26 May 2017

Building resilience in junior doctors

A recent article in The Conversation, What needs to happen to build resilience and improve mental health among junior doctors, highlighted the problems of young doctors coping with extraordinary psychological distress.

Authors Richard Murray and Brendan Crotty referred to two Beyond Blue reports: The Mental health of doctors: a systematic literature review, from 2010, and the 2013 National Mental Health Survey of Doctors and Medical Students. Female doctors particularly are at risk, with one study finding them to have a huge 146% higher risk of suicide than the general population.

Various factors are at play - a culture of not admitting weakness, long hours, workplace bullying, and intense competition for jobs with the current large numbers of medical graduates. Murray and Crotty offer various solutions and a need for changes in the nature of healthcare so that it is "more integrated, person-centred and community-based".

Cervical screening in Australia

Cervical screening in Australia 2014-2015  presents the latest national statistics monitoring the National Cervical Screening Program. The AIHW reports that
  • 56% of women in the target age group of 20-69 took part in the program during 2014 and 2015
  • Cervical cancer cases and deaths in Australia are low by international standards
  • About 9 new cases of cervical cancer were detected per 100,000 women, and 2 deaths per 100,000 women.  This rate has been stable for the past ten years, having halved after the introduction of the NCSP
  • There is strong evidence that Indigenous women have a lower screening rate and poorer outcomes than non-Indigenous women.

Older Australia at a glance

The Older Australia at a Glance online information resource from the Australian Institute of Health and Welfare defines older Australians as generally those aged 65 and over. Here you can find information and statistics on issues affecting older Australians - broadly to do with demographics, diversity, social and economic engagement and health.

In 2016, approximately 15% of Australia's population were "older Australians".  This is projected to grow to 22% by 2056. In general, most older Australians have healthy lifestyles, own their own home, and are increasingly still involved in the workforce.

25 May 2017

Admitted patient care 2015-16: Australian hospital statistics

Some of the data available in this latest report from AIHW includes:  In 2015-16, there were about 10.6 million separations in Australia's public and private hospitals-about 59% occurred in public hospitals. There were 30 million days of patient care reported for admitted patients-20.2 million in public hospitals and 9.7 million in private hospitals.

Between 2011-12 and 2015-16:
  • the number of separations rose by 3.5% on average each year.
  • the number of public patient separations rose by an average of 2.9% each year, compared with 5.5% per year for separations paid for by private health insurance.
  • the median waiting time for elective surgery for public patients in a public hospital was 42 days, while it was 20 days for patients who used private health insurance to fund all or part of their admission.
Download the report here.             

Arthroscopic Surgery for Degenerative Knee Arthritis and Meniscal Tears

The BMJ has published this item on a clinical practice guideline on arthroscopic surgery for degenerative knee arthritis and meniscal tears. This guideline makes a strong recommendation against the use of arthroscopy in nearly all patients with degenerative knee disease.

Siemieniuk RAC, Harris IA, Agoritsas T, Poolman RW, Brignardello-Petersen R, Van de Velde S, et al. Arthroscopic surgery for degenerative kneearthritis and meniscal tears: a clinical practice guideline.  BMJ. 2017;357:j1982  

Brachytherapy for Patients With Prostate Cancer

The goal of this guideline update is to provide oncologists, other health care practitioners, patients, and caregivers with recommendations regarding the use of brachytherapy for patients with prostate cancer that includes the most recent evidence. Prostate cancer is the most commonly diagnosed cancer in men.

Brachytherapy for Patients With Prostate Cancer: American Society of Clinical Oncology/Cancer Care Ontario Joint Guideline Update. (staff at MNCLHD have free access)

Additional information, which may include a Data Supplement, Methodology Supplement, slide sets, clinical tools and resources, and links to patient information at, is available at and

24 May 2017

Osteoarthritis of the Knee Clinical Care Standard

A new clinical care standard for the treatment of osteoarthritis of the knee has been released by the Australian Commission on Safety and Quality in Health Care.

The Osteoarthritis of the Knee Clinical Care Standard aims to guide clinicians in best-practice primary care management of osteoarthritis of the knee. This includes timely comprehensive assessment, conservative treatment and appropriate patient review, which can help patients avoid unnecessary testing and surgery.

Palliative Care Services in Australia 2017

Between 2010-11 and 2014-15, palliative care-related hospitalisations rose by about 19%. About 155,600 people died in Australia, and almost half of these died as an admitted patient in hospital.
Approximately 46% of these had been a palliative care patient during their final days in hospital with over half being aged 75 and above. This latest report from AIHW looks at palliative care delivery in almost all settings where health care is provided, including neonatal units, paediatric services, acute hospitals, general practices, community settings (such as people's own homes) and residential aged care services.

Read the full AIHW web report here.

17 May 2017

Procurement of medical goods and human rights

"The healthcare sector and government in Australia are failing to address labour and human rights violations linked to the production of healthcare goods." This is the conclusion of a recent report by Martijn Boersma published by the Australian Nursing & Midwifery Foundation and The Australia Institute, Do no harm: procurement of medical goods by Australian companies and government.

The existence of labour and human rights abuses in medical goods supply chains means that the health of Australians is coming at the cost of the abuse and exploitation of workers in low-wage countries. The report urges a commitment to the ethical production, procurement and management of medical goods supply chains. This report finds that despite their legal and moral responsibilities, the healthcare sector and government in Australia are failing to address labour and human rights violations linked to the production of healthcare goods. 

Inquiry into funding programs to reduce homelessness

This Australian Housing and Urban Research Institute (AHURI) Inquiry into the funding and delivery of programs to reduce homelessness in Australia comprehensively examines the funding of  Specialist Homelessness Services (SHSs) and other services assisting those experiencing homelessness.

Government funding accounts for 84.6 percent of funding provided to SHSs , and only about one-third of services indicate that they are able to meet client demand with current funding. Non-government funding sources include philanthropic foundations, the corporate sector and other fundraising and sponsorship groups, but they all play a minor role in homelessness services.

Further areas for policy development are suggested in the report, including greater stability of government funding of homelessness services and supportive measures to increase the level of non-government funding.

Meteorology and mood in bipolar disorder

An Australian study looking at seasonal variation of manic and depressive symptoms in bipolar disorder has added to the body of knowledge on this topic. The researchers measured specific meteorological factors such as atmospheric pressure, hours of sunshine, relative humidity, and daily maximum and minimum temperatures compared to self-reported daily mood change in people diagnosed with bipolar disorder. 

Highs and lows, ups and downs: meteorology and mood in bipolar disorder by Ben Bullock, Greg Murray and Denny Meyer was published in PLoS ONE recently, and the results indicated that the daily maximum temperature was the only meteorological variable to predict clinically-relevant mood change. Sunshine hours, humidity and minimum temperatures had no noticeable effect. This contradicts some other studies on these effects, but it was quite a small study.

History of anaesthesia

  Licensed under CC BY 4.0
A short history of anaesthesia: from unspeakable agony to unlocking consciousness by David Liley, Swinburne University of Technology was recently published in The Conversation.  Here he recounts terrifying reminders of how surgery was conducted two hundred years ago and how far we have come.

For more details on this fascinating topic, I recommend the very extensive History of Anaesthesia Society Timeline from the UK. The ANZCA (Australian & NZ College of Anaesthetists) also has a History of Anaesthesia section on their website.

Which all reminds me of a recent episode of the superb podcast, This American Life, where the story of a Russian doctor who performed an appendectomy on himself was recounted in vivid detail from his diary.

Federal budget - analysis of health aspects

The Conversation has run a number of articles in the last week about the latest budget and its implications for health.

08 May 2017

Latest health research summaries in Signals.

The UK’s National Institute for Health Research (NIHR) Dissemination Centre has released the latest ‘Signals’ research summaries. This latest release includes:

  • Repetitive task training can help recovery after stroke
  • Fortified donor breast milk led to similar development for very-low-birthweight babies compared with formula milk
  • Giving immediate antibiotics reduces deaths from sepsis
  • New casting technique is an option for older people with ankle fracture
  • Thrombolysis may reduce complications of deep vein thrombosis
  • Counselling services help expectant mothers quit smoking
  • Antibiotics by injection into the eye can prevent severe infection following cataract surgery
  • The “BabyClear” programme helped pregnant women stop smoking in North East England
  • MRI scans help confirm ultrasound diagnosis of fetal brain abnormalities.

Incidence of selected cancers in 2006-2010

The Australian Institute of Health and Welfare has released an update on the MyHealthyCommunities website. The update on the incidence of different cancers includes local cancer incidence rates (newly diagnosed cases) for all cancers combined, as well as breast, cervical, prostate, colorectal, lung and melanoma of the skin.

Download Incidence of selected cancers in 2006-2010