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"The human capacity for burden is like bamboo- far more flexible than you'd ever believe at first glance."
Jodi Picoult

 

Co-rounding model for advanced cancer

Research from Singapore measured the efficacy of a palliative care and medical oncology co-rounding model on hospital length of stay (LOS). The hospital's existing model of palliative care service delivery was a consultative service with oncologist-driven referrals. In the co-rounding model of care, a specialist palliative care physician and an advanced practice nurse joined the medical oncology rounding team to provide palliative care input. Initial results indicated the co-rounding model was associated with a reduced LOS for cancer patients.

Source: Journal of Palliative Medicine 2017; online first 3 August

Further reading
Early palliative care on an inpatient oncology unit: Impact of a novel co-rounding partnership on patient and health system outcomes
Source: Journal of Clinical Oncology 2014; 32 (31 suppl): 3-3

 

Schizophrenia, clozapine & fatal 'slow gut' reactions

"Clozapine is the preferred antipsychotic for treatment-resistant schizophrenia, but has significant adverse effects, including gastrointestinal hypomotility or 'slow gut', which may result in severe constipation, ileus, bowel obstruction, and even death". Examining drug safety information in Australia, New Zealand, the US, and the UK, researchers concluded that current prescribing guidelines provide inadequate information on clozapine-induced gastrointestinal hypomotility.

Source: CNS Drugs 2017; 31(8): 699-709

Further reading
Clozapine and incidence of myocarditis and sudden death - Long term Australian experience
"Clozapine is the cornerstone of therapy for refractory schizophrenia; however, the potential for cardiotoxicity is an important limitation in its use. In the current analysis we sought to evaluate the long term cardiac outcomes of clozapine therapy".
Source: International Journal of Cardiology 2017; 238:136-139

 

Chewing & swallowing across the lifespan

"The human feeding, chewing, and swallowing mechanism adapts and changes over the life span. The aging process sees an increase in medication use that affects saliva production. Further, physiologic changes in taste and olfaction that occur with aging may see elders benefit from novel food design that utilizes the intact trigeminal system. New food design opportunities exist in the areas of carbonation, dissolvable solids, microencapsulation of flavour volatiles or pressurized carbon dioxide granules".

Source: Journal of Texture Studies 2017; 48(4):271-279
Full text available via request for Austin Health and MHW staff

 

New diagnostic tests: more harm than good?

This analytical report examines how "innovative technologies and ample venture capital are combining to produce new disease biomarkers and mobile monitoring devices". However, the authors question whether technological advances equate to improvements in clinical care or population health. They raise questions around overdiagnosis and overtreatment and suggest that clinicians "develop new diagnostic tests to tackle real health problems, not to generate them".

Source: BMJ 2017; 358: j3314

 

Resilience and burnout in medicine

"I consider myself very resilient; in fact, the evidence is that most doctors are". Geoffrey Toogood provides a thoughtful exposé on resilience in the medical profession. He states "resilience requires health professionals to have and feel a connection, a sense of belonging. It requires a system that allows one to learn from mistakes without fear of reprisals, but with positive suggestions about how to improve... It needs to help doctors learn the skill of asking for support, and then support them when one does".

Source: MJA InSight 2017; 31

Further reading
Physician burnout is a resource produced by the Agency for Healthcare Research and Quality (AHRQ) summarising what is known about burnout and the interventions that can potentially mitigate it.

 

Recognising mental state deterioration

"The Australian Commission on Safety and Quality in Health Care in collaboration with key stakeholders, has developed the National Consensus Statement: Essential elements for recognising and responding to deterioration in a person's mental state. It provides guidance to health service organisations to ensure they have the capacity to safely, collaboratively and effectively recognise and respond to deterioration in a person's mental state".

Source: ACSQHC July 2017

 

Austin Health Research Online - recent submissions

Serum carbohydrate antigen 19-9 in pancreatic adenocarcinoma: a mini review for surgeons
Goh SK, Gold G, Christophi C, et al. ANZ Journal of Surgery 2017; online first: 13 August

Supplemental oxygen and dypsnoea in interstitial lung disease: absence of evidence is not evidence of absence
Bell EC, Cox NS, Goh N, et al. European Respiratory Review 2017; 26(145): 170072

Integrin-linked kinase expression in myeloid cells promotes inflammatory signaling during experimental colitis
Ahmed AU, Yim HCH, Alorro M, et al. Journal of Immunology 2017; online first: 9 August

Fatal azathioprine toxicity
Liew D, Keith C, Booth J, et al. Australian Prescriber 2017; 40(3): 109

How long for epilepsy remission in the ILAE definition?
Fisher RS, Acevedo C, Arzimanoglou A, et al. Epilepsia 2017; 58(8): 1486-1487

See more at AHRO, Austin Health Research Online

 

eBooks Spotlight

New in ClinicalKey Nursing:

Gahart’s 2018 Intravenous Medications / Gahart, Betty - 34th ed. Elsevier, 2018

Nurse Anesthesia / Nagelhout, John - 6th ed. - Elsevier, 2018

 

Journals Spotlight

Journal of Ultrasound in Medicine

Archives of Physical Medicine and Rehabilitation

BMJ

Journal of prosthetics and orthotics

BMJ Supportive & Palliative Care

Liver Transplantation

General Hospital Psychiatry

Newborn and Infant Nursing Reviews

Brain

New England Journal of Medicine

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