Tasman Medical Journal

ISSN:  2652-1881

Category: Research

Patient Controlled Crisis Admission Plan (PCAP): a clinical psychology-led model of care for youth populations with Borderline Personality Disorder

This paper describes a novel approach to treatment of young adult patients with Borderline Personality Disorder, in which the patient has the option of determining when he or she is admitted to a specialist custom clinical psychological unit during a relapse of symptoms. Preliminary data suggests that the approach is effective in reducing symptoms and frequency of admission.

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Accuracy of coded cause of death data: a study based on primary liver cancer

We have investigated the level of agreement for cause of death data in 232 patients who died of primary liver cancer, based on National (Australia Bureau of Statistics) and State (Tasmanian Cancer Registry) data and independent medical practitioners. The agreement between the ABS and TCR was poor but between medical practitioners was strong, and intermediate for comparisons between practitioners and either agency. Overall, cause-specific survival time was similar across the TCR, ABS and medical practitioners; with a small difference observed regarding the type of liver cancer. As liver cancer is a low-survival cancer, such results may be different to cancers with better survival such as breast cancer. Utilisation of specialist clinician oversight might improve data cohesion and fidelity.

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Simulation exercises increase staff confidence, knowledge and skills in managing mass casualty incidents: a pretest-posttest study

Introduction Emergency hospital systems are expected to respond effectively to intentional or accidental mass casualty incidents (MCI). Such incidents are largely unpredictable, and increasing worldwide.1-3  Mitigation of the harms associated with these disasters often requires appropriate high-quality healthcare processes to be enacted rapidly, safely and without duplication or error.4 To prepare clinicians and health systems, effective training and rehearsal using the multi-systems involved in an actual response is necessary. Response frameworks (for example, Homeland Security Exercise and Evaluation Program,5 Disaster Management Indicator Model,6 Hospital Incident Command System7 and disaster preparedness courses such as the Major Incident Medical Management Support (MIMMS) courses offered by MIMMS Australia8 have been created to address this need. Simulation exercises also aim to model surge capacity response,9 and test application of frameworks, plans and learnings. Some systems such as the Emergo Train System® (ETS) are designed to enable testing, but reviews of the literature reveal surprisingly

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The role of ultrasound in scleroderma skin disease

The authors have measured skin thickness in patients with scleroderma and compared the results with the current standard clinical measure, the modified Rodnan Skin Score (mRSS). Though US had satisfactory reliability and reproducibility, and detected changes in skin thickness over time, it did not correlate well with the mRSS, for reasons that remain uncertain.

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Assessing the accuracy of discharge coding for gout, using the International Classification of Disease, at two tertiary teaching hospitals in Perth

Clinical and epidemiological research is often conducted using data from hospital discharge coding. The authors have studied the accuracy of a discharge coding diagnosis of gout, compared to clinical diagnoses based on ACR/EULAR 2015 gout classification criteria and case note review. The coding diagnosis was not supported by the former in over half the cases, or by the latter in almost one third.

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