Clinical Practice Guidelines for Dementia in Australia: A step towards improving uptake of research findings in health and aged-care settings

This author accepted manuscript (post print) is made available following a 12 month embargo form date of publication (21 April 2016) in accordance with the publisher copyright policy

Demographics of infertility and management of unexplained infertility

Peer reviewedPostprin

Dynamic Monitoring and Control of Irreversible Chronic Diseases with Application to Glaucoma

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149269/1/poms12975_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149269/2/poms12975-sup-0001-Appendix.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149269/3/poms12975.pd

Is primary care ready to take on Attention Deficit Hyperactivity Disorder?

BACKGROUND: Attention Deficit Hyperactivity Disorder (ADHD) is a common childhood psychiatric disorder. The management of ADHD has recently been highlighted. The National Institute of Clinical Excellence (NICE) and Scottish Intercollegiate Guidelines network (SIGN) have both produced management guidelines. Doctors working within Primary Care in countries such as the United States play an important role in the management of ADHD. In the United Kingdom however the role of doctors in primary care in the management of ADHD, both individually and within shared care protocols, is only now being identified and defined. Is this role for Primary Care likely to be acceptable and effective? DISCUSSION: There is some evidence that doctors working within Primary Care in the United Kingdom are willing to follow up children on medication for ADHD and carry out monitoring of physical status. However many feel unconfident in the management of ADHD and most have received little or no training in child psychiatry. There are also concerns that adverse media reports will have an undue influence on the attitudes of doctors within primary care to families with children suffering from ADHD. SUMMARY: There are important barriers to be tackled before shared care protocols for ADHD can be successfully implemented in the United Kingdom. Tailored information about ADHD needs to be provided to doctors in primary care. Clear dialogue between planners and healthcare professionals from both primary and secondary care is essential to ensure that service delivery is acceptable to healthcare providers, tailored to their skills and is adequately resourced

Setting the stage for acute-on-chronic kidney injury

Acute-on-chronic kidney disease will be familiar to many nephrologists. Hsu et al. quantify the risk of acute-on-chronic disease across the stages of preexisting chronic kidney disease. Their study demonstrates the valuable insights that large epidemiological studies can bring to the field of acute kidney injury

Children with autism deserve evidence-based intervention

The document attached has been archived with permission from the editor of the Medical Journal of Australia. An external link to the publisher’s copy is included.Jennifer J Couper and Amanda J Sampso

Data Resource Profile: Clinical Practice Research Datalink (CPRD).

The Clinical Practice Research Datalink (CPRD) is an ongoing primary care database of anonymised medical records from general practitioners, with coverage of over 11.3 million patients from 674 practices in the UK. With 4.4 million active (alive, currently registered) patients meeting quality criteria, approximately 6.9% of the UK population are included and patients are broadly representative of the UK general population in terms of age, sex and ethnicity. General practitioners are the gatekeepers of primary care and specialist referrals in the UK. The CPRD primary care database is therefore a rich source of health data for research, including data on demographics, symptoms, tests, diagnoses, therapies, health-related behaviours and referrals to secondary care. For over half of patients, linkage with datasets from secondary care, disease-specific cohorts and mortality records enhance the range of data available for research. The CPRD is very widely used internationally for epidemiological research and has been used to produce over 1000 research studies, published in peer-reviewed journals across a broad range of health outcomes. However, researchers must be aware of the complexity of routinely collected electronic health records, including ways to manage variable completeness, misclassification and development of disease definitions for research.LS is supported by a Wellcome Trust Senior Research Fellowship in Clinical Science grant number 098504/Z/12/Z

Exploring the perspectives of significant others on patients’ experiences of cancer services

Background and objective: Globally, there has been a growing concern that patients are not receiving appropriate cancer care based on their needs. Whilst efforts were made towards better quality of care to meet patients’ expectations, healthcare systems are required to operate with decreasing resources given the overall economic context. This study aimed to explore the perspectives of significant others regarding cancer care experiences of patients receiving antineoplastic medicines for colorectal cancer. Method: A longitudinal design was adopted over a six-month period. Individuals initiating treatment for colorectal cancer with either FOLFOX for 12 cycles or XELOX for 8 cycles at the national oncology centre in Malta were asked to nominate at least one significant other; that is a person who in their opinion was highly involved in their care. Two in-depth interviews with significant others were conducted at patient’s initiation and completion of treatment (24 weeks interval), transcribed verbatim and thematically analysed. Main outcome measures: Themes illustrating perspectives of significant others regarding patients’ experiences. Results: A total of 16 participants, were interviewed [females (n = 12) and spouses (n = 6)]. Three themes were identified: (1) patients’ experiences of cancer services (2) healthcare professionals’ communication with patients and others (3) recommendations for services. Whilst significant others noted that patients were overall satisfied with cancer services throughout the treatment journey, negative experiences were mainly related to misdiagnosis. The issue of being truthful about cancer diagnosis raised different opinions, with some considering that complete disclosure was insensitive. Some argued that healthcare professionals were directly answering patients’ questions without further expansion. This was irrespective of the patients’ lack of knowledge and ability to ask further questions. At initiation of treatment, significant others recommended the need for improved awareness of available support services such as psychological services and more regular contact time with healthcare professionals. At completion of treatment, recommendations shifted to availability of cancer care services in the community setting including provision of ambulatory care. Conclusion: This study showed that timeliness of diagnosis and accessibility to healthcare services were crucial in cancer care. Introduction of interventions along the treatment journey to address the patients’ current needs were recommended and ‘‘one size fits all’’ approach is not suitable.peer-reviewe