Journal Club: Antihypertensive treatment in diabetes

This systematic review with meta-analysis concludes that antihypertensive treatment reduces the risk of mortality and cardiovascular morbidity in people with diabetes mellitus and a systolic blood pressure more than 140 mm Hg. If systolic blood pressure is less than 140 mm Hg, further treatment is associated with an increased risk of cardiovascular death, with no observed benefit.

Effect of antihypertensive treatment at different blood pressure levels in patients with diabetes mellitus: systematic review and meta-analyses

Mattias Brunström and Bo Carlberg

BMJ 2016 352:i717  doi: http://dx.doi.org/10.1136/bmj.i717  Published 25 February 2016

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Journal Club: Use of ward closure to control outbreaks among hospitalized patients in acute care settings: a systematic review

The efficacy of ward closure is unclear. This systematic review sought to identify studies defining and describing ward closure in outbreak control and to determine impact of ward closure as an intervention on outbreak containment. The findings are that ward closure remains an intervention that is not evidence based and healthcare personnel will need to continue to balance the competing risks associated with its use, taking into consideration the nature of the outbreak, the type of pathogen and its virulence, mode of transmission, and the setting in which it occurs.

Use of ward closure to control outbreaks among hospitalized patients in acute care settings: a systematic review
Holly Wong, Katherine Eso, Ada Ip and others

Systematic Reviews 2015, 4:152  doi:10.1186/s13643-015-0131-2

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Journal Club: Peer-Review Fraud – Hacking the Scientific Publication Process

The enormous pressure to publish and publish fast — preferably in the very best journals — influences both authors and editors. Investigations by major publishers Springer, Sage and Biomed Central have all resulted in articles being retracted. As long as authors are (mostly) rewarded for publishing as many articles as they can and editors are (mostly) rewarded for publishing them rapidly, new ways of gaming the traditional publication models will be invented more quickly than new control measures can be put in place.

Peer-Review Fraud — Hacking the Scientific Publication Process
Charlotte J. Haug, M.D., Ph.D.

New England Journal of Medicine October 21, 2015 DOI: 10.1056/NEJMp15

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Journal Club: Type 2 diabetes and sweet drinks

This systematic review and meta-analysis indicates habitual consumption of sugar sweetened beverages is positively associated with incidence of type 2 diabetes, independently of obesity status. Under an assumption of causality, consumption of sugar sweetened beverages may be linked to 4-13% of type 2 diabetes incidence in the United States and 2-6% in the United Kingdom over 10 years, 2010-20. Artificially sweetened beverages and fruit juice were both positively associated with incident type 2 diabetes, but likely to involve bias, and seemed not to be healthy options for the prevention of type 2 diabetes

Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction

Fumiaki Imamura, Laura O’Connor, Zheng Ye, Jaakko Mursu, Yasuaki Hayashino, Shilpa N Bhupathiraju and Nita G Forouhi

BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h3576 (Published 21 July 2015)

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BMJ 2015;351:h3576 

Journal Club: Shared decision making in healthcare environment design

Person-centered care considers both the physical and psychosocial aspects of the care environment. It has been demonstrated that the physical care environment promotes or influences health, reduces the duration of treatment, decreases medication requirements and helps reduce the stress experienced by patients, their families and the teams caring for them.

In this paper, the authors describe and suggest several strategies (critical factors) to promote shared-decision making when planning and designing new health care environments.

Shared decision making in designing new healthcare environments-time to begin improving quality.

Elf M, Fröst P, Lindahl G, Wijk H

BMC Health Services Research 2015 Mar 21;15:114. doi: 10.1186/s12913-015-0782-7.

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Journal Club: Did the ABC’s Catalyst program change statin use in Australia?

On 24 and 31 October 2013, the Australian Broadcasting Corporation (ABC) ran a two-part special of the science series, Catalyst, titled Heart of the matter, that was critical of HMG-CoA reductase inhibitors (“statins”). It questioned the link between high cholesterol levels and cardiovascular disease, and suggested that the benefits of statins had been overstated and the harms downplayed. Nearly 1.5 million Australians watched each episode.

A study of dispensing records for statins from the Pharmaceutical Benefits Scheme (PBS), which provides subsidised access to prescribed medicines in Australia, showed significant and sustained changes in statin dispensing, 2.6% fewer statins were dispensed every week (a total of 504 180 fewer), which equates to 60 897 Australians having been affected up to 30 June 2014.

The ABC has since withdrawn the program, primarily on the grounds that it breached their impartiality standards.

The crux of the matter: did the ABC’s Catalyst program change statin use in Australia?

Andrea L Schaffer, Nicholas A Buckley, Timothy A Dobbins, Emily Banks and Sallie-Anne Pearson

Med J Aust 2015; 202 (11): 591-594. doi:10.5694/mja15.00103

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Journal Club: “headspace” services for young people

These articles describe the services provided to young people aged 12–25 years who attend headspace centres across Australia and how services are being delivered. Data regarding outcomes for young people using mental health care services similar to headspace centres are scarce but results compare favourably with those reported overseas.

The services provided to young people through headspace centres across Australia
Debra J Rickwood, Nic R Telford, Kelly R Mazzer, Alexandra G Parker, Chris J Tanti and Patrick D McGorry
Med J Aust 2015; 202 (10): 533-536.
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Changes in psychosocial distress and psychosocial functioning in young people visiting headspace centres for mental health problems

Debra J Rickwood, Kelly R Mazzer, Nic R Telford, Alexandra G Parker, Chris J Tanti and Patrick D McGorry

Med J Aust 2015; 202 (10): 537-542.

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Journal Club: The dignified approach to care

Providing person-centred, dignity-conserving care for hospitalised patients is central to many healthcare policies and essential to the provision of effective palliative care.

The Patient Dignity Question (PDQ)”What do I need to know about you as a person to take the best care of you that I can” was designed to help health care professionals understand patients better.

The dignified approach to care: a pilot study using the patient dignity question as an intervention to enhance dignity and person-centred care for people with palliative care needs in the acute hospital setting

Bridget Johnston, Jan Pringle, Marion Gaffney, Melanie Narayanasamy, Margaret McGuire and Deans Buchanan

BMC Palliative Care 2015 14:9 doi: 10.1186/s12904-015-0013-3 Published online 9 Apr 2015

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Journal Club: Community wide interventions for increasing physical activity

Despite evidence of the benefits of regular physical activity, global levels of physical inactivity remain stubbornly high. This review found that community wide interventions are very difficult to undertake and they usually fail to provide a measurable benefit in physical activity for a population.

Community wide interventions for increasing physical activity.
Baker PRA, Francis DP, Soares J, Weightman AL, Foster C. Cochrane Database of Systematic Reviews 2015, Issue 1. Art. No.: CD008366. DOI: 10.1002/14651858.CD008366.pub3.

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Journal Club: Peanut Consumption in Infants at Risk for Peanut Allergy

Findings of this study showed that early, sustained consumption of peanut products was associated with a substantial and significant decrease in the development of peanut allergy in high-risk infants. Conversely, peanut avoidance was associated with a greater frequency of clinical peanut allergy than was peanut consumption, which raises questions about the usefulness of deliberate avoidance of peanuts as a strategy to prevent allergy.

Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy
George Du Toit and others for the LEAP Study Team

New England Journal of Medicine February 26, 2015 372:803-813 DOI: 10.1056/NEJMoa1414850

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Editorial: Preventing Peanut Allergy through Early Consumption — Ready for Prime Time?
Rebecca S. Gruchalla, M.D., Ph.D., and Hugh A. Sampson, M.D.

New England Journal of Medicine 2015 February 26, 2015 372:875-877
DOI: 10.1056/NEJMe1500186

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