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Issue 1 - 16 January 2012


1.  Many patients ignorant about malnutrition, survey finds
By Taylor, Amy. Nursing Older People, Oct 2011, Vol. 23 Issue 8: p6-7
More than three million people in the UK are either malnourished or at risk of malnutrition, but patient understanding of the problem is low, according to the Patients Association. In a new report, it warns that malnutrition is endemic in community and hospital settings, particularly among older people, many of whom do not know the signs of or treatments for the condition.

2.  Effects of maternal malnutrition and postnatal nutritional rehabilitation on brain fatty acids, learning, and memory
By de Souza, Amanda Santos et al. Nutrition Reviews, Mar 2011, Vol. 69 Issue 3: p132-144
: Undernutrition still affects mothers and children in developing countries and thus remains the major focus of nutritional intervention efforts. Neuronal development, which classically includes neurogenesis, migration, maturation, and synapse refinement, begins in utero and continues into the early postnatal period. These processes are not only genetically regulated but also clearly susceptible to environmental manipulation. Dietary deprivation during early life is known to have adverse effects on brain anatomy, physiology, and biochemistry, and may even lead to permanent brain damage. Although all nutrients are important for the structural development of the central nervous system, lipids such as long-chain polyunsaturated fatty acids, especially docosahexaenoic acid (22:6 n-3) and arachidonic acid (20:4 n-6), are important for normal brain development. The purpose of this literature review is to examine how early undernutrition involving a deficiency in long-chain polyunsaturated fatty acids can affect brain development and function and produce deficits in spatial cognitive learning ability. [ABSTRACT FROM AUTHOR].

3. An evaluation of a community dietetics intervention on the management of malnutrition for healthcare professionals S. Kennelly et al. Management of malnutrition in the community
By Kennelly, al. Journal of Human Nutrition & Dietetics, Dec 2010, Vol. 23 Issue 6: p567-574
: Healthcare professionals working in the community setting have limited knowledge of the evidence-based management of malnutrition. The present study aimed to evaluate a community dietetics intervention, which included an education programme for healthcare professionals in conjunction with the introduction of a community dietetics service for patients 'at risk' of malnutrition. Changes in nutritional knowledge and the reported management of malnourished patients were investigated and the acceptability of the intervention was explored. An education programme, incorporating 'Malnutrition Universal Screening Tool (MUST)' training, was implemented in eight of 10 eligible primary care practices (14 general practitioners and nine practice nurses attended), in seven private nursing homes (20 staff nurses attended) and two health centres (53 community nurses attended) in conjunction with a community dietetics service for patients at risk of malnutrition. Nutritional knowledge was assessed before, immediately after, and 6 months after the intervention using self-administered, multiple-choice questionnaires. Reported changes in practice and the acceptability of the education programme were considered using self-administered questionnaires 6 months after the intervention. A significant increase in nutritional knowledge 6 months after the intervention was observed ( P < 0.001). The management of malnutrition was reported to be improved, with 69% (38/55) of healthcare professionals reporting to weigh patients 'more frequently', whereas 80% (43/54) reported giving dietary advice to prevent or treat malnutrition. Eighty-percent (44/55) of healthcare professionals stated that 'MUST' was an acceptable nutrition screening tool. An education programme supported by a community dietetics service for patients 'at risk' of malnutrition increased the nutritional knowledge and improved the reported management of malnourished patients in the community by healthcare professionals. [ABSTRACT FROM AUTHOR].

4. Frequency of Malnutrition in Older Adults: A Multinational Perspective Using the Mini Nutritional Assessment
By Kaiser, Matthias al. Journal of the American Geriatrics Society, Sep2010, Vol. 58 Issue 9: p1734-1738
To provide pooled data on the prevalence of malnutrition in elderly people as evaluated using the Mini Nutritional Assessment (MNA).
DESIGN: Retrospective pooled analysis of previously published datasets.
SETTING: Hospital, rehabilitation, nursing home, community.
PARTICIPANTS: Four thousand five hundred seven people (75.2% female) with a mean age of 82.3.
MEASUREMENTS: The prevalence of malnutrition in the combined database and in the four settings was examined.
RESULTS: Twenty-four data sets with information on full MNA classification from researchers from 12 countries were submitted. In the combined database, the prevalence of malnutrition was 22.8%, with considerable differences between the settings (rehabilitation, 50.5%; hospital, 38.7%; nursing home, 13.8%; community, 5.8%). In the combined database, the “at risk” group had a prevalence of 46.2%. Consequently, approximately two-thirds of study participants were at nutritional risk or malnourished.
CONCLUSION: The MNA has gained worldwide acceptance and shows a high prevalence of malnutrition in different settings, except for the community. Because of its specific geriatric focus, the MNA should be recommended as the basis for nutritional evaluation in older people. [ABSTRACT FROM AUTHOR].

5. The high prevalence of malnutrition in elderly diabetic patients: implications for anti-diabetic drug treatments
By Vischer, U. al. Diabetic Medicine, Aug 2010, Vol. 27 Issue 8: p918-924
Type 2 diabetes usually occurs in the context of obesity and associated insulin resistance. Current treatment recommendations are based on lifestyle modifications and incremental drug therapy. However, this approach could lead to inappropriate priorities upon ageing, when diabetes may be compounded by malnutrition and reduced insulin resistance. Methods: We prospectively evaluated glycaemic and nutritional parameters in 146 consecutive diabetic patients (age 82.5 ± 7.3 years, mean ± sd) admitted to our geriatric service. We also implemented nutritional support therapy and a drug therapy adjustment protocol. Oral hypoglycaemic agent withdrawal was attempted in cases of good glycaemic control (HbA1c < 7.5% (<47mmol/mol) or fasting blood glucose < 7.5 mmol/l).
Results: Mean BMI and HbA1c were 29.6 ± 7.1 kg/m2 and 6.9 ± 1.2% (52 ± 9 mmol/mol), respectively. Of the patients, 51.4% were taking 1–3 oral hypoglycaemic agents, 30.8% were on insulin and 9.6% on were on insulin and oral hypoglycaemic therapy. Low Mini Nutritional Assessment scores and serum marker levels indicated a high prevalence of malnutrition and/or chronic disease, even in obese patients. Mini Nutritional Assessment scores were positively associated with HbA1c values. Among patients treated by oral hypoglycaemic agents, complete drug withdrawal was achieved in 65.8%, much more often than new treatments were added ( P = 0.002). Glycaemic control did not worsen after approximately 30 days, despite in-hospital nutritional therapy. Successful oral hypoglycaemic therapy withdrawal was associated with lower Mini Nutritional Assessment scores. Conclusions Malnutrition is highly prevalent in elderly diabetic inpatients and, paradoxically, contributes to ‘good’ glycaemic control. Malnutrition should be screened for in these patients and, when present, should prompt a revision in diet and drug therapy. In particular, the possibility of reducing unnecessary drug therapy should be considered. [ABSTRACT FROM AUTHOR].

Journals - Table of Contents

6. From Primary Health Care - The RCN Community Health Nursing Journal, December 2011

Stuck with short-termism [ Reconstruction of the NHS]
News and analysis
. Employing nurses should not be a cost cutting exercise
6C. Practice nurses key to bowel cancer campaign success
Christian Duffin examines efforts being made to encourage earlier symptom detection
6D. Join the debate online
Should practice nurses contact patients by email and text messaging?
6E. Off to a flying start in practice
Julie Penfold finds out how a web-based resource supports newly qualified community nurses in England and Scotland
6F. Opinion: The future is telehealth
Self-monitoring will empower patients, argues Roy Lilley
6G. Features - Communication bridges for patients with dementia
Simple techniques can enhance care, explains Zoë Elkins
6H. Diabetes education drives quality and fuels NHS efficiency savings
Trudi Deakin shows the effect patient-centred training can have on increasing self-management
6I. Helping a person with autism to overcome her fear of needles
Using a case study, Joanne Edwards and Ruth Northway describe how health care was tailored to enable a patient
6J. Continuing professional development - Motor neurone disease: an overview
Rachael Marsden aims to give nurses confidence when caring for people with this rare progressive neurological condition


7. RNZCGP Quality Symposium 2012
Theme: Integration as an Enabler for Quality and Clinical Effectiveness
10-11 February 2012
Venue: Oceania Room, Te Papa Museum of Wellington
More information:

8. International Congress on Telehealth and Telecare 2012
6-8 March 2012
Venue: London
The International Congress on Telehealth and Telecare brings together researchers, policy-makers, practitioners and innovators interested in the design and application of technologies in health and social care. Now in its second year, The King’s Fund has again joined forces with the University Medical Center Utrecht to develop a programme that will showcase the very newest innovations and will highlight the latest learning, research results and business cases in telehealth and telecare.
More information:

9. 13th Annual Medical Law Conference
: 26 & 27 March 2012
Venue: Museum of New Zealand Te Papa
More information:

10. Mental Health Law Conference
28 March, 2012
Venue: Museum of New Zealand Te Papa Tongarewa, Wellington
More information:

11. Annual Health 2.0 Conference
Health 2.0 technologies intersecting with ancient culture; where modern medicine and technology collide with the Ayurvedic mindset; where mobile health (mHealth) connects the poor, reaches the unreachable and engages the influentials; where the buzz around healthcare is not just about medical tourism, but also used as soft diplomacy in the fight on terror as well as a tool to strengthen social development initiatives;  and where wellness strikes a yoga pose or leverages a Bollywood tune.
Date: January 30th, 2012
Venue: New Delhi, India
More information:

12. HIMSS AsiaPac 2012
Call for Paper submission
17 -19 September 2012
Venue: Singapore, Asia
More information:

13. ICN 25th Quadrennial Congress
Equity and Access to Health Care
18-23 May 2013
More information:

News - National

14. Planned Food Sale Law Too Vague
Waikato Times - 11 January 2012

Waikato small traders are calling for the Government to clear up confusion around a proposed law change that affects how and where people can sell food, saying it is "vague" and hard to understand. The Food Bill – first introduced to Parliament in May last year and now in its second reading – is aimed at revamping 30-year-old food safety legislation. There were initial fears in some quarters that the changes would restrict small-time sellers and charity food stalls such as sausage sizzles, and more than 33,000 people signed an online petition against the bill

15. More smokers trying to kick habit
Bay of Plenty Times - 7 January 2012
Western Bay medical centres are preparing for a rush of patients fulfilling New Year's resolutions to kick the smoking habit and avoid the latest price hike. Since New Year's Day 102 residents from the Bay of Plenty District Health Board region - which includes Tauranga, Whakatane and Rotorua - have taken the step to quit smoking by calling Quitline or registering on its website.

16. Rest-home funding threat
ODT - Tue, 20 Dec 2011
Financial pressure on Otago and Southland rest-homes is likely to increase next year when the Southern District Health Board transfers $1.2 million from residential to community care. The sector is already under strain as the DHB has referred fewer elderly people to rest-homes.'

17. More then 800 Health Workers quit in a year
The Press - 20 Dec 2011
More than 800 Christchurch health workers have resigned this year, a survey shows.
Canterbury District Health Board (CDHB) human resources general manager Allan McGilvray presented the findings of the board's Workforce 15 Months On (from the September 2010 earthquake) survey to board members last week. Of the board's 9500 employees, 809 left in the past 12 months – a 23 per cent increase in the number of staff who left in 2010.

News - International

18. Study finds caffeine poisoning on the rise Nicky Phillips
The Melbourne Age - January 16, 2012.

19. How the brain can make quitting alcohol harder
If you like to drink but want to stop and don't seem to have to willpower to do so, it may be because chemicals in your brain are telling you to order another pint, new research suggests. It's been long thought that alcohol triggers the release of naturally occurring opioids in the brain's reward centers, but research has documented how this process works only in animals. A new study in the journal Science Translational Medicine offers insights into why alcohol can be so addictive in humans

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