Articles: health.
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Internal medicine journal · Mar 2024
A system for developing reasonable adjustments to the application of the National Safety and Quality Health Service Standards for adult patients with intellectual disability in Australian hospital settings.
The Australian Commission of Safety and Quality in Health Care mandates the application of the eight National Safety and Quality Health Service Standards to minimise high-risk adverse events in hospital settings for all Australian patients. It acknowledges that adults with intellectual disability require reasonable adjustments to the application of the standards to optimise the impact of the quality and safety measures for this group. ⋯ Second, the adjustments are broken down into categories of alterations to usual knowledge, process, content and organisation involved in compliance with the chosen aspect of the standard. Third, the categories of reasonable adjustments are simultaneously influenced and shaped by aspects of living with intellectual disability, disability supports and a health-disability sectoral interface.
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Chronic kidney disease (CKD) poses a substantial global health burden. It is classified according to estimated glomerular filtration rate (eGFR) (G1-G5) and albuminuria (A1-A3). In recent years the clinicians' therapeutic options for slowing CKD progression and mitigating cardiovascular disease has been significantly expanded:For CKD with albuminuria, concomitant cardiovascular disease or diabetes mellitus, a target blood pressure <130/80mmHg should be aspired. ⋯ Once started, patients should stay on SGLT2i until dialysis. Finerenon is a novel option for diabetic nephropathy with an ACR >30mg/g [3mg/mmol] and an eGFR >25ml/min/1.73m2. Finerenon slows CKD progression and reduces cardiovascular events.