s & h group project poster

8/8/2019 s & h Group Project Poster

1/24

Stro

Chiang,C

Universit

Aims&

Objectives

Discussdiscussthedemographicsofpeopl

ernSuburbs.

Discuss

the

causes

and

impact

of

stroke

in

SuburbsofSydney,Australia.

Exploreimpactofinterventionsofthishea

INTRODUCTION


2/24

ein

Diabetic

Patients

in

th

Png,

D;

Lam,L

&

Goh

YH.

ofNewSouthWales,MedicineFaculty.Rehabilitation

livingwithdiabetesintheEast

iabetics

living

in

the

Eastern

thproblemincommunity.

RESULTS&

DISCUSSION

DEMOGRAPHICSEastern

Suburbs

(Sydney)

covers

Woollahra,

Randwick

and

inNewSouthWales.Demographicsofpatientswithdiabet

urbs(Sydney)areasfollows:

Majority had type 2 diabetes and is more common with

suburbshasmorethanathirdofitspopulation>45years.

Higherprevalenceofdiabetesinmaleswashigherthanf

DEMOGRAPHICSEastern

Suburbs

(Sydney)

covers

Woollahra,

Randwick

and

inNewSouthWales.Demographicsofpatientswithdiabet

urbs(Sydney)areasfollows:

Majority had type 2 diabetes and is more common with

suburbshasmorethanathirdofitspopulation>45years.

Higherprevalenceofdiabetesinmaleswashigherthanf


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eEastern

Suburbs

of

Sydn

department,PrinceofWalesHospital.

averly

Local

Government

Areas

sandstrokeintheEasternSub

increasing age over 45. Eastern

males,at7.6%and6.5%respec

IMPACTOF

MULTIDISCIPLINARY

INTERVENTION

Groupaffected

byinterventions

ImpactofInterventions

Thediabeticeld

erlywithstroke

inthe

Eastern

Suburbs

LifestyleIntervention

Theelderlystrugglewithcompliancedue

pcES)

Improvedhealthstatusifthereiscomplia

Increasedawarenessofbenefitsofdietc

A reventativestrate thatinvolvesnod

averly

Local

Government

Areas

sandstrokeintheEasternSub

increasing age over 45. Eastern

males,at7.6%and6.5%respec


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y

toincreasingageand/orotherculturalissues(pcCNC;

ce(Colagiuri,Thomas,&Buckley,2007)

angeandphysicalactivity(pcCNC;pcES)

rectmedicalcost Cola iuri Thomas &Buckle 2007


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Diabetesisanincreasingprevalentchronicdis

amongstAustralians*withprevalencedoubled

Easternsuburbsareatlowerriskofdiabetesc

lians,the

severity

must

not

be

overlooked

bec

Strokeisamajorcauseofmortalityandmorbi

nately,itispreventablewhenriskfactorsarei

ventions

implemented.

MATERIALSANDMETHOQuantitativeandqualitativeinformationwere

asshowninTable1.

Table1.Sourcesofinformation.

Interviews Nationalrepo

data

Endocrinespecialist

ClinicalNurse

Consultant

RehabilitationPhysician

AlliedHealthcareworker

AustralianInsti

Healthand

DiabetesAustr

AustralianBure

ll


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aseofsignificanthealthburden

inthelast20years.Residentsin

mparedtoIndigenousAustra

useof

its

aging

population.

ityindiabetespopulation.Fortu

entifiedandappropriateinter

Scollectedfromarangeofsources

tsand Webbasedlitera

turesearches

uteof

elfarelia

uSta

Medline

PubmedScopus

GoogleScholar

tively.

Population ismoreaffluentwithhighaccessibilityresulti

sityratesthatareriskfactorsfordiabetes.*

Prevalence of diabetes was higher with lower socioecon

moteareasandtheIndigenouspopulation.*

DiabetesismostprevalentinpeopleborninSouthernand

andthe

Middle

East

(6.6%),

South

East

Asia

(5.7%)

and

So

Althoughonly14.7% of people living in theEasternsub

higherpopulationnumber willmeanthatmorepeoplemi

InAustralia,

approximately

23,400

(7.2%)

males

and

31,

withdiabeteshadastrokein2003.*Thedirectorofreha

andnursesthatapproximately30%ofstrokepatientsint

bilitationwardhaddiabetes.

Young males are prone to brain haemorrhage because

habits* (Juvela, Hillbom, Numminen, & Koskinen, 1993)

populationisgenerallywelleducatedwith68.3%havingp

sumed to be wellinformed of diet and exercise, the rel

ratewithintheAustralianpopulationmaycontributetot

tively.

Population ismoreaffluentwithhighaccessibilityresulti

sityratesthatareriskfactorsfordiabetes.*

Prevalence of diabetes was higher with lower socioecon

moteareasandtheIndigenouspopulation.*

DiabetesismostprevalentinpeopleborninSouthernand

andthe

Middle

East

(6.6%),

South

East

Asia

(5.7%)

and

So

Althoughonly14.7% of people living in theEasternsub

higherpopulationnumber willmeanthatmorepeoplemi

InAustralia,

approximately

23,400

(7.2%)

males

and

31,

withdiabeteshadastrokein2003.*Thedirectorofreha

andnursesthatapproximately30%ofstrokepatientsint

bilitationwardhaddiabetes.

Young males are prone to brain haemorrhage because

habits* (Juvela, Hillbom, Numminen, & Koskinen, 1993)

populationisgenerallywelleducatedwith68.3%havingp

sumed to be wellinformed of diet and exercise, the rel

ratewithintheAustralianpopulationmaycontributetot


7/24

g inphysical inactivityandobe

omic status, people living in re

CentralAsia(8.7%),NorthAfrica

thernand

Eastern

Europe

(4.9%)

rbs areborn in thesecountries,

htbeaffectedbydiabetes.

00(10%)

females

aged

over

50

ilitationmedicine,otherdoctors

ePrinceofWalesHospitalreha

f heavier drinking and smoking

Although the Eastern suburbs

stschooleducationandthusas

tively high alcohol consumption

eriskofstroke*.Furthermore,

Multidisciplinaryteam

Comprehensivecarebyvarioushealthcar

perhapsreturntonormalfunctioningsta

Greaterinvolvementofthepatientwhich

LocalHealth

Sys

tem


Requireincreasedfundingtoorganiseca

Increasedresourcesneededespecially m

Collaborationandincreasedcommunicati

cialistsand

community

health

team

(pc

Multidisciplinaryteam

Teamworkbetweenhealthprofessionals

patient.

Theoverallcostonthehealthsystemma

creaseddiscussionandreferralstoother

HealthCare

Workers


Extensivecontactwithindividualsrequire

astrainonhealthcareworkers(pcCNC)

Aneed

to

increase

manpower

by

hiring

m

strainonhealthcarebudget(pcCNC)

Moreeffortandtimetobeputintoeduca

Frustrationbyhealthcareworkersdueto

Multidisciplinary

team

Decreasedstressandhenceimprovedme

sionwithotherprofessionals

Goodaccesstoinformationandhenceall

g inphysical inactivityandobe

omic status, people living in re

CentralAsia(8.7%),NorthAfrica

thernand

Eastern

Europe

(4.9%)

rbs areborn in thesecountries,

htbeaffectedbydiabetes.

00(10%)

females

aged

over

50

ilitationmedicine,otherdoctors

ePrinceofWalesHospitalreha

f heavier drinking and smoking

Although the Eastern suburbs

stschooleducationandthusas

tively high alcohol consumption

eriskofstroke*.Furthermore,


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eprofessionalswhichmayimproverehabilitationand

tus

mayspeeduptreatmentandimprovecompliance

paigns,outreachprogramsandhomevisits(pcCNC)

npower(pcCNC)

nbetweenvarioushealthsectors,includingGP,spe

NC)

nddevelopingacoordinatedapproachtomanagethe

increaseandmoretimeistakenupwhenthereisin

departments.

moretimewhichwillincreaseworkloadhenceputting

orenurse

educators

etc.

and

hence

increasing

the

tingindividuals.

oncomplianceoflifestylemodifications(pcCNC)

ntalhealthforhealthcareworkersbecauseofdiscus

wbettermana ementofthe atient


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Theinformationisobtainediscriticallyapprai

dence*thatthesourceofinformationisobtai

Levels Levelsofevide

1

Metaanalysis

or

systematic

revi

2 WelldesignedRCTs

3 Welldesignedcohortorcaseco

4

Opinionsof

respected

authoritie

scriptivestudiesandcasereport

mittees.


10/24

edaccordingtothelevelofevi

edfrom.

cebasedon

wsof

all

relevant

RCTs

trolanalyticstudies

,clinical

experience,

de

orreportsofexpertcom

intoxicationisparticularlyevidentamongyoungadultsint

CAUSESOFSTROKEINDIABETICS:MEDIALCAUSES:

Diabetesmellitusisawellestablishedindependentriskfa

withhighmortality*(Karsito&Soeatmadji,2008).

Hypercoagulabilitystateindiabeticpatientsincreasesthe

stroke* (Takenaka,Yamagishietal.2006).

Studieshavealsoestablishedthatconcomitanthypertensi

theriskofstrokeandhypertensionisfoundtobetwiceas

Sartietal.2005)

SOCIOECONOMICANDBEHAVIOURALCAUSES:

Geneticfactorsarepoorlystudiedduetoraceethnicdispa

Lowsocioeconomicstatusincludinglowliteracyrate,poo

burden

intoxicationisparticularlyevidentamongyoungadultsint


11/24

REFERENCESAustralian

Institute

of

Health

and

Welfare

(AIHW)

(2010)

2004

National

Drug

Strategy

Household

Surve

Canberra.

Hu,G.,C.Sarti,etal.(2005)."Theimpactofhistoryofhypertensionandtype2diabetesatbaselineon

KarsitoandD.W.Soeatmadji(2008)."Diabetesandstroke."ActaMedIndones40(3):1518.

Takenaka,K.,S.Yamagishi,etal.(2006)."Roleofadvancedglycationendproducts(AGEs)inthrombog

he20s.*

torofstrokeandisassociated

usceptibiltytothromboembolic

nanddiabeteswouldincrease

ommonindiabetics.* (Hu,

rities

accesstohealthcare,financial

CONCLUSION Amultidisciplinaryteamwithanactivepatientcenteredap

outcomefor

the

patient

(Govan

et

al.,

2008).

However,theeffectivenessofamultidisciplinaryteamalso

andreasonabledistributionofworkloadtoeachhealthcare

Astudy

has

demonstrated

that

multidisciplinary

ward

rou

than case conferences and this could be implemented f

2005).

he20s.*


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y:First

Results,

Drug

Statistics

Series

13,

Australian

Institute

of

Health

and

Welfare,

theincidenceofstrokeandstrokemortality."Stroke36(12):253843.

nicabnormalitiesindiabetes."CurrNeurovascRes3(1):737.

roachinstrokemanagementwillprovidethebest

reliesstronglyontheorganisationalmanagement

worker(Smithetal.,2010).

dswill

take

better

consideration

of

patient

needs

r greater patient involvement (Monaghan et al.,


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Lifestylehabitswhichincludesinappropriatediet,i


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nadequatephysicalactivity,alcoholandsmoking.


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