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"The people who are crazy enough to think that they can change the world, are the ones who do."
Steve Jobs 


Coroner's case reports

The December edition of the Clinical Communiqué provides insight into the non-clinical aspects of coronial investigation to help clinicians better understand the process. Also included is an expert commentary ‘Helping Clinicians Better Understand the Coronial Process' authored by Dr Ian Freckelton, an experienced Queen's Counsel at the Victorian Bar who has appeared in many of Australia's most significant coronial inquests over the past 25 years. This commentary addresses some of the questions clinicians may have about their participation in a coronial matter.

Source: Clinical Communique 2017; 4(4)


Hospital culture & clinical performance: where next?

Organisational cultures affect the way we work in every workplace, including health facilities. This editorial discusses new interventionist research into organisational culture and healthcare outcomes. The studies substantiate the link between hospital culture and performance, and demonstrate that the "purposeful management of culture is possible". For policy makers and clinical leaders, the elements of culture identified as important include "fostering a learning environment, offering sustained and visible senior management support to clinical teams and services, and ensuring that staff across the organisation feel 'psychologically safe' and able to speak up when things are felt to be going wrong".

Source: BMJ Quality & Safety 2017; online first: 20 December

Further reading

Using patient-reported outcomes measures to improve engagement
"As the healthcare industry continues toward more patient-centric and value-based frameworks, medical professionals will need to measure the elements of care that are most important to patients. Organisations will need to incorporate patient-reported outcomes and measures into clinical workflows in order to do so."
Source: Patient EngagementHIT 2018 

Source: Thinkstock

Tertiary eye care – virtual retina clinics

Due to the increasing incidence of medical retinal diseases creating capacity issues for clinics across the UK, Moorfields Eye Hospital in London has implemented virtual medical retina clinics (VMRC). "VMRC can be implemented successfully using existing resources within a hospital eye service. It may also serve as a first-line rapid-access clinic for low-risk referrals. This would enable medical retinal services to cope with increasing demand and efficiently allocate resources to those who require treatment."

Source: British Journal of Ophthalmology 2018; online first: 6 January


Sugar-sweetened beverages & weight gain

The worldwide prevalence of overweight and obesity has "increased from 23% to 39% in females and from 21% to 38% in males" over recent decades. Researchers suggest that "conflicting results from previous reviews have fueled debates on the effect of SSBs (sugar-sweetened beverages) on the development of obesity". Findings from a new review indicate that 93% of included studies revealed a positive association between the consumption of SSBs and obesity in both children and adults. The authors recommend that new and innovative strategies are urgently needed to address this public health crisis.

Source: Obesity Facts 2017; 10: 674-693

Further reading

A rapid review examining purchasing changes resulting from fiscal measures targeted at high sugar foods and sugar-sweetened drinks
Source: Nutrition & Diabetes 2017; 7(12): 302 

Divergent effects of glucose and fructose on hepatic lipogenesis and insulin signaling
Source: Journal of Clinical Investigation 2017; 127(11): 4059-4074

Effectiveness of behavioral interventions to reduce the intake of sugar-sweetened beverages in children and adolescents: a systematic review and meta-analysis
Source: Nutrition Reviews 2017; online first: 21 December


Bacteremia & pneumonia in oncology

This 16-year study, from a tertiary-care hospital in Mexico City, described the antimicrobial patterns of Stenotrophomonas maltophilia bloodstream infections and pneumonia episodes in patients with cancer. "S. maltophilia infections represent a significant problem in cancer patients, mainly attributable to the difficulty in treating these infections, because this pathogen presents intrinsic resistance to various antibiotic agents. The elevated mortality in patients with pneumonia was related to older age and inappropriate antimicrobial treatment during the first 48h of the diagnosis of infection".

Source: Supportive Care in Cancer 2018: online first 7 January 


Financial incentives in healthcare - US experience

Providing financial incentives to improve the quality and performance of hospitals has become common in the USA over the last decade. This practice also occurs in the UK and several low and middle income countries are increasingly following suit. In a study of 1189 US hospitals, researchers found no evidence that hospitals operating under financial incentive programs for more than a decade had improved process scores or lowered mortality rates compared to 'late adopters' to the program. The authors concluded that "pay for performance programs as currently implemented are unlikely to be successful in the future, even if their timeframes are extended".

Source: BMJ 2018; 360: j5622


Did you know? Social care quick guides

A set of 'quick guides' providing key information for social care topics has been produced by the National Institute for Health and Care Excellence (NICE) in collaboration with the Social Care Institute for Excellence. Topics include: delirium; intermediate care; moving between hospital and home; and more.

Source: NICE 2018


Austin Health Research Online - recent submissions

Postpartum maternal adipokines and infant weight for length at 1 year in women with gestational diabetes
Shub A, Churilov L, Miranda M, et al.Journal of Maternal-Fetal & Neonatal Medicine 2017; online first: 7 December

Intravenous iron therapy in patients undergoing cardiovascular surgery: a narrative review
Lim J, Miles L & Litton E. Journal of Cardiovascular and Anesthesia 2017; online first: 8 November

Prognostic accuracy of age-adapted SOFA, SIRS, PELOD-2, and qSOFA for in-hospital mortality among children with suspected infection admitted to the intensive care unit
Schlapbach LJ, Straney L, Bellomo R, et al. Intensive Care Medicine 2017; online first: 19 December  

Blueprint unknown: a case for multidisciplinary management of advanced penile mycosis fungoides
O'Brien JS, Manning T, Perera P, et al. The Canadian Journal of Urology 2017; 24(6): 9139-9144
Full text available for Austin & MHW Heidelberg staff via document delivery

Sensitive quantitative detection of somatic mosaic mutation in "double cortex" syndrome
Damiano JA, Do H, Ozturk E, et al. Epileptic Disorders 2017; online first: 20 December
Full text available for Austin & MHW Heidelberg staff via document delivery 

See more at AHRO, Austin Health Research Online


eBooks spotlight

Physical diagnosis of pain : an atlas of signs and symptoms / Steven D Waldman - 3rd ed., Elsevier, 2016.
This well illustrated textbook with high quality radiographic images, and real time videos by the author and his staff, examines a full range of conditions in anatomic areas with each procedure following a similar outline and special tests.

Hurst's the heart / edited by Valentin Fuster et al. - 14th ed., McGraw-Hill, 2017. 
The latest edition of this widely recognised multidisciplinary textbook caters for cardiologists, trainees and interns. It contains 16 thematic sections on cardiovascular diseases with a focus on evidence-based medicine, health outcomes and health care quality.

New books on display

The long-term impact of medical complications in pregnancy : a window into maternal and fetal future health / edited by Eyal Sheiner - CRC Press, 2016.
Drawing on evidence-based data the book addresses the impact of complications in pregnancy. A valuable resource for healthcare professionals, students as well as residents in family medicine, obstetrics and paediatrics.


Journals spotlight

These links provide access to the current table of contents:

American Journal of Respiratory and Critical Care Medicine

BMJ Case Reports

Breastfeeding Medicine

Evidence-Based Medicine

Journal of Sleep Research

Kidney International




Postgraduate Medical Journal

Looking for the latest journal issues?
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