streltzer - Springer, 2008.

Multicultural care : a clinician's guide to cultural competence / Lillian Comas-Diaz - American Psychological Association, 2012.

Pocket guide to cultural health assessment / Carolyn E. D'Vanzo, Elaine M. Geissler - 3rd ed. Mosby, 2003

World religions for healthcare professionals / edited by Siroj Sorajjakool, Mark F Carr and Julius J Nam - Routledge, 2010.

Books

 

Austin Health Research Online - recent submissions

PIK-ing the right gene for polymicrogyria. Scheffer I. The Lancet Neurology 2015; 14(12): 1147-1148

Antimicrobial allergy 'labels' drive inappropriate antimicrobial prescribing: lessons for stewardship. Trubiano J, Chen C, Cheng AC, Grayson L, Slavin M, Thursky KA. The Journal of Antimicrobial Chemotherapy 2016; online first: 18 February

The art of managing medical uncertainty. Johnson P, Hoi A. The Lancet 2016; 387(10022): 1026

Mismatch in epitope specificities between IFN╬│ inflamed and uninflamed conditions leads to escape from T lymphocyte killing in melanoma. Woods K, Knights AJ, Anaka M. Journal for Immunotherapy of Cancer 2016; online first: 16 February

Is LiFe worth living? It all depends on the liver. Warrillow S, Herrera-Gutierrez M. Intensive Care Medicine 2016; 42(3): 448-450

Will mouth wash solutions of water, salt, sodium bicarbonate or citric acid improve upper gastrointestinal symptoms in chronic kidney disease. Manley K. Nephrology 2016; online first: 18 February

An assessment of nursing staffs' knowledge of radiation protection and practice. Badawy M. Journal of Radiological Protection 2016; 36(1): 178-183
Full text available for Austin & MHW Heidelberg staff via document delivery

Reflections on music therapy training within e-learning education contexts. Clark IN, Thompson GA. Voices 2016; 16(1)

Adrenaline: insights into its metabolic roles in hypoglycaemia and diabetes. Verberne AJ, Korim WS, Sabetghadam A, Llewellyn-Smith IL. British Journal of Pharmacology 2016; online first: 20 February
Full text available for Austin & MHW Heidelberg staff via document delivery

See more at AHRO, Austin Health Research Online

 

Journals spotlight

These links provide access to the current table of contents:

Alzheimer's and Dementia: The Journal of the Alzheimer's Association

Australian Prescriber

BMJ Quality & Safety

Ethnicity & Health

Fetal Diagnosis and Therapy

Journal of Cultural Diversity

Journal of Intercultural Communication

Journal of Trauma and Acute Care Surgery

Lancet Diabetes & Endocrinology

The Milbank Quarterly

Shock

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