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https://www.readbyqxmd.com/read/27908294/outcomes-of-notifications-to-health-practitioner-boards-a-retrospective-cohort-study
#1
Matthew J Spittal, David M Studdert, Ron Paterson, Marie M Bismark
BACKGROUND: Medical boards and other practitioner boards aim to protect the public from unsafe practice. Previous research has examined disciplinary actions against doctors, but other professions (e.g., nurses and midwives, dentists, psychologists, pharmacists) remain understudied. We sought to describe the outcomes of notifications of concern regarding the health, performance, and conduct of health practitioners from ten professions in Australia and to identify factors associated with the imposition of restrictive actions...
December 2, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27888835/the-association-between-benzodiazepine-use-and-sleep-quality-in-residential-aged-care-facilities-a-cross-sectional-study
#2
Lynna Chen, J Simon Bell, Renuka Visvanathan, Sarah N Hilmer, Tina Emery, Leonie Robson, Jessica M Hughes, Edwin C K Tan
BACKGROUND: Benzodiazepines are commonly prescribed in residential aged care facilities (RACFs) for their sedative and anxiolytic effects. The objective of this study was to investigate the association between benzodiazepine use and sleep quality in residents of RACFs. METHODS: A cross-sectional study involving 383 participants was conducted in six Australian RACFs. Night-time sleep quality, day-time drowsiness and day-time napping behavior were assessed using a validated questionnaire...
November 26, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27888342/putting-recommendations-into-practice-australian-rheumatologists-opinions-on-leflunomide-use-in-rheumatoid-arthritis
#3
Ashley M Hopkins, Michael D Wiese, Catherine E O'Doherty, Susanna M Proudman
Leflunomide is the most recently introduced conventional disease-modifying anti-rheumatic drugs in Australia. It has several unique methods for initiation, unique monitoring recommendations and a distinctive cessation protocol in the event of serious toxicity. The aim of this study was to evaluate initiation and monitoring practices of Australian rheumatologists using leflunomide. A survey was emailed twice, approximately 3 months apart to 332 rheumatologist members of the Australian Rheumatology Association...
November 25, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27884128/a-randomised-controlled-demonstration-trial-of-multifaceted-nutritional-intervention-and-or-probiotics-the-healthy-mums-and-babies-humba-trial
#4
Karaponi Okesene-Gafa, Minglan Li, Rennae S Taylor, John M D Thompson, Caroline A Crowther, Christopher J D McKinlay, Lesley M E McCowan
BACKGROUND: Maternal obesity is associated with adverse pregnancy outcomes and has lifelong negative implications for offspring health. The Institute of Medicine recommends limited gestational weight gain (GWG) in obese women for optimal maternal and infant outcomes. However, there is a gap regarding an effective and sustainable intervention strategy to achieve this goal. The aim of the healthy mums and babies (HUMBA) demonstration trial is to assess whether a multifaceted nutritional intervention and/or an oral probiotic treatment in obese pregnant women can reduce excessive GWG and optimise pregnancy outcomes...
November 24, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27866268/a-genome-wide-association-study-of-essential-hypertension-in-an-australian-population-using-a-dna-pooling-approach
#5
Javed Y Fowdar, Rebecca Grealy, Yi Lu, Lyn R Griffiths
Despite the success of genome-wide association studies (GWAS) in detecting genetic loci involved in complex traits, few susceptibility genes have been detected for essential hypertension (EH). We aimed to use pooled DNA GWAS approach to identify and validate novel genomic loci underlying EH susceptibility in an Australian case-control population. Blood samples and questionnaires detailing medical history, blood pressure, and prescribed medications were collected for 409 hypertensives and 409 age-, sex- and ethnicity-matched normotensive controls...
November 19, 2016: Molecular Genetics and Genomics: MGG
https://www.readbyqxmd.com/read/27859988/challenges-to-the-validity-of-using-medicine-labels-to-categorize-clinical-behavior-an-empirical-and-normative-critique-of-off-label-prescribing
#6
Narcyz Ghinea, Ian Kerridge, Miles Little, Wendy Lipworth
This study aimed to determine whether the label status of a medicine penetrates into the clinical reasoning of Australian medical practitioners and to explore the possible reasons for our findings using semistructured interviews with 14 Australian physicians. The interviews revealed 3 broad catalysts for off-label prescribing. The first of these was lack of awareness or understanding of the regulatory process in general and labels more specifically. The second was the perception that labels are not meaningful guides for clinical practice...
November 14, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27852197/antimicrobial-use-in-australian-hospitals-how-much-and-how-appropriate
#7
John D Turnidge, Karin Thursky, Caroline S Chen, Vicki R McNeil, Irene J Wilkinson
Antimicrobial agents play a central role in modern health care, especially in the hospital setting. This article describes the currently available information on the volumes of antimicrobial use in Australian hospitals, the appropriateness of that use, and the levels of compliance with nationally or locally endorsed prescribing guidelines. The data presented here come from the 2014 National Antimicrobial Utilisation Surveillance Program report and the 2013 and 2014 National Antimicrobial Prescribing Survey reports and are based on voluntary participation in the two programs...
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27832579/screening-and-management-of-risk-factors-for-cardiovascular-disease-in-hiv-positive-patients-attending-an-australian-urban-sexual-health-clinic
#8
Sheena Kakar, Douglas Drak, Tahiya Amin, Jason Cheung, Catherine O'Connor, David Gracey
Background: Few data exist regarding cardiovascular risk among HIV-infected patients attending sexual health clinics (SHC) in Australia. Methods: The medical records of 188 patients attending an inner-city SHC between August 2013 and July 2014 were retrospectively reviewed for cardiovascular risk factors and associated screening and management practices. Results: Cardiovascular risk factors were common among attendees of the SHC, including smoking (38%), hypertension (14%) and dyslipidaemia (11%). Of the 188 patients, 23% reported using potentially cardiotoxic recreational drugs, 25% of dyslipidaemic patients were not on therapy and 10% of patients were hypertensive; none were prescribed treatment...
November 11, 2016: Sexual Health
https://www.readbyqxmd.com/read/27829425/evaluation-of-a-pilot-of-nurse-practitioner-led-gp-supported-rural-palliative-care-provision
#9
Geoffrey Keith Mitchell, Hugh Edgar Senior, Michael Peter Bibo, Blessing Makoni, Sharleen Nicole Young, John Patrick Rosenberg, Patsy Yates
BACKGROUND: Providing end of life care in rural areas is challenging. We evaluated in a pilot whether nurse practitioner (NP)-led care, including clinical care plans negotiated with involved health professionals including the general practitioner(GP), ± patient and/or carer, through a single multidisciplinary case conference (SMCC), could influence patient and health system outcomes. METHODS: Setting - Australian rural district 50 kilometers from the nearest specialist palliative care service...
November 9, 2016: BMC Palliative Care
https://www.readbyqxmd.com/read/27826741/the-porirua-protocol-in-the-treatment-of-clozapine-induced-gastrointestinal-hypomotility-and-constipation-a-pre-and-post-treatment-study
#10
Susanna Every-Palmer, Pete M Ellis, Mike Nowitz, James Stanley, Eve Grant, Mark Huthwaite, Helen Dunn
BACKGROUND: Clozapine, an antipsychotic used in treatment-resistant schizophrenia, causes slow gastrointestinal transit in 50-80% of patients. Clozapine-induced gastrointestinal hypomotility is both common and serious, and potential complications include severe constipation, ileus, bowel obstruction and related complications, with a higher mortality rate than clozapine-related agranulocytosis. Little evidence exists on its prevention and management. METHOD: Using a well-validated radiopaque marker ('Metcalf') method, we compared colonic transit times (CTTs) of clozapine-treated inpatients not receiving laxatives with their transit times when receiving laxatives, with treatment prescribed according to the Porirua Protocol for clozapine-related constipation (docusate and senna augmented by macrogol 3350 in treatment-resistant cases)...
November 8, 2016: CNS Drugs
https://www.readbyqxmd.com/read/27813357/beta-blockers-are-under-prescribed-in-patients-with-chronic-obstructive-pulmonary-disease-and-co-morbid-cardiac-disease
#11
P A Neef, C F McDonald, L M Burrell, L B Irving, D F Johnson, D P Steinfort
The use of beta-blockers in patients with chronic obstructive pulmonary disease and co-morbid cardiovascular disease is controversial, despite increasing evidence to support their use as safe and efficacious. This study retrospectively assessed the rates of beta-blocker prescription in patients admitted to two Australian tertiary hospitals for acute exacerbation of chronic obstructive pulmonary disease. This revealed that less than half of patients (45%) with known cardiac indications were receiving beta-blocker therapy, evident across all degrees of airways disease severity...
November 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27806453/management-of-chronic-heart-failure-in-general-practice-in-australia
#12
Claire J Taylor, Lisa Valenti, Helena Britt, Joan Henderson, Clare Bayram, Graeme C Miller, Fd Richard Hobbs
BACKGROUND: Chronic heart failure is a common clinical syndrome associated with high healthcare system use. OBJECTIVE: The aim of this study was to explore the management of chronic heart failure in Australian general practice. METHODS: Data from the Bettering the Evaluation and Care of Health program were used to determine the prevalence of chronic heart failure, use of natriuretic peptide testing, prescribing patterns, hospitalisation rates and referrals to community-based heart failure management programs in three study periods between 2010 and 2015...
November 2016: Australian Family Physician
https://www.readbyqxmd.com/read/27797997/stepped-wedge-cluster-randomised-controlled-trial-to-assess-the-effectiveness-of-an-electronic-medication-management-system-to-reduce-medication-errors-adverse-drug-events-and-average-length-of-stay-at-two-paediatric-hospitals-a-study-protocol
#13
J I Westbrook, L Li, M Z Raban, M T Baysari, V Mumford, M Prgomet, A Georgiou, T Kim, R Lake, C McCullagh, L Dalla-Pozza, J Karnon, T A O'Brien, G Ambler, R Day, C T Cowell, M Gazarian, R Worthington, C U Lehmann, L White, D Barbaric, A Gardo, M Kelly, P Kennedy
INTRODUCTION: Medication errors are the most frequent cause of preventable harm in hospitals. Medication management in paediatric patients is particularly complex and consequently potential for harms are greater than in adults. Electronic medication management (eMM) systems are heralded as a highly effective intervention to reduce adverse drug events (ADEs), yet internationally evidence of their effectiveness in paediatric populations is limited. This study will assess the effectiveness of an eMM system to reduce medication errors, ADEs and length of stay (LOS)...
October 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27780570/polypharmacy-and-medication-regimen-complexity-as-risk-factors-for-hospitalization-among-residents-of-long-term-care-facilities-a-prospective-cohort-study
#14
Samanta Lalic, Janet K Sluggett, Jenni Ilomäki, Barbara C Wimmer, Edwin C K Tan, Leonie Robson, Tina Emery, J Simon Bell
OBJECTIVES: To investigate the association between polypharmacy and medication regimen complexity with time to first hospitalization, number of hospitalizations, and number of hospital days over a 12-month period. DESIGN: A 12-month prospective cohort study. PARTICIPANTS AND SETTING: A total of 383 residents of 6 Australian long-term care facilities (LTCFs). MEASUREMENTS: The primary exposures were polypharmacy (≥9 regular medications) and the 65-item Medication Regimen Complexity Index (MRCI)...
November 1, 2016: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/27774679/validity-of-prescribing-indicators-for-assessing-quality-of-antibiotic-use-in-australian-general-practice
#15
Lisa G Pont, Tessa K Morgan, Margaret Williamson, Flora M Haaijer, Mieke L van Driel
OBJECTIVES: The aim of this study was to assess the validity of a set of European quality indicators for assessing antimicrobial prescribing in Australian General Practice. METHODS: A modified UCLA/RAND appropriateness method was used to assess the validity of 30 antimicrobial prescribing indicators. An expert panel of 12 general practitioners scored the validity of each indicator for measuring quality in Australian general practice. Four quality domains were considered: monitoring antibiotic resistance, benefit to individual patients, value for money and value to policymakers...
October 24, 2016: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27763809/do-australian-immunoglobulin-products-meet-international-measles-antibody-titre-standards
#16
Megan K Young, Joseph Bertolini, Pushpa Kotharu, Darryl Maher, Allan W Cripps
The effectiveness of passive immunisation post-exposure to measles appears subject to a dose-response effect. New Zealand and the United Kingdom have increased the recommended dose of polyclonal human immunoglobulin for post-exposure prophylaxis within the last decade in response to concerns about decreasing levels of measles antibodies in these products. This study used the plaque-reduction neutralization test (PRNT) to measure the titre of measles-specific antibodies in Australian immunoglobulin products for post-exposure prophylaxis and compared the utility of an enzyme-linked immunosorbent assay (ELISA) to the PRNT in available Australian and international samples: Australian intramuscular (n = 10), Australian intravenous (n = 28), New Zealand intramuscular (n = 2), Hizentra (subcutaneous)(USA) (n = 3), and Privigen (intravenous)(USA) (n = 2)...
October 20, 2016: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/27736371/attitudes-toward-same-sex-parenting-an-effect-of-gender
#17
Stephanie N Webb
The definition of family in Australia has been continuously changing over the past four decades. The 21st century has brought with it various images of family, with an increase of awareness to same-sex families; however, the acceptance of such family structures does not appear to be widespread and is often determined by sex. Substantive literature demonstrates differences between men and women in attitudes toward same-sex parenting, with theory suggesting that gender role norms may explain this. Despite large efforts to determine sex differences in attitudes toward same-sex parenting, little research, and even less in Australia, has been done to investigate whether there are differences in reasons behind negative attitudes toward same-sex parenting between men and women...
October 13, 2016: Journal of Homosexuality
https://www.readbyqxmd.com/read/27714386/the-impact-of-alcohol-pharmacotherapies-on-public-health-in-australia-is-limited-by-low-prescribing-rates
#18
Paul S Haber, Kirsten C Morley
Alcohol use disorders are among the most common and disabling problems in Australia. A number of pharmacotherapies available in Australia have been shown to be effective and are subsidised through the Australian Government's Pharmaceutical Benefits Scheme. The uptake of these medicines is poor, and the majority of those who start treatment do not complete the recommended course. Use of these medicines is significantly lower in regions that are disadvantaged or remote, and in patients who are younger. Taken together, these factors limit the potential benefit to population health from treatment of alcohol use disorders...
September 30, 2016: Public Health Research & Practice
https://www.readbyqxmd.com/read/27701795/adequacy-of-palliative-care-in-a-single-tertiary-neonatal-unit
#19
Deborah Gilmour, Mark W Davies, Anthony R Herbert
AIM: End-of-life care remains part of the scope of practice in all neonatal units. This study aimed to characterise the end-of-life care provided in an Australian tertiary neonatal centre, where paediatric palliative care was accessible via a consultative service. METHODS: This retrospective cohort study examined indicators of quality palliative care provided to 46 infants born within a 30-month period. The cohort included four infants who received palliative care consultations additional to usual neonatal care...
October 4, 2016: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/27686266/optimizing-antibiotic-usage-in-hospitals-a-qualitative-study-of-the-perspectives-of-hospital-managers
#20
A Broom, A F Gibson, J Broom, E Kirby, T Yarwood, J J Post
BACKGROUND: Antibiotic optimization in hospitals is an increasingly critical priority in the context of proliferating resistance. Despite the emphasis on doctors, optimizing antibiotic use within hospitals requires an understanding of how different stakeholders, including non-prescribers, influence practice and practice change. AIM: This study was designed to understand Australian hospital managers' perspectives on antimicrobial resistance, managing antibiotic governance, and negotiating clinical vis-à-vis managerial priorities...
August 31, 2016: Journal of Hospital Infection
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