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Issue 193 - 25 August, 2011

Articles about Type 2 Diabetes

1.  Easing the burden of diabetes care
By Betty, Bryan. New Zealand Doctor, 27/07/2011: p44
Source: Australia/New Zealand Reference Centre Database
The article discusses issues that should be addressed by general practitioners (GP) in providing diabetes care based on the new guidelines, "Guidance on the Management of Type 2 Diabetes." The guidelines include a risk chart that indicate the risk factors to identify whether a patient is low-moderate or high risk for microvascular and macrovascular diabetes-related complications. Treatment options to manage diabetic patients include drug therapy, insulin therapy, blood pressure control and microalbuminu

2. Lack of vitamin D in blood increases risk of diabetes, study shows
By Amy Corderoy. The Sydney Morning Herald, 26/07/2011
Source: Australia/New Zealand Reference Centre Database
VITAMIN D deficiency is putting Australians at risk of developing diabetes, a landmark study has shown. The largest study of its kind found people with higher levels of vitamin D in their blood were less likely to develop type 2 diabetes than those with lower levels. It could lead to at-risk patients using vitamin D supplements along with diet and exercise to stop their development of the potentially deadly condition

3. Creating a Diabetes Chronic Disease Management Program That Works
By Baron, Andrew et al. Physician Executive, Jul/Aug2011, Vol. 37 Issue 4: p32-39
Source: Masterfile Premier Database
The article presents an overview of the successful implementation of a diabetes chronic disease management program by MultiCare Medical Associates in Tacoma, Washington. It notes that the program is a population-based management that includes leveraging the electronic health records (EHR) in generating lists of diabetics. Clinical outcomes posted 11.8 percent of the overall improvement including the increasing rates of diabetic visits and re-engagement of patients in health care.

4. Decoding Diabetes
By Liebman, Bonnie. Nutrition Action Health Letter, Jun 2011, Vol. 38 Issue 5: p1-6
This article discusses how to lower the risk of having type 2 diabetes. It advises people to have a healthy weight and lifestyle to prevent type 2 diabetes. It highlights the link between the disease and obesity. In addition, the article explains insulin resistance in overweight people. The effectiveness of magnesium, vitamin D, whole grains and coffee in lowering risk of type 2 diabetes is discussed.

5. Diabetes and its effects on wound healing
By Sharp, Ailsa & Clark, Jane. Nursing Standard, 7/13/2011, Vol. 25 Issue 45: p41-47
This article discusses the reasons why wounds in people with diabetes take longer to heal and are more susceptible to complications. The physiology of the wound healing process, and how this is affected by diabetes, is outlined. The article also explains why wounds in patients with diabetes are more prone to infection and discusses preventive measures. [ABSTRACT FROM AUTHOR]

Documents on Diabetes
Access these yourself via the web

6. Inquiry into Obesity and Type 2 Diabetes in New Zealand
Report of the Health Committee Forty-eighth Parliament
(Sue Kedgley, Chairperson)
August 2007

7. Guidance on the management of type 2 diabetes (2011) - Endocrine, nutritional and metabolic
Author: NZ Guidelines Group
Published: June 2011
Electronic ISBN: 978-1-877509-49-0
Copyright Holder: Ministry of Health

Articles about Breast Cancer

8. Another drug prevents breast cancer in postmenopausal women
Harvard Women's Health Watch, Aug 2011, Vol. 18 Issue 12: p6-7
The article focuses on a clinical trial which showed that the drug exemestane can help prevent breast cancer development. It references the study published online in "The New England Journal of Medicine" which evaluated the effectiveness of exemestane against placebo in postmenopausal women with high breast cancer risk because of age. It says that the result of the study indicates that the annual rate of new breast cancers was reduced by 65% using exemestane as compared with the placebo

9. Personalizing Mammography by Breast Density and Other Risk Factors for Breast Cancer: Analysis of Health Benefits and Cost-Effectiveness
By Schousboe, John T et al. Annals of Internal Medicine, 7/5/2011, Vol. 155 Issue 1: p10-W4 (12p)
Current guidelines recommend mammography every 1 or 2 years starting at age 40 or 50 years, regardless of individual risk for breast cancer.
Objective: To estimate the cost-effectiveness of mammography by age, breast density, history of breast biopsy, family history of breast cancer, and screening interval.
Design: Markov microsimulation model.
Data Sources: Surveillance, Epidemiology, and End Results program, Breast Cancer Surveillance Consortium, and the medical literature. Target Population: U.S. women aged 40 to 49, 50 to 59, 60 to 69, and 70 to 79 years with initial mammography at age 40 years and breast density of Breast Imaging Reporting and Data System (BI-RADS) categories 1 to 4. Time Horizon: Lifetime. Perspective: National health payer. Intervention: Mammography annually, biennially, or every 3 to 4 years or no mammography.
Outcome Measures: Costs per quality-adjusted life-year (QALY) gained and number of women screened over 10 years to prevent 1 death from breast cancer.
Results of Base-Case Analysis: Biennial mammography cost less than $100 000 per QALY gained for women aged 40 to 79 years with BI-RADS category 3 or 4 breast density or aged 50 to 69 years with category 2 density; women aged 60 to 79 years with category 1 density and either a family history of breast cancer or a previous breast biopsy; and all women aged 40 to 79 years with both a family history of breast cancer and a previous breast biopsy, regardless of breast density. Biennial mammography cost less than $50 000 per QALY gained for women aged 40 to 49 years with category 3 or 4 breast density and either a previous breast biopsy or a family history of breast cancer.

10. To Screen or Not to Screen Women in Their 40s for Breast Cancer: Is Personalized Risk-Based Screening the Answer?
By Mandelblatt, Jeanne S et al. Annals of Internal Medicine, 7/5/2011, Vol. 155 Issue 1: p58-W14 (4p)
The author reflects on the study by J. T. Schousboe and colleagues on the cost-effectiveness of personalized risk-based screening for breast cancer patients in their 40s. He mentions that the authors have used a simple cost-effectiveness model in estimating the mammography screening outcome in the group of American women with risk of breast cancer. He says that results show that the initial screening of women ages 40 could be cost-effective

11. Treatment and care of patients with metastatic breast cancer
By Beaumont, Tara & Leadbeater, Maria. Nursing Standard, 6/8/2011, Vol. 25 Issue 40: p49-56
This article provides an overview of the treatment options available for patients diagnosed with metastatic breast cancer. The article focuses on the four common organ sites affected by metastatic breast cancer, including the bone, lungs, liver and brain. The implications for nursing care are addressed, highlighting common side effects of treatment and frequent areas of concern for patients. [ABSTRACT FROM AUTHOR]

12. Molecular Pathology of Breast Cancer: The Journey From Traditional Practice Toward Embracing the Complexity of a Molecular Classification.
By Gruver, Aaron M et al.  Archives of Pathology & Laboratory Medicine, May 2011, Vol. 135 Issue 5: p544-557
Context.-Adenocarcinoma of the breast is the most frequent cancer affecting women in both developed and developing regions of the world. From the moment of clinical presentation until the time of pathologic diagnosis, patients affected by this disease will face daunting questions related to prognosis and treatment options. While improvements in targeted therapies have led to increased patient survival, these same advances have created the imperative to accurately stratify patients to achieve maximum therapeutic efficacy while minimizing side effects. In this evolving era of personalized medicine, there is an ever-increasing need to overcome the limitations of traditional diagnostic practice.
Objective.-To summarize the molecular diagnostics traditionally used to guide prognostication and treatment of breast carcinomas, to highlight published data on the molecular classification of these tumors, and to showcase molecular assays that will supplement traditional methods of categorizing the disease.
Data Sources.-A review of the literature covering the molecular diagnostics of breast carcinomas with a focus on the gene expression and array studies used to characterize the molecular signatures of the disease. Special emphasis is placed on summarizing evolving technologies useful in the diagnosis and characterization of breast carcinoma.
Conclusions.-Available and emerging molecular resources will allow pathologists to provide superior diagnostic, prognostic, and predictive information about individual breast carcinomas. These advances should translate into earlier identification and tailored therapy and should ultimately improve outcome for patients affected by this disease. [ABSTRACT FROM AUTHOR]

Journals - Table of Contents

13. From nursing.aust, Autumn 2011, Vol 12 No 1
Dementia care and reform: the nurse and the advocate
Not oppressed - just outmanoeuvred [Campaigns by groups with a track record of effective lobbying in social policy are usually well organised and calculated to trigger the desired community response]
13C. Nursing in the "grey zone": extreme preterm birth
13D. Supporting sisters and aunties to survive! [A series of Breast Cancer Summits for Aboriginal and Torres Strait Islander wone have been held around Australia]
13E. Do you hear me? [Australians and hearing impairment]

14. From Midwifery News (New Zealand College of Midwives), Issue 61, June 2011
14A. From the CEO - Earthquake reflections; Keep calm and carry on
14B. Picking up the pieces - my crash course in crisis management [Norma Campbell]
14C. The aftermath - how midwives can help when relationships falter
14D. Joining locum service has kept popular midwife in her profession
14E. Midwives draw on their coping skills - February earthquake 
14F. Maternity units celebrate dedication of midwives during earthquake
14G. Mothers' earthquake terrors eased by midwives
14H. Church hall becomes home for midwifery staff and students
14I. Health board leader praises midwives [Canterbury DHB Chief medical Officer Dr Nigel Millar]
14J. Student midwife tells of her earthquake experience
14K. The pepi-pod - a safe sleeping option for more vulnerable babies
14L. Infant feeding in emergencies: reflections on the Christchurch earthquake
14M. Letter from Japan: Midwives with women - seven weeks after the earthquake
14N. Latest  homegrown research on show at Joan Donley Forum
14O. Practice changes: Newborn Life Support (NLS)
14P. Midwives alerted to changes in immunisation schedules
14Q. Screening update - Free supplies of lancets for midwives
14R. Midwifery Scope of Practice on acupuncture and frenetomy

News - National

15. Flu cases plummet after free jabs
The Press 24 August 2011

Serious influenza cases in Canterbury have fallen sharply this winter, with just nine people admitted to hospital, compared with more than 500 over the past four years. Despite operating with 35 fewer beds since the February 22 earthquake, the drop in flu cases ensured Christchurch hospitals had been able to cope "remarkably well" with winter demand, a Canterbury District Health Board (CDHB) spokeswoman said.

16. The sweet life with less sugar
Stuff - 24 August 2011

When chef Michael Moore was diagnosed with type 2 diabetes, his endocrinologist was as surprised as he was. Fit, active and only 35, Moore, now the chef and owner of Sydney's Summit restaurant, wasn't a typical candidate for a disease linked to being overweight and over 45.  But if his high blood sugar level of 29 was a shock (normal is 4 to 6) there was a bigger one to come. Ten years later - and still committed to regular running and cycling - he was at a family lunch when he had a stroke, a problem for which diabetes is a risk factor.

17. TB scare at west Auckland school
ODT - 24 August 2011
Students and staff at a west Auckland college are to be screened for tuberculosis after a member of the school community was diagnosed with the potentially lethal disease. Liston College principal Chris Rooney said the infected person was being treated in hospital. He would not say whether they were a student or a member of staff.

News - International

18. Nuts, soy, avocado beat low-fat diet for cholesterol health
The Australian - 24 August 2011

PEOPLE who ate a diet rich in foods that lower cholesterol, such as nuts, soy, avocado, olive oil and oats, saw a bigger drop in cholesterol than people on a low-fat diet, a new US study has found. After six months of eating a diet that specifically included foods that lower LDL cholesterol, the randomized trial showed people experienced a 13 percent drop in low-density lipoprotein (LDL, or "bad" cholesterol).Those on a diet that just emphasized low-fat foods, including high-fiber options and whole grains, saw a three percent drop in LDL, said the report in the Journal of the American Medical Association.

19. New watchdog to eye health costs Mark Metherell
The Age - August 24, 2011

AMID deepening consumer concern about the rising cost of healthcare, the federal government is promising a Reserve Bank-style authority to drive efficiency in hospitals. Health Minister Nicola Roxon today will introduce legislation for an Independent Hospital Pricing Authority that she says will bring unprecedented scrutiny to hospital costs, saving up to $1.3 billion a year.

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